Express Healthcare (Vol. 16, No. 9) October 2023

OCTOBER 2023,`50

Chandra Ganjoo Group CEO, Trivitron Healthcare

ALPINIONMEDICALSYSTEMS

WeareUltrasoundProfessionals

ISO13485:2016CERTIFIEDCOMPANY

ISO9001:2015CERTIFIEDCOMPANY

BPLMEDICALTECHNOLOGIESPRIVATELIMITED

11thKM,Bannergha aRoad,Arakere,Bangalore-560076

Phone+918026484388/26484350

TollFree1800-425-2355

Websitewww.bplmedicaltechnologies.com

ForEnquiries:sales.medical@bpl.in

CIN:U33110KA20212PTC067282

Copyright©2023BPLMedicalTechnologiesPrivateLimited.Allrightsreserved.

ALPINIONMEDICALSYSTEMS

15,Magokjungang14-ro,Gangseo-gu,Seoul,RepublicofKorea

Homepage www.alpinion.com

E-mail

TEL+82-2-3282-0900

FAX+82-2-851-5593

Copyright©2023ALPINIONMEDICALSYSTEMSCO.,LTD.Allrightsreserved.

Follo

www.bplmedicaltechnologies.com

Chairman of the Board

ViveckGoenka

Sr.Vice President-BPD

Neil Viegas

Vice President-BPD

Harit Mohanty

Editor

Viveka Roychowdhury*

Editorial Team

Lakshmipriya Nair

Kalyani Sharma

DESIGN

Art Director

Pravin Temble

Senior Designer

Rekha Bisht

Senior Artist

Rakesh Sharma

Marketing Team

Rajesh Bhatkal

Ashish Rampure

Debnarayan Dutta

Production Co-ordinator

DhananjayNidre

Scheduling & Coordination

Pushkar Waralikar CIRCULATION

Mohan Varadkar

Radiology& imaging revolution in India's TB battle

PATIENTSAFETY

MEDTECH

P32: INTERVIEW

SUNILKHURANA

CEO & MD,BPLMedical Technologies

P12: INTERVIEW

CHANDRAGANJOO

Group CEO,Trivitron Healthcare

P23: INTERVIEW

DR VIJAYAGARWAL President,Consortium of Accredited Healthcare Organisations (CAHO)

HEALTHCARE ACCESSIBILITY AND AFFORDABILITYIN INDIA: MEDTECH REVOLUTION

P34: INTERVIEW

SHOBHAGHOSH

Director-Government Affairs & Policy,GE HealthCare South Asia

Anti-TB meds stock outs, Nanded deaths highlight missing links

Even though the WHO chief declared that COVID was no longer a pandemic on May 5 this year, SARS-CoV-2 continues to cast a long shadow. And only rightly so. The Indian SARS-CoV-2 Genomics Consortium (INSACOG), a consortium of 54 laboratories, continues to monitor the genomic variations in the virus. Unfortunately, SARS-CoV-2 takes away attention and resources from other bugs that continue to threaten our health.

For instance, the Nipah virus continues to lurk. Timely action by Kerala’s health authorities restricted the most recent flare up in September to two deaths and six identified cases, out of the 387 samples screened. The stats are chilling: this was the third Nipah virus outbreak in Kerala’s Kozhikode district, the fourth outbreak in the state since 2018 and the sixth outbreak in India.

The chinks in our public health armour continue to be exposed. If the containment of the Nipah virus was an example of alert health officials, we have enough examples of the other extreme.

A sudden spike in deaths in Maharashtra’s Shankarrao Chavan government hospital in Nanded district, (35 patients died within 48 hours, including 12 infants in a 24 hour span) raised the red alert once again.

The Nanded facility is reportedly the only health care centre in a 70-80 km radius, so health authorities initially blamed the increase in deaths on increased footfall and not lack of staff, infrastructure of medication. News reports quote parents alleging that 3-4 infants were sharing a single incubator in the NICU, indicating a shortage of incubators.

While an inquiry is under way, this tragic news is a replay of previous occasions, not just in Maharashtra but in other states as well.

Besides healthcare infrastructure, infectious diseases like TB, malaria, and dengue need to be constantly tracked. As per the WHO Global Tuberculosis Report, 2022 India has 28 per cent of the global TB burden and 36 per cent of TB-related deaths. TB is thus a ticking timebomb with a very short lighted fuse. No wonder Prime Minister Narendra Modi wants to end TB in India by 2025, five years before the global deadline.

Unfortunately, recurring shortages in the availability of anti-TB medicines could roll back years of progress. Since June, Survivors Against TB (SATB) have highlighted severe shortages of essential anti-TB medications in government hospitals and private pharmacies in Mumbai, Uttar Pradesh, and other states. These include linezolid, clofazimine, and cycloserine, meant for multi drug resistant TB cases.

However, the government seems to be in denial. When the health ministry issued a clarification, titled ‘Myths vs facts’, claiming that reports claiming shortage of anti-TB medicines are ‘False, Motivated and Misleading’, SATB

replied with more questions.

The biggest missing link in India’s public health is the lack of doctors and other health care staff willing to serve in government health facilities beyond the urban areas. A recent study titled, The pharmacy as a primary care provider, published recently in theFrontiers of Public Health, posits that one way to fix this is to train pharmacists, who are ‘already more than just mechanical dispensers of medicines in the South Asian context.’

The authors conclude that their analysis ‘provides support for the view that pharmacies have many of the inherent characteristics needed to become an effective primary care channel and already play an important role in providing access to health information and care.’

The article suggests that we need to ‘explore how protocols and training could be used to both improve the quality of clinical services provided by pharmacies and even encourage them to, as it were, step up to this role.’ Given the perceived threat from online/e-pharmacies, and the increasing acceptance of telemedicine among doctors, this could be the right time to get pharmacists on board.

Similarly, community health workers (CHWs) are another underutilised resource, suggests a separate article in the same publication. Titled ‘Evolution of community health workers: The fourth stage’, the authors suggest that there are potentially four stages in the evolution of the CHW – the health messenger, the physician extender, the focused provider, and the comprehensive provider.

Their analysis of CHW-centric programmes across the world threw up six programmes (two global and four in India) that they felt had progressed to the fourth stage. This stage is characterised by a shift in control away from the general practitioner to the CHW; and secondly, comprehensive care, which differentiates it from the other three stages of the evolution of the CHWs.

More data will be required to translate these observations into policy changes but these seem to be rational steps in the right direction.

Technology does hold some solutions to infrastructure and human resource gaps. The cover story in the October edition ofExpress Healthcarefocuses on the radiology and imaging revolution in India's TB battle and explores how imaging technologies, combined with new age tools like AI and ML, can aid screening and early diagnosis.

However, be it getting TB drugs to patients or harnessing innovative imaging solutions, collaborations between the public and private sectors will be required to scale up the success of such interventions.

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

If the containment of the Nipah virus was an example of alert health officials,we have enough examples of the other extreme

HOSPITAL INFRA

Turnkeysolutions in healthcare play crucial role in streamlining process of creating medical facilities

Can you elaborate on the key components that make up a turnkey solution in healthcare, and how do these components differ when applied to greenfield and brownfield projects?

A turnkey solution in healthcare comprises several critical components. The key components of turnkey solutions in healthcare include:

◆ Design and planning: Crafting detailed healthcare facility blueprints, including space allocation and infrastructure needs.

◆ Construction and upgrading: Building new facilities for greenfield projects or renovating existing ones for brownfield projects.

◆ Equipment procurement: Sourcing, acquiring, and installing medical equipment and technology.

◆ Comprehensive training programs: Offering healthcare staff training on equipment usage, protocols, and workflows.

◆ Technical support: This is essential for addressing operational issues and offers ongoing technical assistance and maintenance to ensure the smooth operation of the facility.

The components differ between greenfield and brownfield projects because greenfield projects involve creating facilities from scratch, while brownfield projects involve upgrading existing facilities, often with integration challenges.

In your opinion, how does the concept of turnkey solutions

in healthcare streamline the process of creating or upgrading medical facilities, and what specific benefits does it offer in terms of efficiency and effectiveness?

Turnkey solutions in healthcare play a crucial role in streamlining the process of creating or upgrading medical facilities. These solutions are designed to provide singlepoint responsibility for the entire project, from initial planning and design to construction, equipment installation, and operational readiness. This approach offers several key benefits in terms of efficiency and effectiveness:

◆ Turnkey solutions consolidate project responsibility with a single provider, reducing the need for extensive coordination among contractors, consultants, and vendors, leading to smoother project progression.

◆ Turnkey providers specialise in healthcare facility design and construction, ensuring compliance with regulations, safety standards, and healthcare best practices for a facility that meets all necessary operational requirements.

◆ They offer long-term cost savings through economies of scale and expertise in costeffective solutions.

◆ Single-provider oversight expedites decision-making, minimising delays from disputes or coordination issues, critical for timely healthcare facility access.

◆ Beyond construction, turnkey solutions include

medical equipment installation, IT setup, and staff training, ensuring immediate healthcare service provision and reducing downtime.

◆ Turnkey approaches emphasise rigorous quality control throughout the project, guaranteeing a highquality healthcare facility capable of optimal service delivery.

Ongoing maintenance and technical support are often emphasised in healthcare turnkey solutions. Could you explain why these aspects are critical for ensuring the long-term success and sustainability of healthcare facilities implemented through turnkey solutions?

Ongoing maintenance and technical support are critical aspects of healthcare turnkey solutions for several reasons, all of which contribute to the long-term success and sustainability of healthcare facilities implemented through these solutions:

◆ Regular maintenance and support uphold the reliability of healthcare equipment, preventing breakdowns that disrupt patient care.

◆ Ongoing technical support and maintenance guarantee that healthcare facilities meet regulatory standards, reducing the risk of noncompliance and legal consequences.

◆ Proactive maintenance saves money by addressing issues before they become expensive problems, ensuring cost-effective facility operation.

Chandra Ganjoo ,Group CEO,Trivitron Healthcare in an interaction with Kalyani Sharma describes the role of turnkey solution in healthcare

Planning and design are critical in turnkey healthcare solutions as they lay the foundation for the success of the project

◆ Timely technical support and maintenance reduce downtime, preventing treatment delays and revenue loss in healthcare settings.

◆ Proper maintenance prolongs the lifespan of medical equipment, delaying costly replacements and conserving resources.

◆ Reliable equipment and systems contribute to highquality patient care, promoting safety and consistent service delivery.

◆ Ongoing support minimises the risks associated with equipment failures and system downtime, safeguarding patients and staff.

