Express Healthcare (Vol. 15, No. 9) October 2022

Srinivas Mahankali Chief Business Officer, Blockedge Technologies

Shishir Gupta Head-Growth & Strategic Initiatives, GE Healthcare

Chairman of the Board

ViveckGoenka

Sr.Vice President-BPD Neil Viegas

Asst.Vice President-BPD Harit Mohanty

Editor

Viveka Roychowdhury*

BUREAUS Mumbai Lakshmipriya Nair,Kalyani Sharma

Delhi Akanki Sharma

DESIGN

Art Director Pravin Temble

Senior Designer Rekha Bisht

Senior Artist Rakesh Sharma

Digital Team Viraj Mehta (Head of Internet)

Marketing Team

Rajesh Bhatkal Ambuj Kumar Ashish Rampure Debnarayan Dutta

Production Co-ordinator DhananjayNidre

Scheduling

Pushkar Waralikar

CIRCULATION

Mohan Varadkar

MEDTECH

RADIOLOGY

CONTENTS

Diagnostics has always been revolutionised by the rapid intervention of technologyand data

P12: INTERVIEW

DR ANILKUKREJA

Vice

HOSPITAL INFRASTRUCTURE

P26: INTERVIEW

P29: INTERVIEW

ASHOKKUMAR KAKKAR

Express Healthcare®

Regd.With RNI No.MAHENG/2007/22045.Postal Regd.No.MCS/162/2022 - 24.Printed and Published byVaidehi Thakar on behalf of

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Solving the CGHS conundrum

Aconsortia of healthcare industry associations, namely IMA, FICCI, ASSOCHAM, NATHEALTH and AHPI have expressed serious reservations about some of the new provisions in the revised Memorandum of Agreement (MoA) on the continued empanelment of private hospitals in the Central Government Health Schemes (CGHS).

The CGHS is a welfare scheme introduced by Government of India under Ministry of Health and Family Welfare which covers all government employees. While representing a huge patient population, the low rates of reimbursement and the delay in receiving dues from the government have long been a bone of contention between private hospitals and the Health Ministry.

The new MoA was supposed to come into force from October 1 but thanks to the efforts of the consortia and member hospitals, the last date for submission of the acceptance letter related to the new MOA has been extended to October 15. Officials from the associations indicated that efforts to get the contentious clauses dropped in the new MOA will continue, with the ultimate goal of getting a revision of the CGHS package rates which have not been revised since 2014.

Representatives from key hospitals groups, including Medanta, Max Hospitals, Fortis Healthcare, Narayana Health, Yashoda Hospitals, among others, who participated in the discussions, reiterated concerns raised in a letter to the Health Secretary Shri Rajesh Bhushan IAS dated September 26, that the proposed change in the clauses, will have 'detrimental effects on the functioning of the hospital' and 'delivery of seamless service to CGHS beneficiaries without impacting the quality of healthcare' ultimately affecting the sustainability of the hospitals.

The letter which has also copied Health Minister Shri Mansukh L Mandaviya covers six major concerns, the topmost being the non-revision of CGHS package rates for procedures for the past eight years. The letter points out that in these past eight years, hospitals have continued to pay annual increments to doctors and nurses, deal with rampant increase in medicines and consumables, and pay more for all operating overheads. Their contention is that is impossible for hospitals to maintain acceptable standards of clinical quality at these rates.

The second concern is that medical specialists have indicated that they wouldn’t be interested in seeing patients at CGHS consultation rates, which are reimbursed at Rs 150 for OPD and casualty treatment while most doctors charge between Rs 300 and Rs 1000 for consultations in the OPD and ER.

The third concern is that the MoA suggests that unlisted implants have to be charged at 60 per cent of MRP inclusive of GST and a minimum discount of 20 per cent has to be given on the MRP of medicines and consumables. The letter states that many smaller hospitals indicated that they do not get large discounts from

distributors and these suggested discounts would cause them to lose money. Even charging for implants and medicines at cost price comes at a loss to all hospitals because there are real costs involved in storage, logistics, medicine delivery, and working capital, as per the letter.

On the suggestion to allow chemotherapy drugs to be procured directly by CGHS beneficiaries, the letter claims that most doctors were against this policy because they would not have control over the quality and efficacy of medicines that are being delivered to patients under their care.

The fifth concern is that while the CGHS has a very large list of procedures, there are hundreds of procedures that aren’t coded in the rate list. The mentioned rates are too little to be able to conduct safe surgeries, according to the letter from the health care associations.

The sixth concern, is that while the MoA has very detailed clauses on what is expected of hospitals which sign up for CGHS, ranging from the terms of operation, termination, penalty, performance clauses, Bank Guarantees, etc. it fails to mention any terms or conditions that are placed upon CGHS for fulfillment of their services.

The earlier contract used to pay hospitals 75 per cent on bill submission and the rest on verification, which has now been removed. Given that CGHS reportedly takes nine months to a year to clear their bills, the delay places working capital stress on hospitals as they are bound to pay salaries on a monthly basis and their vendors in 45 days. There is also no clause that allows hospitals to contest arbitrary deductions or denials.

The letter indicated that there are more contentious terms in the new MoA that will discourage private hospitals from continuing the scheme. While conveying their interest to continue working with the Government in PM’s mission of providing healthcare for all, the signatories were clear that these and other concerns needed to be addressed.

While the government might be hoping that the resurgence in hospital bed occupancy rates and a slow return to profitability, justifies extracting more for CGHS beneficiaries, the fact is that it is the corporate chain hospitals which might be able to sustain these cuts. But most mid-sized hospitals, especially the standalone ones in smaller cities, might slip further into debt if they continue with the CGHS. If they are closed down or sold out, this might create accessibility issues for CGHS beneficiaries, which would be counter-productive to the government's intentions. Thus, the hope is that both sides can come to a more balanced agreement, that is a win-win for all sides.

VIVEKA ROYCHOWDHURY Editor

viveka.r@expressindia.com

viveka.roy3@gmail.com

Provisions in the new MoAcould be counterproductive to the government's intentions,thus both sides must come to a more balanced agreement,that is a win-win for all sides

DIAGNOSTICS

Diagnostics has always been revolutionised by the rapid intervention of technologyand data

AstraZeneca recently partnered with Alveofit to scale up the diagnosis and treatment of lung diseases in India. Dr Anil Kukreja ,Vice President-Medical Affairs & Regulatory,AstraZeneca India in an interaction with Kalyani Sharma talks about this partnership and also shares his views on the implementaion of ITin healthcare sector

Tell us about your recent collaboration with Alveofit. What is the objective behind this collaboration?

We are building a legacy with our original research quality inhalation portfolio in the management of Asthma, and are focussed on bringing first in class medically differentiated life changing medicines in respiratory diseases viz. severe asthma and COPD. We are prioritising our mission to reduce the burden of lifestyle disorders and NCDs on the public healthcare systems through meaningful interventions and partnerships.

Our partnership with Alveofit, a SaaS-IoT enabled respiratory healthcare platform, is to offer IoT enabled handheld spirometers at hospitals across the country. It is also aimed at integrating the latest IoT enabled handheld spirometers were provided in clinics and last mile clinics / hospitals in cities like Lucknow, Chennai, Nagpur, Delhi, Ahmedabad and Kolkata to enable point of care spirometry for optimised diagnosis of different lung associated non-communicable diseases. The spirometers were deployed at ESIC hospitals for industrial employees, Command and Military Hospitals and General Hospitals.

This is a firm step towards collaboratively providing point of care diagnosis thereby reducing respiratory ailments, complications and morbidity rate through constant patient monitoring, HCP education and improving respiratory health for all. Regular

monitoring of lung functions and continuous engagement with care providers improve the overall treatment efficacy. Early diagnosis of respiratory ailments through this device will help provide prompt appropriate treatment of lung diseases in the country.

Through collaborations, our aim is to strengthen health systems ensuring everyone has equitable and affordable access to life-changing healthcare solutions. Based on this pilot, we are planning to expand this initiative to tier-2 and tier-3 towns across India to make basic respiratory

diagnosis and care more accessible.

What are your views on the current status of scalability of IT in diagnostics for such therapies?

Diagnostics has always been revolutionised by the rapid intervention of technology and data. We have started to see the potential of technology & innovation in diagnostics. A significant amount of scientific & technological innovation is happening in India today in the healthcare sector to augment the ease of detection and precise detection that can not

only save lives, but also enable physicians to deliver targeted therapies for patients.

According to Global Diagnostic Labs Market Analysis Report 2022-20281, the scalability of IT-enabled diagnostic labs market is projected to rise from US$ 297.06 billion in 2021 to US$ 514.28 billion by 2028; and it is expected to grow at a CAGR of 8.3% from 2022 to 2028.

Chronic Non-communicable diseases (NCDs) today such as cancer, heart disease, diabetes & respiratory diseases are the leading cause of mortality. The increasing prevalence of chronic diseases, increasing use of point-of-care diagnostics, integration of healthcare tech and the rising healthcare expenditures will bolster the scalability of the diagnostic labs market. As diagnostic chains and insurance coverage expand, digital adaptations bestow opportunities for scalability, accuracy and efficiency along with cost optimisation.

Validated reliable point of care diagnostics will see huge potential of growth and scalability and it will significantly reduce indirect costs on health care systems and patients. More experience and use of such devices/solutions through these collaborative pilots will augment scalability further.

How IT enabled healthcare implementation in diagnostics can improve the operational cost for the providers as well as patient experience?

Insights from patients and caregivers belonging to diverse

communities have helped the clinical fraternity to create new technologies. It allows people to play an active role in decision making when it comes to their own health, through tools such as digital sensors, integrated apps, connected devices and artificial intelligence. Such breakthrough technologies are truly empowering us as individuals to make better decisions regarding our health.

Today AI is constantly influencing medical science in quest for new and better ways to diagnose, discover, test and accelerate the potential medicines and treatment outcomes of tomorrow. As healthcare systems & providers begin to adopt big data for diagnosis and recording patient outcomes, tech-enabled systems will track outcome patterns even faster following the treatment and will also identify optimal treatments based on the patients’ profiles, thus facilitating more efficient diagnosis. The IT enabled simple devices & solutions such as Qure.ai or Alveofit will significantly enhance the access to these essential diagnostic tests as well as facilitate early diagnosis and impact evaluation through analysis of these tests remotely and digitally. This enables the healthcare systems and providers to offer appropriate timely treatment thereby improving outcomes for patients.

How technology is helping in the evolution of disease management at various levels?

Technology is increasingly becoming a key driver behind early disease detection and smart analysis thereby improving patient’s outcomes. Currently, we are seeing some of the best minds anchoring key solutions such as noninvasive testing for NCDs in the areas of cardiovascular, metabolic, respiratory and even some forms of cancer.

The diagnostics industry is also extending support and mentorship via numerous knowledge sharing platforms as it increasingly realises the potential of technology in the sector. In a nutshell, emerging and evolving technology platforms are helping to address unmet needs, shape newer interventions and enable them to scale up to increase penetration across the country.

We, at AstraZeneca, are also creating new ways to help people manage their own health. Being able to monitor and manage our own health allows us to identify problems earlier and get the most appropriate support.

Do you think India still needs to work on sector specific policy interventions in healthcare IT?

Given that technology has the potential to influence access to healthcare and identify treatment modalities, sector specific policy interventions would be the logical next step to ensure equitable access is provided embracing these innovations. There is also need for all the relevant and complimentary sector specific eco-system solutions are integrated in a way to transform outcomes for patients.

What are the major challenges and gaps that need to be filled as far as PPPs is concerned?

As global populations live longer and the prevalence of chronic disease increases, the rising cost of healthcare will continue to remain an important topic amongst healthcare stakeholders. In India also, the two biggest challenges affecting healthcare are affordability

and accessibility, with urban and rural experiences varying significantly. PPPs can solve this problem to a great extent and the pandemic has proved that once again. By working together and ensuring all relevant technological scientific innovations are embraced and integrated to

shape patient pathways in public and the private sectors can take quality healthcare in India to the last mile a lot faster and a lot more affordably.

We (Government, academia, health eco-systems public as well as private & industry) need to

systematically identify gaps, challenges and work collaboratively to address these in interests of patients. We all should keep patients at centre and work for improving patient outcomes with continuous improvement mindset by embracing emerging/evolving scientific

technological innovations. At AstraZeneca, we are working as knowledge partner to India Sweden Healthcare Innovation Centre which follows similar approach as outlined above.

kalyani.sharma@expressindia.com journokalyani@gmail.com

Wehelpsavelives

Balancing the clinical,financial,and operational value of digital offerings in healthcare is the need of the hour

ByKalyani Sharma

Who knew that the integration of IT with healthcare will emerge as pivotal pillar in the delivery of healthcare in India. While the pandemic created so many challenges, it has necessitated the healthcare industry to adopt and innovate for disease management and bridge the gap between technology and traditional way of delivering healthcare for enhancing the patient safety and care.

As we reflect on what comes next, it is an opportune moment to pursue real transformation for better connected and integrated data and information systems.

