Express Healthcare (Vol.12, No.8) August, 2018 by Indian Express

VOL.12 NO 8 PAGES 88

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CONTENTS Vol 12. No 8, August 2018

Chairman of the Board Viveck Goenka Sr Vice President-BPD Neil Viegas Editor Viveka Roychowdhury* Chief of Product Harit Mohanty BUREAUS Mumbai Usha Sharma, Raelene Kambli, Lakshmipriya Nair, Sanjiv Das, Swati Rana, Tanuvi Joe Delhi Prathiba Raju Design National Design Editor Bivash Barua

Pg 24

Asst. Art Director Pravin Temble Chief Designer Prasad Tate

KNOWLEDGE

MARKET

STRATEGY

Senior Designer Rekha Bisht

TRADE AND TRENDS

Graphics Designer Gauri Deorukhkar Artists Rakesh Sharma Digital Team Viraj Mehta (Head of Internet) Dhaval Das (Web Developer)

TECHNOLOGICAL ADVANCEMENT IN HAEMATOLOGY COUNTERS

DAVID WESTGATE NAMED CHAIRMAN, PRESIDENT AND CEO, CARESTREAM HEALTH

HOW ONLINE PROCUREMENT PLATFORMS CAN LEAD TO A VALUE-BASED HEALTHCARE SYSTEM IN INDIA?

Photo Editor Sandeep Patil MARKETING East - Ajanta Sengupta. West - Douglas Menezes. North - Sunil kumar. South - Mujahid, Douglas Menezes, Sunil kumar PRODUCTION General Manager BR Tipnis Manager Bhadresh Valia Scheduling & Coordination Santosh Lokare CIRCULATION Circulation Team Mohan Varadkar

JASDEEP SINGH COO, Columbia Asia Hospitals

4TH EDITION OF HEALTHCARE SABHA TO BE HELD IN NEW DELHI

JP NADDA LAUNCHES NATIONAL VIRAL HEPATITIS CONTROL PROGRAMME

DR DAVINDER GILL CEO, Hilleman Laboratories, MSD Wellcome Trust

EVOLVING DIABETES MANAGEMENT STRATEGIES

BHARGAV KOTADIA MD, SMT

Express Healthcare® Regd. With RNI No.MAHENG/2007/22045. Postal Regd.No.MCS/162/2016-18. Printed and Published by Vaidehi Thakar on behalf of The Indian Express (P) Limited and Printed at The Indian Express Press, Plot No.EL-208, TTC Industrial Area, Mahape, Navi Mumbai-400710 and Published at Express Towers, Nariman Point, Mumbai 400021. Editor: Viveka Roychowdhury.* (Editorial & Administrative Offices: Express Towers, 1st floor, Nariman Point, Mumbai 400021) * Responsible for selection of news under the PRB Act. Copyright © 2017. The Indian Express (P) Ltd. All rights reserved throughout the world. Reproduction in any manner, electronic or otherwise, in whole or in part, without prior written permission is prohibited.

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EDITOR’S NOTE

The countdown to AB-NHPM

ven as the operating profitability margin of the six listed healthcare organisations in India declined from 13 per cent in FY2017 to 11.4 per cent in FY2018, the lowest in more than six years, India's corporate healthcare leaders met for their annual rendezvous at Healthcare Senate, held last month in Delhi. With most of our speakers and panelists flitting between our conference venue and closed door meetings with various policy makers who are putting together Ayushman Bharat-the National Health Protection Mission (AB-NHPM), corridor conversations were interesting to say the least! With speakers like Chief Guest Shri Ashwini Kumar Choubey, Minister of State, Ministry of Health and Family Welfare, Government of India; Guest of Honour Shri Satyendra Jain, State Health Minister, Government of Delhi; the Valedictory Address by Dr Vinod K Paul, Member, NITI Aayog it was but natural that there were many heated discussions on the sidelines of the conference. To join or not to join AB-NHPM seems to be the question, but going by a recent ICRA report, inspite of many apprehensions, private healthcare players will have no choice but to sign up. ICRA’s sample set of six healthcare entities, (Apollo Hospitals Enterprise, Fortis Healthcare, Narayana Hrudalaya, Healthcare Global Enterprises, Max India and Shalby) have faced the brunt of many factors during CY2017. The inability to claim input tax credit made the Goods and Services Tax (GST) a major drag on their balance sheets, even as patients rejoiced that hospital services are now exempt from GST. It would be fair to assume that the performance of this sample set more or less reflects that of most healthcare facilities across the country, barring a few fortunate ones who have managed to squeeze out better margins. While AB-NHPM represents a new avenue to leverage existing capacity, the approved package rates have put off most entities. At Healthcare Senate, the most cited example of one such package was that under AB-NHPM, Caesarean deliveries have to performed within `9000. Many industry bodies and associations representing private hospitals are therefore trying to negotiate for increases in package rates for hospitals under AB-NHPM. The ICRA report also cites the cap on prices of

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Private healthcare organisations will have to plan strategies factoring in policies and agendas of individual state governments,as well as Central diktats like the AB-NHPM

stents and knee implants by the National Pharmaceutical Pricing Authority (NPPA) and stiff regulatory actions by certain states, including putting restrictions on procedure rates, levying penalties and placing operational limitations on erring hospitals as further cause of the lack lustre performance of this sample set. These factors negated the fact that the aggregate revenues of these entities actually grew by nine per cent, from `132.6 billion in FY2017 to `144.9 billion in FY2018. In the same vein, the operating profit before interest, tax, depreciation and amortisation (OPBITDA) dropped by approximately four per cent, from `17.3 billion to `16.6 billion, this being the first fall in aggregate OPBITDA in the last six years. Hospitals in the National Capital Region (NCR), previously money spinners, registered the sharpest dip in the OPBITDA (up to 21 per cent) due to additional government restrictions placed on certain players, following reports on alleged cases of medical negligence and overcharging. The bad news is that there will be no respite from these headwinds. The NPPA has already published two office memorandums in CY2018 which indicate additional pricing restrictions. Private healthcare organisations will have to plan strategies factoring in policies and agendas of individual state governments, as well as Central diktats like the AB-NHPM. For instance, while West Bengal and Karnataka have implemented the Clinical Establishment Acts in 2017, the Government of National Capital Territory of Delhi (GNCTD) has also proposed ‘sweeping changes.’ There are thus many hopes riding on Prime Minister Modi’s Independence Day address, when he is expected to formally launch AB-NHPM. Will the scheme become yet another tug of war between the States and the Centre? How will next year’s general election as well as state elections impact the roll out of the scheme? And how do private healthcare players improve operating margins while participating in AB-NHPM? But the larger question is, can AB-NHPM be the first step towards ‘Building the DNA for a Healthier Nation?’ That’s the theme of the fourth edition of Healthcare Sabha, our public health focused event, in October. Do write in for details. VIVEKA ROYCHOWDHURY Editor viveka.r@expressindia.com

MARKET I N T E R V I E W

‘We will continue to assess acquisition opportunities throughout the country’ Jasdeep Singh, COO, Columbia Asia Hospitals explains how Columbia Asia has evolved to provide the best of treatment, in an interaction with Sanjiv Das

When it comes to patient data, Columbia Asia since inception has been using electronic medical records, which is now helping us to move to the next step How has Columbia Asia, as a group, evolved over the years? Columbia Asia is an international private healthcare company, owned by a US-based investment fund: International Columbia USA (ICU). Recently, the group has seen infusion of

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funds by Mitsui and now, Mitsui Corporation owns a sizeable stake in the company. Columbia Asia started operations in 1996. In the past 22 years, the group has built 30 medical facilities across Asia; 12 in Malaysia, 12 in India, three in Vietnam and

three in Indonesia. The company believes in setting up mid-size hospitals built in residential areas for accessibility and efficiency and to better serve the respective communities. In India, the first hospital was opened in Hebbal – Bengaluru in 2005 and now

we are 12 hospitals with the latest one on Sarjapur Road – Bengaluru. We started with a 90-bed hospital but evolved into setting up larger hospitals. Columbia Asia Hospital – Sarjapur Road is a 200-bed hospital and provides all super specialties. Our medical programmes have evolved over the years. From secondary care, neighbourhood hospitals, we are now being recognised for tertiary care. We have introduced high-end specialities like Transplants, DBS (Neurosurgery), highend cardiac and gastro care, etc. All our hospitals now have a cath lab and are geared to manage any cardiac issue. Now, we have renowned doctors and opinion makers joining Columbia Asia, thereby taking the clinical capabilities and care to the next level. With many of our hospitals reaching a certain maturity, in the past 15 months, the organisation has undertaken quite a few changes. We have focussed on reducing expenditure on some activities, e.g., looking at building cost efficiency; we have spent time on tightening the processes, in making sure that employee roles and responsibilities are well defined for better objectivity. For our new hospital, we have managed to get doctors with significant practice, to move from known brands. People have noticed the new building, which is away for the flat structure. The new hospital has 13+ floors and

since it is at a main traffic junction, it can’t be ignored. From all perspectives, we have moved to the next level, probably a Columbia Asia 2.0. What are the current trends in the healthcare business? How is Columbia Asia leveraging them? Some of the new trends in healthcare include: ◗ Artificial intelligence, this is a trend across all industries, but it is especially powerful in the healthcare field. ◗ Leveraging data for healthcare. ◗ Patient personalisation. ◗ Using wearable devices in healthcare Many of our clinical teams utilise AI very effectively. When it comes to patient data, Columbia Asia since inception has been using electronic medical records, which is now helping us to move to the next step and we have developed an app for our patients. This app enables the patient to carry his/her medical records wherever they are. They needn’t carry the reports with them, they have access to the information at a click of a button. We have also been using technology to assist the doctors in far-away clinics to reach us. They can send the patient data via certain apps and the doctors at Columbia Asia can advise real time. Our hospitals’ emergency department also has a patient-retrieval programme, these facilitates our emergency team to take real-time decisions.

Tell us about your growth projections for the next five years. In the past 12 years, we have opened one hospital per year. A second hospital is planned in Pune which is going to be the largest till now. In fact, it will be bigger than our newest hospital which was opened in 2017 at Sarjapur Road – Bengaluru. The hospital will also have radiation oncology which is a super specialisation. Besides opening hospitals, we are also reaching out to smaller hospitals in satellite townships and specialised hospitals within the city helping them manage their emergency rooms. Some of the towns which we reach out to around Bengaluru include Hindupur, Anantpur, Madanapalle in Andhra Pradesh, Hoskote, Kolar, Tumkur, etc., which are smaller but very important industrial hubs near Bengaluru. We are also constantly upgrading our clinical programmes. We are forming centres of excellence at our hospitals. Apart from organic growth and addition of specialists to boost our footfalls in the existing hospitals, we will continue to assess acquisition opportunities throughout the country. What will be your focus areas? ◗ To deliver differentiating clinical quality: Healthcare in India is becoming very competitive and in order to stay ahead of competition we focus a lot of building our core – Clinical outcomes. ◗ Continuously improve our service standards through process improvement and training focus: Our services standards are already appreciated, and we have managed to make that as our USP in the last few years. Needless to say, a lot of hard work has gone into reaching where we are our focus will continue to be putting the ‘patient first’. ◗ Outreach to peripheral

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centres: We will focus on proving our expertise in the hospitals in the peripheral centres. To attain this, we are investing in technologies for critical emergencies such as heart attacks. This will enable the peripheral centres to be connected real-time

with our hospitals. For e.g. there is an ECG device that is Wi-Fi enabled, so whenever there is an ECG at the peripheral centres, it reaches our consultants and decisions can be taken based on the criticality. ◗ Positioning our hospitals

as tertiary care centres: Most of our hospitals provide high-end care. We have level three NICU, HDU’s cathlabs, etc. in all our centres. In some of our centres, we have developed a tertiary care transplant programme, at our centre at Yeshwanthpur, we

have licenses for heart, kidney, liver and bone marrow transplants. We would like to go to market and inform the public that we have these capabilities.

Continued on Page 12

MARKET ‘We will continue...

PRE EVENT

4 edition of Healthcare Sabha to be held in New Delhi th

The event from October 5-6, 2018, will bring together a think tank of policy experts, public health officials, and other key stakeholders to discuss and deliberate on issues pertaining to healthcare and come up with innovative strategies/solutions AS INDIA’S Public health Ecosystem rolls out Ayushman Bharat, the National Health Protection Mission (AB-NHPM), the Fourth Edition of Healthcare Sabha, invites Public Health Leaders to meet, deliberate and share their vision for 'Building The DNA For A Healthier Nation'. Healthcare Sabha's 4th edition, organised by Express Healthcare, a publication of the Indian Express Group, will bring together a think tank of policy experts, public health officials, and other key stakeholders to discuss and deliberate on these issues and come up with innovative strategies/solutions as the nation gears up for the most transformational moment in its public health journey. Thus, with public health elevated as the foremost national

priority, Healthcare Sabha's 4th edition will focus on three core areas: Health economics, equity and efficiency. Public health stalwarts will highlight the role of ethical practices in protecting patients of all socio-economic backgrounds.

Key topics to be discussed are: ◗ Health Economics, Equity and Efficiency: Where does India stand? ◗ Strategies for capacity building in public health ◗ PPPs in healthcare: How can we strike the right balance? ◗ Ramping up health promotion: Dealing with India's dual disease burden ◗ State Health Financing v/s Central Insurance: What works best? ◗ New Age, New realities: The

changing dynamics and priorities of Public Healthcare and methods to deal with it

Delegates profile will include the following: ◗ Secretary, Addl. Secretary, Jt. Secretary, DG, DDG etc from Ministry of Health & Family Welfare, Government of India & various State Government ◗ NHM Mission Directors of various States ◗ NHM Policy Makers and Planning Officials ◗ Dignitaries from Central Drugs Standard Control Organisation (DCGI, Jt. Drugs Controller, Deputy Drugs Controller) ◗ Key dignitaries from NHSRC/SHSRC, NIHFW ◗ Dignitaries from State Health Corporations, State Health Society and State Health Mission Director

◗ Director, Deputy Director of autonomous institutions like AIIMS, JIPMER, PGIMER, NIMHANS etc. ◗ Dignitaries from ESIC (Director General, Medical Commisioners, Deputy Medical Commisioners) ◗ DG - AFMS, Addl. DG-AFMS ◗ DG, ED, Director, Deputy Director - Railway Health Services, CMOs of various railway zones ◗ Chief Procurement Officer, medical superintendents, administrative heads of premier government and municipal hospitals from various states and cities To be held concurrently with Healthcare Sabha, the Express Public Health Awards will honour Champions, Visionaries and Game Changers in Public Healthcare.

RSNA to be held in Chicago from November 25 to 30, 2018 More than 50,000 attendees from around the world are likely to participate in the event THE 104TH Scientific Assembly & Annual Meeting of the Radiological Society of North America, which hosts more than 50,000 attendees from around the world, will be held in Chicago from November 25 to 30, 2018. Highlights from the meeting include: ◗ Breaking news from more than a dozen featured study presentations, and approximately 3,000 scientific presentations and posters covering the latest

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trends in imaging research on important topics like Alzheimer's disease, stroke, breast cancer, heart disease, concussion, artificial intelligence and more. ◗ Opportunities to interview experts in all radiologic subspecialties and related fields. ◗ Access to approximately 2,000 education exhibits and informatics demonstrations. The Radiological Society of North America (RSNA) is an international society of radiologists, medical physicists and

other medical professionals with more than 54,000 members from 136 countries across the globe. RSNA hosts the world’s premier radiology forum, drawing approximately 55,000 attendees annually to McCormick Place in Chicago, and publishes two top peer-reviewed journals: Radiology, the highest-impact scientific journal in the field, and RadioGraphics, the only journal dedicated to continuing education in radiology. Through its educational re-

sources, RSNA provides hundreds of thousands of continuing education credits toward physicians' maintenance of certification—more than one million CME certificates have been awarded since 2000. The Society also develops and offers informatics-based software solutions in support of a universal electronic health record, sponsors research to advance quantitative imaging biomarkers, and conducts outreach to enhance education in developing nations.

Continued from Page 11 What challenges are being faced by the healthcare industry? What are your strategies to tackle them? In the recent past, the government has regulated the cost of stents and joint implants. This regulation may help in making it accessible to many, but on the other hand, many highquality stents and implants have disappeared from the market. This is leading to patients who wish for some better-quality implants, etc to choose other destinations and hence healthcare business moving out of the country. There are many patients who were choosing India for high-quality clinical procedures are now rethinking. Due to the price cap in charging the customers and hence return on investment; new investments in high-end medical equipment which would help in better clinical outcomes is becoming unviable. On the other hand, if there is a price cap, the government should also reconsider the taxation on import of high-end machines. Tell us about your CSR activities. We do not have a formal CSR wing but being in healthcare one is always into helping the needy and people who need the help of experts but can’t afford them. For us, we follow the philosophy of taking care of everyone who walk through our doors irrespective of their economic and social status. As a responsible healthcare provider, we don’t mix financials with health. On the other hand, we have a formal tie-up with multiple NGOs wherein we offer subsidised treatment opportunity to the patients particularly to children who can’t afford the much needed clinical care. One of our most successful tie-up is ‘Paediatric Cardiac Surgery’. sanjiv.das@expressindia.com

MARKET NEWS

JP Nadda launches National Viral Hepatitis Control Programme Guidelines on National Viral Hepatitis Control Program were released “WITH THIS initiative, government is strongly committed to work towards elimination of viral hepatitis by 2030.” This was stated by JP Nadda, Union Minister of Health and Family Welfare as he launched the National Viral Hepatitis Control Programme to mark the World Hepatitis Day, 2018, recently. Nadda also released the Operational Guidelines for National Viral Hepatitis Control Programme, National Laboratory Guidelines for Viral Hepatitis Testing and National Guidelines for Diagnosis and Management of Viral Hepatitis. Manoj Sinha, MoS (Independent Charge), Ministry of Communication also released the commemorative Stamp at the occasion. Ashwini Kumar Choubey and Anupriya Patel, Ministers of State for Health and Family Welfare along with Preeti Sudan, Secretary (Health), Ananta Narayan Nanda, Secretary, Dept. of Posts and Dr S Venkatesh, DGHS were also present at the launch function. He also released guidelines on National Viral Hepatitis Control Program at a function. Addressing the participants, Nadda said that under the guidance of Prime Minister, Narendra Modi, the ministry is aggressively addressing the preventable diseases. Nadda said that there has been a paradigm shift in designing the programme. Nadda further said that the ministry has already launched a campaign to end TB by 2025, five years ahead of global target. He said that the government now has more than 1100 CBNAAT machines for rapid diagnosis of TB and provides daily regimen with fixed dose combinations. Nadda stated that the government has also launched the ‘Test and Treat Policy for HIV’ wherein as soon as a person is tested and found to be positive, he will be provided with ART irrespective of his CD count or clinical stage. Adding further, he said that the government has also launched Rotavirus vaccine, Pneumococcal Conjugate

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Vaccine (PCV), and the MeaslesRubella (MR), Pneumonia vaccine and one thing that was remaining was Hepatitis and with

this launch free drugs and diagnostics for hepatitis B & C will be offered. “This initiative will provide laboratory testing and man-

agement of viral hepatitis with a de-centralised approach,” Nadda said. Choubey said that awareness is a very important

component of the programme. This will help to find the disease carriers and towards their diagnosis and treatment.