◆ Well-maintained healthcare facilities with reliable systems build a trustworthy reputation, attracting patients seeking quality care.

◆ Technical support aids healthcare facilities in

adapting to evolving technologies and staying updated with industry advancements.

Can you discuss the significance of planning and design in turnkey healthcare solutions and how these aspects may differ when working on new medical center construction versus upgrading existing facilities? Planning and design are critical in turnkey healthcare solutions as they lay the foundation for the success of the project. In new medical center construction, thorough planning ensures that the facility meets current and future healthcare needs efficiently. This may involve considerations like patient flow, technology integration, and regulatory compliance from the ground up.

In comparison, upgrading existing facilities requires thoughtful design to seamlessly integrate new systems and technologies into the existing infrastructure while minimising disruption to ongoing operations. Design in both cases should prioritise patient comfort, safety, and accessibility, but the approach will differ significantly based on whether it's a new build or an upgrade.

When turnkey solutions include training and technical support, how do you believe it impacts the overall efficiency and effectiveness of healthcare facilities, particularly concerning staff readiness and patient care?

Comprehensive training equips staff with the skills and knowledge needed to operate

new equipment and systems efficiently, reducing errors and improving patient care. Technical support ensures that any issues can be promptly addressed, minimising downtime and ensuring uninterrupted patient services. Staff readiness is crucial in delivering quality care, and well-trained, confident staff contribute significantly to patient satisfaction and safety.

What role does ongoing maintenance and real-time assistance play in the context of healthcare turnkey solutions, and how do these elements contribute to the long-term success and sustainability of medical facilities?

Maintenance helps prevent equipment breakdowns and ensures compliance with

regulatory requirements, reducing risks to patient safety and financial stability. Realtime assistance provides immediate support when technical issues arise, minimising disruptions to patient care and maintaining operational efficiency. Together, these elements contribute to a facility's ability to provide reliable, highquality care over the long term, enhance staff morale by reducing frustration associated with malfunctioning equipment, and protect the reputation of the healthcare provider. They also help the facility adapt to changing needs and technological advancements, promoting sustainability in an evolving healthcare landscape.

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

We must invest in resilient,low-emission healthcare systems that deliver high-qualitycare

The National Hospital Energy Consumption Survey,conceptualised and conducted by the National Centre for Disease Control,Directorate General of Health Services,Ministry of Health and Family Welfare,Government of India under the aegis of the National Programme on Climate Change and Human Health (NPCCHH),with technical support from Alliance for an Energy Efficient Economy and Centre for Chronic Disease Control,was launched recently. Akash Goenka ,Associate Fellow,Alliance for an Energy Efficient Economy and Dr Poornima Prabhakaran ,Senior Research Scientist,Centre for Chronic Disease Control in an interaction with Kalyani Sharma discuss about this survey

The survey revealed that Indian hospitals consumed 9 per cent of the country's commercial electricity in FY 2019-20. Could you explain the significance of these findings for India's healthcare sector and its energy consumption patterns?

Goenka: Recently, there's been a growing emphasis on constructing sustainable, energy-efficient buildings, driven by increasing expectations regarding environmental, social, and governance (ESG) performance in both the private and public sectors. India has also committed to ambitious goals, including reducing the emissions intensity of its GDP by 45 per cent by 2030 (compared to the 2005 baseline) and achieving 50 per cent of its cumulative electric power capacity from non-fossil fuel sources by 2030, on its journey to attain net-zero emissions by 2070.

The Long-Term Low Emissions Development Strategy (LT-LEDS), unveiled during COP27, has highlighted the substantial potential to diminish national power demand by enhancing energy efficiency in the building sector, encompassing design, construction, and operations. Consequently, improving energy efficiency in commercial buildings, including hospitals, is integral to India's national energy

policy framework.

Indian hospitals display diversity in energy needs, attributed to ownership (public, private, municipal, etc.) and size (ranging from small clinics to large multispecialty hospitals with varying amenities). To advance energy efficiency and incorporate renewable energy effectively, precise data on energy consumption in

various healthcare facilities across different regions is indispensable. This survey's significance lies in bridging the data gap and setting the stage for a data-driven policy framework to reduce carbon emissions within India's building sector.

How was the survey conducted, and what were the key entities involved in

this research?

Dr Prabhakaran: The survey spanned 18 states and encompassed 10 different types of public and private hospitals. It operated through a partnership between two survey entities with differing technical expertise. Initially, a market research firm was chosen for the entire survey, with a parallel effort involving energy engineers and auditors

to ensure data quality. Comprehensive training was provided to all surveyors. However, the generalist surveyors from the market research firm struggled with the survey's technical demands, leading to inconsistent data quality. Consequently, specialists took over, albeit at a higher cost, focusing on data precision rather than quantity.

Akash Goenka

Dr Poornima Prabhakaran

HOSPITAL INFRA

Hospital identification and onboarding followed a topdown approach for public hospitals, supported by the National Program for Climate Change and Human Health. Private hospitals were enlisted from insurance providers' extensive lists, offering participation incentives such as energy performance summaries.

Data collection methods included web-based surveys, telephonic interviews, and face-to-face interactions, with in-person visits providing valuable qualitative insights. Goenka: Data quality control measures comprised regular check-ins, reviews, and backchecks. Dubious data was filtered using a multi-level approach, considering consent forms, critical data points, and outlier ranges. Despite these efforts, some data inaccuracies may persist due to the survey's complexity and the challenges encountered during data collection.

The study highlighted that hospitals released 7.7 million tonnes of carbon dioxide (CO2) in the financial year 2019-2020. How do these emissions contribute to India's overall greenhouse gas emissions, and what impact does this have on the environment?

Dr Prabhakaran: In the broader context, these hospital emissions are a part

of India's total greenhouse gas emissions. While they may not be the largest contributor, they certainly matter, especially considering the nation's commitment to reducing emissions.

Greenhouse gases like CO2 contribute to climate change, resulting in warming temperatures and more frequent and severe heatwaves. This poses a significant challenge for healthcare facilities, especially those lacking adequate air conditioning.

The COVID-19 pandemic has underscored the importance of resilient healthcare systems capable of handling crises. India's Ayushman Bharat program is actively upgrading healthcare infrastructure, but these upgrades will affect hospitals' energy consumption and emissions.

The National Programme on Climate Change and Human Health is already working to enhance our healthcare system's capacity to cope with climate-related challenges. The survey's findings and recommendations can guide us toward a more sustainable and climate-friendly healthcare model. This shift involves moving from one-off energy efficiency interventions to a long-term strategy based on reliable data, making our hospitals

CONTRIBUTOR’S CHECKLIST

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

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

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

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

● Express Healthcare’s prime audience is senior management and professionals in the hospital industry. Editorial material addressing this audience would be given preference.

more resilient to climate change.

Moreover, climate change is expected to trigger more health emergencies, including infectious diseases and natural disasters. This places additional strain on healthcare systems. Therefore, prioritising climate-resilient healthcare systems and low-carbon, sustainable practices is crucial. We must invest in resilient, low-emission healthcare systems that deliver high-quality care while collaborating to address these pressing challenges.

Can you elaborate on the key recommendations derived from the survey? How do they aim to improve energy efficiency in healthcare facilities?

Dr Prabhakaran: The survey serves as a starting point for formulating datadriven policies and programmes and setting aspirational goals for hospitals. For example, state health departments should be empowered to convene State Development Agencies for energy efficiency, Renewable Energy Development Agencies, and other relevant stakeholders to create and implement a coordinated approach for the clean energy transition in the healthcare sector, including developing green procurement

guidelines and ensuring proper operations of clean energy systems. At the central level, the Bureau of Energy Efficiency (BEE), the Ministry of New and Renewable Energy, and the Ministry of Health and Family Welfare can facilitate and promote inter-ministerial programmes, particularly enhancing awareness about the over-arching need for climate-friendly healthcare and building capacities for hospital energy management among hospital administrators, facility managers, and other staff.

Goenka: At the level of individual hospitals should track their energy consumption regularly and calculate energy intensity metrics such as energy used per bed. Hospitals can identify patterns and areas for improvement by comparing energy intensities and energy costs quarterly or yearly. A policy push for disclosing energy use can help policy researchers benchmark the energy performance of different hospital typologies and establish aspirational building performance standards. Hospitals can then compare their performance with their peers and the best-in-class and identify areas for further improvement in energy efficiency. Other programmes, such as BEE's

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

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

● Article length for regular columns: Between 1300 - 1500 words.These should be accompanied by diagrams,illustrations,tables and photographs, wherever relevant.

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

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

● In e-mail communications,avoid large document attachments (above 1MB) as far as possible.

● Articles may be edited for brevity,style,relevance.

● Do specify name,designation,company name, department and e-mail address for feedback,in the article.

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

star rating of hospital buildings and the Perform, Achieve and Trade (PAT) scheme, can also utilise the benchmarking data.

Can you share any specific examples or case studies that highlight the impact of the survey's findings on healthcare facilities or sustainability initiatives?

Goenka: In Telangana, Andhra Pradesh, and Maharashtra, a leading private hospital chain with over 4000 beds initiated an energy efficiency project in July 2018 at one of its 1000bed super-speciality hospitals. Collaborating with a prominent energy services company, this hospital achieved a remarkable 22 per cent improvement in energy efficiency, resulting in Rs 10.8 crores in savings. Key interventions included design improvements for systems like air-conditioning, hot water, and steam, HVAC, lighting, and fans upgrades, and enhanced energy consumption tracking and maintenance practices. These efforts exemplify the effectiveness of monitoring energy use and implementing conservation measures, setting a notable precedent for sustainable healthcare practices in the region.

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

With continued investment, innovation and collaboration, radiology will remain a powerful ally in the quest to eliminate TB from India

ByKalyani Sharma

As per WHO, every year, 10 million people fall ill with Tuberculosis (TB). Despite being a preventable and curable disease, 1.5 million people die from TB each year – making it the world’s top infectious killer.

India's relentless fight against TB has reached a crucial juncture with the government's audacious "End TB by 2025" campaign. At the heart of this battle lies a transformative force: radiology and imaging technologies. The integration technologies, including Artificial Intelligence (AI) and Machine Learning (ML), is serving as a powerful catalyst, promising better outcomes and accelerating progress.

Current state of radiology in TB detection

Global Data in its recent report highlights that, “TB, a persistent global health challenge, continues to impact countries across the world, including India. As the nation strives to combat this ancient disease, India's mycobacteriumtuberculosistests market is anticipated to grow at a compound annual growth rate of 4 per cent between 2023 to 2033.”

