Express Healthcare (Vol. 15, No. 7) August 2022

INTERVIEWS Ram Rangarajan Vice President, SGTC-R&D, Stryker Prof Smriti Arora UPES School of Health Sciences and Technology

Switch to Nephelometry Get Attractive Discount on Mispa Revo Plus

Specialised Parameters Available at Convenient Packs

Buy Reagents* & Get Mispa i2 or Mispa i3

15

HAPPY CUSTOMERS

Specific Protein Analyzer Cartridge Based Specific Protein Analyzer

DIABETIC

CARDIAC

COVID PROGNOSIS

INFECTIOUS

ALLERGY

BONE METABOLISM

*T&C Apply

AVAILABLE PROFILES AUTOIMMUNE

ANEMIA

SEPSIS

Scan Here for more info Join the iclub and earn bonus points on scanning

Toll Free

1800 425 7151 / 1800 891 7251 / 1800 270 7151

“Agappe Hills”, Pattimattom (PO), Dist. Ernakulam, Kerala - 683 562, India.

TEL: + 91 484 2867000 | productcorp@agappe.in | www.agappe.com

CONTENTS START UP

MEDTECH

EDUCATION

Chairman of the Board Viveck Goenka

31

Sr. Vice President-BPD Neil Viegas Asst. Vice President-BPD Harit Mohanty

Delhi Akanki Sharma DESIGN Art Director Pravin Temble

P10: INTERVIEW

P22: INTERVIEW P26: INTERVIEW

DR PANKAJ JETHWANI Executive Vice President, W Health Ventures

RAM RANGARAJAN Vice President, SGTC-R&D, Stryker

ASSISTANT PROFESSOR SMRITI ARORA UPES School of Health Sciences and Technology

HEALTHCARE TRENDS

28

Senior Artist Rakesh Sharma

Marketing Team Rajesh Bhatkal Ambuj Kumar Ashish Rampure Debnarayan Dutta Production Co-ordinator Dhananjay Nidre

21

32

HOW AI IS HELPING HEALTHCARE CONTACT CENTERS TO BE MORE EFFICIENT?

33

IMPORTANCE OF DIGITAL MARKETING IN HEALTHCARE SECTOR

DIAGNOSTICS

Senior Designer Rekha Bisht

Digital Team Viraj Mehta (Head of Internet)

HOW CAN THE DESIGN OF A HEALTHCARE FACILITY IMPACT PATIENT RECOVERY RATES IN INDIA?

HEALTHCARE IT

Editor Viveka Roychowdhury* BUREAUS Mumbai Lakshmipriya Nair, Kalyani Sharma

HOSPITAL INFRASTRUCTURE

CONSUMERDRIVEN & PATIENT-FOCUSED INNOVATIONS IN THE HEALTHCARE INDUSTRY

P24: INTERVIEW SURESH VAZIRANI Founder Chairman, Transasia - Erba Group

PENETRATION OF DIAGNOSTICS IN RURAL INDIA: NEED OF THE HOUR

29

SELF-TESTING IN INDIA: BANE OR BOON

30

WAVE OF CONSOLIDATION IN DIAGNOSTICS SECTOR: KEY IMPERATIVES

INSURANCE

34

THE INSURTECH DISRUPTION AND WHAT LIES AHEAD

STRATEGY

35

HEALTHCARE MARKETING TODAY: HYPERLOCAL AND HIGHLY PERSONALISED

Express Healthcare® Regd. With RNI No.MAHENG/2007/22045. Postal Regd.No.MCS/162/2022 - 24. Printed and Published by Vaidehi Thakar on behalf of The Indian Express (P) Limited and Printed at The Indian Express Press, Plot No.EL-208, TTC Industrial Area, Mahape, Navi Mumbai-400710 and Published at Mafatlal Centre, 7th floor, Ramnath Goenka Marg, Nariman Point, Mumbai 400021.

Scheduling & Coordination Pushkar Waralikar

Editor: Viveka Roychowdhury.* (Editorial & Administrative Offices: Mafatlal Centre, 7th floor, Ramnath Goenka Marg, Nariman Point, Mumbai 400021) * Responsible for selection of news under the PRB Act. Copyright © 2017. The Indian Express (P) Ltd. All rights reserved throughout the world.

CIRCULATION Mohan Varadkar

Reproduction in any manner, electronic or otherwise, in whole or in part, without prior written permission is prohibited.

EXPRESS HEALTHCARE

7

August 2022

EDITOR’S NOTE

Betting on India’s medical devices sector

E

ven as more pharma companies look to the diagnostics sector to diversify their revenue streams, existing pathology chains are staring at loss of revenue and margins as demand for COVID tests moderates. There will be some recovery as testing for monkeypox might increase, but nothing can stop the disruption in the diagnostics sector. In fact, it is long overdue.

New entrants like pharma companies and Apollo Hospitals are buying up less established regional path lab players and launching deep discounts in a bid to acquire customers. The battle is one for market share, but making a big splash with deep discounts will erode margins and typically only favour large players with economies of scale.

This will set the stage for more acquisitions of smaller regional diagnostics companies in the unorganised segment.

Consolidation in the hospitals segment too continues.

The latest example being PE-backed chain CARE Hospitals picking up majority stakes in regional hospitals like Aurangabad-based CIIGMA Hospitals to expand footprint in Maharashtra.

While consolidation in the hospitals and diagnostics sector has attracted PE/VC investors, it is time such investors favour the development of India's struggling medical devices manufacturing sector. Commerce Ministry data analysed by the Association of Indian Medical Device Industry (AiMeD) points to a worrying trend of escalating import of medical devices by a record 41 per cent in FY22.

AiMed's analysis of the six major categories of medical devices - consumables, disposables, electronics and equipments, implants, IVD reagents and surgical instruments - that are imported, shows that the growth has been the highest in the ‘electronics and equipment’ category.

India imported Rs 40,649 crore worth of medical devices that come under this category in 2021-22 against an import worth Rs 4,569 crore in 2016-17.

The import of surgical instruments went up to Rs 1,260 crore from Rs 243 crore during this period. IVD reagents increased from Rs 361 crore in 2016-17 to Rs 6,564 crore in 2021-22, consumables from Rs 5,249 crore in 2016-17 to Rs 8,488 crore in 2021-22, implants from Rs 384 crore to Rs 3,155 crore and disposables from Rs 2,061 crore to Rs 3,084 crore.

Giving the example of the mobile phone and consumer electronic industries, Rajiv Nath, Forum Coordinator, AiMeD urges the government to take similar policy decisions "to give a level playing field, if not a strategic advantage to domestic manufacturers, while safeguarding consumers." Unless this is done, he cautions that India will remain 80 per cent import dependent in medical devices, which is a high healthcare security risk.

At the height of the pandemic, in line with demand and fortified by the government's ‘Aatmanirbhar’ message, many local companies diverted their manufacturing capacities to make masks, PPE kits, thermometers, and gloves. But as the pandemic waned, demand fizzled out, and the AiMeD note alleges that many of the small and

8

EXPRESS HEALTHCARE

August 2022

While consolidation in the hospitals and diagnostics sector has attracted PE/VC investors, it is time such investors favour the development of India's struggling medical devices manufacturing sector

medium units have shut shop.

Can the right policy push and patient investors hand hold some of these entrepreneurs to graduate to more complex medical products?

As per AiMeD’s analysis, India’s top five medical device import sources -- China, US, Germany, Singapore and the Netherlands – together account for Rs 37,519 crore, or 68 per cent, of the total value of imports. Chinese imports still make up the bulk of medical device imports, nearly equaling the combined value of imports from Germany, Singapore and the Netherlands in 2021-22. Imports from China grew 48 per cent from Rs 9,112 crore in 2020-21 to Rs 13,538 crore in 2021-22. Not far behind, medical device imports from the US also increased steeply by 48 per cent to Rs 10,245 crore in 2021-22 from Rs 6,919 crore in 2020-21.

AiMeD has a couple of policy recommendations to set this situation right. Firstly, the disability factor of 12-15 per cent in manufacturing medical devices in India can be neutralised with a 15 per cent import tariff on Chinese medical devices. This was the strategy deployed for the consumer electronics, mobile phones and toy industries.

Unfortunately, at present, it is difficult to identify the medical device areas where India is dangerously dependent on China, as AiMeD's data shows that the bulk of the imported medical devices from China (in value terms) fall in the ‘other items’ sub-sections under various major categories.

To set this right, AiMeD’s second recommendation is that the government should consider shifting from an 8 digit HS code to a 10 digit HS code, as done by US and Europe, to give more granular data for enabling better analysis and policy making.

There are signs that some companies are coming forward to make India self-sufficient in medical materials. For example, Tata Steel's plans for bio ceramics manufacturing will go a long way towards making India self-sufficient in these medical materials like hydroxyapatite, which is used for coating of implants in dentistry and orthopaedics.

But we need many more such projects to increase India's health security. VC/PE investors might be put off by the longer gestation needed by manufacturing units to show RoI, rather than hospitals and path labs which are on the healthcare delivery side and relatively asset light. The slow change of policy too is a definite downer.

But seeding India's medical device sector is a sure bet on an economy which is known for quality, affordable medicines. Replicating India's pharma strategy in the medical devices sector will achieve health security not just for India but other nations as well.

VIVEKA ROYCHOWDHURY Editor viveka.r@expressindia.com viveka.roy3@gmail.com

START UP I N T E R V I E W

Healthtech innovation is still at a nascent stage in India Dr Pankaj Jethwani, Executive Vice President, W Health Ventures in an interaction with Viveka Roychowdhury talks about his company’s current investments in India and highlights the various parameters considered while investing in a new technology or company As a primary care physician turned investor, what would be the red flags you look out for when judging the promise of a company to back for an IPO, or add to your portfolio, a start-up with new technology looking for angel funding, etc? Are there particular segments within this sector where it is more difficult to judge promise/potential objectively?

The red flags to judge a potential IPO backing would constitute a founding team that is either not missionoriented and driven to impact lives using their healthcare solution, or does not have insights into the patient journey and their pain points.

Also, companies that are not focused on perfecting user experience and substantially improving clinical outcomes.

The question of segments where promise or potential is difficult to judge- it is because the healthcare services delivery businesses are typically hard to scale as it takes time to build patient trust. For me as a physician, bringing that lens and patience is critical while evaluating companies.

On the other hand, healthcare and wellness consumer product companies also tend to see high initial growth powered by disproportionate marketing spends on fairly low customer acquisition costs (CAC). Thus, it becomes important to look at metrics such as retention, repeat order behaviour, evolving CAC, and ultimately, the company’s competitive differentiation. High initial growth can be misleading, and we have seen some promising

10

EXPRESS HEALTHCARE

August 2022

health and wellness brands plateau out at ~Rs 100 crore Annual Recurring Revenue (ARR).

The healthcare sector is seeing some interesting innovations.

Vertically integrated platforms that address users’ healthcare need right from diagnosis to management are offering comprehensive, one-stop, solutions to patients. This enables the start-up to capture a patient’s entire spending, allowing healthy returns on the customer acquisition cost

What are the most promising areas in the healthcare space? What is the exit strategy and ROIs for W Health Ventures, can you give examples from companies which the funds have existed since it was founded in 2020?

The healthcare sector is seeing some interesting innovations. Vertically integrated platforms that address users’ healthcare need right from diagnosis to management are offering comprehensive, one-stop, solutions to patients. This enables the start-up to capture a patient’s entire spending, allowing healthy returns on the customer acquisition cost. One such company targeting women's health space in our portfolio is Mylo – a platform that provides to a community of parents, targeted content, wellness products, and expert health services for mothers and babies.

Given that 66 per cent of healthcare expenses in India are paid out of pockets, the future of healthcare is direct to consumer. Even though there are 600+ D2C brands in India acquiring online buyers, therapy-area-focused brands are missing. We are looking for health outcomes driven startups that are combining products with exceptional patient experience – this helps in building trusted brands (lowers CAC), repeat purchases {increase Lifetime Value (LTV)} and tangible health improvements.

W Health started investing in Indian healthcare companies in 2021 and hasn’t exited any of its portfolio companies yet.

What is the company’s rationale for investing in India?

There is a palpable growth in demand being witnessed in India. This has been fuelled by the rapid growth in Internet subscribers to 840 million.

Moreover, the growth is driven not only by growth in urban areas but also in rural areas that has seen as many as 337 million rural internet subscribers. This growing base has, in turn, increased the number of people willing to access and trust healthcare delivered through techenabled solutions.

Furthermore, the pandemic has driven consumers to focus their spending priorities on healthcare. According to a study by Mintel, spending on healthcare products has increased for 51 per cent of Indians in 2021.

On the supply-side too, things are looking quite promising for newer healthcare solutions. India’s traditional healthcare system has multiple gaps, including a lack of infrastructure and inequitable distribution of the infrastructure across the urban-rural divide (Urban India has 2/3rd hospital beds but has only 1/3rd Indian population). Digital-first companies are actively trying to bridge this gap and this thereby creates a tremendous opportunity for us as a fund.

In addition, government initiatives are also acting as a catalyst for growth of digital

health. For example, the National Digital Health Mission (NDHM) is aimed at giving every Indian a Unique Health ID and creating healthcare tech infra.

Similarly, National Health Stack - a cloud-based framework will enable seamless Public Health Records access across all healthcare tech systems. Teleconsult guidelines will help establish policy frameworks.

All of these will go a long way in helping these new digital players establish their foothold in an increasingly healthconscious market.

Another thing that helps is that the exit environment has also become favourable for investors in the last one or two years. All these together have added to our confidence in investing in India.

How does the fund measure value to the end consumer, the patient?

We have developed a robust system of tracking metrics to measure value for users.

These include quantitative improvement in measurable clinical outcomes like HbA1c (for diabetes), PHQ-9 (for depression), etc. We also look at improvement in patientreported behavioural outcomes. Various health conditions have symptoms that are often not measurable but must be tracked. For example, for a PCOS (Polycystic ovary syndrome) management company, we evaluate if patients see

improvement in energy levels, period pain, and so forth.

Customer love measured by NPS and stats around consumer retention, engagement, and referrals also act as indicators of the product/solution utility.

To track these metrics, we conduct multiple customer interviews and calls to understand the true value of a product to its customers. At the same time, we analyse patient data by studying the clinical outcomes and consumer metrics for comparable cohorts of patients. Last, but not least, we evaluate the processes in place to take, process and improve upon the consumer feedback.

What is the size of funding available and the tentative timeline to exit?

The average first cheque size ranges between $ 3-5 million.

As a healthtech-focused fund, we understand that these businesses need patient capital to scale and grow.

Hence, the exit timeliness for us varies between 5-7 years for the majority of our investments.

What are their current investments in India and their portfolio companies?

We have spread our investments across a mixed range of companies providing healthcare solutions. These include BeatO, a personalised chronic disease management platform that is helping over

400k Indians manage their diabetes end-to-end. We have also invested in Wysa - a holistic mental health solution powered by an emotionally intelligent AI chatbot, Cognitive behaviour therapy (CBT)-based therapy packages, and world-class therapists, helping 4 million individuals across 65 countries. Our portfolio also includes, GHC a full-stack sexual health clinic for men (Mars by GHC) and women (Saturn by GHC) helping address their problems effectively, discretely, and affordably. And as mentioned earlier, Mylo is our community and content-based platform providing over 4 million parents with a supportive network of parents and experts, relevant educational material, and high-quality products and services.

What is the quantum of investment the company is planning in the Indian market?

We have committed $ 100 M towards improving the healthcare landscape in India and the US. What are the company’s future goals and plans for the Indian market?

At W Health, we aim to build the future of care delivery in India. Given India’s supplyside constraints in health, for example, only 650 endocrinologists to serve 200 million diabetics and prediabetics in India. We believe a

technology-first approach is the only way to solve India’s healthcare challenges at scale.

Thus, through the companies we fund and found, we aim to impact at least 100 million lives in the next 4-5 years.

Our goal is simple, to build and encourage innovations on the right side of healthcare change and thereby help create a healthcare ecosystem that is inclusive, equitable, and effective.

