Express Healthcare (Vol. 17, No. 1) February 2024

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MEDTECH Pioneering innovations in personalised medicine to tackle NCDs

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Two giants, two systems: Exploring differences between India and US healthcare

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CONTENTS POLICY Chairman of the Board Viveck Goenka Sr. Vice President-BPD Neil Viegas Vice President-BPD Harit Mohanty Editor

Pg 16

Viveka Roychowdhury*

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Editorial Team Lakshmipriya Nair Kalyani Sharma

TWO GIANTS, TWO SYSTEMS: EXPLORING DIFFERENCES BETWEEN INDIA AND US HEALTHCARE

DESIGN Art Director

NABH

Pravin Temble

HEALTH TRENDS

HOSPITAL INFRASTRUCTURE

Senior Designer Rekha Bisht Senior Artist Rakesh Sharma Marketing Team

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Rajesh Bhatkal Douglas Menezes Ashish Rampure Debnarayan Dutta Production Co-ordinator

MEDTECH

Dhananjay Nidre Scheduling & Coordination Pushkar Waralikar CIRCULATION Mohan Varadkar

IISC SIGNS MOU WITH WIPRO GE HEALTHCARE TO ADVANCE INDIAN MEDTECH INNOVATION

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VOCAL FOR LOCAL HEALTHCARE QUALITY AND PATIENT SAFETY

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PIONEERING INNOVATIONS IN PERSONALISED MEDICINE TO TACKLE NCDS

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EVOLUTION OF HOSPITAL INFRASTRUCTURE

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E-ICU: REVOLUTIONISING CRITICAL CARE

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.

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.

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EDITOR’S NOTE

Healthcare sector awaits July budget for more clarity

N

ot much was expected from the Interim Budget 2024-25, and Finance Minister Nirmala Seetharama has largely stuck to the script. The announcements are being seen as clues to how this government intends to treat the healthcare sector.

Thus the increased outlay towards the National Health Mission by 12.7 per cent in FY25 after remaining largely unchanged in the last two fiscals is definitely good news. The Finance Minister proposes that the overall healthcare budget will increase from Rs 80,518 crore in FY 2023-24 to Rs 90,659 crore in FY2024-25, a hike of more than 11 per cent.

The major announcements for the healthcare sector span the setting up nearly 157 new medical schools by utilising the existing hospital infrastructure under various departments, encouraging vaccination for girls in the age of 9 to 14 for prevention of cervical cancer, and expediting the upgradation of anganwadi centres (for early childhood care in rural areas), etc. The clubbing of maternal and child care schemes is obviously aimed at creating better resource synergies and hopefully better outcomes.

Ayushman Bharat PM-JAY coverage has been extended to approximately 10 lakh ASHA workers and and approximately 25 lakh anganwadi workers, while allocation towards PM-JAY has increased from Rs 6,800 crore to Rs 7,500 crore. The Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM ABHIM) also got a higher allocation from Rs 200 crore in FY 2023-23 to Rs 468 crore in FY 2024-25.

The surprise announcement was the introduction of cervical cancer vaccination for women aged 9-14 years, as industry experts point out that the health ministry had indicated that a decision had not yet been taken on this front.

Recommendations are already flowing in for the more detailed budget to be present somewhere around July, by the party that wins the general elections scheduled for April-May. Segments like health tech and startups are expecting more of an impetus, given the potential of new tech like artificial intelligence (AI) in diagnostics and medtech.

The announcement about the roll out off the newly designed U-Win platform for managing immunisation and intensified efforts of Mission Indradhanush is encouraging and is being seen as the government’s continued digital push. Hence it’s being seen as a signal to more investments for health tech and startups in July.

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However, increased fund allocation is not the full solution.

While the centre might release the funds to the states, some states might not have the capacity to use these funds within the timeframe

There has been no specific focus on health initiatives for the rural sector. The issue of integrating medical professionals trained overseas too remains unresolved.

While the setting up of medical colleges in existing hospitals aims to address India’s dearth of healthcare professionals, it needs to be accompanied by an upgrade and revamp of the medical education system itself, to ensure future medicos are in tune with the latest technologies and practices. The PublicPrivate-Partnership (PPP) model could be deployed to meet these goals but incentives need to be balanced by strict regulations.

Similarly, while telemedicine can be incentivised to address shortage of skilled medical professionals in rural areas, there is also the long term need to train a cadre of medical staff to serve in rural /difficult to reach resource strained areas.

But overall, allocations for healthcare still lag India’s counterparts. An increase from 1.3 percent of the gross domestic product (GDP) in 2015-16, to 1.6 per cent of GDP in 2021 to 2.1 per cent in 2023, is still short of 2.5 per cent of GDP, leave alone the aspirational 5 per cent of GDP. Most healthcare experts are hoping the sector gets infrastructure status, and a substantial boost in the July budget.

However, increased fund allocation is not the full solution. Is the sector able to utilise the funds allocated?

Documents submitted as part of the FY2024-25 interim Budget show that the health and family welfare and health research departments were not able to utilise the allocated budget of Rs 89,155 crore for the last fiscal FY2023-24, with the revised estimate (RE) showing a reduced budget of Rs 80,516 crore. While the centre might release funds to the states, some states might not have the capacity to use these funds within the timeframe. This could reveal a lack of healthcare planning and infrastructure, or a lack of human resources, or lack of healthcare or political leadership at the state level to follow through and ensure the funds are utilised down to the district level.

These gaps need to be analysed and plugged, either

by PPPs or other means. Overall, the Interim Budget 2024-25 set the stage for July. Health will remain a focus area, but this government will continue to reward performance (usage of allocation) and results.

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

NABH

Vocal for local healthcare quality and patient safety Dr Atul Mohan Kochhar, CEO, National Accreditation Board for Hospitals & Healthcare Providers (NABH) highlights that in the realm of healthcare quality and patient safety, the "Vocal for Local" movement takes on a profound meaning when aligned with the principles of quality care and patient safety

I

n recent times, the global call for self-reliance and supporting local industries has echoed across sectors. The “Vocal for Local” campaign aims to revive the Indian economy by promoting and encouraging the use of local products and services made in India. The campaign is helping to revive Indian brands in the current economic scenario. Creating awareness among the public about the importance of buying Indian products and services to support the local economy. By supporting the campaign, people can contribute to the growth and development of the Indian economy while also promoting local products and services.

In healthcare, the "Vocal for Local" movement is gaining momentum, emphasising the importance of promoting and patronising indigenous healthcare solutions. As we navigate the path towards healthier communities, the emphasis on vocalising support for local healthcare initiatives is not just a choice; it's a step towards a more inclusive and sustainable healthcare future. In the realm of healthcare quality and patient safety, the "Vocal for Local" movement takes on a profound meaning when aligned with the principles of quality care and patient safety.

This article explores the imperative of advocating for local healthcare solutions that prioritise quality and safety, fostering community well-being and resilience.

NABH has given the country national standards or ‘Desh ka Standard’ and are in line with the vision of ‘Atma Nirbhar Bharat’. The confluence of NABH standards with the "Vocal for Local" initiative marks a transformative journey in healthcare quality. the integration of NABH standards into local healthcare practices not only raises the bar for quality but also aligns seamlessly with the ethos

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performance. By adhering to these standards, healthcare facilities demonstrate a commitment to continuous quality improvement and the delivery of world-class healthcare services.

Community-centric patient safety protocols

of supporting indigenous healthcare solutions.

Localised quality standards and accreditation Promoting local healthcare quality initiatives involves establishing and upholding rigorous standards specific to the needs and nuances of the community. Encouraging local healthcare providers to adhere to accreditation processes ensures that the care delivered meets predefined quality benchmarks, enhancing patient safety and overall satisfaction.

NABH accreditation, with its stringent quality standards, serves as a benchmark for healthcare facilities. Integrating these standards into local healthcare practices ensures that the quality of care aligns with national and international norms. This synergy contributes to the creation of healthcare systems that are not only locally relevant but also globally competitive in terms of quality. NABH accreditation stands as a hallmark of healthcare excellence, setting standards that encompass patient safety, quality of care, and overall organisational

Tailoring patient safety protocols to the unique characteristics of the community is a pivotal aspect of the "Vocal for Local" healthcare initiative. From culturally sensitive communication practices to addressing prevalent health issues, a communitycentric approach to patient safety fosters trust and engagement between healthcare providers and their local populations.

While NABH provides a comprehensive framework, adapting its protocols to the specific needs of the local population is crucial. This involves addressing prevalent health issues, cultural nuances, and community-specific healthcare challenges. By adapting NABH standards and protocols, healthcare providers can enhance patient safety and satisfaction, fostering a healthcare environment that is truly responsive to local needs.

One of the strengths of NABH lies in its adaptability. Local healthcare providers can align NABH standards with the specific needs and cultural nuances of their communities. This not only ensures compliance but also enhances the relevance and effectiveness of healthcare services, fostering a sense of ownership and trust within the community.

Local healthcare workforce development Investing in the training and development of a skilled local healthcare workforce is integral to ensuring quality care and patient safety. By cultivating talent within the community, healthcare providers are better

equipped to understand and respond to the specific healthcare needs and challenges faced by the local population.Ensuring that local healthcare providers have the capacity to meet NABH standards is a key facet of the "Vocal for Local" healthcare quality initiative. This involves providing training, resources, and support to enable healthcare facilities to attain and sustain accreditation. Building local capacity not only strengthens the healthcare workforce but also contributes to the overall quality improvement in the region.