KNOWLEDGE I N T E R V I E W

eVIN has streamlined the vaccine flow network Dr Davinder Gill, CEO, Hilleman Laboratories, MSD Wellcome Trust, gives some insights to Viveka Roychowdhury on the role of technologies like the Electronic Vaccine Intelligence Network (eVIN), which have optimised vaccine outreach and delivery to boost immunisation coverage in India

Why has India only succeeded in achieving 65 per cent coverage in basic immunisation, even though vaccines made by Indian companies are supplied to the world? Immunisation is one of the most cost-effective public

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health interventions for the reduction of mortality and morbidity rates caused by infectious diseases. Every year in India, five lakh children die due to vaccinepreventable diseases. Another 89 lakh children remain at risk, because they

are either unimmunised or partially immunised against vaccine-preventable diseases. Full immunisation is critical to reduce child mortality and progress on socio-economic indicators. In the past, India’s immunisation coverage has been low because of various factors like, inadequate delivery of health services, a huge population with relatively high growth rate, unique geographical challenges, hard to reach populations, lack of awareness regarding vaccination, among others. Over the last two to three years, India has made considerable gains in increasing the immunisation coverage. This progress has been made possible due to key interventions by the government including the launch of Mission Indradhanush (MI), new vaccine launches and ensuring vaccine availability by strengthening the logistics management through technological interventions like Electronic Vaccine Intelligence Network (eVIN). These initiatives have helped in narrowing the gaps in the delivery of potentially lifesaving vaccines to children, particularly in hard-to-reach areas, where children are most vulnerable.

Identifying and scaling up new innovations — from development and delivery of vaccine – to improving monitoring and information sharing – can have a significant impact in achieving universal immunisation coverage. How is India’s immunisation coverage compared with other countries in the same cohort vis a vis GDP etc.? India has the largest birth cohort in the world (more than 26 million a year) and accounts for more than 20 per cent of child mortality worldwide. According to the 2016 Immunisation Report by UNICEF and WHO, full immunisation coverage in India remained at 65 per cent till 2013, while neighbouring countries like Sri Lanka topped the list with 97 per cent followed by Bangladesh at 95 per cent, Bhutan at 92 per cent, Pakistan at 88 per cent and Nepal at 85 per cent. Notably, India was the last country to introduce second shot of measles vaccine in 2015 and stands 75th in line to introduce Rotavirus vaccine in its immunisation schedule. This shows that India needs to keep up with other developing nations as well as its immediate neighbours in

safeguarding the health of its children. What are the reasons for the huge gaps in immunisation coverage on the future productivity of India as a nation? The solutions to the gaps from vaccine-preventable diseases in developing countries involves successfully implementing strategies that ensure high coverage and minimise dropouts and missed opportunities. Achieving maximum coverage, however, has been a challenge due to many reasons, including awareness on number and types of vaccines, importance of immunisation, and myths around immunisation, etc. Out of these, the main challenge is lack of information among beneficiaries. Renewed efforts to strengthen education around timely vaccination are required at a grassroot level so that there are optimal levels of awareness among rural and urban population. This gap can be narrowed down through active participation by the government, paediatricians, private companies and other key stakeholders.

Improper storage of vaccines has led to wastage of precious resources as well as patchy immunisation coverage in the past. What are the other lessons that we have learnt from the past attempts at immunisation coverage?

Renewed efforts to strengthen education around timely vaccination are required at a grassroot level so that there are optimal levels of awareness among rural and urban population

Poor handling and storage of vaccines, cold chain deficiencies such as inadequate infrastructure, power shortages and poor maintenance lead to an inefficient vaccine management system. Periodic assessment of vaccine handling and storage practices is instrumental in correcting wrong vaccine management practices and improving level of knowledge on vaccine management. Identifying various capacity gaps (personnel and equipment), which when duly addressed strengthens the nationâ&#x20AC;&#x2122;s immunisation service delivery, increases vaccination coverage and ensures the administration of potent vaccines to masses. What is the Electronic Vaccine Intelligence

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Network (eVIN) and its envisaged role in addressing these challenges? The eVIN (Electronic Vaccine Intelligence Network) is an ongoing project of Ministry of Health and Family Welfare in partnership with The United

Nations Development Programme (UNDP). It is an indigenously developed technology that digitises vaccine stocks and monitors the temperature of the cold chain through a smartphone application. The technology has

revolutionised the way vaccines are stored and managed by streamlining the vaccine flow network. It aims to support the Government of Indiaâ&#x20AC;&#x2122;s Universal Immunisation Programme by providing real-time information on vaccine stocks

and flows, and storage temperatures across all cold chain points in the identified states. The project has been recognised by the MoH&FW as the global best practise in immunisation. viveka.r@expressindia.com

KNOWLEDGE

Evolving diabetes management strategies Dr Hemant Thacker, consultant physician and cardio-metabolic specialist speaks about the rationale behind the glycemic pentad replacing the triad and why the American College of Physicians' recommendation to relax HbA1c levels will actually be detrimental to diabetes patients in India By Viveka Roychowdhury

ith the ever increasing prevalence of diabetes across the world and in India, there is a constant need to review treatment methodologies. Mumbai is ranked 12.2 per cent on the diabetes prevalence scale. India had 72.8 million people with type 2 diabetes, estimated to have 57 per cent undiagnosed per the 8th International Diabetes Federation (IDF) Atlas. Maharashtra’s known cases of diabetes is at 36.9 per cent, with unknown cases at 2.9 per cent and pre- diabetic incidences as 3.8 per cent. These numbers reinforce the need for constant glucose monitoring as well as a review of diabetes management strategies. The basis for diabetes management strategies has been the traditional glycemic triad, involving monitoring and control of fasting and post meal glucose levels (fasting plasma glucose, FPG and post prandial glucose, PPG) as well as HbA1c levels, which is the three-month average plasma glucose concentration. However, the triad has its shortcomings. As Dr Hemant Thacker, an eminent physician practicing in Mumbai for more than three decades who specialises in cardio-metabolic disorders explains, “Quite often, since fasting and post prandial sugar are point of time sugar (readings), they can be wrong. So often patients come with a low fasting sugar, a normal post prandial sugar but a high HbA1c reading.” The solution was to add two more elements glycemic variability (GV) and quality of life (QOL) making it the Glycemic Pentad (GP), which is a concept proposed by a group of 55 experts in the field of diabetology from across India. Explaining

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The intent is to try and maintain a steady glucose state. Glycemic variability is to be avoided. Therefore the glycemic pentad will help physicians to better understand the treatment of diabetes. A diabetic patient who has understood his disease and has his sugar levels under control, needs to see his diabetologist once in three months with his HbA1c readings, that's all Comparative prevalence (%) estimates of diabetes (20-79 years) in South-East Asia Region, 2017

● <5% ● 5-6% ● 6-7% ● 7-8% ● 8-9% ● >9%

The IDF South-East Asia Region (SEA) comprises seven countries—India, Bangladesh, Nepal, Sri Lanka, Mauritius, Bhutan and the Maldives, but is the second most populous IDF regionafter the Western Pacific Region (WP)

Source: IDF Diabetes Atlas 8th Edition

the rationale and concept in a Consensus Statement published in the July 2017 issue of the The Journal of The Association of Physicians in India (JAPI), the group aims to generate a consensus and ratify the position of GV and QOL, along with the traditional triad, in diabetes management in India. The GP forum discussed various evidences related to the topic and shared their experiences and expressed their opinion on the relevance of the glycemic pentad in the present diabetes management and whether triple fixed dose combination of metformin, glimepiride, and voglibose is able to achieve glycemic pentad targets. As Dr Thacker, who was part of the GP Forum further explains, “We unfurled the hidden fluctuations of sugar during the day which contribute to the abnormal HbA1c. Glycemic vari-

KNOWLEDGE ability refers to the wide fluctuations (of glucose) intra-day, where high peaks of sugar, probably following a very sugary meal, are interspersed with deep troughs of low sugar levels. And that contributes to high HbA1c despite fasting and post prandial being normal.” But adding GV to the pentad could add to the discomfort of the patient, at least in the initial period, as it requires continuous or ambulatory glucose monitoring, to find out where the fluctuations are contributing to high sugar. Mindful that this could put off diabetic patients, Dr Thacker says, “In doing all this, one has to realise that the patient is not a robot or an experimental model, to be pricked or called so many times. So physicians included QOL as the fifth parameter of the pentad, which is a quotient which includes happiness, good cognitive understanding of the problem and emotional understanding. So these two last parameters capture the patient's condition.” But the GP does not mean that blood glucose levels need to be continuously charted. As Dr Thakkar explains, “If the doctor notices this discrepancy and GV, he must educate the patient on food choices.” For instance, if the patient is used to a breakfast of idlis, the doctor can advice him to substitute rice idlis with ragi ones, or an oatmeal porridge, which does not cause a surge in the sugar levels. Similarly, if the patient has to have a desert, the choice should not be a ras malai or chocolate but something which is complex in absorption so that it is a slower to metabolise. This will not cause a surge in sugar levels. Once this is achieved, the patient does not need to continuously monitor sugar levels, resulting in improved QOL. According to him, the GP is already being used by the top diabetologists who met in the 5-6 meetings to propose it.

ACP’s updated HbA1c targets not right for India But while diabetologists in India are open to evolving from the glycemic triad to the pentad as a diabetes management strategy, they have criticised the four updated guidance statements for HbA1c targets in type 2 diabetes (T2D) published online in the Annals of Internal Medicine by the American College of Physicians (ACP). Released in March this year by the ACP, the four guidance statements have been updated based on evidence that “for most people with type 2 diabetes, achieving an A1C between 7 per cent and 8 per cent will best balance long-term benefits with harms such as low blood sugar, medication burden, and costs,” according to Jack Ende, MD, MACP, President, ACP. Physicians in India agree with three of the four guidance statements. The first guidance statement recommends that cli-

nicians create personalised goals for glycemic control in patients with type 2 diabetes, the third statement asks them to de-intensify pharmacologic therapy if a patient with type 2 diabetes achieves an HbA1c level <6.5 per cent, while the fourth statement says that clinicians should aim to minimise symptoms related to hyperglycemia. The second guidance statement which states that clinicians should aim to help their patients with type 2 diabetes achieve an HbA1c level between 7 per cent and 8 per cent, instead of the traditional 6.5 -7 per cent, has been criticised by clinicians in India. Explaining why he does not support ACP's updated guidance for HbA1c, Dr Thacker says, “What is food for the goose may not be food for the gander. Indians have a different genetic set up, we are Asians. We have different eating habits. And we as a group of diabetologists in India are still happy to follow the traditional target of 7. With advancing age, you go up by 0.2 with every five years. So at 65 years you are happy with 7.2, at 70 years you're happy with 7.4 and so on.” As the July 2017 JAPI paper points out, Asian Indian diabetic patients are different from other ethnicities. And on the diet front, the paper points to evidence that carbohydrate content in Indians diet constitutes about 65 per cent, which is more than that is recommended for diabetic patients. As Dr Thacker puts it, “The intent is to try and maintain a steady glucose state. Glycemic variability is to be avoided. Therefore the glycemic pentad will help physicians to better understand the treatment of diabetes. A diabetic patient who has understood his disease and has his sugar levels under control, needs to see his diabetologist once in three months with his HbA1c readings, that's all.” He emphasises that patient satisfaction is very important. “It has to be understood that diabetes is a way of life, not a disease. The diabetic cannot be ostracised. He must have an emotional connect with this family and friends. He should be able to do all and more which his family and friends are doing, be it going on holidays, playing games, participating in sports, etc. Helping him do this are a variety of alternative foods (using low Glycemic Index (GI) sugars that metabolise slower than the normal sugars), alternative medications and alternative health practices which are being followed.” Summing up Dr Thacker says, “Diabetes has evolved the world over and therefore we are proposing the use of this glycemic pentad which I am sure doctors will be glad to prescribe and patients will be happy to follow.” viveka.r@expressindia.com

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OPINION

Price controls in healthcare - the wrong medicine to fix the problem of access Applying price controls in an already distorted market with poor regulation might only worsen the situation for the patients. Dr Ratna Devi, CEO, DakshamA Health & Founder IAPG, gives an insight

he recent announcement by the government to include more devices under price control had a mixed reaction from various stakeholders. While multinationals and private hospitals were not very happy with the decision, there seemed to be a sense of jubilation in the policy makers. Patients and consumers are still wary and not sure what to expect from this decision. Considering the much-hyped reduction in prices of stents and orthopaedic implants hadn’t really created a miracle access jump for the common man. The registry maintained by Indian Society of Hip and Knee surgeons (ISKHS) showed a marginal rise in total knee replacement (TKR) registries from about 24000 in 2016 to 30000 in 20171 with over 95 per cent of patients having osteoarthritis as the causative factor. Osteoarthritis is the second most common rheumatologic problem and it is the most frequent joint disease with a prevalence of 22 to 39 per cent in India2. The number of people who might actually need orthopaedic implants is therefore a mind-boggling number and just a reduction in pricing is in no way going to increase access to these people without the requisite infrastructure and human resources. Another example is cataract surgeries. Though CSR funding for cataract surgeries has nearly doubled in the last few years and technology has helped reach large numbers, India is still lagging in achieving the targets for preventable blindness as the new models are not replicable in difficult terrains and hard to reach areas3. The third example is tackling antimicrobial resistance. Reducing cost of antibiotics without addressing the challenges of

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Patients in fact end up paying more as they do not respond to standard antibiotics or end up having complications requiring hospital stays rampant over prescription, unsafe dispensing and spurious and substandard medicines will increase the risk to patients. Patients in fact end up paying more as they do not respond to standard antibiotics or end up having complications requiring hospital stays. Government is increasingly relying on price controls on medicines and medical devices to rein in the rising cost of healthcare in the country. Though this is well-intentioned, it

may have several unintended consequences such as discouraging investment and R&D spending. India's spending on R&D in terms of percentage of GDP has been stagnant at 0.6 to 0.7 per cent in the last two decades -- much lower than the US, China, South Korea and Israel as per the Economic Survey 2017-2018 report tabled by Finance Minister Arun Jaitley in the Parliament. Although India’s investment in science, which is measured in terms of Gross

Expenditure on R&D (GERD), has tripled in the last decade, the ratio was stagnant at 0.6 to 0.7 per cent of the GDP. According to Forbes, 2017 analysis, there are 26 Indian companies in the list of the top 2,500 global R&D spenders compared to 301 Chinese companies. 19 of these 26 firms are in just three sectors - pharma, automobiles and software. The development of innovative pharma products plays a critical role in ensuring health gains and longevity through the provision of adequate amounts of effective drugs to treat the most important and common disease conditions. Governments play a vital role in encouraging development of new drugs though economic incentives like direct and indirect government funding, effective intellectual property laws and other policies that favour innovation. It is the responsibility of the government to ensure that consumers benefit both from technological breakthroughs and the competition, so that further innovation generates. Applying price controls in an already distorted market with poor regulation might only worsen the situation for the patients. There’s no denying that healthcare costs are rapidly rising, in large part due to the growing elderly population and the large rise in chronic disease. Factors such as very low per capita availability of doctors and other medical practitioners makes a bad situation worse. Increasing the supply of medical seats will reduce the cost of medical education and make doctors less vulnerable to unethical profiteering. The lack of competition from under-staffed, under-funded and over-crowded government hospitals with no accountability adds to the problem. Investing in large

prevention programmes and stronger regulation making quality parameters and patient safety mandatory in all privatelyrun hospitals will further reduce the cost of care and treatment. It is expected that medicines will be procured in bulk for implementing NHPS. Improving the procurement standards, making it corruption free, and ensuring quality gets a higher rating than lowest price will enable innovative pharma companies to bid in the process. This will improve consumers and patient confidence in the government run schemes like the Jan Aushadhi and ensure that medicines remain of the highest quality, while ensuring a reasonable price. The solution to India’s ailing healthcare system does not lie in a narrow view of controlling prices on medicines and devices, but a combination of several steps to strengthen the system, bring in stronger regulation and accountability measures, and improve affordability by expanding healthcare insurance coverage. An increased investment in research and redefining outcome measures to include patient reported outcomes and economic benefits of procedures, medicines, devices and institutional processes will help provide real benefits to patients instead or perceived increase in access through price regulation.