In tandem with our goals, our plans are straightforward.

By funding early-stage companies that are aligned with these goals, we plan to leverage W Health’s resources to support the founders in growing the company. We plan to do this by incubating companies that are building solutions for addressing the various gaps in the Indian healthcare paradigm and by bringing in learnings from the US to help our portfolio companies innovate. We also aim to build greater awareness for healthcare needs and innovate through collaboration and content.

How is the health tech industry in India different vis a vis the US? Especially on the cost front, the lack of health insurance, lax regulation, etc There are some striking differences between the Indian and US health sectors.

For one, there is a much higher insurance coverage in the US. 91 per cent of Americans are covered by

insurance as opposed to 37 per cent of Indians. This leads to 66 per cent of healthcare expenses in India being paid out of pocket as opposed to only 9 per cent in the US. This results in many US healthcare start-ups adopting a B2B model where they are selling to employers and payers.

There is also a stricter but more trusted regulatory landscape in the US, when compared to India. The data privacy laws, interoperability framework, and regulatory pathways (FDA) are far more evolved in the US than here.

However, all this comes at a cost. Quality healthcare is more expensive in the US. The per capita annual healthcare expenditure in India is less than $100, while that in the US is over $10,000. While in part this is driven by more people in the US consuming healthcare, it is also because of the higher prices for healthcare services in the US. For instance, an RTPCR test in the US could cost upwards of $200 whereas in India it is ~$10-15.

Healthtech innovation is still at a nascent stage in India, at the moment it is synonymous with telehealth and e-pharmacies. The more comprehensive interventional health care models remain at an infantile age, a scenario quite different in the US, where healthcare innovation is more evolved. viveka.r@expressindia.com viveka.roy3@gmail.com

EXPRESS HEALTHCARE

11

August 2022

START UP

Periwinkle Tech’s smart solution for women's health Periwinkle Technologies’ patented technology Smart Scope offers Indian women a simple, single visit digital cervical health examination kit, which is easy to use. With cervical cancer claiming one woman every eight minutes in India, Express Healthcare reviews the journey of founders Veena Moktali and Koustubh Naik as they strategise to achieve their mission of scaling up social impact of digital medtech by expanding India’s cancer screening efforts

I

ndia's healthcare ecosystem has many pain points across the private and public health segments. Of these pain points, cervical cancer is a major concern for India as we lose one woman every eight minutes to cervical cancer.

The good news is that these deaths are preventable, as regular screening and early detection of cervical cancer saves lives. According to various estimates, 40 crore women in India in the age range of 25 to 60

years should be screened every 3-5 years to lower the mortality and morbidity due to cervical cancer.

Wanted: an efficient, accurate gyn-onco screening test Prevention is always better than cure and with cervical cancer too, screening regularly can help in making the treatments less invasive and less expensive. The question is, what is an effective method, given

India’s geographical spread and varying socio-economic realities?

The world is rapidly moving away from Pap smear tests due to their low sensitivity. The newer HPV DNA tests can be used for women above the age of 30+ years. However, these tests are also multi-visit since there is a dependency on a well-equipped lab facility, infrastructure, expert personnel, and transport of samples.

Moreover, these tests are

NEWAGE SOLUTION T Veena Moktali

Koustubh Naik

12

EXPRESS HEALTHCARE

August 2022

he Smart Scope® CX, is a medical device with telehealth software and AI for enabling singlevisit detection of cervical cancer by digitising the visual test.According to the company, this has enabled more than 1000 healthcare workers, medical officers, and gynaecologists in several hundred government centers and private OPDs across 10 states in just the last four years, to making the test available to lakhs of women.

The Smart Scope’s risk stratification mechanism powered by Periwinkle’s machine learning (ML) models and the remote expert review facilitated by the company’s robust telehealth software helps reduce the time to treatment.This is expected to increase the number of screenings across the country within a given time and budget.

WHO has called all countries to screen at least 70 per cent of the population by 2030 and treat 90 per cent of those detected with pre-cancer.The founders firmly believe that Smart Scope® is the only test that will help achieve this goal and provide India the kind of coverage needed without compromising the accuracy of the results. Moreover, the risk stratification will help achieve the goal of 90 per cent vaccinations by 2030.

The company is an ISO 13485 certified company, and their device has regulatory approvals by CDSCO.

START UP quite expensive and not a feasible solution for the scale and repeated testing needed for India’s population. And finally, after performing an HPV test, a visual test is recommended to do a biopsy and triage or treat.

Experts thus needed an efficient and accurate gyn-onco screening test. The test also needed to make screening for cervical cancer as painless and hassle-free as possible for women in India. This meant reducing the time lost in repeated visits (travel to the lab/hospital and waiting time), out of pocket expenses for multiple tests and treatments as well as loss of wages. All of these factors are deterrents to women taking time out to do the tests.

Thus public healthcare in India needs an efficient, singlevisit, scalable, easy-to-implement, and accurate visual inspection system, with a good balance of sensitivity and specificity, for a cervical cancer screening programme.

Periwinkle solution: Digitalise medtech to scale up social impact In 2013, two med tech entrepreneurs, Koustubh Naik and Veena Moktali, were scanning India’s healthcare sector for ways to use their engineering and entrepreneurial experience, to make a sizable social impact. They incorporated Periwinkle Technologies in 2013 with the intent of making access to healthcare easier.

Market research introduced the duo to the high morbidity levels due to cervical cancer. Driven by the belief that regular screening can save the lives of over 300,000 women worldwide, the cofounders built a team comprising medical researchers, data scientists, business leaders, technocrats, medical professionals, and innovators.

They developed their healthcare access platform called the “Net4Medix” in 2014 and introduced their first hardware product from the “Smart Scope” family for screening of cervical cancer in 2015. They also built their AI engine in parallel. They work with renowned research institutes and organisations such

ABDM - POWERING INDIA'S JOURNEY TOWARDS A TRULY DIGITAL HEALTHCARE ECOSYSTEM

T

he Ayushman Bharat Digital Mission (ABDM) aims to develop the backbone to support the integrated digital health infrastructure in India. It will bridge the existing gap amongst different stakeholders of the healthcare ecosystem and the gap of convergence and standardization across the eHealth/digital health spectrum in the country.

BUILDING BLOCKS Health ID Ayushman Bharat Health Account (ABHA). The health ID will be used for the purposes of uniquely identifying persons and threading their health records across multiple systems.

Health Records (PHR) A PHR is an electronic record of health-related information on an individual that conforms to nationally recognised interoperability standards.

Healthcare Professionals Registry (HPR)

Health Facility Registry (HFR)

A comprehensive repository of all healthcare professionals involved in delivery of healthcare services across both modern and traditional systems of medicine.

Repository of health facilities of the nation across different systems. It includes both public and private health facilities including hospitals, pharmacies, and imaging centers.

Telemedicine & ePharmacy

Unified Health Interface (UHI)

Telemedicine and ePharmacy will open as a standardised and interoperable market to be leveraged by different private and government players.

UHI will enable a wide variety of digital health services between patients and health service providers, including appointment booking and service discovery.

AWS approach The objective of AWS is to work with state governments on solutions across the value chain/building blocks of the ABDM.This can be done by positioning the right state digital health framework/architecture in line with ABDM and eHealth, and bring in ISVs who have solutions for the respective components, integrated/compliant with the ABDM ecosystem.

The approach is to work with a partner who can stitch an integrated solution around different components like telemedicine, HIMS, PHR, HPR, and CDSS with a POC first approach.There are certain government-built applications that offer solutions for the same components. Here, the approach is to position a cloud-based deployment of these applications across states for adoption and performance at scale.

3-PRONGED STRATEGY TO WORK ON STATE ENGAGEMENTS State Digital Health Framework Come up with a state digital health framework, covering the current readiness and already deployed solutions. Also, identify the new initiatives that may be taken up for the state.

Identify-Proof-Execute Once the gaps/requirements are identified, AWS can present the solutions/ products and ISVs, get on PoCs and subsequently execute upon showcasing success.

Transform, Converge & Standardise Jointly take up the convergence, standardisation and technologyenabled transformation in healthcare for states with solutions, SAs and partners with in-depth experience.

as Tata Memorial Center, several reputed NGOs and International groups, medical colleges, and hospitals across India.

Their solution for screening of cervical cancer, the Smart Scope® CX, described as the ‘Single-visit Digital Cervical Health Examination Device for OPD’, combines three components: hardware, software, and AI. The product was commercialized in 2019.

AWS has been a part of their journey since 2015 as their preferred cloud platform, helping their cloud footprint increase steadily over the past decade.

Future plans The Periwinkle Technologies team has been the recipient of several grants from DBT BIRAC, MeitY, Social Alpha, and more such schemes. In addition, the product has bagged awards along the way, including the prestigious one from the Startup Grand Challenge under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana from the National Health Authority in 2020.

They followed this up with another pat on the back when they won at Maharashtra Startup Week organised by Government of Maharashtra in 2021. The team has been invited to share their story and experiences at global meets like the Geneva Health Forum in 2020 and 2022, and World Health Assembly 2022.

But the team is not resting on these laurels. The founders reveal that Periwinkle Technologies is aggressively expanding in all states of India at all levels of public health care and private as well, leveraging the global experience and expertise of the founders and the team.

They are also expanding internationally, looking at the keen interest in the product from several countries. The founders have a few more products in the pipeline and given their track record with the Smart Scope, one hopes they continue to scale up access to affordable cancer diagnostics across India and the globe.

EXPRESS HEALTHCARE

13

August 2022

cover )

14

EXPRESS HEALTHCARE

August 2022

Teleradiology has seen a boom in the wake of the COVID-19 pandemic, but mitigating risks and challenges in this sector is key to optimise its potential to enhance patient care

By Kalyani Sharma

EXPRESS HEALTHCARE

15

August 2022

cover ) T

he immediate availability of diagnostic services, which plays a crucial role during medical emergencies accompanied by imbalance between the high demand of radiology services and available ratio of the healthcare professionals calls for the adaptation of services like teleradiology. Moreover, the potential of technology in healthcare has always excited the technology oriented and gen next of healthcare professionals.

Today, teleradiology helps in better utilisation of workforce, provides good quality metrics and accelerates speed and accuracy of reporting.

This health tech mode of radiology played even a bigger role during the pandemic by reducing the load on healthcare professionals and transferring and sharing the reports and scans globally among the healthcare community.

However, the diverse nature of medical data, from records to images and live teleconsultations amongst others, results in a wide range of volume that must be managed. In addition, remote handling and transmission of medical data must face challenges such as medico-legal implications and data security including the non-availability of proper teleradiology infrastructure.

Talking about the role of teleradiology during the pandemic, Dr Harsha Rajaram, COO, Aster Telehealth, India and GCC said, “The biggest testament for teleradiology and its role was during the COVID pandemic. Like other healthtech solutions during the period, teleradiology became a pragmatic delivery mode and saw a significant adoption during the period.

Radiology and teleradiology played a significant role in early pandemic in limiting the spread of the infectious, considering the sparse availability and time taken for lab investigation. In few places, radiology investigation was the only option available for screening, The sudden spurt increased

16

EXPRESS HEALTHCARE

August 2022

The biggest testament for teleradiology and its role was during the COVID pandemic. Teleradiology became a pragmatic delivery mode and saw a significant adoption during the period Dr Harsha Rajaram COO, Aster Telehealth, India and GCC

the demand for teleradiology services by nearly 150 per cent, across the country especially for CT chest and Xray reporting.

Many teleradiology providers emerged during the period and were able to deliver for this specific COVID needs.

Artificial intelligence greatly helped in real time covid screening and reduce radiologist burnout resulting from this sudden spurt.”

How effective is teleradiology in India: Market status

India is witnessing a considerable rise in the number of individuals suffering from cancer and osteoarthritis which is catalysing the demand for teleradiology in the country Dr Gur Prasad Vashisht Director Radiology, Asian Institute of Medical Sciences

Teleradiology like every other branch of telemedicine, owes its birth to imbalance between demand and supply. With the advent of accessible and affordable internet, this practice has begun to spread very fast and wide Dr Sunil Narayanaswamy Consultant Radiologist, BGS Gleneagles Global Hospitals, Bangalore

Among the many segments of healthcare that are pacing up on this digital highway, teleradiology is one segment that has a substantial potential to achieve deepest impact both in terms of attending to high unmet need as well as to support supply side in the most consistent and wholesome way Sunil Thakur Partner, Quadria Capital

As per Marketsandmarkets, “The teleradiology market is expected to reach $14.8 billion by 2026 from $7.3 billion in 2021, at a CAGR of 15.3 per cent during the forecast period of 2021 to 2026. Due to the outbreak of coronavirus globally, there is a sudden rise in the demand for teleradiology services. In 2021, teleradiology market reached to $7.3 billion.”

Vikram Thaploo, CEO, Apollo Telehealth explains, “The healthcare industry in India is witnessing sharp growth across various sectors, radiology being a prominent one. The world of technology and imaging is constantly evolving, opening up new avenues to a new world of innovations. According to TMR (Transparency Market Research), the worldwide teleradiology market was valued at $2.6 billion in 2018 and is expected to grow at a CAGR of 16.9 per cent from 2019 to 2027.”

“With a noticeable shift towards preventive healthcare from prescriptive healthcare not only in India but across the world, tele-radiology is further gaining significance as it allows faster and better dissemination of patient information to physicians. The COVID-19 pandemic has also catapulted the growth of teleradiology services in India, emerging as a key solution to rapidly report the huge number of images generated. As India continues to face a severe shortage of radiologists, tele-radiology is turning out to

be a viable option to act as a stuffing buffer”, he added.

The growth of this market is mainly attributed to the rising geriatric population and the subsequent increase in the prevalence of associated diseases; the increasing number of advanced imaging procedures and a shortage of skilled radiologists; advancements in teleradiology the increasing adoption of cloud-based solutions.

Stressing on the possible factors responsible for this sector’s growth, Dr Gur Prasad Vashisht, Director Radiology, Asian Institute of Medical Sciences added, “The rapid expansion of the information technology (IT) sector is one of the key reasons for the growth of the market in the country. Moreover, India is witnessing a considerable rise in the number of individuals suffering from cancer and osteoarthritis which is catalysing the demand for teleradiology in the country.

Other factors such as social distancing and quarantine measures undertaken due to the coronavirus disease (COVID-19) outbreak are responsible for the increase in the utilisation of teleradiology in India.”

Dr Sunil Narayanaswamy, Consultant Radiologist, BGS Gleneagles Global Hospitals, Bangalore also highlights that, “Teleradiology like every other branch of telemedicine, owes its birth to imbalance between demand and supply. Up until very recently, teleradiology was only used in emergencies.

But with the advent of accessible and affordable internet, this practice has begun to spread very fast and wide. It is as easy to send images as it is to send emails that have attachments. There are now computer programs that are dedicated specifically to the transmission of radiological images. These developments have subsequently resulted in teleradiology turning into a significant medical practice, and it continues to grow in importance.”

EXPRESS HEALTHCARE

17

August 2022

Sharing his insights on the teleradiology market, Sunil Thakur, Partner, Quadria Capital said, “Digital tsunami is rapidly revolutionising healthcare, albeit in different

ways and stages, across the world and especially in high tech adoption countries like India. Among the many segments of healthcare that are pacing up on this digital high-

way, teleradiology is one segment that has a substantial potential to achieve deepest impact both in terms of attending to high unmet need as well as to support supply side in the

most consistent and wholesome way.”

“The teleradiology segment in India has grown upwards of $350m growing at 15 per cent pa, thanks to both global and

PORTABLE CT Bringing the Power of Imaging to Your Patient

CereTom Elite

BodyTom Elite

OmniTom Elite

8-slice Portable Head & Neck CT Scanner

32-Slice Portable Whole Body CT Scanner

16-Slice Portable CT Scanner

cover ) local demand. It is mainly dominated by x-rays with 40 per cent followed by CT at 35 per cent and MR at 25 per cent. The Value proposition and service offerings straddles all the way from simple workflow management, to scan reads to supporting training, population health management, second opinion going all the way to deep tech anchored by sophisticated AI. Each of the services have varying degree of manual intervention and that’s what defines the product sophistication. That said, to a very large extent, the success of teleradiology will depend on how it integrates with and supports the radiologist”, he added.

