IT@Healthcare Healthcare: Safety starts with strong IT security As heathcare goes digital, organisations need to revamp their IT security infrastructure to combat more sophisticated threats while supporting business functions and processes. Vishak Raman, Senior Regional Director, India and SAARC, Fortinet, gives an outlook
Page 69 MAIN STORY
Investment in health IT: Gaining ground The Indian healthcare industry is at an exciting juncture and health-IT is leading its path. Although few investors are looking at health-IT firms right now, it has the potential to attract many more in the near future, says M Neelam Kachhap
he Indian healthcare industry estimated at $40 billion in 2010 is expected to reach $280 billion by 2020. This rapid expansion in the segment is due to huge demand in healthcare and explosive development of the healthcare delivery segment. One of the main engines of growth of healthcare is the growing use of IT in healthcare delivery. Health-IT is transforming the way healthcare is delivered, with the application of newer, better IT systems and applications. Adoption of IT has become one of the top priorities for the Indian healthcare providers. According to Frost & Sullivan reports, spending on information technology (IT) by Indian healthcare players
T
was estimated at $244 million in 2010 and is expected to grow at 22 per cent pa over the next 10 years. This throws up a lot of opportunities for IT players as large number of hospitals will be adopting information technology apart from medical technology. Moreover, experts believe that with new and upcoming applications such as telemedicine and e-prescriptions penetrating the healthcare vertical in India, IT investments on software would further increase with a focus on integrated billing and online availability of patient records across hospitals. With all this buzz around health-IT there has been SEPTEMBER 2012
massive influx of funds in this sector as investors are increasing their bets on health-IT.
Global investments in HIT Global Venture Capital (VC) funding in the HIT sector continued to scale new heights reaching $293 million in Q2 2012 in 28 deals. Both the total amount and the number of deals were at their highest levels since 2010. According to a report by Mercom Capital Group, in Q2 2012, Health Information Management (HIM) companies received the most funding as a technology group with $247 million in 19 deals www.expresshealthcare.in
followed by Telemedicine companies with $19 million in three deals and Personal Health Record (PHR) companies with $16 million in four deals. The top VC funding deal this quarter was the $100 million raised by Castlight Health, a provider of healthcare web and mobile-based transparency solutions that enable comparisons of doctors, hospitals, medical procedures based on price and quality, followed by $34 million raised by Practice Fusion, a provider of free web-based EMR, and $30
million each raised by Valence Health, a provider of clinical integration, data collection and analysis software and Liaison Technologies, a provider of cloud-based integration and data management solutions. Other top deals were $14 million each raised by Carena, a provider of healthcare services 24 hours a day via phone, secure video, and the traditional house calls and Aware Point Corporation, a provider of real-time location system (RTLS) solutions for healthcare. The average VC deal size in Q2 was $10.5 million. EXPRESS HEALTHCARE
67
I|T|@|H|E|A|L|T|H|C|A|R|E
There were 39 M&A transactions in Q2 2012 amounting to $2.9 billion, of which only seven transactions disclosed details. Top M&A transactions included Thomson Reuters’ HIT business acquired by Veritas Capital for $1.25 billion, Decision Resource Group, a health information company acquired by Piramal Healthcare for $635 million and Extend Health, a private medicare insurance exchange acquired by Towers Watson for $435 million.