References 1. http://www.ishks.com/ pdf/ISHKS-Outcome-2017.pdf 2. Silman AJ, Hochberg MC. 2nd ed. Oxford: Oxford University Press; 2001. Epidemiology of the Rheumatic Diseases 3. http://www.ijo.in/ article.asp?issn=03014738;year=2017; volume=65;issue=12;spage=1271; =1272;aulast=Honavar

STRATEGY I N T E R V I E W

‘Pricing regulations have certainly improved the accessibility of stent’ Bhargav Kotadia, MD, SMT, in an interaction with Swati Rana, spoke on the stent industry and challenges they came across being an Indian manufacturing company of medical devices. Kotadia also highlighted the company’s roadmap for the next five years and plans to strengthen the footprint in the European market SMT was established in 2001, how has the journey so far? Brief us on the challenges you came across. SMT officially began its operations in 2001, but some of the background work started in 1998. We started with the research work in cardiovascular diseases and after two to three years, we launched our first product Matrix in 2001. Around that time, the work towards drug eluting stents (DES) was being looked upon. So, as soon as we launched Matrix, we started a parallel project on DES as we knew that DES would be the

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STRATEGY future standard of care. When it comes to challenges faced in 2001 and 2018, some of the perception issues still exist today, so imagine how bad it was then. In 2001, the Indian healthcare industry started looking for new technologies and a company like SMT which came up with a medical device like stents; certainly lacked acceptance. It was a challenge to get physicians to trust our products. In that situation, what we did different was, when multinational companies were focussing on bio-stable polymers for the manufacturing of stents, we pioneered the biodegradable polymer. Later on it proved that the biodegradable polymers were much safer than the biostable polymers. Through the biodegradable polymer innovation, the challenge on how an Indian medical device company could create a critical product like stent was answered. Our entire focus was then diverted on quality manufacturing. From 2001 to 2010, we had put all our focus in setting up our initial manufacturing facility and operations, which could withstand the toughest of quality and regulatory standards while being capable of rapid scale up. Once this was achieved, we began looking at how to aggressively commercialise our core technologies while building a pipeline of future products & technologies. As you mentioned that there is trust issue in physician regarding Indian manufactured product, how do you address this issue? We are an engineering and science company. If we can solve the engineering problem well, then we should also be able to scientifically solve the trust issue as well. For cardiologist or for anyone in the medical field, clinical data is essential to prove the safety and efficacy of the product. Over the last few years, we have been aggressively collecting, accumulating and publishing clinical data that shows SMT’s stent in different context and in different clinical

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situation which includes short, medium and long-term duration. These steps were taken to prove the capabilities of Indian manufactured stents among the cardiologists. For last seven years, we have collected this data for the benefit of cardiologists, on the scale unlike anyone else in India. We have more than 12,000 patients’ data and out of these 10,000 patients are of Indian patients. So, here we are talking about relevant data that shows how effective our stent is specifically for the Indian patient. Beyond this, two years ago we also commenced a randomised clinical trial called TALENT, which is taking place in Europe. The trial is being conducted across seven countries in 26 Europeans centres. We expect the data from this trial to be announced by the end of September. We are confident that this trial’s data will unequivocally prove that our Supraflex stent is among the best in the world. The biggest market you are looking for is the European market. I would like to understand the global market scenario of stent and apart from Europe which are the other markets you would like to strengthen your footprint? Globally, on an average, 4 to 5 million stents get implanted. Out of which 1.5 million are used in the US, 1.2 million in Europe,1 million in China and

SMT Facility Surat 1

my calculations, looking at the size and demographic of the Indian population, there are about +12 lakh patients/year who need to undergo stenting. Of this only about 5 to 6 lakh actually do receive the treatment in time. And this gap is largely due to the insufficient number of cath labs and the relevant medical professionals/ doctors etc. To bridge this gap, we need to design policies that encourage further investments into the necessary manpower and infrastructure.

India is around 5 – 6 lakh stents annually. Therefore, Europe is one of our key markets of focus. Beyond Europe, we are also strengthening our presence in Latin America, the Middle East, South East Asians markets. While individually these markets are smaller, we believe the reach across the regions to be equally important as the larger markets. How do you see the Indian market, as you hold roughly 20 per cent market share currently? What are your plans to increase the number?

India has and will always be our primary focus. Over the last few years, what has helped us in India is our direct approach. We have our own teams interacting with the hospitals on a daily bases, making sure that we meet their requirements. Another important aspect for us is that, while growing in market share to the current number, we should be able to hold on to it, and therefore, our first step is to make sure that we continue to deliver quality service and products. Since 2001 our entire focus was on stents and DES, now we are looking at elevating it to the next level by taking the infrastructure and brand equity we have and start providing solutions across the vascular spectrum. In India there are pricing issues related to stents. What are your views on regulatory aspect? The government as a whole has certainly become very proactive and it’s a encouraging move. The government has introduced few programmes; some of them are working well, while some need more attention. While the pricing regulations have certainly improved the accessibility of the stent, I believe as a country we’re still far from the ideal. By

Any plans to expand your manufacturing facility? Yes, in the next two years we will run out of expansion space in our current manufacturing set-up. We are in the process of finalising our next site, which will be designed to meet the needs for another 10 years of both stents as well as the new products we’ll be launching. Brief us on new products in pipeline? SMT is a highly focussed player that believes in developing expertise in specialised areas. We currently have a broad range of products in drug eluting polymer coated stents, bare metal stents, interventional accessories and PTCA catheters. Our focus is to further enhance the accessories portfolio for complex PCIs. We have also diversified into peripheral interventional devices and we look forward to expand our range in the vascular field keeping quality and innovation as our primary focus. What is the company's roadmap for next five years? We are aiming to be among the top three players in Europe in the next five years. In order to achieve this, we will continue to invest aggressively in our products at all three of the stages: R&D, quality manufacturing, and clinical. Specifically, for Europe, we will be taking a focussed approach of understanding the pain points of the cardiologists throughout the European countries and developing solutions that efficiently address them. swati.rana@expressindia.com

IUIH invites ICTenterprises to deliver ITinfra and services for its digital hospitals and clinics IUIH is looking forward to collaborating with ICT enterprises of global repute i.e. best health IT technology service providers and system integrators that can deliver services to the IUIH ecosystem, develop and support innovation, and provide professional experience to all stakeholders

ndo UK Institute of Health (IUIH) aims to provide affordable, available and accountable healthcare in India via 11 medicities and 5000 planned Indo UK clinics. The IUIH facilities will have global expertise both in operations and research from their collaboration with the UK’s National Health Service (NHS), partnerships with leading international healthcare industry companies and international partners in research, education, manufacturing and healthcare delivery. The IUIH ecosystem will be built up over 20 years, serving close to 100 million people by 2025 and over 660 million people by 2037. IUIH is committed to a comprehensive digital strategy across all areas of operation and the utilisation of leading edge healthcare technology solutions for improving clinical quality and safety, continuity of care, patient outcomes, patient experience, and operational efficiency. Indo UK Health Innovation (IUHI), the technology arm of IUIH, will build digital assets and technological capabilities, and provide tech support for all operations in these best of class digital hospitals and clinics. IUIH is looking forward to collaborating with ICT enterprises of global repute i.e. best health IT technology service providers and system integrators that can deliver services to the IUIH ecosystem, develop and support innovation, and provide professional experience to all stakeholders. It is a premier technology partnership opportunity for ICT companies to deliver over $1 billion worth of ICT technology and services and become end-to-end service integrator to the IUIH program over the next 10-20 years. The scope of this technology partnership opportunity includes following aspects: ICT Infrastructure and service ◗ Build, manage and operate ◗ Periodic technology upgrade and planned evolution ◗ Business operations support with medical grade availability and reliability

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IUIH is committed to a comprehensive digital strategy across all areas of operation and the utilisation of leading edge healthcare technology solutions for improving clinical quality and safety, continuity of care, patient outcomes etc Systems and solutions ◗ End-to-end service(s) enablement ◗ Evaluate, deploy, integrate, support and maintain for continuous patient care and business operations ◗ Vendor license, support, risk management Business and clinical processes support ◗ Call Centre ◗ BPO ◗ KPO Innovation ◗ Enable IT and data for internal and external innovations ◗ Co-innovate with IUIH and external parties The technology partners will bring together best of breed systems infrastructure, technologies and services; build service and systems as required to integrate, implement, scale, maintain and evolve the serv-

ice; and align and evolve with requirements of IUIH business and of digital hospitals as well. IUIH’s technology partners may serve as member of IUIH Industry Committee along with other global leaders in healthcare industry to advise IUIH management. Requirements from tech partners in terms of services, solutions and delivery are as follows: ◗ Design, build and operate end-to-end service(s) enablement for EMRAM Stage 7 quality ◗ Managed services and or utility services to support and ensure ❍ Digital hospital and patient care ❍ Connected care ❍ Patient centricity ❍ Medical grade availability ❍ Security and compliances ❍ Flexibility ❍ Scalability ❍ Maintainability ❍ Standardised and shared processes ❍ Future proofing ❍ Smart building and facilities (smart technology deployment and central command centre ops) ◗ Innovation ideation and support ◗ Risk avoidance, mitigation and management ◗ Financial outlay mitigation Some of the existing programme advisors and strategic partners of IUIH include names like PricewaterhouseCoopers, Ernst & Young, KPMG, Pinsent Masons, King’s College Hospital, Stryker, Zimmer Biomet, Larsen & Toubro, Kemp Little and Tech Legis to name a few. ICT enterprises interested in partnering with IUIH can contact it’s London office at: Tel: +44 (0)20 3755 0982 Address: 1 Harvey Street, London, W1G 9QD Website: www.iuih.co.uk

IUIH TEAM THAT’S LEADING THE IT INFRASTRUCTURE AND SERVICES INITIATIVE FOR ITS DIGITAL HOSPITALS AND CLINICS: Dr Ajay Rajan Gupta is a Consultant Orthopedic Surgeon at the NHS with over 20 years in the medical field.Dr Gupta is spearheading the IUIH project leading a team of Indian and UK-based promoters with the support of the Indian and UK Governments.He has had extensive experience in the areas of healthcare policy,management and research and has been an advisor to various government agencies and organisations.He is a proud recipient of many awards including ‘Young Entrepreneur Award’in Dubai in 2011; ‘Young Scientist Award’in Las Vegas in 2013 and the ‘Medical Maestro Award’at the House of Lords, London in 2014 DR AJAY RAJAN GUPTA MD and Group CEO, Indo UK Institute of Health (IUIH)

Dr Gautam Marwah is a portfolio General Medical Practitioner providing services in the NHS and the private sector.He attained extensive experience in the NHS having worked in the primary and secondary care, attaining knowledge and experience across a broad gamut of medical and surgical specialities.Among his various roles,he lead business development of GP resilience pathways in the North East of England, developing innovative integrated healthcare partnerships between primary and secondary care

DR GAUTAM MARWAH Group Director, Indo UK Clinics

Matthew adds over 15 years of Programme and ITexperience to the team.He’s gained this from several private healthcare organisations, delivering solutions and services primarily to the NHS.Advising at board level,he was an integral part in the creation of multi-million dollar business units and businesses of InHealth Group,IHSS for Berendsen,and Theatre Care Rapide for Zimmer Biomet.He is a Prince II practitioner and brings extensive knowledge in IT,budgeting,planning and operations

MATTHEW LEMASONRY Director, IT & PMO

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GLIMPSES

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HEALTHCARE SENATE 2018 AGENDA DAY 1

Healthcare Senate 2018 ◗

Welcome Address Prathiba Raju & Inauguration Ceremony

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KEYNOTE ADDRESS: Responsibility and sustainability go hand in hand; Dr KM Cherian, Chairman & CEO, Frontier Hospitals

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Samsung Vision for Health and Medical Industry Atantra Das Gupta - Director & Head - Health & Medical Equipments, Samsung Healthcare

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Learnings from the Silicon Valley: A story of grit and glory; Sanjeev Saxena, CEO, POC Medical Systems

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Philips’ Vision for Indian healthcare Rohit Sathe - President Philips Health Systems

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Panel discussion - NHPS: The way forward

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ADDRESS BY GUEST OF HONOUR, Satyendra Jain, State Health Minister, Government of Delhi

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Innovatives Models of Healthcare delivery;

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PANEL DISCUSSION - Access strategies in the era of price control

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Express Healthcare Excellence Awards Ceremony

12 July 2018

Inaugural Ceremony

L-R: Atantra Das Gupta - Director & Head - Health & Medical Equipment, Samsung Healthcare; Sunil Khurana, CEO & MD, BPL Medical Technologies; Bejon Misra, Founder, Patient Safety and Access Initiative of India Foundation; Dr KM Cherian, Chairman & CEO, Frontier Hospitals; and Viveka Roychowdhury, Editor- Express Healthcare & Express Pharma

Prathiba Raju, Special Correspondent, Express Healthcare gives the Welcome Address

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ealthcare Senate, India's largest private sector healthcare business summit, in its third edition witnessed interesting dialogues, debates and discourses by key decision makers, budget holders and thought leaders on the theme Healthcare 2.0: Strengthening Values for Sustainable Growth. Experts and veterans of the industry came together to discuss on vital issues shaping the future of the healthcare industry and prepare a blueprint for progress based on values that will make healthcare organisations successful, both in terms of profitabil-

ity and goodwill. The event commenced with a lamp lighting ceremony followed by the Welcome Address. Viveka Roychowdhury, Editor- Express Healthcare & Express Pharma; Dr KM Cherian, Chairman & CEO, Frontier Hospitals; Atantra Das Gupta - Director & Head - Health & Medical Equipment, Samsung Healthcare; Sunil Khurana, CEO & MD, BPL Medical Technologies; Bejon Misra, Founder, Patient Safety and Access Initiative of India Foundation lit the ceremonial lamp and gave an auspicious start to the event.

Responsibilityand sustainabilitygo hand in hand

he third edition of Healthcare Senate witnessed a lot of thought leaders and game changers take the stage to share their ideas and vision. Dr K M Cherian, Chairman and CEO of Frontier Lifeline Hospital, the renowned cardiologist was one of them. In a very insightful keynote address which brought to light various crucial issues in Indian healthcare, he spoke on the rising incidence of heart diseases in India and the need for integrated treatment protocols to tackle this challenge. He elaborated on the various measures undertaken in his hospital and the different initiatives taken by the Kerala government on this front. Emphasizing that India’s healthcare landscape is undergoing tremendous change, he also spoke on how technological disruptions are transforming healthcare delivery. He also highlighted the role of medical technology, emergence of ICT, expanding network of World Wide Web, social media etc, in transforming healthcare delivery. Digital medicine is the future as devices get interconnected. With internet of things

India’s increasing healthcare demands the need to embrace technology, innovation and new business models in Indian healthcare

Dr KM Cherian, Chairman & CEO, Frontier Hospitals

(IOT) we will see a connected home, a connected workplace and a connected city. He also pointed out how teamwork is very crucial when it comes to delivering quality healthcare. He also addressed the need for healthcare businesses to be more sustainable. He said, “Sustainability has become the common and greatest responsibility of the individual, the society and the planet as a whole.”

Samsung Vision for Health and Medical Industry

n this session, Atantra Das Gupta, Director and Head - Health & Medical Systems, Samsung Healthcare took the stage and shared his company's vision for the healthcare industry. He opined that technological innovation is driving progress in healthcare and hence his company is making significant investments in technologies such as AI and machine learning to improve healthcare delivery. He also drew attention to several healthcare challenges in India such as the shortage of health infrastructure coupled by increasingly complex diagnoses. Dasgupta further informed that Samsung is striving to mitigate these challenges and contribute towards uniform access to affordable yet quality healthcare services. The company’s medical devices are being built with the goal to bridge gaps in healthcare delivery. Informing the audience about his company's offerings, he reiterated his

Samsung’s vision is to enhance access, accuracy and efficiency in healthcare delivery

Atantra Das Gupta, Director and Head - Health & Medical Systems, Samsung Healthcare

company's commitment towards improving healthcare in India and stressed that Samsung’s vision is to enhance access, accuracy and efficiency in healthcare delivery.

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HEALTHCARE SENATE 2018

Learnings from the Silicon Valley: Astoryof grit and glory

erial entrepreneur, Sanjeev Saxena's session was an eye-opener in many ways. He shared his learnings and experiences. He spoke on the huge disease burden faced by our country and elaborated on how important it is to reduce healthcare costs. He said, “It is imperative to make healthcare services easily accessible, affordable and more patient-centric.” As the CEO of POC Medicals, he also informed that his company is looking to resolve two major issues in Indian healthcare: geographic inaccessibility and cost prohibition, through next generation screening tools to the market. Citing breast cancer as an example, he pointed out that it was curable if diagnosed early, but many women do not get their tests done because of affordability and the discomfort caused by mammograms. Hence, his company has launched a blood-based test, to screen for cancer. In his opinion, “It is possible to make cancer diagnosis easier with blood tests. All our data lies in the blood.” Reiterating that healthcare entrepreneurship is all about doing some-

Healthcare entrepreneurship is all about doing something for someone else.It is about giving it back to the society thing for someone else. It is about giving it back to the society, he said that all businesses are looking at creating unicorns. However, this mindset needs to change and the focus should be on making a difference, especially in healthcare. He also predicted that next gen technologies like deep machine learning are ushering a new paradigm in healthcare. Sanjeev Saxena, CEO, POC Medical Systems

Philips’Vision for Indian healthcare

everal industry leaders like Philips Healthcare were partners of Healthcare Senate 2018. At the event, Rohit Sathe, President, Philips Health Systems, spoke on his company's vision for Indian healthcare and outlined its strategies to achieve them. He said that though Philips is not an India-origin company, it has been serving the country for so long that many believe it to be one. He stated that his company is committed towards improving healthcare in the country. Further, he informed that Philips’ focus on healthcare in India is set to increase and hence the company would also ramp up its manufacturing capabilities in India, for the Indian market. Armed with the belief that there is always a way to make life better, Philips is working towards touching three billion people by 2015, informed Sathe. He emphasised on the growing role of technology in enhancing health-

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Philips’focus on healthcare in India is set to increase.Its manufacturing in India,for India will increase

Rohit Sathe, President, Philips Health Systems

care delivery and the trends which will drive progress in the sector. He also reiterated that Philips intends to touch maximum lives and encourage healthy living through its health tech solutions in four major areas - prevention, diagnosis, treatment and home care.

NHPS: The wayforward

l- R: Lokesh Sharma, Senior Principal & Practice Leader - Public Health, AMESA at IQVIA; Joy Chakraborty, COO, Hinduja Hospital; Dr Shaktivel Selvaraj, PHFI and Alexander Thomas, President, AHPI

ealthcare Senate 2018 saw several leaders and game changers of the India’s private healthcare sector come together to converse and contemplate on vital issues shaping the future of the healthcare industry, with a focus on the theme Healthcare 2.0: Strengthening Values for Sustainable Growth. One such discussion was on ‘NHPS: The way forward’ by an eminent panel comprising Lokesh Sharma, Senior Principal & Practice Leader - Public Health, AMESA at IQVIA; Joy Chakraborty, COO, Hinduja Hospital; Dr Shaktivel Selvaraj, PHFI and Alexander Thomas, President, AHPI. The panel discussion saw experts and veterans of the industry discuss on the impact of initiatives such as Ayushman Bharat on the private healthcare

sector. While they lauded the intent of the government, the experts were also of the view that it should be imple-

mented in a manner which would benefit all stakeholders. They also mulled on the need to find and create alternate

KEY TAKEAWAYS ❖ Out-of-pocket spending for healthcare in India is very high and the role of every government funded insurance scheme is to bring this down. However, any scheme which only targets hospitalisation will not succeed in reducing out-ofpocket spending. ❖ It is important for all stakeholders to collaborate and find common meeting ground to make Ayushman Bharat a successful initiative. ❖ There is a need to find and create alternate revenue streams for healthcare providers to make schemes like Ayushman Bharat successful and sustainable. ❖ It is imperative to improve the quality of healthcare services provided at government hospitals. Healthcare services in India should be provided with a 70:30 ratio, with the government providing 70 per cent of the services. ❖ Putting systems in place to bring in efficiencies and reducing misuse and frauds of NHPS. Proper regulations are also very pivotal to the scheme’s success.

revenue streams for healthcare organisations to make them sustainable and profitable. Stressing on the importance of all stakeholders collaboration, the experts also reviewed various approaches to remain profitable and sustainable in these times. They drew inferences from similar schemes adopted by state governments and examined their successes as well as failings. They also advocated that the quality of treatment at public sector hospitals should be improved to make the scheme more effective. The panelists concluded the discussion with the unanimous view that putting effective systems in place to bring in efficiencies as well as to reduce misuse and frauds would be crucial to making NHPS successful.