Highlighting the role of IT in healthcare, Rahul Rastogi, CEO and Founder, Agatsa said, “Technology plays an important role in the digitisation of healthcare. Moreover, COVID19 has accelerated the pace of its adoption and use. Not only healthcare, but also radiology, diagnostics, medical technology, and health insurance have reaped the benefits of this technology. Physicians and patients have also benefited from the ever-changing technology. Digital health solutions have been developed and implemented to enable providers to save costs and time, help patients take control of their health data, and allow stakeholders to change their business models to include more personalised treatments for patients.”

“In addition, technology has proven to be very effective in detecting, managing, and curing various diseases that were once tedious tasks. Before the introduction of technology, there were cases of misdiagnosis due to human error. However, with technology, these can be eliminated through accurate and instant diagnosis. AI is being used in oncology to detect cancer; machine learning applications help accurately detect disease in bleeding tissues. In addition, many complex procedures are supported by AI-driven robots”

Satish Manchala, Founder and Managing Director, MedleyMed believes that,

Private healthcare institutions in India possess several key attributes including efficiency in service delivery,capital for projects with the ideal risk-reward equation,and clinical bandwidth to run services in a PPPsetting

Chhitiz Kumar Head of Sales and Service,Philips Indian Subcontinent

Population scale disease prevention and management measures are highly inefficient without ITinfrastructure. Good quality,timely data is critical for policy makers,decision makers, managers and most importantly our frontline health workforce,who manage day to day disease

Pradipta Kundu Director Health Mission,eGovernments Foundation

Digital health solutions have been developed and implemented to enable providers to save costs and time,help patients take control of their health data,and allow stakeholders to change their business models to include more personalised treatments for patients.

Rahul Rastogi CEO and Founder,Agatsa

The access to service providers, facilities,report review and consultation with doctors,home sample collection and medicine delivery all has been integrated and got a push forward due to technology.So,at all levels technology has affected the outcomes

Satish Manchala Founder and Managing Director,MedleyMed

“Chronic care cases have seen the maximum effect and the disease management in chronic care cases has benefitted the most through the new age app, devices and basically the integrated solutions. The access to service providers, facilities, report review and consultation with doctors, home sample collection and medicine delivery all has been integrated and got a push forward due to technology. So, at all levels technology has affected the outcomes. Solutions discovery is one major area which has benefitted the maximum and to best help the patients.”

Krishan Kumar, Marketing Head, SoftClinic GenX explaining the role of IT in disease management said, “IT is helping in coordinating treatments across multiple health care providers and communications for the patient where self-care efforts can be also effective.

Purpose of disease management includes reducing healthcare costs and improving patient quality of life by preventing or minimising the effects of the disease, including delaying disease progression. Effective use of IT can improve care coordination in the healthcare ecosystem, it can streamline daily clinical processes. Additionally, all the chronic disease management happens outside of the hospitals and clinics, IT has a tremendous scope to assist care teams and patients with communication, education and monitoring key data points. Monitoring disease progression, offering patients reminders on when to take their medications and facilitating communication between medical providers and patients are a few examples of where IT can assist”

Current status of scalabilityof ITin healthcare

Healthcare segments like radiology, diagnostics and medtech are now working towards digitising the overall experience of the domain. However, there is a need to scale up theclinical, financial, and operational value

of digital offerings and services from all the healthcare stakeholders.

Talking about the market size and scalability, Vinay K Mayer, Director - Market Research & Consulting, Asia Research Partners LLP explains, “The healthcare industry's IT market is set to grow exponentially over the next few years, due to the increasing digitisation of healthcare. Post-COVID, ehealth has become the new norm, and is expected to grow at a substantial rate! The size of the Indian e-health market is expected to reach a whopping US$ 11.2 billion by 2025. The market for healthcare digitalisation is growing rapidly due to the rising demand for preventive care solutions, the emergence of various entrepreneurship ventures, and growing partnerships & funding.”

“With the Indian Government prioritising healthcare, the market for medical technologies and IT in medicine is on the rise. In general, it is expected that the volumes of global markets and the demand for IT solutions in diagnostics, radiology, medtech, or health insurance will grow by more than 10X”, he added

Emphasising on the current scalability of IT in medtech, Vishal Gondal-Founder and CEO,GOQiiSmart Healthcare said, “major advances in wireless technology and computing power are driving innovation in medtech, leading to the development of an increasing number of connected medical devices that are able to generate, collect, analyse and transmit data. The data, along with the devices themselves, are creating the Internet of Medical Things (IoMT) – a connected infrastructure of medical devices, software applications and health systems and services.”

Stressing on the insurance sector, he adds, “There has also been a rise in demand for insurance due to the new-age insurance players who are transforming the industry. These companies add simplicity,

ITis helping in coordinating treatments across multiple health care providers and communications for the patient where self-care efforts can be also effective

Krishan Kumar, Marketing Head, SoftClinic GenX

With the Indian Government prioritising healthcare,the market for medical technologies and ITin medicine is on the rise.In general,it is expected that the volumes of global markets and the demand for ITsolutions in diagnostics, radiology,medtech,or health insurance will grow by more than 10X

Vinay KMayer

Director-Market Research & Consulting, Asia Research Partners LLP

Major advances in wireless technology and computing power are driving innovation in medtech,leading to the development of an increasing number of connected medical devices that are able to generate,collect,analyse and transmit data

Vishal Gondal

Founder and CEO, GOQii Smart Healthcare

AI,MLis playing a pivotal role in making diagnostics more affordable.In developing countries such as India,the cost of tests such as blood reports, scans,etc.is a major barrier that stops people from seeking medical help. Now,tests are becoming cheaper with technologies such as AI and ML

Aneesh Nair

Co-Founder and CIO, MyHealthcare

transparency, and easy-to-use channels to expand insurance accessibility. This has led the overall industry to adapt to the changing times with disruptive technologies to stay competitive. The digitalisation in insurance has spread through all the processes in the system namely policy pricing, claims management and customer service to underwriting and even risk analysis, technology has disrupted many key functions.”

According to Aneesh Nair, Co-Founder and CIO, MyHealthcare, Artificial Intelligence (AI) and Machine Learning (ML) are playing an important role in diagnostics and also radiology. He added, “AI, ML is playing a pivotal role in making diagnostics more affordable. In developing countries such as India, the cost of tests such as blood reports, scans, etc. is a major barrier that stops people from seeking medical help. Now, tests are becoming cheaper with technologies such as AI and ML. What would earlier cost thousands of rupees is now available for a few hundreds. This is encouraging people to conduct regular check-ups, monitor their health, take timely corrective measures, better manage chronic ailments and lead healthier lives. Additionally, ML is automating medical imaging, which is removing the element of human error, as well as making the process faster. This is ensuring precision and accuracy in diagnostics, and reducing wastage of time and resources. ML is not only helping conduct tests such as ECG, EEG, CT, etc., but also interpreting these scans and creating reports quickly, in effect assisting doctors in making the right diagnosis and providing care in a timely manner.”

ITimplementation in balancing the cost management and patient experience

With the Indian healthcare system emerging from the impact of the pandemic, one aspect that they are focusing on is balancing the cost management

with patient experience.

Sharing his views on this, Gaurav Parchani, CTO & CoFounder of Dozee, “One aspect that most hospitals and healthcare systems are focused on is managing costs. But apart, from simply managing costs, healthcare leaders are looking to find financial predictability. And that’s where technology has the potential to help hospitals make better decisions in areas such as operations, management of the patient flow, staffing, scheduling, and the supply chain. As a result, it can lead to better quality and efficiency of care and patients’ access to it. Technologies also play a very critical role in optimising hospitals’ operational decision-making, which in turn can lead to improvements in the quality and efficiency of care and patients’ access to it.”

Dr Adith Chinnaswamy, COO & Co founder, MedisimVR, while talking about the patient satisfaction and cost management says, “IT implementation in the Indian health care system is a monumental task, but one which will reap rich benefits in the years to come. Operational cost cutting will occur when we start streamlining and automating various facets of healthcare, such as digital communication systems for tele consultation which will vastly improve patient experience, Electronic Hospital Record (EHR) maintenance systems which will reduce the manpower required for hospitals, the advent of artificial intelligence in various medical fields will also reduce margin for human error, leading to overall improvements in the quality of healthcare”.

Nitin Gupta, India Head, Suki adds, “Technology solutions have great potential to help providers and health systems capture significant value. Physician burnout has been an issue for years, and has been exacerbated by the COVID-19 pandemic. Physicians who are burnt out are at risk of making medical errors, reducing their hours, or leaving medicine altogether - all which have

Technology solutions have great potential to help providers and health systems capture significant value. Physician burnout has been an issue for years,and has been exacerbated by the COVID-19 pandemic

Nitin Gupta India Head, Suki

Technology can help in various operational aspects such as ease of collecting and dealing with patient feedback (both inpatient and outpatient).It can also help in creating better experiences for admitted patients and their visitors by streamlining their routine non-clinical requests

Afsal Salu Co-Founder, BestDoc

It is importantto scale up operational efficiencies,increase data safety,enable interoperability,identify existing technological gaps and get past workflow barriers for an efficient and smooth service and transaction flow

Alok Bansal MD Visionet System India and Global Head of BFSI Business

significant cost and medical access implications. Tech solutions can help provide relief.”

Explaining about optimising staff cost and role of technology, Afsal Salu, Co-Founder, BestDoc said, “Technology can help in various operational aspects such as ease of collecting and dealing with patient feedback (both inpatient and outpatient). It can also help in creating better experiences for admitted patients and their visitors by streamlining their routine non-clinical requests. The use of technology for managing inpatient care also helps in optimising staff costs for various departments such as housekeeping, maintenance and IT. Healthcare providers can track the productivity of their staff and reward top-performing staff. They can also use analytics to take smart staffing decisions and allocate non-clinical resources as per need.”

Experience has shown that PPPs could help improve healthcare delivery across India,especially in rural areas. In fact,PPPs have shown to play an extremely important role in enabling the make-in-India innovation

Mudit Dandwate CEO & Co-Founder of Dozee

Deepak Sharma, CoFounder and CEO, MedLern stresses that Indian hospitals are not yet gearing up to take advantage of this stream of innovation. He said, “It is an exciting time for re-imagining the future of healthcare – innovations are pouring out of labs, health, tech, and deep-tech areas like AI, IoT, nanotechnology Blockchain, etc. Regulators in more developed countries are gearing up to evaluate and approve novel and innovative therapies, including digital apps. Innovation will fail to diffuse fast if hospitals don’t need a strong digital foundation. This means moving the needle on three key axes: learning and digitisation of processes, the readiness of employees, and evangelisation to customers.”

“IT systems that can enforce policies in areas like formulary, procurement, and requisitioning through transparency and control can produce dramatic results. Tools that can monitor asset utilisation in key areas like OT, ER, radiology, etc. can identify lowperforming assets to enable rationalisation of investments as well as demand generation strategy to optimise the

capacity. Digitisation of key areas like compliance and record keeping still has significant potential to save time and cost and relatively low-key investments can generate significant returns on investment”, he added.

Alok Bansal, MD Visionet System India and Global Head of BFSI Business believes that in the face ofrising costs, increasing digitalisation and diverse demographics in need of critical care healthcare system must become smarter, simpler, more accessible and costeffective without compromising on positive patient experience. He said, “It is importantto scale up operational efficiencies, increase data safety, enable interoperability, identify existing technological gaps and get past workflow barriers for an efficient and smooth service and transaction flow.To achieve all this,there should be synergybetween health sector reforms and health service delivery processes.”

Vikram Thaploo, CEO, Apollo Telehealth also added, “With increasing labour costs, demographic shifts, and an uncertain regulatory climate, the time has come for the healthcare sector to embrace the world of smart technology to cut healthcare costs – without sacrificing the quality of care. Every healthcare provider uses a slew of systems to store data, treat patients, and manage day-to-day operations. Using smart technology to integrate these systems into a unified system and combine the data into a single repository can help in quicker diagnosis and treatment, giving organisations to embark on a new era of forward-thinking technology. Such interoperability will help enable doctors to understand the exact needs of the patient, share data between systems and the cloud, and drive efficient analysis that can lead to better patient care.”

Policyinterventions and Public-Private Partnerships (PPPs)

While private sector is actively

driving the tech disruption happening across the ecosystem, government is also recognising this revolution by launching digital initiatives like National Digital Health Mission

(NDHM) which is important to create a conducive market for innovation in healthcare and also creating opportunities for investment. However, in order to fast track and strengthen the

overall digital health infrastructure and ecosystem, focusing on more PPPs in this direction is very important. No single company or product has all the resources to create all aspects

of a tech-based system. Each will have its own strengths and core competencies.

Elaborating more on government initiatives in disease management via IT, Pradipta

Kundu, Director Health Mission, eGovernments Foundation said, “Public health relates to taking care of the population and the first step is having information on what diseases affect populations. Population scale disease prevention and management measures are highly inefficient without IT infrastructure. Good quality, timely data is critical for policy makers, decision makers, managers and most importantly our frontline health workforce, who manage day to day diseases. Sharing information in paper-based systems is slow. Therefore, IT helps in sharing crucial information in a timely fashion. Disease surveillance becomes faster, and hence enables taking quicker action as well. We have learnt through painful experience of COVID-19 pandemic how important timely data is to not only reduce mortality and morbidity of citizens but also to improve the overall health of citizens.”