The Indian story Experts believe that the global enthusiasm could also rub off on India. “Potential investors looking for opportunities in health-IT companies have become fully aware of the healthcare-IT market and the fitment of the solution offered by the companies operating in that area,” says Suchet Singh, CEO, Srishti Software, Bangalore. “Availability of quality investments available in India is scarce. Although, there are many health-IT companies in India, the quality of assets, product portfolio, technology, revenues, margins, focus and management are serious concerns,” he adds. While, recent activity in this area has been encouraging with major Indian drug manufacturer leading the way, experts believe that much is left to be desired. “Healthy activity is happening in the Indian Health-IT market, but we are still not there yet,” opines Suchet. “The investors are mostly funds focused on technology and IT. I have not seen many ‘healthcare only’ focused VCs,” laments Ramesh Emani, CEO, Insta Health Solutions, Bangalore. Recently, Piramal Healthcare acquired USbased Decision Resources Group, a healthcare information company which provides web-enabled research, predictive analysis via proprietary databases, for $635 million, the second largest M&A transaction for Q2 2012. This has brought the spotlight back on investment in this sector and in future more such activity is expected. “Both domestic as well as foreign VCs are vying for a piece of the pie in India. The healthcare sector in India is considered a good alternative for investment to the usual IT/BPO start-ups since it is expected to grow four-fold in the next decade. Though still considered in its infancy, that has not prevented investors
68
EXPRESS HEALTHCARE
Availability of quality investments available in India is scarce Suchet Singh
The investors are mostly funds focused on technology and IT
CEO, SRISHTI SOFTWARE
CEO, INSTA HEALTH SOLUTIONS
Ramesh Emani
Health-IT is transforming the way healthcare is delivered, with the application of newer, better IT systems and applications. Adoption of IT has become one of the top priorities for the Indian healthcare providers from pouring close to $320.4 billion into healthcare firms through 2010,” opines Suresh Singh, Head of Marketing, Anthelio Business Technologies, Hyderabad
Inviting opportunities Opportunities in HIT in India are galore. Rising number of private healthcare providers are looking at streamlining their operations with HIT. “India is a huge canvas for opportunities in Health-IT. There is huge potential waiting to be realised, especially after corporates have started investing into healthcare space either to get market entry or expand their business portfolio,” says Suchet. In addition rising use of electronic health record and IT based technology like telemedicine is also fueling the growth of HIT in India. “With the commencement of newer IT applications, the healthcare industry in India is experiencing a transformation. Telemedicine is seen as a fast-emerging IT trend in the healthcare sector in India, supported by exponential growth in the country’s information and communications technology (ICT) sector, and plummeting telecom costs. Several major private hospitals have adopted telemedicine services, including those that have developed public-private partnerships (PPPs). Another www.expresshealthcare.in
opportunity in the healthcare IT sector is the use of technologies such as HIS and EMR. The spate of new private hospitals is likely to boost this further, with investment in EMR being seen as a necessity. With the introduction of 3G, usage of mobile phones for diagnostic and treatment support, remote disease monitoring, health awareness and communication is also being considered,” says Singh. The advent of cloud solutions and maturing of providers, has also started to have an impact. “There is lot of interest since this is a growth sector and technology is under-penetrated in this segment. But the market fragmentation and consequent inability to get good prices, is deterring the investors to invest in HCIT companies. But I think with the advent of cloud solutions and maturing of providers, will start having an impact. The growth of local clinic chains and hospital chains will also have a positive impact. I am bullish on this market. The big investment garnered by Practo (Practo has secured an investment of Rs 25 crore from Sequoia Capital) is an example of that,” informs Emani.
Potential problems HIT is an emerging market in India, with only a small percentage of total hos-
Both domestic as well as foreign VCs are vying for a piece of the pie in India. Suresh Singh HEAD OF MARKETING, ANTHELIO BUSINESS TECHNOLOGIES
pitals adopting and implementing it. However, a fragmented market and lack of awareness on IT’s role to improve profitability has hampered market growth. “The Indian healthcare provider market is very fragmented, with very few large companies. Investors normally do not like such hugely fragmented markets as deals tend to be smaller and will take longer time to close. Smaller provider players also tend not to invest much in IT. The investors are also not seeing signs of consolidation. Investors love (it) if the market is today fragmented but will consolidate in future. Then they can bet on winners and make good return on investment. Though there is lot of interest in healthcare IT, this fragmented nature is deterring them,” analyses Emani. In addition, most investment opportunities in HIT involve early-stage companies with a long gestation cycle and challenging business models. “Investors also demand a proper assessment of the product/company and the value proposition for investors in the growth of the company before investing. In that sense, health-IT companies have to really scale up their operations to attract investment,” warns Suchet. “Major risks involved in investment are proper assessment of the quality of assets; alignment of the solution portfolio according to the business plan; ability of the top management to lead the organisation,” he adds. HIT in India is a growing and dynamic market and an area of investment where only a few investors are ready to venture at this point in time, but the sector has the potential to grow manyfold and will attract a wider investor base in future. mneelam.kachhap@expressindia.com
