VOL.10 NO 8 PAGES 60
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CONTENTS MARKET Vol 10. No 8, AUGUST 2016
Chairman of the Board Viveck Goenka Sr Vice President-BPD Neil Viegas
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INTRODUCING HEALTHCARE SENATE 2016
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SIEMENS WITH FEHI TO ORGANISE PROGRAMMES
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HEALTH MINISTRY INAUGURATES INTERNATIONAL WORKSHOP ON HTA
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COLUMBIA ASIA RECEIVES $101 MILLION INVESTMENT FROM MITSUI & CO
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 Delhi Prathiba Raju Design National Design Editor Bivash Barua Asst. Art Director Pravin Temble Senior Designer Rekha Bisht Artists Vivek Chitrakar, Rakesh Sharma Photo Editor Sandeep Patil MARKETING Regional Heads Prabhas Jha - North Harit Mohanty - West Kailash Purohit – South Debnarayan Dutta - East Marketing Team Ajanta Sengupta, Ambuj Kumar Arun J, Douglas Menezes E.Mujahid, Mathen Mathew Nirav Mistry
WHAT YOUR WOMEN PATIENTS WANT? A patient-driven priority list from radiologists and diagnostic imaging centres | P26
INTERVIEWS P14: SHAMSHEER VAYALIL
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IN INDIA,HIV/AIDS CARRIES A WOMAN’S FACE
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ROCHE DIAGNOSTICS INDIA APPOINTMENT
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NEERAJ JAIN TO LEAD PATH IN INDIA
P25: DR ADITYA GUPTA Director – Neurosurgery, Artemis Hospital
P32: LATESH SEN
Manager Bhadresh Valia
GM, Costing and Business Analysis, Radiant Life Care
CIRCULATION Circulation Team Mohan Varadkar
IT@HEALTHCARE
MD, VPS Healthcare
PRODUCTION General Manager BR Tipnis
Scheduling & Coordination Ashish Anchan
LIFE
P33: DR PRADEEP V MAHAJAN CMD, StemRx
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REVOLUTION IN DIGITAL HEALTHCARE
>>
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Express Healthcare® Regd.with RNI no. MAHENG/2007/22045,Postal Regd. No. MCS/162/2016 – 18,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 © 2016 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
Public good or publicity stunt?
O
ne man's medicine is another man's poison. Or in the case of Kerala's 'fat tax' of 14.5 per cent on pizzas, burgers etc., the state government's concern over having the second most obese individuals among all Indian states, was booed as a publicity stunt by political rivals. Industry groups are concerned that other governments would be pressurised to follow suit, and tax not only fat, but also sugar (colas etc). For instance, CII has urged the Kerala government to review the levy of this tax as it would adversely affect growth of the Quick Service Restaurant (QSR) segment of the food industry and might set a similar trend for other segments, as well. But it does seem odd that the tax is being levied selectively, with oily traditional snacks like samosas, bhajias and the like being kept out of the purview simply because they are not branded. The long term answer to curb the obesity epidemic is not taxes, which are punitive in nature, but educating and incentivising consumers to change their habits. But, this needs policy changes and everyone knows that this moves at glacial speeds, not just in India but across the world. Policy changes may seem like a daunting task but many industry experts and think tanks have suggested road maps for consideration. For instance, The Partnership to Fight Chronic Disease (PFCD) had introduced a National Blueprint – SANKALP, for the management of NCDs in India that emphasised several specific recommendations that are aligned with recent initiatives like Kerala's so called fat tax. A cursory look at some of the recommendations suggest good starting points. Some steps are already in motion like instilling ‘healthy living’ by incentivising healthy habits through voluntary exercise or yoga. We could say awareness levels about yoga have increased with a separate AYUSH ministry. Similarly some state governments have tried to ban alcohol, bracing for a fall in liquor sales revenues. But other suggestions are tougher. Like encouraging healthy eating by providing healthier options at subsidised or affordable pricing in all school, college and university canteens as an alternate to unhealthy food and beverages, banning alcohol and cigarette shops within a two km radius of all schools and colleges across the country and building more parks and jogging tracks. Policy makers will have to choose a
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Policymakers will have to choose a fine balance between investing in the health of future citizens by forgoing revenues from alcohol and cigarette sales,or antagonising some business sectors
fine balance between investing in the health of future citizens by forgoing revenues from alcohol and cigarette sales, or antagonising some business sectors. The Health Ministry's notification to add heart stents to the 2015 National List of Essential Medicines (NLEM) is another example of the divergent perspectives within the healthcare sector in India. On one hand, consumer groups and domestic medical device manufacturers, represented by the Association of Indian Medical Devices industry (AIMED) gave the move a thumbs up while the opposite camp, represented by Advanced Medical Technology Association (AdvaMed) and CII warned that price controls would disincentivise manufacturers from bring new technologies to the Indian market. But everyone is unanimous that hospitals in India can no longer avoid social media and indeed need to follow the patient/consumer and be more social. The cover story in Express Healthcare’s August issue, titled, Tune in to Chatter, examines the strategies of some pioneering social media moves by healthcare chains and medtech companies in India. Just as another story in the radiology section, gives radiologists and diagnostics players some ideas on, 'What your women patients want?' The key takeaway from both stories is that healthcare organisations will have to add many more arrows to their quiver, if they want to get closer to their patients. The impact of such policy changes is going to be a key theme at Healthcare Senate 2016, scheduled for September 22-24, which promises to bring together the who's who of healthcare leadership. In the tradition of the ancient Roman republic and empire, where a Senate consisted of 'an assembly or council of citizens having the highest deliberative functions in a government', our Healthcare Senators are leaders who have or are destined to change the course of healthcare delivery, not just in India but the world. From here, will flow the wisdom of past gurus, to their present day counterparts and into the minds of the aspiring next rung of leaders. The August issue features messages from some of our key speakers but to register and for more information, log on to http://healthcaresenate. financialexpress.com/. See you in September in Hyderabad! VIVEKA ROYCHOWDHURY Editor viveka.r@expressindia.com
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HEAD OFFICE Express HealthcareÂŽ MUMBAI Douglas Menezes The Indian Express (P) Ltd. Business Publication Division 2nd Floor, Express Tower, Nariman Point Mumbai- 400 021 Board line: 022- 67440000 Ext. 502 Mobile: +91 9821580403 Email Id: douglas.menezes@expressindia.com Branch Offices NEW DELHI Ambuj Kumar The Indian Express (P) Ltd. Business Publication Division Express Building, B-1/B Sector 10 Noida 201 301 Dist.Gautam Budh nagar (U.P.) India. Board line: 0120-6651500.
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Adequate use of the existing powerful tools and new guidelines can help prevent and treat hepatitis. National strategies and action plans should optimally utilise these tools and step up efforts at all levels to address the growing threat of hepatitis Dr Poonam Khetrapal Singh Regional Director for South-East Asia,WHO Speaking on the eve of World Hepatitis Day
Mobile: +91 9999070900 Fax: 0120-4367933 Email id: ambuj.kumar@expressindia.com Our Associate: Dinesh Sharma Mobile: 09810264368 E-mail: 4pdesigno@gmail.com CHENNAI Arun J The Indian Express (P) Ltd. Business Publication Division 8th Floor, East Wing, Sreyas Chamiers Towers New No 37/26 (Old No.23 & 24/26) Chamiers Road, Teynampet Chennai - 600 018 Telephone (Board): +91 44 24313031/32/34 Fax: +91 44 24313035 Mob: +91 9940058412 Email id: arun.j@expressindia.com
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Universal Health Coverage is the need of the hour for India and Health Technology Assessment can be a potent solution for this. The government is very keen and has already started a journey towards achieving this Anupriya Patel Minister of State in the Ministry of Health and Family Welfare, Government of India Speaking at the inauguration of international workshop on Health Technology Assessment (HTA)
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MARKET PRE EVENTS
Introducing Healthcare Senate 2016 The national private healthcare business summit will be held at HICC, Hyderabad from September 22-24, 2016 REFORMATION has long been a characteristic of human development. In India, the healthcare development story is similar to the rest of the world. Regardless of all the challenges, healthcare as a discipline continues to evolve. More rightly, it continues to reform. Express Healthcare, a leading magazine of the Indian Express Group, chronicling all the major events in the healthcare industry in India has been a witness to the reformation that healthcare in India has been undergoing in the last 16 years. Taking it a step further, now we intend to be a part of this reformation through Healthcare Senate, a leadership platform for knowledge exchange. Healthcare Senate, the national private healthcare business summit, will be held at HICC, Hyderabad from September 22-24, 2016. It would host the game changers, path finders and and opinion leaders of the healthcare industry, to facilitate sharing of innovative ideas and experiences, and convert them into reality. Most influential healthcare practitioners; CEO/CFO/MDs of hospital chains, medical superintendents, hospital owners and decision makers, owners of single speciality hospitals, owners of diagnostic and other healthcare centres, hospital administrators, HoD of medical and bio-medical departments, HoD of engineering and operations, medical directors, purchase managers, healthcare consultants, project heads, bio-medical engineers, dealers and distributors, thought leaders, industry stalwarts and domain experts would be part of this event. The three-day event will encompass expert speakers, panel discussions, case studies and power discussions, a technology
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the Healthcare Sector ◗ Investing in Quality: Best Practices, Accreditation, Infection control, procurement ◗ Patient-driven Innovation in business models To be held concurrently with Healthcare Senate on September 23, 2016, Express Healthcare Excellence Awards will celebrate the spirit of excellence and leadership in healthcare delivery in the private sector. The awards
CONFIRMED SPEAKERS 1. Speaker from Apollo Group of Hospitals 2. Dr AVelumani, Founder,Thyrocare 3.Ameera Shah, MD, Metropolis Healthcare 4. Dr KK Kalra, CEO, NABH 5. CK Mishra,Addl Secretary, MoH&FW
CONFIRMED PANELISTS: DEALING WITH COST BURDEN OF MEDICO LEGAL TANGLES 1. Bejon Misra, Founder Director, Patient Safety and Access Initiative of India Foundation 2. Sanjay Prasad, President & CEO at Mission of Mercy Hospital & Research Centre, Kolkata 3. Mahendra Bajpai,Advocate, Supreme Court of India 4. Manpreet Singh Sohal, CEO, Global Hospitals-Mumbai
500+ hosted buyers
5000 100+ 18 meetings
5. Dr Vivek Jawali, Director - Fortis, Bangalore 6. Dr Sugandhi Iyer, Deputy Director - Legal & Medical , P D Hinduja Hospital 7. Dr Alexander Thomas, Executive Director,AHPI
CONFIRMED PANELISTS: PATIENT-DRIVEN INNOVATION IN BUSINESS MODELS 1. Chayan Chatterjee, Co-Founder & COO, Lattice Innovations, and India Partner, CamTech 2.Vishal Bali, Senior Healthcare Advisor,TPG Growth in Asia & Founder Medwell Ventures 3. Dr Nagarjun Mishra, Chief Officer - Business & Strategy & Co-founder, Purple Health 4. Suresh Satyamurthy, Founder,Tarnea Technologies
CONFIRMED PANELISTS: BALANCING PROFITABILITY WITH RESPONSIBILITY 1.Joy Chakraborty, COO, Hinduja Hospital 2.Viren Shetty, Senior - VP, Strategy and Planning, Narayana Hrudralaya, Bengaluru 3. Dr Alok Roy, Chairman, Medica Synergy, Kolkata
exhibitors
conference tracks
Pre-fixed appointments Industry awards
4. Dr Sabahat Azim, CEO, Glocal Healthcare Systems 5. Dr Ram Narian, Executive Director, Kokilaben Dhirubhai Ambani Hospital
CONFIRMED PANELISTS: RAISING CAPITAL FOR HEALTHCARE 1. Rana Mehta, Partner – Healthcare Practice, PwC 2.Apoorva Patni,Director, Currae Healthtech Fund (Investor and hospitals) 3. Dr K Krishna Reddy, Senior VP, CARE Hospitals 4. Dr Harish Pillai, CEO,Aster Medcity
showcase featuring leading IT providers, the Express Healthcare Excellence Awards in the private sector, prefixed peer-topeer networking and relationship building (gala dinners, excursions and entertainment).
Healthcare Senate would see discussions on pivotal topics such as: ◗ Sustainable Healthcare Delivery Models for the Future ◗ Balancing Profitability with Responsibility
◗ Raising Capital for Healthcare ◗ Dealing with Cost Burden of Medico Legal Tangles, ◗ Protecting Brand Image: How Intangibles Impact the Bottomlines ◗ Managing Human Capital in
will recognise private hospitals and industry leaders for their vital contributions to healthcare in India. It seeks to honour the pathfinders, innovators and game changers from within the private healthcare industry. The Association partners for the event are Association of Healthcare Providers India, Consortium of Accredited Healthcare Organisations and Karnataka Imaging Education Foundation..