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HEALTHCARE SENATE 2018

Address byChief Guest

ealthcare Senate 2018 saw a congregation of not just private healthcare leaders. Policymakers also chose it as a platform to inform the healthcare fraternity about their initiatives and vision for the growth of this sector and the well-being of the masses. Satyendra Jain, Minister of Health, Government of Delhi was one of them. As the Chief Guest on the first day of the event, he addressed the august audience of healthcare leaders and spoke on the various measures being undertaken by his government to improve healthcare quality and access. He informed that the Delhi government is trying to provide quality healthcare at affordable rates to all the citizens of the state. The mission is to ensure ‘Health for all’ in the state regardless of their socio-economic strata. The government has introduced several initiatives such as providing medical tests at very affordable rates, paying for the healthcare services of all accident victims, setting up Mohalla clinics etc. Advocating healthy living and on preventive healthcare, he accentuated that prevention is always better than cure and hence it is important to focus on preventive healthcare as well. He also said that it is important to bond better as a

Health for all is the motto and mission of the Delhi government and we are striving to achieve this objective through several measures

Satyendra Kumar Jain, Minister of Health, Government of Delhi

society to bring down ailments caused by stress and hypertension. He also cautioned the healthcare fraternity that there is an urgent need is to humanise healthcare. Even as technology brings in new advancements in healthcare, it is essential for doctors and healthcare providers to lend a patient ear to their patients’ ailments and build a bond based on trust and respect. He said, “These days healthcare is more about diseases and less about health. A mind-set change is required to change this scenario.”

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August 2018

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Innovative models of healthcare of skilled healthcare professionals and building alternate ways of healthcare delivery to meet the growing and changing healthcare demands in our

Dr Renuka David, TedX Speaker, Author and Wellness Coach

r Renuka David, a TEDx speaker, spoke on leading a happy and healthy life and the need to promote and adopt preventive healthcare strategies, in her address on 'Innovative models of healthcare' . Dr David emphasised on the necessity of bringing the patient to the centre of healthcare practice and understanding their needs to make it more patient-centric and thereby more effective and efficient models of healthcare. She spoke on building a lasting bond between healthcare providers and patients. She spoke on creating a pool

Home healthcare can act as a supporting arm to hospitals and enable better healthcare services in the country EXPRESS HEALTHCARE

August 2018

country. Making a case for home healthcare services, she opined that they can act as a supporting arm to hospitals and enable better healthcare

services in the country. She highlighted that as our demographics continue to change, and geriatric population in our country continues to grow,

home healthcare will play an important role. Therefore it is pivotal to create a pool of skilled healthcare workers to improve home healthcare services.

HEALTHCARE SENATE 2018

Access strategies in the era of price control

Viveka Roychowdhury, Editor, Express Healthcare & Express Pharma (Moderator); Dr Ratna Devi, CEO, DakshamA Health & Founder, IAPG; Dr A Velumani, CEO, Thyrocare; Dr SB Sinha,Advisor, Healthcare Technologies, WHO-Collaborating Centre for Priority Medical Devices & Healthcare Technology Policy, NHSRC, MoH&FW, GoI; Atantra Das Gupta, Director & Head - Health & Medical Equipment, Samsung Healthcare; Dr Akshay Baheti, Assistant Professor, Dept of Radiodiagnosis, Tata Memorial Center, Mumbai & Affiliate Instructor, Dept of Body Imaging, University of Washington Medical Center, Seattle and Dr VK Monga, Honorary Finance Secretary, IMA

everal pertinent issues were discussed at the third edition of Healthcare Senate of which, 'Access strategies in the times of price control' was one of them. The discussion comprised an expert panel that included Viveka Roychowdhury, Editor, Express Healthcare & Express Pharma (Moderator); Dr Ratna Devi, CEO, DakshamA Health & Founder, IAPG; Dr A Velumani, CEO, Thyrocare; Dr SB Sinha,Advisor, Healthcare Technologies, WHO-Collaborating Centre for Priority Medical Devices & Healthcare Technology Policy, NHSRC, MoH&FW, GoI; Atantra Das Gupta, Director & Head - Health & Medical Equipment, Samsung Healthcare; Dr Akshay Baheti, Assistant Professor, Dept of Radiodiagnosis, Tata Memorial Center, Mumbai & Affiliate Instructor, Dept of Body Imaging, University of Washington

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Medical Center, Seattle and Dr VK Monga, Honorary Finance Secretary,

IMA. Highlighting that Indian healthcare producers and providers in the re-

KEY TAKEAWAYS ❖ The government should devise healthcare strategies which are sustainable, beneficial to all stakeholders and create a conducive environment to foster a quality healthcare ecosystem ❖ One cannot buy gold at the price of iron. The government's price control strategies should be rational and reasonable, say panelists who are against price control. ❖ The government should invest in good quality public healthcare infrastructure and provide quality healthcare at competitive costs. This would lead to private healthcare providers offering more affordable healthcare services as well ❖ Being the patient to the centre of the decision making process and identify the root cause for rising healthcare costs. Every aspect needs to fall into place to make a healthcare system work. So, price control should be supported by other effective measures as well. ❖ Panelists supporting price control argue that it will lead to affordability but it is essential to have effective implementation of these strategies as well.

cent times have been striving under the extreme burden of balancing price control with quality access of medicines and healthcare facilities, they endeavoured to throw more light on the impact and implications of this issue. They also discussed the merits and demerits of the move and deliberated on pertinent questions such as: Is price control sustainable? If so, for how long? Are there win-win examples in India and other similar countries? If price control is not sustainable as a standalone process in the long term, so what are the missing pieces, to this puzzle that still need to fall in place? The panelists also recommended bringing the patient to the centre of the decision making process and identifying the root cause for rising healthcare costs to support price control with other effective measures as well.

HEALTHCARE SENATE 2018

Express Healthcare Excellence Awards celebrated the spirit of excellence and leadership The awards serve as a platform for organisations to showcase their innovative operational processes, strategies and techniques that have facilitated them to achieve better medical outcomes

EXPRESS HEALTHCARE EXCELLENCE AWARDS Category 1: Business Strategies ❏ Sub category: Best cost effective solution by a hospital/s ❏ Winner: Apollo Hospital Hyderabad Category 1: Business Strategies ❏ Sub Category: Best brand evolution award ❏ Winner : Hinduja Healthcare Surgical Hospital Category 1: Business Strategies ❏ Sub Category: Best Patient satisfaction programme ❏ Winner 1: P.D. Hinduja Hospital & Medical Research Centre Category 1: Business Strategies ❏ Sub Category: Best Patient satisfaction programme ❏ Winner 2: Mehta Multi Speciality Hospitals India Pvt Category 1: Business Strategies ❏ Sub Category: Best Patient satisfaction programme ❏ Winner 3: Onco Day Care- Max Healthcare Category 2: Operational Excellence ❏ Sub Category: Finance Management Practises ❏ Winner: Apollo Group of Hospitals Category 2: Operational Excellence ❏ Sub Category: Best Patient safety practises ❏ Winner: Apollo Health city

Winners of Express Healthcare Excellence Awards 2018

he third edition of Express Healthcare Excellence Awards celebrated the spirit of excellence and leadership in India’s private healthcare delivery sector. Concurrently with Healthcare Senate, the awards seek to recognise the vital contributions of private hospitals and industry leaders to enhance healthcare in India. The Awards were presented By Philips Health System. In the last three years, Express Healthcare Excellence Awards has worked to create a platform for organisations to showcase their innovative operational

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August 2018

processes, strategies and techniques that have facilitated them to achieve better medical outcomes, reach profitability and improve processes with their organisations. These strategies, processes and innovations can also be an excellent example for other organisations to adopt. So, these awards are segregated in three main categoriesBusiness strategies, operational excellence and social footprint. The awards ceremony began with Ms Viveka Roychowdhury, Editor, Express Healthcare and Express Pharma speaking on the purpose and vision for these awards.

This was followed by Bejon Misra, member of the Governing Board Member of QCI & NABH as well as Chairperson of Jury expounding on the methodology of the awards. In his address he urged the audience to work towards creating sustainable models of healthcare delivery based on core values of integrity, innovation, accountability, flexibility and quality care. The other jury members were Dr K K Kalra, Ex CEO, NABH and Dr Ratna Devi, CEO, & Co-founder, DakshamA and Prof T Sundaraman, Dean, Tata institute of social science.

Category 2: Operational Excellence ❏ Sub Category: Best Patient safety practises ❏ Winner: Mission of mercy hospital & research Centre Category 3: Social Footprint ❏ Sub Category: Best CSR initiative ❏ Winner: Narayana Health Category 3: Social Footprint ❏ Sub Category: Best Community initiative by a hospital ❏ Winner: Paras HMRI Hospital

Apollo Group of Hospitals

Mission of Mercy Hospital and Research Centre

Apollo Health City

Narayana Health

Apollo Hospital Hyderabad

Onco Day-Care Max Healthcare

Dr Mehta's Multispeciality Hospitals India

Paras HMRI Hospital

Hinduja Healthcare Surgical Hospital

PD Hinduja Hospital and Medical Research Centre

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HEALTHCARE SENATE 2018 AGENDA DAY 2

Healthcare Senate 2018 ◗

Mind of an innovator Aakash Manoj, Prodigy & Innovator

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Business Culture: Why core values matter? Presentation by Standard Chartered

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Decreasing variation and increasing value in healthcare Tim Morris, Product and Partnerships Director, Elsevier India

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Emergence of medical devices in India Sunil Khurana, CEO & MD, BPL Medical Technologies

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Address by the Chief Guest Ashwini Kumar Choubey, Minister of State, Ministry of Health and Family Welfare, Government of India

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Physicians, heal thyself Dr Mickey Mehta, Holistic Health and Fitness Guru

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Panel discussion - Growth agenda: The battle for sustained innovation leadership

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Infection Prevention and Protection: The single use dilemma Sumit Marwah, CEO & Director, Dispoline India

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Cloud and AI in Indian healthcare Ankit Sinha, Business Head (Corporate), Google Cloud, Google India

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Panel Discussion - Consolidation in healthcare: Putting the best foot forward Workshops & Power Discussions

BEST HOSPITAL PHARMACY CITATIONS 2018

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Welcome Address Viveka Roychowdhury Editor, Express Healthcare & Express Pharma

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Presentation of Best Hospital Pharmacy Citations 2018

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Vote of Thanks Usha Sharma, Principal Correspondent, Express Pharma

Networking Gala Dinner

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13 July 2018

Mind of an innovator

Aakash Manoj, Prodigy and Innovator

akash Manoj, the teen prodigy who invented a non-invasive device to detect silent heart attacks and save thousands of lives, enlightened the audience about his invention on the second day of the Healthcare Senate 2018. Manoj said, “After having researched for about three years, I’ve been able to develop a non-invasive device that is inexpensive, portable, and wearable by at-risk patients. It needs no blood test and works 24/7, collecting and analysing data in preset intervals, and what is even more special is that it can detect heart attacks upto six hours in advance.” Explaining about the non-invasive device, Manoj said, “The levels of a cardiac biomarker called h-FABP enables early detection, as against the conventional detection of Troponin in expensive Trop-T tests at hospitals today. A system like this could do away the need for an at-risk patient to go to a doctor for a biomarker blood test because the device could be worn at all times, sensing biomarker elevations in-vivo. If the device senses the biomarker levels going beyond the critical point, the at-risk patient could be warned of an impending cardiac arrest and that he/she needs immediate medical attention. When I got my device tested on at-risk patients under observation at AIIMS, New Delhi and the Tokyo University of Science, results certified

I strongly believe it’s time we rethink medicine.We must establish proactive healthcare technologies 96.46 per cent accuracy and sensitivity. This could indeed transform the diagnostic protocol that medical community currently adheres to.” Moving forward, he would want his innovation to be available to people in two variants. One, which gives a digital analysis of the biomarker levels. And a simpler version for the people in rural areas, which simply vibrates when the levels of the biomarker steadily rises. He also highlighted the need to establish proactive healthcare system and fund researches in which patients are co-designers, co-developers, and thereby, increasingly more responsible for their own and collective health outcomes.

Business Culture: Whycore values matter?

(L-R) Dilip Jose, Group CEO, Manipal Hospitals, Dr Vishal Beri, CEO, Hinduja Surgical, Rajit Mehta,CEO, Max Healthcare, Dr Sabahat Azim, CEO, Glocal Hospitals, Dr Harish Pillai, CEO, Aster Hospitals & Clinics, Rupak Barua, Group CEO, AMRI, Kolkata, Sanjay Prasad, CEO, Mission of Mercy Hospital & Research Centre, Kolkata and Dr Gaurav Thukral, COO, HealthCareatHOME

ealthcare business will not succeed without values and a vision to anchor them. Everyone working in an healthcare organisation is a custodian of its values. Valuesbased healthcare will lead to trust building and make it more patient-centric. These were the central messages from the eight leading CEOs representing top healthcare organisations pan-India. They addressed the topic 'Business Culture: Why core values matter?' on the second day of the third edition of Healthcare Senate 2018. The session comprised eminent panelists - Dilip Jose, Group CEO, Manipal Hospitals; Dr Vishal Beri, CEO, Hinduja Surgical; Dr Sabahat Azim, CEO, Glocal Hospitals; Rajit Mehta,CEO, Max

Healthcare; Dr Harish Pillai, CEO, Aster Hospitals & Clinics; Rupak Barua, Group CEO, AMRI, Kolkata; Dr Gaurav Thukral, COO, HealthCareatHOME; and Sanjay Prasad, CEO, Mission of Mercy Hospital & Research Centre, Kolkata. Moderated by Dilip Jose, Group CEO, Manipal Hospitals, each member in the panel expounded on the role of values in building a successful business.

The CEOs spoke on the need to build and nurture a culture of engagement and accountability to succeed in an era of population health management and accountable care. They also explained the various ways in which values can definitely offer a competitive advantage to a business like healthcare. The experts also reiterated that in times to come, only organisations that stay true to values

KEY TAKEAWAYS ❖ Healthcare business will not succeed without values and a vision to anchor them ❖ In healthcare, values are crucial as they would impact the RoI of the business. ❖ Everyone working in an healthcare organisation is a custodian of its values

like transparency, integrity and honesty would succeed in the long run. Cautioning that it isn’t enough to talk about values, the CEOs informed that they should be applied to all aspects of healthcare. For instance, implementing good governance, monitoring clinical outcomes, patient-centric policies, etc. The discussion established that apart from affecting the RoI in healthcare business, values will also significantly impact employees, patients, services and business processes in healthcare organisations. All the panelists voiced that it was essential to take actions, tangible measures, based on the values that the healthcare organisations uphold.

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HEALTHCARE SENATE 2018

Newage digital banking solutions for the Health care segment A

s digital technologies continue to transform healthcare services and service providers, hospitals are seeking for solutions that expedite their transition to the digital space. In an interesting presentation, Standard Chartered Bank shared a new perspective on how hospitals can opt for digital banking solutions to improve their financial transactions. India as a nation is changing and now digitisation has become a key element in this progress. Technology is transforming India rapidly and as a result, consumer behaviour too is changing. The healthcare sector too needs to be ready to serve changing consumer demands and preferences. Moreover, digitisation is touching all aspects of healthcare including financial transactions. India has one of the most advanced payment systems of the world. The Bank also, highlighted the financial challenges that hospitals face. This leads to further discussion on how digital banking solutions can be beneficial to healthcare organisations. Digital banking solutions can usher in

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more transparency, efficiency and convenience to healthcare. Digital banking enhances adherence to regulations in healthcare, offers manifold benefits to both the healthcare provider and the patients. It simplifies ways to

make payments, improves operational efficiency and helps to save costs. UPI is one of the largest payment systems in India and this system is helpful to healthcare providers in many ways. Standard Chartered Bank has expanded its solutions within the healthcare ecosystem and has created a value proposition that can facilitate healthcare organisations for a smooth transition to the digital space. Manish Jain, Managing Director & Head, Commercial Banking, India states, “India’s healthcare industry is one of the fastest growing sectors and in the next 10 years it is likely to reach $275b. With growing consumer needs for high end diagnostics, improved medical quality and precision the capital investment in the sector has grown multi-fold. This sector in India is well diversified and full of opportunities. Medical tourism is growing at 20 to 25 per cent. Standard Chartered Bank is proud to be the partner in this growth with our specialised products to cater to the needs of the sector for effective collections and

payments. We focus on helping your business by providing bespoke solutions using our expertise developed over the years and across markets.” The Bank can be an ideal banking partner for healthcare organisations with its effective and pertinent digital solutions. Krishnakumar Dharmaraj, Managing Director & Head, Transaction Banking, Commercial Banking, South Asia, opines, “Standard Chartered Bank is a pioneer in providing digital technology solutions. We have innovated many first-in products. When India launched the UPI we were one of the 4 banks which started UPI technology. We have started API stores with lot of used cases and block chain innovation. Our front end platform Straight2Bank is very well accepted by the clients and we are now taking it to the next level – S2B NextGen. Additionally, through our accelerator team, we are working on many such innovations especially through crowd sourcing which would be beneficial for our clients.”