SEPTEMBER 2012
I|T|@|H|E|A|L|T|H|C|A|R|E INSIGHT
Healthcare: Safety starts with strong IT security As heathcare goes digital, organisations need to revamp their IT security infrastructure to combat more sophisticated threats while supporting business functions and processes. Vishak Raman, Senior Regional Director, India and SAARC, Fortinet, gives an outlook
ospitals and other healthcare care organisations have traditionally designed their network infrastructure by concentrating security at the network perimeter, employing security tools as needed to satisfy compliance and other regulatory concerns. Unfortunately, many of these security architectures have not adjusted to the dramatic changes currently taking place in today’s computing environment. As health information exchanges (HIEs), virtualisation, cloud computing and the bring-your-owndevice (BYOD) trend become a reality, the need to rethink the security infrastructure and overall IT architecture has become more pressing in the healthcare industry. We are at a tipping point with electronic health records (EHRs) and the financial incentives to migrate from paper to digital. In the US for example, federal and state requirements for the Health Insurance Portability and Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health Act (HITECH) and the Payment Card Industry—Data Security Standard (PCI-DSS) have all
H VISHAK RAMAN
Senior Regional Director, India and SAARC, Fortinet
SEPTEMBER 2012
become critical factors in the definition of security architecture strategies due to their requirements for segmentation, auditing and control of data. Although similar regulations are currently not widespread internationally, the maintenance of standards on par with the US rules is important because many countries, for example Singapore, Malaysia, Thailand and parts of the Middle East, are aspiring to become medical tourism hubs. HIPAA and related compliance requirements will enable these countries to attract medical tourists from the US and other countries looking for assurance of their privacy. On a more technical level, compliance to these established standards will facilitate a common platform to link up and integrate healthcare institutions in different countries as the industry globalises. In parallel, networks of the various healthcare organisations, payers, providers and other parties are becoming more integrated. EHR systems are becoming the standard, and patient information is moving digitally and being stored on the healthcare www.expresshealthcare.in
organisation’s network. The use of social media has also increased in the healthcare environment as it enables better communication within and among enterprises and stakeholders, driving business, patient care and charitable foundation work. The BYOD phenomenon and the use of wireless technologies - an important part of the landscape as they help to improve operational efficiency and mobility in today's hospitals can complicate the security requirements of networks. So, in this context, here are some important considerations for healthcare organisations, which are currently assessing or revising their IT security infrastructure:
Attacks from all fronts Healthcare firms should take into account the following trends: ● Increase of small-scale data breaches ● Vulnerability resulting from lost mobile devices ● Vulnerability resulting from increased collaboration and sharing as well as the use of social networking ● Proliferation of users’ (both healthcare workers
and patients) personal devices within the organisation to access information ● Another interesting trend is the potential security breaches associated with medical devices. Insulin pumps and defibrillators, for instance, could be hacked (by breaching improperly secured wireless technologies in these devices) with life-threatening consequences. This phenomenon is coming about due to the rapid increase in the number of intelligent networked medical devices, and the disappearing separation between traditional IT infrastructure and devices (infrastructure and data are merging). ● Medical devices introduce distinct IT security issues, including: ◗Network-based attacks by traditional IT malware introduced over a network ◗ Removable-media attacks, possibly introduced during support or maintenance ◗Device-introduced attacks from devices returned after repair, or demonstrator or loaner systems ◗Network proliferationattacks that use a device as a point of entry, then penetrate the enterprise by exploiting similar devices All these trends are driving for the definition and enforcement of strong controls and policies towards users, devices and applications. Healthcare organisations must now have the power to detect and control the use of applications on their networks and endpoints based on application classification, behavioral analysis and end-user association; and to detect and control web-based applications at a granular level.