“We believe that India is undergoing a rapid digital transformation of governance across domains including healthcare. We have managed to get quite a few things right as a country - for example - we are global pioneers on establishing digital public infrastructures for different sectors. For example: ABDM, Aadhaar, UPYOG, DIKSHA are all improving the capacity of governments to deliver services in their sectors. In addition, we have more steadily progressed towards harnessing the latent energy and talent in the Indian tech ecosystem to serve the larger public good through more collaborations with industry, academia and civil society on the digital front. The effects of these transformations will continue to unfold over the next decade.”

On the PPP front, she says, “It’s important to build PPPs with a multi-sectoral lens when helping governments establish digital public infrastructure. The market players can bring in the capacity to implement, while policy-focused organisa-

tions, domain experts and civil society help in improving translation of policy intent into the ground execution. Getting this set up right up front is often crucial to the success of the digital transformation. Each company should not try and build their own stack from the ground up as this will just lead to the creation of silos. Rather each company needs to create and open up APIs that allow other companies to use their products. These APIs may cut across government departments and knowledge domains, but it is precisely this cross-pollination that can lead to the creation of innovative new public products.”

Emphasising the role of PPPs, Chhitiz Kumar, Head of Sales and Service, Philips Indian Subcontinentsaid, “PPPs area great way to increase efficiency in healthcare delivery, improve accessibility while lowering the costs. The creation of resilient and sustainable modern healthcare

Innovation will fail to diffuse fast if hospitals don’t need a strong digital foundation.This means moving the needle on three key axes: learning and digitisation of processes,the readiness of employees,and evangelisation to customers

Deepak Sharma Co-Founder and CEO, MedLern

ITimplementation in the Indian health care system is a monumental task,but one which will reap rich benefits in the years to come.Operational cost cutting will occur when we start streamlining and automating various facets of healthcare

Dr Adith Chinnaswamy

Dr Adith Chinnaswamy, COO & Co founder, MedisimVR

systems, especially in tier-2, tier-3 and aspirational cities in the country, requires a partnership-based approach to address public health problems through the combined efforts of public and private institutions. The Indian private healthcare sector has made tremendous progress over the last two decades and emerged as a partner to the government in its mission to extend the reach of healthcare in the country. The public sector has also evolved during this time frame with commencement of district level planning. While there are some gaps that need to be plugged, the overall outlook for the healthcare industry in India is quite optimistic.”

Elaborating more on the capabilities that a private sector can bring in the PPP model, he added, “Private healthcare institutions in India possess several key attributes including efficiency in service delivery, capital for projects with the ideal risk-reward

equation, and clinical bandwidth to run services in a PPP setting. On the other hand, public healthcare institutions are typically characterised by wide networks of healthcare infrastructure and a steady flow of needy patients, which could serve these patients even better with infusion of modern technologies and best practices in healthcare. It is evident from these attributes that PPPs can be mutually beneficial for both the institutions as their qualities and needs are complementary. Private sector can provide the capital and efficiency to public institutions to address their requirements while the public institutions can provide the private sector with assured patient flow and a predictable business model. From innovative financing models to health technology solutions, the private sector can play a pivotal role in the India’s digital health transformation journey. But no-one can succeed on their

own. Collaborations between public and private sector parties allow governments to leverage private sector investment and capacity to address system-wide problems in partnership that neither public nor private sector could tackle alone.”

Mudit Dandwate, CEO & CoFounder of Dozee said, “PPPs are a must for mass transformation of public healthcare and driving technological scale. Currently, the most significant challenges affecting healthcare in India are affordability and accessibility. And, at present, the Indian government spends 2.1 per cent of GDP on healthcare compared to 9.7 per cent across OECD countries, with more than half (55 per cent) of healthcare expenditure coming from citizens. Experience has shown that PPPs could help improve healthcare delivery across India, especially in rural areas. In fact, PPPs have shown to play an extremely important role in enabling the make-inIndia innovation. Early-stage start-ups and innovation require an ecosystem to help them scale and this is where government initiatives and PPP opportunities play an extremely important role. So, while the government is driving Aatmanirbharta, the ecosystem plays an extremely important role in making this happen. While this is important for India, India is also a proving ground for technologies that will scale internationally to developing as well as developed economies”.

Wayforward

While the healthcare sector has been slower to adapt, interesting business models are gaining momentum. Hospitals and healthcare industry will have to be open and flexible when it comes to embedding these digital solutions in the system and will require a continuous investment in their workforce to adapt their skills in the digital age.

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

Healthcare as an industryis yet to explore the full potential of blockchain

Srinivas Mahankali,Chief Business Officer,Blockedge Technologies in an interaction with Express Healthcare explains about the importance of implementing blockchain technology in EHR

Explain us the state of medical records today

The inherent complexities and huge volume of medical records have strained healthcare professionals for decades. With Electronic Health Records (EHR) saving costs and reducing errors, paper-based health record system does not hold any merit anymore. However, the existing EHRs have failed to live up to expectations, and instead, they have turned out to be a leading cause of physician burnout for healthcare professionals. This comes from a variety of issues linked to these systems in general and the amount of time needed for data entry. Poor-quality documentation, enormous time consumed, template-based reporting, and lack of cohesion between the systems make the current EHR system complicated.

What are the challenges in balancing medical privacy with ease of access?

EHR makes records accessible at the click of a button. However, one worrying factor is medical privacy and the widespread perception about compromising personal medical data. This is more important at a time when easily available electronic data is used for business purposes. The challenge is to ensure privacy. EHR needs to have adhered to existing privacy laws which are distinct from jurisdiction to jurisdiction. To

address this challenge, Blockchain is a vital solution, with its inherent traits, blockchain enables data security, tamper-proofing, immutability, and irreversible without consent while providing utmost accessibility to all participants in the network. Healthcare as an industry is yet to understand and explore the full potential of Blockchain, this innovative technology is set to revolutionise, and in the same way, it is making a positive impact across other sectors.

Even though EHRs have failed to live up to expectations, why does it remain the central tool for capturing the plethora of

new streams of data generated through health care?

Despite the challenges and shortcomings, EHR remains the central tool. This is increasingly influencing clinical practice and pharma trials. However, on the other hand, EHR vendors have been sued for selling nonfunctioning products to hospitals and accused of acts of fraud. Though EHRs improved safety in some areas, they also introduce new risks in the system. This is where the benefits of blockchain technology are frequently discussed and there is widespread agreement that its role could transform across all

technology touchpoints starting from the drug development and the supply chain, clinical trials management, the delivery of healthcare to patients and much more.

And now, finally, there is a compelling reason for Blockchain’s implementation in EHR, this would give doctors and nurses control over the flow of information from a single, trusted source. All concerned participants of the network would be able to see the same data, and every update would be visible to the whole network almost immediately. This implies that medical teams can trust that what they learn about a patient through Blockchain

EHR is both accurate and is up to date.

We have come across many troubling problems with the current EHR system, which became the basis for few lawsuits across the globe. How does Blockchain address the new systemic risks in this industry?

The interoperability of the EHR system is another major concern for the healthcare industry. Blockchain could facilitate nationwide/globalwide interoperability of electronic health records, which would allow healthcare providers to access patients’ medical histories, current medications, and prior imaging studies. According to one study, the complete interoperability of EHR could save the US healthcare system $77.8 billion per year. Data sharing or Health Information Exchange (HIE) is an important aspect of EHR systems, this allows the free flowing of information, without any hurdle and creates opportunities for the exchange of information and makes it usable for further purposes. Integration of blockchain technology could easily address the down point of several EHR systems being deployed in various hospitals, with varying levels of terminologies, technical, and functional capabilities which make them have not universally defined standards could be easily rectified.

October 2022 EXPRESS HEALTHCARE 21 INTERVIEW

How can blockchain revolutionise medical records and save lives?

With blockchain technology, we can create a database of symptoms and treatments for more accurate patient diagnosis. At the present, patients with rare illnesses or symptoms are dependent on local hospitals and medical practitioners. If a healthcare provider is not familiar with a patient’s symptoms or has never dealt with the illness before, their treatment is subjected to the limitations of lack of knowledge and experience. But with blockchain technology we can a central database of the medical histories of patients,

doctors across the globe could access and search through comprehensive records of symptoms, diagnoses, treatments, and outcomes all with one click of a button. For patients with unusual or rare symptoms, this means more accurate, efficient, and effective treatment.

Does this innovative technology be effective in reducing human effort and time spent on spent on data entry?

To a certain extent, it is possible as the blockchain is a distributed ledger with the participation of many stakeholders and sharing of data in a secure, transparent,

and accurate way. The collection of data is also thus distributive in nature. Moreover, Blockchain can work well with other technologies. This technology can be integrated with Medical Document Automation Solutions, which uses state-of-the-art public cloud artificial intelligence and machine learning to recognise and extract and digitise healthcare information from documents, faxes, and narrative from physical paper-oriented reports. Such extracted reports can directly be stored and shared on the blockchain network for easy and secure accessibility.

Will Blockchain be effective in providing more control into the hands of patients and ensure greater level of privacy?

As explained before, privacy is a critical concern. Blockchain technology, being a distributed ledger, ensures and handovers most of the control to the patients, and cryptographic techniques provide a greater level of privacy. The access could be controlled only by the users and trusted care providers with the help of blockchain. Thus, to a great extent, the decision-making is done by the patient.

With standard platform accessible in the future to

healthcare professionals, will blockchain open the door to an overall better healthcare system?

Like in many other sectors, blockchain will ensure a better result in the healthcare too. Apart from greater control on the data, the way consent is given for trials and treatment will be changed thoroughly in favour of the patients. Thus, both the drug development and therapeutic aspects of healthcare will be improved a lot with the help of blockchain which again ensures safety and security. Apart from that, it could also ease the monetary transactions between the patients and the care providers.

Blockchains to transform healthcare and medical record keeping

As industries strive to innovate across all facets of their operations, technology is their indispensable aid. Healthcare sector is also firing on all cylinders to innovate, as hospital systems pursue the lofty ambition of a fully patientcentric model. Almost all newer technologies including robotics, Artificial Intelligence, Machine Learning, Internet of Things, Big Data Analytics etc. have already found some inroads into healthcare. However, one of the greatest impacts in the healthcare sector is likely to come from blockchains as there are seve ral in novations possible by deploying blockchains in this vital sector. Interestingly, some of the pioneering blockchain applications in healthcare and wellness are already happening, and India is leading the way in this.

The prime reason why blockchains can transform healthcare is its potential to put the patient at the center of the healthcare ecosystem. This is primarily done by improving the security, privacy, selective sharing and interoperability of health data. Blockchains bring in neverbefore decentralisation of health data, which ensures that its ownership lies with the patients, and offers unprecedented security of electronic medical data.

At the same time, blockchain technology also offers a hitherto impossible way to exchange health data from one hospital system to another, or to a research

team, but with full control lying with the patient. No wonder then that the global blockchain in healthcare market size which was valued at around $1.5 billion in 2020 has been growing at a rapid CAGR of 76.30 per cent from 2021 and projected to reach $7.3 billion by 2028.

While the varied capabilities of blockchain in healthcare innovation are still being explored, there are several proven ways in which this technology has already been used by some of the pioneering blockchain implementations in the healthcare sector.

Blockchain’s role in preventive healthcare

The next generation of healthcare services denoted by Health 5.0 focuses on preventive health or wellness rather than the conventional reactionary model where healthcare has no role until a chronic disease, an acute infection or a critical event like heart attack or stroke strikes.

Preventive wellness as practiced in Health 5.0 instead relies heavily on keeping diseases at bay by personalised lifestyle modifications which ensures precision and efficacy. The most research validated way to go about this personalization is by genometabolic profiling or in other words a combination of genomic uniqueness and metabolic features of each individual. This requires a genetic test as well as metabolic assessment and generates precious medical data on not only that individual, but also on his race, age, lifestyles etc.

Storing this anywhere except in a blockchain is risky as it involves many privacy concerns and also the risk of other entities making money out of it. Such personal medical data is also huge in size as it involves genomic data, and while traditional blockchains don’t lend themselves to storing a huge amount of data, there are powerful workarounds today where the blockchains simply hold the references to these huge data stores. This ensures a best-of-both-worlds scenario, whereby blockchains become the method of choice for the healthcare sector to store huge amounts of personal medical data including genomic data in a most secure way.

Blockchain’s role in a wellness ecosystem

Using telemedicine and even more modern technologies

like virtual reality, augmented reality, extended reality and metaverses, hospital systems are today trying to reach out to multi-times more people than they normally handle through their outpatient departments. Similarly, wellness organisations like diet & nutrition centers, fitness chains, yoga studios, counselling centers etc. are trying to use such technologies to reach out to more clients on their own, using these virtual means. But such efforts can’t scale beyond a level due to the lack of a robust ecosystem that ensures transparency. Such an ecosystem should be a wellness destination where millions of health seekers throng, and avail varied services from thousands of competing wellness providers and not limited to just one brand or organisation. At the same time, since this is all about healthcare and not e-commerce, maximum data security and controlled modes of sharing personal health data to wellness providers should be possible. Obviously, such a model calls for a decentralized Web 3.0 implementation which is based on blockchain technology and therefore trust less, which means due to its total transparency in storage, modification and retrieval, trust is no longer required. No one organisation really owns such an ecosystem, but is collectively held by the users of this ecosystem.