We focus on helping your business by providing bespoke solutions using our expertise developed over the years and across markets

Standard Chartered Bank is a pioneer in providing digital technology solutions. We have innovated many first-in products

MANISH JAIN, Managing Director & Head, Commercial Banking, Standard Chartered Bank, India

KRISHNAKUMAR DHARMARAJ, Managing Director & Head, Transaction Banking, Commercial Banking, Standard Chartered Bank, South Asia

Address by Chief Guest

“A

yushman Bharat is a new era in healthcare. It would revolutionise and make healthcare accessible, affordable to all,” informed Ashwini Kumar Choubey, Union Minister of State for Health and Family Welfare, at the third edition of Healthcare Senate. Addressing healthcare delegates from pan-India, Choubey, the Chief Guest at the second day of the event said, “We need the support of all stakeholders of healthcare, including the media, to make our movement successful.” “Ayushman Bharat is a holistic healthcare programme, it will cover over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) and provide coverage upto five lakh rupees per family per year for secondary and tertiary care hospitalisation,” informed Choubey. He also informed that Healthcare Senate is a great platform for healthcare leaders as it focuses on values, especially in these times where profit seems to be the biggest motivator. Choubey also emphasised, “Good health is often the result of good nutrition and good sanitation. Therefore, the government is trying to ensure that the country’s citizens get access to these through several initiatives, including

Ayushman Bharat is a new era in healthcare. It would revolutionise and make healthcare accessible to all

Ashwini Kumar Choubey, Union Minister of State for Health and Family Welfare

institutionalised deliveries and nutritional supplementation schemes. ” He also spoke about how the govern-

ment is planning to revamp PHC centres in the country to improve healthcare services in the country. It intends to

launch 15000 centres in this year across the country. Touching upon the role of AYUSH, Choubey stressed that if it is leveraged effectively, it can help tackle the shortage of allopathic doctors and healthcare professionals. “Age-old practices like yoga could be very beneficial in tackling lifestyle diseases. India could show the world the way to live healthier through effective adoption of yoga,” he added. His central message was, “Service to humanity is service to God. It is true worship.”

Emergence of medical devices in India

or the past 20 years, medical technology (medtech) market worldover has been rapidly advancing. With a constant surge in innovation that addresses complex health challenges and increased long-term disease management, the industry shows no sign of slowing down, said Sunil Khurana, CEO & MD, BPL Medical Technologies. “The healthcare devices market will grow at a compounded rate in the times to come,” Khurana highlighted. He also threw light on the technologies that will be transforming healthcare in future and said that wearable devices are going to play a great role in healthcare. The medical devices market has seen a huge change and is currently evolving at a faster pace with growth in ICT technologies. Likewise, speaking of the way in which IOT will applied in medical devices,

Wearable devices are going to play a great role in healthcare

Sunil Khurana, CEO & MD, BPL Medical Technologies

he informed that in future, healthcare devices are going to be more connected which will facilitate faster and better medical outcomes.

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HEALTHCARE SENATE 2018

Physicians,heal thyself

r Micky Mehta, India’s leading health and fitness guru, accentuated on the need for holistic health management, to the healthcare professionals gathered at the third edition of Healthcare Senate. He commenced his session by asking doctors to pay adequate attention to their own health, Mehta said, “We can be co-creators of our own destiny and this co-creation begins with our own health. We become what we eat. Hence, it is very important to eat a wholesome diet which not only nourishes our physical health but also fortifies our mental well being.” He stressed on the need for holistic health management which would include wellness and disease prevention in a big way through proper diet and exercise. Fitness guru also asked doctors to have a stress-free life and informed that laughter was a great medicine, as it improves health, enhances digestion, reduces hypertension and more. The renowned life coach to Bolly-

We can be co-creators of our own destiny and this co-creation begins with our own health

Dr Mickey Mehta, Holistic Health and Fitness Guru

wood superstars, top supermodels, politicians Mehta said, “If death is an event, it should be a choice taken by you after accomplishing all your goals.” Touching upon various aspects of meditation, stress management among doctors, he left the audience with a message - “Never become a host to diseases, let yourself be a host to only health, wellness and well-being.”

Decreasing variation and increasing value in healthcare

“E

vidence-based information for better patient outcomes is need of the hour and value can be improved through information and skills,” said Tim Morris, Product and Partnerships Director, Elsevier India. Speaking at the second day of the Healthcare Senate 2018, Morris elaborated on how to manage healthcare information as it is getting more complex. Explaining how removing operational variations in practice can help, Morris said, “Nursing is one area which was undervalued in many countries and nurses are not paid properly in many countries. Investing in nurses helps and it can turn things around for a hospital and it will increase its value. Even if you train 100 per cent nurses and you lose 40 per cent to attrition, you still have 60 per cent of them with highest skills with you.” Informing that patients are a key part of the value proposition, he said, “Improving patient engagement and satisfaction is crucial, like supplying

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Evidence-based information for better patient outcomes is need of the hour

Tim Morris, Product and Partnerships Director, Elsevier India

information around prescription viz. when a pill should be taken, guidance via video making available in their own language might improve patient outcomes.” Giving details about Elsevier, Morris said, “We help in providing evidence-based clinical reference at point-of-care to clinicians, deliver integrated decision support solutions to the entire care team, machine learning and Artificial Intelligence (AI) in oncology and offer medical training for nurses and health assistants via online.”

Growth agenda: The battle for sustained innovation leadership

(L-R) Dr Aniruddha Malpani, MD, Malpani Ventures; Gauri Angrish, Founder, CEO, Caredose; Vidur Mahajan, Executive Director, Mahajan Imaging; Nachiketas Nandakumar, Assistant Prof, Great Lakes Institute of Management, Chennai; Subi Sethi, VP-Business Excellence, Optem Global Solutions and Dhruv Pandey, Leader Healthcare, Tata Trusts’ Foundation, for Innovation and Social Entrepreneurship

group of expert panelists from the industry discussed and deliberated on growth strategies, consolidation and sustained innovation leadership in the healthcare domain, onthe second day of the Healthcare Senate 2018. The session was moderated by Dr Aniruddha Malpani, MD, Malpani Ventures who steered the discussions on various aspects of this issue. The other panelist who shared the dais with him where Gauri Angrish, Founder, CEO, Caredose; Vidur Mahajan, Executive Director, Mahajan Imaging; Nachiketas Nandakumar, Assistant Prof, Great Lakes Institute of

Management, Chennai, Subi Sethi, VP-Business Excellence, Optem

Global Solutions and Dhruv Pandey, Leader Healthcare, Tata Trusts’

KEY TAKEAWAYS ❖ Innovations should be encouraged from the academic level itself. There is a need to revamp the MBBS curriculum since the current one doesn’t encourage innovation. ❖ Create a ecosystem which is conducive to foster new ideas and usher innovation. It is essential to incubate innovative entrepreneurial ventures and learn from failures. ❖ Healthcare needs enhanced collaboration between stakeholders and in-depth research on products, pricing and promotion strategies for sustained innovation. ❖ Collaborate to devise strategies which will help generate profits and create social impact. Philanthropic capital can also encourage innovation at each level of healthcare.

Foundation, for Innovation and Social Entrepreneurship. The panel members discussed on why the consolidation in healthcare is needed and focused on the strategies which can help companies to grow faster and benefit consumers in a better way. It also covered the need for vertical consolidation to create better interdepartmental synergies and improve overall performance. Talking about innovation in healthcare the panelist opined that there is a need for innovation in go-to-market strategies. Also, emphasised that there should not be afterthoughts for innovation.

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HEALTHCARE SENATE 2018

Infection prevention and protection: The single use dilemma

umit Marwah began his session by highlighting how single use solutions can be effective in infection prevention. Addressing the audience at the second day of Healthcare Senate 2018, Marwah pointed out about the importance of sterilisation in hospitals and use of sterile barrier materials. “Infections are a leading cause of deaths in the world today. Anti Microbial Resistance (AMR) has emerged as a serious health concern. We know very less about the microbes around us and their impact on human health. Single use solutions could be an effective weapon to tackle infections at healthcare settings and to provide proper safety and hygiene to patients,” he said. Elucidating on the significance of infection control and single use solutions with various examples, Marwah said, “India continues to battle the threat of communicable diseases which gets magnified as a result of the country’s huge population. Lack of proper safety and hygiene compounds this

The single-use packaging system offers maximum safety,sterility and efficiency

Sumit Marwah, CEO and Director, Dispoline India

problem and in such a situation, single use products, are safer and more effective alternatives.” Listing down the benefits of single use products, he emphasised that there should be strong adherence and compliance with the Hospital Management Act to prevent the spread of infectious diseases. “The single-use packaging system offers maximum safety, sterility and efficiency. The purpose of this is to prevent the migration of micro-organisms and to reduce infection,” he informed.

Cloud and AI in Indian healthcare

t is the dawn of a digital age and technologies like cloud computing and Artificial Intelligence (AI) are expected to have a major impact in almost every sector, and the healthcare sector is no exception, informed Ankit Sinha, Business Head (Corporate) Google Cloud, Google India. Elucidating about the role of Cloud and AI in Indian healthcare at the third edition of Healthcare Senate, Sinha said that healthcare organisations need to embark on their digital journey and become tech savvy to serve their patients and fulfill their healthcare requirements in today's era. Highlighting about Google Cloud and its role in healthcare industry, Sinha emphasised that digital aggregators will play a vital role in the digital era. He also affirmed that Google Cloud can be a good partner for healthcare providers and help them in creating a digital healthcare platform. Sinha further explained how convergence of healthcare and IT has opened up growth avenues for both sectors and is likely to bring in significant results in terms of improved patient outcomes. He

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Healthcare organisations need to embark on their digital journey and become tech savvy to serve their patients and fulfill their healthcare requirements in today's era

Ankit Sinha, Business Head (Corporate) Google Cloud, Google India

elaborated on the various solutions which the company provides to bring about a digital transformation in the healthcare sector.

Consolidation in healthcare: Putting the best foot forward

(L-R) Dr Sujit Paul, MD, Sarvagun Ausadhi; Gaurav Agarwal, Director, Singhi Advisors; VP Kamath, Group COO, Pinnacle Cancer Centres- India & International; Dr Ravindra Karanjekar, Group CEO, Jupiter Hospitals; Dr Priti Nanda, Founder of Medi-skool/Co-founder of AB Hospitals

onsolidation in healthcare can help companies grow faster and benefit consumers in a better way, it can also help to create financial security as well, informed healthcare industry leaders in a panel discussion, on the second day of Healthcare Senate 2018. The panel was moderated by Dr Sujit Paul, MD, Sarvagun Ausadhi. the other renowned speakers who participated in the discussions were VP Kamath, Group COO, Pinnacle Cancer Centres- India & International, Gaurav

Agarwal, Director, Singhi Advisors, Dr Ravindra Karanjekar, Group CE0, Jupiter Hospitals, Dr Priti Nanda,

Founder of Medi-skool/Co-founder of AB Hospitals. Deliberating on the topic 'Consolida-

KEY TAKEAWAYS ❖ Consolidation means benefiting from sharing of best practices. It helps to standardise quality of care. ❖ Consolidation is a good growth strategy but it should be adopted in a discriminate manner. ❖ If leveraged well, it can play an important role in making healthcare more affordable and accessible.

tion in healthcare: Putting the best foot forward', they highlighted some trends in healthcare. They also opined that acquiring and growing is a trend in healthcare which is very relevant in an era where investors are in a hurry to exit. Hence, consolidation is a trend that is likely to continue. However, the discussion also established that consolidation should not be just horizontal. Healthcare needs vertical consolidation to create better interdepartmental synergies and improve overall performance.

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HEALTHCARE SENATE 2018

Express Healthcare announces Best Hospital PharmacyCitations 2018

Winners at the Best Hospital Pharmacy Citations 2018 along with the jury members

xpress Healthcare, a leading monthly healthcare publication from the Indian Express Group hosted the second edition of Best Hospital Pharmacy Citations 2018, during the third edition of Healthcare Senate in Delhi. Glenmark Pharma also partnered with Express Healthcare in this endeavour to recognise the pivotal role of hospital pharmacies in healthcare delivery. The event began with a welcome address by Viveka Roychowdhury, Editor, Express Healthcare and Express Pharma. In her address, she also explained the methodology of the Best Hospital Pharmacy Citations 2018. She explained that the citations were initiated to reward the most future ready corporate hospital pharmacies which have put in place best practices and systems in terms of operations, quality of care, patient safety and counselling, and health outcomes. She also elaborated on how the jury discussed and decided on parameters and criteria to evaluate the nominations received. The criteria included NABH accreditation, presence of a structured

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formulary, methods to handle medical errors, patient counseling mechanisms, and stock expiry management matrix. Finally, the jury decided to award seven hospital pharmacies, in two different categories: multi-specialty hospitals and multi- specialty chain hospitals. The award presentation ceremony followed her speech. Roychowdhury, alongwith AG Prasad, Vice PresidentSales and Marketing, Glenmark gave

away the awards. they wer also joined by jury members N Udupa, Professor and Research Director (Health Sciences) Manipal Academy of Higher Education, Manipal; Dr Sujit Paul, Managing Director, Sarvagun Ausadhi; Pankaj Bector, Procurement Specialist [Drugs & Medical Equipment), Stores Officer] National Centre for Disease Control (Dte. General of Health Services) Ministry of Health & Family Welfare, Gov-

ernment of India and Dr Suresh Saravdekar Chairman, IPA- MSB Hospital Pharmacy Division. The event concluded with a vote of thanks by Usha Sharma, Principal Correspondent, Express Healthcare and Express Pharma. She congratulated all the winners and thanked the jury members for their valuable insights in selecting the deserving winners. u.sharma@expressindia.com

Winners

Category

Bhatia General Hospital

Multi-speciality

Saifee Hospital

Multi-speciality

GCS Medical College, Hospital & Research Centre

Multi-speciality

Sri Ramakrishna Hospital Coimbatore

Multi-speciality

Apollo Gleneagles Hospital, Kolkata

Multi-speciality Chain Hospitals

Kovai Medical Center and Hospital, Coimbatore

Multi-speciality Chain Hospitals

Aster Medcity, Kochi

Multi-speciality Chain Hospitals

Apollo Gleneagles Hospital, Kolkata receives the citation in the multi-speciality chain hospitals category

Bhatia Hospital bagged the citation in multi-speciality hospital category

Saifee Hospital receives the citation in multi-speciality hospital category

Sri Ramakrishna Hospital, Coimbatore receives the citation in the multi-speciality hospital category

GCS Medical College, Hospital & Research Centre receives the citation in the multi-speciality hospital category

Aster Medcity, Kochi receives citation in the multi-speciality chain of hospitals category

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HEALTHCARE SENATE 2018 AGENDA DAY 3

Healthcare Senate 2018 ◗

Panel Discussion Financial Risk management: What healthcare organisation need to learn?

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Panel discussion Supply Chain Transformation

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Valedictory Ceremony Guest of Honour, Dr Vinod K Paul, Member, Niti Aayog, GoI

14 July 2018

Ayushman Bharat for incremental change

Dr V K Paul

“A

yushman Bharat is not just an incremental change, it is a quantum jump. We are on the cusp of a transformational change”, exclaimed Dr Vinod K Paul, Member, NITI Aayog, while he spoke about the ambitious NHPS plan by the government. There are huge unmet healthcare needs in our country. The current government schemes cover only 15 per cent of our healthcare needs. Ayushman Bharat is an initiative to ensure that there needs of Indian citizens are met adequately, he informed. Dr Paul also spoke on the opportunities for India. He said that the rate at which India’s young population is growing, we are on the brink of a huge growth opportunity. India has the potential to grow exponentially in the next 20-30 years. How-

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States have a right to choose the way they implement Ayushman Bharat ever, we need its population to be healthy in order to leverage it effectively. Ayushman Bharat is trying to drive a Jan Andolan in health, he maintained. Explaining the vision of the scheme further, he said that Ayushman Bharat comprises measures to

revolutionise primary, secondary and tertiary healthcare in India. By 2022, 50,000 health and wellness centres will be set up in the country to improve primary healthcare. A comprehensive family health plan with financial coverage of ` 5 lakhs for around 11 crore families will be instrumental in improving secondary and tertiary healthcare. “Private and public sectors will need to collaborate in a big way to make Ayushman Bharat a success”, he said. Finally, talking about the role of the states in the scheme, he stated that the states have a right to choose the way they implement Ayushman Bharat. They can opt to create a trust model or partner with an insurance players. 21 states of the 25 who have signed up for Ayushman Bharat have opted for the trust model.

Financial RiskManagement: What healthcare organisations need to learn?

L-R: Yogesh Patel, CFO, HCG Group; Sumit Agrawal, VP Finance, Cloudnine Hospitals; Dinesh Mittal, CA and Financial Expert; Ravi Bhandari, Strategy Consultant - Healthcare Services & Ex-CEO, Shalby Hospitals; Anupam Verma, President, Wockhardt Hospitals and Dilpreet Brar, CEO & MD, medCUBE

he healthcare sector in India is currently going through some seismic shifts. Healthcare CFOs and financial heads of organisations, therefore are trying to adapt to these changing environment and are formulating strategies that will facilitate in overcoming obstacles. Panelists, Yogesh Patel, CFO, HCG Group (moderator), Dinesh Mittal, CA and Financial Expert, Sumit Agrawal, VP Finance, Cloudnine Hospitals, Dilpreet Brar, CEO & MD, medCUBE, Anupam Verma, President, Wockhardt Hospitals and Ravi Bhandari, Strategy Consultant Healthcare Services & Ex-CEO, Shalby Hospitals brought to light various multidimensional risk factors that impact the bottom lines of healthcare organisations. The key discussion surrounded subjects as such; core components of hospitals for managing financial risk, strategies for integrating risk management system within organisations, how to approach health IT and other capital spending initiatives, tips for managing

a hospital's investment portfolio as well as how organisation can improve balance sheets and achieve financial sus-

tainability. During the discussion experts pointed out on the three major risk fac-

KEY TAKEAWAYS ❖ Healthcare face risks that are multifaceted and multi-dimensional. Three major forms of risks: cultural integration, obsolescence risk, price changes in the market. ❖ There are several uncertainties in the healthcare market today. We need to tabulate them and devise effective strategies to tackle them. ❖ Most private sector players perceive price control measures by the government as a major financial risk for private healthcare players. They believe that profitability will not be earned easily and collaboration would be crucial to future financial growth. ❖ If there were no capital markets and no risks, great innovation will never come about. Risks are not be feared, they need to be managed. Design the right processes and implement them right to manage risks. ❖ The private healthcare sector call for more inclusive planning. The government should include private healthcare players and other stakeholders while forming policies for price control in healthcare ❖ With the advent of Ayushman Bharat, we may see more consolidation in healthcare. Smaller players may consolidate and become bigger players to be more sustainable and profitable.

tors- cultural integration, obsolescence risk, price changes in the market. They also talked about the current market dynamics that impact the financial strength of healthcare organsiations. Alarming the audience of the coming difficult times, they expressed that profitability will not be earned easily and collaboration would be crucial for future financial growth. Moreover, panelists shared some examples of best practices that they follow at their organisations. They further urged organsiations to be fearless and put the right processes in place to tackle risk. Moving forward, the discussion also talked about the preparedness of organisations to align with the government's Ayushman Bharat scheme. Experts contemplated on the financial investments organisations will need to do in order to be part of this scheme and how consolidation will be the new trend for the sector. Organisation big and small will therefore, need to be abreast for the same.