Dr Manjunath P H, Consultant Interventional Pulmonologist, BGS Gleneagles Global Hospital, Bengaluru while explaining the role of radiology in TB testing and detection said, “TB is primarily detected by examination of Sputum and biopsy specimens in extrapulmonary cases. However, radiology is used as a simple tool for early detection of suspected cases. When patients with lung infection do not respond to antibiotics and their radiological picture remains the same then we can suspect the possibilities of other infections, in which TB is the first differential diagnosis in our practice. So, Radiology can be used as early suspicion in TB.”

In the battle against TB, radiology has been a longstanding and essential tool for detection and diagnosis.

The diagnostic power of radiology lies in its ability to unearth the telltale signs of TB within the human body

Dr M.LRokade Consultant Radiologist, Jupiter Hospital Thane

The two most used imaging modality techniques for identifying pulmonary TB are chest X-rays and CTscans.It is reasonably priced,widely accessible,and capable of identifying a variety of TB abnormalities,such as infiltrates,consolidations,cavities,and lymphadenopathy

Prof.Dr.Sudhir Kumar Kale Lead Consultant - Radiology,Aster CMI Hospital; Governing Council Member - Aster Medical Imaging (India); HOD BMIT Aster-RGUHS

TB is primarily detected by examination of Sputum and biopsy specimens in extrapulmonary cases.However, radiology is used as a simple tool for early detection of suspected cases

Dr Manjunath PH Consultant Interventional Pulmonologist, BGS Gleneagles Global Hospital, Bengaluru

It must be reiterated that radiographs tend to over-diagnose the disease when used in isolation.Therefore,a chest radiograph suggestive of tuberculosis must conform with a sputum analysis

Dr Lancelot Mark Pinto Consultant Pulmonologist and Epidemiologist, P.D.Hinduja Hospital & Medical Research Centre

India's healthcare system has leaned on radiological imaging techniques, primarily chest X-rays and Computed Tomography (CT) scans, to identify TB-related abnormalities in the lungs.

The diagnostic power of radiology lies in its ability to unearth the telltale signs of TB within the human body.

Dr M. L Rokade, Consultant Radiologist, Jupiter Hospital Thane shares, “These signs manifest as characteristic abnormalities within the lungs, most notably cavities and infiltrations. These radiological hallmarks are not only diagnostic but also serve as a crucial benchmark for assessing the severity and progression of the disease. Radiological findings inform medical professionals on the course of treatment, allowing for timely interventions that are essential in mitigating the spread of TB.”

Highlighting some of the imaging techniques,Prof. Dr. Sudhir Kumar Kale, Lead Consultant - Radiology, Aster CMI Hospital; Governing Council Member - Aster Medical Imaging (India); HOD BMIT Aster-RGUHSsaid, “For many years, radiology and imaging have been crucial diagnostic and treatment techniques for tuberculosis. The two most used imaging modality techniques for identifying pulmonary TB are chest X-rays and CT scans. It is reasonably priced, widely accessible, and capable of identifying a variety of TB abnormalities, such as infiltrates, consolidations, cavities, and lymphadenopathy.”

“Yet, especially in infants and those with HIV/AIDS, chest X-rays might occasionally miss early or mild instances of TB. To obtain more precise images of the lungs and other organs that may be impacted by TB, various imaging modalities, such as CT and Magnetic Resonance Imaging (MRI), can be used.”

Dr Lancelot Mark Pinto, Consultant Pulmonologist and Epidemiologist, P. D. Hinduja

Hospital & Medical Research

Centrealso mentions, “Chest radiography is a sensitive test for pulmonary tuberculosis. Unfortunately, it is not very specific when used in itself. Indians have a high p revalence of background scars on chest radiographs, often as a result of childhood infections or infections during the course of their lifetime. And this makes it difficult to interpret chest radiographs, especially when used in the context of screening for tuberculosis. When combined with symptoms such as prolonged fever, cough, weight loss, chest radiography has the potential of improving diagnostic yield for the disease. This can be exploited by standardised questionnaire-based algorithms or AI algorithms that use the combination of these variables to predict the probability of tuberculosis. However, these are screening tests; the confirmatory tests for pulmonary tuberculosis continue to be based on sputum analysis with molecular tests such as gene expert or CBNAT, and culture-based methods.”

“A point of care chest radiography done through mobile tele monitoring systems would be useful in door-todoor screenings as part of active surveillance systems, when used in combination with symptom screens. However, it must be reiterated that radiographs tend to overdiagnose the disease when used in isolation. Therefore, a chest radiograph suggestive of tuberculosis must conform with a sputum analysis.”

Technologyintegration:

Amplifying TB detection

While traditional radiology already plays a significant role in detecting TB, integration with other technologies like AI and ML can significantly improve its accuracy and ultimately help achieve the goal of “End TB by 2025.”

Technology integration allows radiologists to review a larger number of radiology

Computer-aided detection (CAD) systems have brought about a substantial enhancement in the precision and swiftness of TB identification in chest X-rays,while AI and MLalgorithms have fine-tuned sensitivity and specificity in radiological TB detection

Raghavendra Goud Vaggu

Global CEO, Empe Diagnostics

AI isn't just supporting our mission to end TB by 2025; it's driving a paradigm shift in TB control.It's improving access, boosting detection rates,and ensuring timely care for those afflicted.AI represents a revolution that's steadily propelling us towards our goal

Amit Gandhi

Chief Business Officer (CBO), Deeptek

Radiology and imaging technologies, coupled with AI and MLintegration,are indispensable tools in India's battle against TB

Dr (Major) Vimal Raj

Senior Cardiothoracic Radiologist, Narayana Health City, Bangalore

AI algorithms can rapidly and accurately analyse vast datasets of radiological images.They excel at identifying subtle abnormalities that might be overlooked by human radiologists,ultimately leading to earlier and more precise TB diagnoses

Dr

Neetu

Jain

Senior Consultant Pulmonology Critical Care and Sleep Medicine, PSRI Hospital

images in a shorter time frame, increasing efficiency that leads to more patients with TB being identified and treated, ultimately reducing the burden of the disease.

Talking about technology integration,Raghavendra Goud Vaggu, Global CEO, Empe Diagnosticsmentions, “The swift processing and accessibility of images have

been propelled by digital radiography and Picture Archiving and Communication Systems (PACS) systems, outpacing conventional film-based approaches. Computer-aided detection (CAD) systems have brought about a substantial enhancement in the precision and swiftness of TB identification in chest X-rays, while AI and ML algorithms have finetuned sensitivity and specificity in radiological TB detection.”

AI and ML are emerging technologies that have been making significant strides in

While traditional radiology already plays a significant role in detecting TB, integration with other technologies like AI and ML can significantly improve its accuracy and ultimately help achieve the goal of “End TB by 2025

the medical industry, and TB detection is not left behind in this revolution. The integration of AI and ML in radiology and imaging is providing healthcare professionals with improved detection techniques for TB. AI algorithms are being developed to identify lung abnormalities indicative of TB, such as nodules and cavities, by analysing chest radiographs.

Explaining howAI is helping in achieving the objective of the ‘End TB by 2025’ campaign, Amit Gandhi, Chief Business Officer (CBO), Deepteksays, “AI is fundamentally reshaping our approach to achieving the 'End TB by 2025' campaign, ushering in profound changes in TB screening and detection. AI is proving to be a costeffective approach. By reducing unnecessary tests and expenses, only individuals identified as positive by AI undergo sputum or molecular testing, streamlining the process and saving resources. In summary, AI isn't just supporting our mission to end TB by 2025; it's driving a paradigm shift in TB control. It's improving access, boosting detection rates, and ensuring timely care for those afflicted. AI represents a revolution that's steadily propelling us towards our goal.”

Dr (Major) Vimal Raj, Senior Cardiothoracic Radiologist, Narayana Health City Bangaloreopines, “Radiology and imaging technologies, coupled with AI and ML integration, are indispensable tools in India's battle against TB. They not only expedite diagnosis but also contribute significantly to achieving the campaign's objective of eradicating TB by 2025.”

Dr Neetu Jain, Senior Consultant Pulmonology Critical Care and Sleep Medicine, PSRI Hospital also sharesthat, “AI algorithms can rapidly and accurately analyse vast datasets of radiological images. They excel at identifying subtle

Radiomics is now being evaluated in analysing CTimages to differentiate TB fromnon-TB lesions

Dr Tanu Singhal Consultant, Paediatrics and Infectious Disease, Kokilaben Dhirubhai Ambani Hospital, Mumbai

Techniques like Positron Emission Tomography (PET) combined with CT (PET/CT) can visualise metabolic changes associated with TB,offering improved specificity in diagnosis

Dr Divya Kant Consultant –Radiologist, Asian Hospital, Faridabad

The landscape of radiology and imaging for TB detection is dynamic.Emerging technologies such as 3D imaging,which provides a more comprehensive view of affected areas,and portable X-ray machines for remote and underserved regions,are promising advancements

Dr Sunita Dube Senior Radiologist and Founder, Medscape

Conventional detection methods take an astonishing 3 to 8 weeks to yield results. Hence,there is an urgent need to swiftly contain the growth and spread of these drug-resistant bacterial strains.This is where the advancements in modern radiology and imaging technology are coming to our aid

Chander Shekhar Sibal HOD & Vice President, Healthcare Business at FUJIFILM,India

abnormalities that might be overlooked by human radiologists, ultimately leading to earlier and more precise TB diagnoses.”

Promising and upcoming technologies

In addition to AI and ML, India is experiencing a surge of promising and emerging technologies for TB detection via radiology and imaging. Portable imaging devices are gaining prominence, particularly in remote and resourcelimited regions. These devices empower healthcare professionals to capture images and swiftly send them to experts for rapid analysis, thus closing the accessibility gap in radiological services. Furthermore, there are exciting developments in molecular imaging, poised to provide novel insights into TB detection at the molecular level. These advancements hold the potential to significantly improve the accuracy and speed of diagnosis.

Experts explain about various promising technologies for TB detection via radiology and imaging.

Explaining about Radiomics,Dr Tanu Singhal, Consultant, Paediatrics and Infectious Disease, Kokilaben Dhirubhai Ambani Hospital Mumbai said, “Radiomics is a techniquewhich refers to the automatic high-throughput extraction of a large number of quantitative features from images. Radiomics is now being evaluated inanalysing CT images to differentiate TB fromnon-TBlesions.”