HIRANJITH GH
DR RUPALI BASU
DR GAURAVTHUKRAL
JOY CHAKRABORTY
DR ALOK ROY
Director, Corporate Planning, Marketing and Communications, MedGenome Labs
President and CEO ER, Apollo Hospitals Group,India & President, Asso. of Hospitals of Eastern India
Senior Vice President & Head of Business Development at HealthCare atHOME India
COO,PD Hinduja Hospital & Medical Research Centre
Chairman & Managing Director, Medica Synergie
Platforms such as Healthcare Senate provide avenues for scientists, industry, students and government to share work and foster new relationships, enabling newer opportunities to achieve positive healthcare outcomes for our population
Healthcare ecosystem is going through tremendous changesnew diseases, new technologies, new formats of care and is therefore exciting as well as challenging! My personal best wishes to Healthcare Senate. Let it be our biggest support in the journey of quality healthcare within the reach of every Indian, and as soon as possible
The healthcare sector in India is evolving rapidly. However, it still needs improvements in areas of technology and digita lisation. Platforms and forums like Healthcare Senate are an opportu nity for the industry to come together to discuss and deliberate on global practices and learning. I wish the very best to the organisers of Healthcare Senate
The biggest challenges within the private healthcare sector are the availability of trained manpower to meet expectations and the rising cost of healthcare inputs that is driving the cost of healthcare upwards. Let’s come together at Healthcare Senate 2016 to deliberate on this subject and to come up with relevant solutions
DR N KRISHNA REDDY
DR NAGARJUN MISHRA
Vice Chairman, CARE Group of Hospitals
CBO & CSO (Chief officer - Business and Strategy),Purple Health
It is incumbent on us to persistently innovate and redesign our healthcare strategies, and protocols in line with evolving disease trends. Healthcare Senate is a pivotal forum in unifying the best practices in health and wellness, to catalyse improved accessibility and affordability. All the very best to the Express Healthcare team
DR HARISH PILLAI CEO, Aster Medcity & Cluster Head Kerala
With rising costs of modern healthcare, rethinking is happening globally of how healthcare is delivered. A forum like Healthcare Senate is essential to share ideas
Indian healthcare has the clear potential to show the way to the rest of the world in terms of sustainable models in our specific ecosystem. Let us join hands to brainstorm over them and many more exciting topics at Healthcare Senate and evolve a consensus on the way forward
Fragmented healthcare must get united. Let Healthcare Senate unite, develop and drive excellence
SURESH SATYAMURTHY Co Founder, Tarnea Technologies
At first, the Healthcare Senate appeared to be a specialised TED Talk for healthcare. But it is more like the Davos for Indian healthcare sector. It is a great platform for leaders and innovators to meet and find solutions to some of the biggest healthcare challenges of our times. Look forward to seeing you there
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I N T E R V I E W
‘We will position VPS Lakeshore Hospital and Rockland Hospitals as the preferred choices of healthcare across the country’ UAE-based VPS Healthcare, which forayed into India last year with the acquisition of Lakeshore Hospital in Kochi, recently acquired majority stakes in NCR-based Rockland Hospitals. Shamsheer Vayalil, Managing Director, VPS Healthcare, shares more about the groups ambitious expansion plans in India, its plans to transform the healthcare sector and more, in an interaction with Lakshmipriya Nair
VPS Healthcare is on a rapid expansion spree. You have recently acquired stakes in two hospitals, i.e. Lakeshore Hospital and Rockland Hospitals. What are your plans and strategies for the growth of these hospitals? A team of external and internal experts has been set up to determine strategy and the way forward. Keeping in line with our organisation’s vision, we will position VPS Lakeshore Hospital and Rockland Hospitals as the preferred choices of healthcare across the country. There were reports about VPS Healthcare looking to acquire LH Hiranandani Hospital in Mumbai. Is that in the offing as well? Confidentiality agreement prohibits us from discussing anything at present. We will keep you and the public informed about this in due course. What are the unique opportunities in the Indian healthcare sector that VPS Healthcare is looking to tap? India has about 1.3 million hospital beds, which translate into ten beds per
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10,000 people, against a global average of 29 beds and only 6.5 physicians per 10,000 people as compared to a global average of 14.2. Leading private hospital chains account for only about 35,000 of the 1.3 million hospital beds in the country; similarly organised players account for less than 15 per cent of the standalone diagnostics space in the country. Over 60 per cent of beds are under government and trust-run centres. These centres have been the backbone of healthcare delivery and leading institutes like PGI and AIIMS continue to remain key referral centres for all critical ailments. However, government facilities are stretched on resources – overloaded and dated medical infrastructure, over-worked doctors and support staff, and long waiting times, leaving the industry ripe for consolidation. These reasons combined with the fact that over 20 per cent of the global disease burden, exploding epidemic of noncommunicable disease and ever increasing gap in providing quality healthcare, India became a natural choice for our
expansion. We will introduce subspecialised services across our various hospitals to lessen the burden on government hospitals and provide faster treatment to patients, which would ensure better management of any ailments.
We will be introducing sub-specialised services across our various hospitals to lessen the burden on government hospitals and provide faster treatment to patients
Why have you chosen the brownfield route to expansion? Any plans to commence a greenfield hospital? VPS wanted to have a presence in the NCR and Rockland was the most sizeable project that met our standards and vision of expansion within a given period of time. The size of the project also enabled us to mark our presence in the NCR without going the greenfield way of expansion. Had we gone for a greenfield project, it would have taken us around three to four years to build up such a capacity and sizeable operations. Moreover, it would have been a challenge to get such sizeable properties at such strategic locations. It is too early to comment about any plans to commence a greenfield hospital. But if something comes up in the future, we
will keep you and the public informed. What are your investment plans for the Indian market in the next three years? How will these funds be raised? VPS Lakeshore is already undergoing expansion and we also have a couple of upcoming projects in South and West India. In the short run, we intend to reach bed strength of 2,500 in India, which eventually will be doubled with a sizeable number of beds upcoming in the Northern region of the country. What are the differentiators that VPS Healthcare can bring to India’s healthcare sector? The major differentiator is going to be the quality of services that will be provided at our various hospitals. VPS is very particular about the quality of treatment and services we provide, which is evident from the fact that VPS is one of the largest JCIaccredited healthcare groups in the GCC Region. We will introduce and maintain the same quality standards across our Indian hospitals too. lakshmipriya.nair@expressindia.com
MARKET PRE EVENT
Siemens with FEHI to organise programmes in Coronary CTAngiography Interpretation The programmes will be held at Fortis Escorts Heart Institute in New Delhi SIEMENS IN collaboration with Fortis Escorts Heart Institute (FEHI) and Society of Cardiovascular Computed Tomography SCCT (USA) will organise a hands-on training programme in Coronary CT Angiography Interpretation. The programmes will be held at Fortis Escorts Heart Institute in New Delhi from August 24 to 27, 2016. This is the third consecutive year of the International Cardiac CT Course in India by Siemens and FEHI with four programmes conducted over the last two years. Dr Mona Bhatia, Head of Department, Radiodiagnosis and Imaging at Fortis Escorts Heart Institute, New Delhi will conduct the training programme. The course includes a new set of 50 Coronary CT Angiography cases with a wide range of difficulty levels. The two-day training course with expert facility will improve the user’s cardiovascular CT reading skills through personal hands-on training at their dedicated workstations, with immediate feedback through invasive coronary angiography for every case. The training will provide in-depth understanding of cardiac CT guidelines, image acquisition and processing, post-processing and interpretation of datasets, coronary artery stenosis, artifacts detection, limitations and radiation dose.
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MARKET NEWS
Health ministry inaugurates international workshop on Health TechnologyAssessment Government is committed to reducing out of pocket expenses on healthcare: Anupriya Patel FAGGAN SINGH Kulaste and Anupriya Patel, Ministers of State for Health and Family Welfare, recently inaugurated a three-day international workshop on ‘Health Technology Assessment’ (HTA) in New Delhi. The three-day workshop was jointly organised by the Department of Health Research (DHR), ICMR, National Institute for Health and Care Excellence (NICE)-UK and Health Intervention and Technology Assessment Program (HiTAP)-Thailand. Kulaste stated that Health Technology Assessment is very essential and needed for achieving Sustainable Development Goals (SDGs) and goals set under the Five Years Plan of the Government. He also added that this will aid in fulfilling commitment of the Government and will help in bringing people of the country under the Universal Health Coverage (UHC). The minister stressed on the need to develop high quality delivery health systems for the development of the country. He said that HTA will guide us towards strengthening the healthcare systems further.
The Minister of State for Health & Family Welfare, Anupriya Patel addressing at the inauguration of the DHRICMR- iDSI International Workshop on 'Health Technology Assessment-Awareness and Topic Selection,' in New Delhi. The Minister of State for Health & Family Welfare, Faggan Singh Kulaste, the DG (ICMR), Dr Soumya Swaminathan and other dignitaries are also seen.
Kulaste said that the ministry is keen to learn from the experiences of the UK and Thailand in order to deliver affordable healthcare to all citizens. Patel said that UHC is the need of the hour for India and HTA can be a potent solution for this. The government is very keen and has already started a journey towards achieving this. She further added that there is a need to increase health spending in order to reduce the out of pocket
spending of the common masses in the country which is presently very high and most of it goes for buying medicines. This is a serious concern for the government and it is committed towards HTA that will address this. She also said that HTA will help to shift towards an evidence-based policy making. She added that the insights and valuable experiences of NICE (UK) and HiTAP (Thailand) will help to frame an effective UHC.
Dr Soumya Swaminathan, Secretary, Department of Health Research noted that HTA is needed to take forward the SDGs. She stated that HTA will provide a roadmap to set the priorities within the country for promotive, preventive and curative services in healthcare. HTA is essential for making universal health coverage sustainable and effective, he added. Dr Swaminathan said that HTA will provide a transparent, consultative process of
decision making that is based on evidences and provides inputs to policymakers for providing universal health services that are affordable, appropriate and effective. BP Sharma, Secretary, HFW, mentioned that HTA will go a long way in formulating health plans at affordable prices. Sharma added that HTA has been a game changer since the last decade and has resulted in significantly reducing morbidity and mortality in several countries that have adopted it. He further added that HTA will help to resolve questions of cost effectiveness and will bring down the out of pocket expenditure through evidence-based technology and health practices. The workshop will have international delegates from Thailand’s Health Intervention Technology Assessment Programme, The National Institute of Health and Care Excellence (NICE) International of UK, University of York in UK and the World Health Organisation (WHO) South-East Asia. EH News Bureau
Cabinet approves setting up of newAIIMS in Bhatinda The institution will have a hospital with capacity of 750 beds THE UNION CABINET chaired by the Prime Minister Narendra Modi has approved the establishment of a new AIIMS at Bhatinda in Punjab under the Pradhan Mantri Swasthya Suraksha Yojana (PMSSY). The institution shall have a hospital with capacity of 750 beds which will include emergency/trauma beds, AYUSH
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beds, private beds and ICU speciality and super speciality beds. In addition, there will be an administration block, AYUSH Block, auditorium, night shelter, hostels and residential facilities. The cost of the project for establishment of the new AIIMS in Bhatinda shall be Rs 925 crores. The above cost estimate does not include recurring costs (wages and salaries and opera-
tion and maintenance expenses). The recurring expenditure will be met by the respective new AIIMS from their annual budgets through Grant-in-Aid to them from Plan Budget Head of PMSSY of Ministry of Health and Family Welfare. The new AIIMS at Bhatinda will provide super speciality healthcare to the population while creating a large pool of
doctors and other health workers in this region that can be available for primary and secondary level institutions/facilities being created under National Health Mission (NHM). The institute will also conduct research on prevalent regional diseases and other health issues and provide for better control and cure of such diseases. The project will be com-
pleted in a period of 48 months from the date of the approval by the Government of India. It consists of a pre-construction phase of 15 months, a construction phase of 30 months and stabilisation /commissioning phase of three months. The population in Punjab and adjoining regions will be benefited by this AIIMS. EH News Bureau
MARKET
Columbia Asia receives $101 million investment from Mitsui & Co Columbia Asia will use the proceeds from the Mitsui investment to continue to expand its network of hospitals across Asia COLUMBIA ASIA will receive $101 million in investment from Mitsui & Co. Columbia Asia, part of Seattle-based Columbia Pacific Management, has 27 hospitals and one clinic in India, Malaysia, Vietnam and Indonesia, built with an innovative business model focused on serving Asia’s rapidly growing middle class with modern and efficient multi-speciality hospitals located close to where patients live and work. Tokyo-based Mitsui & Co, already a major healthcare investor in Asia, said it saw tremendous growth potential in the Columbia Asia platform, which is the only healthcare provider in Asia to operate hospitals in so many countries under a single brand, and one of the few large, multinational providers in Asia to build the vast majority of its hospitals itself. Columbia Asia will use the proceeds from the Mitsui investment to continue to expand its network of hospitals across Asia, including several current development projects. In addition, the company will open its first facility in Africa next month, a multi-speciality clinic in Nairobi, Kenya under a new brand, Columbia Africa. As part of its investment, Mitsui will gain two seats on the Columbia Asia Board of Directors and play a role in company operations. Mitsui is also using the investment to expand its hospitals business as the core of its healthcare strategy and will look to form partnerships between Columbia Asia and some of the other healthcare companies in which Mitsui is an investor. These include IHH Healthcare Berhad, the largest healthcare company in Asia; MIMS Group, which provides drug information to about two million healthcare professionals in Asia-Oceania; and DaVita Care, the Asian operating company for the largest dialysis operator in the US. “Columbia Asia has proven
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over more than 20 years that it can enter new markets across various countries and
develop international, highquality hospitals that meet the needs of the emerging middle
class,” said Koji Nagatomi, Managing Officer and Chief Operating Officer, Healthcare
& Service Business Unit, Mitsui & Co. EH News Bureau
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Are hospitals in India harnessing the power of social media to grow business and visibility or struggling to understand the medium? BY M NEELAM KACHHAP
S
ocial media has impact, and is instant. Much like the Internet transformed our lives at the turn of the century, social media is impacting our lives and business today. Networks like Facebook, LinkedIn, Twitter, Instagram, Pinterest are defining the way we reach and interact with clients and customers. One of the most talked about topics on social media is health. Be it information on diseases or queries about hospital services, conversation on healthcare delivery
are enticingly high on social media. “Many people use the Internet to get additional healthcare information but most of that knowledge is unstructured, inaccessible or more often, unreliable. Social media adds a layer of social validation to online information that makes it seem credible (there’s another debate around whether more information is better),” says Viren Shetty, Senior Vice President of Strategy & Planning, Narayana Hrudayalaya. In fact social media is an extension of the word-of-mouth culture.