Blockchain’s role in monetising health data

Unknown to most people,

their medical data, especially when it contains their genomic data, is an invaluable resource for research organisations and study teams.

For example, pharma companies invest billions of dollars into drug discovery research and almost all of it call for genomic data from thousands of individuals falling into different races, age groups, sex, locale etc.

This demand is all set to rise exponentially going forward as the thrust of medical research is surely turning towards discovering personalised precision medicines for different groups of individuals suffering from the same disease.

This provides the general population a definitive way to benefit financially by sharing their health and genomic data with reputed research organisations. Such sharing should happen in a controlled and totally transparent mode, and as of today, blockchains provide the only reliable way of doing this, by ensuring data integrity for the researchers, and data security and monetisation for the public.

Moreover, a blockchain implementation readily lends itself to the creation of its native tokens or cryptocurrencies, which can be used to power transactions between such research teams and the public and between wellness providers and wellness seekers for various services. Such inn ovative and pioneering blockchain applications in health & wellness are now beginning to appear.

Sajeev Nair,Founder & Chairman,Vieroots Wellness Solutions emphasises that the prime reason why blockchains can transform healthcare is its potential to put the patient at the center of the healthcare ecosystem

AI’s capabilities: Uncovering hidden patterns that traditional analytics miss

Today, Artificial Intelligence (AI) plays a larger and more pervasive role in our daily routines than most of us often realise. Apps relying on AI for mobility, entertainment, and healthcare among other industries have dramatically transformed outcomes and experiences for their consumers. Compared to the traditional analytical approaches, that were the norm a decade ago, AI is increasingly driving a higher share in decision-making. On closer inspection, it becomes clear that this does not obviate the need for the traditional analytical methods, since the decisions recommended by AI need to consider the biases of the data and the factors driving the outcomes. These are explained and have been the focus of traditional analytical methods for the past many decades. I firmly believe that it is not about one approach being better than the other, it is about the synergy between AI and traditional analytics that will drive impact in a human-centric world. Let us look at some examples to understand why.

Monitoring utility consumption and the due date for the produced bill is a priority for every family each month. The monthly electricity bill received in our inbox reveals a great deal about our consumption habits. Initiatives by power companies, such as "Know Your Electricity Consumption," enable consumers to examine the trend of their electricity consumption via an online dashboard that can be accessed on demand from their mobile devices. An understanding of one's consumption patterns aids in managing one's consumption in a manner that is more fiscally and environmentally responsible.

This is an example of business intelligence employing traditional analytics to influence behavior by analyzing the past.

Most of us can't go a day without searching Google for a response or for seeking help to navigate maps amidst heavy traffic to reach that destination. Those promotions that seem to be pursuing us? Yes, they are powered by AI, based on our search history or proximity to a location, and are tailored for us by the very AI algorithms that deem them valuable to us.

So, it’s true that we wouldn’t be living in the world of above reality without Analytics and AI. But how do Analytics and AI work?

Traditional analytics is used

for quantitative analysis and to helpsynthesise enormous amounts of datato aid human decision-making. Analytics has deductive reasoning atits base and employs statistics to answer the question "What occurred or is occurring based on observed data?" The abilityto quantify uncertainty by usingerror margins further facilitates decisionmaking under ambiguity. Consumers and businesses consume analyticsusing dashboards and reports with intuitive visualisations to drive decisions under the practice of business intelligence.

Due to the descriptive nature of traditional analytics, we were confined to systems that could only report utilising data to de-

scribe what has occurred or is now occurring. Today, we cannot only use data to predict what will happen but also, with AI's help, prescribe what action we must take based on the surrounding circumstances.

AI relies on inductive reasoning and employs algorithms that can learn patterns from data and apply them to new, unknown data. Data may not be identical but similar to the data on which the algorithm was trained to enable reasoning through similarity or induction. AI not only leveragesstatistics but also integrates the fields of computer science, operations research, and mathematics to answer the questions "What will happen? or what action should wetake?"

Your power consumption trends are explained by analytics, but the advertisements for the product you may like and the resolution of whether you must take the next right turn or not are all powered through AI by building over and beyond the traditional analytics output.

If AI is analytics on steroids, then do we still need analytics?

Every day, healthcare practitioners across the worldface a variety of clinical dilemmas and ensuing complications. Moreover, in India, where there is a dearth of skilled medical professionals, the cost of care, from diagnosis to treatment, is significantly greater. The descriptive capabilities of traditional analytics facilitate healthcare experts' automated analysis of medical testing. Analytics helps disseminate caseloads of data to deliver better treatment at a faster rate and at a lower cost, resulting in greater diagnostic efficiency. This early diagnosis enables physicians to monitor and diag-

nose potentially life-threatening illness episodes at earlier, more curable stages. On the other hand, the predictive capabilities of AI help practitioners in prognosis and management of disease burden in patients by predicting patient events and therapy outcomes.

Today, AI is increasingly being utilised to augment the drug discovery and development process by examining combinations of billions of molecules for drug testing via simulations in a few weeks, a task that would otherwise take years to complete. As a result, AI shows a massive impact by drastically cutting costs and accelerating the development cycles of new medicines through in-silico experiments. However, the drugapproved for human use is still contingent upon the findings of in-vivo tests conducted during clinical trials. Therefore the successful launch of the drug for humansinvariably depends on traditional analytics backed by statistics. Here, AI and analytics must work in tandem to enable clinicians to determine the safety of drugs for therapeutic purposes.

In recent times, we have seen this synergy in action during the pandemic, where we witnessed the development of the COVID19 vaccine and testing kit based on the genetic make-up of the virus in record times by multiple companies worldwide.

AI-and-analytics synergy will pave the way for groundbreaking and sustainable innovations in healthcare and other industries in the time to come. Furthermore, these tools, when combined, have the potential to reduce risks that are associated with mass adoption and integration into human workflows.

Mohit Sood,Regional Managing Principal,ZS India emphasises that AI-and-analytics synergy will pave the way for groundbreaking and sustainable innovations in healthcare and other industries in the time to come

Can digital twins disrupt diagnostics in India?

India's healthcare is transforming, with the use of technology, deliverables, and newer applications to expand the scope of its services. Hospitals that were previously restricted to a specific geographic region with minimal facilities and services are now expanding, owing to foreign investment in the sector. The growth of the hospital and diagnostic sector is heavily influenced by foreign investors. The hospital industry in India, which accounts for 80 per cent of the total healthcare sector, is seeing a lot of interest from both international and domestic investors.

A digital twin is the creation or collection of digital data that represents a physical object. Engineering and the creation of engineering drawings and graphics can be traced back to the beginnings of the digital twin concept. The development of digital twins is the result of ongoing product design and engineering improvements. From hand drafting to computer aided drafting/ComputerAided Design (CAD) to modelbased systems engineering, product drawings and engineering specifications have progressed (MBSE).

Digital twins are being redefined as digital replications of living and non-living entities that allow data to be seamlessly transmitted between the physical and virtual worlds. They were originally designed to enhance manufacturing processes. Digital twins make it easier to track, understand, and optimise the functions of all physical entities, and they give humans constant feedback to improve their quality of life and well-being.

The ‘digital twin,' which was coined almost 20 years ago but only recently gained widespread popularity as digital infrastructure becomes increasingly embedded in our industries, cities, and communities, is the latest term to be added to this collection of metaphors.

Individual physical objects are paired with digital models that dynamically represent the status of those artefacts, and this is what digital twins stand for. Digital twins are an emerging technology that is based on in silico representations of an individual that dynamically reflect molecular status, physiological status, and lifestyle over time when applied to people.

We use digital twins to test the theory that one might have access to extremely detailed bio-physical and lifestyle data on a person over time. This viewpoint redefines the concept of ‘normalcy' or ‘health' as a set of patterns that are consistent for a specific individual against the backdrop of population patterns.

Digital twins is a broad technology but it’s in a very initial stage right now. This technology can be widely used in the diagnostics and treatment system support system. Drug development will improve with higher accuracy, which will result in a reduction in time and effort and will increase accuracy. Digital twins would tech-

nically help in Surgery simulation, complex surgery, doctors can analyse the patient’s risk and side effects easily but as per the current situation.

So, in essence, a massive disruption is coming in the diagnostic space, where multiple replicas of a patient can be created in the system, various treatment modalities can be ascertained and the best line of attack can be diagnosed digitally, even before the therapy is implemented on the live patient.

But investments would have to be made in key areas including:

healthcare practices and processes and brief knowledge of the patient in question.

◆ Understanding the working of sensors, as there will be a lot of complex engineering practice involved in the process, which will help in feedback data, ability to innovate, good communication

◆ We also need talent that is at the confluence of medical knowledge, knowledge of the subject, the live data understanding.

As a result of this paper, we'd like to conclude that digital twins is a relatively new area for which little research has been conducted. However, because of its applications, it has the potential to expand significantly in the future. It’s still very much a grey zone that needs delicate attention. Ideally, the concept will materialise in favour of patients and make them point-of-care. Many factors would have to come into play for such an idea to become a reality. These factors may include financial capital to know patients can even afford the technology. But in my opinion, digital health has a potential that c ould revolutionise medicine- it could enable us to predict which patients would become ill weeks or months in advance, how a specific patient would respond to a particular treatment, and which patients would benefit the most.

◆

Understand the working system, the core domain and their technicalities, like proper

In conclusion, while the fundamentals are clear digital twins may be slightly away from making a disruption in the healthcare industry. But when it does it would create a big disruption not only in diagnosis but also in key areas like care management.

Dr Vikram Venkateswaran,Member-Healthcare Working Group,IETFuture Tech Panel talks about digital twin technology and highlights that it is a broad technology but it’s in a very initial stage right now.This technology can be widely used in the diagnostics and treatment system support system

Scaling collaboration and growth to bridge healthcare’s accessibilitygap

India’s healthcare sector is facing several pressing challenges – most prominently lack of accessibility and affordability in healthcare. How is the sector gearing towards bridging these gaps?

In a country as large as India, with ever widening ruralurban disparities, there is a pressing need to innovate and scale affordable quality healthcare solutions. There are a few measured steps the healthcare sector must take to support and augment care delivery on a larger scale. This is where medtech solutions play a critical rolelinking patients to care services across hospitals, diagnostic centers, clinics and at homes.

First, as a med-tech sector we must ensure greater investment in R&D. In India, we require innovation at both the ends of the spectrum –pathbreaking innovations which advance patient care and outcomes and also innovations which address key market requirements related to scalability and resource constraints.

Second, there is need for a renewed emphasis on multistakeholder collaborationsacross government, industry bodies, academia, solution providers, service providers, and health tech startups. This has become a clear business imperative with strategic collaborations enabling us to tap into collective strengths, expertise, tools, and infrastructure to enable seamless end-to-end patient care.

Third, with new

innovations being introduced in the market periodically, there is a continuous need to skill and re-skill the healthcare workforce. MedTech industry needs to continuously focus on this at scale to ensure access to quality healthcare services across the most remote areas as well.

How can medtech companies extend their efforts and their disease portfolios to effectively reach remote and rural regions across critical care pathways?

In the medtech sector, players across segments must work together, leverage resources and create comprehensive offerings to deliver care more effectively for various high burden diseases such as oncology & cardiology. Partnerships can enable better access to treatment for more patients and streamline patient journey to deliver better outcomes.

At GE Healthcare, we are committed to enable access to quality healthcare across the country. We believe that strategic partnerships form a key part of this puzzle. We have partnered in several large public-private partnership (PPP) programs across the country. As an instance, we are collaborating with the state government of Assam in providing freediagnostics service throughout the 28 CT centers in Assam – one in each district. Our recently launched advanced CT scanner – Revolution Aspire –is testament to this as well. It has been specifically designed

Shishir Gupta ,Head-Growth & Strategic Initiatives,GE Healthcare in conversation with Express Healthcare underlines the impact of innovation,helping care reach the last mile - across critical care pathways

There is need for a renewed emphasis on multistakeholder collaborations – across government, industry bodies,academia,solution/service providers and health-tech startups

at our Bangalore R&D center for the Indian market and manufactured at our PLI factory.

Additionally, we have invested in emerging startup GenWorks to maximise the footprint across the districts where we are not present. More than 550 districts are now being covered between GE dealers and GenWorks. These initiatives have helped scale easy access to these devices, services, and technology nationwide. Investment in GenWorks is a testimony to our promise of bridging the treatment gap and enhancing care delivery across India. With the broad spectrum of Wipro GE healthcare products, the healthcare providers have a strong opportunity to build a robust portfolio and provide quality healthcare across all of India.

The healthcare sector has undergone a large-scale digital disruption. What role does technology play in helping the sector solve for healthcare’s accessibility crisis?