Dr Divya Kant, Consultant –Radiologist, Asian Hospital Faridabadon molecular imaging mentions, “Techniques like Positron Emission Tomography (PET) combined with CT (PET/CT) can visualise metabolic changes associated with TB, offering improved specificity in diagnosis.”

Dr Sunita Dube, Senior Radiologist and Founder, Medscape Indiaemphasises, “The landscape of radiology

and imaging for TB detection is dynamic. Emerging technologies such as 3D imaging, which provides a more comprehensive view of affected areas, and portable X-ray machines for remote and underserved regions, are promising advancements. Additionally, teleradiology is facilitating remote diagnostics, improving access to expertise.”

TB is a curable and preventable illness, but the misuse of anti-TB drugs has empowered the disease-causing bacteria to gain resistance—an unfortunate consequence of survival. Furthermore, the drug-resistant strain of TB poses an even graver threat with its complexity and heightened fatality. Therefore, the urgency to detect drug-resistant TB early cannot be overstated. It gives doctors the opportunity to administer precise and effective treatments, thereby halting its transmission.

On this,Chander Shekhar Sibal, HOD & Vice President, Healthcare Business at FUJIFILM Indiashares, “Conventional detection methods take an astonishing 3 to 8 weeks to yield results. Hence, there is an urgent need to swiftly contain the growth and spread of these drug-resistant bacterial strains. This is where the advancements in modern radiology and imaging technology are coming to our aid. Computer-assisted detection software programs are becoming a valuable solution for healthcare professionals to tackle the challenges of interpreting chest X-rays, ultimately streamlining the screening process and addressing the shortage of radiologists. Moreover, digital applications are also leveraging AI to offer a high-quality, efficient, and standardised method for respiratory issue screening. The emergence of ultra-portable digital X-ray systems, characterised by their small size, wireless capabilities, and ease of mobility, represent a valuable resource

Given that screening programs may often be conducted in a rural setting,the use of teleradiology allows for transmission of the images to a centralised teleradiology reporting facility.This allows the rural population to have access to high level subspecialist radiologic diagnosis

Dr Arjun Kalyanpur Founder CEO and Chief Radiologist, Telerad Group

Upcoming technologies are crucial to achieving the objective of the "End TB by 2025" campaign.Innovations like AI can significantly improve early TB diagnosis,while telemedicine helps with remote monitoring of patients and ensuring they adhere to their treatment plans

Dr Meinal Chaudhry Director-Radiodiagnosis and Interventional Radiology, Aakash Healthcare

Convergence of radiology and imaging technologies,assisted by the integration of AI and ML,represents a substantial leap forward in the pursuit of the "End TB by 2025" initiative

Dr E.Ravindra Reddy Senior Pulmonologist, Kamineni Hospitals

Overcoming the challenges associated with data management involves implementing data integration platforms and interoperability standards to enable seamless exchange of information between different healthcare systems

Dr Anita Agarwal Director & Chief of Radiology Department, Indian Spinal Injuries Centre

for delivering healthcare to remote and challenging-toreach communities.”

Talking about X-ray digitisation,Dr Arjun Kalyanpur, Founder CEO and Chief Radiologist, Telerad Group shares, “X-ray digitisation facilitates Teleradiology where the images can be transported over a broadband network to another location for the purpose of analysis by a radiologist.Currently there is a major shortage of radiologists globally including in India where we have only about 20,000 radiologists for our population of 1.4 billion, and most of these radiologists are concentrated in metros. Given that screening programs may often be conducted in a rural setting, the use of teleradiology allows for transmission of the images to a centralised teleradiology reporting facility, such as Teleradiology Solutions reporting center. This allows the rural population to have access to high level subspecialist radiologic diagnosis.”

Aiding the "End TB by 2025" campaign Radiology and imaging have played a significant role in diagnosing TB in India, and innovative technologies like AI and ML are advancing it further. The integration of these technologies has improved the accuracy of TB detection, enabling healthcare professionals to detect TB earlier and treat it promptly, ultimately helping India achieve the goal of “End TB by 2025.”

Sharing her views on this, Dr Meinal Chaudhry, Director-Radiodiagnosis and Interventional Radiology, Aakash Healthcaresaid, “Upcoming technologies are crucial to achieving the objective of the "End TB by 2025" campaign. Innovations like AI can significantly improve early TB diagnosis, while telemedicine helps with remote monitoring of patients and ensuring they adhere to their treatment plans. Further, drug development

and identifying treatment resistance is made possible by next gen sequencing. Furthermore, wearable health technology facilitates real time data gathering for personalised TB care. By streamlining healthcare delivery, enhancing patient outcomes, and supporting monitoring efforts, these developments considerably help the campaign's objective to eradicate TB by 2025.”

Moreover, these innovative technologies are effectively lightening the load on healthcare professionals tasked with TB detection in India. Radiology and imaging experts can now review a significantly larger number of chest radiographs and CT scans within a shorter time frame compared to previous methods, enabling them to serve a greater number of patients. This heightened efficiency translates to the early identification and treatment of more TB cases, ultimately reducing the disease's incidence and steering India closer to the eradication of TB.

Dr E. Ravindra Reddy, Senior Pulmonologist, Kamineni Hospitalsbelieves that the convergence of radiology and imaging technologies, assisted by the integration of AI and ML, represents a substantial leap forward in the pursuit of the "End TB by

2025" initiative. The timely and precise detection of TB plays a pivotal role in curtailing transmission rates and ensuring that individuals affected by the disease promptly receive the necessary treatment. By accelerating the diagnostic process and mitigating the risk of misdiagnosis, these technological advancements play a pivotal role in advancing the campaign's goals.”

Dealing with data: Management and challenges

The integration of innovative technologies, particularly AI and ML, in the field of radiology and imaging has led to a surge in data that needs to be managed. With the immense amounts of data generated from X-rays, CT scans, and other imaging techniques, there needs to be a way to

manage and organise the data effectively to ensure that it is useful in detecting TB.

There are several challenges in managing this data, including its sheer volume, quality, disparate data sources, and data privacy concerns. The volume, velocity, and variety of data involved can be overwhelming, necessitating robust data management solutions. Furthermore, data privacy and security concerns are paramount, given the sensitive nature of patient information.

Dr Anita Agarwal, Director & Chief of Radiology Department, Indian Spinal Injuries Centre said, “The increasing use of radiology and imaging techniques generates vast amounts of data that need to be stored, organised, and analysed efficiently. This requires strong data management systems and

infrastructure. Furthermore, ensuring the privacy and security of sensitive patient information is crucial. Overcoming the challenges associated with data management involves implementing data integration platforms and interoperability standards to enable seamless exchange of information between different healthcare systems. Additionally, training healthcare professionals in proper data handling and analysis techniques is vital for maximising the potential of radiology and imaging in TB detection.”

Gandhi opines, “Efficiently managing patient and screening data is absolutely imperative in the battle to eradicate TB. Through the utilisation of cutting-edge digital applications such as RIS (Radiology Information System), patient data and histories are meticulously recorded, eliminating

the risk of critical information being lost during follow-up procedures. This centralised data management system empowers authorities at all levels to seamlessly engage with the data, gaining profound insights into the current situation.”

Dr Raj believes,”Ensuring data privacy, managing large datasets, and maintaining the quality of data are ongoing concerns. Addressing these issues requires collaborative efforts between healthcare institutions, hospitals, technology providers, as well as policymakers.”

The wayforward

The current state of radiology in TB detection in India is a blend of challenges and opportunities. While challenges like limited access and a shortage of skilled professionals persist, technological advancements, particularly in AI and ML, hold promise for revolutionising TB detection.

Efforts to expand the radiological infrastructure, train healthcare professionals, and ensure quality assurance are crucial steps in improving the accuracy and accessibility of radiological services for TB diagnosis. Collaborative efforts are vital to achieving these goals.

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

The integration of innovative technologies, particularly AI and ML,in the field of radiology and imaging has led to a surge in data that needs to be managed.With the immense amounts of data generated from X-rays,CTscans,and other imaging techniques,there needs to be a way to manage and organise the data effectively to ensure that it is useful in detecting TB

PATIENT SAFETY

PACs hold immense potential for healthcare organisations aiming to prioritise patient-centricity

Dr Vijay Agarwal ,President,Consortium of Accredited Healthcare Organisations (CAHO) in an interaction with Kalyani Sharma explains the role of Patient Advisory Councils (PACs) and highlights that the introduction of PACs is aimed towards fostering structured collaboration between patients and healthcare providers

Can you elaborate on the unique role that Patient Advisory Councils (PACs) can play in fostering collaboration between patients and healthcare providers? What are the key benefits of such collaboration? Looking ahead, how do you envision the evolving role of PACs in the healthcare landscape, especially in light of advancements in technology and changing patient expectations?

There has been a growing concern about the increasing incidence of medical errors in hospitals worldwide. It has also been observed that patients when empowered and engaged to take part in decisions regarding their own healthcare, the outcomes are likely to be better and safer. The introduction of PACs is aimed towards fostering structured collaboration between patients and healthcare providers.

Important thing is to make all stakeholders (patients and healthcare providers) believe that patients play an integral role in safeguarding their own care and well-being.

Introduction of PACs in hospitals is a very important step for getting the voice of patients a place in hospital’s eco system. With PACs in the picture, patients can voice out their concerns and be part of the decision-making process throughout. This collaboration will help patients also to understand the complexity of hospital functioning and will help

bridging the trust gap. Expansion of PACs across hospitals in tier 1 and tier 2 cities of the country can help build an extensive hospital network where healthcare administrators and patients can come together to share their learnings and, challenges to collectively elevate the standard of care.

The widespread adoption of this initiative by hospitals can transform PACs into hubs for gathering patient data. The patient generated data, the insights gained, and the feedback collated can help in paving the way for

further medical research, study, and innovation.

In what ways do you see technology and AI-based solutions enhancing patient engagement in healthcare? Can you provide specific examples of how these technologies are being implemented effectively?

The emergence of AI-based remote patient monitoring solutions and virtual health assistants has profoundly changed the way the healthcare sector functions. Most of all, it has empowered

patients to actively engage in their healthcare journey. Continual advances in technologies and their assimilation into the healthcare landscape enable patients to obtain a better understanding of their condition, be aware of various treatment options, leading to improved disease management. With the help of contactless remote monitoring devices, nurses and doctors can now remotely keep a check on patients’ vital signs and health metrics. This allows medical practitioners to timely intervene in case of emergencies or deteriorating patient conditions, and potentially save lives. With patients taking control over managing their own health conditions, it helps the healthcare providers to identify areas of improvement to reduce medical errors and make collective and informed decisions. Involving patients in their own care can increase patient satisfaction and enhance health outcomes.