“Healthcare as a service category works on word of mouth. People always recommend good doctors and hospitals to their friends and family at the first given opportunity. Nowadays, since social media is being rampantly used, this creates an additional platform for people to talk about healthcare providers,” shares Vivek Shukla, GM and Head of Marketing-GCC, Aster DM Healthcare. It is a two-way communication platform. “Users today are self-diagnosing themselves, going as far as even researching
about remedies and cures. Social media ensures a two-way discussion where not only is the user reading about a condition/disease but is also getting answers. In fact, I would go as far as to say that social media is the best tool for any country’s health department to make sure all citizens are in line with the best healthcare facilities and practices,” says Chiragh Cherian, Director – Online & Below the Line Initiatives, Perfect Relations. “If there is one thing that social media does most effectively is create awareness. First step to good health-
care in any country is to make the people aware, whether it is about precautions, cures or centers where treatments can be found. Case in point is the recent Ebola epidemic. Had there not been social media, the widespread knowledge about precautions and symptoms would not have reached the people at such a fast pace and many more lives could have been lost," he adds. Although there are no studies to illustrate the number of hospitals using social media in India, big corporate hospitals have been early adopters. "Most of the large hospitals in
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Social media is the best tool for any country’s health department to make sure all citizens are in line with the best healthcare facilities and practices Chiragh Cherian, Director Online & Below the Line Initiatives, Perfect Relations
Many people use the Internet to get additional healthcare information but most of that knowledge is unstructured, inaccessible or more often, unreliable Dr Viren Shetty, Senior Vice President of Strategy & Planning, Narayana Hrudayalaya
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India run Twitter, Facebook and LinkedIn accounts. I can’t comment on whether we use them effectively, but this is a nascent field and we’re all still trying to get over losing our Blackberries. Social media gives hospitals and doctors the tools to have two-way conversations with patients and this benefits the patients a lot more than in years past,” points out Shetty. A larger patient base has more scope to engage in a two-way communication. Examples like Apollo Hospital, Fortis Hospital, Max Healthcare and Narayana Hrudayalaya have had accounts on at least three social media networks. Besides a large number of doctors employed with these hospitals engage with patients like never before. “We have seen that today most doctors use Facebook or Twitter and also maintain good websites. As far as I know, very few hospitals make their mark on social media and actually provide necessary help to patients,” feels Dr Srinidhi Karti Chidambaram, Vice-President , Health Communications & International Patients, Apollo Hospitals and Senior Consultant, Special Quality Initiatives, Apollo Hospitals. Ideally, hospitals should use social media to understand any unique requirements or pain points of their existing services through user generated content, but most hospitals online do not use this medium effectively. “Almost all hospitals have a profile on one or more social media channels. But most of them do not use it effectively. They need to work proactively on relevance and impact all the time. Making a Facebook page just for the sake of it and loud selfpropaganda on it defeats the purpose and sometimes even harms the brand,” shares Shukla. Looking through another lens Cherian says, "You would be surprised that not only large hospitals, but also pharmacies and independent clinics use social media. However, each of them has their own level of outreach, whether it’s social media or even online advertising and
APOLLO HOSPITAL @TheApolloHospitals
2,181,480 LIKES 32086 CHECKINS NARAYANA HEALTH @NarayanaHealth
1,143,114peopleLIKES talking about it 37,282 on Facebook ASTER MEDICITY @dmmedcity
152,786people LIKES talking about it 20652 on Facebook FORTIS HEALTHCARE (@fortishealth)
926,222people LIKES talking about it 23,444 on Facebook clinic listings. The large hospitals rely on social media to dig into the medical tourism influx in the country.”
Are you ignoring the elephant in the room? With the advent of low cost mobile technology and access to telecom services, penetration of Internet has doubled in India. With this the reach of social media has crossed social as well as geographical boundaries. According to “Mobile Internet in India 2015” a report released by Internet and Mobile Association of India (IAMAI) and IMRB International in June 2015, there are approximately
371 million mobile Internet users in the country as of June 2016. The report said that yearon-year growth of mobile internet users in India for December 2014-2015 was 71 per cent in urban India while the user base in rural India has gone up by 93 per cent. Clearly, Internet is the mainstream in India today and not keeping up with this flow may not be favourable for hospitals especially when there are numerous benefits in doing so.
Not just a fad Although logging-in may seem like a remote way to achieve patient safety and care goals, it may just be the remedy hospi-
tals are looking for to create awareness. “Social media is indeed a very powerful tool in healthcare particularly in creating health awareness which is the first step in disease prevention,” says Chidambaram. Another reason for hospitals to be on social media is easier access to community outreach. “If used well, hospitals can use social media to reach out to a more targeted audience. It can help make messages and initiatives viral. It is a great tool to spread socially relevant messages that have a bearing on healthcare,” opines Shukla. Besides this, patients looking for support from people suffering from similar diseases find solace on social media. "Doctors shouldn’t treat diseases over facebook but the more important role of social media in healthcare is around connecting patients with each other. There are countless support groups on social media for patients suffering from chronic or terminal conditions. These support groups have tremendous psychological value and fill the social vacuum created by the nuclear family structure,” shares Shetty. Public relation is another growing discipline that effectively uses social media. “Starting from talking about the core services, to specialists, the hospitals can also use social media effectively for other brand building activities. These could be World Breast Cancer Awareness Day, Marathons for Awareness, etc. These not only help build the brand but are also used as a tool to make people aware. I am sure that the number of women who go for mammograms today is way more than the number five years ago. All this is because of the awareness that hospitals have spread using various tools, social media being a major one of them,” says Cherian. Many hospitals introduce new services on social media as well as training programmes and workshops. "Hospitals use social media as an extension of their marketing strategy. Some of them announce the launch of new departments, new specialities, or new hospi-
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tals in new locations. Some hospitals conduct marketing campaigns thinly disguised as awareness campaigns on subjects like stroke prevention, diabetes, or heart health. Other hospitals conduct workshops and seminars online with videos, live Q&A and questionnaires," shares Shetty. Brand-building activity is yet another use of social media to create value. “There are many roles a hospital needs to play when using social media. Not only are they supposed to build their brand and talk about their services, specialists, they must also perform the duty of making people understand,” opines Cherian. “You cannot let a complaint or SOS on your social media handle go ignored or unanswered for long. The approach is simple. Set your teams into two departments, reactive and proactive. Your reactive team has to consist of a 24-hour tracking and monitoring and ORM (Online Reputation Management) mechanism. The proactive team is a mirror to your corporate communications and marketing departments. If a hospital is on social media, the team has to be sewed into the corporate communications and marketing departments. Unless there is a good sync between the three, being on social media will become a disadvantage rather than an advantage,” Cherian adds.
Vivek Shukla, GM and Head of Marketing - GCC, Aster DM Healthcare
If used well, hospitals can use social media to reach out to a more targeted audience. It can help make messages and initiatives viral. It is a great tool to spread socially relevant messages that have a bearing on healthcare
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What’s the ROI for putting your pants on!! Return on investments (ROI) are difficult to determine for a social media activity. Being on social media is important, there is value in it but it is difficult to measure. Many activities at hospitals as in other business cannot be quantified or weighed against or connected to revenues like admin or housekeeping. As a marketing guru once asked ‘What’s the ROI for putting your pants on in the morning’. In fact, marketing activities also cannot be quantified directly in terms of revenues or profits because they do not affect financial outcomes directly. Similarly, social media affects the business
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Social media is indeed a very powerful tool in healthcare particularly in creating health awareness which is the first step in disease prevention Dr Srinidhi Karti Chidambaram, Vice -President , Health Communications & International patients,Apollo Hospitals and Senior Consultant , Special Quality Initiatives, Apollo Hospitals
Healthcare as a service category works on word of mouth. People always recommend good doctors and hospitals to their friends and family at the first given opportunity Vivek Shukla, GM and Head of Marketing-GCC, Aster DM Healthcare
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through a series of cause and effect relationships so its difficult to calculate ROIs in monetary value. The value that social media brings is in terms of connections and visibility. "ROI for social media is very high, assuming you subtract the manpower costs, because the costs of running online campaigns is next to nothing. Manpower costs get rolled into the overall marketing spend," says Shetty. In addition, there are various matrix used to track social media like Reach, Site traffic, Leads generated, Sign-ups and conversions etc. "ROI is usually quite good. Mainly because the investments are very minimal and the messages can be targeted at the exact demographic and geographic locations of your choice. Additionally, it is easy to measure the ROI on social platforms as you can gauge the number of responses and conversions clearly," shares Shukla.
Do it like them NurseJournal.org a a social community website exclusively for nurses and healthcare professionals gathers social media statistics for hospitals around the US to find the most social media-friendly hospital. A list of 100 hospitals for 2014 has Mayo Clinic on the top with (five lakh Facebook fans, eight lakh Twitter followers) followed by Cleveland Clinic, Baylor Regional Medical Center, Mount Sinai Hospital, Dana-Farber Cancer Institute and University of Texas MD Anderson Cancer Center. Here in India no such data exists but a cursory look at Facebook reveals that among Indian corporate hospitals Apollo hospital (@TheApolloHospitals) is most liked hospital on Facebook with 2,181,480 likes and 32086 checkins. Narayana Health (@NarayanaHealth) had 1,143,114 likes and 37,282 people talking about it; Aster Medicity (@dmmedcity) has 152,786 likes with 20,652 people talking about it where as Fortis Healthcare (@fortishealth) has 926,222 likes and
TIPS ON USING LINKEDIN TO ENGAGE HEALTHCARE PROFESSIONALS (Courtesy LinkedIn) B
elow are a few examples of how specific healthcare industries can use LinkedIn groups to interact with healthcare professionals in a credible place where they are seeking out information to increase their understanding of the medical field: ◗ Healthcare IT companies can use groups to start conversations around pain points in the industry, such as electronic health records and management, and increase awareness around products and information that offer solutions. Groups like Healthcare Information Technology and the National Association for Healthcare Quality each have hundreds of discussions every month on a range of Healthcare IT topics. ◗ Pharmaceutical companies have a similar opportunity within groups to engage with healthcare professionals around upcoming events and launches. Conferences and product launches can be promoted within existing groups or new groups can be created that are dedicated to a specific event, for example Healthcare Conference: A Student Club Conference at Harvard Business School ◗ Authentically responding to discussions or starting conversations with group members about what a company is offering and the impact on patients can elevate your image with healthcare professionals more than direct marketing alone. Some of the most popular group topics range from how new health tracking tools are changing the way doctors can treat patients to holistic approaches to healthcare. Groups such as Continuing Medical Education can be used to highlight education materials and invite discussions on new research findings or upcoming journal articles.
Social media is an extension of the word-of-mouth culture
23,444 people talking about it on Facebook. There are many hospitals listed on Facebook along with the ones mentioned but do not update their pages frequently and have much less ‘likes’ to display.