Healthcare has witnessed a sweeping digital transformation through the pandemic, with adoption of new technology innovations advancing care delivery. Overall, technology has immense potential to enable precision healthcare – by

assisting decision making for clinicians with real-time data and insights and also enabling access to a greater number of patients. The digital shift can help put patient at the center of the ecosystem and support personalised care.

Various novel technologies have been adopted recently, revolutionising the sector. These include Augmented & Virtual Reality (optimising medical training), cloud platforms (connecting health systems and clinicians efficiently), and Artificial Intelligence (faster and more accurate data interpretation), helping clinicians achieve greater efficiency and enhancing patient outcomes.

To solve specifically for accessibility – technology has bridged gaps across the country and streamlined connectivity. We are in early stages of 5G introduction in the country and the MedTech sector is ready to leverage it as well. We, at GE Healthcare, have embraced this by launching a 5G Innovation Lab aimed to uncover groundbreaking advances in patient care, including potentially bringing cuttingedge technology to rural and suburban regions using this technology. This lab is the first for GE Healthcare across the globe, which is situated at the John F. Welch Technology Centre (JFWTC) Bengaluru,

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GE Healthcare’s largest R&D centre outside of the USA. Another area where GE Healthcare is leveraging technology is to establish an omni-channel presence. We have established GE Shop – a one-stop B2B e-commerce platform where all our products can be easily accessed and purchased from any part of the country.

The CVD burden in our country has been on a meteoric rise, especially in tier 2 and tier 3 communities. How can digital intervention and innovation help solve this cardiac care pathway problem?

As per NCBI, NonCommunicable Diseases (NCDs) now contribute to 60 per cent of all deaths. Add to that, cardiovascular diseases, chronic respiratory diseases, cancer, and diabetes are causing 82 per cent of all NCD deaths. CVDs are affecting Indians nearly a decade earlier than the rest of the world. With the growing disease prevalence nationwide, and shifting disease demographics, the need for evolved cardiac care interventions is clear.

Interventional cardiology offerings, supported by intelligent technologies, have the potential to support rapid decision-making, especially

during critical procedures. These also ensure more precise and personalised care, which addresses the growing demand for minimally invasive procedures and limited incisions, especially amongst the younger generation affected by CVDs.

For example, Wipro GE Healthcare recently launched a ‘Made in India’, ‘AI-powered’ Cath Lab - Optima IGS 320 to advance affordable cardiac care in India, utilizing a neural network-based interventional image chain (AutoRight technology). Through this, we aim to help clinicians focus their attention on patients during operations where every second matters. We have achieved this by automatically optimising image quality and dose parameters at the lowest possible dose in the Optima IGS 320.

Additionally, we have recently established a strategic partnership with one of South Asia’s other leading technology innovators in CVD space, Boston Scientific. This partnership is aimed at providing comprehensive interventional cardiac care solutions and strive to help less invasive heart care solutions reach the last mile. Introduction of products like our ‘AI-enabled’ Cath-Lab, as well as our

strategic partnerships with innovators like Boston Scientific, we aim to scale!

Looking forward, what factors are pivotal to spur the Indian medtech sector’s growth story?

The pandemic led to a largescale upheaval of the healthcare industry, highlighting gaps but also spurring a rapid innovation and adoption across the ecosystem. As a result, the industry transformed greatly, with operations shifting to meet newer, pressing health needs in an altered landscape. While this was the start of the MedTech sector’s growth story, various factors must be strengthened and prioritised to scale its reach.

One of these includes technological innovation, which can enable hospital networks, health systems, practitioners, and patients to be more connected, spearheading accessible care. Beyond this, other key measures include a robust policy environment which incentivises domestic manufacturing and attract further domestic and foreign investment. Public-private partnerships are also vital for the future of the sector, in addition to greater support for medical device research, to guide the innovations of tomorrow.

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Building opportunities for indigenous medtech manufacturing in India

Chandra Ganjoo,Group Chief Executive Officer,Trivitron stresses that the public's capacity to obtain affordable,high-quality healthcare is a major concern due to heavy import dependency. Moreover,India's economic dependence on the import of medical equipment negatively influences the nation's healthcare system,particularly in rural areas

Over the past 50 years, the Indian healthcare system has made several remarkable advancements, particularly in terms of life expectancy, infant mortality, and the use of smart solutions for successfully treating many dreaded diseases. The public's capacity to obtain affordable, high-quality healthcare is a major concern due to heavy import dependency. Moreover, India's economic dependence on the import of medical equipment negatively influences the nation's healthcare system, particularly in rural areas.

India imports between 75 and 80 per cent of the medical equipment it uses, with the government playing a major role in creating an environment favorable to expanding the medical technology sector in India. To promote innovation, the government and the business community must cooperate. Several demands exist on the government and the business community for the medical technology sector to have sustained growth. To overcome the barriers, the government introduced the PLI scheme for medical equipment to reduce imports and turn India into a center for exports. The government will provide a 5 per cent bonus on further sales for a limited time. The PLI scheme's incentives for producers will aid in controlling production costs, which are now higher than rival countries.

Moreover, large amounts of expensive medical technology are imported into India. In reality, imports account for nearly 75 per cent of the Indian market for medical technology. It's important to note that, de-

spite India's medical technology industry being heavily dependent on imports, approximately 60 per cent of what is produced is exported. In some cases, exports account for up to 75 per cent of a company's revenue. However, India exports

very few high-end, high-tech goods compared to other emerging nations. Various indigenous organisation has made good strides in reach, client satisfaction and relationships, scientifically based solutions, R&D, and production.

The next stage of business is quite intriguing, especially for the Indian medical device industry, which is the country's burgeoning healthcare industry and is setting down roots to provide the highest caliber of medical treatment worldwide.

Global medical technology companies are forced to consider expanding their manufacturing in India due to growing input costs. The medical technology sector is expanding due to changing patient demographics, better healthcare funding and delivery systems, and evolving medical technology. However, a few significant roadblocks have hindered the industry's development. The cost of imports for these businesses in India has soared due to the devaluation of the rupee against the dollar, freight costs that have climbed five times from pre-pandemic levels, and hefty import levies, forcing them to consider the possibility of transferring some manufacturing there.

The current demand and supply for medical devices in India are vastly out of balance, which presents a tremendous opportunity for device manufacturers. The vast underutilisation of medical devices in India is currently being pursued by numerous medical device makers (both domestic and foreign) as a significant growth opportunity. Moreover, the demand for novel applications is growing, and transformative technologies like machine learning, artificial intelligence, cloud computing, next-generation sequencing (NGS), information technology, and enhanced imaging are being integrated. With native manufacturing, the leading players in the medtech industry concentrate on producing the highest quality indigenous medical devices and diagnostic products to make healthcare equitable and accessible by providing high-quality care products to millions of people.

To promote innovation,the government and the business community must cooperate.Several demands exist on the government and the business community for the medical technology sector to have sustained growth

RADIOLOGY

Radiation therapycan improve survival rates and the qualityof life for cancer patients

Ashok Kumar Kakkar,Senior Managing Director,Varian in an interaction with Kalyani Sharma emphasises on the role of radiation therapy in improving patient outcome and highlights the current opportunities and challenges in cancer care

Cancer burden in India is rising significantly. In your view, how can cancer care in India get better to improve the treatment of the patients?

Cancer burden in India is rising at an average annual rate of 1.1-2 per cent from 2010-2019. The number of deaths in the country has risen at an average rate of 0.1-1 per cent in the same period.

Over 95 per cent of cancers centres are in city areas, while 70 per cent of the population lives in rural areas. Cancer remains the largest contributor to deaths after cardiovascular disease.

According to the National Cancer Registry Programme (2020), 1 in 9 Indians will develop cancer in their lifetime. India can improve the treatment of patients by strengthening the screening process at rural levels, while enhancing infrastructure at district-level hospitals to receive treatment closer to home.

Cancer care delivery must be prioritised to facilitate early diagnosis and treatment. We do this by raising awareness and screening for cancers, and by bridging the gaps in treatment in rural regions through policy reform.

How has the emergence of new advanced technologies in the field of radiation therapy have improved the patient outcome?

Radiation therapy can improve survival rates and the quality of life for cancer patients. It remains a crucial way of treating cancer. Recent advancements, including as image guidance and proton

therapy, have ushered in a new era of precision treatment.

Radiation therapy can kill cancer cells and stop tumors from growing. It can be used alone or in combination with other treatments, such as surgery or chemotherapy. RT is provided before or after surgery for common malignancies like breast cancer, bowel cancer, uterine cancer, skin cancers and prostate cancers.

Radiation therapy usually lasts no longer than 30 minutes per session and does not require you to stay in the hospital, so you can continue to live your life.

We are seeing a gradual transition to prioritising investments in the digital health space and expanding internet access. The Indian government is taking steps to improve cancer treatment facilities, such as the Ayushman Bharat Digital Mission. This is part of a trend

that should create better treatment outcomes and promote preventive healthcare across parts of Bharat.

PPP models are also being used by state governments to build radiation therapy capacity in public hospitals. What role does it play in cancer treatment in India?

Under such an arrangement, the space and physical infrastructure is provided by the government, while the radiation therapy equipment and the clinical services are provided by the private operator, treating patients at a mutually agreed price. Publicprivate partnerships can help the cancer patients in tier 2 and tier 3 cities get better cancer treatment by enhancing public benefits in the form of a growth in capacity. PPPs could also help increase the facilities for skilled human resources –

training medical, paramedical and nursing staff to improve cancer care delivery.

We can see a significant demand supply gap in radiation therapy centres in India. In your opinion, what is the main cause and how may this problem be resolved?

The cancer care delivery system is one of the worst affected health sectors, especially in developing countries such as India, where 95 per cent of cancer centres are situated in urban areas.

Cancer patients would usually have to move from villages to big cities or different states to get proper treatment, which is nearly impossible due to the travel restrictions and countrywide lockdowns implemented.

Both government and semi-government setups require careful planning for an efficient cancer treatment and to smoothen the overall experience of cancer patients. There is a need to establish more public centres and strengthen the present government-run cancer centres to make sure uninterrupted and low-priced treatment near patients' homes during times of crisis and afterward as well. In addition, screening measures and cancer awareness programs should be increased to help early detection and decrease cancer incidence.

Recently, Prime Minister Modi inaugurated seven cancer treatment centres in Assam, laying the foundation for more enhanced cancer care in the Northeast. The Assam Cancer Care

Foundation (ACCF), a joint venture of the state government and Tata Trusts, is developing these centres, which will use Varian's True Beam to treat cancer patients, saving them from travelling greater distances to tier 1 cities for treatment.

What is Varian doing in bringing change in cancer care in India as now it has joined forces with global firm like Siemens Healthineers?

As a Siemens Healthineers Company, we are well-placed to take leaps collectively: a leap in cancer care and in our effect on overall healthcare. Through this combination, we offer customers a strong, trusted associate along the entire cancer treatment pathway, with the remarkable service levels and focus on patient care that we are recognised for.

Through the transformative combination of Varian and Siemens Healthineers, our united organisation will address the developing need for personalised, data-driven diagnosis and precision care to respond to growing cancer rates. Together, we have a complete portfolio from invitro diagnostics and best-inclass imaging to therapy and follow-up care addressing the entire cancer care continuum.

By bringing our unique and complementary portfolios and capabilities, we will support oncology clinicians and patients to acquire even better results and move closer to accomplishing our vision of a world without fear of cancer.

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

HOSPITAL INFRASTRUCTURE

Smart healthcare infrastructure will enable sustainable and resilient ecosystem

Every individual is entitled to a basic requirement for health care, which can be met through hospitals, nursing homes, clinics, and other medical facilities. H owever, the role of a modern-day healthcare provider goes beyond simply treating patients; it also includes effectively managing resources, improving patient experience, lowering operational costs, streamlining workflows, and fostering teamwork. With so many responsibilities to fulfill, it is inevitable that healthcare providers today are turning to "smart" technology to effectively manage their responsibilities toward patients.

A major component of enhancing and improving the medical facilities in the country is technology. The hospitals must be technologically advanced in order to provide effective diagnostic techniques and a viable cure to the patients. As technology increases the accuracy percentage of every medical procedure including surgery, operation procedure, and the administration of medicine, it has acquired great relevance within healthcare companies. The multipurpose nature of new technology in hospitals has increased significantly. It has been used in numerous applications in a novel, and approachable manner, and its impact on hospitals brings forth new advancements in the medical sector.

The automated in-patient room system is one such instance of smart technology. Automated rooms in hospi-

India needs services that are affordable and should benefit the general public at large. Better hospitals do not always have to be more expensive in nature.India is a tropical nation with a wealth of natural resources,including wind and solar energy,all of which may be utilised efficiently

tals completely utilise digital connectivity and cutting-edge technologies to improve patient experiences and boost the overall quality of healthcare. They enable efficient and fast patient communication, which then results in proactive and accurate patient monitoring, by utilising Artificial Intelligence (AI), the Internet of Things (IoT), and Machine Learning (ML). These automated patient rooms, which create connected healthcare both inside and outside the facility, will shape the healthcare infrastructure in the country in the near future.