Can you share some success stories or instances where PACs have played a pivotal role in promoting innovation and patientfocused research?

PACs have been instrumental in many healthcare settings by serving as a conduit between patients, caregivers, and healthcare providers. Their unique position allows them to offer invaluable insights into the healthcare process from the patient's

perspective, often resulting in innovative solutions and more patient-centric research. Here are some instances and success stories showcasing the influence of PACs:

◆ Feedback on medical devices

In some hospitals, PACs have been actively involved in providing feedback on medical devices. For instance, certain wearables or monitoring devices might be uncomfortable or not user-friendly from a patient's perspective. With the input of PACs, manufacturers were able to refine and redesign these devices to be more comfortable, efficient, and tailored to the patient's needs.

◆ Improving hospital design

Several healthcare institutions have leveraged PACs in decisions related to hospital architecture and interior design. Patients and caregivers provided feedback on room layouts, the placement of call buttons, the design of waiting areas, and more. Such feedback led to the creation of spaces that are not just functional but also comfortable and healing for patients.

◆ Digital health feedback

As telehealth and digital health platforms have proliferated, PACs have been crucial in refining these systems. They've highlighted issues with user interfaces, accessibility challenges for older patients, and offered

Introduction of PACs in hospitals is a very important step for getting the voice of patients a place in hospital’s eco system

PATIENT SAFETY

suggestions to make virtual consultations more patientfriendly. Their feedback has directly influenced the evolution of many digital health platforms to be more intuitive and accessible.

◆ Refining care pathways

In some instances, PACs have played a role in streamlining the patient's journey through the healthcare system. By highlighting bottlenecks, unnecessary procedures, or redundant steps, healthcare institutions have been able to simplify and improve care pathways, resulting in quicker, more efficient care that places the patient's experience at the forefront.

What strategies or best practices do you recommend for organisations looking to establish and maintain successful PACs?

Establishing and maintaining successful PACs in India is crucial for fostering patientcentric healthcare improvements. To achieve this, it's essential to begin with a well-defined purpose and objectives for the PAC, ensuring a clear roadmap for its activities. Diverse membership, representing various backgrounds and experiences, enriches the council's perspectives and insights. Equipping PAC members with adequate training and resources empowers them to fulfil their roles effectively, while wellstructured meetings with ample time for feedback sharing can facilitate productive discussions.

The careful analysis and utilisation of PAC feedback in the decision-making process demonstrate the value placed on the members' input. Independence and transparency within the PAC, free from conflicts of interest, are vital. Members should be well-informed about organisational plans to maintain trust, and empowering PAC members to influence decisions and acknowledging their contributions with

celebrations of success can further enhance their engagement.

In the Indian context, cultural sensitivity is paramount. Meetings should be conducted in languages comprehensible to all members, and opportunities for social interactions should be provided to build relationships. Rural patient representation is essential, requiring inclusive recruitment and tailored meeting schedules and agendas. Collaborating with local patient advocacy groups and organisations can also expand the PAC's reach.

By following these strategies and tips, organisations can establish and sustain successful PACs in India, facilitating the development of more patientcentric healthcare products and services.

In the context of technology and AI in healthcare, what measures should be taken to ensure that patients' privacy and data security are adequately protected while promoting patient engagement and collaboration?

In the realm of healthcare technology and AI, safeguarding patient privacy and data security is paramount, while fostering patient engagement and collaboration. To achieve this, robust security measures, such as encryption, access controls, and firewalls, must be implemented to shield patient data from unauthorised access and cyberattacks. It's crucial to anonymise data by removing personally identifiable information before deploying it for AI development or research. Patients should have control over their data, with the ability to opt in or out of its use for AI purposes and the right to request data deletion at any time.

Transparency plays a pivotal role in building trust. Dozee, for instance, utilises innovative technology to monitor patient vitals, ensuring data security

through encryption, access controls, firewalls, and regular security audits. Patients using the technology have control over their data, with the option to determine its use for research or development. This approach helps in building trust between patients and healthcare organisations.

Additionally, advanced techniques like federated learning and synthetic data can be adopted to further protect patient privacy and security during AI model development. Patient advisory councils can offer valuable input to ensure ethical and patient-centric AI implementation in healthcare. By adhering to these measures, healthcare organisations can harness the benefits of AI while safeguarding patient data and privacy effectively.

What are the key challenges that PACs might face, and how can these challenges be addressed to maximise their effectiveness in improving patient-provider collaboration and healthcare outcomes?

Enhancing patient-provider collaboration and healthcare outcomes in India through PACs requires addressing key challenges while leveraging statistics and technology. Firstly, recruiting and retaining PAC members can be challenging, particularly for smaller healthcare organisations. Simplifying membership with online registration, virtual meetings, and travel reimbursement can facilitate participation. Statistics show the importance of PACs, with a 2019 study by the Indian Institute of Management Ahmedabad indicating that 90 per cent of PAC members believe their feedback positively impacts their organisation's products and services.

Secondly, ensuring that PAC feedback influences healthcare decisions is crucial for member engagement. Establishing a

structured feedback process and transparent communication of outcomes can reinforce the significance of PAC input. The National Health Systems Resource Centre's 2020 study found that 82 per cent of PAC members believe they have a genuine voice in their organisation's decisionmaking process.

Lastly, building trust and rapport between PAC members and healthcare providers is vital. Encouraging personal interactions and creating an atmosphere of respect and collaboration fosters productive relationships.

According to a 2021 study by the Indian Institute of Technology Madras, 76 per cent of patients believe that PACs can enhance the quality of healthcare in India.

In addition to these strategies, technology plays a pivotal role. Leveraging platforms like Dozee for continuous and real-time patient monitoring can make PACs more responsive and impactful, ultimately benefiting both patients and healthcare organisations.

How can healthcare organisations effectively integrate patient feedback gathered through PACs into their decision-making processes and day-to-day operations? What are some best practices in this regard?

In India, PACs hold immense potential for healthcare organisations aiming to prioritise patient-centricity. However, effectively integrating PAC feedback into decision-making processes and daily operations presents its own set of challenges. To address this, healthcare organisations in India can implement the following strategies.

Firstly, it's crucial to establish a clear and documented process for collecting, analysing, and utilising PAC feedback. This process should be communicated to all stakeholders, including PAC

members, healthcare providers, and administrative staff. Furthermore, maintaining a regular review cadence for PAC feedback, whether through periodic PAC meetings or dedicated committees, ensures that feedback remains at the forefront of decision-making.

Prioritisation of PAC feedback is key. Not all feedback holds the same weight or feasibility, so healthcare organisations should prioritise suggestions that promise significant improvements in patient care and can be realistically implemented within available resources. Interestingly, in a 2021, research from the Indian Institute of Technology Madras revealed that 76 per cent of patients in India believe that PACs can enhance the quality of healthcare.

Developing specific, measurable, achievable, relevant, and time-bound (SMART) action plans to address prioritised feedback is the next step. This ensures that feedback translates into tangible improvements. Effective communication is vital. Keeping PAC members informed about the progress made in addressing their feedback fosters trust and demonstrates the value placed on their input.

Best practices for Indiaspecific integration of PAC feedback include leveraging technology for efficient collection and analysis, involving PAC members directly in action plan development, and regularly reviewing and updating the feedback integration process to ensure its continued effectiveness.

Effectively integrating PAC feedback into decisionmaking processes and daily operations empowers healthcare organisations in India to enhance care quality, safety, and patient-centricity, ultimately delivering a more satisfactory healthcare experience.

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

Enhancing healthcare accessibilityand affordabilityin India: Medtech revolution

Uma Shankar,Global Delivery Head-Healthcare and Life Sciences,LTIMindtree emphasises on the role of medtech in bridging healthcare gaps

India's healthcare landscape is a paradox, boasting cutting-edge medical facilities and world-renowned healthcare professionals while grappling with issues of accessibility and affordability. In the recent decades, India has certainly augmented its health intensity with many global accreditations, that provide care at par or above global standards. There are about 40+ Joint Commission International (JCI) accredited hospitals, 1600+ National Accreditation Board for Hospitals & Healthcare Providers (NABH).

While there are efforts to build a healthy nation, innovative solutions are needed to bridge any gaps. Medtech emerges as a ray of hope in this scenario, poised to revolutionise healthcare delivery and access across the nation. For a population that exceeds 1.3 billion, the medtech industry is expected to grow at a CAGR of 15 per cent and has the potential to reach $50Bn in revenues by 2030.

Current healthcare scenario in India

Uniform standards and easy accessibility of healthcare are critical in any nation. Medical research has made remarkable progress, but the accessibility and affordability of healthcare services as a whole, continue to be a concern for us, in India. Key issues of the current system include:

◆ Geographic disparities: India's healthcare system is a complicated collage, with world-class hospitals in the cities and restricted access to primary care in the countryside. Playing a vital role, urban congestion has pushed the best in care to the most populated zone leaving the rest behind.

For e.g., India has only 0.9 beds

per 1000 population and out of which only 30 per cent are in rural areas.

◆ Financial barriers: High healthcare costs with price disparities, especially for critical illnesses, place an enormous financial burden on families, often pushing them into financial crisis. The inflation rate in healthcare costs is presumed to be around 14 per cent.

◆ Limited specialised care: Access to specialised medical

duced quality of care.

Medtech's role in bridging healthcare gaps

Medtech offers promising solutions to some key issues listed above. The Indian medtech industry encompasses a range of technologies offering promising solutions to enhance healthcare accessibility and affordability, especially for rural populations. Here's how medtech can revolutionise healthcare in India:

◆ Improved diagnosis and treatment: Advanced diagnostic tools like portable ultrasound devices, digital x-rays, and AI-powered diagnostic software expedite disease detection and improve treatment outcomes, especially in underserved areas. Portable diagnostic devices provide quick and accurate assessments, enabling timely interventions in rural areas.

◆ Patient monitoring: Wearable devices and remote monitoring solutions allow continuous tracking of patients' health, facilitating early interventions and effective management of chronic conditions. Remote monitoring empowers individuals to take charge of their health, and in cases like diabetes, remote apps help patients monitor their condition and receive timely advice from healthcare professionals.

