VOL.9 NO.11 PAGES 64
www.expresshealthcare.in NOVEMBER 2015, `50
CONTENTS Vol 9. No 11, NOVEMBER 2015
Chairman of the Board Viveck Goenka Sr Vice President-BPD
HEATING AND LIGHTING: CRUCIAL TO TREATING DEMENTIA
MARKET
Neil Viegas Editor Viveka Roychowdhury* Chief of Product Harit Mohanty BUREAUS Mumbai Sachin Jagdale, Usha Sharma, Raelene Kambli, Lakshmipriya Nair, Sanjiv Das Bengaluru Assistant Editor Neelam M Kachhap DESIGN National Art Director Bivash Barua Deputy Art Director Surajit Patro Chief Designer Pravin Temble Senior Graphic Designer Rushikesh Konka Artist Vivek Chitrakar, Rakesh Sharma Photo Editor Sandeep Patil MARKETING Regional Heads Prabhas Jha - North Dr Raghu Pillai - South Harit Mohanty - East & West Marketing Team Douglas Menezes G.M. Khaja Ali Ambuj Kumar E.Mujahid Arun J Ajanta Sengupta PRODUCTION General Manager B R Tipnis Manager Bhadresh Valia Scheduling & Coordination Ashish Anchan CIRCULATION Circulation Team Mohan Varadkar
Professor June Andrews, Dementia Services Development Centre, University of Stirling, UK lays emphasis on the need for the right heating and lighting systems to treat dementia and offers insights on how to make a living space comfortable for patients with dementia| P34 P27:INTERVIEW: MUNISH DAGA CEO, Remedinet
SATISH SINHA
P36:INTERVIEW: KANIKA TEKRIWAL
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DR SUJIT CHATTERJEE CEO, Dr LH Hiranandani Hospital, Powai
P38:INTERVIEW: DR RAJENDRA PATANKAR COO, Nanavati Super Speciality Hospital
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JSPL FOUNDATION TIES UP WITH ECHO FOR SPECIALITY HEALTHCARE IN RURAL INDIA
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GOVT INCREASES FINANCIAL ASSISTANCE UNDER RASHTRIYA AROGYA NIDHI
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ANTWORKS ACQUIRES US-BASED BENCHMARK SYSTEMS
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ASTER DM HEALTHCARE ACQUIRES MAJORITY STAKE IN SANAD HOSPITAL, SAUDI ARABIA
TECHNOLOGY: AN ENABLER FOR HOSPITAL ADMINISTRATION
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HOSPITAL INFRASTRUCTURE & MANAGEMENT EXPO TO BE HELD AT BEC, MUMBAI
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TISS ORGANISES CONVOCATION FOR ITS EPGDHA STUDENTS
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MUSOC CELEBRATES ITS 25TH YEAR IN INDIA
STRATEGY
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CEO and Co-founder, JetSetGo
P37:INTERVIEW:
ABBOTT AND SOCCER STAR CRISTIANO RONALDO JOIN HANDS TO PROMOTE BLOOD DONATION
IT@HEALTHCARE
P28:INTERVIEW: HOD-IT, Fortis Hospital, Mulund
10
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SKILLING WITH TECHNOLOGY
LIFE
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ISCOS LAUNCHES GUIDE ON SPINAL INJURY
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GOWTHAM JAYARAM JOINS NIGHTINGALES AS CTO
Express Healthcare® Reg. No. MH/MR/SOUTH-252/2013-15 RNI Regn. No.MAHENG/2007/22045. Printed for the proprietors, The Indian Express (P) Ltd. by Ms. Vaidehi Thakar at The Indian Express Press, Plot No. EL-208, TTC Industrial Area, Mahape, Navi Mumbai - 400710 and Published from Express Towers, 2nd Floor, Nariman Point, Mumbai - 400021. (Editorial & Administrative Offices: Express Towers, 1st Floor, Nariman Point, Mumbai - 400021) *Responsible for selection of newsunder the PRB Act.Copyright © 2015 The Indian Express (P) Ltd. All rights reserved throughout the world. Reproduction in any manner, electronic or otherwise, in whole or in part, without prior written permission is prohibited.
EDITOR’S NOTE
Building a healthier future
A
recent study on malnutrition in rural Maharashtra, released recently at a two day event organised by Jan Arogya Abhiyan (JSA-Maharashtra), Anna Adhikar Abhiyan (Right to Food campaign, Maharashtra), Tata Institute of Social Sciences (TISS) and Nutrition Rights Coalition, has some dismal news for us. The title of the study report, ‘Systems that failed - Major gaps in public systems for tackling malnutrition among children below three years of age’ actually says it all. And it seems the gaps are rooted in the different approaches followed by the two key ministries dealing with malnutrition: the Health & Family Welfare and Women and Child Development. As the study points out, the Integrated Child Development Services (ICDS), run by Ministry of Women and Child Development and health system today follow divergent criteria for identifying malnourished children. As a result, many malnourished children are denied services from Nutrition Rehabilitation Centers (NRC). In this qualitative study which covered 55 children across tribal areas, rural districts and urban areas of Maharashtra including Amravati, Nandurbar and Gadchiroli, 24 out of 55 severely malnourished children were not referred for any treatment and out of seven severe acute malnutrition (SAM) children, only one was identified with SAM by ICDS. As Dr Vandana Prasad, former Member, National Commission for Protection of Child Rights, who released the report pointed out, the ICDS today does not deal with all malnourished children, they only focus on treating SAM. Thus, ICDS effectively waits for a child to become severely malnutritioned, before taking action, instead of taking comprehensive preventive measures. For instance, in the areas covered by the study, researchers found that malnutrition was not being detected early enough at the anganwadi level because workers were not aware or trained to use WHO standards to detect malnutrition. Instead of using the three criteria mandated by WHO viz. weight for height/length, upper arm circumference (MUAC), and edema (swelling on feet), anganwadi workers were recording only the first. Thus children were being labeled as severely underweight (SUW) or moderately underweight (MUW) using growth charts when they were actually in the SAM or moderate acute malnutrition (MAM) categories. As they were not being identified properly, these children could not avail essential services such as
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ICDS effectivelywaits for a child to become severely malnutritioned, before taking action, instead of taking comprehensive preventive measures
Village Child Development Centers (VCDC) or referral to NRCs for malnourished children. Worse, VCDCs were observed to be closed in the region covered by the study and since NRCs were only at the district/sub-district level, they were inaccessible in most cases. And when families did get help, it was quite a waste: Take Home Ration (THR) packets were not being given to children due to the 'bad taste' and in some cases mothers admitted to feeding them to animals like cattle, hens and dogs. Clearly, there is a lack of coordination between ministries and their implementation agencies, with a lack of supervision and investment in training resources at the frontline of the battle against malnutrition, i.e. the anganwadi workers and families of such children, especially mothers. Such first hand ground reports, like the study released at TISS, question the validity of official malnutrition statistics like Union Minister of Women and Child Development, Maneka Gandhi's statement in a July 23 PIB release, that there is a reduction in underweight among children under five years of age from 42.5 per cent in the National Family Health Survey (NFHS)-3 to 29.4 per cent as per a provisional India Fact Sheet of the Rapid Survey on Children (RSoC) commissioned by her Ministry with assistance from UNICEF India. While there are corporate bodies and NGOs involved in the battle against malnutrition, activists like Ulka Mahajan of the Anna Adhikar Abhiyan point out that with nutrition being a constitutional right, it is the government's duty to set the agenda and implement it and cannot be allowed to walk away from this duty. While there can be partners from the private or NGO sector, this might lead to a piecemeal approach with each third party having different approaches (and agendas). One hopes that the Maharashtra Government takes strong and speedy steps to plug the gaps identified in this report. Solving larger socio-economic issues like the impact of migration on malnutrition will take long term action but work can certainly start at the grassroot level, with every anganwadi worker being taught to correctly categorise the children under her care. Ending on some good news from the study: Pilot studies on community based monitoring and action to improve child nutrition have shown some positive results which can be scaled up to larger areas. Which shows that where there is a will, there is a way. VIVEKA ROYCHOWDHURY Editor viveka.r@expressindia.com
QUOTE UNQUOTE
We need more medical colleges. Both public and private sector education has expanded. But medical colleges are still inadequate. A review of the policy is required as far as increasing the number of medical schools is concerned
ARUN JAITLEY Finance Minister,Government of India (Speaking at 43rd Annual Convocation of AIIMS)
Medical equipment worth Rs 64 crores would be provided to all hospitals in various districts
ANIL VIJ Health Minister,Haryana
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SUSHMA SWARAJ External Affairs Minister,Government of India (Speaking at the Third India-Africa Forum Summit)
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MARKET NEWS
JSPL Foundation ties up with ECHO for speciality healthcare in rural India The tie up will help gain access to real-time medical consultations in areas that have scarce resources
JSPL FOUNDATION has tied up with Extension of Community Health Outreach (ECHO), a healthcare programme that uses technology to expand access to speciality healthcare in rural and medically underserved areas. JSPL Foundation and ECHO will provide speciality healthcare to rural India. ECHO, a project of the University of New Mexico (UNM) Health Sciences, uses healthcare services through case-based learning. This programme provides rural communities with an
ECHO, a project of the University of Mexico (UNM) provides rural communities with an opportunity to obtain real-time consultation with specialists and other critical disease management through Q&A sessions via web/teleconference opportunity to obtain real-time consultation with specialists and other critical disease management through Q&A sessions via web/teleconference. ECHO implements such preventive
extension models with the help of community health workers through rigorous training embedded with technology. The tie up is expected to help provide medical facilities in
areas that have scarce resources such as Chhattisgarh, Odisha, Jharkhand, Haryana and Arunachal Pradesh. With their technological expertise, healthcare can now be provided to peo-
ple living in the rural areas. They will have access to real-time medical consultations for complex medical cases and we hope to see many lives benefitting from these facilities. JSPL Foundation will be connecting the telemedicine centre to Jindal Fortis Hospitals, Jindal Cancer and Referral Hospital, Hisar, Medical College, Agroha, Max, Fortis Hospitals, All India Institute of Cancer and Biliary Sciences, AIMS and NIMHANS. EH News Bureau
Abbott and soccer star Cristiano Ronaldo join hands to promote blood donation The leading soccer player will serve as the first global ambassador for the BE THE 1 movement ABBOT AND Real Madrid soccer star Cristiano Ronaldo are partnering to bring even more attention to the important cause of blood donation. The leading soccer player will serve as the first global ambassador for the BE THE 1 movement - developed to inspire young people around the world to regularly donate blood. "We can all make a difference by donating blood. Each donation can benefit up to three people in emergency
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situations and for long-term medical treatments," said Ronaldo, forward for Real Madrid and Captain for Portugal National Football. "That's why I am enthusiastic to be partnering with Abbott to bring awareness to the importance of blood donation and to encourage people around the world to become lifelong blood donors and help save lives," he added. As a regular donor, Ronaldo understands the importance of
blood donation. Reportedly, he first gave blood after seeing his teammate's son was sick and was in need of a donation. Since then, he has continued to donate regularly and avoids any activities that would even temporarily prevent him from donating. As a leading player in infectious diseases and diagnostics, Abbott's testing instruments reportedly screen more than 50 per cent of the world's blood supply. As a result of careful
donor selection and testing, millions are safely given blood transfusions every year. Through its Global Surveillance Program, Abbott seeks to keep the blood supply safe by continually identifying new
viruses and diseases, as well as newly-emerging strains of HIV, Hepatitis B and Hepatitis C, in order to incorporate detection of such viruses into the blood screening process. EH News Bureau
MARKET
Govt increases financial assistance under Rashtriya Arogya Nidhi Enhances the financial powers delegated to designated Central Government hospitals/institutes from Rs two lakhs to Rs five lakhs for providing financial assistance in cases where emergency surgery is needed TO FURTHER ease access to financial assistance under Rashtriya Arogya Nidhi (RAN), the government has decided to enhance the financial powers delegated to designated Central Government hospitals/institutes from Rs two lakhs to Rs five lakhs for providing financial assistance in cases where emergency surgery is to be conducted. The RAN was set up in 1997 to provide financial assistance to patients, living below poverty line prescribed from time to time and who are suffering from major life threatening
diseases related to heart, liver, kidney and cancer cases, etc., to receive medical treatment at any of the super speciality government hospitals/institutes or other government hospitals. Revolving funds have been set up in 12 Central Government hospitals/institutes and an amount up to Rs 50 lakhs is placed at their disposal for providing financial assistance. Accordingly only cases for financial assistance beyond Rs five lakh would now be required to be referred to Ministry of Health and Family Welfare, Govern-
ment of India. For patients suffering from life threatening diseases, where time is a premium, this would facilitate commencement of treatment of poor patients found prima facie eligible for assistance under the scheme by these hospitals. This would also enable to curtail the procedural delay for treatment, which would bring relief to thousands of patients annually. The Government also provides financial assistance through the Health Minister’s Cancer Patient Fund (HMCPF) set up for providing financial assistance to
the poor patients suffering from cancer having treatment in 27 regional cancer centres (RCC). Financial assistance is also available under the Health Minister’s Discretionary Grant (HMDG) to patients having family annual income up to Rs one lakh and below to defray a part of the expenditure on hospitalisation/ treatment in government hospitals, in cases where free medical facilities are not available. Reportedly, these schemes have benefitted 37063 poor patients so far. Source: PIB
AntWorks acquires US-based BenchmarkSystems Post-acquisition, AntWorks will focus on improving clinical, economic outcomes in hospitals, physician offices and other care settings TECHNOLOGY STARTUP, AntWorks has acquired USbased Benchmark Systems, a cloud-based healthcare application services provider. A company release informed that the Board of Directors of both companies have unanimously approved a definitive agreement under which AntWorks will acquire Benchmark Systems, which will generate $10 million in revenue in the next 12 months. Through the acquisition, AntWorks expects to improve physician practices and ambulatory care globally to achieve greater levels of efficiency and
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reduce healthcare costs for its customers. Benchmark Systems will continue to operate as a standalone brand with integrated R&D activities with AntWorks’ existing infrastructure. Asheesh Mehra, CoFounder and CEO, AntWorks, said, “We are at a stage in our life cycle where we are looking at platforms which could help us in going global. The opportunity to acquire Benchmark Systems is fantastic, not least because of the highly scalable cloud based solutions which the company has developed, but also the strong platform
the company offers for growth in terms of talent, clients, geographic footprint and offerings.” Mehra continued, “The potential is apparent — especially with the growing requirements from medical practices — and Benchmark Systems’ operational ability, coupled with AntWorks’ engaged customer base, bring tremendous scale to this space.” He added, “AntWorks will now be able to offer a fully integrated suite of leading edge technology solutions including patient portal, scheduling, elec-