Technology integration for local solutions Harnessing technology to develop and implement local healthcare solutions enhances both quality and safety. From telemedicine applications to locally relevant health information systems, technology can bridge gaps, improve communication, and provide timely interventions, contributing to a safer and more efficient healthcare environment.

Technology plays a pivotal role in NABH compliance, and integrating local innovations into healthcare technology can further enhance the quality of care.

From electronic health records to telemedicine solutions, leveraging technology ensures that local healthcare providers can meet the digital standards outlined and developed by NABH, contributing to efficient and safer healthcare delivery. Technology also ensures that healthcare delivery is not only standardised but also responsive to the unique challenges faced by local communities.

Patient empowerment through localised health education An essential component of ensuring healthcare quality and patient safety is empowering in-

dividuals with knowledge. Localised health education campaigns can inform communities about preventive measures, early warning signs, and the importance of adhering to prescribed treatments. Informed and empowered patients actively participate in their own well-being, contributing to a safer healthcare landscape.

Engaging the community in understanding the significance of NABH standards fosters a sense of accountability and transparency. By involving the local population in quality improvement initiatives, healthcare providers can build trust and enhance the perception of healthcare quality. Community engagement also ensures that healthcare services align with the expectations and preferences of the people they serve.

In healthcare, the "Vocal for Local" movement is gaining momentum, emphasising the importance of promoting and patronising indigenous healthcare solutions Conclusion Being "Vocal for Local" in healthcare quality and patient safety is not just an advocacy; it's a commitment to the health and resilience of communities.

By setting localized standards, tailoring safety protocols, investing in local workforce development, integrating technology, and empowering patients through education, we can create a healthcare ecosystem that is not only high in quality but is deeply connected to the well-

being of the people it serves. As the "Vocal for Local" movement gains momentum, integrating NABH accreditation into local healthcare practices emerges as a powerful strategy for elevating healthcare quality. By combining national accreditation standards with locally tailored initiatives, we can create healthcare ecosystems that are not only accredited but also deeply rooted in the well-being of the communities they serve.

The synergy between NABH

standards and the "Vocal for Local" healthcare quality initiative creates a dynamic framework for indigenous healthcare excellence. By combining the rigorous standards of NABH with a commitment to community-centric care, we embark on a journey that not only raises the quality of healthcare services but also celebrates the rich tapestry of diverse healthcare practices within our communities.

As we champion local solu-

tions, let our collective voice resonate in support of healthcare practices that prioritise quality, safety, and the overall health of our communities. In the harmonious convergence of NABH accreditation and local healthcare ethos, we find a path towards healthcare excellence that is both standardised and intimately connected to the diverse needs of our local populations. In this transformative intersection, NABH standards become more than just benchmarks; they become instruments for elevating the health and well-being of local populations. As we vocalise our support for local healthcare quality, let it echo in the halls of NABH-accredited facilities that champion excellence rooted in the ethos of their communities.

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cover )

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The market for testing kits is rapidly expanding but awareness building, strategic collaborations and accessibility will be key for sustained growth

By Kalyani Sharma

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n the dynamic landscape of Indian healthcare, a transformative shift is underway through the widespread adoption of self-testing kits.

These kits are altering the landscape of diagnostics by not just reducing the burden on traditional healthcare systems but are reshaping the entire paradigm of diagnostics.

Emphasising on why in a developing country such as ours there is an increase in the demand for cost effective testing strategies, Dr Anubhav Pandey, Head of the Department of Laboratory Medicine, Amrita Hospital, Faridabad shares, “The developments in medicine and laboratory techniques have dawned a new age era of selftesting kits which has led to the complete change in the outlook of how illness is detected. The modern advances such as immunochemistry and immunodiffusion has led to creation of numerous testing strategies. It has become so rudimentary that without requirement of any basic training, analytes can be tested at the confines of one’s home. There are numerous benefits for self-testing kits such as such rapid and curate test being performed at a short span of time lending a great advantage in clinical management of illnesses.”

Current market scenario of self-testing kits in India The outbreak of infectious diseases, such as COVID-19, has heightened the awareness of the importance of infectious disease testing. During pandemics and epidemics, there is an urgent need for accessible and convenient testing methods, which self-testing kits can provide.

Dr Rajesh Bendre, National Technical Head & Chief Pathologist Apollo Diagnostics, Delhi mentions, “As the demand for convenient and discreet healthcare options increases in India, more

18 EXPRESS HEALTHCARE February 2024

The developments in medicine and laboratory techniques have dawned a new age era of self-testing kits which has led to the complete change in the outlook of how illness is detected Dr Anubhav Pandey Head of the Department of Laboratory Medicine, Amrita Hospital, Faridabad

With the traditional healthcare system often crowded and time-consuming, these self-testing kits offer individuals the opportunity to take their health into their own hands Dr Rajesh Bendre National Technical Head & Chief Pathologist Apollo Diagnostics, Delhi

As technology advances and awareness grows, the potential for growth in additional areas within the self-testing kit domain remains promising, further expanding the scope of at-home diagnostics Dr Vikramjeet Singh Senior Consultant, Internal Medicine, Aakash Healthcare, New Delhi

These kits may also be compatible with artificial intelligence technologies, which would further make it easier for people to keep a check on their health from home. These developments, which take into account the changing landscape of at-home diagnostics, could improve healthcare monitoring at home Dr Shilpa Gupta Associate Director- Pathology, Asian Hospital Faridabad

people are turning to self-testing kits as a viable solution.

With the traditional healthcare system often crowded and time-consuming, these self-testing kits offer individuals the opportunity to take their health into their own hands. From diabetes monitoring to fertility testing, these kits provide a level of autonomy that is empowering for users. Furthermore, the privacy and convenience that self-testing kits afford cannot be overstated, especially in a country where discussions about certain health issues may still carry social stigmas.

By being able to conduct tests at home and receive accurate results without having to visit a clinic or hospital, individuals can overcome barriers related to privacy concerns or societal taboos surrounding certain medical conditions.”

According to TechSci Research recent report, “India Self-Testing Kits Market has valued at USD 551.41 million in 2023 and is anticipated to witness an impressive growth in the forecast period with a CAGR of 8.56 per cent through 2029.”

Talking about the current market scenario, Dr Nilesh Shah, President & Chief of Science & Innovation, Metropolis Healthcare said, “The current market scenario for self-testing kits in India is marked by a nuanced landscape, shaped by various factors. Point-of-care testing (POCT) in the country can be broadly classified into two categories: Type 1, where patients conduct the tests themselves, and Type 2, where small labs administer the tests.”

Dr Shah also shares, “The prominence of self-testing surged during the COVID-19 pandemic due to limited lab access and extended wait times. However, post-pandemic, widespread adoption of self-testing has yet to take firm root in India. Even established self-testing options, such as urine pregnancy kits, have not gained substantial

popularity in the Indian market. Key challenges hindering the growth of self-testing in India include issues of awareness and accessibility. In contrast, countries like the UK offer a diverse range of self-testing options, including blood group, cholesterol, and prostate cancer screenings, readily available in pharmacies.”

Primary health spheres addressed by self-testing kits and prospective growth avenues Self-testing kits cover a spectrum of health concerns, ranging from infectious diseases, some chronic conditions, and preventive care.

Pregnancy kit, glucose monitoring kits, Troponin I, COVID rapid antigen test, Hepatitis rapid test are some of the major therapeutic areas being covered by self-testing kits. The former two are the most commonly and most widely available kits to monitor and test analytes at a much cost effective and rapid manner.

Dr Vikramjeet Singh- Senior Consultant, Internal Medicine, Aakash Healthcare, New Delhi opines that as technology advances and awareness grows, the potential for growth in additional areas within the self-testing kit domain remains promising, further expanding the scope of at-home diagnostics.

Sharing his views on future of these kits, Dr Shilpa Gupta, Associate Director- Pathology, Asian Hospital Faridabad also believes, “These kits may also be compatible with artificial intelligence technologies, which would further make it easier for people to keep a check on their health from home. These developments, which take into account the changing landscape of athome diagnostics, could improve healthcare monitoring at home.”

Anticipating on the future growth of self-testing kit, Dr Amardeep Singh Kohli, Chief Executive Officer, PSRI

TYPES OF SELF-TESTING KITS ◆

One type of at-home medical test kit is the glucose meter, which measures blood glucose levels. This is particularly useful for individuals with diabetes who need to monitor their blood sugar regularly. People with diabetes are also getting benefitted with the advent of continuous glucose monitoring device (Ambulatory Glucose Profile- AGP). This user-friendly device has a sensor that can be applied by patients themselves and they are able to have a close monitor of their blood sugars all through the day.

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Another commonly used kit is the BP monitor, which allows you to check your blood pressure at any time, helping you keep track of this vital health indicator.

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For those concerned about respiratory health, a pulse oximeter can be an essential tool. It measures oxygen saturation levels in your blood and can indicate if there are any underlying issues that need attention. Additionally, ketose meters are helpful for individuals following a ketogenic diet as they measure ketone levels in urine or blood.

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Pregnancy kits are also available as at-home test kits, providing accurate results within minutes. These tests detect hormone levels that indicate pregnancy and offer privacy during such an important time.

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With the ongoing COVID-19 pandemic, at-home COVID test kits have gained significant popularity. These tests allow individuals to self-administer nasal swabs or saliva samples and receive results quickly from the comfort of their homes.

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One popular type of wellness test kit is the home cholesterol testing kit. High cholesterol levels can increase the risk of heart disease, so knowing your numbers can be crucial for making dietary and exercise changes to improve your cardiovascular health. There are self-testing kits available to monitor even kidney parameters at home. Another useful wellness test kit is the vitamin deficiency test. This kit allows you to check if you have any deficiencies in essential vitamins like Vitamin D or B12. Identifying these deficiencies early on can help prevent potential health issues down the line.