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HEALTHCARE SENATE 2018

SupplyChain transformations within hospitals

L-R: Zarine Najmuddin Khety, Head - Clinical Pharmacy and Scientific Officer, Clinical Research and Pharmacy Department, Saifee Hospital; Sojwal Vora, VP & Group Head - Supply Chain, Chief Procurement Officer, Manipal Hospitals; Dr Suresh Saravdekar, Consultant - Procurement and Supply Chain, Institute of Medical Sciences - BHU, Varanasi and Gaurav Loria, Group Head Quality & Administration, Apollo Hospitals

systematic supply chain management system within hospitals is not only crucial to an organsiations's operational functioning, but has some far reaching impact of its financial stability. Zarine Najmuddin Khety, Head Clinical Pharmacy and Scientific Officer, Clinical Research and Pharmacy Department, Saifee Hospital, Sojwal Vora, VP & Group Head - Supply Chain, Chief Procurement Officer, Manipal Hospitals, Dr Suresh Saravdekar, Consultant - Procurement and Supply Chain, Institute of Medical Sciences BHU, Varanasi and Gaurav Loria, Group Head Quality & Administration, Apollo Hospitals in this panel discussion, began an dialogue on having a holistic strategy for end-to-end supply chain within a hospital—and how it can have a dramatic result on a hospital's bottom line and patient care. Experts on this panel, discussed on aspects such as

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need for a well-framed supply chain strategy, strategic advantages of supe-

rior supply chain system, critical capabilities required for the same, how

KEY TAKEAWAYS ❖ Supply chain starts from the manufacturer. It is anything that happens from the time a product is manufactured to the time until it reaches the patient. Cash flow management, inventory management, purchasing, patient-centricity all are elements of supply chain management. ❖ Maintaining an optimally functioning hospital formulary is essential to managing an efficient supply chain management ❖ Healthcare organisations should pay attention to details and ensure that each link in the supply chain such as identification of the right product, vendor identification and evaluation etc., is functioning properly to bring in better efficiencies in supply chain management. ❖ Supply chains are expected to be very agile and hence governance and monitoring mechanisms in supply chain management are very crucial. Just setting up processes aren't enough, it needs to be ensured that they are being implemented efficiently. ❖ Improved communication, automation, data analytics, etc. will be very important towards revolutionising supply chain management in healthcare.

NELEM can be helpful, quality checks and audits for medicines and processes and the impact of an holistic supply chain system on patient care and bottom line. The panelists highlighted that healthcare organisations espcially hosptials, need to be concise on the quality standards and SOPs that ensures each link in the supply chain such as identification of the right product, vendor identification and evaluation etc., functions efficiently. They also stressed upon that fact that communication, automation, data analytics are key in building a strong supply chain system. Supply chains are expected to be very agile and hence governance and monitoring mechanisms in supply chain management are very crucial. At the end, the audience were engaged in an Q&A where a lot of pertinent queries were raised and the experts shared their insights on the same.

RADIOLOGY AND IMAGING CONCLAVE 2018 AGENDA DAY 1

Radiology 2018 ◗

Inaugural ceremony

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Keynote address Dr Bhavin Jankharia, Chief Radiologist, Picture This by Jankharia

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Radiation safety in radiology: How to protect patients and healthcare providers? Dr PK Dash Sharma, Head, Radiological Safety Division, Atomic Energy Regulatory Board (AERB)

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Samsung Solutions for Dynamic Radiology Landscape Khushboo Srivastava - Manager Health & Medical Equipment, Samsung Healthcare

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Technicalities of AI in Radiology Dr Prashant Warier, CEO, Qure.ai

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Clinical perspective of AI in Radiology Dr Vasantha Venugopal, Imaging Lead, CARING, Mahajan Imaging

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Panel discussion: AI in Radiology

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History of Teleradiology and the Path Forward Dr Arjun Kalyanpur, Chief Radiologist, Teleradiology

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Panel discussion: Teleradiology and its future

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Technological advancements in radiology Mandeep Anand - Business Head X-Ray Business, BPL Healthcare

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Panel discussion: Adding ‘value’ in radiology

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Intrinsic and extrinsic value of a radiologist Dr Bhavin Jankharia, Chief Radiologist, Picture This by Jankharia

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AI conclave-Radiology and imaging Sanjeev S, MD & CEO, Meddiff Technologies

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Awards ceremony

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13 July 2018

Inaugural ceremony: Radiologyand Imaging Conclave 2018

adiology and Imaging Conclave, India's specialised gathering of the best minds in radiology, in its first edition witnessed interesting dialogues, debates and deliberations by top radiologists, innovation heads and thought leaders on the future of radiology. The conclave organised by Express Healthcare and Radiology Education Foundation was held on the sidelines of Healthcare Senate 2018. Experts and veterans of the diagnostic sector congregated to discuss on vital trends, innovations and business models shaping the future of radiology in India. These experts also prepared a blueprint for progress based on various skill development activities that will make radiology organisations successful, both in terms of profitability and goodwill. The event commenced with a lamp lighting ceremony followed by the Welcome Address. Viveka Roychowdhury, Editor- Express Healthcare & Express Pharma; Dr Bhavin Jankharia, Chief Radiologist, Picture This by Jankharia, Dr PK Dash Sharma, AERB, Atantra Das Gupta - Director & Head - Health & Medical Equipment, Samsung Healthcare lit the ceremonial lamp and gave an auspicious start to the event. Dr Jankharia in his wel-

Experts and veterans of the diagnostic sector congregated to discuss on vital trends,innovations and business models shaping the future of radiology in India come address explained the vision behind bringing together this august gathering. He highlighted that the future of the radiology as bright, radiologists, industry, innovators and government need to cohesively tap the umpteen opportunities that will enhance radiology services in India for the betterment of patients.

Radiation safetyin radiology: Howto protect patients and healthcare providers?

adiation safety is an integral component of the working infrastructure of any radiology department. Dr PK Dash Sharma, Scientific Officer, AERB, in his talk, spoke on the essentials of radiation safety in radiology. While highlighting the need for radiologist and healthcare organisations to follow the AERB norms on radiation safety, Dr Dash Sharma said, “In radiology, the most at risk area of the human body is the eye. It imports the risk of cancer.” He also highlighted the need to protect radiologists and healthcare providers from radiation. He opined that apart from patients, radiologists also need to be safe while they provide diagnostic imaging services. “By reducing radiation dose you can also reduce risk for healthcare providers,” he maintained. During his presentation, Dr Dash Sharma, spoke on various technologies that give out higher radiation. Speaking on the hazards of highend imaging technologies and techniques, he then pointed out that higher image quality can lead to higher radiation. Radiologists need to choose their

It is mandatory to obtain licence from AERB for every radiology department.Also, there are two parts of safety mechanisms that needs to be strictly followed as per AERB norms Dr PK Dash Sharma, Scientific Officer, AERB

imaging equipment very wisely. Further on, Dr Dash Sharma gave an update on the latest AERB norms for radiation safety to be maintained within

radiology departments. He said that it is mandatory to obtain licence from AERB for every radiology department. Also, there are two parts of safety

mechanisms that needs to be strictly followed as per AERB norms. Explaining the nuances of both the aspects, Dr Dash Sharma informed the audience that built-in safety combined with operational safety ensures total radiation safety for both patients and radiologists.

Samsung solutions for dynamic radiologylandscape

adiology as a medical field has witnessed immense tranformation backed by innovation. Sansung Healthcare in recent times has been at the forefront of providing cutting-edge technologies in radiology. The company has a huge focus in the Indian radiology market and is looking to expand its reach across India. Khusboo Srivastava, ManagerHealth and Medical Equipment, Samsung Healthcare, in her presentation spoke about innovations that have changed the way radiology is practiced. She highlighted on the solutions offered by Samsung that are currently changing the radiology landscape. She began her presentation by providing a brief history of Samsung Healthcare and how the company has

Khusboo Srivastava, Manager-Health and Medical Equipment, Samsung Healthcare

played a crucial role in aiding radiology practitioners with the technologies and expertise for providing better patient care. Srivastava, talked about Samsung's focus in women’s healthcare and how their technologies facilitate radiologists to provide comfort and better diagnosis to their women patients. Moreover, she informed the audience on Samsung's 5D technology that facilitates early diagnosis of CHD and can be instrumental in providing solutions to treat IT as well. Srivastava also shared an update on radiology solution offerings by Samsung that can create more access to better imaging diagnostics and foster innovation in medical care.

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RADIOLOGY AND IMAGING CONCLAVE 2018

Technicalities in AI

ccording to experts, artificial intelligence algorithms have demonstrated remarkable progress in image-recognition tasks. Dr Prashant Warier, CEO, Qure.ai in his presentation, discussed the technicalities of AI in radiology. He began by explaining the advances in AI and its application in radiology. “All the advances in AI comes from a class of algorithm called deep neutral networks that can now perform tasks that previously required human expertise”, he mentioned. In order to promote AI in radiology and to create an ecosystem that supports the transformation associated with this requires creation of strategies, training programmes that provides clear understanding of machine learning etc. He also mentioned that in the future, radiologists’ need to develop algorithms. This will lead to further engagement of radiologists rather than replacement. Delving deep into understanding

Dr Prashant Warier, CEO, Qure.ai

the kind of research happening in the field of AI and diagnostic imaging in India, Dr Warier said that research in AI should be focussed on small images. His presentation also highlighted the need for training in AI application. However, appropriate training programmes will require huge data. “Training deep learning models requires a lot of data”, he said. Therefore the imaging sector will need to work on an appropriate data collation system. Moreover, warning on the misuse of data he cautioned, “There should be a check of algorithm on own data before using it anywhere.” Further, discussing on the technicalities he spoke sensitivity and specificity of AI application in radiology. “There is always a trade-off between sensitivity and specificity,” he maintained. Moving ahead, he spoke on the visualisation aspects and informed, “Visualisation of algorithm output is critical.”

AI in radiology: Clinical perspective

I is said to hold great protential in shaping the future of diagnostic imaging. Dr Vasantha Venugopal, Imaging Lead, Caring, Mahajan Imaging, in his presentation expounded on the clinical aspects of AI application in radiology. He also explained how AI is improving the quality of radiology services and increasing patient satisfaction. He also spoke on the myths associated with AI application. Speaking about the benefits of AI, Dr Venugopal said, “Deep learning is going to improve the quality of radiology services.” Further, he warned of the black box in AI application. He said that the black-box paradox haunts proponents of AI in radiology. Therefore, it is important to unfold the methods used to reach a conclusion of diagnostic results. He said, “Opening the black box is most important for incorporating AI routine practice.” Dr Venugopal also touched upon on the fears that surround clinicians and radiologists about AI. Agreeing that the radiology fraternity is worried thinking whether AI will replace their jobs. Another important aspect brought to light during Dr Venugopal’s presentation was that while initial success is encour-

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The path forward for AI is encouraging but relies on collaboration

Dr Vasantha Venugopal, Imaging Lead, Caring, Mahajan Imaging

aging, AI has two important hurdles to cross- validation and implementation. All of this will not be possible without upgrading the current skills. He said that the role of radiologists will evolve from doing perceptual things to do more transformational work. It will increase the demand for more training and education in radiology. Finally, he said, “The path forward for AI is encouraging but relies on collaboration.”

AI in radiology

(L-R) Dr Prashant Warier, CEO, Qure.ai, Dr Arjun Kalyanpur, Chief Radiologist, Teleradiology Solutions, Rohit Sathe, CEO, Philips Healthcare India, Vivek Kanade, CEO, Siemens Healthineers, Dr Vansantha Venugopal, Imaging Lead, CARING, Mahajan Imaging, Dileep Mangsuli, Chief Technology Officer, GE Healthcare, South Asia and Ravi Srinivasan, Chief Manager, Health & Medical Equipments, Samsung Healthcare

s radiologists seek to become a significant part of the healthcare management system, AI can be their aid in transforming their role and make them more efficient and effective in medical decision making. Dr Vidur Mahajan, Head (R&D), CARING. Mahajan Imaging (moderator), Rohit Sathe, CEO, Philips Healthcare India, Vivek Kanade, CEO, Siemens Healthineers, Dr Arjun Kalyanpur, Chief Radiologist, Teleradiology Solutions, Dr Prashant Warier, CEO, Qure.ai, Dr Vansantha Venugopal, Imaging Lead, CARING, Mahajan Imaging, Dileep Mangsuli, Chief Technology Officer, GE Healthcare, South Asia and Ravi Srinivasan, Chief Manager, Health & Medical Equipments, Samsung Healthcare deliberate on the potential

of AI in changing landscape of diagnostic imaging in India in the coming times. Experts on the panel began by analysing the current opportunities associated with AI application in radiology. They discussed ways to use AI to create more opportunities for radiologists and patient care. The panelists believed that AI is a performance enhancer for accuracy and efficiency and should be utilised to im-

prove and upgrade current skills. Data capture is important and AI will be able to help radiologists at their workstations in future, experts added. Additionally pointing out to the most important aspects that radiologists, AI platforms and healthcare companies need to look at, panelists unanimously acknowledge was that affordability, accessibility, accuracy, acumen are the essentials for AI in radiology. They also discussed on how health-

KEY TAKEAWAYS ❖ ❖ ❖ ❖

AI will create new opportunities for radiologists and patient care AI will be able to help radiologists at their workstations in future An ecosystem for AIwill be created very soon Affordability, accessibility, accuracy, acumen are the essentials for AI in radiology

care technology companies are trying to solve complex health and healthcare problems using AI. During this, experts on the panel agreed that medical history is where healthcare technology companies want to create better patient care programmes. This lead the conversation towards examining the opportunities, pros and con of building an AI ecosystem in India. Well, this raised some queries on the possibilities of radiologists losing their jobs to machines and how radiologists in the future will need to be trained in AI application. Experts on the panel shared examples of how AI cannot be enabled without the help of an expert, in this case the radiologist. At the end, they did inform that an ecosystem for AI will be created very soon.

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RADIOLOGY AND IMAGING CONCLAVE 2018

Historyof teleradiologyand its future

eleradiology has been a successful application of telemedicine that exists today. It has immense opportunities in India to transform healthcare delivery like never before. Some experts believe that teleradiology can be the uberisation of healthcare. Dr Arjun Kalyanpur, Chief Radiologist, Teleradiology solutions elaborated on the history and evolution of teleradiology in our country. He also highlighted the future trends and opportunities for radiologist in the field. He began by talking about the history of teleradiology and its relevance in the Indian context. He chronicled the evolution of the field saying, “Technology evolution in tele radiology began with RIS/PACS to workflow, enterprise to cloud and now it has transformed to AI and deep learning.” According to Dr Kalyanpur, teleradiology offers new avenues for global reach. Moreover radiology as a medical discipline in India has advanced rapidly, but sadly the radiology training programmes have not kept pace and radiologists in most parts of the country are currently in short supply. Dr Kalyanpur, believes that teleradiology provides a

Teleradiology provides a bridge that allows radiologists’skills to be better utilised at a time of short supply.

Dr Arjun Kalyanpur, Chief Radiologist, Teleradiology

bridge that allows radiologists’ skills to be better utilised at a time of short supply. He also believes that India can be a good market for teleradiology service providers opening new avenues for competitive business as well as subspecialisation of radiology services. It can be a catalyst for rising expectations from patients and healthcare providers as well as for improved standards. It can also be a potent enabler for AI, Dr Kalyanpur maintained.

Technological advancements in radiology

andeep Anand, Business Head-X Ray Business, BPL Healthcare, talked about data points on how they are relevant to the radiology sector. He gave an overview of the Indian healthcare sector, the statistics of Indian healthcare providers ecosystem, advancements in radiology and disruptive technologies in radiology. Anand gave a brief history of BPL Medical Technologies where he talked about working towards building a strong presence in radiology solutions. He talked about products offered by BPL Healthcare which are both for the global and the Indian markets. He said that there is a need for innovation and displayed ECG product which with the help of cloud technology can be accessed by the doctors who are located at far away places. He mentioned about the company’s mis-

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There is a need for innovation and displayed ECG product which with the help of cloud technology can be accessed by the doctors who are located at far away places

Mandeep Anand, Business Head-X Ray Business, BPL Healthcare

sion and said that as the company grows, they will be able to cater to the client requirement in a effective way and that will be BPL’s mission.

Teleradiologyand its future

Dr Hemant Patel, Incoming President, IRIA (Moderator), Dr Arjun Kalyanpur, Chief Radiologist, Teleradiology Solutions, Dr Abhishek Mahajan, Associate Professor, Tata Memorial Hospital, Mumbai, Dr Sumer Sethi, Founder, DAMS & Telerad Providers, Dr Uday Patil, HOD Radiology,Aster Hospital and Narayanan AK, Principal Architect, Philips Healthcare

nformation technology has changed the face of modern medicine in many ways. Teleradiology, one such field of healthcare delivery has been a significant advancement, which has seen instrumental in providing health access. But what does the future hold for such an technological advance field of medicine? Dr Hemant Patel, Incoming President, IRIA (Moderator), Dr Arjun Kalyanpur, Chief Radiologist, Teleradiology Solutions, Dr Abhishek Mahajan, Associate Professor, Tata Memorial Hospital, Mumbai, Dr Sumer Sethi, Founder, DAMS & Telerad Providers Dr Uday Patil, HOD Radiology, Aster Hospital and Narayanan AK, Principal Architect, Philips Healthcare contemplated on the future prospects of telera-

diology in India. Panelists began the discussion by understanding the relevance of teleradiology in a country like India. Teleradiology has raised the bar for radiology practice in the US, but India still lags behind, experts pointed out. They also

talked about how the field can help in addressing manpower crunch in healthcare. However, there is a need to gather relevant clinical data in order to integrate teleradiology in India's healthcare system. Also, there is a need to get clinical, lab and other relevant in-

KEY TAKEAWAYS ❖ Teleradiology has raised the bar for radiology practice in the US, but India still lags behind ❖ There is a need to get clinical, lab and other relevant information integrated in teleradiology ❖ There are hidden opportunities for youngsters in this field. ❖ AI can be useful for decision making in teleradiology. ❖ Provisions for tackling legal issues, practice standards, data privacy are the prerequisites in India

formation integrated in teleradiology, the experts reiterated. Additionally, multi-disciplinary approaches are necessary to further the growth of teleradiology in India. Experts also discussed on the regulatory aspect of teleradiology. In the US teleradiology is a highly regulated industry, however, India does not have any regulations. India needs to therefore, built a strong regulatory system for teleradiology. Provisions for tackling legal issues, practice standards, data privacy are the prerequisites in India. Further on, discussions touched upon the subject of job opportunities that teleradiology can offer. AI can be useful for decision making in tele radiology.