tronic health records, practice management, and revenue cycle management at a price point that is affordable to solo physicians and large group practices.” Govind Sandhu, CFO, AntWorks, said, “AntWorks expects the acquisition of Benchmark Systems to be immediately accretive to AntWorks’ adjusted gross and EBITDA margins. Benchmark Systems’ strong cash flow will help AntWorks to generate $10-$12 million in revenues in the next 12 months of operations.” EH News Bureau
Exostar receives $10 million investment from Merck GHI EXOSTAR HAS announced an additional $10 million investment in its life science and healthcare business from the Merck Global Health Innovation Fund (Merck GHI). Merck GHI has $500 million under management and provides growth capital to emerging healthcare technology companies worldwide. Reportedly, Merck GHI’s investment will allow Exostar to enhance and expand its HIPAA-compliant solutions that help pharma companies, healthcare providers, and others in the industry securely, productively, and compliantly collaborate with one another to develop new drugs and therapies and deliver the best possible patient care. Exostar’s information security solutions – such as the cloud-based Secure Access Manager (SAM) for federated identity and access management with web-based single sign-on – protect sensitive data and intellectual property while promoting the ongoing migration to partner-centric research and development and digital health. The latest round of funding follows a $5 million investment by Merck GHI in October 2014. Exostar’s life science and healthcare community comprises over 1000 global organisations who rely on SAM to access applications, exchange information, and conduct business. It also launched its ProviderPass solution that supports leading health IT vendors and healthcare providers with compliant electronic prescribing of controlled substances. EH News Bureau
MARKET
Attune Technologies secures $10mn funding from Qualcomm and Norwest Venture Partners Attune will use the latest investment to fuel the company’s growth plans in India ATTUNE TECHNOLOGIES has secured $10 million in Series B funding from Qualcomm Incorporated, through its venture investment group, Qualcomm Ventures, and Norwest Venture Partners. Reportedly, Attune will use the latest investment to fuel the company’s rapid growth in India. It will also utilise the funds to accelerate its expansion into international markets like Africa, West Asia and South-East Asia. “Qualcomm is pleased to make the first investment from its $150 million Strategic Venture Fund in India, in Attune Technologies,” said Karthee Madasamy, VP, Qualcomm Ventures India. Qualcomm recently announced its intention to invest up to $150 million in Indian start-up companies across all stages as part of its commitment to India. It currently has more than 20 Indian companies as part of its global portfolio, across the mobile ecosystem that includes hardware, software platforms, e-commerce, healthcare, location based services and retail technology. “We are excited to partner with Attune on their journey and their success. We believe that the technology they provide has the potential to be a gamechanger in addressing the issues related to healthcare globally,” commented Mohan Kumar, Executive Director, Norwest Venture Partners, India. With the new funds, Attune aims to offer its software solution to 25,000 hospitals and labs across the globe in the next three years. Source: PTI
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MARKET
Lancet Oncology Commission calls for expanding global access to radiotherapy The Commission found that up to 60 per cent of all cancer patients worldwide will need radiotherapy at some point in their treatment
INCREASING ACCESS to radiotherapy worldwide through greater investment could save millions of lives, according to The Lancet Oncology Commission’s report presented at the 2015 European Cancer Congress in Vienna, Austria , and published in The Lancet Oncology. The Commission’s results were presented at the 2015 annual meeting of the American Society for Radiation Oncology (ASTRO). The Commission found that up to 60 per cent of all cancer patients worldwide will need radiotherapy at some point in their treatment, but a lack of investment in radiotherapy services has severely limited access to radiotherapy treatments worldwide, especially in low-income and middle-income countries (LMIC). LMIC have 80 per cent of the global cancer burden but only five per cent of the resources for cancer control, and in low-income countries, 90 per cent of the population lack access to radiotherapy. Even in high income countries the numbers of radiotherapy facilities, equipment, and trained staff are inadequate. Radiotherapy is important for managing most cancers, such as breast, lung, prostate, head and neck, and cervical cancers, which account for more than two-fifths of cases worldwide. In their report, the
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Increasing access to radiotherapy in LMIC by scaling up capacity from current levels could lead to a saving of 27 million life years by 2035, over the lifetime of patients who receive this treatment Commission details how a persistent under-investment in radiotherapy globally has diminished access, and describes the substantial health and economic benefits of investing in radiotherapy. With the number of new cancer cases expected to rise to 24.6 million by 2035, the Commission claims that increasing access to radiotherapy services in LMIC by scaling up radiotherapy capacity from current levels could lead to a saving of 27 million life years by 2035, over the lifetime of patients who receive this treatment. In addition to saving human lives, providing full access to radiotherapy through investment could reduce the economic burden of cancer worldwide, which was $2 trillion in 2010. By 2035, full access to radiotherapy for all patients in LMIC could be achieved for as little as $97 billion, with economic benefits ranging from $278 billion to
$365 billion over the next 20 years. The Commission called for a long-term commitment to cancer care and treatment through the following actions: ◗ 80 per cent of countries should have cancer plans that include radiotherapy by 2020. ◗ By 2025, radiotherapy treatment capacity should be increased by 25 per cent from 2015 capacity. ◗ Each LMIC should have at least one cancer centre by 2020. ◗ LMIC should train 7,500 radiation oncologists; 20,000 radiation technologists; and 6,000 medical physicists by 2025. ◗LMIC should invest $ 46 billion by 2025 to establish radiotherapy infrastructure and training. ◗ 80 per cent of LMIC should include radiotherapy services as part of their universal health coverage by 2020. EH News Bureau
Aster DM Healthcare acquires majority stake in Sanad Hospital,Saudi Arabia Invests AED 900 million to increase its shareholding to 97 per cent in the hospital
ASTER DM Healthcare has acquired an additional 57 per cent stake in Sanad Hospital in Saudi Arabia for a consideration of AED 900 million (Rs 1,600 crores). With this investment, the company has consolidated its position and increased its shareholding to 97 per cent in the hospital. Sanad Hospital is a private tertiary care facility with over 250 beds, located in Riyadh in the central region of the Kingdom of Saudi Arabia. In 2011, the company had acquired 40 per cent stake in Sanad Hospital, marking its entry into Saudi Arabia. Dr Azad Moopen, Chairman, Aster DM Healthcare said, “This investment is a reiteration of our commitment to provide advanced medical care of the highest quality at affordable cost to the residents of Saudi Arabia. Our financial commitment will help accelerate the expansion plans of Sanad Hospital as also help Aster DM Healthcare Group to enhance its presence in West Asia.’’ Alisha Moopen, Director Strategy commented, “Over the past eight years, Sanad Hospital has delivered quality healthcare and our aim is to upgrade the hospital facilities to ensure more accessibility. In response to increase in the number of patients, we are adding new bed capacity of 100 inpatient beds with two new buildings
Dr Azad Moopen
and upgrading the main building to accommodate more emergency rooms and outpatient clinics.” Aster DM Healthcare has been steadily expanding its footprint in GCC and India. The company had launched operations in Bahrain earlier in the year. With the Sanad Hospital acquisition, Aster DM Healthcare now has presence in all the six GCC countries, Jordan and Philippines. The company also has five greenfield projects underway in GCC countries, including one hospital in Qatar and four in the United Arab Emirates. In India, the group has three hospitals in Kerala (Kozhikode, Kottakal, Kochi), two in Maharashtra (Pune, Kolhapur), two in Telangana (Hyderabad) and one in Karnataka (Bengaluru). EH News Bureau
MARKET PRE EVENT
Hospital Infrastructure & Management Expo to be held at BEC, Mumbai
HOSPITAL INFRASTRUCTURE & Management (HIM) expo, organised by The Ideas Exchange (IDEX) is set to provide the Indian healthcare industry a platform to educate them on hospital infrastructure, design and management. Recognised as India’s premier international exhibition on hospital infrastructure and design, Hospital Infrastructure & Management (HIM) seeks to give visitors’ access to a broad spectrum of high profile solution providers and experts who are involved in the future development of regional healthcare systems and infrastructure, including ministry and senior government officials, key decision makers and influencers across the healthcare spectrum. Reportedly, the second edition of HIM is expected to see over 90 exhibitors, with an expected footfall of 5000+ key decision makers and policy makers gathering from November 6-8, 2015 at Bombay Exhibition & Convention Centre, Mumbai. Recognised as the ideal platform for companies looking to grow in the healthcare infrastructure and design management space, the second edition of HIM will also witness an intense three
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The second edition of the event is expected to see over 90 exhibitors, with an expected footfall of 5000+ key decision makers and policy makers
MARKET day conference summit of industry leaders discussing topics to overcome critical challenges to the growth of new hospital construction in India. According to some estimates, the overall Indian health care market is today valued around $ 65 billion, of which the hospital supplies and health care equipment segment is believed to be only around $ 4.5-5 million. Healthcare delivery, which includes hospitals, nursing homes and diagnostics centres, and pharma products, constitutes 65 per cent of the overall market. Apparently, India requires 600,000 to 700,000 additional beds over the next five to six years, which potentially throws an opportunity of more than $25-30 billion. While the exist-
ing hospitals would look at expanding their capabilities, a lot of new properties would also come up providing an ideal opportunity for the private players to fill the gap. HIM expo intends to be one such initiative designed to fill the gap, creating a platform to improve the foundations of success of the Indian healthcare industry. Experts like Lalit Varma, AVP of Apollo Hospitals; Dr
Ram Narain of Kokilaben Dhirubhai Ambani Hospital (KDAH); Amit Sharma from Max Institute of Health Sciences; Parag Ringdani from Wockhardt; Tarang Gianchandani from Jaslok Hospital; Gautam Khanna from Hinduja Hospital; Anupam Verma from Wockhardt Hospital; Dr Vivek Desai of Hosmac, Surjeet Thakur of TrioTree; Tushar Kumar Desai from HN Re-
liance; Joy Chakraborty from Hinduja Hospital have reportedly confirmed as key speakers. They would facilitate industry discussions on developing new and refurbishing existing hospitals to world class standards in India. They will focus their attention on three key areas that need critical attention: ◗ Hospital Build and Design ◗ Technology Integration
◗ Finance and Operations “The healthcare industry in India has witnessed a massive increase in investment, as is particularly evident by the rising number of public and private hospitals, military hospitals, clinics and specialty centres that have been constructed and developed across the country over the last few years. Our intention with HIM is to make this the key platform for the design, build and management of healthcare facilities within the South Asia region. So when the decision makers behind public and private hospitals want solutions to building and refurbishing healthcare facilities, HIM would be the one stop solution for their needs,” said Vikas Vij, MD, The Ideas Exchange, organisers of HIM.
PD Hinduja Hospital to host 3 Healthcare Management Series,'Redefining Healthcare: Value Based Delivery' rd
The event aims to bring together diversified minds on a single platform to discuss healthcare trends, challenges and future PD HINDUJA Hospital & Medical Research Centre is hosting the 3 rd Healthcare Management Series by the hospital, titled “Redefining Healthcare: Value Based Delivery” on December 4-5, 2015. It is planned with the aim of bringing all the components/individuals of healthcare delivery system together to share their experiences and propose new concepts in this area. The 'value-based healthcare delivery' system includes creating various organisational structures like integrated practice unit, management practices and payment models that are in line with modern learning practices
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and today's medical science. The conference is expected to see the presence of professionals working in hospitals, nursing homes, healthcare consultancy companies, healthcare IT companies, health insurance companies, and other companies from the health industry. Reportedly, distinguished faculty from PD Hinduja Hospital, PWC, KPMG, IMS Health, NABH, JCI and AHPI as well as eminent and senior leaders from the healthcare industry will share their experience and expertise on creating a sustainable future. The conference, on December 4, will begin with a session on ‘Developing hospitals for
Gen-Next’ and then eminent speakers will discuss to improve patient experience and achieve patient centric care through the session ‘Transforming patient experience’. The session will discuss different challenges that the patient may face during their care journey and emphasise on the importance of working alongside patient and care givers. Day 1 will also see a panel discussion on ‘What healthcare consumers want today’ by some prominent faces from the healthcare industry. On Day 2 of the conference, a special session on ‘Enhancing quality and safety in healthcare: a mandate or
choice’ will be held in lieu of the fact that many healthcare institutions invest enormous effort and resources in order to improve quality and patient safety but often fail to reach that aspired ultrasafe environment. Following this, industry stalwarts will discuss the trends in the healthcare industry. The day will end with a special note on ‘Innovation Shaping future of healthcare.’ Other topics to be covered during the second day of the conference are: Healthcare Service Delivery: Excellence, Uniqueness and Outcomes; Moving to Value Based Competition: Improving Health Insurance and Access; Enhancing Quality and Safety in
Healthcare; Healthcare: Competing on Values and Outcomes; Harnessing the Power of Information Technology; Building Human Competencies: Leveraging Human Assets; Delivering Right and Appropriate Healthcare; Innovation - Shaping Future of Healthcare; New Paradigm of Healthcare Delivery- Coice of Customer. Express Healthcare is one of the media partners at the event. Contact Ph: +91 22 24451515 (Extn: 3204/7465), 07506423432 Email: mgmtseries@hindujahospital.com Website: www.hindujahospitalmgmtseries.com
MARKET POST EVENT
TISS organises convocation for its EPGDHA students 31 students were conferred the EPGDHA, Dr Juhi Chandwani Consultant Anaesthetist & Intensivist, Royal Hospital, Oman received the best student award SINCE ITS inception in 2013, Tata Institute of Social Sciences' (TISS') Executive Post Graduate Diploma in Hospital Administration (EPGDHA) has drawn a good response from the healthcare fraternity, reflected yearly in the number of entrants and the fact that the drop out rate is mostly nil. This year, 31 students were conferred the EPGDHA on October 5, with Dr Juhi Chandwani Consultant Anaesthetist & Intensivist, Royal Hospital, Oman receiving the best student award. The Chief Guest at the function was Indu Capoor, Founder Director, CHETNA and Director, CHETNA ‘Outreach’, Centre for Health, Education, Training and Nutrition Awareness (CHETNA), Ahmedabad. In all, around 130 students received their certificate/diplomas in 11 courses. TISS' EPGDHA is a 12month (two semesters), dual mode programme consisting of online learning and two-weeks of contact programme in each semester. Open to healthcare professionals across the globe, the programmeintends to enhance the knowledge and skills of working personnel in hospitals. Most students are post graduate medicos, including dentists and paramedical professionals.