Source: Dr V. Mohan, Chairman, Dr. Mohan’s Diabetes Specialties Centre Hospital, New Delhi said, “The future growth of selftesting kits is anticipated to expand into new therapeutic areas, driven by continuous advancements in diagnostic technologies. Emerging areas may include cardiovascular health, respiratory conditions, and infectious diseases.”

Accessibility and affordability: Penetration in rural healthcare Self-testing kits have the ability to transcend geographical constraints. By enabling people to conduct diagnostic tests at home, self-testing kits could bridge the gap between urban and rural healthcare, breaking the geographical barriers.

On accessibility and afford-

ability, Sriram Natarajan, Founder and CEO, Molbio Diagnostics said, “The market has grown in urban areas where awareness of the general population is high. In rural areas, the access to such diagnostic modalities can be increased by equipping ASHA workers with such technologies, or collating various of self-kits in a portable box that can be either hand-held or carried in mobile vans. Many such alternatives are now present in India and other geographies. Information dissemination needs to happen in the vernacular and regional languages to reach the most remote parts.”

“The average purchasing power of an urban consumer

is higher than that in the rural areas. For self-testing kits to truly penetrate the rural market, it has to be extremely affordable. Use of low cost, adequately sensitive testing technologies that contribute to a highly economic bill of materials is of paramount importance. This would make the end product highly affordable”, he added.

Also, the simplicity and ease of use of these kits can empower rural India to take charge of their health without the need for extensive medical infrastructure. This shift towards decentralised diagnostics can be a pivotal step in transforming the healthcare dynamics of rural healthcare.

Dr Geethu Joe, Consultant

Microbiologist, Jupiter Hospital, Pune opines that this shift will be especially significant for the elderly, the crippled, and those confined to their homes because it gives them the required lifeline to independently manage their health She shares, “Self-testing is not only feasible for patients but also cost-effective for medical staff, generally increasing patient satisfaction and yielding positive outcomes in terms of early detection and preventive care. The accessibility and ease of use of self-testing kits is crucial to the global growth of preventive healthcare.”

Dr Bendre emphasises that self-testing kits are heralded as a convenient way to monitor one's health, but their accessibility in rural areas presents a significant problem.

He said, “The lack of infrastructure and resources in remote regions often means that residents have limited access to these essential kits.

This disparity not only hinders individuals from proactive healthcare but also widens the gap in healthcare inequality between urban and rural populations. Moreover, the reliance on self-testing kits in these areas can lead to misinterpretation of results due to limited education and guidance, potentially leading to improper diagnosis and treatment.”

In addition, the expense of self-testing kits poses a substantial barrier for those living in rural communities with lower income levels. Despite their potential benefits, selftesting kits may end up exacerbating disparities rather than alleviating them by further marginalising vulnerable populations. As such, addressing the issue of accessibility and affordability must be at the forefront of any efforts to expand healthcare access in rural areas. Only through innovative solutions and policy changes can we ensure that everyone has equal opportunities for proactive health

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cover ) management regardless of their geographic location.”

Impact of self-testing kits on preventive healthcare?

Using self-testing kits can be a bit tricky. The effectiveness and how much they cost are important things to think about. These tests need to be affordable, especially when putting together health packages. But some people might see them as pricier than other regular tests. Also, most of these tests tell you if something is there or not, rather than giving exact numbers. Some of the tests that do give numbers might not be perfect for what they're supposed to do.

India's self-testing boom while promising for decongesting healthcare systems presents a double-edged sword for preventive care.

Dr Sheela ChakravarthyDirector-Internal Medicine, Fortis Hospital, Bannerghatta Road, Bengaluru opines, “India's self-testing boom while promising for decongesting healthcare systems presents a double-edged sword for preventive care. Accessibility and convenience undoubtedly empower individuals especially in remote areas to take charge of their health. Early detection of chronic conditions like diabetes or STIs, enabled by kits can lead to timely intervention and prevent complications. However, concerns like test accuracy, particularly for complex diseases, and affordability for resource-scarce populations can compromise effectiveness. Misinterpretation of results or lack of follow-up with healthcare professionals can worsen underlying conditions. Moreover, unregulated marketing and over-diagnosis due to user anxieties fueled by readily available tests pose risks.”

“To maximise the positive impact on preventive healthcare, comprehensive government measures are crucial.

Stringent regulation of test kits coupled with public education on proper usage

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The future growth of self-testing kits is anticipated to expand into new therapeutic areas, driven by continuous advancements in diagnostic technologies. Emerging areas may include cardiovascular health, respiratory conditions, and infectious diseases Dr Amardeep Singh Kohli Chief Executive Officer, PSRI Hospital, New Delhi

The market has grown in urban areas where awareness of the general population is high. In rural areas, the access to such diagnostic modalities can be increased by equipping ASHA workers with such technologies, or collating various of self-kits in a portable box that can be either handheld or carried in mobile vans Sriram Natarajan Founder and CEO, Molbio Diagnostics

Self-testing is not only feasible for patients but also cost-effective for medical staff, generally increasing patient satisfaction and yielding positive outcomes in terms of early detection and preventive care. The accessibility and ease of use of self-testing kits is crucial to the global growth of preventive healthcare Dr Geethu Joe Consultant Microbiologist, Jupiter Hospital, Pune

India's self-testing boom while promising for decongesting healthcare systems presents a double-edged sword for preventive care Dr Sheela Chakravarthy Director-Internal Medicine, Fortis Hospital, Bannerghatta Road, Bengaluru

and interpretation is vital. Integrating self-testing seamlessly into existing healthcare systems with clear pathways for follow-up care, can ensure early detection translates into meaningful prevention. Ultimately, striking a balance between individual empowerment and responsible use, backed by robust public health policies, will determine whether self-testing kits truly revolutionize preventive healthcare in India.”

Although these kits have the capability of putting more control of the health in the hands of individuals and proactively monitor their health, the effectiveness of these kits can vary, and factors such as cost and the type of tests performed play a crucial role.

While they enhance accessibility, concerns about accuracy and the need for proper follow-up remain, highlighting the importance of informed and responsible use in achieving the full potential of selftesting kits in preventive healthcare.

Stressing on the positive side, Natarajan said, “It would help reduce healthcare costs.

It greatly increases the pool of patients opting for active triaging and screening, thereby reducing overall burden on the healthcare system.

It will have huge impact on India’s health indices and overall economic productivity.”

Technology integration The integration of technology in self-testing kits can play a pivotal role in shaping a healthier and more connected future for healthcare in India.

Dr Singh believes that striking a balance between technological innovation and regulatory oversight is essential to harness the full potential of self-testing kits in India's evolving healthcare landscape and says, “technology integration in self testing kits is an important aspect to enhance their accuracy and make them more reliable for users.

Additionally,

technological innovations can improve accessibility by ensuring that these kits are user-friendly and easily understandable for individuals with varying levels of health literacy. Moreover, leveraging technology can contribute to affordability by streamlining manufacturing processes and reducing production costs.

This, in turn, makes the selftesting kits more economically accessible to a broader population.

While technology integration enhances the overall effectiveness of self-testing kits, it also brings about the need for robust regulatory measures to prevent potential misuse.”

Dr Kohli also said, “Technology integration is a key factor in addressing many of the challenges associated with self-testing kits. Advanced technologies, such as artificial intelligence and digital health platforms, can enhance the accuracy of results and improve the overall user experience. Regulatory frameworks should encourage and guide the integration of such technologies, ensuring that they contribute to the effectiveness and reliability of self-testing kits.”

As technology continues to advance, this fusion is also capable of creating a promising chapter in the evolution of healthcare by making

The rapid uptake of self-testing kits in India represents a paradigm shift in healthcare dynamics that releases pressure on established systems Dr Mahendra Dadke HoD-Internal Medicine, Jupiter Hospital, Pune

Challenges and regulatory landscape: In need of collaborative approach

Lack of trained professionals available to provide counselling and support after using self- testing kits is a challenge Dr V. Mohan Chairman, Dr. Mohan’s Diabetes Specialties Centre

diagnostics more accessible but also empowering people.

Dr Mahendra Dadke, HoDInternal Medicine, Jupiter Hospital, Pune opines, “The rapid uptake of self-testing kits in India represents a paradigm shift in healthcare dynamics that releases pressure

on established systems. But issues with precision, price, accessibility, and possible abuse highlight the importance of giving it considerable thought. Integrating technology is essential to resolving these issues.”

“These kits' integration of

products more affordable.

Harnessing the full potential of self-testing kits in India's changing healthcare scene requires striking a balance between solid regulatory measures and technical improvements.”

cutting-edge technology can improve accuracy and guarantee consistent outcomes.

Technology also helps to increase accessibility, which makes the kits easy to use for a variety of users. By simplifying production procedures, innovations also help to make

One of the primary challenges faced by self-testing kits in India revolves around ensuring accuracy and reliability.

On this, Dr Bendre said, “One of the key hurdles is the lack of clear guidelines and standards for these kits, leading to concerns about their accuracy and reliability. As a result, many consumers are hesitant to trust the results obtained from self-testing kits, hindering their widespread adoption.”

Striking a balance between using digital capabilities for enhanced user experience and ensuring the confidentiality of health data is a complex process which poses another challenge.