Protecting the network end-to-end Below are some recommendations for healthcare organisations to take into account as they deal with security issues: Electronic Medical Record Security (EHR/EMR,) (HIPAA/HITECH) ● Encrypt records in transit from site to site EXPRESS HEALTHCARE
69
I|T|@|H|E|A|L|T|H|C|A|R|E ●
Encrypt remote access to EHR applications Network segmentation ● Segment biomedical devices ● Segment EMR Systems ● Segment PCI Networks Web filtering/application control ● Restrict and monitor employees’ web traffic ● Restrict use of web-based applications. For instance, allow access to Facebook but prevent viewing of embedded videos or the playing of games ● Monitor for EHR/PHI/ DLP. Prevent credit card information, social security numbers and patient identification numbers from being sent to unauthorised individuals. In each of these areas, healthcare organisations need to eliminate potential blind spots, demonstrate their policy compliance, lower their response times to security incidents, accelerate adoption of best practices and expert systems, and reduce the potential for significant loss to reputation and revenue. Fortinet advocates that healthcare organisations think about the implementation of a complete IT security
70
EXPRESS HEALTHCARE
strategy while embracing HIPAA and PCI regulations. Healthcare organisations need to segment, monitor and control the various aspects of their operations, including users, behaviour, data, devices, operating sys-
trative processes in the health care system. It also helps to secure health data and ensure the privacy of the information in the process. The HIPAA act aims to drive adoption of network security solutions and create
Healthcare organisations need to segment, monitor and control the various aspects of their operations, including users, behaviour, data, devices, operating systems and applications tems and applications. The consolidation of security functions into unified threat management devices should be seriously contemplated, as it is the best way that organisations can gain endto-end visibility and control while decreasing cost and complexity. About HIPAA and HITECH Enacted by the US Congress in 1996, the HIPAA comprises two parts to protect health insurance of workers and their families, as well as to standardise the adminis-
www.expresshealthcare.in
a disciplined environment for healthcare organisations to protect the access/confidentiality of electronic health information. It also ensures that doctors and patients can assess the required personal medical information. Already, this is a step ahead to ensure that there is overarching rules of engagement in the chaotic cyberspace today. HIPAA holds promise for law and order to take root in the virtual space for the healthcare vertical. It is imperative that the industry takes on a more orderly way
to communicate medical information, as globalisation causes patients to travel seamlessly across the world for professional and personal reasons. In the midst of this evolving landscape lies a not so distant yet only hopeful future when individuals can seamlessly access their own medical records in the event of relocation or moving overseas. This way, medical practitioners can provide a more holistic form of treatment to their patients instead of taking their diagnosis as a piecemeal approach or simply relying on the patient’s ability to safely keep all printed files or plainly grasp his or her own ailment(s) and communicate accordingly to the next available doctor. On a broader scheme of things, both HIPAA and the HITECH Act are key standards to address the data privacy of electronically protected health information and medical records. Compliance requires the implementation of technical policies and controls over systems managing such information, allowing access to only people or software, which has been granted access rights.
SEPTEMBER 2012
Knowledge ThinPrep was available in India from 2009 and day-by-day the awareness is increasing
“ACI is a landmark procedure”
Page 72
Page 73
MAIN STORY
Eliminating healthcare associated infections Dr Bhaskar Jyoti Sonowal,Technical Advisor–Infection Control and Patient Safety, BD stresses on the importance of addressing healthcare associated infections (HAI) finding effective measures to curb them
SEPTEMBER 2012