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MARKET
MUSoc celebrates its 25 year in India th
A four-day conference was held recently with hands-on workshops to impart instant training to radiologists on how to perform musculoskeletal ultrasound
MUSCULOSKELETAL ULTRASOUND Society (MSUS) organised its 25th edition of MUSoc Conference at Taj Vivanta, Dwarka in New Delhi from 8-11 October, 2015. The international conference marked 25 years of MUSoc, a conference that has been held in different parts of the world for the past 25 years and marks teaching of the technique of performing musculoskeletal ultrasound Musculoskeletal ultrasound, or the ultrasound of bones, muscles and joints, while a popular technique used as an alternative to CT and MRI across the world, is still in the nascent stage of development in India. Explaining the importance of
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musculoskeletal ultrasound for the country, MUSoc Organiser in India, Dr Nidhi Bhatnagar said, “MSK USG technique is still very new to the country with only a handful of radiologists knowing how to perform this technique. MUSoc coming to India is quite a turning point in this situation. We have had more than 400+ radiologists
coming here, not just from across the country but from across the globe to get a handson experience on how to perform this technique.” Talking about the response that was received at the conference, founding member of MUSoc, Michael A Dipietro, a renowned paediatric radiologist from the University of
MUSoc is a conference that has been held in different parts of the world for the past 25 years and marks teaching of the technique of musculoskeletal ultrasound
Michigan said, “We are quite overwhelmed by the response that we have got from India, both in terms of the number of participants as well as the enthusiasm that they have shown towards learning this technique. I am sure this conference has given them a great opportunity as a starting point to learn and use this new technique.” At the event, Dr Bipin Batra, Director, National Board of Examinations was the Guest of Honour. Talking about bringing MSK USG to the Indian curriculum, he said, “The development of MSK USG is a technical advancement that has taken place in the past 15 years. Having said that, the applications of
MSK USG have now grown so much that it can be transformed into a sub-speciality within the ambit of radiology. It’s important to promote this technical advancement, and MUSoc has given a good starting point. We had the world’s most renowned in the field of radiology, both teaching and learning this technique. As National Board of Examinations, we are working closely with these international experts as well as Musculoskeletal Ultrasound Academy to develop training guidelines, curriculum and accreditation to be able to announce this as a formal program in the year 2016.”
EVENT BRIEF NOV - DEC 2015 06
HOSPITAL INFRASTRUCTURE & MANAGEMENT (HIM) EXPO
HOSPITAL INFRASTRUCTURE & MANAGEMENT (HIM) EXPO
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Date: 6-8 November 2015 Venue: Bombay Exhibition & Convention Centre, Mumbai Summary: Recognised as the ideal platform for companies looking to grow in the healthcare infrastructure and design management space the second edition of Hospital Infrastructure and Management (HIM) will also witness an intense three-day conference summit of industry leaders discussing topics to overcome critical challenges to the growth of new hospital construction in India Contact Sharmila Pandey Ph No: 022 61713202 Email: sharmila.pandey@ideasexchange.in
3rd HEALTHCARE MANAGEMENT SERIES ON ‘REDEFINING HEALTHCARE: VALUE BASED DELIVERY’
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3RD HEALTHCARE MANAGEMENT SERIES ON “REDEFINING HEALTHCARE: VALUE BASED DELIVERY” Date: 4-5 December, 2015 Venue: PD Hinduja Hospital & Medical Research Centre, Mumbai Summary: The event aims to bring together diversified minds on a single platform to discuss healthcare trends, challenges and future. The conference is expected to see the presence of professionals working in hospitals, nursing homes, healthcare consultancy companies, healthcare it companies, health insurance companies, and other companies from the health industry. Reportedly, distinguished faculty from PD Hinduja Hospital, PWC, KPMG, IMS Health, NABH, JCI and AHPI as well as eminent and senior leaders from healthcare industry will share their experience and expertise on
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BIG DATA
ANALYTICS
AND INDIAN HEALTHCARE Rationale for big data analytics in healthcare is cogent, however implementation is one of the biggest hurdles providers face along with data security. To ride this new wave of business intelligence, Indian healthcare providers must realise that big data is a necessity and not a luxury BY M NEELAM KACHHAP
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I
f you have a social media account, chances are that you would have encountered a wishful debate/ discussion on big data analytics in recent times. Big data is the current buzzword and by all means, it is going to affect healthcare. But if you are not from the IT domain it's difficult to gauge and keep track of the conversation on big data. In the present healthcare business environment, providers need to understand that big data analytics is a necessity and not a luxury and so is the understanding of big data analytics. Big data analytics has enormous potential to impact healthcare positively by improving quality of care, saving lives and lowering costs. "Fundamentally, big data is helping organisations become more productive, efficient and reduce costs. Like many other industries, healthcare has adapted to data analytics not only for its financial returns but also for improving patients' quality of life," says Arvind Sivaramakrishnan, CIO, Apollo Hospital Enterprise, Chennai.
So, what is big data? Professor Wullianallur Raghupathi from Fordham Graduate School of Business New York, US describes big data in healthcare as ‘electronic health data sets so large and complex that they are difficult to manage with traditional software or hardware; nor can they be easily managed with traditional or common data management tools and methods.’ For some time now, Indian providers have been using electronic health records (EHR) and hospital information systems (HIS) to make their organisation productive and profitable. These technolo-
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gies collectively generate a lot of data. "Indian healthcare industry is engaged in generating zettabytes (1021 gigabytes) of data every day by capturing patient care records, prescriptions, diagnostic tests, insurance claims, equipment generated data for monitoring vital signs and most importantly the medical research. Growth of the digital data would be exponential and explosive in the next two years," explains Niranjan Ramakrishnan, CIO, Sir Ganga Ram Hospital, Delhi. According to a industry report, California-based managed care consortium Kaiser Permanente is believed to have between 26.5 – 44 petabytes (1,000,000 gigabytes) of potentially rich data from EHRs. "Organisation like us have data close to 500 terabyte of information," informs Ashokkan VRS, Group CIO, Columbia Asia Group. "Healthcare as an industry should definitely have data in exabytes," he adds. However, 'big' in big data analytics not only defines the size but also the quality and complexity of data. "Big data could be defined as the total comprehensive data about an entity encompassing all sources. To better understand big data, it is important to understand what data is and how it differs from information, which are quite often thought of as one and the same. Data should be considered as raw information with or without filter, duplication, or structure that forms the building block for information. Transformation of data to information happens when one adds some logic to present a particular fact or view point. Information gathered from big data is often more substantial and unique, hence its value," explains Sumit Singh, CIO, Wockhardt Hospitals, Mumbai.
Healthcare has adapted to data analytics for financial returns and improving patients' quality of life Arvind Sivaramakrishnan
IT adoption in healthcare industry needs a large revolution and standardisation in the Indian subcontinent Ashokkan VRS
CIO, Apollo Hospital Enterprise Chennai
Group CIO, Columbia Asia Group
Growth of the digital data would be exponential and explosive in the next two years
Indian healthcare sector is expected to contribute around 12 per cent of the big data generated in India
Niranjan Ramakrishnan CIO, Sir Ganga Ram Hospital, Delhi
Ravi Ramaswamy Sr Director & Head – Healthcare, Philips Innovation Campus
Big data is also defined as large volumes of high velocity, complex and variable data that require advanced techniques and technologies to enable the capture, storage, distribution, management and analysis of information. “Big data is a term which describes the exponential growth and availability of structured and unstructured data,” says Ravi Ramaswamy, Sr Director & Head – Healthcare, Philips Innovation Campus. He further describes the characteristics of big data by the 4Vs: volume, velocity, veracity and variety. (As described by the research and advisory firm Gartner) Volume: It’s the quantity of data which gets generated and denoted in peta/exa/zeta bytes of data. Velocity: Data is streaming in at an unprecedented speed and must be dealt with in a timely manner. RFID tags, sensors and smart metering are driving the need to deal with torrents of data in near-real time. Variety: Data today comes in all types of formats. Structured, numeric data in traditional databases. Information created from line-of-business applications. Unstructured text documents, email, video, audio, stock ticker data and financial transactions. Managing, merging and governing different varieties of data is something many organisations still grapple with. Veracity: In addition to increasing velocities and varieties of data, data flows can be highly inconsistent with periodic peaks. Is something trending on social media? Daily, seasonal and event-triggered peak data loads can be challenging to manage. Even more so with unstructured data involved. “As per SAS Institute, a
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fifth element is also to be considered, which is complexity,” says Ramaswamy. “Today's data comes from multiple sources. And it is still an undertaking to link, match, cleanse and transform data across systems. However, it is necessary to connect and correlate relationships, hierarchies and multiple data linkages or your data can quickly spiral out of control,” he explains.
Sources and ownership of big data Data in healthcare comes from many sources like machine-to-machine data, transaction data, biometric data, human generated data as well as web and social media data. This data has to be pooled, cleansed and readied for the purpose of big data analytics. “As big data is all the data about an entity, say for example healthcare, the existence of it is distributed across multiple sources and hence housed in a distributed fashion all over. The data may not be all electronic or digital either. Hence, it is likely it will not be under any specific control either and will have multiple sources or ownership. Much of it would be on social sites so popular today and a lot of intelligence could be harnessed out of it if one could get to them,” says Singh. In the US and other developed countries, national registries and state departments collect health related data and aggregate it over the years. Thus making big data available for scientist to work on. However, in India health records are aggregated and stored by individual health organisations. There is a fair chance that this data may be in duplicates and is difficult to access. Having said that, some health organisations, for the larger benefit of the patients, may agree to share the data but even then it is a herculean task to get all similar data on one platform.
Scope for big data analytics in India According to a report ‘Big Data Vendor Revenue and Market Forecast 2011-2026’ by
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Data in healthcare comes from many sources like machine-to-machine data, transaction data, biometric data, human generated data as well as web and social media data. This data has to be pooled, cleansed and readied for the purpose of big data analytics
Wikibon the US Big Data market reached $27.36 billion in 2014 and is slated to grow to $84 billion in 2026 . According to the report, one of the factors driving growth of the big data market was the increasing establishment of big data-driven decision making as a key strategic priority in
cover ) board rooms and C-suites across vertical markets but particularly in the financial services, retail, healthcare and telecommunications industries. On the other hand, Indian business intelligence (BI) software revenue is forecast to reach $150 million in 2015, a 15 per cent increase over 2014 revenue of $133.8 million, according to Gartner. "Anecdotal studies indicate that the Indian healthcare sector is expected to contribute around 12 per cent of the big data generated in India. It is expected that this number will grow to 25 per cent of the overall data generated by 2017," predicts Ramaswamy.
Advantages Big data analytics generate actionable insights which can be used to predict disease outcomes, plan treatment protocols and for strategic organisational planning. By digitising, combining and effectively using big data, healthcare organisations ranging from single doctors practice to small and large hospitals to national hospital networks stand to benefit. "Data analytics can help hospitals in financial planning, supply chain management, humane resource management and quality care delivery," says Sivaramakrishnan. "Decrease in re-admission rates, predictive algorithms for diagnostics, real-time monitoring of ICU vacancies are some of the practical applications of big data in hospitals," he adds. According to Prof Raghupathi, potential for big data analytics in healthcare to lead to better outcomes exists across many scenarios. For example; applying advanced analytics to patient profiles to proactively identify individuals who would benefit from preventive care or lifestyle change; or creating new revenue streams by aggregating and synthesising patient clinical records to provide data and service to third parties like licensing data to assist
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USE OF BIG DATA IN HEALTHCARE CLINICAL OPERATIONS Comparative effectiveness research to determine more clinically relevant and cost-effective ways to diagnose and treat patients RESEARCH & DEVELOPMENT ◗ Predictive modelling to lower attrition and produce a leaner, faster, more targeted R&D pipeline in drugs and devices ◗ Statistical tools and algorithms to improve clinical trial design and patient recruitment to better match treatments to individual patients, thus reducing trial failures and speeding new treatments to market ◗ Analysing clinical trials and patient records to identify follow-on indications and discover adverse effects before products reach the market
BIG DATA IN HEALTHCARE
sequencing more efficiently and cost effectively and make genomic analysis a part of the regular medical care decision process and the growing patient medical record Device/remote monitoring: Capture and analyse in real-time large volumes of fastmoving data from in-hospital and in-home devices, for safety monitoring and adverse event prediction; Patient profile analytics: Apply advanced analytics to patient profiles (e.g., segmentation and predictive modeling) to identify individuals who would benefit from proactive care or lifestyle changes, for example, those patients at risk of developing a specific disease (e.g., diabetes) who would benefit from preventive care
There are examples across the globe where big data analytics has benefitted healthcare organisations. The Institute for Health Technology Transformation, US cites a famous example of Kaiser Permanente which associated clinical data with cost data to generate a key data set, the analytics of which led to the discovery of adverse drug effects and subsequent withdrawal of Vioxx from the market in US. An IBM report cites
◗ Health tracker data: Data acquired from various devices, sensors, home monitoring and telehealth
◗ Health publications and clinical reference data: Clinical research, drug information, disease information, ministry and health body reports ◗ Other releated data: Personal preferences, behaviours etc. Administrative, commercial, socio economic, population etc.
EVIDENCE-BASED MEDICINE ◗ Combine and analyse a variety of structured and unstructured data-EMRs, financial and operational data, clinical data, and genomic data to match treatments with outcomes, predict patients at risk for disease or readmission and provide more efficient care; Genomic analytics: Execute gene
Cases in point
◗ Genomic data: Data acquired from gene analysis and sequencing
◗ Web and social media: Health related data tweets, posts and publishers
PUBLIC HEALTH ◗ Analysing disease patterns and tracking disease outbreaks and transmission to improve public health surveillance and speed response ◗ Faster development of more accurately targeted vaccines, e.g., choosing the annual influenza strains ◗ Turning large amounts of data into actionable information that can be used to identify needs, provide services, and predict and prevent crises, especially for the benefit of populations
pharma companies in identifying patients for inclusion in clinical trials. In the public health domain, big data helps to analyse disease patterns to improve public health surveillance and speed response. “Big data analysis can help public health department to understand disease trends, help control sudden breakouts, lastly, helps in building awareness with facts and data," says Ashokkan.