Dr Pandey stresses, “There is always a bittersweet aspect of any technology or innovation we humans have come across. In the current fast paced life of ours growth for the sake of growth must not be the lay of the land. Innovation without oversight is a recipe for disaster as it is as

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cover ) same as playing with fire. The proper regulation and proper quality control of every innovation is mandatory as it is going to gravely influence the outcome in their absence.

Self-testing kits cannot shy away from these regulations as they must be carefully studied and relevant studies backed by a solid principle is always a must.”

Another significant challenge lies in fostering public awareness and education regarding self-testing kits.

Dr Mohan also believes that lack of trained professionals available to provide counselling and support after using self-testing kits is a challenge. Proper guidance is

The prominence of self-testing surged during the COVID-19 pandemic due to limited lab access and extended wait times. However, post-pandemic, widespread adoption of self-testing has yet to take firm root in India Dr Nilesh Shah President & Chief of Science & Innovation, Metropolis Healthcare

essential when interpreting test results or understanding further steps that need to be

taken based on the results.

Addressing the challenges and navigating the regulatory

landscape of self-testing kits in India requires a collaborative approach. All the concerned

stakeholders must work together to establish guidelines, foster innovation, and ensure that these kits contribute positively to the broader healthcare ecosystem.

Way forward While self-testing kits bring transformative potential to healthcare in India, addressing challenges and establishing robust regulatory frameworks is essential. The market for testing kits is rapidly expanding but awareness building, strategic collaborations and accessibility will be key for sustained growth.

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

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22 EXPRESS HEALTHCARE February 2024

HEALTH TRENDS

IISc signs MoU with Wipro GE Healthcare to advance Indian medtech innovation The first-of-its-kind collaboration between the organisations is aimed at increasing industry-academia knowledge sharing in emerging technology areas like Precision care, Robotics, Cybersecurity, Artificial Intelligence, and 5G to improve the innovation ecosystem and accelerate local manufacturing

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ipro GE Healthcare, a leading global medical technology, diagnostics, and digital solutions innovator has signed a Memorandum of Understanding (MoU) with the Indian Institute of Science (IISc), India’s premier research institution, for a pioneering alliance to advance healthcare innovation, research, and technology development in India. This collaboration aims to take a comprehensive approach in solving the care gap by addressing the full lifecycle that includes co-developing solutions, validating the technologies, and manufacturing them locally to bring them to the market. With the impending commencement of the Bagchi-Parthasarathy Hospital & IISc Medical School, this strategic collaboration will enable translation of technologies from bench to bedside.

According to World Health Organisation Report 2018, “Globally, Non-Communicable Diseases (NCDs) accounted for 71 per cent of total deaths. In India, NCDs were estimated to account for 63 per cent of all deaths, and cancer was one of the leading causes (9 per cent).” This industry-academia collaboration aims to advance indigenous innovation and manufacturing of medtech products that meets the needs of both global and local patients suffering from NCDs including cancer, cardiology, and neurology in line with the agenda of ‘Atmanirbhar Bharat’.

The collaboration will entail co-development initiatives in the areas of basic and applied science, systems engineering, product & software development, consultancy, publications, academic studies, intern-

From left to right- P S Anil Kumar, Dean of Administration & Finance, Indian Institute of Science (IISc), Govindan Rangarajan, Director, Indian Institute of Science (IISc), Chaitanya Sarawate, Managing Director, Wipro GE Healthcare and President & CEO, GE HealthCare South Asia andGirish Raghavan, VP – Engineering, GE HealthCare

The collaboration will entail co-development initiatives in the areas of basic and applied science, systems engineering, product & software development, consultancy, publications, academic studies, internships, fellowships, and training ships, fellowships, and training.

IISc and GE HealthCare will constitute a joint working committee, comprising representatives from both sides, for research around product and solution development.

Govindan Rangarajan, Director, Indian Institute of Science (IISc), said, “We see a tremendous need for innovative R&D that can improve outcomes in patients with NCD. The collaboration will emphasise combining science and en-

gineering with translational & clinical research to epitomize “bench-to-bedside” innovation.

GE HealthCare is the right partner for us in this initiative, given their leadership and strong footprint in India for R&D and manufacturing. We are confident that together, we can accelerate India’s position as a global force for healthcare for the world.”

Chaitanya Sarawate, Managing Director, Wipro GE Healthcare and President &

CEO, GE HealthCare South Asia, said, “India today is at an inflection point, with a potential to become the hub for the world. IISc is a premier educational institute engaged in technical education, basic and applied research, innovation, entrepreneurship, and industrial consultancy and GE HealthCare is a world leader in MedTech with strategic R&D and manufacturing footprint in India. This is a strategic collaboration that combines the

strengths, capabilities, and local infrastructure of both entities. Our aim together is to invest in technologies of the future that can revolutionize the care paradigm – with more precise, connected, and compassionate care to patients in India and worldwide.”

The collaboration aligns with the Indian Government's emphasis on fostering local Research and Development (R&D) and manufacturing in the medtech sector, necessitating Public-Private Partnership (PPP) models to further drive technology development. Collaborative efforts by both the entities will be deployed for product development and clinical research, improving indigenisation of manufacturing and academic activities to strengthen the healthcare ecosystem.

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February 2024

MEDTECH

Pioneering innovations in personalised medicine to tackle NCDs Dileep Mangsuli, Executive Director and Head, Siemens Healthineers Development Centre shares how incorporating innovation in personalised care is an important step in the battle against NCDs and advancing a healthier future

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he healthcare industry is undergoing a significant technological evolution, particularly in terms of combating Non-Communicable Diseases (NCDs).

Studies show that about 75 per cent of all deaths globally are caused by NCDs. Moreover, in India, conditions like heart disease and cancer cause 63 per cent of all deaths.

These alarming numbers have raised concern for a more holistic and integrated approach toward NCD treatment procedures. Incorporating innovation in personalised care is an important step in the battle against NCDs and advancing a healthier future.

The goal of a personalised healthcare approach is to choose and provide patientspecific solutions that address their unique needs. This can be achieved by implementing best practice standards to organise care along the patient’s clinical pathway. By integrating precise diagnostic data, healthcare professionals can build a digital twin of the patient that provides a holistic understanding and actionable insights at the point of decision. Combining highly precise image guidance with minimally invasive, robot-assisted, and intelligent therapies, enables professionals to deliver better patient outcomes with improved therapy results. This strategy guarantees that each person has access to individualised information, professional counsel, support, and help throughout their medical journey in order to obtain the best care to manage their health.

Precision medicine and personalised treatments are already making significant strides in the healthcare

24 EXPRESS HEALTHCARE February 2024

The goal of a personalised healthcare approach is to choose and provide patient-specific solutions that address their unique needs ecosystem. Today, technological advances in personalised healthcare include the rise of wearable technologies, genomics, electronic health records, and data analytics.

These technologies make it seamless to collect and analyse patient data, giving out important information regarding the patient’s health profile. There are technologies that are specifically engineered to simplify and enhance every aspect of image-guided volumetric IMRT (Intensity-modulated radiation therapy), which gives fast and high-quality treatments to win the fight against NCDs like cancer.

IMRT uses computer-gener-

ated images to deliver focused radiation beams, which spare the adjacent healthy tissues and target only the affected tissues. The high radiation beams from IMRT target the three-dimensional shape of the tumor, thereby increasing treatment effectiveness.

Moreover, the integration of robotic systems to provide improved efficiency and greater adoption will continue to increase. Over the next 10 years, we can expect robotic systems to transform and become more sophisticated, with the ability to do more things. Most significantly, they will improve patient outcomes, which will increase both patient and payer de-

mand for these systems. Hospital leaders must foster an environment where this technological innovation is able to flourish, or they risk being left behind.

Medical robots are revolutionising healthcare due to some amazing advancements made in recent years. For example, cutting-edge robotic imaging technology for multiple surgical disciplines enables minimally invasive treatments. Such technologies give high importance to patient care as the automated C-arm positioning allows users to focus on the patient rather than on the imaging system. With the recent development of technologies, the next generation of surgical and interventional robots will be smaller, more precise, and more user-friendly, resulting in improved patient outcomes across all specialty areas.

Such innovations can accelerate personalised care in the country. However, the next challenge is ensuring health equity that makes innovations accessible to all parts of the country. The cost of implementing technology to carry out accurate diagnosis, guaranteeing accuracy, and timeliness while carrying out the diagnosis also becomes a concern. The lack of patient longitudinal data hinders diagnostic and tracing efforts and makes prevention in a patient's community or workplace more challenging.

Achieving personalised healthcare can only become a reality once these challenges are resolved.

At present, 17 million people die prematurely from NCD before the age of 70 every year. In order to envision the UN's global ambition

to reduce premature mortality from NCDs by one-third before 2030, the Indian Government announced the Medical Devices Policy early this year. In the Production Linked Initiative (PLI) scheme of the policy, a total of 14 projects producing 37 products have been commissioned and domestic manufacturing of highend medical devices has begun which include Linear Accelerator, MRI Scan, CTScan, Mammograms, C-Arm, MRI Coils, high-end X-ray tubes, etc. This initiative makes it easier for players in the medtech industry to further accelerate personalised care. Personalised healthcare looks at long-term solutions to enhance patient outcomes that benefit general societal health.

According to the Asia-Pacific Personalised Health Index, developed by the Copenhagen Institute for Future Studies, India ranked 10th on a list that revealed positive progress towards personalised healthcare across 11 countries. Progressing by investing in personalised healthcare has the potential to transform the landscape of the healthcare industry. It can improve the well-being of an individual, along with fostering resilience and preventing potential health issues. This, in turn, optimises the use of resources available within the healthcare industry. Considering that much of today's medicine is still predicated on a "one-size-fits-all" concept, personalised healthcare can assist in overcoming this by allowing each patient to receive the right treatment at the right time, eventually ensuring health equity in the country.