t was visualised that the Global Patient Safety Challenge (GPSC) rolled out by the World Health Organization (WHO) will catalyse the commitment by all healthcare players–policy-makers, international experts, front-line staff, patients and managers–to make safer care an everyday reality in all countries. The World Alliance for Patient Safety had selected healthcare associated infection (HAI) as the topic for its first 'Global Patient Safety Challenge'. These infections are a major patient safety concern. They affect hundreds of millions of people worldwide every year. Infections take their toll in terms of avoidable patient deaths and disability. They also waste scarce healthcare resources. No country can claim to have solved the problem completely. Some of these HAIs also impact healthcare workers, compromising their safety and thereby putting a huge burden on these scarce resources. HAI is growing as a problem. Patients are becoming more susceptible to infections because of more serious underlying illnesses. Poor compliance with hand hygiene by healthcare staff, lack of access to safe water, unclean instruments and environmental surfaces all contribute to the problem. The environment of patient care is also important. Factors such as understaffing, high levels of bed occupancy and increased transfer of patients, all create new risks of infection. WHO reports that at any
I
time over 1.4 million people worldwide are suffering from infections acquired in hospital. Between five and 10 per cent of patients admitted to modern hospitals in the developed world acquire one or more HAIs. In the US, one out of every 136 hospital patients becomes seriously ill as a result of acquiring an infection in hospital; this is equivalent to two million cases and about 80,000 deaths a year. In England, more than 100,000 cases of healthcare associated infection lead to over 5000 deaths directly attributed to infection each year. In Mexico, an estimated 450,000 cases of healthcare associated infection cause 32 deaths per 100,000 inhabitants each year. Healthcare associated infections in England are estimated to cost £1 billion a year. In the US, the estimate is between $4.5 billion and $5.7 billion per year. In Mexico, the annual cost approaches $1.5 billion. www.expresshealthcare.in
There is no uniform data on HAIs in India, as a result of which the incidence and prevalence is not known. There is not yet a surveillance programme that has been institutionalised across healthcare setups, and as a result the information on HAIs is limited. However WHO reports that the risk of healthcare associated infection in developing countries is two to 20 times higher than in developed countries. In some developing countries, the proportion of patients affected by a HAI can exceed 25 per cent. The most common sites of HAIs are the urinary tract, lung, surgical site and blood. There are also certain risk factors that underlie the occurrence of these HAIs. a. Urinary tract infections may be caused by catheterisation and invasive procedures while it has certain risk factors like advanced age, severe underlying disease, urinary stones, pregnancy
and diabetes. b. Lung infections may be caused by ventilators (ventilator associated pneumonia—VAP) and aspiration procedures. Predisposing factors like prolonged hospital stay, malnutrition, old age, immunodeficiency, surgery etc. are associated with development of lung infections. c. Surgical site infections (SSI) may be caused by inadequate and wrong antibiotics following surgery, improper skin preparation before surgery, prolonged surgery, inappropriate wound care etc. Diabetes, immunodeficiency, inadequately trained staff and poor supervision on adherence of infection control processes could be the precursor for such SSIs. d. Blood stream infections (BSI) are usually caused by improper vascular access. Critical care patients, immunodeficient patients and patients with underlying disease can have higher BSIs. It is therefore critical to ensure that proper preparation of the vascular access site is made with appropriate cleansing agents. Moreover scientifically proven long lasting cannula materials made of Vialon or PTFE should be used, so that there is no need for repeated cannulation, which usually happens when materials of lower quality are used. Training of healthcare workers in understanding BSIs and supervision of the healthcare workers is critical to EXPRESS HEALTHCARE
71
K|N|O|W|L|E|D|G|E reduce BSIs. Some of the WHO statistics are worrying. In intensive care, healthcare associated infection affects about 30 per cent of patients and the attributable mortality may reach 44 per cent. In Brazil and Indonesia, more than half of the babies housed in neonatal units are affected by HAI, with a fatality rate between 12 per cent and 52 per cent. The infection rate associated with vascular devices among neonates is three to 20 times higher in developing than in developed countries. The greatest risk of nosocomial transmission of hepatitis B virus takes place from patients to healthcare workers. Despite these statistics, hepatitis B vaccine is not made available to immunise healthcare
workers in the majority of developing countries. The magnitude of HAIs prevalent in India is still unknown because of the paucity of data. However, India has the knowledge and resources to dramatically reduce the impact of HAIs. What is needed is commitment and action at all levels, to ensure that every patient’s right to safe care is achieved. India has committed to reduce risks of HAIs, by joining hands to fight the spread of healthcare associated infections. The Ministry of Health and Family Welfare, Government of India has signed the Global Patient Safety Challenge and pledged to acknowledge India’s commitment to address this problem. A programme called NIPS (National Initiative for Patient Safety) was launched by the Department of Hospital Administration, All