◗ Clinical data: Doctor's notes, prescriptions, machine generated data, large format of images, cine sequences, scanned documents which are generated during clinical care and are not analysed as normal text data analysis
the example of North York General Hospital, a 450-bed community teaching hospital in Toronto, Canada, which uses real-time analytics to improve patient outcomes and gain greater insight into the operations of healthcare delivery. North York is reported to have implemented a scalable real-time analytics application to provide multiple perspectives, including clinical, administrative, and financial. The Rizzoli Orthopedic Institute in Bologna, Italy, is re-
portedly using advanced analytics to gain a more ‘granular understanding’ of the clinical variations within families whereby individual patients display extreme differences in the severity of their symptoms. This insight is reported to have reduced annual hospitalisations by 30 per cent and the number of imaging tests by 60 per cent. In the long-term, the Institute expects to gain insight into the role of genetic factors to develop treatments.
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The Hospital for Sick Children (Sick Kids) in Toronto is using analytics to improve the outcomes for infants prone to life-threatening nosocomial infections. It is reported that Sick Kids applies advanced analytics to vital-sign data gathered from bedside monitoring devices to identify potential signs infection as early as 24 hours prior to previous methods. Back home, Sivaramakrishnan describes infection control using data analytics at Apollo Hospital. "Microbiology department has important roles to play in any potential outbreak situation, including early recognition of possible clusters and outbreaks, rapid notification
Big data analytics generate actionable insights which can be used to predict disease outcomes, plan treatment protocols and for strategic organisational planning. By digitising, combining and effectively using big data, healthcare organisations stand to benefit of and collaboration with the infection control team, which requires maintenance of an organism bank," says Sivaramakrishnan. "The microbiology laboratory should also act in a consultative capacity with the infection control team to help determine whether an outbreak is 'real' or a poten-
tial pseudo-outbreak due to contamination of specimens outside or within the laboratory," he adds. "The current process is laborious with manual statistical analysis by the Microbiology department and by the infection control team to get this output. Apollo Hospitals
has developed in house analytical tools for use on our HIS. The system was created using Microsoft Business Intelligence tool and utilised Excel front end dashboard. Both Microbiology department and infection control team was granted access to the analytical tool. Since it’s an Excel
front end dashboard training the staff was easy on the use of the analytical tool," he further adds. "Dengue seems to rear its ugly head in many part of the country regularly and effects many citizens and their families. With the availability of big data, many factors that help in its formation are identified and then alerts are sent ahead of time to prepare to handle the outbreak," explains Singh. Talking about examples of the benefits of big data analytics in India, Ashokkan says, "Very little is being done today, as the information technology adoption in healthcare industry needs a large revolution and standardisation in
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cover ) the Indian sub-continent." Some examples of application in Columbia Asia are; determining the accuracy of diagnostic investigation reporting with cross match of data sets which vary from diagnostic images, culture reports, clinical notes, diagnosis identification etc. And customising healthcheck packages for customer segments," he adds. Sharing examples from Philips, Ramaswamy says, "A study over five years examined the impact of Philips' remote intensive care unit (eICU) programme on nearly 120,000 critical care patients. The programme enables healthcare professionals from a centralised eICU centre to provide round-the-clock care for critically ill patients using bi-directional audio/ video technology, and a clinical decision support system.
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The study found that eICU patients, compared to patients receiving usual ICU care, were 26 per cent more likely to survive the ICU, and were discharged from the ICU 20 per cent faster." Philips is now extending these initiatives by building an open digital platform that can link to all kinds of devices, allow doctors to feed information about patients, allow patients, relatives and doctors to be connected to each other, and do large scale analytics. "Any doctor anywhere will be able to look into the entire history of a patient to do better diagnosis. Relatives and professional care folks can get immediate alerts if something goes wrong. And the vast amounts of data collected on the platform can lead to algorithms that can improve diagnoses, figure out what works
for what kind of patient," explains Ramaswamy.
Challenges According to Prof Raghupathi, "Healthcare data is rarely standardised, often fragmented, or generated in legacy IT systems with incompatible formats." This is one of the biggest challenges in India. "Over a period of time, India will build a staggering amount of healthcare data but it would be spread among hospitals, primary care providers, researchers, health insurers, and state and central governments—just to name a few. Each of these act as a silo, preventing data transparency across the healthcare system," says Ramaswamy. Another challenge would be veracity of data. "Different types of data from different
systems, adherence to standard formats, inter-operability issues and homogeneity would also pose a great challenge," says Ramaswamy. In addition to aggregating a massive amount of data, there’s the challenge of maintaining patient privacy. According to Dwayne Spradlin, CEO of the non-profit Health Data Consortium, private healthcare data is critical to big data’s success, it doesn’t mean that private data will become public. Figuring out how to leverage that information to deliver better quality care to patients while keeping it secure is a major challenge. Policies related to privacy, security, intellectual property, and even liability will need to be addressed in a big data world. Organisations need to not only put the right talent and technology in place but
also structure workflows and incentives to optimise the use of big data.
Conclusion Healthcare in India is witnessing a new wave of competition with foreign investments and disruptive technology and this will further intensify as the turf gets structured. The organisations that are looking at big data now are the ones with lowest-hanging fruit, and their success stories will help other providers see how they can make their own ventures, fruitful. Reference: Raghupathi, W., Raghupathi, V.: Big data analytics in healthcare: promise and potential. Health Inf. Sci. Syst. 2, 1, 3 (2014). mneelam.kachhap@expressindia.com
IT@HEALTHCARE I N T E R V I E W
‘There definitely is a need to implement technological solutions to provide health insurance cover’ Munish Daga, CEO, Remedinet shares details of the recent tie-up with Bajaj Allianz and elucidates how it would be beneficial for the latter, in an interview with Lakshmipriya Nair
Remedinet recently entered into an alliance with Bajaj Allianz for a healthcare insurance solution. Tell us how would the solution help in simplifying operations? At present, when a patient with a health insurance policy gets admitted into a hospital that offers cashless claim settlement service, the hospital staff e-mails the patient details and policy ID to the insurer and waits for the approval. Similarly, all other information, documents and approval exchange involved takes place manually through e-mails/fax, etc. These processes being manual are prone to errors and delays and thus, lead to a higher turnaround time. Bajaj has partnered with Remedinet’s platform to further streamline their cashless claim settlement process and reduce manual intervention. With Remedinet’s technology, these processes go from offline to online where the data entered by the hospital staff flows into Bajaj Allianz’s platform electronically through Remedinet. Thus, when the patient arrives he/she does not have to wait as member validation happens realtime by entering only the member ID into the system. Similarly, all followContinued on page 29
Bajaj has partnered with Remedinet’s platform to further streamline their cashless claim settlement process and reduce manual intervention EXPRESS HEALTHCARE
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IT@HEALTHCARE I N T E R V I E W
‘EHealth is all set to revolutionise India’ Recently, Fortis Hospital, Mulund was awarded the Asian Hospital Management Award (AHMA) 2015 for ‘Innovations in Healthcare IT' for its effective use of IT to improve healthcare. Satish Sinha – HOD, IT, Fortis Hospital Mulund, speaks about how HIS has helped in improving efficiency within the hospital, in an interaction with Raelene Kambli Congratulations on receiving the ‘Asian Hospital Management Award 2015.’ What does it mean to you to achieve this award? The AHMA platform has provided Fortis Mulund IT team an enviable position in the IT space. To be able to showcase our work amongst the best hospitals in the Asia-Pacific Region is an honour to say the least. This award reinforces our efforts in working towards an efficient and IT-enabled healthcare unit. It reinforces that innovations in the backend can impact process efficiency at the front-end and gives us and our user-departments a tremendous boost to continuously design solutions and leverage information technology to the fullest. What was truly remarkable is the culture change amongst end user and increased adoption, leading to new requirements coming from them.
hospital-level by the Zonal Director along with senior management group under various categories. The best projects and outcomes are uploaded on the AHMA website. These nominations then go through a rigorous round of selection (initial screening, comments by advisors and final selection). The judges are from healthcare industries. An esteemed panel is drawn from representatives of Joint Commission International (JCI), John Hopkins Medicine International, members of the advisory board, distinguished members of the hospital industry etc. This year, the awards committee selected winners from 361 entries out of 101 hospitals across 12 countries. The awards were presented at an awards ceremony in Yangon, Myanmar in the presence of more than 1500 hospital delegates attending the Hospital Management Asia Conference.
Tell us about this award and the criteria for winning it? The IT team won the AHMA 2015 for the category ‘Innovations in Healthcare IT.’ This award is given to hospitals in the Asia-Pacific region who have implemented innovative projects and best practices. The solutions developed facilitates the caregiver fulfilling their primary role of caring the patient. The criteria are centered around recognising initiatives working on the issues of patient safety/quality/ operational efficiency of the healthcare delivery system with simple solutions to operational problems of healthcare provision.
How did you manage to increase operational efficiency within the hospital? Fortis Mulund is a multi-speciality, tertiary care hospital in Mumbai and part of the fast expanding Fortis network. One of the 2014-15 focus areas being patient care, Mulund Management lead by the Zonal Director undertook the challenge to enhance patient services across multiple touchpoints. Our team recognised that while patient-communication was crucial, there was dire need to improve data input points, especially at front-end employee-level. Data-sharing with management/patients needed to happen with minimal human effort so that employees could focus on patient care/servicedelivery. Data-analysis/MIS-
Did someone nominate you? How did it happen? The projects are selected at the
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generation through authentic system-generated data was crucial. At this point, our IT team’s role became vital, the situation was analysed to bring in-house solutions. So, what objectives were set to bring about this change? ◗ Enhance patient experience with error-reduction ◗ Increase efficiency with minimum human-effort/optimum use of technology ◗ Real-time data-tracking for reporting/analytics, enabling better operational management/governance
One of the 2014-15 focusareas being patient care, Mulund management, lead by Zonal Director undertook the challenge to enhance patientservices across multiple touch-points
And how did you go about doing so? We did it in the following manner: We created a patient-interface. Call centre: Creation of single point-of-contact improving accessibility by centralising doctor appointments/healthchecks/diagnostic-tests Diagnostic-tests tracker: The application displays all diagnostics OPD/inpatient/ health-checkups in single platform helping in effective tracking reducing patients’ waiting time Estimations/financial counselling: Web-application tracks bills against estimations in real-time. Help in identifying financial-counselling need so that attendants could plan finances realistically Bed management: Integrated with current HIS for beds-allocation. Admission waiting time reduced due to efficiency provided by the system Billing updates: Relatives are informed regarding bill amounts payable everyday though an auto-SMS to primary patient-attendant
Refunds: Instant notification regarding TPA refunds Pharmacy first indents: Nursing station alerted pharmacy about new admissions through phone. Tracking of first indents/delivery was not happening on time. Automated spreadsheet integrated with HIS tracks data real-time and pharmacy is aware when medication is administered Complaint management: Inpatient complaints picked by patient-care were escalated to user-departments. Module enables complaint-logging, if not closed is escalated to next level through system. Turnaround time tracked to improve patient satisfaction Then we went on to create platforms for operational efficiency/governanceperspective through: Emergency alert: In case of RTA/mob/potential attack etc. SMS is sent through companywebpage to a user-group with customised content (location/ reason etc.) to be available for crisis-management Doctor-wise consultation report for performance management Pending purchase-orders: Purchase/stores created manual POs. Online-tracker created showing pending POs. Outgoing-calls tracking for cost-effectiveness With success of these initiatives, IT was able to bring a paradigm shift in the hospital culture - moving from manual to an automated-mode of working at zero-cost. Prior to developing the HIS system, what was the efficiency rate, if measurable? Can you explain to us in terms of patient flow, operational expenses, profits, waste management etc?
IT@HEALTHCARE The hospital already has a HIS system. It flows from the process of patient admission till discharge including all tests, doctors consultations etc. The IT team, based on user-requirements, developed value-added plug-ins compatible with the current platform. e-ICU (all patient related data from the devises like ventilator, patient monitor, syringe pump) are centrally stored and can be seen anytime which has enabled ICU to become paperless. Patient first indenting alerts are available to the pharmacist which helps to start medication faster and in a safer manner. Features also include e-medical records (all records related to patients are available online which helps patients’ further medical care), reports are available online (PACS doctor can do reporting from anywhere and the report can be seen. Patient can be treated without any delay),
OPD tracker (information is available with all departments for quick service to patients), the diagnostics tests tracker (reduce patient services time from department to department), web-application for bill estimates, and escalation matrix for complaint management. A lot of automated MIS reports analytics will help in delivering care. These are some of the innovations that the team has designed which reduced unnecessary manual work for staff and improved efficiency, giving them more time for serving the patients.
What were the benefits? Effective manpower utilisation due the automation, analysis of real-time data, standardised information dissemination were just a few of the organisational benefits. Customers’ experience enhanced due to better accessibility, reduced waiting
ance/outcomes.