Navigating the regulatory landscape for medical devices in India Sidharrth Shankar, Partner and Co-Chair, Corporate Practice, JSA talks about the Indian medical device regulatory framework

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n recent years, India's medical device industry, a critical component of the healthcare sector, has experienced significant regulatory transformation.

The introduction of the Indian Medical Device Rules in 2017 and subsequent amendments have reshaped the industry's landscape, presenting various challenges and opportunities for manufacturers. This article offers a comprehensive overview of the current regulatory framework, the role of the Central Drugs Standard Control Organization (CDSCO) and the implications of these regulations for innovation, market-entry, and compliance, particularly in light of recent concerns with regard to surrounding high-risk devices.

The Indian medical device regulatory framework The Indian Medical Device Rules, 2017, marked a significant turning point in regulating medical devices. This framework introduced a risk-based classification system, dividing devices into four categories based on the level of risk they pose. These regulations brought India's medical device sector closer to global standards, enhancing the safety, efficacy, and quality of products available.

The Medical Devices (Amendment) Rules, 2020 In 2020, the Medical Devices (Amendment) Rules were introduced, refining the regulatory process and focusing on quality and safety standards. With the aim of elevating the overall standard of medical devices, this amendment streamlined registration and licensing procedures and established stricter manufacturing and compliance requirements.

The role of CDSCO CDSCO, functioning under the Ministry of Health & Family Welfare, is the regulatory au-

tic equipment manufacturers and innovative startups, reveal the importance of strategic planning and understanding regulatory nuances. Such examples serve as models for other companies in the industry.

Impact on specific segments of the medical device market

thority for medical devices in India. It plays a pivotal role in the approval, surveillance, and quality control of medical devices, ensuring these devices meet the required safety and efficacy standards.

quests for extensions. The situation has highlighted the need for CDSCO to strengthen its resources to ensure efficient regulatory processes.

The regulatory changes have varying impacts on different medical device market segments. High-tech and innovative products, such as AI-driven devices and telemedicine equipment, may face more complex regulatory pathways, while more traditional medical devices might have a more straightforward compliance process.

Impact on innovation and market entry

Global context and comparison

Challenges and opportunities for manufacturers

The evolving regulatory landscape offers a structured framework for innovation and market entry. Predictable and clear regulations can encourage investment in research and development, fostering the creation of advanced medical devices. A thorough understanding of these regulations is crucial for new market entrants to navigate the market successfully.

Comparatively, India's regulatory framework is evolving to align more closely with global standards, such as those of the FDA in the United States and the European Union's Medical Device Regulation (MDR). This alignment is crucial for Indian manufacturers aiming to compete in the global market.

Different challenges for large corporations vs SMEs

The future of medical device regulation in India is likely to entail continuous adaptation to technological advances and alignment with international regulatory trends. This evolution will be crucial for fostering innovation and maintaining the competitiveness of the Indian medical device industry in the global market.

Manufacturers, especially small and medium-sized enterprises (SMEs), face considerable challenges in complying with the detailed and stringent regulatory requirements. The need for extensive documentation, adherence to quality standards, and navigating complex approval processes are often resource-intensive. However, these challenges are counter balanced by innovation and quality improvement opportunities. The clear regulatory environment can enhance consumer trust and thereby open new markets for Indian medical device manufacturers.

Resource constraints at CDSCO and high-risk device compliance A significant issue that has come to light is the resource constraints within CDSCO. These limitations have been cited by manufacturers as a factor in delaying regulatory compliance for high-risk devices, leading to re-

Large corporations and SMEs face distinct challenges in this regulatory environment. Large corporations often have the resources and expertise to navigate complex regulations, but they may face challenges in rapidly adapting to regulatory changes. On the other hand, SMEs may struggle with the resource demands of compliance, requiring support and guidance to meet regulatory standards.

Case studies of successful compliance Successful compliance stories, such as those of leading diagnos-

Future trends in medical device regulation

Wrapping up Navigating the regulatory landscape for medical devices in India requires an in-depth understanding of the evolving framework, CDSCO's role, and the broader industry context.

Manufacturers need to remain

agile and compliant to succeed in this dynamic environment, ensuring innovation and quality in the growing Indian medical device market.

The Indian medical device sector is undergoing a transformative phase driven by regulatory changes. The Indian Medical Device Rules 2017 and subsequent amendments have introduced a structured regulatory environment. Challenges such as resource constraints within CDSCO need to be addressed to ensure efficient compliance, especially for high-risk devices. The industry's growth potential, with a market projected to reach USD 50 billion by 2025, underscores the importance of a robust regulatory framework. Successful case studies highlight the benefits of strategic compliance and adaptability. The future of medical device regulation in India will likely involve continuous updates to accommodate technological advances and align with global trends.

In the context of these evolving regulatory challenges and opportunities, the key to successfully navigating this landscape lies in strategic adaptability and a thorough understanding of the regulatory nuances. Proactive compliance and manufacturers' adoption of a forward-thinking approach are of utmost importance. India's medical device sector has the potential to emerge as a global leader, provided a concerted effort is made towards aligning with international standards and fostering innovation.

While the necessary guidance and support to manufacturers, particularly SMEs, in understanding and complying with the complex regulations is a given, the secret to success lies in a collaborative approach between the industry and regulatory bodies to address the challenges.

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HOSPITAL INFRASTRUCTURE

Evolution of hospital infrastructure Chinmay Patil, Vertical Head - Medical Planning & Interiors, Edifice Consultants stresses that future healthcare infrastructure focuses on creating adaptable spaces that can effectively handle the challenges posed in the near future

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esigning hospitals necessitates an interdisciplinary approach to effectively coordinate the construction of high-quality and adaptable units that can cater to the diverse needs of various users and swiftly adapt to evolving research innovations. Given the rapid advancement in human and healthcare practices, there is ongoing research to modernise hospitals and adjust functional connections accordingly. The future challenge lies in constructing facilities that not only foster sustainable adaptability but also enable a harmonious synergy with supplementary external activities, promoting overall well-being. As stated in the National Institute of Health research, hospitals are complex buildings that directly impact human emotions due to their articulation, function, organisation and technology equipment. Various engineering and medical services add layers of parameters that should be in sync with hospital infrastructure. Focusing on the availability and approachability of healthcare spaces is essential to fundamentally improve the quality of hospital infrastructure and patient care in India. To tackle this, the first strategic action report

by HIMSS describes the necessity of 'scalable healthcare spaces.' In response to the overwhelming COVID-19 surge, numerous hospitals in India are actively undergoing remodelling efforts to enhance their preparedness for future crises.

What are scalable hospitals?

Scalable hospital design can adapt, shift function and modify in response to patient care and employee needs. A scalable oncology hospital model is strategically designed to facilitate cancer care that can start small and grow with demand in a planned and efficient manner. With a strong commitment to sustainability, the design of the scalable

26 EXPRESS HEALTHCARE February 2024

Fundamental design principles of oncology hospitals

module demonstrates contextual awareness and deep respect for the surrounding environment.

Scalable modules: The future of healthcare infrastructure Future healthcare infrastructure focuses on creating adaptable spaces that can effectively handle the challenges posed in the near future. With the concept of 'scalability in hospitals,' healthcare facilities can adapt to the situation at hand and efficiently prepare for future impediments. Moreover, promoting scalability can introduce various innovations that improve patient care. A radical shift from traditional hospital designs is necessary to cater to India's evolving number of patients. As per research conducted by the Indian Council of Medical Research, it is projected that there will be nearly 30 million cancer patients in India by 2025. In response to this growing concern, distributed models of cancer care centres are being designed across the country to cater to the increasing number of patients.

Particularly in cancer care, a 'scalable module' is the solution for designing oncology hospitals to meet the changing healthcare

landscape. This approach could serve as a prototype for future scalable hospitals in India that can be replicated and adapted across the country to cater to the evolving healthcare needs of different regions.

The need for scalable healthcare design in India According to a recent survey conducted to understand why flexible healthcare spaces need to be implemented for a better future, 70 per cent of respondents think flexibility is an essential aspect of good design. In addition, a scalable model also encourages a large section of stakeholders, including healthcare decision-makers, healthcare administrators, facility and nurse managers and clinical workers, to overcome entry barriers in patient care. The replicable design of scalable hospital modules in India emphasises the potential of such services in the near future. The prototypical planning of such scalable modules is designed to create a sense of spatial similarity throughout all upcoming cancer care centre modules in India. This approach allows for future expansions and ensures a cohesive and familiar environment for patients and healthcare providers.

Essentially, oncology hospitals are highly 'equipment intensive' and require care in their incorporation into the blocks. In times of such crisis, hospitals require a greater need for specialised spaces that can accommodate varying patient-care protocols tailored to specific diseases. It is essential to note that equipment placement in scalable hospital layouts is just as crucial as designing various other spaces, as they require specific spaces to accommodate patient well-being and ease in pedestrian circulation. The challenge lies in making the equipment virtually invisible in the psyche of the patients to reduce their anxiety levels and provide an environment of hope and healing.

Cost-effective solution to the ever-increasing number of cancer patients in India Hospitals, being services and equipment-specific, have higher associated costs with them. For example, a linear accelerator is equipped inside a bunker of concrete walls and ceilings as thick as 8 feet at some locations. This is a significant cost considering the bunker spreads over 1,500 sq. ft.