Dark side of the moon Reliability of information has been a key concern while using social media. “People discuss current healthcare-related issues on social media. It is not uncommon for us to see some household tips or some latest information on zika virus on social media. All of us have sometime or the other seen and liked or shared healthcare relevant information with our friends on social media. However, as a word of caution, there is another side to this. Social media can also promote myths and incorrect information. So the society at large should be aware that information needs to be cross verified,” warns Shukla. Providing a different perspective Shetty says, “In innocent times gone by, a hospital’s reputation was developed by word-ofmouth and the reputation of their doctors. This trust took many years to acquire and was earned by organisations that put a lot of effort in being the best in their field. Social media has reduced the cost and time of building a reputation by orders of magnitude. This is both an advantage and a disadvantage because some hospitals who let the work speak for itself didn’t evolve a social media strategy and are losing the battle for our diminishing attention." This is true for many good hospitals in India. Another major concern for hospitals is negative publicity. “Social media can be used to build up factually inaccurate stories, which is a cause for concern. However, timely interventions can help mitigate such crisis,” shares Chidambaram. Adding to this Cherian says, "This is a sensitive industry. An unsatisfied patient or their family, can use social media to defame a
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doctor or the entire chain of hospitals. Social media is often seen as a review platform, but what many people do not understand is that medical situations don’t always proved to be 100 per cent successfull. When emotions run high, even a stranger will relate to your situation and spread a negative post.” Another important point to consider here is privacy and regulations. There are no guidelines drawn on the dos and don’ts of using social media by hospitals or healthcare practitioners in India. This has caused dual distress to the hospitals where patient privacy and consent are not taken into account. Also doctors are not sure if using social media will land them on the wrong side of the law. “There aren’t welldefined rules around doctors
EXAMPLES OF SOCIAL MEDIA ENGAGEMENT Example 1- One hospital actively promotes Do it Yourself at home videos for first aid and other medical conditions. Example 2- One healthcare player created a very successful campaign where people can take one pledge for improving their lifestyle and living healthy through social media. This saw active participation from a about two lakh people including celebrities. Example 3- One hospital engaged corporate players and created a poster designing completion on facebook. Employees of various companies made posters on healthy living and shared on the hospital’s page.
being listed on social platforms and several doctors have found themselves at the receiving end of a legal notice from their medical councils. Until the government clearly defines what constitutes building awareness, and what constitutes advertising, doctors are
staying away from these platforms,” informs Shetty.
Edge of tomorrow Social media is evolving at a rapid speed. "This is a fast evolving domain. Every other day we witness some innovative way to utilise social media for creat-
ing brands and communities. Patient support groups, infusion of medical updates, medical tourism, etc. are a few areas where social media will play a huge role. In the coming years," opines Shukla. Video sharing is the way to go forward. From important events to product show-
case business are exploring ways to engage customers with live videos. Besides, newer apps are taking the market by storm. For example, Snapchat was only seen as a way to share crazy selfies but brands are using it to get their message out. And WhatsApp has become more than message sharing app. It is the fastest way to get someones attention these days. “I believe at the end of the day, healthcare is all about clinical excellence, patient safety and providing a great patient experience. Social media is an adjunct to achieve these and we need to use it effectively to spread the message of good health,” draws Chidambaram. Virtual reality and augmented reality are just on the horizon. Much effectively used by Video Games but can also provide plenty of avenues for social media. Like following a
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cover ) surgery, a stent or a micro camera in real time. “This is the realm of prediction, but large aggregators like facebook and twitter will continue to be used but will become less useful because of the information overload
problem. They will probably splinter into several social media platforms focused on healthcare and nutrition. If you’re looking for a fantastic prediction – then algobots will start trawling through your posts and
feed this data to the Artificial intelligence over mind, which will predict your mental state and direct dronecopters to dispense 3D printed happy pills directly to your home,” imagines Shetty. The future implications of social
SOCIAL MEDIA Case study 1 (Courtesy LinkedIn)
Challenge GE Healthcare was launching a global campaign supporting GE’s Integrated Healthcare solutions and wanted to translate the campaign digitally into a LinkedIn-specific campaign. With a predefined campaign look / feel and existing video assets to be featured, Vertic – digital agency was tasked to develop a pilot programme to reach GE Healthcare’s target audiences leveraging LinkedIn’s targeting platform and campaign strategy. The goal of the campaign was to generate awareness of GE Healthcare’s Integrated Care Solutions and the offerings of GE Healthcare’s two business groups; Centricity Business (Financial Management) and Enterprise Imaging. Each business group had a specific target audience and associated offerings and value propositions, which is why a highly dynamic solution was necessary to fulfill GE Healthcare’s needs. Additional goals were to generate user engagement and consideration of GE Healthcare’s brand and products / services (i.e., interaction with content) and subsequently, conversions (contact submission, downloads).
Solution Vertic – digital agency, developed an end-to-end highly customised experience that featured dynamically relevant messaging, content and value propositions according to GE Healthcare’s segment groups. The campaign supported a customised messaging from pre-click (on LinkedIn prior to clicking through) to post-click (redirected from LinkedIn onto GE Healthcare’s campaign site). Users were targeted in granular detail to ensure qualified traffic according to their LinkedIn profile including industry, company size, role and seniority on LinkedIn and redirected to the campaign landing page. In doing so, users were only presented with tailored messaging and content relevant to their segment group and pain points, in order to ensure a consistent and highly customised experience. Vertic created and deployed LinkedIn Sponsored Updates that targeted each of the audience groups with customised messages and assets accordingly. Once the user clicked on the Sponsored Update, he/she was redirected to a dynamic landing page that would change content and messaging according to the user’s role as listed on their LinkedIn profile. For example, if a radiologist targeted with a LinkedIn Sponsored Update clicked through, the landing page would display correlating content, messaging and calls-to-actions relevant to the radiologist role to incite him/her to take the next step in their decision journey. Likewise, the content assets featured in the landing page featured hero area would dynamically change according to the correlating LinkedIn Sponsored Update that the user had previously clicked on, so that the user’s experience would be consistent and reinforce click through. Additional content was provided to invite users to further engage with GE Healthcare’s products and offerings; content was featured according to the role selected, which could then be downloaded, watched, or shared. To increase the likelihood of conversions, the contact button was prominently shown throughout the user’s experience as he/she scrolls through the site. When the user clicks on the contact form they would also have the option to auto-fill the form if signing in through LinkedIn. This auto-fill functionality supports the likelihood of conversion, as the user does not have the fill out the form manually but can complete contact submission within a single click.
Result The media campaign proved to be successful in engaging the small yet relevant target audiences, with click-through-rates of our CPC campaigns performing as high as 1.28 per cent. (compared to LinkedIn industry benchmark of 0.3 per cent). Delivering relevant content to each of the target audiences increased the overall engagement and click-through-rate, as users received content relevant to their functions and pain points. The site optimizations made mid-campaign increased conversion rates from .31 per cent to four per cent. A 1,166 per cent increase.
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media on healthcare are huge and social media cannot be ignored. “This space has already developed. If you are not in it yet, then you’ve already lost. Agencies/ brands that have already adopted this medium have loyal
followers and advocates who see them not just as medical organisations but as expert voices in healthcare industry,” signs off Cherian. Healthy Social Media-ing! mneelam.kachhap@expressindia.com
Social Media Case study 2 Challenge Philips used to have many different businesses and was known for its television business. Within 10 years, Philips made a complete change. Now it is focused around three main areas; Healthcare (35 per cent of sales), Lighting (28 per cent), and Consumer Lifestyle (37 per cent). Philips has 118.000 employees worldwide and spends 6% of its sales in R&D which represents $1.8 billion. They focus on B2C and B2B and one of their target on the B2B market are doctors and hospital staff. On the healthcare side, their main focus is doctors and medical staff where doctors need trustworthy information. They found out that doctors spend a lot of time on the Internet and especially they love being part of communities for sharing information/fears/discoveries. Philips wanted to build a sustainable community. They also researched and found five million medical professionals on LinkedIn. They wanted to stick to their mantra: Designed around you, simple. They wanted to strengthen their brand, create more promoters, focus on clinical staff, build relationships, facilitate dialogue, be trustworthy/credible.
Solution They based the whole strategy around three pillars: ◗ Philips Commercial website: It is “me and the company” where people ask questions about the Philips products and more technical questions. The commercial relationship between Philips and its customers. ◗ Get Inside Health: It is a stand-alone website which provides valued and trusted information to doctors and medical professionals (see picture). You can find information about oncology, radiology, cardiology (the latest data or research). ◗ LinkedIn groups: It is more about “me as a professional amongst my peers”. The group is there to facilitate discussions between peers about health issues and concerns. That is the overall strategy to maximise the healthcare professionals’ experience with Philips, whether they want to get information about their industry, Philips products or interact with other professionals. They stuck to the Philips mantra: Sense and Simplicity and they applied it to their community building strategy.
Results Their groups gather more than 11,000 members on LinkedIn, They are in the top five in Health. Lively discussions and professionals exchanging information. Traffic has been rising steadily on both sites, LinkedIn group and Get Inside Health. They went where their audience is, key element for any community building strategy. They really kept it simple with 3 pillars and a small number of groups on LinkedIn. They realised that moderation was key. They used trusted hosts and experts with their strategy to moderate and provide content, they really used influencers to drive memberships and credibility to their LinkedIn groups. They listened and adjusted the groups/content accordingly.
KNOWLEDGE
I N T E R V I E W
‘With CyberKnife m6, the treatment can be done in 40 minutes’ Artemis will become the first hospital in North India to install the latest and advanced CyberKnife m6 model, elucidates Dr Aditya Gupta, Director – Neurosurgery, Artemis Hospital, in an interaction with Prathiba Raju What is unique about CyberKnife m6, the latest generation of robotic radio surgery system? CyberKnife m6 is a revolutionary radio-surgical device that uses a combination of robotics and sophisticated image-guidance technology. The new model is safe, pain free and it is the most comfortable radio surgery treatment available. Unlike the earlier version having a stereotactic metallic frame, which is mounted on the patient face during the procedure, m6 version comes with a thermo plastic mesh mask where the patient can breathe and see through it. The mask is painful because the four pins of the frame goes into the skull of the patient. But the CyberKnife m6 series is more like a mobile radiation head which shoots individual beam of radiation. Even claustrophobic patients can be treated easily. With CyberKnife m6, the treatment can be done in 40 minutes. It is just like a CT and an MRI scan, but the same procedure takes 2.5 hours in gamma knife and modified linear accelerators. What are the clinical features that Cyberknife m6 Series offers? The common tumours which can be treated by CyberKnife is pituitary ademomas, acouste neuroma, meningioma, glomus tumour and other benign tumours. Apart from tumours, we can treat arteriovenous
malformation. These are clumps of blood vessels in brain which can be burned with the help of radiation and trigerminal neuralgia. The m6 version is highly precise and helps to treat patients who have larger or more irregular shape tumours and who are resistant to conventional radiation, as they can be given more focused radiation. It also helps in cases where surgically tumour is inaccessible. In many western countries, out of 100 cases, 40 cases are brain metastases and they get radiation for the deposits. However, in our country for every case, many undergo full brain radiation, which leads to side effects. It leads to memory loss, forgetfulness, behavioural changes and higher mental loss. India has around 1.8 million cancer patients. How useful will this new age system be to cater to a large number of patients? It will help to treat lung, prostrate and pancreatic cancer by offering an alternative to surgery. The reason being sometimes patients might have already undergone a surgery or radiation surgery so many don’t want it again. The m6 series helps to track only the deposits. So, this is a boon for them. Is the technology operational at Artemis hospital. Will it be the first hospital in the northern region to install this
CyberKnife m6 the new advanced model worth Rs 25 crores will be operational in Artemis Hospital by October. Patients who undergo the CyberKnife m6 procedure will not be charged high
equipment? What is the cost of the machine? Artemis in Gurgaon (Haryana) is the first hospital to install this new advanced technology in north India. It will be installed by October, while one more will be operational by next month (August), in a private hospital in Kochi (Kerala). A lot of awareness should be created on this advanced technology as it is more precise and advanced than a regular radio therapy machine. Other physicians across the northern part of India should understand the value of m6, as it is the most advanced and comfortable radio surgery available. The cost of the machine is about Rs 25 crores approximately $5 million. Patients who undergo CyberKnife m6 treatment from Artemis will not be highly charged, as it will be similar to the linear accelerator or a conventional radio surgery CyberKnife machine. Even though radiation therapy has become a
cornerstone in cancer care today, our country has 0.47 machines per million population. Why is there a shortfall of such machines. ? A country like Taiwan has six Cyberknife machines. However, India with a high burden of tumour cases, and with Cyberknife m6 going to get installed in Artemis, there will be a total of six Cyberknife machines in the country. So, there is a shortfall of such high cost machines. How will radio surgery evolve in the five years? In five years time, we will be detecting tumours early. Physicians will be more aware of these advanced treatments. With more health insurance penetration, such treatments will be available for larger section of people and is likely to be cheap. I hope universally the Positron Emission Tomography (PET) scan and metabolic information will be integrated in the planning part of the radio surgery procedure. prathiba.raju@expressindia.com
A model of CyberKnife m6 , which will be operational in Artemis Hospital by October
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IN IMAGING
WHAT YOUR
WOMEN PATIENTS WANT? 26
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A patient-driven priority list from radiologists and diagnostic imaging centres BY RAELENE KAMBLI
‘C
ONSUMER IS KING'! This old business mantra has time and again underlined the importance of a customer first approach for any business model to succeed. Even today within the healthcare sector, services are driven by patient demand. Be it care within hospitals or diagnostic centres, healthcare providers are becoming sensitive to the clinical and emotional needs for their patients. World over, healthcare providers are introducing various customised services that will lead to patient satisfaction and improved healthcare outcomes. Micah Solomon a Washington-based patient-centred care consultant and author, writes about how successful healthcare providers worldwide have made a science of customer service to drive patient satisfaction. In his article tilted '8 ways to improve patient satisfaction and patient experience' he explains this science and mentions how patient satisfaction and patient experience can be a successful strategy to run a healthcare business. This strategy has the potential to improve traditional healthcare delivery systems as well as empower patients, build trust in the long run as well as earn profits for the organisation. Interestingly, patientdriven services are a familiar territory for those in the business of women's imaging. This field of expertise has high traction in terms of volumes and value and form a larger segment of imaging businesses, contributing to maximum revenue. Therefore, providing special services to their women patients certainly is an important component. However, patient satisfaction and experience can be achieved only when healthcare providers comprehend with the needs of their patients. As experts say, the successful application of medical knowledge depends on what patients think and feel about
25 WOMEN SPEAK THEIR MIND
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Women opine that precision in diagnosis is a must
20 19
Feel hygiene factors cannot be compromised while seeking diagnostic services
22 Believe that advanced medical technology used at the radiology centres will help improving precision of diagnosis
Prefer to go to a radiologist who explains to them the process and results of the diagnostic test
The other priority is hospitality services as 16 say that their trust in an radiology centre is built when the staff is more hospitable, the services provided there give them more comfort
THE PARAMETERS P
recision in diagnosis: This is one of the major factors that determines patient satisfaction. Experts are of the opinion that when diagnostic centres provide accurate information, patients receive better medical care.It also reduces medical errors in turn improving patient outcomes. Health communications: we are currently living in an age where our healthcare system is constantly evolving. Patient today are loaded with a lot of information which also causes them to have several questions in their minds, especially women who seek diagnostic services for medical conditions such as cancers,pregnancy etc.Proper health communication can reduce fear and make these patients feel comfortable. Health communication includes having empathy and respect for the patient,a willingness to explain things in a way the patient can understand,and taking the time to listen.Putting these principles into practice can lead to increased patient satisfaction, improved outcomes,and better management of patient expectations. Hospitality services and comfort: In an ideal radiology department focussing on women patients,every employee should focus on creating successful outcomes and surpassing patient expectations.A courteous attendant and a helpful technician can make a woman patient feel at ease.Similarly,a radiologist who spends time speaking with patients and explains their study results will add value to this service. Cleanliness and hygiene: Hygiene is of paramount importance when it comes to women-related healthcare services.It is the first impression of any healthcare organisation and so becomes a vital component of creating patient experience. Technology used: This is built over a period of time and is the culmination of the above mentioned factors.