Weighing the pros and cons As per industry experts, the advantages of adopting a teleradiology in Indian healthcare system is way more than its disadvantages except few like data privacy and availability of enough teleradiology solution providers in the Indian market and sometimes miscommunication and confusion in terms of analysing the final diagnosis in the process of a scan going through the acquisition, storage, transfer, and final view.

Also, since teleradiology is technology dependent, if the internet is down at the hospital, telereporting cannot be done. This could result in a delay in diagnosis and treatment.

Stressing on the pros of teleradiology, Ayanabh DebGupta, Co-founder & Jt. Managing Director, Medica Group of Hospitals said, “Teleradiology allows ordinary radiology hospitals to submit complicated pictures to larger medical institutes for review.

Furthermore, clinical radiologists can obtain a second opinion from a specialist without transporting the patient, reducing patient suffering, and enhancing service delivery efficiency. It also plays an important role in enhancing service to rural areas and can

18

EXPRESS HEALTHCARE

August 2022

Teleradiology allows ordinary radiology hospitals to submit complicated pictures to larger medical institutes for review. Furthermore, clinical radiologists can obtain a second opinion from a specialist without transporting the patient, reducing patient suffering, and enhancing service delivery efficiency Ayanabh DebGupta Co-founder & Jt. Managing Director, Medica Group of Hospitals

For Indian teleradiology, the main open markets at the moment are the US, Singapore, and UK. English-speaking nations and those where the cost difference makes financial sense are the ones that are most likely to look to outsource teleradiology Dr Sanjeev J Mudakavi Consultant-Radiologist, Manipal Hospital

Radiology practice needs to adequately assess and address the security risks to protect patient names and other sensitive identifying information that can be accessed by unauthorised individuals Dr Nikhil Kamat Senior Consulting Radiologist and Head of Department of Radiology, Jupiter Hospital

In the present era of evidence-based medicine, tele-radiology services should be in sync with the clinical profile of the patient and should be integrated with the tele-consultations Dr Nitin P. Ghonge Senior Consultant, Department of Radiology, Indraprastha Apollo Hospitals

ease the present radiology deficit by giving access to specialised radiologists in locations where healthcare inequalities exist. An MRI done on a cutting-edge scanner in India costs a few thousand rupees, which is substantially more in US money. At these prices, having an Indian radiologist report outsourced scans might provide a major financial benefit.”

Dr Roshan Shetty, MD, DMRD Radiology and Director Pinnacle Imaging explains that, “Teleradiology in India has been done mostly for CT scans, MRIs, and sometimes for X rays. It is not used in sonography as it is operator-dependent.

In essence, teleradiology is being used to fill the gap between demand and availability of inperson diagnostic services. It is used in case of emergency when a good-quality radiologist is unavailable. Therefore, this last-minute resort is predominately used in tier 3 cities and its peripheral areas.

The situation is entirely different in metros and tier1 cities, where radiologists are clinically connected with the patient and conduct proper investigations of a patient’s medical history.”

“It’s difficult to get highquality services through this technology which, although has been used in India for over 2 decades, is less accurate than a physical radiology inspection. Those performing teleradiology is also not as highly qualified as a clinical radiologist. That being said, its most important advantage is how it reduces the burden of case inspection for any senior radiologist. That advantage has made India a solid supporter of US-based radiologists, as teleradiology provides the first round of scanned data to those experts. On the other hand, excessive use of teleradiology is rendering young radiologists, who want to work on CT scans and MRIs, unemployed.

Many hospitals install their own teleradiology machines, for which a clinical radiologist

misses every assignment that teleradiology covers”, he added.

Emphasising on the cons, Dr Nikhil Kamat, Senior Consulting Radiologist and Head of Department of Radiology, Jupiter Hospital says, “The other side of teleradiology brings to the fore the concerns about protecting sensitive patient information from miscreants. While it is HIPAA compliant, there is always a possibility of confident data being leaked when transmitting data electronically. Radiology practice needs to adequately assess and address the security risks to protect patient names and other sensitive identifying information that can be accessed by unauthorised individuals. Besides the risks of leakage of patient data, teleradiology might face an uphill task to be accepted by physicians who find it hard to understand and embrace new technology. Also, some facilities with a high attrition rate may find it difficult to dedicate time to training their staff in various components of teleradiology. Tele-radiology from remote areas or studies done in emergency hours that may be performed without supervision of radiologist - may not be optimum.

Medico-legal aspects in such and other situations of tele-reporting also need to be addressed.

Providers need to work closely with their medical imaging vendors to find ways to make this industry innovation work in their favor.”

Dr Sanjeev J Mudakavi, Consultant-Radiologist, Manipal Hospital Millers Road considers small markets and lack of board-certified radiologists as one of the major hurdles for Indian teleradiology market. He said, “For Indian teleradiology, the main open markets at the moment are the US, Singapore, and UK. English-speaking nations and those where the cost difference makes financial sense are the ones that are most likely to look to outsource teleradiology. Few

EXPRESS HEALTHCARE

19

August 2022

countries meet these requirements, and certain European nations, as well as New Zealand and Australia have succeeded in leveraging their advantages to establish

themselves as outsourcing hubs.”

“Due to the significant variations in pay between India and the US, radiologists who pursue board certification

there may be reluctant to return. The handful that does return may do so for reasons related to their "Indian" ideals, their way of life, or their families. “

Need of the hour While India is making great strides in strengthening its healthcare system and services, the weakest link that continues to disrupt the improvements

Scan to watch the tutorial

INDIA’S MOST TRUSTED BRAND

PROMOTING PATIENT SAFETY AVAI LABLE IN AVAILABLE G & 32 G 31G

Precision, P ii Engineered, E i d Affordable Aff d & Easy E to t Use. www.hmdhealthcare.com

info@hmdhealthcare.com

cover ) is the unavailability of specialised manpower. eleradiology is already proving its worth in terms of number of advantages it can offer to Indian radiology system. The need of the hour is to engage with public sector healthcare organisations in a PPP model to ensure the smooth implementation of teleradiology in India.

Talking about the need of the hour, Dr Nitin P. Ghonge, Senior Consultant, Department of Radiology, Indraprastha Apollo Hospitals highlights, “In the present era of Evidence-based Medicine, Tele-radiology services should be in sync with the clinical profile of the patient and

20

EXPRESS HEALTHCARE

August 2022

should be integrated with the tele-consultations. Tele-radiology services should not only be confined to generating a piece of paper without any correlation with the clinical background.

Tele-radiology services should address the clinical problem, address the diagnostic dilemma, and serve the purpose of providing direction to the healthcare delivery in a more comprehensive manner. Most of the present tele-radiology services are not fulfilling these requirements and should be more inclusive in approach. As with clinical radiology practice, tele-radiology should have a 'patient-centric' approach and 'problem-solving'

attitude. Tele-radiology services of the future should essentially include 'direct online consultation' between the patient and the Radiologist. This will ensure that the image interpretation is appropriate and the diagnosis is more precise and clinically relevant.”

Thaploo added, “The need for tele-radiology services is quite evident considering the severe unavailability of trained radiologists in the country. It is the need of the hour to support healthcare institutions that lack qualified radiologists through tele-radiology to create a positive impact on healthcare delivery and in turn, strengthen

the healthcare system of India.

If tele-radiology services are provided following proper regulations and rules, with a sole focus on quality, it has the potential to provide tremendous value to the healthcare industry and the public overall.”

Dr Narayanswamy suggests, “The modern practice of radiology involves several different healthcare professions working as a team. Teleradiology utilises standard network technologies such as the internet, telephone lines, wide area network, local area network (LAN) and the latest high tech being computer clouds. So, it is imperative to have quality and

affordable technology available at the most remote parts of the country. Adequate care should be taken to avoid loss of quality of radiological images / information during transmission or display. Communication lines should be robust, easily accessible and the subject of a mutual contractual agreement.

Provision to access clinical information of the patient including lab investigations, previous imaging etc. helps in delivering quality and clinically relevant reports by the teleradiologist.”

Kalyani.sharma@expressindia.com journokalyani@gmail.com

HEALTHCARE TRENDS

Consumer-driven & patient-focused innovations in the healthcare industry Charu Sehgal, Partner, Healthcare and Lifesciences Leader, Deloitte India explains that till a few years ago disease was presumed to be inevitable, and the focus was on how best to cure it or in most cases, keep it under control. This has now changed, and the focus has shifted to prevention and wellness, led largely by the younger generation

W

hile the healthcare industry has seen many advances over the past few decades, the most significant change that we have witnessed with respect to healthcare delivery from a customer perspective is that patients moved from being passive recipients of diagnosis and treatment, with very little information, discretion or choice, to being empowered consumers.

They now have the information and services that could help validate the diagnosis and even have the option to select doctors and hospitals based on parameters such as service quality, convenience, and cost. This has flipped the dynamics of healthcare delivery and put patients at the center of it. The modern patient demands better services, convenience and health outcomes than ever before.

The market was quick to take note of this changed dynamic and both established healthcare and medical technology players have begun developing protocols, products, and solutions to address these needs. An analysis by Forbes shows that healthcare marketplaces that allow patients to search for and book healthcare services online experienced a 3.2x year-over-year funding growth in 2021 in the United States. Similarly, in India we have seen the emergence of several startups which fulfill the same requirements.

A recent report by the Deloitte’s Center for Health Solutions estimates that up to 70 per cent of startups in healthcare diagnostics are working on point-of-care diagnostic solutions that allow diagnostic studies to be conducted outside the hospital setting and therefore

While over the years we did see patients and consumers increasingly adopt and use technology, both doctors and patients remained relatively reluctant to accept remote diagnosis and care as a substitute to face-to-face doctor patient meeting and examination aid patients in caring for themselves. In the coming decades, we are likely to see several such point-of-care and DIY diagnostic solutions emerge and gain mainstream adoption.

Till a few years ago disease was presumed to be inevitable, and the focus was on how best to cure it or in most cases, keep it under control. This has now

changed, and the focus has shifted to prevention and wellness, led largely by the younger generation. This has led to the usage of patient centric wellness gadgets, mobile applications, and fitness tracking apps becoming ubiquitous. According to the report by Deloitte’s Center for Health Solutions, 46 per cent of healthcare start-ups

in the United States focus on prevention and/or wellness or detection/diagnosis, and only 19 per cent focus on treatment. In 2022, the US FDA approved Apple Watch’s ECG app to track and store a user’s atrial fibrillation history. This is just an indication of the things to come. In a few years from now, we can expect a casual user to be able to obtain medical grade data for things like sleep cycles, reproductive cycles, brain waves, respiratory rhythm, body temperature, stress levels, SpO2, levels etc. through affordable wearable devices. This newfound focus on prevention and wellness has huge implications for resource constrained countries like ours, whose only hope to tackle disease for their growing population is to focus on prevention rather than spend the enormous resources needed for cure.

While over the years we did see patients and consumers increasingly adopt and use technology, both doctors and patients remained relatively reluctant to accept remote diagnosis and care as a substitute to face-to-face doctor patient meeting and examination. This changed due to COVID-19 in 2020, when lockdowns and infection risks forced people to opt for remote care.

Several reports indicate that users have not only availed increased virtual services during the past two years, but also plan to continue doing so in the future.

Both private healthcare providers as well as governments have sought to use these shifts to their advantage and are increasingly leveraging remote care technology to not only enhance their reach to patients but also reduce stress on their

limited healthcare resources.

However, you don’t need fancy technology like advanced sensors, artificial intelligence or machine learning to make a difference. There are several easy to implement solutions that can enhance efficiency of care delivery through simple data digitisation. Closer home in India, there are several successful examples of State & National governments effectively deploying mobile apps to enhance patient access to healthcare in resource stressed environments

Conclusion Given that the healthcare industry deals with the lives of people, it has been a highly regulated industry that must follow protocols that have been developed after many years of trials and research. As a result, it has typically been slow and resistant to change. However, it is going to undergo a technology led revolution in the 21st Century.

The pandemic has rendered the public, regulators as well as governments to be more amenable and trusting of technological solutions. This is a particularly opportune time for technology led disruption since changes in consumer behavior are coinciding with an acceleration in digital connectivity and the development of enabling technologies such as artificial intelligence, machine learning, sensors, and internet speed.

These industry shifts will enhance patient access to healthcare, improve health outcomes and improve patient experience by leaps and bounds.

It is critical for healthcare organisations of the 21st century to take note of these changes and prepare for a vastly different future.

EXPRESS HEALTHCARE

21

August 2022

MEDTECH I N T E R V I E W

We are also focused on developing products that meet the specific needs of the Indian market Ram Rangarajan, Vice President, R&D, of the recently launched Stryker Global Technology Centre (SGTC) explains to Viveka Roychowdhury on how the center will help engineers get direct feedback from surgeons to improve the design of products, thus scaling up innovation and improving clinical outcomes faster

Could you give an idea of Stryker’s vision or current strategy for the Indian market?

Stryker is one of the world’s leading med-tech companies and together with our customers, we are driven to make healthcare better by offering innovative med-tech products and services that help improve patient and hospital outcomes. Science and innovation have been in our DNA from day one and this is one of our pillars of our company strategy and vision.

In the past 5 years, about 6-7 per cent of our annual revenue has gone into R&D. In 2021 alone, Stryker has spent about $1.2 billion on research & development, and we now own about 11,000 patents worldwide.

Another one of our visions is driven by values and at Stryker we create an environment, for people to feel empowered to come up with ideas. We value their potential which helps us work as a team as diverse backgrounds, identities, and experiences help fuel this innovation and solve complex problems for our global customers and patients. Our vision is to bring Stryker’s legacy of innovation to India and leverage world class talent and technology ecosystem.

Stryker Global Technology Centre (SGTC).

The SGTC is an enterprisewide cross divisional capability which works with different business units, and that is unique to Stryker. This new center will bring newer breakthrough inventions and technologies to address the needs of patients’ world over.

It houses over 1000 R&D employees, mainly engineers and scientists working on various projects for different businesses all under one roof.

The center will have stateof-the-art labs spread over an area of 45,000 square feet.

These labs are equipped with world-class infrastructure and equipment to support our engineers in undertaking complex engineering activities.

The new center houses a world-class Neurovascular Innovation Lab. This lab will help in enabling interaction between neurosurgeons and our world class engineers to improve stroke care. Imagine, orthopedic surgeons operating on sawbones using a robot inside our facility with our engineers watching it and getting direct feedback to improve the design. Besides this, this building is USGBC (US Green Building Council) LEED Platinum certified and offers features for differently abled people.

Tell us about the work being done at the recently opened

Could you give us examples of technological innovations

22

EXPRESS HEALTHCARE

August 2022

from Stryker which enable healthcare professionals to enhance patient safety?

One of the areas that we function in is that of orthopedic surgeries, (where) we are moving from traditional surgeries and mechanical instruments to more computer aidednavigated and robotic surgeries – MAKO SmartRobotics. It is an innovative solution for patients suffering from painful arthritis of the knee or hip. Mako Robotic-Arm Assisted Surgery enables surgeons to deliver more predictable surgical outcomes with increased accuracy.

Surgeons are armed with better planning before the surgery starts, enabling them to make better decisions in the OT. For a market like APAC, which has over 2.6 billion people, the scalability of technology is of paramount importance. These smart technologies will help in providing access to great clinical outcomes and will play a role in improving healthcare and ensuring patient’s safety.

Most new technologies come with a certain cost to them.

In India, if the cost is covered by insurance, it is good, but with low insurance penetration, what has been the uptake of these technologies in the

Indian patient population?

Our global technologies have to a great extent succeeded in addressing a certain segment of the Indian population.

However, we have also realised that the technologies that we have for the global population are not always suited for this market, so we are also focused on developing products that meet the specific needs of the Indian market. A product that we are launching later this year is focused on a solution designed in India, for India and the world.