Doctors could monitor hundreds of patients via a mobile phone app or webbased dashboard using cloudbased technologies and an AIenabled diagnosing system. The automated system puts patient carefirst and gives themand attendants a single point of access to various room services like nursing, food and beverage, housekeeping, and feedback. There is enormous potential for such smart technology in hospitals to bring about a paradigm shift in the current healthcare system, especially in light of what we have learned from the recent pandemic, which revealed that the nation continues to suffer from a shortage of adequate healthcare facilities and medical personnel in times of an emergency.

However, India needs services that are affordable and should benefit the general public at large. Better hospitals do not always have to be more expensive in nature. In-

dia is a tropical nation with a wealth of natural resources, including wind and solar energy, all of which may be utilised efficiently. An effective hospital structure and planning reduce operational expenses and promote smooth operations. It has been found that hospitals that make the switch to digital operations become even more effective as a result of absorbing all the advantages of healthcare technology, trends, and inn ovation. Any hospital could be energy-efficient to improve operational effectiveness, as well as to better patient outcomes, lower costs, and an integrated approach to patient care, among other benefits.

In addition, reducing the cost of energy can further increase a hospital's efficiency. As healthcare facilities are one of the top most energy-intensive categories, energy costs are skyrocketing in hospitals. Finding smarter ways to save energy will assist in lower costs and relieve pressure on operating budgets. One can save costs by using building management system software to limit the energy used in vacant spaces. These technologies will also allow for the management of lighting and temperature in and around the facility.

Therefore, it becomes absolutely necessary for healthcare institutions to provide better, technologically advanced healthcare facilities so that their patients can receive prompt care and technologically sophisticated diagnostic treatments whenever they want, wherever they want.

Bhupesh Arora,Business Head,Digital Energy,Schneider Electric India highlights that a major component of enhancing and improving the medical facilities in the country is technology.The hospitals must be technologically advanced in order to provide effective diagnostic techniques and a viable cure to the patients

INSURANCE

Embedded finance in the healthcare system paves the wayfor the futuristic model

Indian population is turning health conscious and with rising out-of-pocket medical expenses, the demand for financing in healthcare is skyrocketing. India’s out-of-pocket expenses account for about 62.6 per cent of total expenditure which makes it one of the largest healthcare spends in the world. It is further braced with the fact that a majority of the Indian population is still uninsured or underinsured. On the other hand, those who have medical cover do not get the benefits of financing OPD visits, small procedures, emergencies, hospitalisation, etc.

The present market scenario creates an accessibility and affordability gap for the population. With integrated fintech in healthcare, new-age health tech startups are exploring ways to create an ecosystem where every Indian gets funds for their medical treatment that are even outside the insurance policy purview. Simply put, bringing the financial services and healthcare system into better alignment can play an indispensable role in addressing the issue of late or unpaid medical bills.

Understanding the concept of embedded finance

In the present healthcare landscape, Indians are used to paying for healthcare expenses from their pockets. Either they exhaust their savings or borrow from people which is common among people with lower income. As per the recent NITI Aayog’s facts –the amount has reached a jaw-

dropping $72 billion. As a result, the healthcare expenses in India are one of the reasons that drag people below the poverty line.

The irony in India is that the country has a multitude of options available to buy a washing machine, cellphone, or any other gadget on no-cost EMI or buy now, pay later scheme, but it is impossible to avail of similar services in healthcare expenses.

However, the integration of fintech in healthcare proves to be advantageous for patients as well as healthcare providers. The emergence of embedded finance in healthcare has enabled healthcare transactions seamless like swiping a card or scanning a QR card. It creates a transaction equation between the patient and the healthcare provider or even a pharmacy, diagnostics, or any other merchant.

Introducing digital processes to avail instant medical loans at zero-interest EMIs brings massive disruption to the sector. It simply makes medical treatments accessible to patients by installing QR codes at a doctor’s clinic or merchant’s center that has a certain pre-approved credit limit for patients’ medical treatment. This acts as a carrier for nocost pre-approved medical loans that funds the medical treatment and help the patient channel their savings in a better way.

Solution for every patient’s healthcare budgeting

Healthcare payments are often associated with critical

care expenses that a patient incurs at the time of hospitalisation. We fail to recall the payments that were made for the numerous doctor visits, health checks, lab tests, purchasing medicines, or even for dental or derma treatments. These are all considered noncritical and non-emergency based. This adds a considerable amount to a patient’s overall healthcare expense which burns a hole in their pocket.

With the use of embedded finance, banks, lenders, and other payment systems are aggregated that have the power to lubricate the flow of money to the healthcare provider, keeping the patient’s total savings safe. This works well at both ends – the provider and the customer. The provider receives their money much earlier while the customer gets access to their treatment with improved cash flow and reduced costs.

Wayahead

Embedded finance in healthcare is no longer considered an experimental technology.

With the ‘Buy Now, Pay Later scheme, the industry can experience frictionless transactions that further bridge the accessibility and affordability gap in healthcare. It will expand more opportunities within the sector that will offer increased revenue to the providers and allow patients to opt for better procedures and treatments.

Since this inn ovation was largely limited to retail space, the healthcare industry is also ripe for disruption through this breakthrough innovation.

Gaurav Gupta,Co-founder,Navia Life Care stresses that bringing the financial services and healthcare system into better alignment can play an indispensable role in addressing the issue of late or unpaid medical bill

The emergence of embedded finance in healthcare has enabled healthcare transactions seamless like swiping a card or scanning a QR card.It creates a transaction equation between the patient and the healthcare provider or even a pharmacy, diagnostics,or any other merchant

HEALTHCARE TRENDS

J MITRAlaunches 4th gen Elisa-based HCVtest

JMitra has announced the launch of their 4thGeneration Elisa-based HCV Test-the HCV Gen 4 Ag& Ab Microlisa.

The 4th Generation HCV Microlisa is an in-vitro qualitative enzyme-linked immunosorbent assay for detecting HCV core antigen and antibodies against HCV (anti-HCVs) in human serum or plasma.

The kit is intended to screen blood donations to identify and eliminate the infected units of

blood and for clinical diagnostic testing of Hepatitis C. Key features of the indigenously developed HCV Microlisa test kit are:

◆ 4 th Generation (even more advanced than the existing 3rd generation kit)

◆ Detection of HCV Core Antigen and Antibody to HCV Core, NS3, NS4, NS5 in human serum or plasma

◆ Detects all 11 HCV Genotypes

◆ User friendly with total test

time being 150 mins

◆ Long shelf life of 24 months at 2-8° C

◆ 100 per cent sensitivity-100 per cent specificity (evaluated

by NIB, GOI)

The HCV Microlisa test kit has been evaluated by the National Institute of Biologicals (NIB), Government of India.

Rely+On Virkon from LANXESS shows effectiveness against monkeypoxvirus

The product is used for hard surface disinfection in hospital,healthcare and institutional facilities

With

cases of monkeypox continuing to rise and spread around the world, government health departments are providing advice and guidance on how to help prevent transmission of the disease with hygiene and disinfection of the utmost importance.

The high level disinfectant Rely+On Virkon from specialty chemicals company LANXESS is effective against the monkeypox virus. The product is used for hard surface disinfection in hospital, healthcare and institutional facilities, airports, public transport terminals, clinics, shopping malls and many other routes of transition.

Francois Martignoni, Head-Human Health Disinfectants Business, LANXESS said, “Practicing good hygiene must always be a part of our everyday routines, but the selection of a disinfectant proven to kill the target pathogen is critical”.

Rely+On Virkon inactivates monkeypox virus quickly: Independent tests have proven that Rely+On Virkon inactivates a closely related surrogate of the currently spreading pox virus strain.

“From these tests it can be concluded that Rely+On Virkon is also effective against monkeypox virus,” Martignoni said.

Rely+On Virkon achieved inactivation of the pox virus strain at a 1:100 dilution rate with a 15-minute contact time. This corresponds to test conditions set out by the French AFNOR Association and proves the performance and suitability of Rely+On Virkon for practical use.

Rely+On Virkon is diluted for application and sprayed on hard surfaces. It can therefore help to reduce the risk of cross-contamination.

The kit is intended to screen blood donations to identify and eliminate the infected units of blood and for clinical diagnostic testing of Hepatitis C

The HCV Microlisa test kit has been evaluated by the National Institute of Biologicals

HEALTHCARE TRACKER

Newborn screening in India: An overview on challenges and opportunities to improve public health

Diwakar Sharma ,General Manager,Life Sciences & Diagnostics Systems - Sales,India & South Asia of PerkinElmer India Pvt.Ltd.,talks to Express Healthcare about company’s vision to build a positive environment around Newborn Screening (NBS),associated technology and its importance in improving healthcare in India

What is Newborn Screening (NBS), and why is it the need of the hour in India?

NBS is a form of preventive health care in which babies are tested within the first days of their life to discover evidence of diseases for which the main symptoms may not yet be apparent. Screened conditions are varied; they may be genetic, endocrinologic, metabolic or hematologic. Unlike treatment-based health care processes, newborn screening is population-based.

With more than 29 million pregnancies and birth rates amounting to as high as 25+ million annually, it is essential that the central and state governments act proactively to take stringent initiatives for NBS to be a part of the national program. This would encourage and advance the screening to help identify the affected babies.

Inborn Errors of Metabolism (IEMs) comprise approximately 15 per cent of total admissions in Neonatal Intensive Care Units (NICUs) annually. If undiagnosed and untreated, these children are more likely to develop mental retardation, learning disabilities, autism, dyslexia or behavioral abnormalities that cause a considerable financial and emotional burden on the families hoping to diagnose, treat, and manage these children.

NBS is a process where newborns receive a simple blood test from the heel prick 48 hours after birth, which can

aid in detecting up to 70 potentially life-threatening disorders. Babies screened for IEMs can benefit from early detection through timely management, diet modification and/or early therapy. Thus, there is great value in creating a structured program for NBS in India.

What are the latest trends in newborn screening across the world? And where does India stand on the global map in the sphere of NBS? We have seen that newborn screening has been adopted as a valuable public health program in certain countries worldwide. Emerging economies have started successfully addressing commonly known challenges in child health, like infections, malnutrition, and diarrhea;

they are now looking at newborn screening to further improve neonatal and infant mortality rates. We are seeing countries such as Sri Lanka, the Philippines, Maldives and China adopt newborn screening. The Philippines integrated NBS into their public health delivery system in 2004, enacting the Newborn Screening Act that mandated universal screening of five disorders for all newborns in the country. Today, PhilHealth provides 100 per cent reimbursement for an expanded panel that covers 90 per cent of babies born in the country and includes 29 disorders.

Sri Lanka has also enacted a national program to screen for congenital hypothyroidism. Similarly, Bangladesh is currently running a pilot

program for the same disorder that will soon be upgraded to the national program. The Maldives is screening five conditions for all newborns in the country. The United States and Western Europe have more established NBS programs. They have further extended the umbrella of NBS programs with the addition of newer disorders, including lysosomal storage disorders (LSD), severe combined immunodeficiency (SCID) and spinal muscular atrophy (SMA). Moreover, testing is being upgraded from biochemical to gene-based tests.

India has made significant developments in the identification of newborn disorders. At the country level, India has already been credited with implementing a screening program called Rashtriya Bal Swasthya Karyakram (RBSK)which primarily emphasises congenital physical disabilities. The program aims to train physicians to identify physical malformations and recommend optional screening for disorders like Congenital Adrenal Hypothyroidism (CAH). The next natural phase would be to implement biochemical testing for IEMs through the heel-prick method.

Understanding the nature of the two types of disorders is essential – physical congenital disabilities and IEMs.

We have many states and institutions within India that have taken valuable initiatives for implementing newborn

screening programs through the generous support of central & state governments and other organisations. I am happy to see that institutes viz MAMC New Delhi, AIIMS New Delhi, PGIMER Chandigarh, Safdarjung Hospital, Delhi, AIIMS Bhopal, Vani Vilas Hospital, Bangalore, SGPGI Lucknow, JK Lone Hospital, Jaipur, to name a few and many states examples – New Delhi, Chandigarh, Kerala, Goa and Maharashtra are carrying out state newborn screening programs. Indian Council of Medical Research (ICMR) has funded several multicenter studies over the past decades, and according to ICMR Task Force, it would be beneficial to consider screening universally for congenital hypothyroidism (CH) and congenital adrenal hyperplasia (CAH) as both contribute significantly to morbidity and mortality of children. Also, glucose-6phosphate dehydrogenase deficiency should be considered due to the high incidence and ease of treatment.

Many private laboratories prioritise newborn screening and build infrastructure for even extended rare disorder screening like Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA). Overall, the future of newborn screening looks bright, and we look forward to continuing to work in this direction.

HEALTHCARE TRACKER

How do you look to establish PerkinElmer in India over the next few years regarding challenges and expectations?

PerkinElmer has been improving global human and environmental health for over 75 years. In India, PerkinElmer caters to a wide range of markets, viz. analytical science, food safety, Life Sciences, and diagnostics. However, although we have a significant presence across the sectors in the country, we still see that a nation-level newborn screening program policy is required; a lack of awareness around newborn screening in major cities across the country is a significant roadblock.