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RADIOLOGY AND IMAGING CONCLAVE 2018

Adding value in radiology

(L-R) Dr Arjun Kalyanpur, Chief Radiologist, Teleradiology Solutions, Dr Nobhojit Roy, National Advisor, Public Health Planning & Evidence, NHSRC, Dr Bhavin Jankharia, Chief Radiologist, Picture This by Jankharia, Dr K Mohanan, President, IRIA

n the era of consumerism, healthcare providers are slowly but steadily, shifting focus from feefor-service to a fee-for-value reimbursement model. The panel discussion on ‘Adding value in radiology’ brought to light various viewpoints from leading radiologists on how this fraternity can add value to patients and the entire healthcare system in India. The panel comprising Dr Bharat Agarwal, Chief Radiologist, Max Healthcare (moderator), Dr Arjun Kalyanpur, Chief Radiologist, Teleradiology Solutions, Dr Nobhojit Roy, National Advisor, Public Health Planning & Evidence, NHSRC, Dr Bhavin Jankharia, Chief Radiologist, Picture This by Jankharia and Dr K Mohanan, President, IRIA deliberated on fundamentals and pre-requisites by which radiologists can add value. The pan-

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elists also raised questions on the role of the government to create value amongst radiologists within the country. Also, experts in the panel informed that improving access is one of the

most important goal in the ministry. Radiology will soon be integrated with Ayushman Bharat scheme. Is the industry ready for this leap? Secondly, the panel also contem-

KEY TAKEAWAYS ❖ Radiology is an all enveloping stream in healthcare. The real value that we need to demonstrate is our ability to span the entire spectrum. ❖ Radiology is an absolute, crying necessity in healthcare. There is a very fundamental and basic need for it. It is only set to rise. ❖ In a scenario where price controls are coming into place for medical products and services, reimbursements for radiologists are going down. Hence, it would become necessary for them to work more for their money. ❖ It might be volumes game in radiology, going forward. Large volumes, small profits may become the new normal. ❖ It is an era of knowledge and skill. Radiologists will have to improve their competencies to keeping providing value to healthcare and stay relevant in future.

plated on the impact of the government’s move to bring price cap for medical devices and healthcare services. Will there be a price cap for radiology services as well? These were some concerns raised during the panel discussion. Moving forward, panelists also discussed on how radiologists in the coming years will need to look at monetary valuation. Experts spoke on how radiologists will have to look beyond image reading and evolve themselves to take part in clinical decision making. While discussion the prospects for the transformations in the business of radiology, panelists pondered on how large volumes, with small profit margins will be the new normal. The audience, also joined the discussion and raised pertinent questions.

Intrisic and extrinsic value of radiologists

n this session, Dr Bhavin Jankharia, Chief Radiologist, Picture This by Jankharia threw light on how radiologists could add value to their services, patients and the entire healthcare system. He began by talking about the need for radiologists to break the monotony and look beyond image reading. “A radiologist is a doctor, who uses images and imaging modalities, solves clinical problems and helps in early detection and prevention of diseases. But there is a need to look beyond image reading. A radiology must look beyond structural imaging to add value to healthcare delivery,” he said. Dr Jankharia also spoke about how radiologists can play a better role in making decisions for patients and healthcare providers. “A clinical radiologist is an integral part of the healthcare system bringing value to stakeholders from the patient to the institute and the system. The primary duty of a radiologist is to augment better clinical decision making,” he stressed.

Dr Bhavin Jankharia, Chief Radiologist, Picture This by Jankharia

AI conclave-Radiologyand imaging

anjeev S, MD & CEO, Meddiff Technologies started his session by providing some insights on IT companies. He mentioned that IT companies should follow three basic tenants, which are improved quality of care, improved productivity and reduced costs in order to sustain themselves. He also advised the audience to be ready for any circumstances in the AI sector. AI will help doctors to improve productivity manifold and IT will play a major role in this context. He gave an insight on how Meddiff Technologies has been able to overcome certain challenges to provide the right kind of services with its new products.

Sanjeev S, MD & CEO, Meddiff Technologies

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RADIOLOGY AND IMAGING CONCLAVE 2018 AGENDA DAY 2

Radiology 2018 ◗

Education in radiology: Dr Sumer Sethi, Founder, DAMS & Telerad Providers

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Dr Akshay Baheti, Assistant Professor, TMH, Mumbai (Moderator)

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Panel Discussion: Changing needs and opportunities for the future radiologist

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Presentation by GE Healthcare

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Panel discussion: Is radiology a viable business?

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Presentation by Chander Shekhar Sibal, Sr. Vice President, Fujifilm India

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Panel Discussion: The Next Big thing

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Presentation by Rahul Sethi, Head Business Development- Healthcare Division, Barco India

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Panel Discussion: The Big Brother

14 July 2018

Changing need in education

he Day 2 of Radiology and Imaging Conclave started with a session by Dr Sumer Sethi, Founder, DAMS & Telerad Providers, who gave an insight on 'Changing need in education.' He started the session by asking the audience on what attracts a radiologist to get into this job? Mentioning that diversity, increasing dependence of medicine on radiology, technology, possibility to work for longer years are the key factors, that attracts youngsters towards a career in radiology. Saying that technology is going to get better, he insisted that there is a need to redefine the classroom. In a nutshell, he mentioned that the world is changing and the role of education has to evolve with time. He also emphasised on creativity and curiosity, which transform the educational need in radiology. He also said that radiology in India still attracts the best talent.

Dr Sumer Sethi, Founder, DAMS & Telerad Providers

Advances in imaging

hrikanth Suryanarayanan was of the opinion that there is definitely an opportunity to improve patient experience in MRI and that is where AIR Technology is an exciting experience in this space. He mentioned that AIR Technology is a big breakthrough in the radiology sector. GE’s revolutionary CT addresses all patients' needs and it is key for planning TAVR procedures which can provide growth for CT practices. It leverages comprehensive care solutions for patient. He opined that the evidence for spectral Imaging CT is mounting. GE is trying to uncomplicate clinical choice.

Shrikanth Suryanarayanan, GM, Radiological Solutions, GE Healthcare

Value of innovation

hander Shekhar Sibal in his session gave an overview of Fujifilm's history and how it has evolved over the years. The company has a current business of $23 billion and has around 77,000 employees. He talked about innovation out of crisis. Sibal gave an overview about the company's logo, which denotes value for innovation. He mentioned about the company's goal which is to empower the potential and expand the horizons of tomorrow's businesses and lifestyles He also mentioned about Fujifilm's growth rate in India where 50 per cent of the business comes from medical division. Wave of digitisation and management reforms, comprehensive structural reforms and motivated employee skill are some of the growth drivers which he suggested. He emphasised on early detection and prevention, which is key to success.

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Chander Shekhar Sibal, Sr Vice President, Fujifilm India

He also talked upon digitisation and its application and how Fujifilm with the help of teleradiology has been able to contribute to primary healthcare centres.

Panel discussion: Education in radiology

L-R: Dr Akshay Baheti, Assistant Professor, TMH, Mumbai; Dr Nandini Bahiri, HOD- Radiology, Government Hospital in Jamnagar; Dr Sumer Sethi, Founder, DAMS & Telerad Providers; Dr Deelip Mhaisekar, VC, MUHS; Dr Raju Sharma, Professor of Radiology, AIIMS and Vasumathi Sriganesh, Founder & Hon CEO QMed Knowledge Foundation and Director QMed Services

he first panel discussion on Day 2 of Radiology Conclave was on 'Education in Radiology.' where discussions were held on the need to revamp radiology education etc. The panel discussion was moderated by Dr Akshay Baheti, Assistant Professor, TMH, Mumbai and the panelists were Dr Nandini Bahiri, HoD of the Radiology Department, Government Hospital in Jamnagar, Dr Sumer Sethi, Founder, DAMS & Telerad Providers, Dr Deelip Mhaisekar, VC, MUHS, Dr Raju Sharma, Professor of Radiology, AIIMS and Va-

sumathi Sriganesh, Founder & Hon CEO QMed Knowledge Foundation and Director QMed Services. Panelists discussed ways to learn

about team building, to divide responsibilities and credit to make radiology education more interesting. They agreed that there is lack of standardisation for radiol-

KEY TAKEAWAYS ❖ Curiosity element needs to be continuously engaged and introduced right in the teaching ❖ Radiologist need to learn about team building, have to divide responsibilities and credit ❖ Better methods of assessment should be in place

ogy curriculum. Courses are unequal and since radiology is an expensive education with stipends varying from place to place, pupils are unable to get the right inputs, which should be pondered over. Panelists were of the opinion to change the curriculum, which also needs to be updated and clinical oriented. They all agreed to the need for subspecialists who can provide good services as well as accreditation for those services. A lot of reading is going to help radiologist in the long-run, was what the panelists agreed to in the end.

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RADIOLOGY AND IMAGING CONCLAVE 2018

Panel discussion: Is radiologya viable business?

L-R: Dr Vidur Mahajan, Associate Director, Mahajan Imaging; Rahil Shah, Director, NM Medical; Dr Avinash Nanivadekar, Chief Radiologist; Ruby Hall, Pune; Dr Bhavin Jankharia, Chief Radiologist, Picture This by Jankharia; Brijesh Suneja, MD, Phantom Healthcare; Dr Sanjeev Mani, Senior Radiologist, Mumbai and Dr Uday Patil, HOD, Aster Healthcare

he panel discussion on 'Is radiology a viable business' emphasised that viability is not based on funding, but on revenue generation. The panel was moderated by Dr Vidur Mahajan, Associate Director, Mahajan Imaging and the panelists were Rahil Shah, Director, NM Medical, Dr Avinash Nanivadekar, Chief Radiologist, Ruby Hall, Pune, Dr Bhavin Jankharia, Chief Radiologist, Picture This by Jankharia, Brijesh Suneja, MD, Phantom Healthcare, Dr Sanjeev Mani, Senior Radiologist, Mumbai and Dr Uday Patil, head of radiology,

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Aster Healthcare. Th panelists discussed ways to make better investment decisions, acquire indepth knowledge of CAPEX in order to set up a new radiology businesses. They

were of the opinion that hospitals should have their own radiologists rather than consultants. They agreed that the referral fee system is a huge challenge for young radiologist trying to do viable business

KEY TAKEAWAYS ❖ The referral fee system is a huge challenge for young radiologist trying to do viable business ❖ Viability is not based on funding, but on revenue generation ❖ It is very important to do your market research and establish radiology businesses in areas where access to radiology services is scarce

and market research is significant to the viability of any radiology business. One of the panelist was of the opinion that in order to make a business viable, it is important to invest in manpower satisfaction. Organisation should look at making workplaces more manpower friendly, a lot of flexible time, leaves when needs, more creative environment, skill development opportunities, ideas sharing platforms should be offered to employees in order to make help feel involved in the business. These efforts could be beneficial in the long run .

Panel discussion: The Next Big Thing

L-R: Dr Abhishek Mahajan, Associate Professor, Tata memorial Hospital Mumbai; Dr Avinash Nanivadekar, Head of Radiology, Ruby Hall Clinic; Dr Balaji Ganeshan, CEO, TexRad, Rohit Sathe, CEO, Philips Healthcare; Vivek Kanade, CEO, Siemens Healthcare India; Suthirth Vaidya, CEO, Predible Health and Chander Sekhar Sibal, Sr VP, Fujifilm India

he panel discussion on 'The Next Big Thing' was moderated by Dr Avinash Nanivadekar, Head of Radiology, Ruby Hall Clinic where Dr Abhishek Mahajan, Associate Professor, Tata memorial Hospital Mumbai, Dr Balaji Ganeshan, CEO, TexRad, Rohit Sathe, CEO, Philips Healthcare, Vivek Kanade, CEO, Siemens Healthcare India, Suthirth Vaidya, CEO, Predible Health and Chander Sekhar Sibal, Sr VP, Fujifilm India, were the panelists.

Discussions were held on how combining the power of deep learning and cloud computation will help to deliver the future of radiology reporting. Panelists were of the opinion that deep

learning and radionomics-based algorithms for the detection and characterisation of cancers is the need of the hour. Incremental upgrades on right platform is key to the growth of the

KEY TAKEAWAYS ❖ There is a need to change the way radiology is practiced ❖ Elevate radiologists from image reading to be more holistic ❖ Incremental upgrades on right platform is key to the growth of the sector

sector. They argued that nobody is talking about ehancing the role of radiologists that will add value to the system. More Public Private Partnerships (PPPs) could help the radiology sector in the long run. Prognosis prediction in a known malignancy is what everyone wants to know. Enhanced or completely new technology replaces and disrupts an existing technology thus, rendering it obsolete, is what the panelists agreed to.

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RADIOLOGY AND IMAGING CONCLAVE 2018

What makes a good read for radiologists

huge percentage of radiologists believe that image quality is important and it really impacts the way they read. Need for brighter displays will help radiologists to easily read without fatigue thus increasing their productivity. Innovations are happening but regulatory changes are also trending. Industry itself is moving to colour calibration. He was also of the opinion that Barco works with organisations to understand their needs in imaging and probably make displays to match the quality standards.

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Session: Rahul Sethi, Head Business Development-Healthcare Division, Barco India

Panel discussion: Role of 'Big Brother'

L-R: Dr Bhavin Jankharia, Chief Radiologist, Picture This by Jhankharia, Tishampati Sen, Advocate, Supreme Court, Dr K Prabhakar Reddy- Past President, IRIA, Dr Nobhojit Roy, National Advisor, Public Health Planning and Evidence, NHSRC, Dr Suleman Merchant, Prof & Head and Lokmanya Tilak municipal Hospital & LTM General, Dr Milind Gune, Vice Chairman, ICRI, Pankaj Tandon, Atomic energy Regulation Board and Dr SB Sinha, Advisor, Healthcare Technologies, WHO-collaborating centre for Priority Medical Devices and Healthcare Technology Policy, NHSRC, MoH&FW, GoI

he 'Big Brother' concept! Wondering how is the Orwellian concept connected to radiology? Is it about attempts to put radiologists and their work spaces under constant surveillance to enforce rigorous quality assurance systems? If yes, what is the impact of such measures on radiologists? Does it have any financial implications to entrepreneurs in this space? The panel discussion on 'Role of Big Brother' moderated by Dr Bhavin Jankharia, Chief Radiologist, Picture This by Jankharia and panelists, Tishampati Sen, Advocate, Supreme Court, Dr Nobhojit Roy, National Advisor, Public Health Planning and Evidence, NHSRC, Dr Suleman Merchant, Prof & Head and Lokmanya Tilak municipal Hospital & LTM General, Dr K

Prabhakar Reddy, Past President, IRIA, Dr Milind Gune, Vice Chairman, ICRI, Pankaj Tandon, Atomic Energy Regulation Board, Dr SB Sinha, Advisor, Healthcare Technologies, WHO-collaborating centre for Priority Medical Devices and Healthcare Technology Policy, NHSRC, MoH&FW, GoI in this discussion, answered some these pertinent

questions. While deliberating on this concept, experts on the panel believe that the sector is under constant government scanner. The panelists were of the opinion that there is too many government intrusion in healthcare practice. However, better governance in radiology in place is the need of the hour. Experts observed

KEY TAKEAWAYS ❖ There is too many government intrusion in healthcare practice ❖ There is a clear need to remove ulterior motive from radiology practice and business ❖ The value systems need to be revised in order to build patient trust among patients ❖ Adapting to changing times will be necessary for all radiologists in times to come.

that there is a clear need to remove ulterior motive from radiology practice and business. Apart from this, the panelists also discussed on the doctor-patient trust factors that needs a boost. They also agreed that the value systems need to be revised in order to build patient trust among patients. Likewise, they felt that that regulations can be put to good use and price control could be beneficial to patients. However, price control will need to be done appropriately without a complete negative disruption of businesses. A lot more is expected from the government for the radiology sector to take radiology as a medical field to new heights. Adapting to changing times will be necessary for all radiologists in times to come.

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RADIOLOGY AND IMAGING CONCLAVE 2018

Express Medical Imaging Awards 2018 recognises radiology heroes,game changers and front runners The Radiology and Imaging Conclave was held recently in New Delhi with a vision to brace the radiology fraternity for future developments within the sector

Express Medical Imagings presented by Philips Healthcare celebrates excellence in radiology practice

he Indian Express Group and the Radiology Education Foundation recently organised The Radiology and Imaging Conclave with a vision to brace the radiology fraternity for future developments within the sector. The conclave was held on the sidelines of Healthcare Senate 2018, the largest business summit. During the conclave, The Indian Express group also honoured radiology heroes, game changers and front runners in this industry through Express Medical Imaging Awards 2018 presented by Philips health Systems for their invaluable contributions to healthcare in India. Qure.ai received the award in Best Artificial Intelligence Co. Dr Senthil Kumar, Royalcare Super Speciality Hospital, bagged the Best Radiology

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Administrator award. The Best Radiology Entrepreneur award went to Dr Harsh Mahajan,Founder & Chief Radiologist, Mahajan Imaging. Niraj Arora, HealthMaP Diagnostics won the award in the category Best Radiology Chain (< 5 years old). The Best New Diagnostic Centre (2017) went to Mahajan Imaging, Gurugram. The Best Radiology Teacher award went to Prof Satish Kumar, KBHealth Care Diagnostic Centre. Mahajan Imaging, Defence Colony bagged the award in the category Best Diagnostic Centre (single city) 2-10 years. Mahajan Imaging, Hauz Khas also received the award in the category Best Diagnostic Centre 11-20 years. The Best Promising Radiologist (3540 years or age) award went to Ab-

hishek Mahajan, Tata Memorial Centre, Mumbai. Dr Sikander Shaikh, Yashoda Hospitals received the award in the category Best Promising Radiologist â&#x20AC;&#x201C; 41-45. The award for Best Teleradiology Company went to Teleradiology Solutions. The Special Recognition citations were received by Dr PK Dash Sharma, Head, AERB for promotion of radiation safety for patients and Dr Pankaj Tandon, AERB for promoting radiation safety for patients. The next citation went to Dr K Mohanan, President, IRIA, for his dedication to promote radiology education in India followed by Diplomate of National Board, for their contributions to the field of radiology education. Dr Dilip Mhaisekar, Vice Chair, MUHS, received the citation for his contribution to the

field of radiology. Dr Sanjeev Mani bagged a citation for successfully organisation largest international radiology congress AOCR in India early this year. Dr Shailendra Singh, who was also part of the AOCR organising team to successfully execute this congress, was also recognised. The awardees were felicitated by the Jury Members: Dr Bhavin Jankharia, Cheif Radiologist, Picture this, Dr Bharat Agarwal, Head of radiology, Max Hospitals, Vasumathi Sriganesh, QMed Knowledge Foundation, Dr K Mohanan, President IRIA, Dr Sanjeev Mani, Founder and Chief Radiologist, Dr Maniâ&#x20AC;&#x2122;s Clinic and Rohit Sathe, President, Philips Health Systems as well asViveka Roychowdhury, Editor, Express Healthcare and Express Pharma.