Since Stryker has been developing and designing products in India for quite some time it is in line with PM Modi's Make in India initiative. Could you give us some insights on what is the company’s manufacturing footprint in India, as of today?

As we work on different healthcare problems, based on the current technologies or business needs our manufacturing strategy varies a little bit. For example, there is a product that we will be launching soon called SmartMedic, which is a platform that upgrades existing beds in a hospital.

Now that we are planning to launch it here, this product is made in India, for India and our strategy for making it in

In India, we are designing cutting edge products for this market as well as the rest of the world and with this launch of SGTC, we will be able to take our efforts up a notch India is to solve the healthcare problems and clinical needs within the ICU. What are the products conceptualised and made in India which have been adopted to other markets?

We leverage our global manufacturing footprint and design capabilities across different regions while we continue to work towards creating a strong pipeline of innovation and robust product portfolio that cater to market specific needs. In India, we are designing cutting edge products for this market as well as the rest of the world and with this launch of SGTC, we will be able to take our efforts up a notch.

Stryker established its first R&D facility in India more than 15 years ago to provide engineering support to R&D functions in domestic and other emerging markets. Since then, the SGTC R&D team has been partnering across divisions to drive innovation and research to provide better healthcare solutions.

In order to make healthcare better in India, we have and are innovating to cater to specific needs of surgeons across specialties.

Some of the products conceptualised in India and adopted to other markets include: SmartMedic (To be launched in India soon): A product conceptualised and developed in India and only for India. This is a platform that upgrades existing beds in a hospital. It is a connected device that measures patient’s weight and monitors turncompliance to prevent bed sores. A smart innovation that is designed to eliminate the need for a new bed and is custom-made for it to solve problems for India at affordable prices.

Endocart: It is another product which is first made in India. It houses different endoscopic cameras, light sources, and all other devices Moving back to the Make in India policy, what are the advantages of making in

India especially on the cost, availability, access aspects of medical products?

The industry is witnessing tremendous challenges and pricing problems because of supply challenges, and we are obviously not immune to the problem of chip shortages.

There are supply chain disruptions due to the war and such global problems are affecting cost.

However, the country is benefiting from a world-class domestic innovation and research. It helps in minimising the impact of these fluctuations. From the business standpoint, we will not be able to provide the affordability and accessibility that we are striving for if we are purely dependent on our global supply chain. Digital is also transforming technology and with it coming to India, it will help us upskill the market and help in improving scale by doing it locally and ensuring access and affordability.

How supportive has the Indian government been in their policies for medical

devices? Should we see Stryker's investment in this new facility as a thumbs up for the Government of India's policies? Are you comfortable with the direction that they are taking when it comes to medical devices and the healthcare sector per se?

We continue to partner with the government. Quoting from the draft approach paper on National Medical Device Policy, the policy “envisages to promote innovation and Research and Development (R&D) by focusing on creating a dedicated fund, enhancing industry-academia linkages, promotion of innovation hubs, centres of excellence and intellectual property protection.”

With the current policies and environment, currently we see a very enabling partnership with the Government of India and the overall industry. As a global leader in medical technology, Stryker aspires to drive progress in innovation and to make healthcare better by offering innovative products and services in Medical and Surgical, Neurotechnology, Orthopaedics and Spine that help improve patient and hospital outcomes. viveka.r@expressindia.com viveka.roy3@gmail.com

CONTRIBUTOR’S CHECKLIST ● Express Healthcare accepts editorial material for the regular columns and from pre-approved contributors/columnists. ● Express Healthcare has a strict non-tolerance policy towards plagiarism and will blacklist all authors found to have used/referred to previously published material in any form, without giving due credit in the industryaccepted format. ● As per our organisation’s guidelines, we need to keep on record a signed and dated declaration from the author that the article is authored by him/her/them, that it is his/her/their original work, and that all references have been quoted in full where necessary or due acknowledgement has been given. The declaration also needs to state that the article has not been published before and there exist no impediment to our publication. Without this declaration we cannot proceed. ● If the article/column is not an original piece of work, the author/s will bear the onus of taking permission for re-publishing in Express Healthcare. The final decision to carry such republished articles rests with the Editor. ● Express Healthcare’s prime audience is senior management and professionals in the hospital industry.

Editorial material addressing this audience would be given preference.

● The articles should cover technology and policy trends and business related discussions. ● Articles by columnists should talk about concepts or trends without being too company or product specific. ● Article length for regular columns: Between 1300 1500 words. These should be accompanied by diagrams, illustrations, tables and photographs, wherever relevant. ● We welcome information on new products and services introduced by your organisation for our Products sections. Related photographs and brochures must accompany the information. ● Besides the regular columns, each issue will have a special focus on a specific topic of relevance to the Indian market. You may write to the Editor for more details of the schedule. ● In e-mail communications, avoid large document attachments (above 1MB) as far as possible. ● Articles may be edited for brevity, style, relevance. ● Do specify name, designation, company name, department and e-mail address for feedback, in the article. ● We encourage authors to send a short profile of professional achievements and a recent pho-

tograph, preferably in colour, high resolution with a good contrast.

Email your contribution to: viveka.r@expressindia.com viveka.roy3@gmail.com Editor, Express Healthcare

EXPRESS HEALTHCARE

23

August 2022

MEDTECH I N T E R V I E W

Implementation of AI and ML in the IVD instruments is becoming the next big thing to watch out for!

Suresh Vazirani, Founder Chairman, Transasia - Erba Group in an interaction with Express Healthcare talks about the evolution of IVD manufacturing in India and explains Transasia’s upcoming technologies for Indian market for disease management How has manufacturing of IVD instruments in India evolved over the past 5 years?

I would say that the last five years in particular have seen the floodgates open up to offer a host of opportunities for Indian manufacturers: Making in India: The government’s focus on recognising medical devices as a sunshine sector in its ‘Make in India’ campaign has given an impetus to indigenous manufacturing with many IVD and medtech companies realising their potential for meeting India’s needs for affordable diagnostic solutions.

Adoption of automation: The growing demand for testing for lifestyle-related and infectious diseases has led to labs adopting automation for reduction of workload, convenience, speed and accuracy. Until a few years ago, who would have thought that total lab automation would allow integration of analysis across different segments on to a single platform? The focus of labs is now on TAT. Conveyor belts and rack systems are being deployed for a continuous flow analysis with automatic loading, mixing, pipetting of sample and reagent. This helps to establish more efficient workflows by relieving lab technicians from manual work and enhancing user safety by reducing exposure to bio-hazardous materials. For labs that run

24

EXPRESS HEALTHCARE

August 2022

manufacturers are adopting rapidly evolving technologies such as IoT to meet the huge demand for fully automated products and services.

Moreover, instruments are now available with a complete suite of LIMS that brings in a lot of convenience and data integration.

Faster introduction of instruments in the market: Manufacturers of IVD instruments are now focusing on reducing the ‘time to fly’ by developing and launching new products in a short time. A deep-rooted collaboration of the R&D, manufacturing and sales teams helps achieve this goal, offering customer solutions that are easily adoptable by labs, big and small, easily available in every region and affordable to all.

Transasia is expanding its manufacturing and R&D base by setting up dedicated centres of excellence in medtech parks. These facilities will form the hub design and development of newer technologies especially in the areas of infectious diseases round-the-clock, it allows for faster TAT and increases walk-away time.

AI and ML: It is interesting to note how the implementation of AI and ML in the IVD instruments is becoming the next big thing to watch out for!

AI tools aid in augmenting the accuracy of clinical decision and improving patient care.

On the other hand, ML can be used to predict out-of-control events in internal QC studies, detecting instrument failures before they even occur or

determining compatibility between analysers in central labs where several instruments running the same parameters are tested.

IoT and LIMS: With an increasing focus on offering value-driven services,

You have attained installations of 40,000 units of Erba analysers, in the last four decades. What are the key benefits, these analysers bring to the labs, clinicians and patients?

Adoption of the latest technologies, timely accessibility and affordability remain the biggest challenges of healthcare in India and the emerging markets. The Transasia-Erba group addresses these challenges by adopting the latest technologies from its European subsidiaries and manufacturing in India to meet the needs of the emerging markets. As a result, labs in India have

MEDTECH access to the latest European technology that is customised to India.

At Transasia, the focus is on offering total solutions across segments, be it instruments or reagents and backing it up with a well-knit sales and service network, the largest in the Indian IVD industry.

Our instruments and reagents are designed and adapted from time-to-time to offer robustness, accuracy and timely reporting to meet the needs of the customers in large labs in cosmopolitan cities as well as small labs in some of the most treacherous locations. As a result, more than 70,000 labs in India have a Transasia instrument and one test is conducted on a Transasia product every two seconds!

Tell us about how you overcome design challenges.

Do you have any best practices for reducing human error and offering reliable results?

As mentioned earlier, we take into consideration the needs of our customers to design solutions that are a hallmark of quality. We adopt various best practices that help us reduce manual intervention, automate the processes and bring in standardisation. All of Transasia’s products and manufacturing facilities are ISO certified. Transasia was the first Indian IVD company whose products received the CE certification to enter the European market. In fact, Transasia was also the first Indian IVD Company to receive ICMED certification the country’s first indigenous QA system for India manufactured medical devices. Additionally, Transasia is also the first IVD Company to be awarded the ZED Diamond quality rating from the Ministry of MSME, GOI and the Quality Council of India for its manufacturing facility at Mumbai. And just recently, the company’s manufacturing facility at Sikkim was awarded the gold certification. All the IVD instruments, manufactured at Transasia’s Mumbai facility

have been successfully registered under USFDA. Our products can now be marketed and exported to the USA. Transasia has one of the largest hematology reagent filling lines in India with a capacity of 30,000 Litres per day. This makes Transasia the first and only Indian IVD company to have a fully automated production line made of 316L stainless steel and meets GMP requirements. Specially designed for Erba range of hematology diagnostic reagents, the system is free of manual intervention, which ensures that reagents are consistently produced and are devoid of contamination.

The fully automated clinical chemistry range of analysers use hard glass cuvettes that reduce plastic usage making them environment-friendly while also lowering the CPT by eliminating the recurring cost of disposable cuvettes.

Transasia has recently upgraded its Made in India, fully automated clinical chemistry analyser, Erba XL 640 by integrating a Conveyor Rack System. The CRS allows for continuous flow analysis with automatic loading, mixing, pipetting of sample and reagent. This establishes more efficient workflows while minimising manual intervention.

Laura XL is a fully automated urine analyser, combining urine strip reading with digital microscopy powered by AI. This results in greater accuracy and more reliable results.

Considering the varying temperature and storage conditions in India, Transasia developed a next-gen lyophilised RT-PCR kit for detection of COVID-19. The kit has been engineered to improve detection and ease of use and is compatible with room temperature storage and transportation.

Another example of a design change is the ErbaLisa HCV Gen 4 ELISA kit, which is India’s first and only indigenously manufactured 4th generation kit for detection of HCV Ag + Ab.

While most Indian pathology labs perform HCV ELISA testing based on 3rd generation assay, 4th generation assay offers additional advantage for early and more accurate detection of HCV infection.

How will artificial intelligence and machine learning improve the efficiency of a clinical laboratory and the overall health of patients?

The COVID-19 outbreak has been an accelerator in the adoption of digital technologies in laboratories. According to a recently published report, several examples of applications of Artificial Intelligence (AI) to COVID-19 are already reported such as AI-enabled outbreak tracking apps, chatbots for diagnostics, AI-powered analysis of scientific publications and triage using natural language processing for screening potential patients and prognosis prediction tools, using radiology CT scans to manage system capacities, among others.

Do you think there are gaps at the policy level that still needs to be filled, for India to be more globally competitive, as a manufacturer and an exporter of IVD instruments?

While I applaud the government’s efforts in recent years to bring diagnostics and manufacturing in India in focus, there are still certain policy gaps that can be filled: PLI scheme: It is a good start and will incentivise domestic manufacturers to engage in high value production. It can make Indian manufacturers globally competitive, attract investment in the areas of core competency and cutting-edge technology; ensure efficiencies; create economies of scale; enhance exports and make India an integral part of the global supply chain.

However, currently, the PLI scheme offers incentive of just 3-5 per cent for IVD industry.

Such low incentive is too small to make India a global player.

There is a need to increase the

PLI incentive to atleast 15 per cent for five years to help local manufacturers become global players.

GST rates on diagnostic equipment: There is an urgent need to revise GST rates for the essential diagnostic equipment, from the current 18 per cent to 5 per cent. The introduction of GST has worked against Make in India, as it has led to imported devices being cheaper by 11 per cent. In addition, there being no import duty on blood analysers, makes it difficult for the Indian manufacturers to compete with the cheaper imports. The interests of the domestic manufacturers need to be protected through a revision in the GST regime so that not everyone gets the benefit of input credit. While the government has exempted the healthcare services and hospitals from GST, the taxation on the medical supplies and devices, ultimately is a hindrance in bringing down the cost of treatment. The common man can get some relief from this burden by a reduction in the GST rate on medical supplies, diagnostic equipment and devices.

Import Duty: Even now, the import duty on several raw materials is higher than that on finished products. In fact, India's import duty is the lowest among BRIC countries, at zero to 7.5 per cent - making it cheaper to import devices rather than encouraging home-grown, cutting-edge technology Indian devices.

This should be raised to 15-20 per cent, as lower import duties dissuades manufacturers from producing them in India. To reduce the dependency on imports, we expected the government to provide reasonable tariff protection for enabling Make in India.

Preferential Purchase Policy for locally manufactured medical devices: Government of India has recently introduced this well-intentioned policy.

However, its implementation is extremely slow and ineffective. Government of

India should implement it not only for Central Government departments but make it mandatory for all State Government purchases as well.

Development-Linked Incentive (DLI) Scheme: As medical devices industry is highly technology oriented, it is important for India to not just to manufacture instruments but also develop necessary technologies for it.

Just like the PLI scheme, the Government should support R&D by introducing a Development-Linked Incentive (DLI) Scheme to encourage companies who are investing in R&D in India and filing design and project patents in India. Building R&D infrastructure needs huge amount of investment and we expect the Government to provide 200 per cent weighted tax deduction on expenditure made on R&D of medical devices.

Encouraging exports: At present, there are zero incentives on exports.

Introduction of export incentives would help manufacturers take care of the high investments in cost of land, labor, financial and R&D cost and this can then be used to encourage their growth engine and boost up their sales in export markets.

In parallel with the regulatory approval process, tell us about Transasia's preparations for developing newer technologies for disease diagnosis.

To start with, Transasia is expanding its manufacturing and R&D base by setting up dedicated centres of excellence in medtech parks.

These facilities will form the hub design and development of newer technologies especially in the areas of infectious diseases and TTIs. In addition to introducing new and advanced diagnostic systems in CLIA, Molecular, high-end hematology, AI, LIS, etc, we will soon be launching a very innovative and affordable ‘Total Solutions in Laboratory Diagnostics.’

EXPRESS HEALTHCARE

25

August 2022

EDUCATION I N T E R V I E W

The pandemic has given a panoramic view of inadequacies in the Indian healthcare sector UPES School of Health Sciences & Technology recently signed an exclusive partnership with Wipro GE Healthcare to jointly launched the B.Tech Biomedical Engineering program at UPES, Dehradun. Assistant Professor Smriti Arora, UPES School of Health Sciences and Technology in an interaction with Kalyani Sharma talks about this collaboration and its key objectives What are the major highlights of this exclusive partnership between UPES and GE Healthcare?

This exclusive partnership provides solutions to existing challenges that biomedical engineers face: Lack of infrastructure and hands on experience to be industry ready professionals: A ‘UPES X GE centre of excellence’ has been set up by GE Healthcare at the UPES campus. There will be intense training on diagnostic devices such as X-rays, CT/MRI images, ventilators, anaesthesia, and ECG machines will be rendered jointly by experts at UPES and from GE Healthcare. Students can operate/fix technical errors and also set parameters relevant to the human body.