Fortis Mulund’s vision for ‘patient care’ transformed into a reality on the groundlevel through innovative use of technology times, proactive approach of bill-updates, faster turnaround time of complaints closure etc. With these interventions, the hospital institutionalised a culture of leveraging technology. Employees across functions are conscious of the technology-advantage hence there is a constant need to explore ways to utilise IT for better perform-
You also speak of small innovations within the hospital. Can you throw some light on the same? Fortis Mulund’s vision for ‘patient care’ transformed into a reality on the ground-level through innovative use of technology. With due diligence, the IT team converted manual/ conventional methods of performing tasks into automated systems, making lives of endusers simpler. Process efficiency was created through real-time data-capture, easy accessibility and error-reduction. Tracking mechanisms and analytical reports were incorporated for better management/governance. Seamless integration of the new applications with current HIS is the project’s USP, which makes the modeldesign easily replicable. The
CIO is now exploring ways of replicating these apps across the Fortis network. Lastly, do you think that e-health is poised to revolutionise healthcare delivery in India and why? Digital health is top-of-mind for both consumers and providers these days, as patients increasingly demand online access and interactivity from their healthcare providers. Smart mobile devices and applications will be at the core of global healthcare transformation. Working handin-hand with cloud computing, social networking platforms and big data analytics, these transformative technologies will continue to lead the ways to rein in cost-efficient services, broaden accessibility, transform behaviour and improve outcomes. Ehealth is all set to revolutionise India. raelene.kambli@expressindia.com
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There definitely is... ing information and documents are exchanged and processed electronically for a quick response time. This partnership will help to reduce the turnaround time for responding to queries by 40 to 50 per cent initially. Are there any more tie-ups in the pipeline, as far as the healthcare space is concerned? We are in the process of tying up with other private health insurers. However, we cannot reveal them at this point, we will announce in due course. What are your solutions for healthcare? How will they help to revolutionise healthcare delivery? The healthcare insurance sector needs to implement in-
novative technological solutions, which are already being leveraged by other sectors, to make services accessible and affordable for all. Currently, only a minute percentage of the population is covered under some kind of health insurance. As a result, majority of healthcare spending is out of pocket. Rising healthcare expenditures are one of the major causes that drive citizens below the poverty line every year. Thus, at this juncture, definitely there is a need to implement technological solutions to provide a health insurance cover, not only for in-patient care but for out-patient as well, that can efficiently cater to the diverse and rising needs of consumers. Leveraging technology to build such a system will lead to standardisation of
processes, transparent and error-free transactions, reduced turnaround and waiting times, paperless transactions and a process which is completely real-time. Furthermore, such a system will also, automate all processes involved, which in turn, will lead to a bank of structured data that can be
Today, services that can be provided at the click of a few buttons are the most sought-after
used to gain tremendous insight into mapping healthcare usage patterns and trends. With such insight, planning and research for preventive measures can become much more efficient, thus, preparing well in advance for the healthcare needs of the people. How has the healthcare IT space evolved? Which are the areas that Remedinet seeks to leverage? Today, services that can be provided at the click of a few buttons are the most sought-after. With every other sector gearing steadily towards mobile technology, it is only fitting that the healthcare insurance sector makes the move too. At Remedinet, we have put our foot in the door by making it possible for the hospital admin-
istration to monitor the status of cashless healthcare policies of their patients using an app on mobile phone/handheld devices. Remedinet is also gearing towards making it possible to submit and adjudicate claims using an app – processing the entire transaction from end-to-end using a mobile phone. We have also introduced apps for patients/their relatives accessible on kiosks in hospitals where they can themselves check the status of the claim by using an ID number. With initiatives such as these, we envision a healthcare insurance industry where people can subscribe to, monitor and utilise health insurance policies using their mobile devices. lakshmipriya.nair@expressindia.com
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IT@HEALTHCARE OPINION
Technology: An enabler for hospital administration
AJAY DESHPANDE Chief Technology Officer Rakya Technologies
Ajay Deshpande, CTO, Rakya Technologies outlines the importance of adopting technology to automate hospital administration. He also debunks the myths and fears that generally hinder adoption of technology and elaborates on how hospital administration can be made more efficient and error-free Picture this: A policeman has stopped a typical ‘Tempo’ like vehicle in a semi-urban Indian setting. The driver gets down with a half salute and half smile to the policeman. “How many people are you carrying?” the policeman asks. “Thirty sir,” is the prompt reply. The policeman is amazed and confused at the same time. Looking at his expression on how so many people could fit in such a vehicle, the driver asks everyone to get down. Yes, thirty people come out of that vehicle. With a last nod of amazed wonder, the policeman lets the driver go without a fine.
Although no scientific research exists, it is common knowledge from the anecdotal experience at Rakya that unsupervised and undocumented procedures are quite open to theft. In some of the case studies conducted at Rakya it was seen that there are multiple ways to siphon off resources (right from hospital supplies to real money) without the knowledge of the hospital administrators. While one cannot completely eliminate it, theft can certainly be minimised. Hospitals need to implement checks and balances, close vigilance and a water tight process to control pilferage.
THE HOSPITAL Administrator in the semi-urban and rural Indian scenario is in a situation similar to the driver above. Yes, resources are limited – but one cannot leave behind the large number of patients arriving at their doorsteps for help. As India progresses, her spending capacity is improving, and is thereby setting some bar of expectations from the healthcare industry as a whole. It has become imperative today for Hospital Administrators to manage the affairs of the hospital with predictability and efficiency. It is not just about saving a life – it is about providing good healthcare. A common scene in India today is that of a doctor in the hospital playing the role of an administrator. This makes the situation even more significant. In this article, I would
◗ Non-scalable models Many of the hospitals in India are family run and have achieved considerable success running that way. However many of them implement archaic procedures which become impediments to their growth. For example; hospitals are unable to treat more patients in a day even if they want to. Adding more doctors to a multi-speciality hospital does not lead to a proportional increase in revenue. These are symptoms of deeper systemic problems that pose large barriers to growth.
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Pic used for representational purposes only
like to discuss the many aspects of this problem in India and how one can use technology as a cost effective way to address it.
Factors under consideration While there are many facets to the Indian healthcare situation, it is important to note that sometimes it is tough to consider this industry a business, especially because it boils down to ‘saving a life’. It is surreal to worry about efficiency in a situation like this – but truth be told, technology has come to the rescue of several such situations in
the past many decades. And extending technology in the hospital administration realm is equal to taking the next step towards raising the bar of efficiency of a business invested in ‘saving lives’. ◗ Decreased patient satisfaction If hospitals had to worry about only one thing, then it would be ‘ensuring uniform satisfaction for all its patients’. While healthcare can still be person dependent, hospitals can definitely take steps to avoid other frustrations for its patients. This will need to be through a combination of training,
process improvements and technology implementations. ◗ Issues arising out of non-compliance Since healthcare is so people oriented, it can also become error prone. Human errors and lack of knowledge lead to non-compliances. If people involved are unlucky these non-compliances may result in serious issues. Noncompliances can occur in actual patient care as well as in record maintenance. Both of these could lead to governmental and legal complications. ◗ Resource pilferage
◗ Administrative stress It is common knowledge how stressful lives doctors lead. More so when the doctor plays the role of an administrator as well. With ever changing patient expectations, rising
IT@HEALTHCARE administrative pains, changing policies and the fact that hospitals run 24x7, it is no wonder that doctors are stressed out. A multi-pronged strategy is needed to control such stress.
Technology as an enabler Technology can be key in tackling all these issues. Interestingly, healthcare in India has embraced technology in actual caregiving. Newer devices are being used and automated checkups are now available. But technology in hospital administration is still not very developed and has a lot of catching up to do. Patients still do stand in long queues to get registered. Patient discharge from IPD still takes more than half a day in such hospitals. Why do these hospitals tend to not implement technology solutions in administration? In this section, we explore some typical causes as well as ideas to overcome such drawbacks.
Reason 1: A hospital management system (HMS) does not suit our situation One of the most common things heard in the market is ‘automation does not suit our way of running the hospital’. ‘Our hospital is too unique to use an HMS’. This probably stems from the fact that the hospital was founded long back and processes that have worked for them for years are being used. While there is no harm in following what has worked, Hospital Administrators need to ask themselves, “Do we need to change?”, “Can I reduce the number of headaches/issues we face today?” “How many of these issues result from inefficient processes?” Answers to these questions are also closely related to growth of the hospital. Growth in terms of better patient satisfaction, better staff satisfac-
tion, treating more number of patients in a day and so on. It is a common fact that every situation is unique. It is very important to accept this fact. However, one needs to also consider the benefits of standardisation. For example; while every car is unique yet there is still so much standardisation that one hardly needs to learn anything to drive a new car for the first time. Similarly, while hospitals can preserve their uniqueness, they can standardise on a lot of processes that are commonplace. Here is where automation comes into picture. Further, if the HMS is good, it will be customisable for different situations. The take at Rakya is that there are no situations where automation does not help. It is just a matter of recognising the current state and understanding the end goal that one wants to achieve.
Reason 2: HMS is very expensive It is natural for healthcare administrators to think that HMS systems are very expensive. This is however just a perception. These administrators are the same people who do not flinch an eye when buying medical equipment worth lakhs. Then, why is there a perception that HMS is expensive? From experience at Rakya it is usually not the cost that hospital administrators are concerned about. They do not have a good understanding of the value they get out of it. In other words they do not clearly understand the return on investment. It is hard for them to visualise how they will save money by moving away from pen and paper based systems. Hence at Rakya, customers are first educated on how to understand the ROI plan. Even though the same software systems might be used, every hospital, every situation has a different way to achieve ROI.
FACTORS LEADING TO ADMINISTRATIVE STRESS Decreased patient satisfaction Non-compliance related problems Resource pilferage Non-scalable models
IMPEDIMENTS TO IMPLEMENTING TECHNOLOGY SOLUTIONS HMS does not suit our situation HMS is very expensive No trained staff available to run the HMS Loss of confidence in the system
Convincing doctors about this ROI and then actually realising the savings, is part of typical consultative approaches to address customer needs.
Reason 3: Unavailability of trained staff Another very important predicament that hospitals face is the shortage of the necessary personnel to run an HMS. While it is natural that there is shortage of skilled personnel in every walk of life, there are also a couple of under currents to this perception. The first aspect is that the HMS software is too complex to use. While the discipline of HMS is indeed complex, all users need not be exposed to all of it. HMS software can be made user-friendly by implementing role-based tailoring of the interface. The second aspect why staff find it difficult to adapt to an HMS is that they are too comfortable with the pen and paper method. It allows them to change things as needed on the fly. This allows for the setting in of a lack of discipline. Computerisation however encourages ‘Do it right the first
time’ culture. So, the training issue actually turns out to be a culture issue. So, hospital administrators need to introduce this culture change slowly. They need to find champions in their staff who can advocate this change and enunciate the benefits that the staff gain from the move.
Reason 4: Loss of confidence in the system There are instances where hospital administrators have ventured to purchase HMS software but were unhappy with the outcome. They are typically sold an HMS by a flyby-night operator and now do not get any support. The system being inadequate to meet their needs, is now gathering dust in a corner of the hospital. When such things happen, it is but natural that the administrators lose confidence in the system. In such cases, it is important to understand that inexpensive does not always mean good for the hospital. In fact, as it turns out to be wasted money, the outcome turns out to be actually very expensive. Administrators have to first look for a vendor who makes them comfortable and is willing to listen to the problems that the hospital faces. Administrators should take active interest to understand the methodology used in deploying the HMS. They should invest larger amounts only after a certain trust level is built. Another key factor is to check the references. Talk to the hospitals that are already using the HMS and then make a wise decision. Getting frustrated by the system does not help; in fact, people need to realise that they are the system and they can change it by being judicious. These are all very valid reasons to not opt for automation and probably there are many more. However, getting automation to work for you in the
long run outweighs all of them. Hospital administrators need to look at this as there is no choice but to automate. In the process it is very important for them to pick the right system and the right vendor for their HMS. Actually, the right approach is not to look for a vendor, but to look for a long term partner. It is going to be a long term game to play.
The road ahead While there are many impediments to implementing technology solutions for administration in a hospital, there are also solutions found over time. Most of the impediments are temporary in nature. What is thought of as a weakness can be turned into a strength. Technology solutions can increase patient satisfaction while at the same time reduce wastage and pilferage. The key things to change are the mindset and the culture in your organisation. As India is on the cusp of being a developed nation, the expectations from the healthcare system are going to significantly increase. In many cases, hospitals will not be able to run in the same way they have been doing. They have to take a hard look at their goals and aspirations. Then, they have to chalk out plans on how to meet these goals. Healthcare administrators can take advantage of companies like Rakya, who can provide them end-to-end solutions to automate their hospitals. Rakya also follows it up with business support services so that customers are not left out in the dark afterwards. Implementing automation helps increase compliance both in providing healthcare and in the administration of the hospital. These in turn help the Administrator to be more at peace and thus prepare for growth. In short, Rakya can be your trusted partner in your journey of ‘reaching for the stars!’
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STRATEGY CASE STUDY
Skilling with technology A case study of Wadhwani Foundation partnering with Narayana Health to develop and deploy an innovative learning programme with the help of technology to skill their nursing employees by creating jobs-driven curriculum and vocational training
I
ndia continues to face a growing gap in maintaining a skilled labour force in healthcare industry’s support and paramedical staff. Especially since these individuals are required to perform a skilled job without access to a job-competency-driven curriculum or having undergone limited formal training. India has only 24 nurses or nurse midwives per 100,000 people but needs to produce 1,200,000 additional nurses to meet internationally acceptable ratios. With appropriate training, ‘freshers’ who have passed secondary school, can be transformed into responsible healthcare support workers. The challenges are manifold, including the creation of high quality coursework that builds job skills, scarcity of teachers (across regions and centres) who can deliver the training with consistent quality, and an inability to run these classes for in-service nursing workers who are busy with full shift schedules, etc. To overcome these challenges, Wadhwani Foundations partnered with Narayana Health to develop and deploy an innovative learning programme. The programme leverages technology to skill their nursing employees by creating jobs-driven curriculum and vocational training. The courses will be implemented through a unique blend of online and in-class learner-centric strategies. By adopting this cutting edge ‘Flipped Classroom’ approach, nurses can participate in elearning in their own time, anywhere. They can then
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The courses will be implemented through a unique blend of online and in-class learner-centric strategies. By adopting this cutting edge ‘Flipped Classroom’ approach, nurses can participate in e-learning in their own time, anywhere come together for discussions, practicums, and evaluations in focused classroom sessions, thus reducing teacher/student coordination, while making high quality learning feasible.
The need Narayana Health is projected to grow from 5,000 beds to 30,000 beds by 2020. Narayana Health identified the following ‘pain points’ it
faced, in relation to talent development, which are fairly symptomatic of the healthcare and general industry: ◗ Highly dependent on expert trainers who are already in
short supply ◗ Inadequate training content and inconsistent training delivery ◗ Shortage of job-ready applicants; skill and competency gap among new hires ◗ The hours involved in training for instructors and employees viewed as ‘off-productive’ time; difficulty in planning training while staff juggles full-time shifts Wadhwani Foundation’s formula is designed to address these types of issues, requiring buy-in and dedication from a variety of stakeholders.
STRATEGY The solution Wadhwani Foundation funded the pilot/proof of concept of the programme, while Narayana Health’s team provided required industry expertise and access to facilities. During the research and development phase, Wadhwani Foundation’s instructional design team for healthcare conducted weekly visits to meet with hospital leadership, senior nurses, and attended nursing staff training sessions and practicals. Prior to this project, Narayana Health’s induction and training challenges were emblematic of those faced in hospitals across India. Wadhwani Foundation’s solutions to these issues are: (Check table) The Wadhwani Foundation method not only helps new staff orient themselves to a new environment more quickly, but also encourages camaraderie and healthy competition among cohorts. In order to meet the needs of staff members with long shifts and difficult schedules, these courses may be used for on-demand self-study. It is important to note that the healthcare modules begin with entry level jobs and are designed to progress to upper levels. General duty assistants (GDAs)/ nursing assistants (NAs) are encouraged to interface with patient families and perform basic medical procedures, such as patient feeding, patient movement, documentation and record keeping, etc. GDAs encounter a steep learning curve once they have joined a hospital and are often ill-equipped for their new role. The course outline was devised jointly in order to meet the National Occupational Standards (NOS) for job-specific skills, and provide GDAs/NAs with the necessary soft skills. The resulting curriculum was also closely mapped to meet the training requirements of international
dents improved by more than 25 per cent. Some students’ scores jumped by 30 – 35 per cent.