PerkinElmer provides complete end-to-end innovative solutions for newborn screening, including sample collection cards, instruments and reagents for testing, reporting software and many more technologically advanced devices and equipment to empower pediatricians and hospital staff to deliver positive patient health outcomes. In addition, the shortage of trained technicians is a challenge in India.

To help solve that problem, PerkinElmer is continuing to invest in India for the longterm with dedicated efforts and resources for talent development. Overall, we are upbeat about our growth and increased penetration in the Indian market.

What are some recent company developments that

stand out in Newborn screening?

For many of today’s newborn babies screening for disorders is a standard procedure. Yet it’s a process that has the power to improve health outcomes in later life vastly. At PerkinElmer, we're here to help to make sure the process of screening in the laboratory runs smoothly and precisely. We have screening solutions covering all stages of newborn screening, from sampling to equipment, from testing reagents to software, no matter the size or sophistication of your lab.

PerkinElmer has offered maternal fetal health and newborn screening solutions in India since 2004. Our cuttingedge diagnostic solutions include a wide range of instruments, reagents, assay platforms and software offerings that enable newborn screening for disorders like:

Congenital Hypothyroidism (CH), Congenital Adrenal Hyperplasia (CAH), Phenylketonuria (PKU), Biotinidase deficiency (BTD), Galactosemia, G6PD deficiency, Cystic Fibrosis (IRT) Duchenne Muscular Dystrophy (DMD), Severe Combined Immunodeficiency (SCID), Spinal Muscular Atrophy (SMA) as well as several IEMs and Lysosomal Storage Disorders (LSDs).

PerkinElmer currently offers semi-automated and automated platforms, including the Victor 2TMD, AutoDELFIA® and GSP® for newborn screening

applications. Our product range also comprises advanced tandem mass spectrometrybased solutions (such as the QSight® 225 MD UHPLC System) for expanded screening of various IEMs, systems for hemoglobinopathies like the Migele™ Gel Electrophoresis Unit, and the EONISTM for SMA, SCID and XLA screening.

Furthermore, PerkinElmer provides cards for blood spot collection and the backend software (Specimen Gate® Essentials) that streamlines information management and reporting.

What, according to you, are the prospects of newborn screening, especially in the context of India? Do you think you’ll be getting subsidies or other benefits from the government?

In India, the objective is to reduce the infant mortality rate, and a substantial step is required to upsurge screening across the country. We know that about 25mn births annually, roughly 4-5 per cent are being screened for IEMs. A vast majority of the babies in India are not screened today.

PerkinElmer is committed to helping create greater awareness among government representatives and policymakers about the benefits of newborn screening and how to set up and implement NBS programs.

We are also receiving support from state governments in helping people

receive mandatory newborn screening services at affordable prices.

Why are rare diseases so prevalent in India? How impactful is the National Policy for Rare Diseases recently formulated by the Ministry of Health and Family Welfare, Government of India?

The prevalence of rare diseases in India is partly due to this country being the second-most populous in the world, and around 80 per cent of rare diseases are genetic.

India has a high prevalence of consanguineous and endogamous marriages –unions within extended families or from the same narrow social group, respectively – in some population clusters, which can increase vulnerability to genetic disorders due to a lack of genetic diversity.

In India, a common question arises among policymakers regarding the number of rare diseases and the number of patients suffering from rare diseases.

As before, on 30th March 2021, India does not have a clear definition of rare diseases, so it is hard to estimate accurately the number of patients affected by them. Therefore, it was challenging for policymakers to draft a health care policy that adequately addresses the needs of patients and develops tertiary infrastructure to treat rare disease patients.

Awareness of disease and symptoms is essential for

screening and early detection. If more people in India are aware of a disease and its symptoms, they are more likely to take action to prevent it by screening expectant mothers and their newborn babies. With active government initiatives toward National Rare Disease Policy, we hope that awareness of rare diseases increases among the public, health societies, development organizations, NGOs, and decision-makers.

Are there any current activities PerkinElmer is doing to raise awareness about maternal health and NBS?

Indeed, totally... PerkinElmer is a medical organisation, so we lead standard media projects and workshops focused in on Maternal wellbeing and NBS worldwide and in India. There are likewise unambiguous yearly gatherings we join in and in which government officials additionally take part. Our aim with these exercises is to bring all partners onto one stage that not just catches the consideration of the general population or the public authority of India yet additionally supporting offices like the World Bank, formative associations like WHO, UNICEF, US-India Strategic Partnership Forum. India Foundation etc. I think there is something else to be finished on this issue by the public authority and the confidential area to proliferate and teach the majority about the basic significance of NBS.

HEALTHCARE TRACKER

The customer is nowkeeping a futuristic approach and is willing to give due place to healthcare IT

Manju Goyal ,Deputy Director- Patient Monitoring and Life Support Division,Mindray India in an interaction with Express Healthcare talks about the current market trends and technology advancements in critical care

Could you please walk us through the journey of the company so far In India?

Mindray has been observing the Indian healthcare market since their perception. After understanding the customer requirements, buying pattern, competition and healthcare industry growth pattern to a reasonable extent, Mindray decided to come directly in Indian market with direct subsidiary operations as Mindray India in 2007. Since then, Mindray India has been strengthening its base and extending wings across all states and all customer segments and giving a live example of sustainable growth with right mindset and utmost customer satisfaction.

Mindray India believes in simple strategy of “KEEP THE CUSTOMER FIRST, EMPLOYEES NEXT AND FINANCIALS FOLLOWS

“and that’s what is making Mindray India special in terms of long-term customer relationship, employee satisfaction and financial growth.

What are the future plans of the company?

Indian healthcare market is recovering very fast from the COVID phase and is showing signs of growth in terms of hospital expansions and new healthcare setups, enabling the growth of healthcare sector faster then estimated, before the COVID phase. We also sense that there is a considerable change in customer buying influences than a traditional one after

facing unexpected turbulences during the COVID phase. The customer is now looking at the products and solutions from a different perspective and keeping a futuristic approach and is willing to give due place to healthcare IT. Mindray is quite aligned with this direction and is providing products and solutions which are future-ready and give endto-end complete solutions.

We are emphasising the need for healthcare IT on various platforms and trying to make the buyers aware of the strength of IT and the solutions it can bring to their daily work-related issues. Digital healthcare is enabling us to connect two tier 3 cities'

healthcare systems with mainstream healthcare via remote IT healthcare and Mindray is also emphasising on the affordability of such solutions as we believe ‘NO SOLUTION IS A SOLUTION IF ITS NOT AFFORDABLE”.

Can you throw some light on the emerging trends in the critical care market in India?

In India, there is a scarcity of experienced clinicians in tier 2/3 cities as compared to tier 1 cities, but a large number of populations lives in tier 2/3 cities and need and deserve equally good critical care too. The situation needs some solution to bring these critical care experts to a platform to

connect with tier 2/3 cities. To solve this persistent issue, we are seeing some great initiatives from many hospitals and expert clinicians that can support these tier 2/3 hospitals' critical care departments by taking support from healthcare IT. They are virtually getting connected to patient vitals from multiple devices, doing live diagnosis and advice and support the bedside clinicians in decision making. We believe this trend is here to stay and will uplift the critical care quality across India.

How crucial is the role of technology in critical care in India? How scalable it is currently and what else needs to be done as far as its adaptation is concerned? Information technology can bring a lot of transformation in India's critical care field and will provide solutions to many underlying problems and will support the healthcare system quite well. Currently, this point needs more and more discussions & debates, and reference sites creations so that the medical industry can overcome the inertia in adapting this as the solution. While we speak about providing easy access to patient data outside the hospital premises, remote accessibility, and remote consultation for better patient outcomes. The second aspect of caregiver benefit also needs to be explained to overcome the hesitation they may have while adopting this technology related to their outside

working hours. Mindray has done a thorough analysis on this aspect and designed solutions which are easy to adapt and beneficial for both clinicians and patients.

Can you highlight the crucial role of industryacademia collaboration to strengthen the skill development, training and education in the healthcare sector? Where are we and what else needs to be done? In the healthcare industry, we face a lack of skilled manpower at almost every level in hospitals be it ICU /OT support staff, nurse, technicians, or expert clinicians. We cannot wait for organic growth in the expertise level of the healthcare team as the Indian healthcare industry is growing very rapidly. In such a situation the industry needs to come forward and support the education programs, skill development programs, CME, and other medical educational activities to strengthen healthcare. Though in India many great organizations preexist and doing exceptional work in enhancing the clinical expertise such as ISA, ISCCM, IRC IMA, ASI, TNAI, IAGES, and many more, The industry needs to contribute their bit by supporting such organisations in these educational programs for raising the bar of the Indian healthcare industry. We have come a long way and still have a long way to go as we want to be a healthcare hub for the entire world.

HEALTHCARE

Point of Care Diagnostics and CLIA immunology: Wayforward

POC as a proven concept worldwide

Point of Care systems in IVD have become widely accepted globally and India is no exception. The global pandemic has expedited its acceptance further as mobility was hindered, availability of hospital beds was scarce and every additional minute of delay in obtaining right care could mean fatality.

POC Testing can be a gamechanger for both private and public health care. In public health POC can help in mass screening, deciding who needs secondary or tertiary care etc. In both private and government hospitals, POCT can help practitioners diagnose patients more quickly, give better care, save time, save ICU beds only for the needy and a quicker turnaround in general.

Patient focussed and affordable

Adoption of POC innovations has been faster round the globe. Near patient or bedside testing tremendously supplements the patient-centric approach in providing timely care. In this age of mobile telephony, POC technologies are often built with access to highquality data. Healthcare practitioners can make those critical decisions about a patient's course of treatment more swiftly, potentially saving golden minutes (not hours), with less reliance on highly skilled technicians. E.g., sending the samples from ICU/ICCU to a Laboratory, waiting for the results and then deciding the therapy could mean loss of precious hours and even life at times. Additionally, POC testing has become quite economical and afford-

able to all classes of hospitals and clinics in India.

Turn Around Time,the POC advantage

Improving a patient-centric strategy by reducing the turnaround time (TAT) is the key to better patient care. The bed TAT for the ICU or ED refers to how quickly a patient is directed to the appropriate department or transfers from the ICU to the general ward, freeing up a bed for the next pa-

tient in need. Small laboratories and clinics would benefit greatly from POC because it will enable them to provide patient care with a quicker turnaround time.

Agappe POC division offering one point solution provider

Having been at the forefront of IVD manufacturing and marketing for over 27 years, Agappe had a set of Rapids and other small Point of care devices. With

a slew of new offerings in POC segment such as - Mispa Chem Dx- Auto Dry chemistry analyser, Mispa HbX- Hb+ Hct metre, Creamatocrit Plus, Mothers milk nutrition testing device, qLabs- Q3 Plus Meter for Coagulation - PT INR and APTT combo, Agappe has created an exclusive POC Division to support medical fraternity. The portfolio will continue to be expanded in the coming months with distinguishable products, offering superior benefits eg. Mispa Immuno Dx-a POC Immunoassay analyser and AG Arteria, Arterial Blood Gas pre heparinised syringe.

Agappe & CLIA

Agappe, has obtained considerable traction for its cuttingedge offerings in CLIA systems. The equipment is appropriate for small or medium sized Labs.

It is a matter of great pride to announce that Agappe is the first company in India to obtain manufacturing licence for CLIA reagents. The broader test panels include thyroid, cardiac, fertility, infectious, cancer, diabetic, autoimmune, bone chemistry, and bone metabolism. Thanks to this ‘Atmanirbhar’ efforts, Agappe will be able to offer reasonably priced immunology solutions across India.

For all these years, CLIA equipment and reagents have been imported into India. Agappe now intends to break this vicious cycle of dependence on imports and increase the technology's accessibility for the general public at a reasonable price and optimum pack sizes.

Agappe has introduced i1000 CLIA equipment system where magnetic microparti-

cles-based Acridinium Ester (AE) direct chemiluminescence technology is used. This AE system is completely suitable to a variety of application due to its consistent performance, quick report, convenient operation, and accurate results. The architecture of the i1000 might enable large hospitals' assay development and STAT tests in addition to meeting the needs of medium and small hospitals for routine tests. The accuracy and dependability of the test results could be guaranteed with welldefined traceability system.

With the support of 30 reagent and 50 sample loading positions, this CLIA analyzer can process 180T per hour. Reagent vials with RFID integration enable an error-free reagent management system. Each test is handled by a sophisticated cuvette handling system employing disposable cuvettes with barcode assistance.

All reagents are available from Agappe in 1x100 T packs. The package comes with the calibrators, and there is enough volume for five calibrations to meet the 35-day stability requirement for open vials & reagents can be tracked to commonly used quality assurance programs.

Agappe was the industryfirst in India to develop a 3 PDA Haematology system using technologies developed within India and won several excellence awards for it. These 3Part analysers are now exported to many countries. Agappe contributes to the Atma nirbhar Bharat concept and aims to drastically reduce India’s import dependence in IVD sector.