the medical personnel and the hospital/ diagnostic centre. How many radiologists, diagnostic centres and hospitals in India with a special focus on women truly know what their patients want? Express Healthcare in this article presents an opinion poll of what women patients want when they seek for diagnostic imaging services. Likewise, we also come up with a list of few strategies that have been adopted by leading radiologists, hospitals and diagnostic centres to provide best services and build trust among their women patients.
What women want? Women have unique healthcare needs or issues that require special focus. When women seek for radiology services their needs would differ depending upon the medical condition, mental condition and their preferences. For example, the diagnostic care requirements of a woman undergoing an ultrasound test during pregnancy would differ from a woman getting a HIFU ultrasound done to check for a fibroid. Similarly, requirements of a woman undergoing a mammography examination would differ from a woman getting a CT or MRI done. To understand these requirements, we approached 25 women in the age group of 20- 60 years from metro cities such as Mumbai, Bengaluru, Delhi and Kolkata (five to six women from each city) to understand their expectations from radiology service providers. These are women who have undergone ultrasound examinations, X-ray, mamography examinations, CT and MRI examinations on at leastthree to five occasions in their life time. We set few parameters for this opinion poll based on factors such information flow, transparency maintained, customisation services, patient engaging, hygiene etc., and asked women to rank them as per their priority.
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IN IMAGING
The poll As per the opinion poll, around 23 women opine that precision in diagnosis is a must and so, it becomes the most important criteria while choosing these services. Technology stands second in the priority list. 22 women said that they believe that advanced medical technology used at the radiology centres will help improving precision of diagnosis. Cleanliness and hygiene, is third on the list. 20 women said that that hygiene factors cannot be compromised while seeking diagnostic services. Next on the list is health communications received by radiologists. 19 women say that they prefer to go to a radiologist who explains to them the process and results of the diagnostic test. The other priority is hospitality services as 16 women said their trust in a radiology centre is built when the staff is more hospitable, the services provided there give them more comfort. We now have a general idea of what women patients from the metros require when it comes to diagnostic imaging services. Moving forward we then approached some leading radiologists and diagnostic centres in India, to understand whether the industry comprehend with the needs of their patients. Based on the their feedback we derived that the following strategies are being adopted to cater to their women patients. Sensitivity training programmes and patient counselling facilities: As the number of healthcare providers increase, patients have a wide range of choice available to them. This also means that there is an increasing competition for these service providers. Keeping this in mind, it’s important to not only maintain patient relation, but attract new ones. That’s where good patient service comes in. But part of the effort comes from identifying who, exactly, the customers are, as well as how best to service their needs. Acting upon this aspect, Bengaluru-based Cytecare Hospi-
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tal group, has introduced a sensitivity training programme for the employees. According to the spokesperson of the hospital, the group has designed all their hospitals to be patientcentric. For this reason, the Cytecare has evolved a sensitivity training for all our patient-facing staff to understand how to talk to patients and in particular, women patients. They also have in-house counsellors to provide emotional support to patients, as they undergo treatment. The spokesperson reveals that Cytecare has ensured that there is a woman nurse or technician in the room during examination (if by a male doctor). They encourage patient’s to voice their thoughts and concerns, and provide feedback on how to better the patient experience. Additionally, they follow standard safety procedures of ensuring that women are examined for pregnancies prior to undergoing any diagnostic imaging procedure that may involve radiation. Dr Anisha S Tandon,Consultant - Radiology & Imaging, DMRD, DNB, Paediatric Radiology Fellowship (USA), Department of Radiology & Imaging, Sakra World Hospital and Dr Amitha Vikrama KS, Consultant - Interventional Radiology & Imaging, MDRD, DNB (Radiology), Fellowship in Vascular & Interventional Radiology, Department of Radiology & Imaging, Sakra World Hospital also stress upon the importance of patient interaction at their hospital and how radiologists go that extra mile to do so. They reveal that once the trust factor is established, both the patient and the doctor find it easy to perform the particular imaging procedure in detail. They further convery that at Sakra Hospital, prior to the imaging procedure radiologists speak to their patients on the aim of the diagnostic test and prepare them for the same. On the same lines, Dr Vivek Chail from iCliniq also discloses that they have hired a patient counsellor who helps women patient with understanding the purpose of the diagnostic test and explains the
Specially designed services for women patients seeking diagnostic imaging drive innovative thinking and raise the bar of caregiving making healthcare not only a basis necessity but a value added service as well results as well. Chipping in, Dr Chandrakant M Shetty, Professor and Head, Dept of Radiology, KJ Somaiya Hospital also informs that the hospital has a dedicated patient counsellor to cater to women. Maintaining patient privacy: Dr Sunita Gopalan, Consultant Radiologist, Columbia Asia Hospitals says that one of the best ways to understand the needs of the patients is to talk to them. Another area is maintaining patient confidentialitywhich is also paramount in building the trust factor. Customer service unit: Privacy is certainly an important criteria to build patient trust. Likewise frequent patient interaction often builds a doctorpatient relationship. Dr Sudhir Kumar Kale, Lead Consultant Radiology, Aster CMI Hospital, explains how his hospital does it. He says that they collect feedback from each patient. The hospital's customer service co-ordinator and radiology manager interact with the patients for better under-
standing of their demands. They generally are more comfortable with female staff. The hospital has also created a women-friendly atmosphere within their radiology department. They have recruited dedicated women staff in front office, nursing and technical staff to enhance feel good experience. Most importantly, they interact with patients and guide them through imaging and procedures with care and attention. Also, We have plush waiting area, dedicated change rooms and rest rooms with female staff at all frontiers. Comprehensive service models: Dr Govind Rajan, HOD, Radiology Services, Apollo Hospitals (Bangalore), personally feels women are more aware of their requirements when it come to their diagnostic needs. They expect effective treatments for their problems and are more open to accept certain inherent limitations. Like all human beings, they would prefer organ processing treatments over radical treatment, which is again possible with accurate diagnosis and high-end technologies. They also expect a comprehensive service mode where almost all facilities come under one roof. Therefore, Apollo hospitals, Bangalore has a comprehensive radiology clinic that caters to all their patient needs. Power of feedback: Taking feedback from patient is extremely necessary for hospitals, diagnostic centres and for radiologists running private imaging services. This is the key to under the patients. Dr Sumer Sethi, MD, Sr Consultant Radiologist & CEO of TeleRad Providers informs that taking feedback and frequent online reviews from patients have helped his business to yield better returns.
Key observations This entire exercise has prompted me to consider the following trends: Patients are driving healthcare models: Patients are becoming more and more vocal
about their healthcare needs. With wider choice available, they have the privilege today to insist on the kind of services they prefer to have. From the 25 women we spoke to, it was extremely clear that these women are certain about their diagnostic needs and expectations from their healthcare providers. Surprisingly, they also speak of medical technology that can be used to make diagnostics imaging more accurate and prefer to visit a radiologists who use these technologies to conduct medical examinations. Off course, we have to take into account that these are learned women from leading metros of India. However, this was not the scenario 10-15 years ago. People were aware of good doctors, hospitals or diagnostic centres that provided better healthcare facilities but seldom spoke of medical technology. This indeed is a noteworthy change of mindset. it also reflects upon the growing awareness among patients about available medical technologies. Therefore, it can be positively said that healthcare in India is already in the era where patients are the key driver for healthcare business models. The healthcare industry is moving towards providing value-based care: As mentioned above that healthcare business models are being designed keeping in mind target patient. Healthcare providers are now zeroing on individual needs of their patients, whether preventive, chronic or acute. Hospitals and diagnostic centres are constituting patient care teams within their organisations that coordinates patient care, with help of technology that connects them with patients help them get the right care. Special services for women patients seeking diagnostic imaging is just one example of the same. What's impressive about these services are that they drive innovative thinking and raise the bar of caregiving making healthcare not only a basis necessity but a value added service as well. raelene.kambli@expressindia.com
IN IMAGING NEWS
Radiologists face no elevated risk of radiation-related mortality Studies of mortality among radiologists are important for evaluating radiation protection measures and understanding the long-term effects of protracted exposure to low level radiation RADIOLOGISTS WHO graduated from medical school after 1940 do not face an increased risk of dying from radiation-related causes like cancer, according to a new study appearing online in the journal Radiology. Researchers said the findings point to the success of efforts to reduce occupational radiation doses over the past several decades. Studies of mortality among radiologists are important for evaluating radiation protection measures and understanding the long-term effects of protracted exposure to low level radiation. Previous US studies have been limited by smaller data sets and reflect only earlier time periods. In the US, the last follow-up of radiologists ended in 1975, leaving a large gap in under-
standing the risks today. Study leader Amy Berrington de González, Chief of the Radiation Epidemiology Branch, National Cancer Institute (NCI), in Bethesda, and her colleagues based the new study on records from the American Medical Association (AMA) Physician Masterfile, a database established in 1906 that has grown to include current and historical data for more than 1.4 million physicians, residents and medical students in the US. They compared cancer incidence and mortality rates between 43,763 radiologists and 64,990 psychiatrists who graduated from medical school between 1916 and 2006. Psychiatrists were chosen as a comparison group because they are unlikely to have had
occupational radiation exposure. “There’s been a big change in practice over the past few decades, with more doctors performing fluoroscopicallyguided procedures, making it more and more difficult to find a physician comparison group that did not have exposure to radiation,” noted Martha Linet, study coauthor and sen-
ior investigator at the NCI Radiation Epidemiology Branch. Overall, male radiologists who graduated after 1940 had a better health profile than that of their psychiatrist colleagues. The death rate for radiologists from all causes was lower and there was no evidence of increased mortality from radiation-related caus-
es such as cancer or cardiovascular disease. In contrast, radiologists who graduated before 1940 faced increased death rates from certain conditions, including acute myeloid leukemia and myelodysplastic syndrome, which are known to be related to occupational radiation exposure. In these earliest workers, there were also increased death rates from melanoma and nonHodgkin’s lymphoma. The older radiologists also had a higher risk of cerebrovascular disease. Research in the last few years has found evidence that low to moderate doses of radiation may be associated with circulatory diseases and stroke. EH News Bureau
Scientists develop new imaging tool to scan brain for common disorders It may provide insights into the diagnosis and treatment of diseases such as epilepsy and Alzheimer’s SCIENTISTS HAVE developed a new approach to scan the brain for changes linked to common disorders, an advance that may provide insights into the diagnosis and treatment of diseases such as epilepsy and Alzheimer’s. Certain changes in synapses, the junctions between nerve cells in the brain, have been
linked with brain disorders. However, researchers have only been able to evaluate synaptic changes during autopsies. For their study, the research team set out to develop a method for measuring the number of synapses, or synaptic density, in the living brain. Richard Carson, a professor at Yale University and colleagues
combined positron emission tomography (PET) scanning technology with biochemistry. They developed a radioactive tracer that, when injected into the body, binds with a key protein that is present in all synapses across the brain. They observed the tracer through PET imaging and then applied mathematical tools to
quantify synaptic density. The researchers used the imaging technique in both baboons and humans. They confirmed that the new method served as a marker for synaptic density. It also showed synaptic loss in three patients with epilepsy compared to healthy individuals. PTI
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Revolution in digital healthcare Brinda Sampat, Assistant Professor, NMIMS Global Access – School for Continuing Education, NMIMS University, Mumbai and Dr Ashu Sharma, Associate Professor, School of Business Management, Narsee Monjee Institute of Management Studies, Mumbai, give an insight about IoT, which has gained popularity in healthcare because of the increasing ageing population and rising costs of healthcare services
H
ave you envisaged treating a patient for a particular ailment without he or she being physically present? Ever wondered what it would be like to drop a reminder to your patients who has forgetten to take his/her medicine doze on time? Would it not be great, if you could use your phone to access patients’ medical history or monitor their vital stats and share the same data with your colleagues to take expert opinion? The fusion of technology and healthcare have made companies produce many innovative devices which can help achieve these results. Healthcare solutions can now be offered to patients sitting in their living rooms. Telemedicine, a practice of connecting doctors and patients remotely across different regions, is practiced in many parts of the world today to provide healthcare at affordable rates to underserved and secluded communities in a timely manner. This enables medical professionals to interact with patients eliminating the barriers of boundary and time. Advancements in technology have radically refined diagnostics, monitoring and tracking of patients. Intelligently interconnected devices have altered the way in which data is being generated and consumed. Real-time diagnosis is now possible with the proliferation of bio-sensors which are connected to smart-phones that relay data continuously.