Landing the first internship: The first internship is the hardest to find, and that has been a key challenge in the past for biomedical engineers based on reviews. This collaboration provides a one-month internship to all incoming biomedical engineers in the 7th semester at GE Healthcare’s The John F. Welch Technology Centre, Bengaluru, besides the hands-on training at the centre of excellence at UPES. GE Healthcare will also interview few with exceptional candidature as potential employees.

Bring out specialised biomedical engineers: The joint B. Tech UPES-GE biomedical engineering program has its curriculum benchmarked against international universities Harvard, Stanford, Michigan Tech, and several Indian IITs.

26

EXPRESS HEALTHCARE

August 2022

medical devices, medical robots, and Industrial design and ergonomics. These specialisations overcome the ‘jack of trades and master of none’ stigma associated with existing biomedical curricula.

The collaboration also intends to promote entrepreneurship in the country using incubator set up at various universities, such as the Runway incubator at UPES. This would promote R&D and manufacture of medical devices in India, paving the way towards building a more self-reliant India The curriculum is a blend of core engineering courses, computer science, elements of design, and courses in biology.

Minors are offered where students can specialise in one of the three branches: Engineering assisted design of

What do you aim to achieve with this partnership? What is the objective behind this collaboration?

UPES has ensured experiential learning to raise industryready professionals. The collaboration tends to do the same as the medical device industry is envisioned as a sunrise sector endorsed by several schemes under the honourable Prime Minister’s ‘Make in India campaign.’

MedTech parks have been launched in several states, including one in Noida, Andhra Pradesh, and Chennai, with one due in Nalagarh in Himachal Pradesh. India stands in the fourth spot in Asia and amongst the top 20 in the world as a medical device market. And with this, jobs in the medical device sector are on the rise. While one aim is to meet this increasing demand for biomedical engineers; the other is since GE Healthcare is one of the biggest medical device companies with a focus on research, the students would get an opportunity to align projects with the vision of the company and work with them to meet unmet medical needs. In India, industry and academia run in isolation; this collaboration would seal this gap with both teaching and research being conducted jointly by academicians and industry experts.

The collaboration also

intends to promote entrepreneurship in the country using incubator set up at various universities, such as the Runway incubator at UPES. This would promote R&D and manufacture of medical devices in India, paving the way towards building a more self-reliant India.

The pandemic has highlighted the crucial role of R&D and industry-academia collaboration. Which all parameters need attention to strengthen this? Can you highlight the same?

The pandemic has indeed given a panoramic view of inadequacies in the Indian healthcare sector. Insufficiency of clinicians, biomedical engineers, and medical devices such as medically equipped ambulances, respirators, ventilators, ergonomic patient beds, MRI/CT, X-ray, RT-PCR to calculate viral loads and experts to deal with and retrieve data from these devices was unearthed. India imports medical devices such as ventilators, oxygen cylinders, air purifiers, etc.

India is the largest importer of medical devices and medical electrical equipment, with 86 per cent of devices being imported. Another huge revelation was that of educational institutions and industries working in isolation.

Indian academia was unaware of the needs of industry and vice versa. In terms of healthcare, a lot of unlearning and learning was expected. An upskilling of life science professionals with the knowledge and use of diagnostic devices such as MRI/CT scans, X-rays, and

ventilators was expected by the industry, hospitals, and even households. As a country of billions and fear of the pandemic still looming large, we need to be future-ready and build institutions or strengthen institutions that hold industry accountability, embed industry early and often, and create value-based education.

With the digitalisation of healthcare, demand for skilled professionals who can run these platforms is also rising and an unanswered bell. Some organisations, such as NITI Aayog, are trying to bridge the industry-academia gap, but the opportunities for publicprivate partnerships are still few. To summarise, for upskilling of the workforce to the needs of industry, more industry-academia connect, in particular medtech companies, hospitals, and NGOs need to work in concert to work on the

five A’s that define challenges to healthcare in India – awareness or the lack of it (education in particular in health science and allied courses), access or lack of it (rural versus urban healthcare reach differs), absence of skilled workforce during a crisis, affordability of healthcare, and accountability (of each of these partners).

What are the major challenges and opportunities as far as scaling up the level of skill development in healthcare in India is concerned?

As mentioned, the five challenges to Indian healthcare are awareness or the lack of it, access to the lack of it, absence of skilled workforce during a crisis, affordability of healthcare across India, and accountability. The same are also opportunities to work on

and build a healthier India or at least a country with better healthcare infrastructure.

Some more challenges are: ◆ Lack of knowledge about Indian healthcare regulations. ◆ Significant medtech device imports into the Indian market, resulting in no upskilling or R&D in India. ◆ Fewer government programs and funding opportunities for private institutions related to healthcare. Healthcare is integrated with other schemes such as Make in India and Ayushman Bharat, and there are no separate schemes for the healthcare sector.

Some of these challenges can be turned into following opportunities: ◆ Economic freedom to institutions that provide healthcare courses ◆ Increase in the availability of expert healthcare

professionals ◆ Government’s accountability and thrust on research and development in the country in both public and private setups.

What is the need to upgrade India’s medical education with advanced training programmes to meet the growing needs of the healthcare industry?

The following areas require upgradation to improve Indian healthcare: Skill development: Skill development training/upskilling must be done as per the industry’s demands. The areas that need to be worked on include clinical research, drug delivery, Six Sigma technique in medtech, regulatory science, AI/ML in healthcare, biodata analytics and predictive analysis, and intellectual property rights, which are industry relevant

and can boost the employment and start-up environment in India.

Launch of interdisciplinary/ transdisciplinary schools and programs: Healthcare is no longer about the mixing of compounds. It requires interdisciplinary faculty and training from science, engineering, and business who can work together on same platform and deliver affordable products to the market.

Industry-academia partnership: A strong industry-academia connect will help students work on realworld problems. The fund flow from the industry would be smooth as academia would work on industry-related problems, and students would get exposure to the technologies that are much in demand.

Kalyani.sharma@expressindia.com journokalyani@gmail.com

EXPRESS HEALTHCARE

27

August 2022

DIAGNOSTICS

Penetration of diagnostics in rural India: Need of the hour Ankur Gupta, Associate Partner, Singhi Advisors stresses that diagnostics have indeed been available for quite some time now. Still, their penetration into rural areas has been minimal due to a lack of education and awareness among people about using these tests for prevention purposes

D

iagnostics play a crucial role in the early identification of diseases and treatment. The proper diagnostic support at an early stage can save lives, maintain health status and prevent further complications. However, most rural areas do not have access to such services due to a lack of infrastructure, last-mile connectivity and subsequent scarcity of doctors. Thus, there is a need to bring diagnostics closer to rural populations through innovative methods so that more people can benefit from them.

of knowing that it exists unless they hear about it through word-of-mouth.

When they get to the hospital, they will likely find long waiting lines to consult the doctors, who may not even speak their language.

Most people in rural areas don’t know what symptoms mean when it comes to their health concerns—they simply know what happens when things go out of hand. They neither have the privilege nor the knowledge to deal with the early symptoms that appear at the onset of common diseases. National Health Mission (NHM) has progressed toward providing access to free primary diagnostics.

However, there’s still a long way to go as the median availability figures are as low as 19 per cent in the basic primary care facilities.

Situation in India As per the UN, India is the world’s second-largest country in terms of population, with over 1.4 billion people 2022 living across its vast expanse. India is home to over 17 per cent of the world’s total population, more than any other country on earth.

The country has the world's largest rural population and holds the highest number of people living in poverty in its urban areas.

While it ranks third on global poverty lists, with around 6 per cent of the population living in poverty in 2021 as per World Poverty Clock, India has some unique challenges that make it difficult for medical diagnostics to penetrate rural areas. This situation must be addressed if healthcare is to improve for all Indians.

Accessibility of diagnostic services in rural India In rural India, diagnostic centres are few and far between.

The population is dispersed over large distances, and the average person has to travel

28

EXPRESS HEALTHCARE

August 2022

Role of diagnostics

Diagnostics don’t just help doctors to identify the cause of the disease but help them single out the root disease at a stage when it can easily be treated.The importance of diagnostics cannot be underestimated in India, where most people live in rural areas where medical services are not as accessible many miles to visit a hospital or clinic. Even those who have

access to a diagnostic centre in the rural areas have no way

Diagnostics are an essential component of the treatment, prevention and management, which can have a significant impact on: ◆ Early detection and treatment ◆ Prevention of diseases ◆ Disease management & effective cure

Lack of access to primary diagnostics in rural India has a significant impact: ◆ Major cause of avoidable disability, from lack of or delayed treatment ◆ Cause of loss of productivity, and poverty ◆ Leading cause of deaths ◆ It results in half of the patients not being treated for racer conditions (hepatitis, hypertension, HIV, diabetes, malaria and TB)

Need for diagnostic intervention at an early stage Diagnostics don’t just help doctors to identify the cause of the disease but help them single out the root disease at a stage when it can easily be treated. The importance of diagnostics cannot be underestimated in India, where most people live in rural areas where medical services are not as accessible. In fact, diagnostics has been identified as the most critical aspect of ‘cascade of care’.

Diagnostics have indeed been available for quite some time now. Still, their penetration into rural areas has been minimal due to a lack of education and awareness among people about using these tests for prevention purposes.

While, the recent pandemic has significantly contributed both in raising awareness in care seekers and care givers in the rural India inclusive ‘Bhaarat’, it will still require the government willl have to shoulder the burden and create initiatives to improve the general well-being of its citizens and to be prepared for adverse cases while giving everyone a fair chance for healthy survival.

Way forward In the end, I would like to emphasise that the need for diagnostic services in rural India is more than ever and if we indeed want to reduce morbidity and mortality rates across our nation, we are in dire need of adequate health care initiatives. We need to provide primary diagnostic facilities in all nooks and corners of the country, especially where such services are arduous to come by.

Self-testing in India: Bane or boon Dr Shivali Ahlawat, Head- National Reference Laboratory, Gurugram & Head- East & South Regional Labs, Oncquest Laboratories talks about the factors responsible for the growth of selftesting kits in India

T

he Indian self-testing kits market has been driven by certain factors like the increasing concerns and general awareness regarding the early diagnosis of diseases.

The self-testing market in the country has been valued at $421.49 million in 2021 and is predicted to grow at a Compound Annual Growth Rate (CGAR) of 7.29 per cent during 2023-2027 to become a market worth $767.36 million by 2027.

urine analysis, COVID-19 testing and others, blood glucose testing dominates the self-testing market with 39.52 per cent. India has the second-largest diabetic population. However, the rising prevalence of cardiovascular disorders has also led towards a significant increase in the cholesterol testing segment. The ongoing pandemic has also jolted the demand for COVID self-testing kits. Another growing segment is self-testing kits for pregnancy, popular among women all over the world.

Factors responsible for growth The widespread turmoil following the outbreak of the novel coronavirus has escalated the demand for self-testing kits, mostly due to concerns relating to hospital acquired infections and cross contamination. The rising prevalence of the chronic disease across the country and the general populous’high susceptibility to infectious diseases has been another major booster in promoting the culture of selftesting methodologies.

Most frequent diseases for which people tend to prefer regular self-monitoring include diabetes mellitus, cardiovascular illnesses, COVID-19, renal and urological disorders, etc. Especially, patients suffering from type 1 diabetes which affects around 76 million people in In-

Prone to inaccurate results

dia require monitoring their blood glucose levels at regular intervals to alter their insulin dosage. Some of the leading causes of diabetes among Indians like obesity, particularly central obesity and increased visceral fat owing to physical inactivity, as well as high-

calorie/high-fat and high-sugar diets can be self-monitored and the symptoms of it can be selftested, owing to the advancements in medical science.

While the type of self-testing in India can be split into blood glucose testing, pregnancy & fertility testing, cholesterol testing,

Based on the intended use, the Indian self-testing market can be further divided into disposable and reusable kits, with disposable kits more frequently used by people due to the increasing health and hygiene concerns. The reusable kits require more care and attention to handle since only diseasespecific tests are performed through them.

Though the market of selftesting kits and its acceptance among people is steadily growing, most medical practitioners advocate against self-testing for the diagnosis of diseases; the primary reason being the inaccuracy of the results that might come out of the kits. Also, most patients using self-testing kits

are unaware of how to administer the tests through the technical tools and also might find difficulty in interpreting the data, which might result in further inconvenience for the patients. By misinterpreting the data from self-diagnosis, patients can also get misguided regarding a disease or be unable to detect it.

Not good alternative to labs Specifically, in case of self-diagnosis of COVID-19, many kits had been made available in the market, but the common observation has been that while the kits have shown good accuracy for positive results it has been very much misleading in case of a negative result. Doctors have stated that the rate of false negative has been as high as 10 to 15 per cent and one should always get the results reconfirmed through a RT PCR test even after found negative through self-test.

Even for pregnancy tests, while there had been more accurate results, home pregnancy tests might differ in the ability to diagnose pregnancy in women who have recently missed a period. Thereby, medical experts suggest that even if the test result is negative and the woman still feels pregnant, she should consult her physician and repeat the test in a laboratory.

EXPRESS HEALTHCARE

29

August 2022

DIAGNOSTICS

Wave of consolidation in diagnostics sector: Key imperatives Kaustav Ganguli, Managing Director, Alvarez & Marsal and Ram Panda, Senior Director, Alvarez & Marsal explains that there are significant opportunities to deepen the adoption of quality diagnostics in lower tier towns and cities as well as support the development of specialised testing centers or centers of excellence in the hub locations

T

he Indian diagnostics market is currently estimated to be 700 billion as of FY22. It has been growing at 13-14 per cent CAGR driven by increase in ageing population, rise in noncommunicable diseases as well as infectious diseases, upsurge in convenience and preventive wellness categories and emergence of direct-toconsumer channels. Worldwide as well as in India, there has been a massive shift in consumer ideologies in health management after the three substantial waves of COVID-19 and its rapidly mutating virus strains. This has accelerated the consumer propensity towards proactive management of health and wellbeing.

Need to exhibit high growth to sustain premium valuation: For more than a decade, pathology businesses have been lucrative to investors as this space offers significant headroom for rapid growth of organised market participants and is highly capital efficient. These industry traits meant the organised chains (listed or unlisted) were offered significant premiums on their valuations. To sustain these valuation premiums, the organised players would need to display high growth and sustainable margins over a long period of time.

Headwinds in the diagnostics sector: In the last five years, the diagnostics space has witnessed multiple headwinds. One, the industry has witnessed the rapid emergence of low-cost diagnostic providers and digital ecosystem players in the industry, who are disrupting the routine testing and preventive/wellness categories with their D2C sourcing and deep discounting vs. traditional

30

EXPRESS HEALTHCARE

August 2022

Kaustav Ganguli

Ram Panda

India is still a vastly under-tested and underdiagnosed market in comparison to most developed nations.There are significant opportunities to deepen the adoption of quality diagnostics in lower tier towns and cities as well as support the development of specialised testing centers or centers of excellence in the hub locations players. Secondly, in the maturing micro-markets in metro and tier 1 cities, there has been a discernible slowdown in growth. The key imperatives for traditional players to drive growth and sustain valuations are to expand beyond their core geographies, deepen the doctor network and develop a menu of specialised test offerings.

Mounting pressure on small regional players: At the same time, small regional players who have typically had 70 per cent+ of their revenues from routine tests are

also experiencing heightened competition from new-age players. Discounted pricing to compete with the new-age players, the need to offer convenience to patients through home collections and partnerships with aggregators for patient sourcing have led to pressure on both revenue and margins for unorganised labs and small-sized players. The pandemic has widened the gap even further with unorganised players struggling to operate in the first year of pandemic and large organised players benefiting from

COVID-19 and related testing during the pandemic.

Factors driving consolidation: Given this industry context, there are several factors that are driving the wave of consolidation in the pathology sector. The larger organised players who are cashrich and have faced challenges in driving organic growth in the recent past, are looking at inorganic opportunities to drive growth. This inorganic drive is well-timed, given the struggles of the smaller, unorganised players.