As per building codes, even the rest of the structural design for a healthcare facility needs to be 1.5 times greater than any other building typologies to withstand natural calamities like earthquakes and continue to serve the patients. The challenge was to incorporate the clinical and operational requirements and opportunities to improve the clinical flows with the ease of spatial access while creating spaces that evoke a sense of similarity.

Façade details and building interiors The built form, façade, and interiors have been carefully curated to ease a cancer patient's strug-

gles, anxiety levels, and social stigma in making the entire treatment process as non-intimidating as possible. These design aspects enable the centres to seamlessly weave themselves into the community, offering comprehensive care with humane attributes.

Planning principles of a strategic hospital layout The layouts of the projects at all locations are based on a single planning principle, and the shape of the structure is designed to ensure ease in replicating and increasing the scalability of the structures in a fast-paced manner during construction. The development is being envisaged in two phases.

In service demand, a seamless addition of building blocks from L2 to L1 is ensured. Phase 1 would be an L2-A typology consisting of supporting facilities.

The facility and master plan for phase 2 will be designed to cater to the L1 typology if necessary.

Architecture elements of the scalable hospital module The architecture of the built form, façade, and interiors are carefully curated to ease cancer patients' struggles, anxiety levels, and social stigma in making the entire treatment process as non-intimidating as possible.

These design aspects enable the hospital centre to seamlessly weave itself into the community, offering comprehensive care with humane attributes. The design prioritises the well-being of the occupants, ensuring that their needs are met while also considering the long-term sustainability of the environment.

Such scalable hospital modules balance functionality, aesthetics, and environmental consciousness by embracing responsible architecture principles, resulting in a contextually relevant and environmentally responsible project. The design incorporates efficient airflow by ensuring that

a significant number of openings have access to the cooling winds, thereby maintaining a pleasant temperature. Additionally, the building orientation is arranged to decrease the overall heat, providing indoor ambient temperature.

Focus on patient well-being Patient and clinical areas are thoughtfully designed with access to natural light and also accommodate the presence of relatives, recognising their role in the healing process and foster-

ing a supportive environment.

Clean planning of departments is prioritised, ensuring ease of wayfinding for users and minimising anxiety levels. Staff functionality is optimised by arranging departments in clinically appropriate adjacencies, contributing to their efficiency and improving healthcare delivery outcomes.

Achieving sustainability in healthcare infrastructure through scalable modules To design environmentally responsible and resilient built en-

vironments, commitment to sustainability extends to every stage of the design and project implementation process on site.

The design must employ environmentally responsible design strategies to minimise its ecological footprint and enhance energy efficiency. Natural lighting and ventilation must be optimised to minimise energy consumption and create a comfortable indoor environment. Cutting-edge equipment, locally sourced materials, and energy management systems should be integrated through-

out the construction process, promoting energy conservation and reducing environmental impact. The layout of a scalable hospital is based on a single planning principle, allowing the design of a unified facility with the same operational parameters and a similar look and feel across all centres, incorporating each location's unique cultural, art & geographical influences. This approach helps fasten the construction process and allows users to focus more on patient well-being rather than physical movement during

critical times.

Collaboration is key to healthier India Devising scalable healthcare architecture in India is based on the strategic translation of 'scalability' into a tangible built form.

To facilitate cancer care that can start small and grow with demand in a planned and efficient manner, a scalable model is the need of the hour. However, such projects require encouragement from a large section of stakeholders to overcome entry barriers in cancer care.

E-ICU: Revolutionising critical care Dr Dilip Dubey, Director, Medanta e-ICU explains how e-ICUs are revolutionising critical care across India

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any developing nations, like India grapple with a significant shortage of qualified intensivist team for round the clock coverage to manage critically ill patients. This scarcity leads to delays in clinical decision-making and thereby, increase in mortality and morbidity rates. That creates a financial strain on both patients and healthcare institutions. With advancement in medical techniques and facilities in term of diagnostics and therapeutics, the traditional reliance on on-site ICU doctors is no longer adequate to meet the escalating needs of a growing patient population, especially in intensive care units. Hence, alternative strategies are imperative to provide expertise and proactive, continuous care to critically ill patients. In response to the resource constraints of existing ICUs located in different areas, e-ICU support by a super-specialised critical care expert team has emerged as an effective solution that surpasses traditional boundaries.

What is e-ICU? An e-ICU is a form of telemedicine that uses state-of-the-art technology, seamlessly integrating remote monitoring, virtual consultations, and realtime interventions to enhance

across different locations. This model facilitates continuous monitoring and coordination, empowering healthcare professionals to make informed decisions promptly. In the background, a specialised team of doctors, including experts in diagnostic critical care medicine and ICU infections, operates in the Command Centre. This team ensures continuous monitoring and timely interventions, addressing the challenges posed by remote site ICU doctors/ staff. The e-ICU system's structure and capabilities enhance healthcare delivery by leveraging technology for seamless coordination and informed decision-making.

The challenges an e-ICU addresses

patient care, particularly for those in critical conditions.

This medical technologydriven platform provides nearreal-time updates for remote patient monitoring and early interventions, even during odd hours of the night. As a result, the decision-making ability of an ICU is enhanced and can

bring extraordinary results in clinical outcomes. The e-ICU represents a paradigm shift in critical care delivery.

Components of e-ICU At its core, the e-ICU system operates on a hub-and-spoke model, connecting a central hub with various spoke units

The e-ICU model not only helps manage current critical care demands but also positions healthcare institutions to respond swiftly to unforeseen surges in patient volumes or emergencies.

It addresses issues caused by geographical constraints and staffing shortages by providing 24/7 virtual ICU support and continuous remote monitoring. Remote monitoring of multiple patients allows hospitals to optimise resource allocation and prevent extended hospital stays. This ensures

that critically ill patients receive timely identification of the issues and their rectification without the need for physical transfers to super-specialty hospitals. This not only reduces operational costs but also enhances the efficient use of medical resources. If patients need a referral to a higher facility, it provides guidance for a timely referral with no unnecessary delay.

Medical science and diseases do not have any limitations, and for this, we are committed to providing you with solutions for all in a timely manner by giving medical and surgical super-specialty opinions whenever needed.

Medanta e-ICU also has the provision of providing training and teaching to remote ICU staff, giving them the capability to deal with all possible critical events in ICUs. Now, that enhances the ability of the hospitals to tackle anything coming in their way to success and provide patients with all the resources they need to live a healthy life.

In implementing such technologies, the healthcare industry is not merely adapting to change but actively shaping a future where critical care is accessible, efficient, and capable of delivering optimal outcomes for patients in need.

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POLICY

Two giants,two systems: Exploring differences between India and US healthcare Namit Chugh, Principal, W Health Ventures and Tushar Sadhu, Investment Associate, W Health Ventures offer insights on how the start-up ecosystem will evolve in India and US healthcare

N

o one would be surprised when we claim that India and the US have drastically different healthcare systems. But as the quality of in-patient care in India’s foremost cities becomes comparable to that in the US, it is interesting to pen down the contrasts and avenues of crosslearnings. As investors in both the geographies, we feel this juxtaposition offers insights on how the start-up ecosystem will (and hopefully should) evolve in both countries.

In this article, we analyse the healthcare ecosystem from the point of view of the three big institutional stakeholders: provider, pharma, and payor and assess the two countries in terms of healthcare innovation and entrepreneurship.

Namit Chugh

Tushar Sadhu

Hospitals Publicly listed hospitals trade at a median revenue multiple of ~2x in US vs ~5x in India showing a larger growth potential and promise. This is well reflected in the fact that the top 10 hospital chains have only ~35k hospital beds out of the ~1.4M beds in Indian hospitals are groups/chains; and most of the remaining care is delivered through individual doctors and small nursing homes (smaller than 50-bed hospitals). That also means there is so much more room for consolidation. In 2022, India saw $4B+ in M&A just within the hospital sector.

Private Equity investors have also shown a firm belief in the growth of India’s single specialty care by pouring $4B in 2022 in therapy areas like fertility/IVF, ophthalmology, oncology and nephrology. The US has already seen Private Equity investments in multiple therapy areas.

Higher adoption of technology for business and clinical processes in the US makes the

patient flow more predictable (based on one’s insurance coverage). While organised mar-

kets are always beneficial, India’s paper-dependent, offline healthcare system does have

one unintended advantage (at least in the top 20 cities with infrastructure) – direct, zero

wait-time access to doctor at a fractional cost. An Indian living close to a good hospital can usu-

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POLICY ally walk-in and get an appointment without the insurer influencing their choice while wait times in the US are usually longer. In Indian context, the reimbursement will most likely be out of pocket.

makes the system very fragmented (and there are startups disrupting the space) and rife with inefficiencies.

Demand side: The patient journeys could not have been more different. But we will highlight the key differences: ◆ Doctor Rx is a must in the US vs in India where a lot more medicines can be procured over the counter ◆ In the US, your insurance determines the pharmacy whereas in India the patient/doctor select the pharmacy ◆ In the US, pharma purchasing is influenced by your insurance vs in India it is determined by your doctor or pharmacist ◆ Though the insurance covers your medicine – there is a copay associated which is typically as expensive as the price of the drug in India ◆ For a price comparison, ❖ A strip of 30 Lipitor tablets costs ~$400 in the US (copay + insurance) vs in India it costs $2 for the same ❖ A strip of 12 OTC paracetamol tabs will cost ~$5 vs in India the branded variants are available for ~$0.25

Insurance/Payer US is a largely insurance led market (~92 per cent population has health insurance) while India is predominantly direct patient pay “OOP” (Only ~45 per cent population has some form of health insurance). The US insurance market size is $1.6T vs the $15B market in India. While the premium costs are generally higher in the US, they also cover OPD services and have stricter control over medicines.