Digital infrastructure and internet connectivity

To fully harness medtech's potential, India needs a robust digital infrastructure and widespread internet connectivity, ensuring seamless health services across the country. This is essential for:

◆ Telemedicine: Technologies like 5G can revolutionise telemedicine, enabling remote consultations, monitoring, and even surgical procedures, reducing the need for physical travel.

◆ Digital health records: Centralised digital health records improve information sharing among healthcare providers, enhancing continuity of care and ensuring access to patient records.

◆ Health apps: Mobile health apps empower individuals to proactively manage their health and seek timely medical advice, bridging the digital divide. As an example, ABHA (Ayushman Bharath Health Account) health app allows for cashless transactions, which makes it convenient for patients to pay for their medical bills through UPI (Unified Payments Interface). The account holder can use an UPI payment method to make payments at empaneled hospitals and healthcare facilities.

expertise is limited in many regions, compelling patients to travel long distances for treatment.

◆ Ineffective healthcare delivery: Inefficiencies in the healthcare delivery system leads to delays in diagnosis and treatment, worsening health conditions. Taking a closer look, public health system often faces overcrowding and resource constraints, leading to longer waiting times and re-

◆ Personalised treatment plans: Medtech solutions analyse patient data to create personalised treatment plans, optimising drug regimens and reducing adverse effects. This tailored approach is particularly beneficial for patients with complex conditions, such as cancer treatments customised based on genetic mutations, increasing chances of success while minimising side effects.

Cost-effective alternatives to traditional diagnostics

Medtech provides cost-effective alternatives to traditional diagnostic methods. Point-ofcare testing devices and smartphone apps equipped with AI algorithms can quickly diagnose diseases, reducing the need for expensive laboratory tests. For example, smartphone-based ophthalmic screening devices can detect eye diseases early, preventing vision loss and reducing the fi-

To fully harness medtech's potential,India needs a robust digital infrastructure and widespread internet connectivity, ensuring seamless health services across the country

MEDTECH

nancial burden on patients. Portable ultrasound devices make prenatal care more accessible, ensuring healthier pregnancies. These innovations democratise access to quality diagnostics, making healthcare more affordable.

Balancing technologyand human touch

While medtech promises remarkable advances, it is essential to maintain a balance between technology and the human touch in healthcare. The doctor-patient relationship relies on trust, empathy, and human interaction. Medtech should complement healthcare professionals' efforts, enabling them to focus on patient inter-

action and decision-making rather than routine tasks.

Collaborative efforts for success

The successful integration of medtech into India's healthcare system requires collaboration among various stakeholders:

◆ Government initiatives: Government support is crucial to create policies and regulations that foster medtech innovation while ensuring patient safety and data security, as seen in initiatives like the National Digital Health Mission (NDHM). Similarly, the digital health program Ayushman Bharat Digital Mission (ABDM) helps in bridging the gaps between different stake-

holders of healthcare ecosystem by having a Unified Health Interface (UHI). This provides the backbone necessary to support the integrated digital health infrastructure of the country.

◆ Industry involvement: Medtech companies can collaborate with healthcare providers to develop tailored solutions addressing India's unique healthcare challenges. Having realised the potential, many IT leaders have provided innovative technology solutions for teleconsulting services to remote areas and overcome geographical barriers. Some product companies leverage medtech to deliver healthcare services at home, reducing the

need for hospital visits and associated costs.

◆ Healthcare training: Healthcare professionals should receive training in using medtech effectively to maximise its benefits.

◆ Community engagement: Educating communities about the advantages of medtech and digital health tools is crucial for widespread adoption.

Conclusion

The medtech revolution holds immense potential to enhance healthcare accessibility and affordability in India. By improving diagnosis, treatment, and patient monitoring, MedTech can bring advanced healthcare services to even

the remotest corners of the country. Ho wever, this transformation requires a concerted effort from government, industry, healthcare professionals, and the community. Striking the right balance between technology and the human touch in healthcare is key to achieving a holistic and patient-centric healthcare system that truly serves the diverse needs of India's population, ultimately improving the health and well-being of millions of Indians.

Leading the digital health revolution, our nations ABHA program will transform the healthcare outlook of the country just like what UPI changed digital payments in India.

INTERVIEW

Integration of digital health will playpivotal role in reshaping healthcare landscape

Sunil Khurana ,CEO & MD,BPLMedical Technologies in an interaction with Express Healthcare talks about his company’s vision and highlights that our technological advancements are aimed at streamlining healthcare delivery,empower clinicians,and ultimately improve patient care and outcomes

BPL Medical Technologies covers a wide range of healthcare segments, including Cardiology, Critical Care & Surgery, Women & Child Care, Imaging, Homecare, and Consumables & Accessories. How do you prioritise innovation across these diverse areas?

At BPL Medical Technologies, innovation is embedded at the core of our work towards advancing the healthcare landscape of India. Each of the segments that we cater to present a unique set of trends, market needs and gaps in itself, whether it is Cardiology, Critical Care & Surgery, Women & Child Care, Imaging, Homecare or Consumables & Accessories segment. Central to our vision is a steadfast commitment to fostering innovation and research within the company, by prioritising investment in state-of-the-art research and development facilities and forming strategic partnerships with leading technology partners to avoid reinventing the wheel, harness the existing expertise and bring already tested products to localise. By nurturing a culture of curiosity and open dialogue, we encourage our teams to explore new ideas and pioneer breakthrough technologies that address India's unique healthcare challenges. I have spoken on multiple occasions, advocating for clear and robust R&D initiatives from

the GOI to put product development on fast track for companies like ours that are engaged in making local products for Indian demographic. At the same time, our intent to collaborate with academia such as IISC, IITs and other esteemed tech institutions, underscores our dedication to tapping into a pool of talent and research capabilities.

What recent technological innovations has your company developed or adopted, and how do they impact patient care and healthcare providers? Our company has made significant advancements in healthcare technology. In

We are committed to establish strong partnerships with hospitals, clinics,and healthcare providers to better understand their challenges and needs

the new era of seamless collaboration, we have enhanced the connectivity of most of our products that helps senior clinicians to remotely access patient data and provide valuable guidance to on-duty doctors and caregivers, assisting them in the suggested clinical protocols. By bridging the geographical gaps and enhancing healthcare accessibility, such connectivity features hold immense value in a country like ours, with the potential to greatly improve healthcare delivery in remote locations. In collaboration with our partners, we've developed state-of-the-art ventilators that offer a wide range of ventilation modes. These modes have proven invaluable to treating the patients, empowering clinicians with versatile tools to address diverse patient needs effectively. Moreover, our latest ultrasound technology boasts high-density single crystal technology. This breakthrough enables us to deliver exceptional grayscale imaging, facilitating quicker and more accurate diagnoses. By providing healthcare providers with superior imaging capabilities, we contribute to better patient care outcomes. Additionally, we’ve also incorporated connectivity features to our homecare range of solutions, allowing multiple health monitoring devices to sync with a user-friendly app. This data can be stored by the end user for monitoring and analysis of their vital signs, enabling care providers to track their patient’s trends and adapt clinical protocols as needed.

In essence, our technological advancements are aimed at streamlining healthcare delivery, empower clinicians, and ultimately improve patient care and outcomes.

What challenges and opportunities do you see in the current healthcare

landscape that are driving the need for advanced medical technologies?

Integration of digital health technologies will play a pivotal role in reshaping the healthcare landscape in India. We will embrace telemedicine, remote patient monitoring, and other capabilities to create connected medical devices that enable seamless data sharing, facilitate remote consultations, and improve patient engagement. This transformation will empower patients to take charge of their health while enhancing the efficiency of healthcare delivery. With the rising trend in ageing population and chronic

in healthcare. How does your company collaborate with other healthcare stakeholders, including hospitals, research institutions, and regulatory bodies, to advance medical technology?

We are committed to establish strong partnerships with hospitals, clinics, and healthcare providers to better understand their challenges and needs. This approach guides us to tailor our products such that it meets real-world requirements, ensuring an enhanced patient care. We also collaborate with regulatory authorities to ensure our

adapt to these changes?

BPL Medical Technologies looks forward to significant advancements in medical technology over the next decade. Over the coming years, there will be a continued shift towards remote patient monitoring and telemedicine. Our team is constantly working on upgrading our devices and offering solutions that enable real-time remote monitoring of patients' vital signs, enabling healthcare professionals to intervene promptly when necessary. Our aim is to facilitate seamless telehealth experiences while maintaining the highest standards of patient care.

healthcare delivery, patient outcomes, and overall industry dynamics. Our company is committed to staying at the forefront of these changes and actively contributing to the transformation of medical technology.

Could you share your vision for the future of BPL Medical Technologies and how the company plans to continue enhancing the productivity of healthcare in India and beyond.

illnesses, we need better medical solutions. Also, healthcare costs are going up a lot, so we need smart ways to save money, and that's where advanced technologies that are made in India will help. They can also help bring healthcare to faraway places with remote monitoring and telemedicine. But as we gather more patient information, we need extra protection for that data. On the bright side, there are great opportunities too. We can personalise treatments based on someone's unique traits, and advanced medical devices can help clinicians understand health data better.

Collaboration is often key

products adhere to the highest standards of quality and comply with all relevant regulations. All our collaborations are characterised by a strong feedback loop. We take input from our channel partners and healthcare stakeholders, incorporating their suggestions and feedback into our operations. This ensures that our solutions remain relevant, user-friendly, and aligned with the evolving needs of the healthcare industry.

How do you envision the role of medical technology evolving over the next five to ten years, and what are your company's plans to

Personalised healthcare where patients will play an active role in managing their health will be another key development, and medical technology will play a critical role in this paradigm shift. BPL has already taken a step to address this by introducing our homecare range of solutions that allow patients to keep a track on their vitals at the comfort of the home. These devices will act as EMR data of various vitals being captured in home setting on daily / weekly basis for associated clinician to see the trend and chalk out treatment accordingly. While these are just a few of the many, these developments will undoubtedly rev olutionise

As an aspiring CEO in the India Medical Devices industry, I envision a future where cutting-edge technology, accessibility, and inn ovation conv erge to transform healthcare in India. My vision is rooted in the belief that our mission as a company goes beyond mere business success; it is about making a meaningful difference in the lives of millions by providing advanced medical devices tailored for our needs that enhance patient care, improve health outcomes, and contribute to the overall advancement of healthcare in India. Our organisations one of the key Vision is “Delivering affordable solution to the last mile in the market we serve” and have built our service and distribution network in last one decade. Our vision is to lead BPL Medical Technologies towards becoming a beacon of innovation, accessibility, and impact in healthcare. By advancing research and innovation, developing affordable and accessible solutions, collaborating for meaningful change, embracing digital health technologies, ensuring regulatory compliance and quality, and investing in our talented team, we will contribute significantly to the improvement of healthcare outcomes in India. Together, we will forge a path towards a healthier and more prosperous future for the nation.