It will help them eradicate

roadblocks pertaining to growth, especially in lower tier markets which have not yet seen penetration by the new-age players. On the other hand, negotiating the onslaught of the new age models in leading metro or tier 1 markets will require the traditional organised players to develop deeper capabilities in specialised testing, some of which could again be acquired through inorganic routes.

Given the softening prices of listed assets and the headwinds that the sector has endured over the last 12 months, prices of smaller acquisition targets are likely to be rational and that would make this an opportune time for consolidation. Post-acquisition valuation will be contingent on the ability of the organised players to drive successful integration and value creation.

India is still a vastly undertested and under-diagnosed market in comparison to most developed nations. There are significant opportunities to deepen the adoption of quality diagnostics in lower tier towns and cities as well as support the development of specialised testing centers or centers of excellence in the hub locations. With the largescale deal activity prevalent in the diagnostics space and advent of many new-age players, penetration of diagnostics is expected to increase. We expect many unorganised players to be gradually acquired by the larger chains or become a part of their sourcing and delivery network. Organised players will have to ramp up digital capabilities and expand their play in acute and specialised segments to stay relevant in the sector.

HOSPITAL INFRASTRUCTURE

How can the design of a healthcare facility impact patient recovery rates in India?

Ravideep Singh, Associate Director, Creative Designer Architects (CDA) emphasises that a growing body of evidence demonstrates that the built environment of healthcare settings – their layouts, materials, equipment and furnishings, and consequently healthcare architects play a vital role in preventing the transmission of pathogens

A

s civilisation battles through an unceasing threat of viral upsurges, healthcare providers across the country are beginning to acknowledge the significance of healthcare analytics and other crucial metrics such as patient recovery rates. Subsequently, it has become evident that access to these parameters can help optimise patient turn-around which would allow for higher resilience against adversities such as COVID-19. The acknowledgement of patient recovery rates as a crucial metric for determining healthcare quality is still in its nascent stages in India. In contrast, the west has a much higher degree of data and awareness on this phenomenon, that can potentially help us understand its relevance in the Indian subcontinent.

As several evidence-based studies suggest, patient recovery rates are a rationale of several factors, including high efficacy infection control, ingress of natural light and views to outside, controlled acoustics and friendly caregivers. Interestingly, healthcare facility design has a significant role in ensuring the success of these factors.

Hospital design and infection control According to the National Guidelines of Infection Control, 30 per cent of all ICU patients in developed countries are affected by an HAI (Hospital Acquired Infection) during the course of their hospital stay. The percentages are expected to be even higher in lower- and middle-income countries. In addition, a growing body of evidence demonstrates that the built environment of healthcare settings – their layouts, materials, equipment and furnishings, and con-

sequently healthcare architects play a vital role in preventing the transmission of pathogens.

IHFG (Indian Health Facility Guidelines) recommends a minimum distance of 2.45 metres between beds for maintaining asepsis – an environment free of disease-causing microorganisms. Additionally, evidencebased design (EBD) studies have also found patients in single rooms are at a significantly lower risk of acquiring HAIs. Further, ante rooms with efficient mechanical systems with ACH (air changes per hour) conformity can minimise the spread of infections. Similarly, another study suggests that strategically located hand-wash sinks and hand sanitisers (especially near patient areas) have promoted handwashing amongst the caregivers enabling better infection control within the facility.

sign of the medical facility also impacts patient recovery. A study conducted in 2018, ‘The effects of natural daylight on length of hospital stay’ (PubMed), found that patients with beds near the windows had significantly shorter hospital stays than patients with beds near the door, in a sample size of 87,351 patients. Optimal natural light and views to the outside have been found to stimulate patients' positive immune responses, resulting in expedited recovery. EBD studies have also found slower recovery rates in patient rooms oriented towards the west, perhaps due to a patient’s psychological and circadian responses to the optics of a setting sun. Additionally, larger windows with potential views of nature promote biophilia along with the therapeutic effects of nature.

Natural light and views

Acoustics and stress and caregiver satisfaction

Besides innovation and upheaval in medical technology, the de-

Environmental acoustics are one

of the most prevalent stressors in healthcare facilities today. The ramifications of poor acoustics affect both the patients and caregivers alike. In hospitals and respite environments, a patient’s recovery is heavily dependent on the quality of sleep. Patient recovery becomes difficult when operating without adequate noise control measures or consideration for acoustics and noise transfer issues as sleep is more disturbed. Disruptions and poor sleep quality ultimately cause a noticeable reduction in healing. Interestingly, controlled acoustics also minimise stress amongst the caregivers, enabling them to better focus on the patients' individual needs, eliminate medical errors, and render quality care. Employing the right materials and finishes, like sound-absorbing ceiling tiles along with strategic spatial planning can result in minimising stress and overall patient and caregiver satisfaction.

Psychology of colours Colours play a significant role in improving patient recovery rates and also enhance the caregiver's efficiency and visitor’s experience. For instance, ‘Healing Colours’ such as whites, greys and light browns are used to imbue a soothing effect on the residents and visitors. This palette consists of neutral and calming colours, wherein the green colour symbolises health with its biophilic connotations. When used in healthcare design, biophilic green can be employed alongside light wood and whites to elevate the patient and the visitor's experience. In contrast, Paediatric hospitals, designed for children’s health, should attain a balance between colourful and calming tones. A combination of vibrant orange and calm-

ing blue achieves the equilibrium of vivid and soothing interiors suitable for children.

Improving indoor health Following the COVID-19 pandemic, precautions around indoor health have increased.

Healthcare designers take special consideration for sensitive hospital environments that are more prone to infections. The indoor air has a lasting impact on patients’ health and recovery.

The inclusion of Minimum Efficiency Reporting Values (MERV) -13 or higher media filters during the design phase can help reduce the spread of airborne viruses. Additional carbon filters installed in existing mechanical systems can also ensure improved indoor air quality.

Moreover, the designers must also focus on selecting low Volatile Organic Compounds (VOC) paints, finishes, and safe cleaning chemicals that comply with health and safety standards. If contaminated, water can also become a disease vector. Therefore, it must be ensured that the healthcare buildings have carbon filters for healthy and potable water. Ultraviolet Germicidal Irradiation (UGVI) filtration also helps eliminate harmful microbes and bacteria and keep water quality in check.

The design of the built environment, especially hospitals and medical facilities, is undoubtedly one of the most significant factors of patient health, safety and experience. Today, healthcare architects are using such principles of evidencebased design along with the learnings from the pandemic to push the boundaries of conventional hospitals in order to create safe and healing environments.

EXPRESS HEALTHCARE

31

August 2022

HEALTHCARE IT

HowAI is helping healthcare contact centers to be more efficient?

Amit Gandhi, Founder, NovelVox explains that AI in healthcare has become a reality and brought about significant changes in every realm, be it making doctors across the globe accessible and cutting down on wait time with live tracking of appointments, leading to efficient diagnosis

H

uman beings developed machines to make their work easier. Over the years, with the help of technological innovations, they have created technologies and their various subsets that can work with minimal human intervention.

After testing success with automated machines, the next big step was to interlink Artificial Intelligence (AI) with machines. Though the latter could only function with a human brain behind, it marred the purpose of chores getting done automatically. For this reason, AI has become a field with top innovations. Programmed to simulate human intelligence and to think while mimicking human actions, AI has come a long way. Restaurants being managed by robots, classes run by robots, nurses as robots, and contact centers of healthcare are examples of AI finally infiltrating normal lives. The future belongs to AI, with newer avenues opening up.

AI has already taken over the healthcare sector, especially the contact centers.

Nowadays, one can easily book appointments, order medicines, book diagnostic tests and get reports with the help of apps that run on AI. According to a detailed study, global AI in the healthcare market was valued at USD 10.4 billion in 2021 and is expected to grow at a CAGR (compound annual growth rate) of 38.4 per cent from 2022 to 2030. AI, combined with machine learning algorithms is being increasingly used to diagnose illnesses at an early stage, to provide early diagnosis and treatment, which is the biggest boon to mankind.

32

EXPRESS HEALTHCARE

August 2022

To automate everything,AI can help the contact centers of healthcare units like hospitals and diagnostic centers.

Appointments with doctors or for tests like MRI, CT scan etc can be booked through apps, cutting down on wait time In the fast-paced world, getting an appointment with a doctor and getting a correct diagnosis is a big challenge.

Even after booking prior appointments, patients wait for long hours for their turn due to staff shortage, every patient seeking more attention, and mismanagement on the part of the hospital. Some patients,

especially those who come for follow-ups, need not require one-on-one consultation and could have been fine with an online consultation too. These barriers prevent patients from accessing healthcare unless it is urgent, crucial and the pain is not being managed.

To deal with these and many more such issues, AI

and machine learning is the answer. Optical Character Recognition (OCR) technology that enables one to digitise the doctor’s handwriting is being extensively used nowadays.

Deep learning models built on machine learning can interpret medical images like X-ray, MRI, CT scan, etc., to perform diagnoses. The algorithms compute and can detect anomalies in medical images, including cancer. AI, on the other hand, can cut down on waiting lines with the use of Natural language processing.

This enables the patient to communicate in various languages, while the AI machine converts it to text, enabling auto diagnosis by it or by a doctor, which will take less time, thereby shortening the queues. Chatbots are another innovative app feature that enables one to access medical help at any time from the convenience of the patient’s home.

So, earlier when a patient suffers the entire night till morning for lack of availability of a doctor while suffering from fever or stomach ache, can connect with a chatbot and get instant medical advice.

Not just this, but AI in the healthcare sector has immense potential. The healthcare contact center industry has been revolutionised. To automate everything, AI can help the contact centers of healthcare units like hospitals and diagnostic centers. Appointments with doctors or for tests like MRI, CT scan etc can be booked through apps, cutting down on wait time. AI can also help analyse unstructured data, helping pick out rush hours, where more doctors can be put in to ease the rush. This data can also assist

emergency medical staff, enabling them to deal with crises promptly. When information is available in an organised manner, the usage of electronic health records can be reduced, curbing e-waste, apart from paper waste. AI in healthcare and contact centers is set to revolutionise clinical decisions, as a patient can access the best doctors, get a second opinion when needed from the comfort of their homes. It will also decrease the cost of developing medicines.

AI in healthcare has become a reality and brought about significant changes in every realm, be it making doctors across the globe accessible, cutting down on wait time with live tracking of appointments, leading to efficient diagnosis, innovation in the drug development sector, e-inventories at every step helping in going paperless as well as making information available to various stakeholders.

Healthcare contact center is one industry where AI has made the biggest impact. Today smartphones have turned into a powerful diagnostic tool, which enables access to healthcare across the globe.

Parallelly, they have also enabled people from remote areas and developing regions to access world-class healthcare.

All this has been possible only because of AI in the healthcare contact center industry.

While it is still nascent, there is tremendous scope to grow and the next five years will bring about many more changes. From where we look at it, the future of AI is very bright, and the world is moving everyday to ensure that both are moving at the same pace, to gain fully from it.

Importance of digital marketing in healthcare sector Dr Sanket Agrawal, CEO, House of Doctors explain in detail how healthcare is also getting more organised, digital media is playing a significant role in creating a brand presence

L

ike other sectors, healthcare too is rapidly transforming.

Currently, mobile apps, software supporting physicians’ clinical decisions, artificial intelligence, machine learning, telemedicine, Internet of Medical Things (IoMT), and digital transformation in the Healthcare sector will allow one to get easy access to diagnosis and treatment even at their homes. Good health is just a click away due to digitisation.

It is a known fact that the digital transformation of the healthcare industry has the ability to help doctors, hospitals, and organisations to treat patients so that they can live longer and disease-free. In such a scenario, there is more important to market your healthcare services digitally rather than the traditional way of marketing.

Why we should move more towards healthcare digital marketing? ◆ Digital marketing makes sure that you stay connected with current and new patients whenever they are in need. ◆ People opt for online health-

and can track down any info, trend, or happenings easily. ◆ Ability to target particular demographics. ◆ Most health service seekers are college-educated and understand the value proposition of a healthcare brand.

Other important benefits of digital marketing

care services because they can get instant responses and communicate with specialists from their comfort environment at their convenient times. ◆ Consumers trying to reach physical therapists, nursing homes, and optometrists tend to connect to healthcare providers after performing a search. Similarly, social media platforms are also playing a pivotal part in generating a

prospective customer base when it comes to healthcare.

Digital marketing has an upper hand over traditional marketing ◆ Prospective patients and/or their relatives hand around online. ◆ The use of mobile devices has risen. ◆ The digital metrics track down system is very powerful

◆ Cost per patient acquisition: Patient acquisition cost significantly goes down in the case of digital marketing as the target audience is in bulk. ◆ Location-based targeting: One can select the particular location where their presence is significantly marked, at the same time they can explore other locations by giving them chance by using target-based demographic services. ◆ Data-driven decisions: Healthcare marketing is not a new thing in the market. Many have used these services for time and their performance data is well available to the agencies. Apart from its target data can be fresh and can be acquired from various platforms. ◆ Better reach and visibil-

ity: Wide visibility across the platforms is one of the key benefits of digital marketing.

One should consider the following aspects of the smart digital marketing plan ◆ Plan for local Search Engine Optimisation (SEO): SEO and user experience go hand in hand. An efficient local SEO strategy will help in meeting your business goals. ◆ Consider PPC (Pay Per Click) advertising: PPC is an advertising service implemented by search engines, social media, and other platforms where you only have to pay when a lead clicks on your ad. It is also a good move ◆ Social media marketing: There are multiple social media platforms and there are various ways of social media marketing such as video ads, GIF ads, ad posters, success stories, etc. ◆ Invest in email marketing: If you want to maintain a healthy, near-direct relationship with your patients, email marketing is one of the most cost-effective ways to achieve this goal.

EXPRESS HEALTHCARE

33

August 2022

INSURANCE

The insurtech disruption and what lies ahead Dr Suman Katragadda, Founder & CEO, Heaps.ai explains how technology can make health insurance truly accessible to as many people as possible and better the country’s overall healthcare ecosystem

W

e know that over the past decade, technology has been a disrupting force across industries. It has created new ways of doing business and transformed previously stifled industries. This is especially true for the insurance industry which has witnessed a boom in tech intervention, resulting in the concept of insurtech. A combination of two words, insurance and technology, insurtech continues the trend that was started by fintech and applies it to the insurance sector. The health insurance segment has particularly benefited from this tech-led surge as estimates suggest that nearly 672 million Indians will be covered by health insurance by 2025.

However, these numbers still account for less than 50 per cent of the country’s vast population. Hence, the questions that now remain are-how can technology make health insurance truly accessible to as many people as possible and can it better the country’s overall healthcare ecosystem?

Most insurtech players today are focussed on providing aggregation services that aim to improve discoverability and accessibility. Such platforms measure success based on the volume of services pushed out to the public and a lot of focus is placed on marketing and ad campaigns. Hence, there is little to no innovation taking place when it comes to truly disruptive change such as creating models that leverage the power of digitisation, AI and machine learning to connect hospitals with insurers. Currently, insurance processes and patients’ hospital records are still heavily paper-based, making the entire industry archaic and slow-moving.

Claims adjudication, insurance underwriting and all other related procedures con-

34

EXPRESS HEALTHCARE

August 2022

Currently, insurance processes and patients’ hospital records are still heavily paper-based, making the entire industry archaic and slowmoving. Claims adjudication, insurance underwriting and all other related procedures continue to be fairly manpower intensive tinue to be fairly manpower intensive. This has led to a lack of customisable pricing, real-time data, and speedy processing of claims, resulting in an overall trust deficit be-

tween insurance providers and customers. In order to change this, insurance companies have to place a renewed focus on developing their middle office.

The insurance middle office and why it holds the key?

Traditionally, insurance front offices work on marketing, ads and sales campaigns, while

back offices work on processing insurance papers trails and other administrative processes. However, most companies do not have fully developed middle offices that can function as value-added centres. Middle offices have the potential to work as nerve centres of insurance companies because they can work to manage the risk of policyholders better and minimise unnecessary claim payouts. How can this be done? The simple answer to this question is by assessing each patient individually and analysing their case history, medical conditions and hospitalisations in a thorough manner so as to determine differentiated risk.