Although there is a marked increase in innovation in multiple aspects of insurance from sales to education, claim management to settlement, adoption of tech in Indian insurance is still limited and primarily seen only in distribution in the recent years. Traditionally, individual brokers/agents use community networks to sell health and life insurance (~57 per cent of health insurance sold through individual agents and brokers). This is changing fast for both retail and corporate.

Reimbursement gets us to the discussion about FFS (fee for service) and VBC (value based care). FFS is the legacy healthcare payment model where the provider/hospital bills a patient for every service provided (without any outcomes associated). As an unfortunate consequence, re-admission to the hospital for a relapse condition actually means double billing for hospital despite the fact that the patient was not cured. To address this, VBC is the newer approach where providers bill for a set of outcomes and not the number of times a service is provided.

While the US has been attempting to bring value-based care to its systems, India is far away from having these discussions.

Pharma Supple side: ◆ US Pharma is a $500B+ market where individual “blockbuster” drugs like Humira, Keytruda and Wegovy garner

30 EXPRESS HEALTHCARE February 2024

billions in sales (Humira $18.5B+ in sales in 2022 in the US alone). The Indian market in comparison is a $60B market with the largest selling drugs being anti-diabetics. ◆ The US big-pharma spends 17 per cent on R&D and that also ensures their access to innovator molecules is the highest. This is also reflected then in the blooming clinical trials

ecosystem and focused regulations there. ~60 per cent of world’s clinical trials happen in US sites while less than 1 per cent happen in India. ◆ On the other hand, India is the generic business manufacturing capital of the world (one in every three pills consumed in the United States is produced by in India) but sees limited innovation and biotech activity.

This also means the CROs do not see global trials and early access to innovator drugs that is much desired for. New biotech start-ups are trying to change status quo here. ◆ US pharma distribution is very concentrated with some large distributors as opposed to India where the supply chain is managed by multiple small distributors and stockists which

In summary, two of the largest democracies have a lot to learn from each other’s healthcare and healthcare entrepreneurship ecosystem. The way forward will be defined by the use of technology for both the countries. As was recently remarked by the leaders of both countries – the coming decade is the decade of AI (Artificial Intelligence and America-India).

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From the exhibition experts Mr.Balasundaram Doraisamy

Concurrent Events Components Expo Diagnostic Expo Infrastructure & Rehabilitation Expo

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Date: 26,27,28 April 2024 Venue: Palace Grounds (Tripura Vasini, A/C) Bengaluru, India.

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HEALTHCARE TRACKER

Charting the course to a USD 50 billion medtech economy Himanshu Baid, Managing Director, Poly Medicure highlights that partnership between public and private sectors is of paramount importance for the development and advancement of the medical technology industry

T

he Indian medical device industry has experienced significant evolution over the past decade.

From a nascent stage, we have grown into a robust and dynamic sector, offering a diverse range of cutting-edge products catering to both domestic and global markets. This growth is underpinned by factors such as a burgeoning healthcare landscape, increasing awareness, and a growing middleclass population demanding advanced healthcare solutions.

The 'Make in India' initiative has been a catalyst for our industry, fostering a conducive environment for domestic manufacturing. This, coupled with regulatory reforms and a focus on R&D, has propelled us towards self-sufficiency and global competitiveness. As a result, India is emerging not only as a key player in the regional market but is also gaining recognition on the global stage for its innovative medical technologies.

While our growth story is commendable, achieving the USD 50 billion milestone by 2030 demands concerted efforts and strategic initiatives.

The partnership between the public and private sectors is of paramount importance for the development and advancement of the medical technology industry. This collaborative synergy brings together the strengths of both sectors, leveraging resources, expertise, and innovation to address complex healthcare challenges.

The public sector typically possesses substantial funding resources, which can be channelled into research, development, and infrastructure. The private sector contributes specialised knowledge, technolog-

ical expertise, and entrepreneurial acumen, enhancing the efficient utilisation of resources.

Collaborating on a global scale positions the medtech industry for international competitiveness. International partnerships can enable the exchange of best practices, technology transfer, and collaborative research efforts, fostering a global ecosystem of innovation.

Providing a boost to healthtech startups in AI, robotics, IoT, and related fields is poised to have a transformative impact on the medtech industry. This synergy holds the potential to drive innovation, enhance healthcare accessibility, and propel the sector to new heights. Healthtech startups specialising in AI, robotics,

and IoT can collaborate with the medical device industry to create innovative solutions.

This could include smart medical devices, wearable technologies, and robotic-assisted surgical tools, revolutionising healthcare delivery.

Fostering a collaborative environment between healthtech startups and the medical device industry is a strategic imperative for the growth and evolution of healthcare in India. By leveraging the strengths of these innovative entities, we can anticipate a surge in groundbreaking medical technologies that not only address current healthcare challenges but also position India as a global hub for medical device innovation.

Strengthening robust collaborations between the med-

ical device industry and academic institutions is also pivotal for creating a holistic ecosystem that supports innovation, skill development, and the overall growth of the sector. This collaborative approach not only advances the industry's technological capabilities but also nurtures a workforce that is adept, adaptable, and ready to meet the evolving challenges of the medical device landscape. This collaboration allows researchers to address real-world challenges faced by the medical device sector, leading to the development of innovative solutions.

Joint R&D projects enable the pooling of resources, expertise, and facilities from both industry and academia. This collaborative approach fosters a culture of continuous improvement, allowing for the development of cutting-edge technologies that align with global standards.

Implementing more efficient regulatory approval processes will facilitate quicker market access for new medical devices. Aligning regulatory standards with international benchmarks will enhance the industry's global competitiveness.

The emphasis on Skill Development Initiatives is crucial for the sustainable growth and competitiveness of the industry. Skill development programs should be tailored to the specific needs of the medical device sector. Specialised training in areas such as advanced manufacturing techniques, regulatory compliance, and quality control processes is essential.

The importance of preventive healthcare cannot be overstated in the pursuit of trans-

forming the Indian medical device sector. Integrating preventive healthcare measures plays a pivotal role in not only improving public health outcomes but also creating a conducive environment for the growth and sustainability of the medical device industry.

By addressing health proactively, the sector can not only meet the demands of a healthier population but also foster an ecosystem conducive to innovation, economic growth, and global competitiveness.

Embracing preventive healthcare is not just a strategic imperative; it is a transformative force that can elevate the entire healthcare landscape in India.

Preventive healthcare often involves empowering individuals to manage their health at home. This trend opens up opportunities for the development and adoption of home healthcare devices, further diversifying the product portfolio of the medical device sector.

Emphasising the integration of telemedicine and digital health solutions will further enhance healthcare accessibility, especially in remote areas.

The Indian medical device industry stands at a pivotal juncture, ready to script a remarkable growth story. With the right blend of strategic planning, government support, and industry collaboration, we have the potential to not only meet but exceed the USD 50 billion target by 2030.

As we navigate this transformative path, let us, as stakeholders in this thriving industry, collectively strive to make the Indian medical device sector a global leader, symbolising excellence, innovation, and resilience.

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February 2024

HEALTHCARE TRACKER

Technology trends in flow cytometry Amardeep Gupta, Senior Business Manager-Flow cytometry, Manager, Regional Marketing, EHC-APAC, Sysmex highlights that today’s flow cytometers support multiple lasers and fluorescence detectors, which aid users in labeling multiple antibodies and in identifying precisely a target population by its phenotype

I

t all started when Prof.

Dr. Wolfgang Göhde, launched the world’s 1st Fluorescence Flow Cytometer in 1968. The original name of this technique was Pulse Cytophotometry, and he named it as ICP-11 (Immuno Cytophotometer). 10 years later in 1978, at the Conference of the American Engineering Foundation in Pensacola, Florida, the name was changed to Flow Cytometry. Since its inception, this technique has started developing interest in many scientists thereafter. Advances in this field have been tremendous, and even now there are many developments day by day.

Initially, Flow cytometers were used as experimental devices in research institutes only. However, the uses and application of this instrument gained great momentum, and other industries have started to explore this technique too, and now it has become a major market. Today’s flow cytometers support multiple lasers and fluorescence detectors, which aid users in labeling multiple antibodies and in identifying precisely a target population by its phenotype.

Apart from research segment, flow cytometry is now being applied in Clinical, Industrial, Essential healthcare, Agriculture, Aquaculture, Microbiology, etc. and the list goes on. People have now understood the importance of this technique, and now improvising in its existing technical aspects. Advances in laser sources, sample preparation automation, detection sensitivity, digital-signal processing speed, rare-event analysis, and cell-sorting performance, coupled with a broad portfolio of reagents with a varying spectrum of dyes and fluorochromes, provide the tools

38 EXPRESS HEALTHCARE February 2024

vative analysis capabilities to enhance diagnostic quality – we have now embarked on a journey to address the needs of clinical flow cytometry laboratories.

Combining our competence in diagnostics and workflow optimisation, our vision is to create an integrated clinical flow cytometry analysis system that helps increase the workflow efficiency of flow cytometry laboratories, allowing you to deliver your services with confidence in the results.

This vision of intelligent automation for a new level of workflow efficiency has started to become reality, while there’s still more to come.

Thoughtful automation for a new level of workflow efficiency

necessary to answer questions in immune monitoring, immunophenotyping, stem-cell analysis, cell-signaling, and signal transduction.