Integration of digital health technologies will play a pivotal role in reshaping the healthcare landscape in India.We will embrace telemedicine,remote patient monitoring,and other capabilities to create connected medical devices that enable seamless data sharing,facilitate remote consultations,and improve patient engagement.This transformation will empower patients to take charge of their health while enhancing the efficiency of healthcare delivery

HEALTHCARE TRACKER

Mapping India’s medtech growth trajectory: From ‘local’to ‘global’

Shobha Ghosh ,Director-Government Affairs & Policy,GE HealthCare South Asia in an interaction with Express Healthcare talks about the growth of medtech sector in the coming decade and opportunities that India can leverage to attract investment from domestic and global manufacturers to make localisation a success

How do you anticipate the growth of the medtech sector in the coming decade, considering the objectives outlined in the National Medical Devices Policy 2023, which aims to position India among the top global manufacturing hubs and accelerate the growth of the medical devices sector?

With National Medical Policy (NMD) 2023, India embarks on its journey of self-reliance and potential five-fold growth by 2030 to become one of the top five global manufacturing hubs. This will require streamlining the regulatory environment, significant investments in manufacturing & R&D, and ensuring demand in healthcare.

The first step would be to delink the medtech industry from pharma completely. Medtech is distinctly different from pharmaceuticals as these are a combination of mechanical, electrical and software processes, while pharmaceuticals are essentially chemical molecules. Therefore, medical devices cannot be regulated as drugs but have separate provisions to ensure safety, efficacy, and quality standards.

As the domestic manufacturing footprint expands, a strategic shift from assembly manufacturing to researchbased indigenous manufacturing is necessary. Currently, most components, such as displays, sensors and detectors used in radiology and imaging devices, are

imported because of a lack of economy of scale, inverted import duty structures and adequate incentives. Similarly, sourcing expensive raw materials such as Yttrium from China, Photo Diode from Japan, etc., needs Government-to-Government (G2G) facilitation. Hence, demand aggregation with sectors like defence, aerospace, etc., that use similar technologies and raw materials is critical to provide economy of scale.

Strengthening brownfield clusters, fast-tracking setting up ‘state of the art’ new Medical Parks, and implementing PM Gati Shakti multi-modal connectivity and volumes, ensuring decent margins, will help attract investments from global and domestic medtech and component manufacturers.

What are the opportunities that India can leverage to attract investment from domestic and global manufacturers to make localisation a success?

As the most populous country in the world with 300 million middle class, 20 per cent of 1.4 billion population covered under some form of health insurance and 40 per cent of population comprising the very poor being assured health cover through the Pradhan Mantri Swasthya Arogya Yojana (PMJAY), India has immense potential for demand generation. Robust medical tourism growing at 20-25 per cent also adds to demand attracting investments.

The demand-supply gap

Strengthening brownfield clusters,fast-tracking setting up ‘state of the art’new Medical Parks,and implementing PM Gati Shakti multi-modal connectivity and volumes,ensuring decent margins,will help attract investments from global and domestic medtech and component manufacturers

HEALTHCARE TRACKER

that we have in the country today is a crucial trigger for attracting investments.For instance, 60 per cent of our hospitals are in large cities, leaving 80 per cent of our country devoid of adequate healthcare. There are only 2700 mammograms installed, which is less than 5 per cent of USA, and only 30 per cent of our cancer centers have advanced technologies (e.g., only 120 PET CT scanners). This leads to only 15-20 per cent of cancer patients undergoing radiation therapy as against 40-50 per cent globally and 30-35 per cent of patients undergoing surgery compared to 60-65 per cent globally.

In response to this, the Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), with an outlay of Rs 64,180 over six years, envisages the creation of tertiary healthcare capacity in the underserved areas of the country. Similarly, there are ~USD 3 billion (Rs 24962 crores) grants/loans collectively from multilateral & bilateral agencies for infrastructure expansion, thus opening up opportunities for localisation.

Given this, the government is actively promoting local manufacturing through schemes like the Production Linked Incentive (PLI) scheme for cancer & radiation therapy, imaging &

radiology and in-vitro diagnostic, Phased Manufacturing Programme (PMP) for X-rays that is now being expanded for another 40 devices/components. The Medical Devices Export Promotion Council (MDEPC) recently set up is intended to boost the export strategy.

Wipro GE Healthcare is a proud founding member of MDEPC.

The scheme for ‘Promotion of Research and Innovation in Pharma MedTech’ (PRIP) has been recently announced to push local manufacturing from cost-based to innovationbased manufacturing. In addition, the engineering and tech talent pool, thriving IT & software industry, digital and analytics capabilities, emerging start-up ecosystem, increasing investments in R&D and manufacturing by global MNCs and 100 per cent FDI through automatic route makes India an attractive destination for investors.

As the global medtech manufacturers explore the China plus One option, there cannot be a better time for India to leapfrog.

What is GE HealthCare’s strategy to contribute to Atmanirbhar Bharat story?

Can you share some examples of the work done so far and the plans for the future?

Wipro GE Healthcare is

committed to addressing healthcare challenges in India and the world. Over the last three decades, it has invested heavily in harnessing local talent for manufacturing, R&D, and innovat ion, developing the country's first line of local suppliers. We have been at the forefront of supporting ‘Make in India’, setting up four joint venture manufacturing facilities in Bangalore, one with the PSU Bharat Electronics Ltd and three with IT major Wipro Enterprises Limited India, the latest being PLI greenfield entity [Wipro GE Medical Device Manufacturing].

From the product design perspective, in 2007, we introduced the Mac 400 ECG Machine, the first localised product. This was followed with ‘Make in India’ Baby Warmer- Lullaby in 2008 and PET CT system for cancer diagnosis and staging in 2014. We launched the first ‘Make in India’ CT Revolution ACT, expanding diagnostic capabilities for cancer and other ailments in 2015. Our local content has grown from 20-25 per cent to an impressive 40-45 per cent this year.

In terms of R&D, we were among the first healthcare companies to start healthcare technology R&D in India over two decades back. With 1100+ filed patents and the delivery of

125+ innovations, our R&D efforts have been significant. We also established GE HealthCare’s 5G Innovation Lab in JFWTC, Bengaluru –the first for us, globally.

The policy ecosystem in India witnessed significant changes in the last few years, especially after the pandemic. We aim to reduce import dependency from 80 per cent to 50 per cent by 2030 through ‘Make in India’, Make for India efforts. How can we achieve this while ensuring that quality standards are not compromised - as a part of the Make in India story? Reducing import dependency from 80 per cent to 50 per cent by 2030 while upholding quality standards requires a comprehensive approach. With the implementation of the Medical Device Rules 2017/2020, all types of medical devices have been brought under the regulation under the aegis of (Central Drugs Standard Control Organisation (CDSCO). This is a positive move towards ensuring the safety and efficacy of medical devices as per the World Health Organization’s (WHO) norms.

The local manufacturers need policies to help provide a level playing field by removing anomalies, inverted duty and regulatory structures and access to

assured markets. The three key impediments that need to be addressed are:

◆ Exemption of multiple Quality Control Orders and Compulsory Registration Scheme from other Ministries on imports of components, accessories and spares for manufacturing, services and research in medtech. These add to the cost of local manufacturing, impacting global competitiveness as multiple QCOs & CRS are not applicable on imported medical devices.

◆ Address predatory pricing and dumping by medical device companies from land border countries by creating duty arbitrage through Quality Control Orders (QCOs) and compulsory registration Scheme (CRS). This will provide a level playing ground for the domestic manufacturers.

◆ Seamless integration of locally manufactured medical devices in public procurement and 20 per cent rebate for private procurement in underserved areas for assured access to the market.

To bolster domestic manufacturing capabilities and reduce import dependency, it is crucial to have predictive policies, a stable regulatory regime with adequate transition time for adoption, ease of doing business and adequate incentives.

HEALTHCARE TRACKER

Erba Institute of Medical Lab Technology and St.Francis Hospital collaborate to inaugurate DMLTcourse in Ajmer

This partnership marks a significant stride in empowering aspiring medical laboratory technicians with essential skills and knowledge in the dynamic field of medical diagnostics

Erba Institute of Medical Lab Technology, set up under the aegis of Transasia Bio-Medicals Ltd – India’s no. 1 IVD company, is proud to announce its collaboration with St. Francis Hospital, Ajmer, in the inauguration of the highly anticipated Diploma in Medical Laboratory Technology (DMLT) course. This partnership marks a significant stride in empowering aspiring medical laboratory technicians with essential skills and knowledge in the dynamic field of medical diagnostics.

The grand inauguration ceremony took place on September 20th at the prestigious St. Francis Hospital campus, located in Ajmer, Rajasthan. The event was graced by distinguished guests from both Erba Institute of Medical Lab Technology and St. Francis Hospital, including Anil Jotwani, Sr. President – Sales &

Marketing, Transasia who delivered an inspiring keynote address, highlighting the critical importance of providing students with exposure to cutting-edge instrumentation and new technologies in the field.

“Transasia firmly believes that education is the most effective means to give back to society. With this intention, we persist in our efforts to nurture highly trained and skilled laboratory technologists for the healthcare industry. It is of utmost importance to provide students with exposure to the latest technology,

new methodologies, and automation through the provision of state-of-the-art instrumentation. Transasia is dedicated to assisting this institute in achieving its goals. We will collaborate and share knowledge by appointing external faculty members to ensure that we stay updated with the latest developments in the field of Laboratory Technology”, he added.

Some of the key highlights of the course include:

◆ Expert faculty: Students will learn from a distinguished team of highly qualified in-

structors.

◆ Cutting-edge facilities: Access to state-of-the-art laboratory equipment and resources.

◆ Comprehensive curriculum: The program covers a wide spectrum of clinical laboratory sciences.

◆ Practical training: Handson experience with modern diagnostic tools.

◆ Ethical practices: Emphasis on patient safety and ethical standards in healthcare.

St. Francis Hospital's unwavering commitment to education and skilled training in the healthcare sector aligns

seamlessly with this collaborative initiative.

Sr. Sunita Antony, Director, St. Francis Hospital said, "Investing in education is an investment in the future of healthcare. The DMLT course not only addresses the skills gap but also contributes significantly to the enhancement of healthcare delivery within our community."