Complex patients, patients with at-least 3 or more chronic conditions, account for majority of the claim payouts for the insurance companies. These are the policy holders who typically have a lot of care gaps and also have higher incidence rate of hospitalisation. If insurance companies can invest into developing analytical engines that can give an idea of a patient having such care gap proactively, suitable interventions can be initiated to ensure the care gaps are addressed and eventually control the rate of hospitalisation as well to get down the overall claim payouts.

Insurance companies are, thus, in need of leveraging a new kind of insurtech - one that will use technology to do more than just aggregate and compare policy offerings. It needs to develop superior tech-enhanced capabilities that can form a thriving middle office, thus leading to connected models that are capable of communication and data interpretation. Only then can insurtech create a true revolution in India’s healthcare ecosystem.

STRATEGY

Healthcare marketing today: Hyperlocal and highly personalised Spriha Biswas, CPO, Augnito talks about the latest trends in healthcare marketing and highlights that going forward, healthcare marketing will experience innovation that is directly correlated to the exploration of tech in medicine Crowdsourced authenticity

W

hile the country’s healthcare system has been witnessing a revolution in the past decade, the trajectory of the sector’s marketing landscape has also undergone a seismic shift. Gone are the days when healthcare relied on satellite advertisements, or other traditional forms of communication to showcase their offerings to an uninitiated audience. Today’s consumer is well informed and has access to more information than before. In a post-COVID world, patients are almost akin to consumers, looking for the next best thing that will positively impact their health.

Rapid growth

By FY22, Indian healthcare infrastructure is expected to reach US$ 349.1 billion. The industry itself is touted to increase 3x, with a CAGR of 22 per cent between 2016–2022 to reach US$ 372 billion this year.

The hospital industry is expected to reach $132 billion by 2023 with at a CAGR of 16-17 per cent. This exponential growth is in some part due to the increasing domestic and international investment in the healthcare industry to fuel innovation. The Indian government too is implementing policies to support the industry such as lowered GST on clinical trials and research, permitting 100 per cent FDI on certain projects, etc. Start-ups especially are a driving force with more healthcare businesses gaining unicorn status year on year. Medtech is touted to reach a whopping $50 billion by 2025.

This is also testament to rapid increase in diverse medical services offered as seen in diagnostic solutions, pathology labs, telehealth, virtual medicine, home care providers, etc.

In order to resonate with potential patients, today’s successful marketing strategy leverages the power of storytelling to engage audiences on social media.

Eventually, traffic converts to an audience base which results in direct sales With the advent of 5G and growing smartphone penetration in India, digitisation has already permeated every aspect of our lives. India has 646 million active internet users as of December 2021. And social media has emerged as a recourse to the isolation caused by the pandemic. So, it’s only natural then healthcare marketing has

adopted a digital-first approach with a heavy skew towards social media. Today’s healthcare marketing techniques are highly customised, engaging and almost always have a call to action that translates into sales. Essentially, healthcare marketing has become more consumer-driven than ever before.

In addition to reaching a wider audience at a fraction of the cost and effort, another huge driver for social media-driven healthcare marketing is the trust consumers have in crowdsourced reviews of services rendered. Whether it’s a doctor at a world-class hospital or the technician who is conducting a home visit for a blood sample, reviews are pushing service providers to improve quality in order to attract more customers. Visiting a service provider’s website is perhaps last on a potential patient’s research journey. User experience, reviews, social media posts all come together before a decision is made.

Healthcare marketing’s primary goal, in this case, is to be able to communicate with consumers effectively to acquire patients and create long-standing relationships. In order to resonate with potential patients, today’s successful marketing strategy leverages the power of storytelling to engage audiences on social media.

Eventually, traffic converts to an audience base which results in direct sales. In this arena, video marketing has proved to be a forerunner that has efficiently resulted in growth for healthcare businesses. Other effective methods include sponsored posts, paid promotions, reputation management, regular engagement initiatives, influencer collaborations, etc.

Service providers have to prove the quality of their offerings instead of the reverse.

Future of healthcare marketing Going forward, healthcare marketing will experience innovation that is directly correlated to the exploration of tech

in medicine. One such advance is the integration of Artificial Intelligence (AI) with healthcare marketing. An obvious outcome is precision marketing, i.e., highly customised communication determined by the analyses of behavioural data to grow returns on investment and increase customer acquisition, retention and reactivation. Then there’s voice search, as people are increasingly shifting from manual internet inputs to find healthcare services close to them.

With adequate investment, AI will soon create content too for newsletters or appointment reminders, policy renewals, etc or replace human interaction for troubleshooting through chatbots that will be at the beck and call of a patient.

As AI continues to evolve, there is widespread curiosity over healthcare’s role in the near-future decentralised world of Web 3.0 that will harness technologies like IoT, and machine learning. This shift to Web 3.0 is being touted as a revolution that could successfully implement universal healthcare, a feat India aims to accomplish by 2030. Technology will greatly aid in bridging the healthcare gap. Similarly, engagement with consumers and potential patients will also need to successfully make the shift from Web 2.0 to adopt technologies like augmented and virtual reality to resonate with users of a decentralised web world.

As innovation progresses, one thing is for certain, healthcare’s consumerist outlook is here to stay. The future for healthcare marketing is hyperlocal and highly personalised.

It’s no longer about creating just awareness; but creating an experience that resonates individually.

EXPRESS HEALTHCARE

35

August 2022

BUSINESS AVENUES

36

August 2022

EXPRESS HEALTHCARE

EXPRESS HEALTHCARE

BUSINESS AVENUES

EXPRESS HEALTHCARE

EXPRESS HEALTHCARE

August 2022

37

BUSINESS AVENUES

38

August 2022

EXPRESS HEALTHCARE

EXPRESS HEALTHCARE

BUSINESS AVENUES

EXPRESS HEALTHCARE

EXPRESS HEALTHCARE

August 2022

39

BUSINESS AVENUES

40

August 2022

EXPRESS HEALTHCARE

EXPRESS HEALTHCARE

HEALTHCARE TRACKER

Agappe-The champion in specific protein testing crosses a major milestone Thomas John, MD, Agappe Diagnostics explains how about a dozen years ago, Agappe indigenously developed the first i-series of nephelometry equipments. The Mispa-I was commercialised in 20 with a very affordable price point, keeping Indian customers in view. On the hindsight, it was a true ‘Atmanirbhar’ breakthrough in Indian IVD

C

onventional visual latex method, which has drawbacks of its own, was employed to estimate roughly 35 per cent of specific proteins up until the start of the twenty-first century. The three primary types of visual latex procedures were normal visual technique, semi-auto latex method, and fully auto latex method. Higher capital cost of fully automated nephelometry was the primary reason of non-adoption of the technology till recently.

About a dozen years ago, Agappe indigenously developed the first i-series of nephelometry equipments. The Mispa-I was commercialised in 20 with a very affordable price point, keeping Indian customers in view. On the hindsight, it was a true ‘Atmanirbhar’ breakthrough in Indian IVD. Literally there has been no looking back. Soon after the first launch, Mispa i2 followed in 3 years’ time. Mispa i2 came with a novel “channel shifting technology”. It was priced at about /0th of the cost of thencurrent automated devices.

What really matched with other automatic nephelometry machines - be in terms of output and quality of results - was the system's 26 parameter testing capabilities. The Mispa i2 machine comes with a unique and clever smart card system for pre-calibration with built-in controls for open vial stability.

Customers appreciated its smaller footprint, attractive form factor, superior convenience and accuracy.

The classic latex method was superseded by the Mispa I series

by Agappe with the combination of nephelometry & immunoturbidimetry technology, offering a broad measurement range with

Agappe intends to soon launch Mispa i3 Plus with cloud-based technology so that we may get calibration data from the cloud and execute various applicationlevel modifications online great sensitivity and superior linearity at an affordable price.

With this, most medium-sized labs and many lower-end labs in rural India could own protein testing equipment with smaller

reagent pack sizes, affordable and appropriate for their lower daily workload.

The i2 found great acceptance in several international markets too. In 205, company

launched a cartridge-based revolutionary nephelometry system branded as Mispa i3.

This intelligent system is again built on smart cards. Each cartridge pack includes a pre-calibrated smart card.

To popularise testing of advanced parameters in medium and lower end labs, Agappe introduced numerous special parameters (in protein testing) with Mispa i3. These include vitamin-D, cardiovascular risk profile, allergy profile, COVID profile, diabetic profile, rheumatology profile, osteoporosis screen profile etc. The use of many test profiles enables lab technologists and clinicians to detect disease/s relatively quickly and improve patients' quality of life. Mispa i3 equipment is an ideal solution for medium or lower end labs with light workloads.

Cystatin C is a better marker than enzymatic creatinine, which helps to find early kidney failures. Cardiovascular risk profile includes hs-CRP, Lp(a), D Dimer, Apo A, Apo B. Diabetic profile includes HbAc and Microalbumin tests which can be easily estimated without any calibration at an affordable cost.

Increased or decreased levels of CRP, RF, ASO, Ferritin, PCT, C3, C4 due to infections or inflammation, by dint of viral or bacterial responses can be easily estimated with the advanced UCS technology used in Mispa i3.

Due to the immune responses in the body, test of elevated levels of IgG, IGA, IgE and IgM can be performed on Mispa i3 with zero reagent wastage and least reporting times.

New generation instrument automation with an affordable cost and convenient pack sizes for many special parameters dif-

ferentiate Mispa i3 from the rest.

With automation reducing manual errors and reporting time of about 5 minutes, Mispa i3 quickly became the market’s top choice in particular protein testing.

Mispa i series (i-2 and i-3) developed with patented technology today has well over 5,000 successful installations across the world.

Agappe intends to soon launch Mispa i3 Plus with cloud-based technology so that we may get calibration data from the cloud and execute various application-level modifications online. Agappe can provide improved online support for optimal equipment maintenance thanks to cloudbased technology. Considerable R&D efforts continue in house to provide future upgrades and substantial technological advancements to the i-series customers. Fully automatic cartridge based nephelometry equipment Mispa i4 is getting launched this financial year, however.

Let's work together to help humanity by offering highquality goods that will guarantee precise and trustworthy outcomes for quicker diagnosis and treatment.

Agappe takes pride in its innovations and introduces the most modern technology while maintaining affordable pricing thanks to state of the art scaled-up manufacturing capabilities. Agappe's mission is to be a key player in the country's initiatives to accomplish the millennium goals of "Health for All" by providing technologically cutting-edge, excellent, and affordable diagnostic equipment that truly embody the word "Agappe", the Divine Love.

EXPRESS HEALTHCARE

41

August 2022

HEALTHCARE TRACKER

Teleradiologyis a rapidlyexpanding discipline Navjot Singh, President – Medical Imaging, Trivitron Healthcare highlights the major parameters responsible for rapid expansion of teleradiology

T

eleradiology is the process by which a radiologist interprets medical images while not physically present in the location where the images are generated. It is used in hospitals, urgent care centers, mobile imaging companies, and even some private practices. It is the computerized transmission of medical imaging to distant locations for the purposes of consultation, review, or formal interpretation. The network technology may comprise LAN or WAN, as well as Internet access through VPN or cloud computing. Security and privacy must be maintained at the same level as ordinary data transmission and storage. In addition, imaging data must be transferred promptly utilizing an adequate bandwidth, and no clinically relevant information must be lost during transmission. Utilisation of strong communication and image transmission technologies to rely on the knowledge of remote radiologists may alleviate some of these issues. This approach of transmitting pictures to remote sites for interpretation and diagnosis is known as teleradiology.

Objective of teleradiology The objectives of teleradiology are diverse. Hospitals and other institutions that lack radiologists on-site may need emergency on-call study interpretations or the prompt assessment of tests. Groups of radiologists may employ teleradiology or outsource their calls to other firms. Additionally, sites might be provided in regions with a need for specialized radiologic assistance. Teleradiology may also be utilised to transmit pictures that have been interpreted to other providers for quality improvement or instructional purposes.

Teleradiology provides underserved hospitals with prompt access to a radiologist who acts as if they were there.

42

EXPRESS HEALTHCARE

August 2022

reasons: ◆ Demand and acceptance growth ◆ Increasing volume in emergency departments; ◆ Increasing emphasis on final reads and not preliminary anymore; ◆ Local organisations use teleradiology instead of hiring new radiologists; ◆ An increase in subspecialty reporting.

Importance of teleradiology

The objectives of teleradiology are diverse.Hospitals and other institutions that lack radiologists on-site may need emergency oncall study interpretations or the prompt assessment of tests.

Groups of radiologists may employ teleradiology or outsource their calls to other firms With the growth of Picture Archiving and Communication Systems (PACS) and business communication, teleradiology is now an integral aspect of a radiologist's life and may take on a variety of forms: Reporting from home for call coverage has enhanced the radiologist's experience by reducing the amount of time spent traveling to the hospital.

Large radiology organisations commonly use teleradiology not only to cover calls but also to pro-

vide subspecialty reports.

Teleradiology organisations offer teleradiology as a service, beginning with emergency service and evolving to specialised readings and day coverage. These organisations leverage time zones for remote reading, using board-certified radiologists stationed on different continents to give night coverage during their normal work hours.

Teleradiology is a rapidly expanding discipline for many

Partly due to the discrepancy between the demand for and supply of diagnostic services, teleradiology arose. In most countries, the high demand for radiology services often exceeds the number of in-house healthcare experts. While the number of scans done are seeing a significant rise, there remains a persistent scarcity of radiologists.

The absence of fast diagnostic services creates significant difficulties for physicians during crises and at night. The fast availability of diagnostic services, which is crucial during medical crises, is a major benefit of outsourcing. Night reporting outsourcing is generally known as "nighthawking."

A second reason for the expansion of teleradiology is that the majority of rural areas in India lack adequate radiological services and people. This disadvantage may be remedied via teleradiology by utilising the assistance of more experienced professionals in major urban areas. Even in urban locations, not all imaging institutions have specialised competence; complex situations in certain fields of radiology may be sent to specialists for their evaluation.

Trivitron Healthcare’s mobile digital radiology solution - Ultisys 3.5 with integrated PACS Mobile X-Ray system Ultisys 3.5 by Trivitron Healthcare is

a comprehensive and versatile mobile radiography system that is easy to use and has well-proven features for streamlined operation due to which it has been receiving overwhelming acceptance throughout the healthcare ecosystem.

Ultisys 3.5 is designed for radiographic imaging in different healthcare centers and different clinical specialties like radiology, orthopaedics & urology; making it a smart investment with excellent diagnostic value. Ultisys 3.5 aids in seamless integration of Picture Archiving and Communication System (PACS) which helps the institutions in storing and transferring of data securely to any location without loss to the quality of the output.

Ultisys 3.5 Mobile X-Ray is ideally suited for applications in ICUs, OTs, Wards, and Sports Centres. The machine is ideal for X-rays of the chest, skull, and extremities. A range of optional accessories is also available: Horizontal & manual multi-position bucky examination tables.

When compared, mobile general radiography systems are an economical alternative to a fixed radiography room and allow health practitioners to bring the equipment to the patient, rather than having to bring the patient to the equipment thus proving extremely vital for serious cases.

This system is comparatively economical, portable, and can be easily sterilised & cleaned thus reducing the risk of microbial contamination. The units can be transported to the patient’s room who cannot move or is bedridden.

The product meets all the essential requirements in terms of ease of use, mobility, and manoeuvrability with high-quality images that are rich in contrast offering excellent diagnostic value.

HEALTHCARE TRACKER

MR Pressure Injection System: Atool to improve workflow Bayer MR injection systems assures desired flow rate delivery and volumes required for certain procedures like MRA, Perfusion which practically can’t be achieved with manual injections1

W

ith the increase in number of enhanced MRI scans, the work load of the radiologists and technologists is substantially increasing. Manual contrast media injection has many challenges as it is not always accurate, varies according to the user efficiency and not reproducible.1 Bayer Radiology offers their state of the art MR Injection systems to address the above challenges. Further the Bayer MR injection systems assures desired flow rate delivery and volumes required for certain procedures like MRA, Perfusion which practically can’t be achieved with manual injections.1

Pressure injectors in MR Imaging in radiology ensure optimised opacification and delineation of normal anatomy, including arterial and venous anatomy and abnormal lesions. Steadier flow rate compared to hand injection.1 Power injectors help to assess correct bolus timing, contrast volume, and infusion rate. Also Improve quality of CEMRA Images.