Thomas John,Managing Director,Agappe highlights that POC testing can be a gamechanger for both private and public health care.In both private and government hospitals,POCTcan help practitioners diagnose patients more quickly,give better care,save time,save ICU beds only for the needy and a quicker turnaround in general

Adoption of POC innovations has been faster round the globe.Near patient or bedside testing tremendously supplements the patient-centric approach in providing timely care

Bayer Medard® MRXperion Injection System: Optimise

workflowand create newdimensions in digital healthcare

piece of medical equipment,which provides

Medical technology and medical devices play major roles in the diagnosis and treatment of patients in healthcare facilities.

Moreover, each health care facility should assure that a newly acquired technological advancement does not pose safety hazards to patients; that the device, when used in the clinical situation, produces the desired results reliably and consistently with its intended purpose.

Medrad® MRXperion from Bayer is such an excellent piece of medical equipment, which provides both the patient safety and reliable results.

Let’s have a look at the features of Medrad® MRXperion MR Injection system based on automation, usage efficiency, healthcare IT and remote service system.1

Automation

MEDRAD® MRXperion MR Injection system with automatic features increases ease of use, enables workflow efficiency, and allows the hospital staff to focus their attention on patient care.

The patient care is being improved by the on board calculators for weight-based dose and eGFR which help to provide the accurate dosage of the contrast media needed for the patient and prevents overdosing or underdosing and automatic features such as priming, test inject (to check the viabil-

ity of the venflon) and KVO (Keep Vein Open) which helps to reduce blood clots during the patient preparation.

Usage efficiency

The MRXperion injection system helps to reduce the workload of the technologists by automating the manual workflow steps such as automatic lock of syringes using the snap & go syringe design, automatic docking and piston movement once the syringes are locked, automatic filling of the syringes according to the protocol and the programmed

value of contrast media and saline, automatic retract of the pistons once the syringes are removed, real time display of pressure graph during the study, reminders etc.

Healthcare IT

Apart from helping the technologists in reducing their workload and improving workflow efficiency, there are other options to optimise the Healthcare IT requirements like,

◆ Smart ID with Barcode reader - automatically capture contrast media information

such as brand, concentration, lot, expiry date, vial volume using barcode reader.

◆ Modality worklist - automatically retrieve patient demographics and study information

◆ PACS Interface - automatically combine contrast, patient, and injection information into a secondary capture.

◆ Dictation Interface - autopopulate contrast and injection details in the report.

◆ RIS Interface - send contrast and injection information to RIS to help invoicing, where applicable.

◆ Radimetrics - compile, contrast and injection information from multiple procedures for statistical analysis.

Due to the automation of all the manual IT steps, it leads to enhanced quality for operational consistency within radiology department.

Remote service system

The Service side of the injection system is also considered with the aim to maximise uptime with VirtualCare™ a remote support system. VirtualCare™ is a Round-the-clock remote support for Bayer devices, identifying issues before they become problems and providing real-time monitoring, advanced diagnostics, and rapid resolution. With the inclusion of a VirtualCare™ remote support system, alerts are monitored and resolved proactively.

Conclusion

To conclude, MEDRAD® MRXperion MR Injection system with automatic features increases ease of use, enables workflow efficiency, and allows the hospital staff to focus their attention on patient care. 1

References

1. www.radiology.bayer.com

For more information and product details you may connect with Bayer team on sb.karthikeyan@bayer.com or write to Bayer Pharmaceuticals Private Limited, Bayer House, Central Avenue, Hiranandani Estate, Thane, India. Pin: 400 607 or email: medicalinfo.india@bayerzyduspharma.com

The Article published in this newsletter is for education and information purposes only. Although great care has been taken in compiling the information, Bayer Pharmaceuticals Private Limited or its affiliates shall not be responsible/ liable in any way for the present and/or continued accuracy of the information or for any errors, omissions or inaccuracies in this publication whether arising from negligence or otherwise howsoever, or for any consequences arising therefrom. For the use of Registered Medical Practitioner or Healthcare professionals only. To report an adverse event, please enter the relevant details on https://pharma.bayer.com/ report-side-effect

Sequoia Healthcare introduces the inspiration 64 Slice CTScanner

It provides exceptional CTexperience for the end users

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

The Inspiration 64-smart large bore Slice CT Scanner

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

scan facilities as compared to the standard scanning.

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

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

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

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

HEALTHCARE

PCOD: Symptoms and simple ways to overcome it

Everyone has heard of PCOD or Polycystic Ovarian Disease. A hormonal disorder that a woman goes through. This is very common during their reproductive age. 9 per cent – 22 per cent of women suffer from the problem of PCOD in India. Life with PCOD is different from that of women who do not have PCOD.

Symptoms of PCOD

Many women do not even realise that they are suffering from PCOD. It is very important to pay attention to these symptoms for an early diagnosis of the problem.

Irregular periods

This is the most common symptom of PCOD. Irregular or scarce periods are the first sign of PCOD. Pay acute attention to monthly cycle to detect PCOD.

Excessive facial and body hair

Hirsutism is the condition of excessive hair growth on the face. In PCOD, ovaries secrete a huge amount of male hormone androgens and this leads to excessive hair growth in women.

Mood swings

PCOD causes irregular periods and hormonal imbalance in the body. This hormonal imbalance leads to sudden mood swings.

Acne

PCOD messes with the hormones and results in various facial problems like acne. Excessive male hormones in the body lead to acne. Some women suffer from severe cystic acne due to PCOD.

Sudden weight gain

In PCOD, high levels of insulin and male hormones are produced in the body. This leads to sudden weight gain in women. Fat deposit in the lower abdomen area is a common symptom in PCOD.

Oilyskin

Due to hormonal imbalance, the

skin also goes for a toss. It produces excessive amounts of sebum and causes acne.

Heavybleeding

Since the periods are irregular, the build-up of the uterine wall is more. This leads to heavier bleeding whenever the periods happen.

Hair thinning

Most women with PCOD suffer from hair thinning on the crown. Some even suffer complete hair loss. This is due to hormonal imbalance in the body.

Diabetes

Women suffering from PCOD are at a higher risk of develop-

ingdiabetesdue to high insulin levels.

Skin darkening

Darkening of the skin in the neck or around the private parts is a common symptom of PCOD.

PCOD can be minimised but not cured. Starting with low energy, we need to motivate ourselves to start the day and complete daily tasks, focus on eating habits, prepare our own meals and continue to motivate and believe in ourselves. PCOD is about your lifestyle, the way you treat yourself.

Certain changes in lifestyle and diet can help manage it. Here are some ways to manage PCOD:

Eat a healthy diet

Avoid sugar and carbohydrates

Eat more high fibre foods

Eat lean protein-rich food

Exercise regularly

Be physically active

Eat lots of fresh fruits and vegetables

Avoid junk food and saturated fats

Avoid estrogen boosting foods

Sleep for at least 8 hours

Practice yoga

Keep yourself busy

Manage stress better Adding few nutrients and proteins to diet will also help a lot to manage PCOD naturally so here are few of them that you can add to your daily diet-

Vitamin B6 –It helps to maintain the hormone balance and is the key to control PCOD. Found in almonds, wild rice, milk, yogurt, eggs, brussels sprouts, spinach, and soybeans.

Vitamins B2, B3, B5, and B6

– Are particularly useful for controlling weight. Found in yeast, red meat, milk, eggs, beans, and green vegetables.

◆ Vitamin B5 – It helps to control fat metabolism and is helpful in weight loss. Found in avocados, yogurt, eggs, meat, and legumes.

◆ Vitamin B6 with B2 and B3

– Are necessary for normal thyroid hormone production.

Found in chicken, turkey, tuna, salmon, Lentils,sunflower seeds, cheese, brown rice, and carrots.

PCOD should be normal in society where it's not talked about, many women are ashamed of it, but it's not that bad to have it, it's just normal to have PCOD. Managing PCOD is challenging but not impossible. If you know someone who is experiencing PCOD, be kind to them and acknowledge their efforts to alleviate it. Remember that they have a lot to handle and are going through a lot, so be kind to them and show them your appreciation. Always remember that PCOD is more about mental than physical health. Remember you are not alone if you are reading this and going through the same thing. Share this with your loved once and Happy reading.

Madhuri Amin,Executive-Domestic Marketing,Ami Polymer explains about PCOD and highlights that certain changes in lifestyle and diet can help manage it

MADHURI AMIN Executive-Domestic Marketing

Expand your reach with Medikabazaar

The business world is transforming at a rapid pace. The way customers and consumers buy products is evolving. The COVID-19 waves had been the fuel to the fire in this shift from offline to online. In India the geography is vast and the sellers are concentrated in and around the urban areas. The hospitals, pharmacies, and diagnostic centers are in a constant state of struggle for procurement of supplies. They have to wait for supplies and the long distribution chain results in increased landing prices. A Similar scenario is visible when it comes to equipment life cycle management. The spares don’t come easy and so do the biomedical engineers carry out the maintenance.

Medikabazaar-the largest and fastest growing platform for B2B

Medikabazaar is the fastest growing and largest platform that can provide anything and everything that one needs to set up and run a medical facility. Be it a 10-bed hospital, a diagnostic center, an independent clinic, a dentist, or a medical professional in making. They can fulfill their requirements of medical equipment, pharmacy, medical furniture, consumables, reagents. From finance for capital investment, working capital requirements, and Ad hoc equipment service to AMC, Medik-

abazaar gets you all. Medikabazaar brings the buyers, the sellers, and the distributors on the same platform so there is rationalisation in terms of price and removes the limitation of geographical boundaries.

Advantages of being on Medikabazaar as a seller

There are a number of advantages on being on this platform.

Some big ones are as below:

Instant scale-up at no cost

For sellers that are looking to expand their reach and business, Medikabazaar is an obvious choice. One can register on the Medikabazaar platform for free.

The entire process takes a little over ten minutes if one has the KYC documents and product catalog handy. The registration is a three-step process that includes:

◆ Filling in an online registration form

◆ Uploading KYC documents

◆ Uploading product catalogue

Doing the above gives you access to 2 lakhs plus hospitals, clinics, and individual practitioners. These networks of buyers are spread across the Indian subcontinent and Bangladesh.

Recently Medikabazaar has also opened its offices in China and Dubai. This is a big advantage to sellers who are looking to scale up their business across geographies and do not want to commit to a big budget.

Part of a growing network

Medikabazaar is growing every day. The platform has more than 7 lakh SKUs covering all categories of medical products including medical equipment, reagents, consumables and disposables, surgical instruments, hospital establishments, lab diagnostics and equipment, pharmaceuticals products, implants, veterinary products, dental and ophthalmic products etc. This range is growing and daily newer categories and products are being added. Thus, attracting newer buyers of these products on the platform. Medikabazaar has created the largest online marketplace and an opportunity for sellers looking for an online presence.

Timelypayments

Getting paid on time is crucial in any business. The team at Medikabazaar ensures that the sellers get paid on time. The payment terms are decided by the seller at the time of creating the catalog and the same is visible to the buyer. Enhancing transparency between the buyer and the seller ensures a stress-free transaction between them. With Medikabazaar, the sellers can focus on their core business and not get haggled with payments.

Marketing support

Medikabazaar helps sellers facing the following challenges of business

◆

Sales decline or stagnation issues

◆

Creating new avenues for growth

◆

Enhancing brand awareness for products

◆

Run focused digital marketing campaigns for Target group.

Medikabazaar has designed a 360-degree marketing amplification platform and offers the power of 4 for the sellers. The power of 4 includes

◆ With Medikabazaar, sellers can also drive their database marketing and offline campaigns. The team at Medikabazaar can help design emails, content, SMS, and direct mailers also.

The seller gets the best ROI for the money that he invests as the marketing spends. Medikabazaar has an offer to match all kinds of marketing budgets, large medium and small.

The Medikabazaar online platform is accessible on any device with internet connectivity. Sellers can leverage this advantage by promoting their products through pop-ups, large and small banners, putting links to the landing page of their sites, or giving a shout-out for any promotional offers. The seller can choose options suiting his budget.

◆

Warehousing and last mile strength

◆

Medikabazaar has a team of marketing professionals that generate monthly traffic of more than 5 lakh plus visitors on the net. The team can run remarketing ads, search optimisations, and run google ads catering to seller-specific requirements.

Medikabazaar is an ideal plugand-play distribution partner. The company has more than 30 plus fulfillment centers that cater to 20000 plus pin-codes across the country. Sellers can leverage the distribution strength of the company and start reaching buyers from day one by partnering with Medikabazaar.

◆

With Medikabazaar the sellers can build a strong social media presence. As Medikabazaar has a strong presence across social media platforms. The team generates 10 million impressions on the net. Sellers can drive awareness campaigns and be a brand of choice during the purchase decision.

With wafer-thin margins and an ever-evolving competitive landscape, it is imperative to gauge customer preference and buying behaviors. There is a radical shift in the way customers buy products. Whether in B2C or in B2B domain, customers make informed choices based on research and reviews of the products. With increased awareness and data speeds, customers spend more time online. Medikabazaar is a recommended choice for sellers as it catapults them to a world where customers are.

Medikabazaar brings the buyers,the sellers,and the distributors on the same platform so there is rationalisation in terms of price and removes the limitation of geographical boundaries