Testimonials We are helping skill nurses, nurses’ aides, sales clerk, etc, not because this was the easiest thing to do but because this is where the largest number of jobs is. And our mission over the next 5-7 years is to skill five million people and then place all or most of them into jobs. And if we do that then there would be some meaningful impact in the scale of India. - Dr Romesh Wadhwani, Founder & Chairman, Wadhwani Foundations
Issue
Solution
Inconsistent training sessions due to varying trainers across induction classes
Wadhwani Foundation’s e-modules allow for consistent deployment, with every incoming class receiving same instruction and content
Staff complaints against training practice due to time constraints
Wadhwani Foundation’s ‘anytime, anywhere’approach minimises (previously a requisite) face-to-face teaching time.This reduces workload for busy teachers and improves students’job-readiness Students and staff are exposed to job-specific ‘dos and don’ts’via video modules and experiential learning.This enables students to practice patient care in safe conditions before working with patients independently
Errors while on the job
Basic (Induction Training)
Intermediate Training
Advanced Training
Refresher Training
5 days 40 hours
3 months 40 hours
6 months 40 hours
3 months 20 hours
and national accreditation boards such as JCI and NABH respectively.
The result Reportedly, the six-month long effort resulted in development of content for the basic/induction training programme which can be disseminated over five working days or 40 hours. Intermediate training
consists of 40-hour modules that can be deployed over three months and the advanced training consists of 20hour modules that can be implemented over six months. The induction training programme was administered to 3000 nursing staff and has paved way for an innovative approach to learning across 40 subjects. 97 per cent of the stu-
dents reported that they prefer the Wadhwani FoundationNarayana Health approach, as opposed to their normal class or training sessions. They administered pre- and post-training tests to determine the cohort’s collective and individual knowledge. The post-training test results revealed that every single student achieved significant gains; on an average, stu-
Wadhwani Foundation has done a great job in creating these teaching modules and I am sure in the years to come, these teaching tools will be available to every nurse of this country and the world. - Dr Devi Shetty, Founder & Chairman, Narayana Health We had the subject matter expertise and Wadhwani Foundations could bring in technology into the space so that we could marry them together and come out with something really useful -Dr Rakesh Verma, Group Head – Training and Organizational Development, Narayana Health‘ I advise all my colleagues and practitioners to go through e-modules and it is really useful. I am now more confident in taking care of my patients - Saamya Salem, Staff nurse, Oman - Nurse from Oman undergoing training at Narayana Health It will enable nursing education institutions to bring better trained and skilled population of nurses who are job ready. - Sonali Tarachand Jadhav, Principal, MS Ramaiah Institute for Nursing Education and Research
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HOSPI INFRA INSIGHT
Heating and lighting: Crucial to treating dementia PROF JUNE ANDREWS Dementia Services Development Centre, University of Stirling, UK
Professor June Andrews, Dementia Services Development Centre, University of Stirling, UK lays emphasis on the need for the right heating and lighting systems to treat dementia and offers insights on how to make a living space comfortable for patients with dementia
A
s dementia is increasing with the ageing population, so is awareness in the UK that businesses which supply services to the general older population need to make adjustments for customers living with dementia. This is one of the elements of the UK Prime Minister’s Challenge on dementia, an important health policy. A major energy company approached the Dementia Centre at Stirling to train their staff in how to support customers with dementia. Staff and customers needed authoritative guidance, in plain English, but based on research about what works. This guide, written as a short booklet, has been provided to customers of that company and forms the basis of staff training. It is expected that this will improve the welfare of these people and reduce the burden they place on health and social care services. The booklet is about heat and lighting and their importance for older people living with dementia. 'Carers' are people who support a person living with dementia, either as a relative, friend or paid helper, including housing officers or home care workers, who need to notice and take action on problems in someone’s home. Many older people in the UK worry about rising energy
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bills. In June 2014, AgeUK produced a report ‘Reducing fuel poverty – a scourge for older people’ which said that 1.14 million older people in England live in fuel poverty attributed to rising energy prices, leaky and inefficient housing and low incomes. This poses a health risk. People living with dementia have particular requirements for heat and light. It is vital to help without causing
distress or making anyone feel undermined. The structure of the booklet is to share ten hints about dementia, because very many people find it hard to find information about what it is and how to respond to it, followed by ten hints on lighting and ten on temperature control. This article outlines the hints that are given on lighting and temperature, which in the UK focuses mainly on keeping warm.
Ten hints on light ❖ Increase the light level to help communication. It will also help people with dementia to do everything else they want to do, for example; ◗ Find their way more easily ◗ Move about safely ◗ Maintain hobbies and interests like reading or sewing ◗ See to eat as well as possible Make the most of natural light. Keep windows clean, pull the curtains right back,
open blinds and go outside whenever possible. Cut down vegetation that blocks the light. For windows facing outside walls, paint the wall white to reflect light back inside. Lighting may comprise 25 per cent of the electricity bill so lights should be off when not in use. Light coloured décor may reduce the need for electric lights. Movement sensors can switch off lights automatically when the person leaves.
❖To maintain diurnal rhythms older people need natural light, especially morning light, either by looking out of the window or going outside. This will help to ensure better sleep at the right time. ❖Choose bulbs carefully. Compact fluorescent light bulbs (energy saving light bulbs) last longer and are efficient but can get dimmer to around 50 per cent of initial output over time. Older people may not be aware how poor the lighting level has become. The bulbs are also slow to light up when switched on and Royal National Institute for the Blind recommends you don’t use compact fluorescent light bulbs in potentially hazardous areas such as stairwells. Other types to consider: ◗ Tungsten Halogen, which are more like the old fashioned tungsten bulb that older people are used to ◗ LED lights, which cost more but last a long time. Although the light output may be equal to other types, the light source is more direct and intense and will generally need a diffuser to prevent glare, particularly in bathrooms and above kitchen surfaces. Quality is variable and the cheapest are not always the best. At present tungsten halogen seem to be a reliable purchase for the home. ❖ Check that all light bulbs are still working, particularly if you only visit in daylight. People living with dementia may not notice or forget to tell you. ❖ Watch out for glare that reduces visibility. Sunlight reflected from furniture like glass-topped tables can be uncomfortable. Translucent nets or blinds may help without cutting too much light. That’s difficult in winter in some countries when the sun comes in at a low angle. Take care to pull them back later so natural light can penetrate the room as much as possible. ❖ Some activities need addi-
tional light. Is there plenty of light on the kitchen work surfaces? Is there a good, bright light for reading? Getting washed and dressed, cooking – all need plenty of lighting. The person may forget to put the light on which is why making controls easy to see is crucial, though if judgement is impaired, some controls may need to be hidden and automated. ❖ Finding and using the toilet requires light and this varies depending on the layout of the house. If the bedroom has an en-suite toilet, a continuous low light in the toilet can be helpful at night. Others may prefer the light to come on when they get out of bed. A passive infrared movement detector achieves this. If the toilet is outside the bedroom, movement detectors in the bedroom or the hall can switch on that light as a guide. Light in the toilet itself is important. ❖ When natural light levels are reduced people in northern countries may experience Seasonal Affective Disorder (SAD). Special lights can be purchased that contain a lot of blue (morning) light since it seems that SAD is connected with the body clock not working well. Getting outside is good because light levels there are very much higher than indoors, even when conditions are cloudy. ❖ Clearly the use of lights needs to be economical. Painting rooms with light colours to maximise light reflectance and using light coloured curtains will all help with light levels in a room. Using light fittings that cast light upwards to a white ceiling will also help. Light coloured lampshades will transmit more light than dark ones. ❖ Make sure that the light switches and power sockets are easy to see and use. A contrasting colour against the wall, with contrasting switches would be very help-
THE DEMENTIA CENTRE The Dementia Services Development Centre (the Dementia Centre), an organisation supported by charity at the University of Stirling, has been working for over 25 years to improve services for people with dementia and their carers. Knowledge from research and expert consensus about what makes a difference in the care of people with dementia is translated into tools and resources for families, care workers, and professionals. For example this might be training programmes for unqualified staff, distance learning degree modules for professionals, informal advice for families, or books and publications in simple language for people to use unaided
ful as can illuminated switch surrounds.
Environmental temperature and dementia Dehydration is dangerous in dementia. It increases confusion and lethargy and leads to constipation and urine infections, which make people with dementia very unwell, perhaps bad enough to go to hospital. Older people don’t adjust well to heat and cold; and dementia means the person may be unable to tell you that they are too hot or too cold or to do anything about it. Even in the UK it is easy for someone with dementia to fail to understand how dehydrated they are becoming in the heat. Ensure they are drinking enough by leaving plenty of attractive drinks very visible. Being too cold makes existing health conditions worse. Cold affects breathing, heart and circulation and blood pressure as well as making someone more confused and affect-
ing mental health. Hypothermia can result in death. Thrifty older people constantly worry about fuel bills and turn heating down or off altogether. They are at risk. What to do depends on how active the person is, how plump they are, what they wear, how sensitive they are to temperature, and what they are used to. Many older people have always been frugal with fuel and are adapted to cooler rooms. They would put on more clothes before putting on the heating which is fine as long as they are warm enough.
Tips ❖ Use a thermometer. If the person with dementia insists on a high temperature, check for dehydration. If they let the temperature drop below a safe level, in the UK you can ask social services about technology which links a thermometer to the phone system and alerts someone when the temperature gets dangerously low. ❖ More active people need less heat because they generate it by movement that keeps their circulation working well. They may overheat if the house/main room is hot. People who are inactive can get very cold, even in a reasonably warm house. ❖ The position of the house or appartment can have a significant effect on how warm or cold it is. ❖ Have the windows been painted shut or are they easy to open? An occupational therapist may be able to advise if the person is finding windows difficult to open for fresh air. ❖ Consider draft-proofing or replacing the windows. Doors too can be a source of draughts. ❖ Thick window curtains preserve heat and can also be put over ill- fitting doors; but ensure they are generally of a light colour to avoid cutting out too much reflected light and that they can be pulled
fully back to allow natural light in during the day ❖ Even if avoiding draughts people need fresh air coming into the room. Good air quality is key to remaining as alert as possible. If the old person avoids opening the window, do so when the person is not in the room to improve the air quality. ❖ Obviously clothes need to be the kind they prefer and should be comfortable and light. Fleeces are often lighter than wool and wash easily. Layers can help with warmth. Longer sleeved vests and tops will keep arms warmer. It is a good idea to leave suitable clothes for cold weather where the person can see them rather than tidied up and put away – make sure they are easy to see. ❖ Rooms need different temperatures. For example, people may spend most time in the kitchen, then prefer a colder bedroom and wear socks and a hat in bed. Some turn everything off at night and ignore thermostats or timers. Consider whether the person is able to properly use the controls. A room thermostat and thermostatic radiator valves are needed to be economical, but warm. Unused need not be heated, other than at a low safe level to prevent any pipework from freezing. This will save costs for someone who does not use every room. ❖ Bedding can be complicated when the person is incontinent and they are using mattress protectors, pads etc. some of which can make the bed very hot and the person dehydrated in the mornings. The research undertaken by the Dementia Centre would be of little value if it does not give rise to benefits for people with dementia, and this practical advice, spread via businesses rather than health professionals, is an important adjunct to the care and support that is given formally.
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‘JetSetGo can now mobilise an air ambulance in any part of the country in as little as two hours’ JetSetGo recently introduced air ambulance services to offer better emergency services and help improve healthcare access, even in remote areas of the country. Kanika Tekriwal, its CEO and Co-founder, talks about the infrastructure in these air ambulances, the investment that has gone into the venture, affordability of these services and more, in an interaction with Lakshmipriya Nair
Tell us more about the air ambulance service launched by JetSetGo? What kind of investment has gone into launching this service? For a whole lot of specialised treatments including for trauma, advanced transplantation surgeries, head and spinal injuries etc. patients generally have no choice but to rely on experienced doctors with more advanced facilities in the larger cities. With the paramount objective of providing better service and increasing the odds of saving lives for patients in need, JetSetGo quickly targets the right aircraft or helicopter and hospital at the right locational proximity, minimising the cost and time for transit from Point A to Point B. The focus so far has been on building a robust technology platform to manage the logistics of coordinating between hospitals, airport service
providers and existing owner operators of helicopters or private jets along with ensuring the right mix or availability of aircrafts/helicopters in different cities. Each aircraft or helicopter capable of providing such a service in itself cost in excess of $four million to which the cost of fitting them out with necessary advance life support systems etc would cost a further $1,00,000. Which are the areas that this service would serve? Would it be accessible to people across the country, including those living in very remote areas and difficult terrains? JetSetGo can now mobilise an air ambulance in any part of the country in as little as two hours. Even in remote areas, as long as there is a suitable clear landing area, a helicopter can land to serve and/or evacuate people.
Whilst a lot of progress has been made over the last few years in intra-city emergency and ambulance services in India, turnaround time for patients travelling from other cities has been a very difficult process for patients and most often the effective mode of transport sometimes is only by air. The service has been launched to be able to fulfill this need better. What kind of services are provided in these ambulances? What are the features incorporated in each of them? Commercial airlines cannot meet this requirement as this requires specialised aircraft with Advance Life Support (ALS) systems including a flight stretcher, specialised medical equipment including ventilators and defibrillators, a full assortment of patient specific drugs and medications along with a medical team to meet the specific needs of the patient. Are you looking for any partnerships to run these services? Any tie-ups in the pipeline? These services will be almost impossible to run without partnerships. We are in fact looking at various part-
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nerships across the value chain starting with leading hospitals, paramedics, ground service providers within and outside airports to ensure smooth transfer for patients and several of the existing private jet and helicopter operators to better utilise their fleet to provide these services and to increase coverage. We stringently select partners to work with who can provide professional services while maintaining the highest level of medical care.