Power injection systems are there in Indian market since long, however with launch of Medrad® MRXperion system (Fig 1) the workflow efficiencies are taken to a newer height with some added features. 2 ◆Sensors: Different types of sensors are available. Medrad /MRXperion has unique KVO Sensor (keep-vein-open) which prevents vascular occlusions during injection intermissions. ◆Power source and MR pressure injectors: Traditionally, MR pressure injectors are battery operated due to the inherent DC nature of electrical supply within an MRI suite. In recent times, ACpowered MR injectors have emerged. ◆ Injector and MR System Interface: IT-enabled pressure injector systems with dedicated

Medrad® MRXperion (Fig. 1)

hardware and software directly pull the work list and patient data from Radiology Information System (RIS), Picture Archival & Communication System (PACS), and Hospital Information System (HIS). They can store more than 50 injection protocols of different modalities. They are advantageous as they can ensure consistency in handling same and different patients for similar indications and for regions of examination.

Examples of such a system are Bayer Medard’s® ISI, Workflow Solutions, Radimetrics.

Scientific evidence of the benefits of power injection compared with manual injection1 To achieve successful contrastenhanced MR procedures, accurate and repeatable contrast agent e.g., Gadobutrol (Bayer) administration is necessary. Bayer performed two studies to compare outcomes of power injection with MEDRAD® MRXperion Injection System versus manual injection. In both studies, the MRXperion Injector was operated by an experienced Bayer technician and Manual injection was performed by ten technologists with at least five years of experience in clinical practice and who have performed more than 1,000 hand injections.

Study1 The first one was a laboratory study to assess flow rates over time and their deviations.3 The aim of this study was to compare flow rates over time and the deviation from the target flow rate of a magnetic res-

onance imaging contrast agent achieved by an automated injector versus manual injection.

Materials and methods In this laboratory study, 6 scenarios with 2 different target flow rates ( 1 and 5 mL/s), 2 different contrast volumes (10 and 20 mL), and 2 different intravenous (IV) catheters (22 gauge and 20 gauge) were tested. The flow rates overtime was recorded. The target variable was the average absolute deviation and average absolute percentage deviation from the target flow rate.

Results of lab study ◆ Identical flow rates over time with MRXperion. (Fig 2) ◆ High variability in flow rates over the whole course of the manual injection.

Study conclusion Injector administration of a magnetic resonance contrast agent minimally deviated from the target flow rate, whereas manual injection varied widely. Injector administration is more accurate and repeatable.

Study 2 The second study was conducted using animal testing (minipigs) to

Gadobutrol (Bayer), followed by 20 ml saline) was injected using either manual injection or an automated injection system. A quantitative comparison of vascular signal enhancement and quantitative renal perfusion analyses were performed.

Results of animal study ◆ Highly reproducible administration with MRXperion. ◆ Clearly defined and standardised bolus shape with MRXperion. ◆Higher arterial phase signal enhancement in 4D-MRA with MRXperion. (Fig3) Fig. 3 Maximum intensity projections for different time points (a, d pulmonary artery; b, e arterial phase; c, f venous phase) of the subtracted 4D-MRA datasets for manual injection (top row a–c) and automated injection (bottom row d–f).

Fig. 2 Injection profiles of 2 power injector administrations (arrow) in comparison to a series of manual administrations by multiple technologists.

Aim was ml/sec flow rate.

This example graph shows the consistency of achieving the desired flow rate when using MRXperion.

see the impact of contrast administration in time-resolved MR angiography (4D-MRA).4 Materials and methods Six anesthetised minipigs underwent two identical 4D-MRA examinations at 1.5 T in a single session. The contrast agent (0.1 mmol/kg body weight

Study conclusion The results of both qualitative and quantitative 4D-MRA depend on the contrast agent injection method, with automated injection providing more defined bolus shapes and more standardised examination protocols.

Pressure injectors are important accessories in modern radiology departments and are used in MR radiology suites to improve the CM Administration workflow.2 Compared with manual injection, power injection provides more standardised bolus shapes and higher image quality due to higher arterial enhancement and less superimposition of nontargeted vessels.1 References 1. https://www.radiology.bayer.com 2. Indrajit, Inna & Sivasankar, Rajeev & D'Souza, John & Pant, Rochan & Negi, Raj & Sahu, Samresh & Hashim, Pi. (205). Pressure injectors for radiologists: A review and what is new. The Indian journal of radiology & imaging. 25. 2-0.

0.403/097-3026.5005.

3. Endrikat J et al., Invest Radiol.

208 Jan;53():-5 4. Budjan J et al., Eur Radiol. 208 May;28(5):2246-2253 For more information and product details you may connect with Bayer team on sb.karthikeyan@bayer.com or write to Bayer Pharmaceuticals Private Limited, Bayer House, Central Avenue, Hiranandani Estate, Thane, India. Pin: 400 607 or email: medicalinfo.india@ bayerzyduspharma.com The Article published in this newsletter is for education and information purposes only. Although great care has been taken in compiling the information, Bayer Pharmaceuticals Private Limited or its affiliates shall not be responsible/ liable in any way for the present and/or continued accuracy of the information or for any errors, omissions or inaccuracies in this publication whether arising from negligence or otherwise howsoever, or for any consequences arising therefrom. For the use of Registered Medical Practitioner or Healthcare professionals only. To report an adverse event, please enter the relevant details on https://pharma.bayer.com/ report-side-effect PP-GAD-IN-0089-, Approved July 2022

EXPRESS HEALTHCARE

43

August 2022

HEALTHCARE TRACKER

Sequoia Healthcare introduces the inspiration 64 Slice CTScanner It provides exceptional CT experience for the end users

S

equoia Healthcare, based out of Bangalore and intensely focused on driving global innovation in the imaging solution segment manufactured indigenously in the country, has launched an advanced yet affordable Inspiration 64 Slice CT scanner with smart features and bore design recently.

The Inspiration 64-smart large bore Slice CT Scanner

44

EXPRESS HEALTHCARE

August 2022

comes with a 3D vision camera with auto-positioning and remote control. It brings in the finest quality of images and stable performance consisting of innovative workflow for topogram to diagnosis by generating HD Image Chain of 024 matrix. It is a new detector design for shortening the X-RAY path and improving on the image quality with the help of a 75 cm Gantry aperture that offers extra

scan facilities as compared to the standard scanning.

According to S. Viswanathan, Chief Executive Officer, Sequoia Healthcare, “The company’s purpose is to improve the quality of human life by helping healthcare providers to do more with technology. It guides our actions and is the key to deliver our strategy. Inspiration 64’s precision tomography is independently developed in a Hi-

Resolution, High-Definition Algorithm. Inspiration 64 adopts a unique low-dose technique to minimise the radiation dose to patients, which is better known as iDream. The adequate X-Ray tube heat storage and generator capacity are increased 2.7 times with the help of iDream software.

He further said, “Sequoia Healthcare strives to bring in advanced and affordable in-

ternational technology, which serves in cost-effective healthcare. Sequoia believes in delivering radiology equipment accessibility for cost-effective healthcare. In short, we want to bring diagnostic reach to all. With high-tech services accompanied with new world Artificial Intelligence (AI), robotics, etc., Sequoia aims to become the number imaging devices manufacturer in the world.”

HEALTHCARE TRACKER

MEDIKABAZAAR celebrates Azadi ka Amrit Mahotsav for 5 DAYS,in 5 WAYS As part of ‘Azadi Ka Amrit Mahotsav’, marking the 75th anniversary of India’s Independence, MEDIKABAZAAR has launched Azadi Ka Amrit Mahotsav offer for all its customers. The campaign theme is ‘Celebrate 5 Days in 5 ways’ and it encompasses Medikabazaar’s vast range of products and solutions for healthcare establishments and Independent Practitioners

M

edikabazaar is celebrating and commemorating 75 years of independence pan India.

Under this initiative, Medikabazaar is offering attractive offers to its customers across 7 lakh plus SKUs for various medical product categories.

As part of ‘Azadi Ka Amrit Mahotsav’, marking the 75th anniversary of India’s Independence, MEDIKABAZAAR has launched Azadi Ka Amrit Mahotsav offer for all its customers. The campaign theme is ‘Celebrate 5 Days in 5 ways’

and it encompasses Medikabazaar’s vast range of products and solutions for healthcare establishments and Independent Practitioners.

In this celebration period, starting st Aug’22 till 5th Aug, Medikabazaar is celebrating the 5 days celebration of Independence Day with its customers and sellers by thanking them for transforming healthcare and offering attractive offers.

Medikabazaar is working to make healthcare more accessible and affordable in the

nation's Tier , 2, 3, and 4 cities.

To commemorate its 75th anniversary, Medikabazaar is providing attractive offers and financing options across a majority of medical products listed on the platform for the next 5 days.

Medikabazaar's MB FREEDOM solution adds another reason to celebrate Azadi ka Amrit Mahostsav. In its real sense, MB FREEDOM delivers financial freedom from Working Capital difficulties, upfront payment hassles, and Financing Hassles. MB Freedom as-

sists medical practitioners in establishing or renovating treatment facilities by providing affordable monthly payment alternatives ranging from no-cost EMIs to longterm asset financing and EMIbased loan arrangements. As a result, centres may keep their budgets in check by obtaining medical equipment with fewer down payments.

This maintains a healthy cash flow while providing excellent medical care with cuttingedge technology.

Throughout the 5-day com-

memoration, Medikabazaar will release podcasts with renowned doctors on recent developments in healthcare, as well as commemorate healthcare achievements since independence on its social media accounts.

Medikabazaar will also commemorate Independence Day with its customers and sellers, who have not only been instrumental in bringing India this far in its evolutionary journey but also hold within them the power and potential to transform healthcare.

CONTRIBUTOR’S CHECKLIST ●

●

●

●

●

Express Healthcare accepts editorial material for the regular columns and from pre-approved contributors/columnists.

Express Healthcare has a strict non-tolerance policy towards plagiarism and will blacklist all authors found to have used/referred to previously published material in any form, without giving due credit in the industryaccepted format.

As per our organisation’s guidelines, we need to keep on record a signed and dated declaration from the author that the article is authored by him/her/them, that it is his/her/their original work, and that all references have been quoted in full where necessary or due acknowledgement has been given. The declaration also needs to state that the article has not been published before and there exist no impediment to our publication. Without this declaration we cannot proceed.

If the article/column is not an original piece of work, the author/s will bear the onus of taking permission for re-publishing in Express Healthcare. The final decision to carry such republished articles rests with the Editor.

Express Healthcare’s prime audience is senior

●

●

●

●

●

●

●

●

management and professionals in the hospital industry. Editorial material addressing this audience would be given preference.

The articles should cover technology and policy trends and business related discussions.

Articles by columnists should talk about concepts or trends without being too company or product specific.

Article length for regular columns: Between 300 - 500 words. These should be accompanied by diagrams, illustrations, tables and photographs, wherever relevant.

We welcome information on new products and services introduced by your organisation for our Products sections. Related photographs and brochures must accompany the information.

Besides the regular columns, each issue will have a special focus on a specific topic of relevance to the Indian market. You may write to the Editor for more details of the schedule.

In e-mail communications, avoid large document attachments (above MB) as far as possible.

Articles may be edited for brevity, style, relevance.

Do specify name, designation, company name,

●

department and e-mail address for feedback, in the article.

We encourage authors to send a short profile of professional achievements and a recent photograph, preferably in colour, high resolution with a good contrast.

Email your contribution to:

viveka.r@expressindia.com viveka.roy3@gmail.com Editor, Express Healthcare

EXPRESS HEALTHCARE

45

August 2022

HEALTHCARE TRACKER

Environmental perspective on menstrual hygiene Rutuja Sonawane, Officer – Business Development, Ami Polymer explains that a plastic, industrially manufactured, disposable sanitary pad requires about 500–800 years to decompose. The most effective and eco-friendly alternative are the menstrual cups, also the most cost-effective and inexpensive, with a lifetime up to 0 years without any health hazards

A

s it is said and done from the old times that a women must maintain the menstrual hygiene for better health, but the fact that environmental hygiene is also of utmost importance is often neglected when it comes to this, already a taboo topic.

Environmental impact caused by sanitary waste is one of the significant topics in discussions today. A plastic, industrially manufactured, disposable sanitary pad requires about 500–800 years to decompose. Thousands of tons of disposable sanitary waste is generated every month all over the world. Incineration is a technique to dispose of menstrual waste. But the burning of pads releases gases that affect health and environment, where the chemical dioxins are toxic and carcinogenic.

Even most tampons contain chemicals such as dioxin, chlorine and rayon. While the products sit in landfills, these chemicals get soaked up by the earth and are released as pollution into groundwater and air.

This waste is toxic and hazardous to human health as well.

Isn’t it time to make the ecofriendly switch, yet?

Below are some facts about the safest period product for the environment: ◆ The most effective and ecofriendly alternative are the menstrual cups, also the most cost-effective and inexpensive, with a lifetime up to 0 years without any health hazards. It saves a person who menstruates 2,400 pads or tampons in their lifetime. ◆ Menstrual cups are estimated to have less than .5 per cent environmental impact, which can be otherwise huge in case of disposal of other period products. ◆ Silicone, which most menstrual cups are made of, is derived from silica, a type of sand that goes to its original state once it degrades and is an abundant material on earth that isn’t haz-

46

EXPRESS HEALTHCARE

August 2022

nificant, positive impact on the planet, where every woman’s contribution to this transition from disposable to sustainable menstrual products matters.

The final implementation of this product will also benefit society by employing rural women empowerment.

ardous to the environment. ◆ Medical grade silicon has the lowest chances to contract any vaginal infections, diseases or itching out of all products currently available in the market.

◆ Since the cup holds the menstrual blood at the cervix, it prevents the blood from flowing through the vaginal canal, allowing hassle-free sexual intercourse.

◆ Extremely travel-friendly, allowing it to remain for hours without any discomfort or worry.

Does not need to be changed often. ◆ Usually leak-proof, which ample storage and does not emit an odour.

The environmental benefits of this product will create a sig-

Rutuja Sonawane Officer – Business Development Mobile No: 90803884 Mail Id: tubing@amipolymer.com

" % % $

From fast patient throughput to robust cardiac scanning and new diagnostic capabilities, the new Aquilion Prime SP is a CT system of choice for all your imaging needs.

Built with premium technology migrated straight from our high end CT, Aquilion Prime SP empowers your facility to handle all patients from pediatric to bariatric, even the most challenging cases, while providing all staff with a fast and efficient solution to make their work easy.

Complete Clinical Capabilit y Assisted by AI technology

https://global.medical.canon/ Learn more about Aquilion Prime SP

©Canon Medical Systems Corporation 2022. All rights reserved.

Please contact your local sales representative to learn more.

ERBIS ENGINEERING COMPANY LIMITED 39 Second Main Road, Raja Annamalaipuram, Chennai - 600 028. Tel:044 42961400 Mail ID : info@erbismedical.com

! " # $

REGD. WITH RNI NO. MAHENG/2007/22045, POSTAL REGD. NO. MCS/162/2022 – 24, PUBLISHED ON 8TH EVERY MONTH, POSTED ON 14TH, 15TH, 16TH EVERY MONTH, POSTED AT MUMBAI PATRIKA CHANNEL SORTING OFFICE, MUMBAI – 400001

ULTISYS 3.5

SMART DIGITAL RADIOGRAPHY SOLUTION

ENHANCED WORKFLOW PRODUCTIVITY

Reach us at +91 98400 80008

DIAGNOSTIC CONFIDENCE WITH COLLABORATION

for more details www.trivitron.com | corporate@trivitron.com

IMPROVED PATIENT CARE OUTCOMES