Abhishek Mahajan, Tata Memorial Centre, Mumbai receiving the The Best Promising Radiologist (35-40 years or age) Award

Dr PK Dash Sharma, Head, AERB, received the Special Recognition Citation

Dr Prashant Warier, CEO, Qure.ai receives the award in Best Artificial Intelligence Co

Dr K Mohanan, President, IRIA, received the citation for his dedication to promote radiology education in India

Dr Pankaj Tandon, AERB received citation for promoting radiation safety for patients

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RADIOLOGY AND IMAGING CONCLAVE 2018

Dr Vidur Mahajan recieves the award on behalf of Dr Harsh Mahajan,Founder & Chief Radiologist, Mahajan Imaging as he won the Best Radiology Entrepreneur award

Mahajan Imaging, Defence Colony bagged the award in the category Best Diagnostic Centre (single city) 2-10 years

Dr Senthil Kumar from Royalcare Super Speciality Hospital, receives Best Radiology Administrator award

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Yashoda Hospitals received the award on behalf of Dr Sikander Shaikh

Mahajan Imaging, Hauz Khas received the award in the category Best Diagnostic Centre 11-20 years

Niraj Arora, HealthMaP Diagnostics received the award in the category Best Radiology Chain ( 5 years old)

Teleradio Solutions recieved the Best Teleradiology Company award

Mahajan Imaging, Gurugram bagged the Best New Diagnostic Centre (2017) award

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TRADE AND TRENDS

Technological advancement in Haematology counters Automation will continue to grow in Haematology laboratory as the number of technologists continue to decrease. Harshad Bhanushali, Product Manager- Instruments, DiaSys Diagnostics India Pvt Ltd, gives an insight HAEMATOLOGY analysers are the workhorses of a pathological laboratory. In order to recognise cell types in a blood sample and to count them individually, Haematology analysers utilise various technological solutions and generate a complete blood count (CBC) with differential. These include measuring cellular volume by direct current impedance principle. The data generated is used to plot cells in a histogram. A key challenge of Haematology analysers is discrimination among different cellular elements that fall in similar regions of a histogram, making it difficult to differentiate one from another. Another key limitation of most analysers is that data obtained in each module is analysed independently. Often information from one module can be useful to the detection of interfering particles in another module, but the opportunity is missed because there is no communication between the modules High-end 5 part Differential Analysers deliver reliable cell counts identifying Lymphocytes, Monocytes, Neutrophil’s, Eosinophil’s, and Basophil’s. Atypical Lymphocytes and Immature Granulocytes are emerging as sixth and seventh parameters. While electrical impedance still has a firm foothold in determining the overall number and size of cells, flow cytometry techniques have proven their worth in differentiating white blood cells and identifying abnormal cells. The increasing sophistication of flow cytometry techniques on the

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However, Haematology is becoming a very competitive market, and sometimes pricing rather than best available technology does influence the purchasing of the analysers analyser will push some tests back to the Haematology analyser. Using the advanced technology appropriately will not only increase efficiency but also improve clinical -decision making. Manufacturers often market their instruments by focussing on the particular package of technologies they use to differentiate from the rest of the analysers. However, the benefits of this package of technologies is not well explained to the end user and hence the value derived out of this is not differentiated. For instance, some analysers determine leukocyte differentials by inserting a fluo-

rescent dye into the cell nucleus and measuring how strongly it fluoresces. Another may measure enzyme activity in a cell placed in a particular substrate. The Newer technology is the Volume Conductivity and Scatter (VCS) method that analyses cells in their 'near-native' state. The new technologies are great as they are evolving toward flow cell-based technologies, where cells are interrogated one by one through optical systems that can measure many new parameters which, at the beginning, were never measured. Also, many manufacturers have started incorporating Mi-

crofluidics in the Haematology analysers greatly shrinking the size of the analyser and reducing the sample volume required to run the test. This also greatly reduces the reagent consumption making it cost effective and environment friendly. Instrument manufacturers also promote automation systems to high-volume laboratories to help with staff shortages. Middleware allows laboratories to set up rules for auto-validation and suspect flags based on sample location or patient population. The important thing is not just to auto-validate normal samples, but to reduce the number of

false positive flagging. The bottom line is to reduce the amount of time someone goes to the microscope. Automation will continue to grow in the Haematology laboratory as the number of technologists continue to decrease. The need for today is to have sophisticated systems where you can put your samples on and only be available to look at those truly abnormal samples. The ability to automate for walk-away systems to improve productivity is a big area. However, Haematology is becoming a very competitive market, and sometimes pricing rather than best available technology does influence the purchasing of the analysers. In summary, technological advances being incorporated into Haematology analysers today are allowing the laboratorial access to more cellular information than was ever available before. This can be used to improve cellular counting and decrease the rate of unnecessary manual reviews. Current research is beginning to demonstrate that this information also has great potential to identify cellular changes that typically occur in several important medical conditions—bringing us all one step closer to using Haematology analysers as more than simple cell counters, but instead as powerful tools for the management of any medical condition that impacts blood cells. The use of these technologies can translate into a smoother workflow for the laboratory and an improved diagnostic quality of care for patients.

David Westgate named Chairman, President and CEO,Carestream Health Westgate will help the business to grow for long-term success DAVID C Westgate has been named the new Chairman, President and CEO, Carestream Health. With more than 6,000 employees worldwide and conducting business in nearly every country in the world, Carestream is an independent provider of medical imaging systems and healthcare IT solutions; X-ray imaging systems for non-destructive testing; and precision contract coating services for a wide range of industrial, medical, electronic and other applications. “Our focus will be on delivering innovation that is life-changing—for patients, customers, employees, communities and other stakeholders—and we will grow our business for long-term success,” said Westgate. “We are excited about pursuing new product development road maps that will position us to meet the diverse needs of our customers in the markets we will serve. Customer satisfaction, continuous innovation

Westgate previously served as CEO of Jason Industries, where he led successful efforts to diversify the company’s portfolio while emphasizing a culture of growth and innovation

and operational excellence will be fundamental to our culture and we are committed to being the very best at what we do.” Westgate previously

served as CEO of Jason Industries, where he led successful efforts to diversify the company’s portfolio while emphasizing a culture of growth and innovation. Under his

leadership, Jason Industries experienced tremendous increases in both revenue and earnings, and accelerated growth through acquisitions, geographic diversification, performance improvements and a focus on developing breakthrough innovations. “Dave has an impressive record of success in corporate leadership roles and his vision for Carestream is clear: move the company toward long-term growth and market leadership, and drive continuous innovation across the company’s broad portfolio of products,” said Robert Le Blanc, a Senior Managing Di-

rector, Onex Corporation. Westgate replaces Kevin Hobert who had decided to leave the company and will assist with the transition. “Kevin Hobert has done an excellent job leading Carestream’s development into a worldwide leader in the medical and dental imaging fields, and has prepared the company for sustainable growth in the coming years. I would like to thank Kevin for the many significant contributions he has made to Carestream’s success since launching the company more than 11 years ago,” said Le Blanc.

Virosil: A Swiss eco-friendly, chlorine-free fumigant An operation theatre can be made 100 per cent sterile within 60 minutes using Virosil as a fumigant VIROSIL IS an eco-friendly formulation manufactured and marketed by Sanosil Biotech in technical collaboration with SANOSIL of Switzerland. Sanosil Biotech is a Mumbai-based company which is the first company to pioneer the novel concept of ecofriendly fumigation in operation theatres in hospitals and healthcare industry with its

product Virosil. Virosil completely replaces the use of carcinogenic proven formalin. The product Virosil is based on Hydrogen Peroxide (H2O2) & Silver Ions. (Nanotechnology). The combination of these two ingredients gives a broad spectrum synergistic activity on all kinds of viruses, bacteria, fungi, yeasts, molds, protozoa and algae. It is a clear, colourless, odourless, tasteless

disinfectant which is non-carcinogenic, non-mutagenic, revolutionary and can be used where other chlorine based disinfectants have been feared. An operation theatre can be made 100 per cent sterile within 60 minutes using Virosil as a fumigant. Healthcare workers will not face any irritation as our product is 100 per cent eco-friendly. This also

results in faster turnaround time for OT’s and prevention of hospital acquired infections. The formulation is presently being used in reputed hospitals and institutions in the healthcare industry as a very effective fumigant and disinfectant thereby providing an microbe free and a completely safe and sterile environment. The added benefits of Vi-

rosil is that it does not give any foul odour, irritation to the eyes, requires no de-fumigation and is very safe and easy to handle as per our recommendations. Our formulation (Virosil) was being earlier marketed by Johnson & Johnson under the brand name Ecoshield. The company also offers a customised disinfection audit on its website:www.sanosilbiotech.com

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TRADE AND TRENDS

How online procurement platforms can lead to a value-based healthcare system in India? Adoption of online procurement can bring about equality in terms of setting up healthcare facilities in such locations and ensuring smooth and regular medical supplies for serving the underserved in such locations. An insight by Medikabazzar IN INDIA, access, quality and affordability of healthcare is a prime concern. As per a report ‘Medical Technology, Shaping Healthcare For All In India’ by Deloitte and Confederation of Indian Industry (CII), there is a lack of spending by the government in the healthcare sector. India spends 1.3 per cent of its GDP on healthcare, much lower than the global average of 6 per cent. Also, just 15 per cent of India’s population is under health insurance coverage. Healthcare is still an out-ofpocket (OOP) expenditure, a personal expenditure borne by the people out of their own pocket. 70 per cent of the total healthcare expenditure in India is borne by the consumers themselves as OOP. As per the Healthcare Access and Quality (HAQ) Index 2016, India scored just 41.2 which is low in comparison to a global average of 54.4 points. Basic indicators of maternal and child mortality clearly establish this fact. Despite bearing high medical expenses the patients are not getting their desired medical outcomes and that clearly shows a lack of value in the healthcare system. Regardless, the healthcare industry in India is projected to grow at a rate of 15 per cent by 2020 and industry size is expected to reach $280 billion. On charts, the Indian healthcare industry seems to be growing positively. But the question is, are we on a mission to make healthcare accessible and affordable in India? Let’s take a deeper look and identify whether there is a solution which can lead to a value-based healthcare system. Healthcare system in India

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Patients will benefit as they will pay lower medical bills and still receive quality medical service anywhere across India, thus achieving the final objective of a value-based healthcare system in India is a highly complex structure consisting of both public and private sectors, geographic diversity, and disease burdens. Also, the medical supply industry is highly fragmented and this results in faulty healthcare supply chains. One of the major costs incurred by the hospitals and medical establishments is towards the procurement of medical supplies. Many healthcare providers are still operating through an offline procurement system, an operation which has a lot of limitations. Due to limited channels of information on products, brands, and substitutes, the hospitals are unable to take an informed decision on capital expenditure and operations expenditure purchases thus resulting in wrong purchases and massive revenue leakages. Lack of communication with medical supplies manufacturers coupled with high turnaround times or no availability for order fulfillment in tier 2, 3 and remote locations of India are some of the disadvantages of an offline procurement system. Offline procurement platforms don’t allow hospitals to compare products. Hence, many a time, medical healthcare centres end up buying mediocre quality medical sup-

plies at high prices adding to their bottom line which, in turn, affects patient care and finances alike. All put together, this increases the total cost of operations (TCO) for a healthcare establishment and patients bearing high medical expenditures. To achieve parity between desired medical outcomes and medical expenses, or in other words, bring about a positive change in terms of valuebased healthcare in India, healthcare providers can look at bringing down their total cost of operations. Medical supplies constitute 1/3rd of the total cost of operations in any hospital or medical establishment. By switching medical supplies procurement process from a complex offline process to an online one, hospitals can bring about 25 per cent efficiency in their operations expenditure. In an online procurement platform, the customers (hospitals and medical establishments) can search for different brands selling similar products, compare prices and other features and then make an informed decision on what to purchase. Whereas in an offline system, the customers have to communicate with multiple vendors for procuring medical supplies, ask for quotations and negotiate,

which makes the whole process slow and taxing. Online procurement makes the whole process self- serving, more streamlined and transparent. One of the biggest advantages of an Internet-based procurement platform is its ability to reach beyond geographical boundaries. Medical establishments in remote areas can also search and order medical supplies online and can receive doorstep delivery. Online procurement platforms also offer a transparent communication line with the supplier and they also consolidate essential details such as past purchases, in-process orders, and frequently bought products and give reminders to purchase well in time. All these features allow the customer to make informed choices and ultimately take a decision which is based on detailed analysis. Some online medical supplies procurement platforms have also started to provide consultation services where customers can interact with product specialists who offer recommendations and advice. The healthcare sector has acknowledged technology and has integrated the same, which has resulted in quality and advanced diagnostic and clinical systems. However, it

should be noted that these developments are only concentrated in the urban metropolitan areas of India where multi-specialty medical establishments are providing their services to a population who can afford to pay heavy medical bills. The other side paints a very different picture. Tier 2, 3 cities and the rural areas in India are not at all benefiting from the above-mentioned developments. According to a 2017 news report, there is only one allopathic government doctor for 10,189 people, one government hospital bed for every 2,046 people and only 1 state hospital for every 90,343 people. Fewer numbers of healthcare facilities coupled with a poor doctor-patient ratio and substandard infrastructures has resulted in people getting ill more frequently and high mortality. Adoption of online procurement can bring about equality in terms of setting up healthcare facilities in such locations and ensuring smooth and regular medical supplies for serving the underserved in such locations. By making use of such platforms, hospitals will be able to procure quality medical supplies, at the right time and right price anytime and anywhere in India, which will not only reduce revenue leakages and bring down TCOs, but also bridge the healthcare divide. Due to a domino effect, as TCOs go down, the patients will benefit as they will pay lower medical bills and still receive quality medical service anywhere across India, thus achieving the final objective of a value-based healthcare system in India.

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RadTag

IRRADIATION INDICATORS FOR BLOOD BANKS

R R

An innovative way to conrm your blood products were irradiated The RadTag label is a radiation indicator device used by blood banks that irradiate blood Transfusion bags. Distributers and dealers wanted all over India. Contact :supportrosalina.in

Negative

August 2018

Minimum

Mid-Range

Maximum

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Business Avenues Blood Bank Equipments

Please Contact: ■ Mumbai / Bangalore: Blood / IV Fluid Warmer

Douglas Menezes 91-9821580403

Plasmatherm Blood Donor Chair

■ Ahmedabad: Nirav Mistry 91-9586424033 ■ Delhi: Ambuj Kumar / Sunil Kumar Blood Collection Monitor

Blood Bank Centrifuge

Biological Refrigerator

91-9999070900 / 91-9810718050 ■ Bangalore:

Platelet Incubator with Agitator

Sunil Kumar 91-9810718050 ■ Hyderabad: E.Mujahid Benchtop Sealer

Centrifuge Bucket Equalizer

REMI SALES & ENGINEERING LTD.

Blood Bank Refrigerator

Remi House, 3rd Floor, 11, Cama Industrial Estate, Walbhat Road, Goregaon (East), Mumbai-400 063. India Tel: +91 22 4058 9888 / 2685 1998 Fax: +91 22 4058 9890 E-mail: sales@remilabworld.com l Website: www.remilabworld.com

August 2018

Biological Deep Freezer

91-9849039936 ■ Kolkata: Ajanta 91-9831182580

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August 2018

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August 2018

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Bubble CPAP Combo Kit

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nice 8050 Heated (Respiratory) Humidifier

nice 5005 Low flow Air Oxygen Blender

nice 5020 Infant T-Piece Resuscitator

nice 3010 H Infant Incubator nice 3000 Infant Transport Incubator

nice 5000 RP Infant Radiant Warmer with T - Piece Resuscitator & Phototherapy

Looking for National & International strategic partnership!

M/s. nice Neotech Medical Systems Pvt. Ltd., was established in the year 1997. 'nice' stands for 'Neonatal Intensive Care Equipment' which aptly ampliﬁes the objectives of the organization. nice Neotech design the product as per world standard which symbolizes excellence in form, function, quality, safety, sustainability and innovation, and communicate that the product is usable, durable, aesthetically, appealing and socially responsible & most user-friendly. Our product range include Infant Incubator, Infant Transport Incubator, Infant Radiant Warmer with T – Piece Resuscitator & Infant Phototherapy, Infant Radiant Warmer, Infant CFL Phototherapy, Infant LED Phototherapy, Bubble CPAP System, Heated(Respiratory) Humidiﬁer, Infant T – Piece Resuscitator, Infant/Neonatal Fiber Optic Transilluminator, Oxygen Analyser, Infant/Neonatal Respiration Monitor, Infant Observation Trolley, Infant Weighing Scale, Oxygen Hood, Air Oxygen Blender, Medical Air Compressor, Reusable/ Disposable Breathing Chamber, Reusable/Disposable Breathing Circuit, Nasal Mask, Nasal Prongs, Head Bonnet, and Eye Mask etc.

nice

Neotech Medical Systems Pvt. Ltd.

An ISO 13485 Certied Company (With Design)

Applications: 1. Mother & Child Care

4. Level III NICU

2. Level I NICU

5. Pediatric ICU

Neonatal Respiratory care

3. Level II NICU

6. Newborn Emergency care Unit

Adult Respiratory Care

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7. Respiratory care

August 2018

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August 2018

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August 2018

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REGD. WITH RNI NO. MAHENG/2007/22045, POSTAL REGD. NO. MCS/162/2016 – 18, PUBLISHED ON 8TH EVERY MONTH, POSTED ON 10TH, 11TH, 12TH EVERY MONTH, POSTED AT MUMBAI PATRIKA CHANNEL SORTING OFFICE, MUMBAI – 400001