We are currently exploring the opportunity to tie-up with leading medical insurance providers in the country to include this as an offering within their existing plans
How affordable is this service for a country like India? The cost of utilising an air ambulance starts at Rs 70,000. This may not be affordable for some people but given that an air ambulance involves able to always keep available on demand an aircraft or helicopter at one’s beck and call with each having significantly high overheads, what is charged for these services is only to professionally run a sustainable operation.We are currently exploring the opportunity to tie-up with leading medical insurance providers in the country to include this as an offering within their existing plans. With that the cost burden for utilising this service will go down significantly. lakshmipriya.nair@expressindia.com
HOSPI INFRA I N T E R V I E W
‘We have an infrastructure that compares with the best in the world’ A hospital's website plays a vital role in attracting potential offshore patients. Dr Sujit Chatterjee, CEO, Dr L H Hiranandani Hospital, Powai, Mumbai speaks how they have managed to increase the flow of medical tourists to their hospital with the help of an informative website, in conversation with Raelene Kambli
What is your general opinion about medical tourism? India is a country that is gradually taking its place with the best of best in the field of healthcare. While certain high-end sophistication may be lacking, the medical expertise and treatment modality is of extremely high order. Thus it is only natural that there is a magnetic draw for people to come to our country looking for treatment. While those who massively advertise may get a larger share there are the discerning who prefer to check online and engage with the hospital through emails, evaluate responses and choose to come across on their own depending on the hospital to look after them from end to end, i.e. from the time they reach the airport to depart to their parent country. How many such patients do you cater to at your hospital on a yearly basis? We have approximately 150 medical tourist patients treated at our hospital on an annual basis.
Offshore patients generally go online to scout for suitable hospitals in India. They primarily target the metros. A number of established healthcare brands promote their hospitals very agressively overseas as being the very best in the business. However, the offshore traveller is cautious and likes to do a thorough search. Thus, they log on to a number of leading hospitals who may not possibly consider marketing aggressively for offshore patients. They also scan for the infrastructure, the accolades, the initiatives and also ‘happiness quotients’ (various forms of co-curricular activities that the hospital engages in). They generally have a mental perception of what the hospital should look and feel like, the staff as well as what is mentioned about the various activities that the hospital engages in. Once the mental perception they have and what they see on the website is similar, they generally tend to choose the healthcare facility. So, we have an attractive and informative website that helps us attract offshore patients.
How do you plan to tap medical tourists for your hospital?
What kind of other infrastructure elements have you added within the
We have approximately 150 medical tourist patients treated at our hospital on a yearly basis
hospital to attract medical tourist? We have an infrastructure that compares with the best in the world. The operations theatres have the air-conditioning as recommended by the American Society of Heating Refrigeration and Air-conditioning Engineers. The ICU has complete air separation from one to the other. The technology is frontline and the medical equipment is sourced from the world’s best vendors. The rooms and suites are incomparable. The rooms are capable of being monitored from the nursing station and also the ICU. When the prospective patient read about all this they get attracted. What ,according to you, are the infrastructure requirements of medical tourists? It’s about a holistic ambiance of the place. The Hiranandani Gardens itself is such an attraction. Tree line avenues, gardens, shopping, hotels and sparkling clean. This combined with the infrastructure of the hospital makes it a delight for the offshore patient. Do you make special arrangements for relatives
of such patients? Yes. They are also accommodated in the room and can avail some complimentary services that the hospital offers. You have mentioned about complimentary services for relatives of medical tourists. Can you elaborate on these services? The hospital does not only focus on the patient but is also attentive to the accompanying attendant. To keep them occupied there are various initiatives that the hospital has started. Amongst the many, one which is more popular is the Department of Dermocosemtology where the attendant is given a free check as well as a facial which they highly appreciate. How important are these aspects to keep such patients and their relatives happy? Perception is very important for the offshore patient. Thus what they see on the website creates a perception. There is an expectation they come with. Hence, when that is delivered on ground they are very pleased. raelene.kambli@expressindia.com
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‘There are several chartered carriers with whom we engage on a regular basis for ferrying medical tourists’ Healthcare providers now feel that good infrastructure will not only improve quality of service but also add value to medical tourism. Dr Rajendra Patankar, COO, Nanavati Super Speciality Hospital, in an interaction with Raelene Kambli, explains how his hospital has attracted medical tourists by way of improving their infrastructure and hospitality
What role does infrastructure play in attracting medical tourist? Medical tourists are looking for a world-class institution with best service standards and the latest medical equipment which offers quality medical care at economic rates. He is keen to be treated at a hospital which offers a safe environment which follows the best Infection Control Practices and the best in class medical care plans by qualified specialists under one roof. Any modern tertiary care medical institution which does not compromise on installing state-of-the art technology like the latest wide bore MRI machines,
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Modular OTs with HEPA filters, a well-equipped ICU, a modern cardiac Cath Lab unit equipped with the latest techniques can go a long way in attracting medical tourists. What kind of infrastructure elements have you added at your hospital to attract medical tourists? Nanavati Super Speciality Hospital (NSSH) has a dedicated deluxe floor, a dedicated administrator for each floor, a dedicated butler, higher nurse to patient ratio, a concierge service in order to cater to the varied needs of the medical tourist. In addition, we also offer the services of a translator
Nanavati Super Speciality Hospital believes in giving the best in class quaternary level of treatment to every patient, national and international
in case a medical tourist is not in a position to communicate in English. We also have an airport pickup-and-drop service wherein a patient can directly be picked up from the airport and brought to the hospital. The hospital also has a dedicated and well-equipped advanced cardiac life support (ACLS) ambulance unit which can transport the patient to and from the airport. How many medical tourists do you cater to at your hospital? How many of them are from the other states of India and how many are from abroad? It would be difficult to state the number in volumes though the number is substantially large. We also attend to a sizeable number of medical tourists from abroad. Does your hospital have special stay areas for relatives of medical tourist? NSSH offers comfortable guest accommodations for relatives of medical tourists in its deluxe floor within the hospital premises. We have an in-house kitchen facility which looks after the meal requirements. We also
assist the relatives in securing accommodation in nearby hotels. Has Nanavati hospital tied up with Pawan Hans to airlift patients. If yes, what is the development on this? NSSH is just across the road to Mumbai’s Helicopter Base which also houses an small air strip, while the main International Airport is just five minutes’ drive from the hospital. At present, there is no formal tie-up with Pawan Hans for airlifting patients although there are several chartered carriers with whom we engage on a regular basis for ferrying medical tourists regularly. On an annual basis, how much do you invest in infrastructure to attract medical tourists? It is difficult to quantify the stated investment in numbers though the amount is substantially huge as NSSH does not compromise on the quality of services offered and believes in giving the best in class quaternary level of treatment to every patient, national and international. raelene.kambli@expressindia.com
HOSPI INFRA I N T E R V I E W
‘We aim to touch Rs 100 crores/annum turnover in the next three years’ Sanjay Jaiswal, Founder & MD,Airox Technologies elucidates on his company’s offerings for healthcare and plans for future growth, in an interaction with Express Healthcare
Tell us about Airox Technologies' journey within the healthcare sector? Airox started its journey in 2011, we realised that hospitals are spending huge money on oxygen which we found can be reduced drastically. Also, after the fire at AMRI Hospital, Kolkata and many such other incidences, we decided to offer a safer, economical and quality solution for oxygen supply to hospitals. This idea prompted us to launch the new generation oxygen generator system in India. Now we have 150+ installation across India which includes almost all major states in India. We have 80 employees and 20 strong distributors with head office at Aurangabad, Maharashtra and own branch offices at New Delhi, Kolkata and Vapi, Gujarat. You specialise in oxygen generators. Can you throw some light on its importance with modern hospitals? Modern hospitals are adopting newer technology and modernisation helps to reduce operating costs and increase efficiency. Oxygen is a life saving component in the hospital. The oxygen supply should be unin-
Modern hospitals are adopting newer technology and modernisation helps to reduce operating costs and increase efficiency EXPRESS HEALTHCARE
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HOSPI INFRA terrupted and manpower should not be involved in supply. You have seen many instances where hospital ran out of cylinders and in case of liquid oxygen the line got blocked due to valve blockages. This kind of problem is not there with our oxygen generator system. It is a completely automatic system whichmakes hospital self-sufficient on oxygen. It runs when you consume oxygen, rest of the time it is on standby mode. In our system, one can monitor the purity of oxygen with a digital online analyser which is given with the system and assures purity. Also, all other headaches involved with cylinders and liquid oxygen billing, stock, weighing of liquid oxygen etc. can be avoided with our system since the oxygen generator is a completely automatic system and runs only when you consume it. What are the advantages of oxygen generators as compared to cryogenic and oxygen cylinders? ◗ Oxygen generator saves approximately 70 per cent and 50 per cent on oxygen consumption bills as compared to cylinders and liquid oxygen respectively. ◗ Quality of oxygen in our oxygen generator is better. In our system, harmful gaseous content like Co2, CO, SO2, hydrocarbon and water content is far lower than cryogenic and oxygen cylinders. We have done random laboratory tests to prove that. FDA has given us clearance considering all these points. This is the reason why many government and corporate hospitals have now adopted this technology. ◗ The oxygen generator system is compact and can be installed on the terrace which helps in saving huge space in comparison to liquid oxygen which is installed on prime space of the ground floor where the truck can reach. ◗ The oxygen generator system is safer compared to cylinder or liquid oxygen. Our oxygen is in gaseous form and only at 4.5 bar pressure. It helps in avoiding fire hazards and makes the hospital a
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A modern hospital should have a combination of a great doctors’ team and latest equipment which help diagnose diseases accurately and operate on critical patients. The information flow in the hospital should be fast and that can be done with a good HIS and PACS software. Hospital should have trained manpower to increase efficiency. The manpower, electricity and oxygen are major operating cost in any hospital. Our aim should be to reduce it without compromising quality safer place. ◗ The system has life of atleast 24 years and can be upgraded any time as per the hospital’s need. ◗ There is no heat transfer lose unlike in the case of liquid oxygen where you lose major oxygen due to evaporation (liquid oxygen heat transfer from -183o C to room temp almost 200o C). Our system operates on room temperature. ◗ In our system, you produce what you use, not like cylinders where you are never assured about what oxygen feeling capacity you are getting. Even if one is getting cylinders at 125 bar (compared to 160 bar) you are losing almost 20 per cent oxygen and when you change cylinders, six to eight per cent oxygen cannot be vacated and is counted as waste. What, according to you, should a modern hospital consist and how do you see Airox contributing to that? A modern hospital should have a combination of a great doctors’ team and latest equipment which help diagnose diseases accurately and operate on critical patients. The information flow in the hospital should be fast and that can be done with a good HIS and PACS software. Hospital should have trained manpower to increase the efficiency. The manpower, electricity and oxygen are major operating cost in any hospital. Our aim should be to reduce it without compromising quality.
Airox launched Telelift which improves hospital goods transportation, increases workflow and efficiency. Also it helps reduce manpower and electricity cost. Airox oxygen generator helps reduce oxygen cost drastically and is a completely automatic system. How does the Airsep oxygen generator supplied by Airox Technologies differ from the oxygen generator supplied by other companies? What are the unique features? Any quality certification received so far? To maintain 4.5 bar pressure and consistent purity at Indian conditions which include high temperature, humidity and atmospheric pressure, one requires state-of-the-art technology. Ours is the only proven product which works in Indian atmospheric condition with more than 150 installations across India. The Zeolite which separates oxygen from air is developed by the core team of Airsep Corporation in the US, it is not available with any competitor. Our PSA process is unique and cannot be duplicated. Due to this robust process, Zeolite, our service team with 35 dedicated engineers and spare part inventory of almost three crores we can guarantee minimum 20 years of our system life. These things make us a market leader in India with more than 90 per cent market share in Indian private hospitals. AirSep Corporation is the
only PSA oxygen manufacturer that meets the following standards of construction ◗ CE 93/42/EC (European Medical CE) ◗ American Society of Mechanical Engineers (ASME ) VIII ◗ EN-ISO 9001 (2008) ◗ EN-ISO 13485 (2012) ◗ National Electrical Manufacturers Association (NEMA) ◗ Canadian Standards Association/Canadian Registration Number (CSA/CRN) ◗ New York Fire Department (NYFD) ◗ Nationally Recognized Testing Laboratory/Underwriters Lab 3101.1 (NRTL-UL) ◗ Indian FDA Our system oxygen complies with: ◗ USP93XXII (United States Pharmacopeia) ◗ EUROPIAN Pharmacopoeia ◗ Indian Pharmacopeia ◗ HTM 2022 ◗ HTM 02-01 ◗ ISO 7396-1 and EN 737-3 ◗ ISO/DIS 10083 (International Organization for Standardization) Do you plan to introduce new products in this space? We have recently launched the electric tracking vehicle (ETV) from Telelift, a German technology in India which will be a major revolution in the Indian hospital industry. The system has life of atleast 30 years. This technology is a modern way of transporting hospital material within hospitals. It reduces manpower,
electricity cost and improves work-flow. The container can carry load till 15 kg. It can transport surgical goods from CSSD to different operation theatres keeping surgical instrument sterile using UV light technology. It can transport blood samples including LDH and ASAT analysis. Intravenous drips, blood bags, consumables, files,postal mails, X-ray, CD, cash etc can be transported through this system. In short, ETV will transport all small goods except linen and food. What are your plans for Airox Technologies in the coming year? We are promoting our product as ‘oxygen for modern hospitals’. We have been highly successful in this regard since we have 150+ installations in India including government and corporate hospitals. In coming few years, we will be taking this technology to other major hospitals in India. Airox has its head office in Maharashtra, with branch offices in Delhi, Vapi and Kolkata. We have 80 employees and 20 strong distributor team which will help us to grow and achieve new heights. With present installation and infrastructure in place, we aim to touch Rs 100 crores/annum turnover in the next three years. We also see ourself as a pioneering company that launches new generation technology in India which will immensely benefit the Indian hospital industry. Is there anything else that you would like to highlight? There are a few state-ofthe-art hospitals across the globe like Niguarda Ca´Granda Hospital, Milano, Italy (1300 beds), Central Hospital Augsburg, Germany (1200 beds) and Binhai Hospital, Shenzhen, China (1500 beds) using ETV system for hospital goods logistics. We also wish Indian hospitals to adopt this technology which will improve their efficiency and quality, and also help to reduce manpower and electricity cost.