One of key step in FY 23 is to bring focus on our new launch. We are a global leader in multiple castigations including hematology, urinalysis and hemostasis and a benefactor in automation workflow. Sysmex now introduced “A next level of automation of flow cytometry”.

Our Flow cytometry system comprises PS-10 sample preparation system, “Rotolavit-II-S Automatic Cell Washing Centrifuge”, “XF1600 Flow Cytometer”, Abs portfolio, ancillary reagents, and “VenturiOne data analysis software”. With this, highly trained operators are no longer need and spending hours manually pipetting, leaving their valuable time for

more complex analytical activities with Sysmex next level of automation of Flow Cytometry.

Specialised flow cytometry laboratories today are facing several challenges: the number of requests and the complexity of the analyses are increasing, while at the same time, the requirements for documentation are growing, and achieving the required traceability of reagents and processes is a complicated feat. To add to this, the number of skilled staff and resources is declining.

Many laboratories are looking for ways to improve efficiency to sustainably continue to provide their services.

Building on our experience in helping clinical laboratories in the areas of haematology, haemostasis and urinalysis – by adding automation to increase productivity, and inno-

Discover a comprehensive solution that addresses the challenges posed by increasing demands for testing and documentation under declining skilled staff and resources. ● PS-10 sample preparation system: The programmable PS-10 automates sample preparation steps to match your SOPs, adding increased efficiency and standardization for complex and routine flow cytometry applications ● Automated cell washing system: The Hettich Rotolavit II-S cell wash centrifuge automatically carries out the routine washing steps when preparing samples for flow cytometry ● XF-1600 flow cytometer: The award-winning Silent Design of the XN-Series set the standard for the development of this 10-colour flow cytometer for highest-level clinical requirements ● Antibody and reagent portfolio: A broad choice of high-quality Sysmex CyFlow™ antibody reagents to create

the perfect panel for your needs, plus a selection of lyse, fix and permeabilization reagents, and instrument setup and maintenance reagents Our aim is to establish a solution that automates processes from sample preparation to the reporting of measurement results to help clinical flow cytometry laboratories reach a new level of workflow efficiency and deliver their services with absolute confidence in the results. The launch of the PS-10 and associated reagents is the first step towards such an integrated clinical flow cytometry solution from Sysmex.The PS-10, flexibly and intelligently automates many of the manual steps in the preparation of samples for flow cytometric analysis, thus freeing up the time of laboratory staff to do other, more demanding tasks, such as data analysis.

As a programmable system, it offers efficient sample processing for both routine and/or complex tests. The standardisation of sample processing reduces possible human handling errors and improves confidence in the results. The PS-10 provides traceability of samples, reagents and processing steps, thus easing the burden of documentation.

To accommodate protocols with wash steps, the PS-10’s rotors are compatible with the Rotolavit II-S automated cell wash centrifuge (Hettich Group), which automatically carries out the routine washing steps when preparing samples.

The PS-10 addresses several challenges that today’s clinical flow cytometry laboratories are facing, posed by increasing demands for testing and documentation under a declining availability of skilled staff and resources.

HEALTHCARE TRACKER

Application of silicone in medical sector Raju Mahato, Executive-Business Development, Ami Polymer talks about some of the common applications of silicone in the medical field

M

edical grade silicones which is biocompatible and are appropriate to be used for medical (Critical) applications with its non-toxic, nonhaemolytic, and non-pyrogenic properties. Basically Silicone is an elastomer in nature and hence it’s a polymer and is best known for: Inert in nature, Biocompatible, Flexible, Temperature-resistant and Water-resistant.

Silicone is a versatile material that has been widely used in the medical industry due to its unique properties. Here are some common applications of silicone in the medical field: ◆ Medical implants: Silicone is commonly used in breast implants, as well as other types of implants such as facial implants and penile implants. It is biocompatible, meaning that it is not harmful to the human body, and has a low risk of causing an immune reaction. ◆ Wound care: Silicone is also used in wound dressings and scar treatments. Siliconebased dressings are often used for the treatment of burn wounds, as they help to reduce scarring and promote healing. ◆ Medical tubing: Silicone is used to make medical tunings, such as catheters and feeding tubes. It is flexible, durable, and resists kinking, which makes it ideal for these applications. ◆ Medical adhesives: Silicone-based adhesives are used in medical applications such as wound closures and surgical incisions. These adhesives are biocompatible and are designed to adhere to the skin without causing irritation or damage. ◆ Medical equipment: Silicone is used to make a variety of medical equipment, such as syringe plungers, valve diaphragms, and O-rings. It is resistant to high temperatures and sterilization, making it ideal for these ap-

plications.

Overall, silicone has a wide range of applications in the medical industry due to its unique properties. Its biocompatibility, flexibility, and durability make it a popular choice for medical implants, wound care, tubing, adhesives, and equipment.

The application of the silicone tubing depends upon the size of the tubes. ◆ Small size tubing: Due to its thin walls and flexibility, they are used most commonly as electrical sleeving. ◆ Medium sized tubes: Generally, it is used to carry liquids and powders thereby making it popular with the pharmaceutical, Biopharma, and food industries. These type of silicone materials are specially designed in applications that are hygiene and very critical in use. ◆ Large size silicone tubing: It is majorly applied in air ducts and dielectric applications.

based silicone tube which are majorly used in following ways: ◗ Peristaltic Pump Application ◗ IV Cannula ◗ Feeding Kit ◗ Silicone Foley Catheter ◗ Suction Catheter ◗ Haemodialysis Catheter ◗ Medical Balloon Tubing ◆ Enema kit: Enema kits are typically used for colon cleansing or as a treatment for constipation, and they typically involve the use of a bag or container filled with a liquid solution that is inserted into the rectum via a nozzle or tube. ◆ Menstrual cup: Ami polymer offers 100 per cent medical-grade liquid silicone rubber, which is manufactured in gle product tested by highly qualified Rubber Technologists & Engineers for maintaining all the regulations and safety for women. ◆ Moulded products: Ami Polymer offers medical moulded products such as stoppers, O-rings, Gaskets, bellows, caps, and closures.

These products are used in various medical devices and equipment such as syringes, IV sets, and blood transfusion sets and in various other blood transfusion equipment.

Overall, Ami Polymer’s product portfolio in the med-

Ami’s portfolio of silicone products for medical segment ◆ Medical tube: Ami Polymer offers medical-grade tubing for various medical applications. These tubes are used in various medical applications such as IV infusion sets, dialysis machines, catheters, and oxygen masks. Ami Polymer are specialized into Medical

Clean Room ISO Class 7. It complies with all regulatory documents including Food Grade, FDA21CFR, BPA Free, TSE- BSE free, etc. Every sin-

ical sector offers a wide range of polymer-based solutions for various medical applications, ensuring quality and safety in the medical industry.

EXPRESS HEALTHCARE

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HEALTHCARE TRACKER

Richard Wolf's cutting-edge products now on Medikabazaar This collaboration provides healthcare professionals with convenient access to specialised solutions for a range of specialties from urology to ICU bronchoscopy

R

ichard Wolf, a leading endoscopy manufacturer in the medical technology sector, has recently started offering its expert products on Medikabazaar.

This collaboration provides healthcare professionals with convenient access to specialised solutions for a range of specialties from urology to ICU bronchoscopy.

Particularly in the field of critical care medicine, Medikabazaar now exclusively offers various flexible sensor bronchoscopes in conjunction with an ENDOCAM Flex HD controller and associated accessories.

Evaluation sets are also available to test the bronchoscopes in various sizes in your environment.

Renowned for its innovative contributions to healthcare, Richard Wolf's products are

By partnering with Richard Wolf, Medikabazaar expands its offerings, providing a seamless experience for professionals seeking advanced medical equipment now within reach for a broader audience through Medikabazaar's platform.

Medikabazaar, a prominent online medical supply platform, is recognised for its commitment to delivering high-quality products to healthcare professionals.

By partnering with Richard Wolf, Medikabazaar expands its offerings, providing a seamless experience for professionals seeking advanced medical equipment.

This collaboration is set to streamline the procurement

process and enhance accessibility for medical practitioners.

Richard Wolf's comprehensive product range, which extends from minimally invasive diagnostics to state-of-the-art therapy in human medicine, covers the diverse needs of medical professionals.

Of course, flexible bronchoscopy, which enables applications right up to the peripheral areas, has also become indispensable. With its many years of experience in flexible endoscopy, Richard Wolf offers state-of-the-art sensor broncho-

scopes with the latest technical features.

These products aim to expand diagnostic and therapeutic options and improve patient care in various medical fields such as critical care medicine.

The collaboration emphasises Medikabazaar's dedication to making high-end medical solutions more accessible. By offering Richard Wolf's products on its platform, Medikabazaar enhances the reach of these advanced medical technologies, making them available to a wider audience of healthcare

professionals. This strategic partnership aims to facilitate an easier and more efficient process for acquiring state-ofthe-art medical equipment.

The availability of Richard Wolf's expert products on Medikabazaar signifies a notable advancement in medical accessibility. This collaboration bridges the gap between a renowned medical technology provider and an established online medical supply platform, promising to empower healthcare professionals with advanced tools and technologies for improved patient care and diagnostics. Professionals are encouraged to explore the expanded range of options now accessible through Medikabazaar, marking a significant step forward in the integration of cutting-edge medical solutions into everyday practices.

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See New Possibilities Beyond the Image The new Alphenix family of interventional systems deliver images with greater clarity and precision.

Combined with industry-leading dose optimization technologies, enhanced workflow, and a new set of features, Alphenix continues Canon Medical’s commitment to supporting you and your mission to provide patients with safe, accurate and fast imaging.

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