India Institute of Medical Sciences (AIIMS), WHO, INCLEN Trust and Becton Dickinson India (as knowledge partner) in 2009 to address the important issues on patient safety, especially HAIs. This educational programme carried out over two years has reached more than 80 medical and teaching colleges on aspects of addressing Infection Control. Another programme called “Safe-I” has been rolled out by National Accreditation Board for Hospitals and Healthcare Providers (NABH) with Becton Dickinson (as knowledge partner) has been rolled out across two states of Punjab and Kerala. This programme is being considered as the stepping stone towards complete accreditation of NABH. Most hospitals across India do not possess time, and managerial bandwidth to carry out an impor-
tant task like accreditation, since it requires time and effort to improve infection control processes. “Safe-I” seeks to address these issue that hospitals and healthcare institutes face in terms of paucity of resources. Dedicated infection control specialists are provided to help hospitals achieve the primary step of setting up and infection control programme; one that is robust and has aspects of quality parameters based on processes, protocols and outcomes. Efforts are being made to set up data repositories which would put a proper perspective on efforts required to make Indian healthcare comparable with the best available anywhere across the globe. The opportunity for further action has never been greater, nor its need more urgent. (Adapted from the WHO)
30 MINUTE INTERVIEW
ThinPrep was available in India from 2009 and day-by-day the awareness is increasing Mahendra Paranjape PRODUCT MANAGER — DIAGNOSTICS, TRIVITRON HEALTHCARE
C
ervical cancer is said to be a leading cause of cancer-related deaths amongst women in India. In fact, a global survey commissioned and funded by GSK states that every year, more than 72000 women in India die due to cervical cancer. Therefore, the emphasis is on early testing and diagnosis. It has been revealed that pap smear, the most commonly used technique to diagnose cervical cancer has some limitations that includes, more ‘false negative’ rate which cause lot of complications later and when detected can cause costlier medical interventions. However, ThinPrep system which uses liquid based technology to address preparation and screening errors is said to be more effective for the detection of epithelial lesions than conventional pap smear. Mahendra Paranjape, Product Manager— Diagnostics, Trivitron Healthcare speaks about the benefits of ThinPrep over the conventional pap smear, in an interaction with Raelene Kambli
72
EXPRESS HEALTHCARE
What is ThinPrep technology? How effective is it in detecting cervical cancer? With the conventional pap smear, a preparation error can occur when abnormal cells on the collection device do not make it to the slide for diagnostic review. When a clinician prepares a conventional pap smear slide, he or she literally “smears” the sample onto a slide and discards the collection device. Studies have found that more than 80 per cent of the sample can be discarded with the device. The portion of the sample that does make it to the slide is a non-representative sub-sample, meaning the clinician has no control over which cells make it to the slide and which do not. Existing cervical cell abnormalities may be on the collection device after the sample is collected from the patient but may never make it onto the slide for diagnostic review. With the ThinPrep system, a doctor collects a sample in the same way he or she would for a conventional test, but then rinses the collection device in a vial of proprietary
www.expresshealthcare.in
preservative solution. The ThinPrep pap test addresses preparation errors because virtually all of the cervical cells collected from the patient are then collected in the vial, which is sent to the lab for slide preparation. The slide, containing a representative sub-sample of cells, is prepared at the laboratory for diagnostic review. At the lab, the ThinPrep system addresses screening errors, another cause of false negatives. Using the conventional method, a doctor smears the sample collected from the patient onto a slide. This sample is commonly clouded with mucus and debris. This, combined with a slide containing cells that are overlapping and clumped together, results in a slide that is exceptionally difficult to read. With the ThinPrep system, the physician needs only to send the vial containing the cell sample to the lab. At the lab, a clear, easy to-read slide sample that displays a thin layer of evenly distributed cells is produced.