IoT: The Technology Enabler The Internet of Things (abbre-
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BRINDA SAMPAT, Assistant Professor, NMIMS Global Access – School for Continuing Education, NMIMS University, Mumbai
DR ASHU SHARMA, Associate Professor, School of Business Management, Narsee Monjee Institute of Management Studies, Mumbai
the analysis of the data generated by them will facilitate major advances in medical science research. Results thus generated can help improve research outcomes to combat various diseases in the future. Companies such as IBM, Cisco, Microsoft, Google, Amazon, and GE, etc. have invested heavily in IoT.
viated as IoT by many companies), Internet of Everything (Cisco), Industrial Internet (GE) consists of a series of intelligently connected devices which are capable of collecting and monitoring unprecedented level of real time, life critical data. Put it simply, these are nothing but smart sensors. These sensors can be controlled remotely across existing network infrastructures and can share the data with each other and over the cloud. This enables quick data collection, storage and analysis and at the same time automatically triggers certain events in order to take timely, accurate decisions. IoT has gained popularity in healthcare because of the increasing ageing popula-
tion and the rising costs of healthcare. IoT creates opportunities for more direct integration between the physical world and computer-based systems. ‘Things’ that are not computers will be enabled with the power to collect and process data acting as computers. Medical IoT or Internet of Things for Medical Devices (IoT-MD) is patient centric and concentrates on prevention, diagnosis, treatment and wellness. This eco-system has paved a new way of communication between people, devices and apps that interact with each other. With the help of mobile networks these ‘remote things’ such as a person with a heart monitor transplant, electrocardiograms, temperature
monitors or blood glucose levels, empower a series of life changing services. By 2020, there will be a $117 billion market for IoT in healthcare. IoT opens the doors for doctors and patients to share patient data, lab results seamlessly in real time. In 2020, 25 billion connected ‘Things’ will be in use. With more and more devices being connected each day, large databases would be needed to find correlations between the data generated. Technologies such as Cloud and Big Data enable storing the vast amount of data that is generated and analytics aid in uncovering various trends that emanate from this data. The collaboration between the devices enabled with sensors and
Smart devices: Enabling connected healthcare Smart devices play an important role to help achieve this thereby reducing the need for direct patient-physician interaction. While technology continues to develop in this field, there are three key areas of healthcare in which IoT technology has made the greatest impact so far namely, remote monitoring, wearable technology and information exchange. For e g. heart monitoring devices have now made it possible to detect abnormalities and ensure that patients reach the hospital well in time. Sensing devices are able to determine the respiratory rates in children and aid in diagnosing pneumonia. Wearable devices monitor different health markers such as heart rhythms, breathing patterns, temperature, blood pressure, footsteps, physical position and balance, to name just a few. Data generated by these wearable devices will give insurance companies, pharmaceutical companies and the likes the opportunity
IT@HEALTHCARE to capitalise on the data and render services to patients most appropriate for them. Apple watches and Fitbit wrist bands to home glucometers and blood pressure cuffs give consumers instant access to personal measures of well-being. Wearable devices will become a $6 billion market by 2016, with 171 million devices sold, up from $2 billion in 2011 and just 14 million devices sold.
Smart beds prevent bed sores and free nurses from turning and moving patients from side to side every few hours. In an IoT-enabled world, nurses will be able to spend more time taking care of patients. The BAM Labs Smart Bed Technology solution helps to achieve these functionalities. A ReST Bed collects and reports ones sleep behaviour and automatically adjusts itself to help one sleep better.
$117BILLION will be the market for IoT in healthcare by 2020
Smart pills These are ingestible medical devices consisting of sensors, cameras, patches and trackers that help to measure various physiological measures such as weight, sleep patterns, temperature, pH levels etc. They can also be used to monitor the patient’s adherence to medication. They enable doctors to remotely observe a patient’s internal conditions and diagnose problems without exploratory surgery. These pills will soon replace conventional diagnostic techniques of colonoscopy and endoscopy. Home medical dispensers will automatically upload data on to the cloud indicating when the medication is taken and when it is not or for any conditions that needs immediate attention. Proteus Digital Health has made substantial contribution in this area by developing a system consisting of a smartphone, a sensor patch and a pill. These pills consist of sensors which get activated by the electrolytes in body when they are consumed. The pill then sends a signal to a battery-powered patch worn by the user and also informs the caregiver about the same on his smartphone. The global smart pills market is expected to reach $965 million by the year 2017.
Smart beds Smart beds are able to monitor patients’ vital signs and mobility without using electrodes. They can interface with information systems to transfer information collected and alert healthcare providers when a patient is getting out of bed unattended. It can also adjust itself to ensure appropriate pressure and support is applied to the patient without manual interaction of nurses.
Smart lens Patients suffering from diabetes need to prick themselves many times a day in order to measure their body’s production of glucose. Continuous monitoring of the blood glucose level is difficult and incorrect monitoring could lead to serious repercussions. Smart lens is a non-invasive means of continuously monitoring the blood glucose levels by analysing the tears. They can be used for other ophthalmic ailments such as vision correction, which have been difficult to cure via traditional methods. Smart lens can be used to capture images with the help of micro camera embedded in them, process data related to them and take appropriate actions.
Smart hospitals Smart hospitals in the near future will provide various smart devices to communicate with each other enhancing patient’s experience. The smart rooms will be mounted with devices, which will not only provide entertainment but will also enable doctors, nurses to provide instant help or interact with the patient at regular intervals. On the other hand, video conferencing technology can be used to educate medical interns while the doctor performs his rounds to see a patient and the same can be streamed live in a classroom fostering experiential learning. Smart hospitals will be an amalgamation of kiosks to register the non-resident patients who have come for consultation, location tracking devices to track the in-ward patient’s movement through the healthcare facility, a mobile app which not only makes it easy to register a patient at the hospi-
25 BILLION
$6 BILLION
connected ‘Things’will be in use by 2020
tal eliminating the wait in long lines and the manual registration process, GPS-enabled app that provides directions to a particular department in the hospital optimising navigation. This app also makes room for consultation with specialists; helps schedule future appointments, make payments and view reports. Hospitals will use the IoT to identify inventory levels that are running low and machines will play a vital role in replenishing the same. Hospitals will use IoT to keep a tab on the location of medical devices, personnel and patients. IoT can be used to collect and share patients’ biometric data and monitor them after they’ve been discharged from a hospital. Internet-connected devices have been introduced to patients in various forms. The plethora of medical devices that relay information about a patient’s condition such as heart monitors, IVs, respirators and blood pumps will now
is the wearable devices market in 2016
automatically transmit patient data to Electronic Health Records (EHR) increasing accuracy. All the scattered data will now be automatically available at one location.
Challenges of connected health While IoT brings a plethora of opportunities, it brings with it new challenges. Managing different devices and their interoperability, integrating data from different sources, processing volumes of data in realtime accurately and the need for medical expertise are some of the challenges to address. Some of the other restraints of IoT implementation are technology adoption by hospitals and the elderly people. Most of the IoT implementations take place on the cloud and thus are vulnerable to attacks by hackers. A major question that IoT must address in future is to ensure how to secure patient sensitive data and prevent it from being used against the individ-
$ 965 MILLION will be the market for the global smart pills which is expected to reach by the year 2017
ual. According to Gartner, the worldwide spending on Internet of Things (IoT) security will reach $348 million in 2016, a 23.7 per cent increase from 2015 spending of $281.5 million. The government must make sure that there are systems and standards in place to enable IoT deployment to maintain a balance between the boons and the banes. Keeping in mind the complexity of the implementation of these technologies, leading IoT solution providers encompass various monetisation strategies from one-time payment to subscription-based services. With the patient data available on the cloud, doctors will be able to respond more efficiently in case of emergencies. Just as each coin has two sides on one hand privacy and security are the main concerns for IoT implementations, while on the other IoT will integrate the healthcare ecosystem thus providing improved health outcomes.
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‘Cost management is like the spine of the healthcare industry’ BLK Super Speciality Hospital recently bagged an Excellence Award from the Institute of Cost Accountants of India for its unique costing and business analysis systems. Latesh Sen, GM, Costing and Business Analysis, Radiant Life Care, which redeveloped BLK Super Speciality Hospital at a cost of Rs 3500 million explains to Viveka Roychowdhury why cost management is the spine of the healthcare industry
What are the peculiar features of hospitals that make it challenging when it comes to conducting a costing and business analysis, vis-a-vis establishments in other sectors? Out of 18 years of my career, I have spent ten years in the hospital industry. In my view, the hospital industry is still far behind in establishing costs of resources utilised as against many other industries. The reason may be vast number of services, complexity involved and various permutations and combinations of such services provided to a patient. Way back in 1998, Donald Shepard in a book titled, Analysis of Hospital Costs: A Manual for Managers, had written, “A hospital cannot set rates and charges which are realistically related to costs unless the cost-finding system accurately allocates both direct and indirect costs to the appropriate cost centers.” Incidentally, while the statement has been relevant all these 18 years, the concept of cost management has come into focus only recently for hospital managements in India. At BLK Super Speciality Hospital, we have been among the first few in the country to have done so, and a recent award by The Institute of Cost Accountants
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of India only affirms our conviction. Hospitals have large number of specialities and each speciality has many services. Each patient (even for the same procedure) goes through different processes of the treatment cycle wherein the cost of resources and material may vary. Let us take an example of angioplasty: Two patients going for angioplasty with different clinical complications will have different treatment/recovery plan. Healthcare, being a service industry, is manpower intensive. The spectrum of manpower is very large from highly skilled doctors to helpers. Costs involved in each segment is high and requires very efficient and effective cost management. The Ministry of Health & Family Welfare has recently approached the Institute of Cost Accountants of India (ICAI) to establish costing methods of various procedures and surgeries to make it more viable for hospitals as well ensure affordable healthcare services to people. How will this change the dynamics of healthcare delivery in India? And how should healthcare facilities prepare for this era?
For patients, accurate costing of procedures and services will lead to competitive pricing, which will make high-end and quality healthcare services affordable to large sections of the masses In 2014, maintaining and submission of the cost records by hospitals became mandatory under the Companies Act, but the effectiveness and scientific methods to capture the various cost elements was not achieved. Later in May 2015, in a meeting with Dr B
D Athani, Special DGHS, it was decided to explore the possibilities of the institute to extend its expertise in fixing the range of costing rates for some key medical procedures decided by DGHS. At the same time, ICAI tied up with two medical
groups - Association of Healthcare Providers (India) and Delhi Medical Association. Under the arrangement, ICAI would provide expert advice to hospitals for having a system to manage and control costs in a more efficient manner. Effective procedure costing and cost management can play very large roles in changing the dynamics of the healthcare industry. Efficient cost management is beneficial for both – the service provider as well as those who avail of the services. For patients, accurate costing of procedures and services will lead to competitive pricing, which will make high-end and quality healthcare services affordable to large sections of the masses. This is more relevant in India due to low penetration of medical insurance. For corporate hospitals, high capital investment and continuous upgradation of technology along with expensive resources makes the pricing of treatment in private sector unaffordable for the masses. For hospitals to provide affordable services while maintaining the quality and financial viability, effective cost management and optimum utilisation of resources are Continued on page 34
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I N T E R V I E W
‘The way forward is to change our mindset and bring about disruptive innovations’ Staying focussed on your passion and constantly striving for excellence will certainly reap good fruit. This is exactly the case of StemRx Bioscience Solutions, a biotech start-up registered under the Start-up India scheme. Dr Pradeep V Mahajan, CMD, StemRx, talks about this success and vision for this venture with Raelene Kambli
Congratulations, Dr Mahajan on winning the National Award in Healthcare Excellence in Clinical Research. Tell us about the research for which you were nominated. A vast majority of patients today suffer from untreatable conditions such as multiple sclerosis, cancer, cardiac abnormalities, neurodegeneration etc., for which current advanced technologies do not have an answer. The way forward is to change our mindset and bring about disruptive innovations which rise above the current needs. Few among such innovations are regenerative medicine, cell-based therapy, genetics, nanotechnology etc. StemRx was nominated and won in the clinical research category for regenerative medicine and cell-based therapy. What according to you is of paramount importance in achieving excellence in clinical research? I usually say, ‘You carry your own repairing kits in your body.’ By utilising the existing healing power of our body, that is, by use of body’s own cells, fluids etc., we can now treat conditions that were previously thought to be untreatable even with the most expensive conventional treatment modalities. The challenge, however, lies in simplifying research in these
technologies so as to reach the population as a whole and not just the crème de la crème. Cost effectiveness and mass appeal in new technologies is the excellence I am looking for. Dr Mahajan you are an expert in cellular therapy. Can you elaborate on the advantages of this therapy in regenerative medicine. Also, in which sphere of medical treatment can this therapy be explored further? In addition to being a researcher, I am in the field of clinical medicine and surgery for about three decades now. Current dogma of treatment is using pills/medicines predominantly for management of symptoms and surgical management in advanced cases (when possible). Autologous cellular therapy and regenerative medicine focuses on eliminating the root cause of the problem by use of cells (cytokines, chemokines etc.), growth factors from one’s own body. We can further explore the prospects of this form of therapy in management of organ failure, to overcome rejection following organ transplants, developmental defects, cancer immunotherapy etc. At present, we are just at the tip of the iceberg. As I firmly believe, there will be a day when treatments will
will drastically benefit our patients and country and will also propagate India towards becoming the leader in cellular therapy and regenerative medicine.