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26th & 27th November, 2015 - India
HEALTHSCAPE SUMMIT
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TRADE & TRENDS
Carestream Health introduces DRX Plus Detectors Contains new features to improve image quality and performance CARESTREAM HEALTH has introduced its third generation of DRX detectors that are faster and lighter than previous generations and offer a host of features to help users achieve higher productivity and improved image quality. The new CARESTREAM DRX Plus 3543 and DRX Plus 3543C detectors have received FDA 510(k) clearance and are available for order in India. “Our new detectors offer functionality designed to address healthcare providers’ current imaging challenges—everything from the need for enhanced image quality to faster availability of the full-resolution image and longer battery life per charge,” said Chandan Naphade, GM – X-ray Solutions, Carestream Health India. The new detectors offer higher detective quantum efficiency (DQE) to enable im-
proved image quality and lower dose. In addition, the newly designed detectors can be submerged in one meter of water for 30 minutes without failure, which achieves IPX Level 7 rating for liquid resistance and the IEC standard 60529. A reduced weight and thinner profile allows even easier handling. Other advantages include: ◗ Fast frame rate provides compatibility with advanced applications in the future ◗ Tri- and bi-colour LEDs offer
improved feedback of detector status ◗ On-detector calibration file storage means quicker setup of the detector on multiple systems ◗ Faster calibration time, boot time, preview time and full-resolution display time boost workflow and ◗ Beam detect mode (for room retrofit applications) eliminates the need for cable connection to the generator. Image capture will automatically start when the detector senses the X-ray
exposure. Battery life has been significantly increased in the new detectors to enable more imaging between battery changes and a battery hot swap now allows a quick battery change without a reboot. Carestream’s DRX Plus 3543 Detector is designed for general radiography imaging while the DRX Plus 3543C cesium iodide detector offers benefits for paediatric and other dose-sensitive applications.
The new generation of DRX Plus detectors continue Carestream’s design that enables each DRX detector to work with all other DRX systems within a provider’s environment. These detectors also can be inserted into almost any existing X-ray system to deliver enhanced functionality. Contact Nilesh Dattatray Sanap Carestream Health India 022- 67248816 nilesh.sanap@carestream.com
Omega inaugurates facility in Pune The new facility is based at International Biotech Park, MIDC Phase II, Rajiv Gandhi Infotech Park, Hinjewadi, Pune UK-BASED OMEGA Diagnostics Group provides high quality in vitro diagnostics products for use in hospitals, blood banks, clinics and laboratories in over 100 countries and specialises in the areas of food intolerance, allergy and autoimmune and infectious diseases. It was first formed in 1987 and has grown organically and by acquisition since listing on AIM in 2006. For the most recent year ended March 31, 2015, group turnover was £12.1 million which generated an adjusted profit before tax of £1.4 million.
Omega has sold products into India since 1992, firstly through a subsidiary of GSK (a UK-based global healthcare company) until 2007, after which, that distributor was acquired by Thermo Fisher Scientific (TFS). Omega continued to supply products into India through TFS until 2011, at which point we established our own direct presence with a registered office facility at Kanakia Spaces, Borivali (East), Mumbai. Omega Dx currently employs 19 people in India including representatives based in
the main metropolitan cities. It has its warehouse for distribution of products across pan India with sub-distributor network in excess of 100 to serve customers at short notice and offer technical and customer service support by its head office team. Since May 2014, Omega Dx has leased c 20,000 sq ft of space at the International Biotech Park in Hinjewadi, Pune. The main purpose was to establish a manufacturing facility to produce lateral flow rapid diagnostic tests (RDTs). The company is at its final
stages of the fit-out fabrication of the interior space. The facility will then be equipped with specialist manufacturing equipment to produce RDTs. The combined investment of capital expenditure, lease/ maintenance costs and fees involved in obtaining factory licences and FDA approval is expected to be c. $0.9 million at completion. In 12 months’ time from the date of this report, the company estimates it could be employing up to 50 people, including high quality positions in production management and technical/
QC roles. Omega’s facility in Pune will initially concentrate on two RDT opportunities. They are Visitect CD4 and Visitect Malaria. Contact Moitry G Patnaik Customer Service Executive Omega Dx (Asia) Western Edge-I, 508, 5th FloorFont Color Kanakia Spaces Opp. Magathane Bus Depot Borivali (E) Mumbai-400 066 Tel: +(91) 2228702251 Mob: +(91) 9766832134
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TRADE & TRENDS
Bajaj Electricals’IBMS Unit bags ‘Best IBMS Company’Award Bajaj Electricals has entered into an alliance with Delta Controls to offer dependable, openplatform and user friendly BMS and EMS BAJAJ ELECTRICALS – IBMS UNIT has recently bagged 'Best IBMS Company Award' by CIMS Healthcare Excellence Award. Speaking at the occasion, Shakti Leekha, Sr GM and Head IBMS, said, “The award encourages Bajaj IBMS to keep doing customer delight, and getting new technologies, product and solution to market by innovating and creating smarter solutions which are customer-centric, open technology and simple.” Bajaj Electricals has entered into an alliance with Delta Controls to offer dependable, open-platform and user friendly building management system (BMS) and energy management systems (EMS) to commercial, healthcare, education, leisure buildings along with specialised applications for datacentres with energy management and energy reporting tools for energy
efficiency. The building management systems provided by Delta Controls consists of controllers that operate on Native BACnet (BACnet/IP, BACnet Ethernet, BACnet MS/TP) along with options of controllers with hot swappable modules for easy maintenance and expansion and Power over Ethernet (POE) controllers which are IT-friendly and future ready with wireless and EnOcean products. The software is designed as a unified enterprise platform for building automation, access control solution and lighting controls with multi-site management tools. The software consists of web-based application that combines the power of enterprise dashboards with easy-to-use facility management tools with customisable energy management dashboards and powerful energy
reports give managers the tools to reduce consumption and drive down costs. Bajaj IBMS today has the potential to solve and transform the critical business challenge using technological innovation. The same has been demonstrated in different vertical markets with projects in datacentre done on
wireless solutions so that racks are movable and provide flexible options to datacentre owners and operators. The company have been engaged with close to 100 datacentres in last three years only in India and have demonstrated a clear leadership with multiple tier III level datacentre delivered for full
range of solutions on IBMS. The company has completed done projects with Radisson Hotel, Goa and Cosmos Bank Headquarters, Pune. Bajaj Electricals- IBMS now has the products and solutions for Internet of Things (IoT) and the ecosystem of system integrators to move from smart buildings to smart cities and ensuring conservation of energy. To sustain and gain momentum in bringing this change for smart infrastructure the company has created an ecosystem of 30 system partners who are up-skilled to ensure that building technologies and solutions are developed and maintained. This skilled expert’s pool is growing and by next financial year, it expects to have 50 system partner organisations working together with Bajaj IBMS to bring this change.
Klenza, silver enriched alcohol free hand sanitiser launched A patent pending silver-based technology, Klenza actively shields hands with 99.999 per cent protection against germs KLENZA, SILVER ENRICHED alcohol free hand sanitiser with three-hour germ protection, has been launched in India. A patent pending silver-based technology, Klenza actively shields hands with 99.999 per cent protection against germs. Klenza is a non-toxic and nonflammable green product that doesn’t use any harmful ingredients like triclosan or
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paraben etc. Formulated using natural ingredients, this sanitizer can be used at all times without any harmful side effects. Exceptionally gentle and safe on all skin types including kids (three plus years). Klenza endorses proper hand washing and the most effective method of maintaining hand hygiene. Also, Klenza’s continuous three
hours protection after application, ensures longer protection while using less of the product. Klenza sanitizers are much safer and ensure three hour continued germ protection, making Klenza the best of its kind hand sanitizer. Its distinctive foam dispenser pumps small quantities for easier and smoother application. Available in two exquisite
fragrances Cool Cologne and Smooth Strawberry, Klenza comes in the 200ml foam pump for Rs 198 with 250 applications and the 50ml foam pump for Rs 90 with 120 applications. Klenza hand sanitizers are available in select stores and malls across Bangalore. Customers can also buy online at stores like Flipkart, Amazon, FirstCry, PayTm.
LIFE
ISCoS launches guide on spinal injury, a text book on spinal injury management in India The textbook compiles works of 184 contributing authors from 25 countries. It aims to present the global scenario by including perspectives on spinal injury management as a team approach from multiple countries and regions
T
he ‘ISCoS textbook on Comprehensive Management of Spinal Cord Injuries’ was launched by the International Spinal Cord Society (ISCoS) recently. It was an initiative to compile comprehensive, balanced and multi-disciplinary resource book on spinal injury management. The book was launched in India by Thawar Chand Gehlot, Union Minister of Social Justice and Empowerment Government of India, during the inaugural ceremony of the 15th annual conference of Spinal Cord Society, ‘ISSICON 2015’ at New Delhi recently, in the presence of Lov Verma, Secretary, Department of Empowerment of Persons with Disabilities, Ministry of Social Justice and Empowerment Government of India; Awanish K Awasthi, Joint Secretary, Department of Empowerment of Persons with Disabilities, Ministry of Social Justice and Empowerment, Government of India; Dr JJ Wyndaele, President ISCoS, Maj HPS Ahluwalia, Chairman, Indian Spinal Injuries Centre (ISIC) and Dr AK Mukherjee, President, Spinal Cord Society. Reportedly, the ISCoS textbook on Comprehensive Management of Spinal Cord Injuries is aimed at fulfilling the need for a comprehensive resource addressing management of spinal cord injury (SCI) as a team-based approach. Dr Harvinder Singh Chhabra, Medical Director & Chief of Spine Service of the Indian Spinal Injuries Centre has helmed the effort as the Editor-in-Chief of
Unveiling the ISCoS textbook on comprehensive management of Spinal Cord Injuries
the carefully selected works of 184 contributing authors from as many as 25 different countries. With a view to ensure that the book represents a global scenario, and not just the prevalent expert discourse in the developed world, a separate chapter on ‘Challenges of Management in Less and Least Developed Countries’ has been added to highlight the difficulties of the less resourced and the solutions to overcome them. “When it comes to making lives better for people with
Dr HS Chabbra
spinal cord injuries there is a substantial gap between ‘the possible’ and the ‘actually available’. A wide variety of different injury management approaches are practiced in different parts of the world, which may not be adequately shared with healthcare professionals elsewhere. At the same time, a large amount of information and expertise remains unavailable to healthcare professionals in many regions. The textbook aims to compile the latest best practices and approaches being followed by doctors, physiotherapists, occupational therapists, orthotists, assistive technologists, and counsellors across the world with an objective of making a comprehensive guide available to people everywhere,” says Dr Chhabra. The textbook is a comprehensive guide containing information for all disciplines involved in SCI management including doctors, nurses, physiotherapists, occupational thera-
pists, orthotists, assistive technologists, vocational counselors, psychologists, social workers, and peer counsellors, with additional information for doctors. The textbook has various new topics which are not covered in the currently available textbooks including Assistive Technology, Pre-discharge Planning, Nutritional Management, Outcome Measures, Challenges of Management in Less and Least Developed Countries, Neglected Spinal Cord Injuries, Translational Research, Issues Specific to Women, Empowerment, Legislation and Rights of Persons with Disability, Vocational Rehabilitation, SCI in Complex Emergency Situations, Geriatric Spinal Cord Injuries, Active Rehabilitation, Concomitant Diagnosis: Traumatic Spinal Cord Injury and Traumatic Brain Injury, Associated Injuries, and Polytrauma. 24 of the 82 chapters in the textbook have been contributed by Indian authors, including seven by Dr Chhabra
himself as the first author and six as co -author. A simple and comprehensible presentation has been ensured to help all disciplines to easily assimilate the knowledge. Appropriate use of illustrations and figures has further made the content user friendly. The availability of the online version of the textbook is expected to help the readers since the two will morph with each other such that indexing, searching, and grasping the entire domain of the topic becomes a lot easier. The entire work for coordination and administrative support of the project took place from Indian Spinal Injuries Centre. The ISIC Editorial team comprising 21 experts contributed to the textbook. The textbook represents ISCoS desire to bridge the gap in professional development opportunities for health professionals involved in SCI management. It will hopefully be able to meet the requirements of the reader.
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LIFE PEOPLE
Nightingales Home Healthcare appoints Gowtham Jayaram as CTO He brings more than 20 years of experience in leading technology at multinationals and a wide range of start ups in US and India NIGHTINGALES, THE home healthcare company of Medwell Ventures announced the appointment of Gowtham Jayaram as Chief Technology Officer of the company. Gowtham brings to Nightingales more than 20 years of experience in leading technology at multinationals and a wide range of start ups in US and India. He joins Medwell Ventures from Ezetap Mobile Solutions, a mobile point of sale processing solution company. Gowtham was VP Engineering at Ezetap where he was responsible for growing the engineering team. Prior to Ezetap, Gowtham was the Engineering Head of Yahoo's Store (Yahoo's Small Business e-commerce platform). In
a previous assignment at Nuance, Gowtham was one of the early engineers and responsible for architecting the Operations, Administration and Management platform and building Nuance’s Solution Delivery team for India and ASEAN region. His core expertise is in building highly scalable software platforms and assembling world class engineering teams. Commenting on the appointment, Lalit Pai, CEO, Nightingales Home Healthcare, said, “We are delighted to have Gowtham on board as the Chief Technology Officer of Nightingales. Having set the foundation of our business across three cities and multiple branches we are now ready to take a big leap
Jayaram is joining Nightingales when the company is looking to scale its operations across 10 cities, following its series A $ 10 mn funding from Fidelity Growth Partners India
as a technology led speciality home healthcare provider. We are looking to leverage Gowtham’s expertise in driving the transformation of our business towards superior customer experience, to develop a robust technology team and create innovative solutions.” This appointment comes at a strategic time for the company, with Nightingales on the path to scale its operations across 10 cities, following its series A $ 10 million funding from Fidelity Growth Partners India. Medwell Ventures has a planned outlay for $ 1million for its various technology initiatives for the current fiscal. “Technology enabled home healthcare services have the po-
tential to create a new patient centric healthcare delivery model in India. As a biomedical engineer I have seen the positive impact that medical technology has delivered to improve patient lives, Nightingales has a unique opportunity to be a home healthcare leader in chronic disease management and I look forward to creating the technology ecosystem within the company to scale its products and growth. This is indeed an exciting opportunity” said Gowtham. Gowtham holds a Bachelor of Engineering degree from University of Mysore and Master of Science (Biomedical Engineering) degree from Louisiana Tech University.
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