St. Francis Hospital, renowned for its multidisciplinary approach to healthcare, remains dedicated to compassionate patient care, groundbreaking medical research, and the provision of top-tier medical education.

This collaboration between Erba Institute of Medical Lab Technology and St. Francis Hospital represents a pivotal moment in shaping the future of healthcare education, promising to empower the next generation of medical laboratory technicians.

St.Francis Hospital's unwavering commitment to education and skilled training in the healthcare sector aligns seamlessly with this collaborative initiative

PEG tube: Gatewayto enhanced nutrition as a lifesaver for patients in need

AMI Polymer have developed advanced medical-grade silicone PEG tubes that are soft,clear, biocompatible,and radio-opaque for accurate placement detection.These PEG tubes come with multi-function connectors,enabling the injection of nutrient solutions and diets through various connecting tubes

Percutaneous Endoscopic Gastrostomy (PEG)

Tube is a significant medical device used to provide essential nutrition to individuals unable to consume food orally or face difficulty in swallowing due to various medical conditions. This minimally invasive procedure involves the insertion of a feeding tube into the stomach, enabling individuals to receive the necessary nutrients directly. PEG tube placement is a widely per-

formed endoscopic procedure with paramount importance in modern medicine.

Understanding PEG

PEG procedures are recommended for patients with inadequate oral intake, aiming to meet their metabolic requirements through enteral feeding.

Unlike parenteral feeding, which involves intravenous routes and poses additional risks, enteral feeding via PEG is preferred for patients with a

functional gastrointestinal system. Introduced in 1980, PEG has become the preferred method for medium- to longterm enteral feeding, lasting for months or even years.

Indications for alertness

Understanding the need for PEG tube insertion is crucial for managing patients effectively. Patients with insufficient oral intake due to conditions such as dementia, head injuries, cancer, prolonged coma,

motor neuron diseases, or other severe health issues benefit from PEG tube placement. Compared to nasoenteric tubes, PEG tubes offer fewer complications, improved comfort, and higher feeding efficacy, making them the preferred choice for long-term enteral nutrition.

Techniques involved in gastrostomy procedure

There are two primary techniques for performing a PEG procedure: The GaudererPonsky technique and the Seldinger wire technique. Both involve inserting a feeding tube into the stomach through small incisions, allowing for enteral feeding and nutritional support.

PEG tube solution byAMI Polymer

AMI Polymer have developed advanced medical-grade silicone PEG tubes that are soft, clear, biocompatible, and radioopaque for accurate placement detection. These PEG tubes come with multi-function connectors, enabling the injection of nutrient solutions and diets through various connecting tubes.

Contradictions and complications

While PEG tube placement is generally safe, certain contraindications and potential complications must be considered. Contraindications include serious coagulation disorders, hemodynamic instability, abdominal wall infections, gastric outlet obstruction, and more. Complications may range from minor issues like local stoma bleeding to severe problems like infections, pressure necrosis, or gastric ulcers.

Conclusion

PEG tube placement plays a crucial role in providing enteral nutrition to patients with limited oral intake capabilities. It is a safe and widely accepted procedure, offering numerous benefits to those in need. Proper understanding of the procedure, its indications, contraindications, and potential complications is essential for successful outcomes and improved patient care. Effective management and timely removal of PEG tubes, when necessary, contribute to overall patient well-being.

Ami Polymer Pvt Ltd medical@amipolymer.com

HEALTHCARE TRACKER

SysmexXQ-320: Areal workhorse for clinical laboratories

Sachin

Rajguru

,Deputy Product Manager-Haematology and Sales & Marketing,Sysmex

Sysmex, a front runner in in-vitro diagnostics in India has acquired market leadership in Haematology with more than 20,000 successful installations across India with customer base starting from smaller stand-alone pathology laboratories to India’s largest sample processing labs. Sysmex Analysers are preferred choice and used by pathology labs since 1993, the year in which Sysmex started selling their quality products in India thru then distribution network. Over the years and with advance quality products, Sysmex customer base and acceptance increased in India many folds.

Sysmex always hears from customers and incorporates their feedback and requirements in the analysers through extensive R&D. Since India is one of the biggest markets for 3-part Differential Analysers (3-PDA), so we have listened all the customer’s expectations and considered them while designing our new 3-part haematology analyser.

Sysmex is proud and incredibly excited to announce that we have recently launched the much awaited and most advanced 3-part haematology analyser; XQ-320.

India: 3-PDAmarket segment

The 3-part differential haematology market is a high-volume segment with more than 10,000 analysers sold per year. Due to their simplicity, 3-part differential analysers are still cost-efficient devices for developing healthcare systems. For small hospitals, clinics and physician offices that conduct sophisticated testing, a 3-part heamtology analyser system is the best option.

The persistent growth of the hematology market is attributed to the increasing inci-

dences of blood disorders and increased prevalence of other diseases and infections. Rapid technological advances in hematology analysis and the emergence of high-throughput technology analysers with novel parameters have also contributed to rapid growth.

Modern hematology analysers are operated by advanced algorithms that implement data-fusion capabilities to integrate information from multiple separate modules, identify patterns, detect, and correct interfering elements. This function leads to greater convenience in detection and correction of errors and reduces the need for manual reviews. Heamatology analysers provide laboratory technicians with access to greater and more specific cell information for highly accurate complete blood count with differential and lower review rates. They are crucial for streamlining lab processes and improving diagnostic testing. The focus has shifted toward improving clinical utility and exceeding expectations with new-age data

informatics and algorithm science. Heamatology analysers have evolved greatly and now they can perform a variety of morphology analyses in addition to cell counting. Aspirations have replaced expectations and users are interested in achieving even more from hematology analysers.

The new XQ-320 is designed to bring quality hematology testing to as many sites as possible in this highly diverse market segment. XQ-320 is equipped with a multitude of different features allowing it to meet the diverse needs of the

various types of laboratories in the healthcare facilities. The XQ-320 offers a great solution as it can be used as a standalone device, for instance for physician’s office laboratories, or as a supplementation in more complex facilities such as bigger hospitals where 3-part differential analysers quickly provide results for example in emergency rooms, on specialized wards or other rapid-response diagnostic settings.

While keeping the proven technology of the XP-300, we have added new features used in our recent 5-part differential analysers, such as a large touch screen, the user interface, and the flagging messages. The results correlate well with the flagship XN-Series, making the XQ a match in any lab network.

XQ-320 is an open-tube 3part differential analyser with a space-conscious design, very little maintenance, and flexible options for connectivity. A multitude of useful features allows it to fit in all kinds of laboratory environments and do the job you need it to do – with excellence. Numerical values, histograms, and flags on a single screen enable convenient result interpretation while the advanced QC settings of XQ320 support you in fulfilling your regulatory requirements.

Time is of the essence and regulations are becoming

more and more strict, especially in working areas like ERs, ICUs or other rapid-response scenarios. XQ-320 finds the balance between these requirements that make those areas special. With many different users operating the system, we’ve made sure login is simple without compromising on safety. Also catering for special needs in terms of regulations, XQ-320 offers a range of functions related to quality control and patient data safety, some of which can be optionally activated depending on the area.

XQ-320 has been designed keeping in mind the needs of the pathology community for shorter TAT, higher throughput, accurate reporting, all leading to enhanced patient care.

Keyfeatures

◆ 20 parameters including a dedicated neutrophil countScreening of bacterial infection

◆ Very low aspiration volume of 16 μL

◆ No daily maintenance required – only one weekly shutdown

◆ Easy-to-perform QC – conveniently scan all QC parameters in one go

◆ Flagging system with 20 messages, providing more indepth information about potential abnormalities detected by the analyser

◆ Network capability, 5,00,000 data storage

◆ Throughput up to 70 samples per hour

◆ Large coloured LCD touch screen of 10.4 inch

◆ New quality control security feature which complies with ISO 22870

With the XQ-320 analyser, Sysmex continues to provide quality solutions for all our hematology customers, from the smallest to the biggest laboratory.

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.”

Medikabazaar: The game-changer for the dental industry

Medikabazaar is an online platform that has revolutionized the way dental products are bought and sold in India. The platform boasts of having the largest dental catalogue in the country, which includes a wide range of products from some of the most well-known and respected brands in the industry.

The dental catalogue on Medikabazaar is truly a onestop-shop for all dental needs. Whether you are a dentist looking to purchase equipment for your clinic or a laboratory technician looking to buy dental materials, the platform has something to offer everyone. The catalogue includes products such as dental

chairs, dental handpieces, dental X-ray machines, dental materials, and much more.

One of the key advantages of using Medikabazaar's online platform is the convenience it offers. Dentists and dental professionals can now purchase dental products from the comfort of their own homes or offices. The

platform is easy to navigate and allows users to search for products based on various criteria such as brand, price, and category. This makes it easy for users to find exactly what they are looking for.

Another advantage of using Medikabazaar's online platform is the competitive pricing. The

platform has established partnerships with leading dental manufacturers and suppliers, which allows them to offer their products at very competitive prices. This is great news for dentists and dental professionals who are always on the lookout for ways to save money on their purchases.

In addition to the large dental catalogue, Medikabazaar also offers excellent customer service. The platform has a dedicated customer support team that is always available to assist users with any queries or concerns they may have. This ensures that users have a smooth and stress-free shopping experience.

Overall, Medikabazaar's online platform is a game-changer for the dental industry in India. The platform's large dental catalogue, competitive pricing, and excellent customer service make it a must-visit for dentists and dental professionals looking to purchase high-quality products at affordable prices.

The dental catalogue on Medikabazaar is truly a one-stop-shop for all dental needs.Whether you are a dentist looking to purchase equipment for your clinic or a laboratory technician looking to buy dental materials,the platform has something to offer everyone

One of the key advantages of using Medikabazaar's online platform is the convenience it offers. Dentists and dental professionals can now purchase dental products from the comfort of their own homes or offices

Startwithhigh-endtechnology

Whetheryouarestartinganewimagingbusiness,lookingfor areliableworkhorsetohandleincreasingworkloadsefficiently, orexpandinganestablishedimagingbusiness,AquilionStart istheCTsystemofchoiceforallyourroutineimagingneeds.

AquilionStartispackedwithpremiumtechnologyoriginally developedforourhigh-endCTsystems. Itiscarefullycraftedandadaptedtothechangingrequirements ofhealthcareorganizations,includingtheneedforfaster workflows,universalaccessibility,andsoundeconomics.

https://global.medical.canon/

©CanonMedicalSystemsCorporation2022.Allrightsreserved.