StemRx further aims to be a major contributor of regenerative medicine, cell, molecular and scaffold based technology in India consists of cells and not pills! Currently in India what opportunities do you see for this discipline? India is a nation with increasing population demands. Being a developing economy, the application and opportunity of cellular therapy and regenerative medicine is different when
compared to other countries. A number game exists between diseases and finances in our country. What we aim, with this technology, is for a diseased person to use his own body cells and fluids for treatment thereby addressing the issue of extreme financial burden as seen with conventional treatment modalities. This
How is StemRx establishing its footprint in India? StemRx further aims to be a major contributor of regenerative medicine, cell, molecular and scaffold-based technology in India. A multidirectional approach is employed at StemRx consisting of education, research and therapeutics. StemRx has academic affiliation/collaborations for various training, degree, PhD and fellowship programmes with ITM, Maharashtra University of Health Sciences (MUHS) and Ohio State University (USA). On the research front, StemRx is on its way to introduce products with cell and scaffold-based technology through tissue engineering. Additionally, research is ongoing in the field of molecular therapy, target-based immunotherapy and cancer treatment. As an Indian company, we have an Intellectual Property Right to acquire patents related to cell-based therapy in accordance with Indian/International laws. StemRx has published numerous research papers and has filed patents for conditions such as avascular
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necrosis, ankylosing spondylitis etc. Therapeutic application of cellular therapy is our strength and we perform autologous stem cell therapy with minimal/no manipulation for more than 75 conditions which were previously thought to be untreatable. As on date, StemRx is registered under Start-up India scheme of the Government of India. Who is your biggest competitor in this segment? How do you differentiate yourself from your competitors? Major pharmaceutical companies are beginning to understand the power of cellbased technology and regenerative medicine and are entering this field. As with any segment, there will
always be competition and our aim is to rise higher than the others through continuous research and dedication. StemRx has a dedicated clinical and research team along with world class infrastructure since the last seven to eight years. What would be your success mantra? Be focused and work towards excelling in your goal. Compete with yourself and not others.
The need of the hour is newer treatment modalities.With a curious mind and in-depth research in cell-based therapy and regenerative medicine, I decided to change from being a general surgeon and academician to a stem cell therapist
Tell us about your one business decision that changed your life? As mentioned earlier, the need of the hour is newer treatment modalities. With a curious mind and in-depth research in cell-based therapy and regenerative
medicine, I decided to change from being a general surgeon and academician to a stem cell therapist. This was a game changer in my career and StemRx was started. With this change, however, I have found my passion and am working towards
achieving higher standards in healthcare with renewed vigour. Share your learning lessons? It is not easy to adapt to a new philosophy after having followed certain set of
principles and methods for a long period of time. The important aspect to understand here is that, change is the only constant and in order to achieve anything meaningful, one has to be flexible and open to learning at all times. Moving forward, what would be your vision for the future? Looking back at the 19th and 20th century, innovations and cutting-edge technologies have been developed in neither space nor computer sciences, but in the field of genetics, cell-based medicine and nanotechnology. These innovations are a gift to mankind and my vision for the future is excellence in regenerative medicine. raelene.kambli@expressindia.com
Continued from page 32
Cost management... certainly essential. Only then can they take the services to a larger section of society, thereby increasing volumes and further save on costs. Government/NGO-run medical facilities have limited resources in terms of availability of funds and have to prioritise the same for different essential programmes. Optimum use of resources can be achieved with efficient cost management. It can help to take quality healthcare to the masses and in areas where private facilities are not available. On the whole, efficient cost management and business analysis can change the scope and dynamics of the healthcare industry for all the stakeholders. The new era of the industry will be data driven, and cost management will work like the spine to the industry.
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From a cost analysis and business analysis point of view, what are some of the essential tools that need to be deployed to ensure that optimum performance is achieved in hospitals? Essential tools for effective cost analysis include timebased and activity-based costing. They mean to capture the cost of each and every effort and process as well as provide the impact of underutilised resources. Kaizen costing i.e. cost control efforts without compromising on the quality of healthcare delivery will lead to providing quality healthcare services to the society at affordable prices. Another tool is standard costing, which is the standardisation of consumption and time in various services and activities. Variance analysis also helps in optimum
utilisation of resources and in enabling control over the cost of the procedures. Various approaches of management accounting include tools of management accounting such as capital budgeting, Net Present Value (NPV) and Internal Rate of Return (IRR) analysis, zero base budgeting, etc. They provide insights for strategy planning. For instance, at BLK Super Speciality Hospital, we provide the costing of each and every service, procedures and packages with respect to various combination of services. This offers insights to the management for decision making. How can data analytics be leveraged to help in the cost and business model revamp of healthcare facilities? Earlier, bed occupancy was
the yardstick to measure the performance of a hospital but with the advancements in medical technology, the average length of stay (ALOS) is reducing and hence, bed occupancy is not the main measure of performance. Increased utilisation of costly resources, for e.g. equipment in operating theatres, ICUs, cath-lab, radiology, pathology lab, manpower planning, deployment of nurses etc, are the key to success in hospitals. The data analytics help to measure the performance of various resources. This, in turn, enables the management to take corrective actions at the right time. Trend analysis and quantifying efforts can change the perspective of any decision. Adequate and accurate knowledge on breakeven of
any investment or any additional resource deployed; in various specialities will help achieve the desired profitability. How should hospitals respond as patients become more price sensitive, particularly in India, where most of the healthcare costs are out-ofpocket and insurance penetration is still poor? Hospitals should effectively allocate their resources. The outcomes and various parameters must be analysed in real time to take corrective measures. The pricing of services must be done on the basis of costing. Only then can the hospital provide the most competitive price to the patient as well as maintain its financial sustainability. viveka.r@expressindia.com
TRADE & TRENDS
EOLIS Air Manager: First CE marked intelligent air filtration system The lifespan of the product is expected to be eight years, due to the robustness of the motor and filters EOLIS, PEGGED as the first intelligent air purifier system to be launched in India, is designed and manufactured by Natéosanté. The product is currently made in France but there are plans to manufacture it in Bengaluru later this year at the EOLANE industrial plant. EOLIS is a CE marked high technology product and is intended for professionals in healthcare sector. Salient features of the product include medical grade filters (HEPA 13 or ULPA 15). Each filter in each machine has received a certification by French and European Health regulations (European Norm EN 1822-4). The high density active carbon filter at 22 mm is reportedly thicker than in any other air purifier device and the product has three types of filtrations: particles, gases, odour. The lifespan of the product is also expected to be eight years, due to
the robustness of the motor and filters, which is substantially longer that the two-three years for another types of air purifiers. But of particular interest to hospital/medical facilities is the monitoring system of the EOLIS air purifier. As each facility is expected to have a high number of devices installed in a same building, in each room of an hospital for instance, the monitoring system allows the quality of the air to be monitored by a remote control, through a PC or a smartphone, from a unique place thus ensuring the same quality of air in all the rooms. The device are also autonomous and can be programmed in advance to ensure the same effect. EOLIS air manager has been conceived from the initial idea to provide an air filtration system combining high performances and simplicity of use. Tailored for professionals in home appli-
ances, hospitality and heath/ medical sectors, EOLIS will incorporate a filter system consisting of a medical grade filter HEPA H13 or ULPA U15 and a high density active carbon filter able to treat an area of either 60 or 120m2 (two versions will be proposed). Nateosanté air filtration systems are equipped with the most efficient filters on the market. In order to ensure 99.9 per cent purification, the units are silent, reliable, easy to use, adapted to user needs and energy efficient. Natéosanté is very successful in Asia, with several trusted references (Renault, PSA, Mutualité Française, Miele
to name a few). The Indian market is extremely promising as declared by Stéphane Monnier, International Business Development Manager, EOLIS, “India is a strategic market for our company and we want to provide Indian professionals with the best equipment to treat air pollution. Some of the cities in India like New Delhi are facing huge challenges due to very heavy levels of concentration of fine and ultrafine particles in the air, and NateoSante wants to work with Indian professionals with products like EOLIS that have a proven track record for improving quality of air and quality of life.” EOLIS is more an air manager than an air purifier. Thanks to the ACTIV mode, EOLIS is a smart unit automatically adapted to your environment. It includes a monitoring system easy to use thanks to a three user
control interface: touch screen panel, computer or smartphone. Because each product is unique and has a specific ID number, the operators can see how it works and when it needs maintenance and filters to be replaced. EOLIS Air Manager is available in two versions depending on the area surface to be treated (60 or 120m2), it is the first intelligent air filtration system to be marked with CE certifications. Contact Thomas ILHE Trade Officer Marketing and Communication Business France India – The French Trade Commission – New Delhi Embassy of France in India Tel : + 91 11 43 19 63 03 Mob: +91 83 76 89 50 05 E-mail : thomas.ilhe@ businessfrance.fr* www.businessfrance.fr
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TRADE & TRENDS
Rober to launch full range of pioneering pressure mattress solutions in India The company in the last few years has invested heavily in R&D to develop a complete range of pressure ulcer mattresses UK-BASED ROBER will launch an innovative range of pressure mattresses in India that will cater for immobile, critically ill and bariatric patients. Over the last few years, Rober has invested heavily in R&D to develop a complete range of pressure ulcer mattresses that can be used in everyday nursing environments, as well as acute care facilities. The innovative range of mattresses and overlays have been developed in conjunction with clinicians, and includes solutions and features clinically proven technology that prevents pressure injuries from developing. The technology also has therapeutic properties that promote the healing of established ulcers. The new generation of mat-
tresses are fully automatic, and patients nursed upon them require less frequent manual repositioning, thus relieving the pressure on busy nursing staff. Designed to mechanically replicate the body’s natural spontaneous movement in response to unrelieved pressure, the mattresses provide regular and complete pressure elimination to all parts of the body
in contact with the mattress. The company has focused on four key areas - microclimate control, patient safety and comfort, maximising infection control and offering additional nursing support. Additional features such as a touch screen visual display panel, comfort settings, timed static mode, audible and visual alarms, permanently inflated side formers, maximum infla-
tion mode, and simplicity of decontamination for effective infection control provide benefits to both patients and busy nursing staff. Included within the new product ranges are two different mattress types - the premium NoDec range and a secondary ‘cost effective’ range of mattress solutions, AirFlex, which have been designed to fulfill the requirements of ‘af-
fordable healthcare’. Mike Hutson, Chief Executive, Rober, said, “We have been working closely with our partners in India and we are delighted to be able to launch our new range of mattresses here. All of our technologies have been designed to offer maximum flexibility to patients who are at risk of pressure damage. They are effective and proven solutions in the prevention and treatment of pressure ulcers and we are looking forward to ‘stopping the pressure’ across India.” Contact Rober Wheatbridge Road, Chesterfield S402AB Tel: +44 1246 245 404 email: info@roberlimited.com
‘We are able to maintain an optimum stock of films in tune with our consumption’ Dr Kuldeep Kumar Chalasani, MD, Pramodini Imaging and Diagnostics, Vijaywada, in an interaction with Express Healthcare talks about the benefits of Carestream’s MPS When did you install MPS at your organisation? We adopted Carestream’s Managed Print Solutions (MPS) in October 2015, about six months back. What prompted you to go for MPS? The mechanism for ordering films has become much easier. Earlier, we had to mandatorily order a fresh supply every month with most film companies. Now, we need not
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place an order for films every month. Besides, the Carestream printer that goes with the system is very compact, about half the size of the earlier printers. Also, the response from the service team is very swift. How is your experience with MPS? Now all that headache and uncertainty is gone, we are able to maintain an optimum stock of films in tune with our
consumption and do not have to worry about a stock-out. Since the MPS is a web-based system, it keeps track of the consumption levels on a daily basis, and when the stock reaches below a predetermined trigger, an order is automatically placed with Carestream. I then receive an email notification as to when the new stock would reach my institution. The billing and payments are also automatic and a huge administrative
responsibility is taken off our hands. How has the new system helped your organisation? The ordering, billing and payment are all automatic. It saves time for the management, enables us to avoid allocating one extra person for this work. Besides, we are now dealing directly with the company and therefore we can plan our operations better.
TRADE & TRENDS
Hindustan Syringes & Medical Devices receives ICMED scheme ICMED, which was launched recently, is the country’s first indigenous quality assurance system for medical devices HINDUSTAN SYRINGES & Medical Devices (HMD), makers of DISPOVAN, has received the Indian Certification of Medical Devices (ICMED) Scheme. ICMED is the country’s first indigenous quality assurance system for medical devices, which was launched recently. ICMED is a joint initiative of Association of Indian Medical Device Industry (AIMED) and Quality Council of India (QCI) and the National Accreditation Board for Certification Bodies (NABCB). ICMED is aimed to enhance patient safety, to provide consumer protection along with much needed product credentials to manufacturers for instilling confidence among buyers and users. The scheme is intended to significantly eliminate trading of substandard products or devices of doubtful origins, a widespread and injurious phenomenon in the Indian market. For manufacturers, it aims to bring down the substantial time and cost-run to obtain globally accepted quality certification for Indian companies and eliminate the malpractices of sub-standard or fraudulent certification or quality audits, thereby ensuring substantial savings, enhanced credibility and increased competitiveness. As currently, there is no India-specific official quality assurance system, due to which Indian medical device manufacturer’s encountered loss of competitiveness to foreign companies while consumers ended up paying extra premium with no concomitant benefits, ICMED also fills a big regulatory void. “The scheme fills a big reg-
(L-R) Sandeep Vig, Regional Director, Intertek and Rajiv Nath, Jt Managing Director, Hindustan Syringes & Medical Devices
ulatory vacuum in quality certification space for medical devices in the country and will enhance the competitiveness and profitability of Indian medical device industry, said Anil Jauhri, CEO, National Accreditation Board for Certification Bodies. The ICMED Certification Scheme is a significant milestone for both consumers as well as manufacturers as it brings quality, accountability and competitiveness in the system,” said Rajiv Nath, Joint Managing Director, HMD. He said, “In due course it will also bring respect to Brand India for those carrying this certificate.”
Currently, the certification scheme has two options for certification, one being ‘ICMED 9000 Certification (an ISO 9001 plus additional requirements)’ for low risk medical devices and other being ‘ICMED 13485 (An ISO 13485 Plus additional requirements) for medium and higher risk devices. A third level, which would additionally prescribe medical device specifications developed by NHSRC of the Ministry of Health and Family Welfare is still under development and will be launched later this year. According to Dr MK Bhan,
Former Secretary, Government of India, Department of Biotechnology, Ministry of Science and Technology, “For a country like India, the twin challenge is to ensure availability of quality healthcare products at reasonable cost so that the overall healthcare cost remains reasonable. In this direction, the launch of ICMED is a significant collaborative initiative and will go a long way to ensure realisation of these objectives.” “QCI is happy to lend a helping hand to the medical devices industry in India to showcase its strength in terms of meeting the highest international stan-
dards. We have already devised such schemes for ayurvedic products, ready mix concrete plants and yoga professionals and this would be a valuable addition to our portfolio. It would go a long way in contributing to the success of the government's flagship Make in India programme,” said Adil Zainulbhai, Chairman, QCI. It may be added that NABCB has already secured international equivalence for most of its accreditation programmes and it would facilitate international acceptance of Indian medical devices. “NABCB is accrediting certification and inspection bodies and its accreditation programmes are internationally equivalent placing it on par with European and American accreditation bodies. This equivalence would help facilitate acceptance of ICMED certification in overseas market and respect for Indian manufacturers,” pointed out Jauhri. “The manufacturers would need to approach any one of the certification bodies approved by QCI under the Scheme for obtaining certification. The certification bodies shall be under the oversight of NABCB, which as the national accreditation body, would accredit these certifying bodies as per applicable international standards. The certification scheme is open to both indigenous and foreign manufacturers though Indian manufacturers would be expected to queue up initially. Since, it’s a voluntary certification scheme its initial success would ride on procurement agencies demanding for this as a qualifying criteria,” said Nath.
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TRADE & TRENDS
Lindström India launches workwear services for healthcare industry Lindstrom India is the only organised rental workwear services company in India, which provides a reliable, flexible, carefree and economic way for companies to look after their workwear, releasing time and resources for core business LINDSTROM INDIA, a subsidiary of Lindstrom Group, a Finnish workwear service company, has announced the company’s expansion into the healthcare sector. Lindstrom India will now offer workwear solutions to the healthcare sector including rental of customized workwear as per the company’s requirements along with its ongoing servicing and maintenance. Established in 2007, Lindstrom India is the only organised rental workwear services company in India. It provides a reliable, flexible, carefree and economic way for companies to look after their workwear, releasing time and resources for core business. The healthcare sector has witnessed a huge intake of workforce, which requires companies to take proper measures in order to ensure health and safety of the employees as well as the customers. Having the right kind of workwear for right people at the right time is a must for companies to safeguard their employees from potential industry risks as well as protecting products from getting contaminated. Anupam Chakrabarty, Managing Director, Lindstrom India said, “We see a huge growth potential across industries in India and believe that workwear plays a very important role in the maintenance of health, hygiene and safety at the clinics, hospitals and labs. With a promising growth rate, the Indian healthcare sector is poised to touch $280 billion by 20201 accounting for about 4.2 per cent of GDP, leading us to believe that there is huge potential in this sector.”
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Having the right kind of workwear for right people at the right time is a must for companies to safeguard their employees from potential industry risks as well as protecting products from getting contaminated Commenting on Lindstrom services, Dr Partha Bhattacharya, Director, Salt Lake City Medical Centre and Reliance Diagnostic Centre said, “We took the services offered by Lindstrom to maintain operational efficiency and international hygienic standards.
The way Lindstrom strengthens our image and offers basic aesthetic garments is exceptional. Lindstrom provides cost benefit rental services which make us free from noncore activities like uniform handling. The logistics and overall handling of uniforms
and related service is of international quality. We appreciate their services.” Lindström offers its customers cost efficient and sustainable solutions by favouring recycled materials, minimising waste and recycling textiles as long as they remain us-
able, bringing the best of both: savings in its production costs and a smaller ecological footprint. Its use of new technology to optimise laundry processes results in lower consumption of water, energy and detergents. In India, Lindström offers workwear services to presently pharmaceutical, manufacturing, automotive and engineering sectors and for businesses in 24 countries and dressing over one million people daily worldwide. Contact www.lindstromgroup.com www.lindstrom.in
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LIFE I N T E R V I E W
‘In India,HIV/AIDS carries a woman’s face’ Dr Glory Alexander recently received the coveted Dr BC Roy National Awards from the President of India, Pranab Mukherjee. Founder of ASHA foundation, Dr Alexander is known for her work in the field of HIV/AIDS in Karnataka. In a brief conversation with M Neelam Kachhap, she talks about her work that culminated into the awards Tell us about the state of HIV/AIDS in India. According to the HIV estimates of 2015 brought out by NACO the estimate of people living with HIV (PLHIV) in India is 21.17 lakhs. The seroprevalence is 0.26 per cent . Children below 15 years account for 6.54 per cent and women account for 40.5 per cent of all HIV infections. How has the treatment changed over the years? In the 90’s we were losing PLHIV because there was no treatment and patients were dying from opportunistic infections. The turning point came in early 2000 when India started manufacturing drugs for HIV/AIDS generically and this reduced the cost of AntiRetroviral Therapy (ART) drastically. Further, in 2004, NACO started providing ART free of cost to patients, and it was also available in the private sector at affordable rates. I would say that ART has made the single most important difference in the life of a PLHIV because it extended both the quantity and the quality of life of a PLHIV and turned this infection from a life threatening, fatal illness to a chronic, manageable illness. How did you start your NGO? There was genuine concern in the 1990s, that after Sub Saharan Africa, India would be the next flash point for HIV/AIDS. By this time, we were beginning to see HIV infection in our own community and the trauma, stigma and pain that went with it. Simultaneously, I was asked to give lectures to students on HIV/AIDS and I was witness to the ignorance, concern, fear
and vulnerability of young people. It was then that I decided to step out of my comfort zone and start ASHA Foundation, my NGO. My husband was a huge support in this venture and encouraged me to follow my heart. The first project was the HIV/AIDS helpline which received 346 calls on the day it was inaugurated in June 1998. This was followed by the HIV/AIDS clinic and the Adolescent Health Education programme. Tell us about your work through the NGO? The ASHA Foundation provides a range of services in the field of HIV/AIDS. ◗ Counselling and testing services: We started the first private automated AIDS Helpline in the country which received almost 4,00,000 calls and have had more than 20,000 manual telephone calls and around 8000 counselling sessions have been conducted. Additionally, we respond to email queries and along with Ivolunteers , we conduct awareness programmes. ◗ Adolescent health education: A teachers’ manual dealing with adolescent issues was developed in-house and taught to students by trained teachers. So far, more than 2500 teachers have been trained all over the country. About one lakh students have used the curriculum in one way or the other in the past and currently more than 300 schools, colleges and other institutions are participating in the programme. About 40,000 students in Pune, Mumbai, Nagpur, Tamil Nadu, Andhra Pradesh, Bengaluru, Mangalore, Mysore, Kolar, Hunsur, HB Kote, Koppal,
Shimoga, Dakshin Kannada and Hubli are doing the programme. ◗ Prevention of Mother to Child Transmission (PMTCT) of HIV: In partnership with some hospitals in Kerala, Andhra Pradesh, Tamil Nadu and Karnataka, ASHA Foundation has worked in the field of PMTCT. So far 1,64,064 pregnant mothers have been tested for HIV of these, 855 were diagnosed as HIV-positive and treated with ART and other measures so that the children would be born HIVnegative. In our cohort, we have brought down the risk of transmission from 30 per cent to less than two per cent. So far, in our partner hospitals, we have trained more than 100 nurses and 40 other staff as counsellors, sensitised around 2000 doctors and other staff on PMTCT, and around 20,000 other nurses, nursing and medical students, ward aides, paramedical workers, community health workers and community have been sensitised about HIV/AIDS and PMTCT. ◗ Camp Rainbow: This is a psychosocial intervention where we take HIV-positive children, between 10 and 16 years of age, to a residential summer camp for five days and teach them life skills, health and hygiene, arts and crafts, knowledge of HIV/AIDS, environment preservation etc. These camps have improved their self-esteem, confidence, ART adherence and social behaviour. Children from Bengaluru, Mysore, Mandya, Kolar, Ramnagara and Andhra Pradesh have attended these camps. We also train volunteers from colleges who give three weeks of their time night and
day to help in these camps. ◗ Support for children and their families: The care component includes medical care and support to a large number of HIV-positive individuals and their families through provision of ART, treatment for TB and opportunistic infections, care for HIV-infected and affected children through educational support, nutritional support and ART, empowerment of women through knowledge creation, vocational training, job placements, micro-credit and formation of Self Help Groups (SHGs), with SHG bank accounts. ◗ Capacity building : We have built the capacity of doctors, nurses, teachers, counsellors, community health workers and community through our programmes. ◗ HIV Research: ASHA Foundation is recognised as a Scientific and Industrial Research Organisation by the Dept of Science and Technology, Government of India, focusing on operational research in Prevention of mother to child transmission of HIV infection, adults with HIV, children with HIV, adolescent health education, counselling in HIV, and socioeconomic aspects of HIV. We have published papers in scientific and educational journals. ◗ Advocacy: Facilitation of free legal services for HIV infected women, facilitation of free housing for women under Rajiv Gandhi housing, facilitating access to government schemes such as widows’ pension and facilitating educational support for children through Child Welfare Committee. What challenges did you face
how did you overcome those? Challenges have been many. The main challenge of course has been in raising funds to run our NGO. We cater to the poorer section of the community in our work and funds are always needed to help them. Many people think that HIV/AIDS is a lost cause, but with the advent of ART, this is not so and so many things have been possible. I am eternally grateful to funders like Krishna of INDO-MIM, and others who have supported us for so many years. Share some of your notable moments. In India , HIV/AIDS carries a woman’s face. At the micro level, the greatest burden of HIV infection has been on the Indian woman. She is the one who gets married young, gets infected in marriage, becomes a young widow, is left behindHIV infected , with young, dependent children, uneducated, financially unstable and facing stigma and discrimination – and she is strong, she copes- she rises from the ashes and again makes a life for herself and her children. What are your plans for the NGO in coming years? ASHA Foundation will continue its work in the field of HIV/AIDS. We want to extend our AHE programme across the country. Through Camp Rainbow, we want every HIV positive child in Karnataka, to experience the psycho-social intervention that improves their well being, self esteem and social behaviour and makes them confident, self-assured individuals in their own right. mneelam.kachhap@expressindia.com
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