So can you list down the
reasons why ThinPrep technology should be chosen over the conventional pap smear method ? a)
Decrease in sampling error—In conventional pap testing—a) Cells are not collected properly, b) Cells are not transferred on slide completely, c) Cells are not preserved completely leading to drying artefacts. All these are avoided in ThinPrep pap test thereby causing higher cell yield– as more than 80 per cent cells are discarded in conventional technique. b) Decrease in transportation errors—Slide breakage is avoided, mislabelling is minimised. c) Decrease in screening errors—False negative rate is minimised. Diagnostic accuracy is far more than the conventional. d) Decrease in interpretative errors—Due to excellent fixation of cells, interpretation is made very easy leading to decrease in continued on page 73 SEPTEMBER 2012
K|N|O|W|L|E|D|G|E 30 MINUTE INTERVIEW
“ACI is a landmark procedure” Dr Ashish Babhulkar SHOULDER SPECIALIST AND JOINT REPLACEMENT SURGEON, DEENANATH MANGESHKAR HOSPITAL, PUNE
A
s an aftermath of an accident, 20-year old, state-level badminton player, Kunal Bhide was suffering from excruciating pain and stiffness in his right shoulder. During his treatment Kunal got an implant in his shoulder so that he could continue playing his favourite sport. However, after some time his right shoulder cartilage deteriorated due to the implant. He was later directed to Deenanath Mangeshkar Hospital, Pune where Dr Ashish Babhulkar, a Shoulder Specialist and Joint Replacement Surgeon conducted an Autologous Chondrocyte Implantation (ACI) to save his shoulder joint. After six to eight weeks of post-operative rehabilitation, Kunal has regained full range of motion and function. Dr Babhulkar explains this rare surgery case in conversation with Raelene Kambli
Congratulations on the success of the first shoulder regeneration case in India. Can you brief us on the complexity of this case? The challenges were formidable for two reasons. First, the ball of shoulder joint is round unlike the knee joint. To pour a liquid graft on around eroded surface has its own challenges. Hence a silicone jacket was designed to retain the cell culture to help keep it snug and prevent spillage. The other complexity, in Kunal’s case, was the presence of the protruding screws. If they were left in place the screws would scrape the fresh
continued from page 72 repeat pap smear testing. No ambiguous reports. e) Decrease in inadequacy/unsatisfactory rate. f) Decrease in limiting factors like blood mucous, inflammation etc. g) Additional testing of HPV is possible in same vial. No need to collect another sample thereby decrease patient trauma. h) Glandular disease detection rate is superior
SEPTEMBER 2012
cartilage cover. So an arthroscopic removal of the screws was planned with an innovative technique. A special instrument - hollow mill was used to drill around the protruding screws and extricate them. This was achieved with a minimally invasive arthroscopic procedure. Following this the joint was then opened up and the cartilage defect was freshened and the donor cartilage cell ulture was pasted over the defect within the silicone jacket. After three years now, Kunal finally has a cartilage cover and along with that the hope that he would eventually have a functioning right shoulder.
Were there no shoulder joint related surgeries done before in India? Or this a rare type? Shoulder surgery is now popular. I have been a shoulder specialist since 2001. However cutting edge arthroscopic surgery is rather high tech and we have very few training centres in India. Over the next few years major milestones will continue to be achieved. The ACI for the shoulder is arguably the first of its kind that we are aware of. There are no precedents for ACI in shoulder.
What is Autologous Chondrocyte Implantation (ACI)? The idea of an ACI procedure is to take a few cartilage cells from the knee, grow them in the lab, and once millions of
How effective is this technique in detecting cancers in high-risk patients? The ThinPrep pap test has FDA-approved labelling that states it is “significantly more effective than the conventional pap smear for the detection of low-grade squamous intraepithelial (LSIL) and more severe lesions in a variety of patient populations,” thereby increasing the opportunity to detect and treat these types of cervical abnormalities.
www.expresshealthcare.in
cells have been grown they are implanted into the area of cartilage damage. ACI is a two step procedure: Step one: Arthroscopy: The first step of ACI is to perform an arthroscopic surgery to identify the area of cartilage damage, and determine if it is appropriate for an ACI procedure. During the arthroscopic procedure, cartilage cells are collected. These cells are sent to a cell expansion laboratory where they are multiplied by growing in a culture. Growing enough cells takes about four to six weeks. Once enough cells have been grown, they are sent to the surgeon, and the second surgery is scheduled. Step two: Implantation: Once sufficient cartilage cells have been grown, a second surgery is scheduled. The cultured cells are implanted back into the defect site during this surgery.
Doctor you have done a lot of research in the area of shoulder and joint replacement. Tell us in which cases should ACI be used? ACI is a landmark procedure. The recovery is lengthy, and patients must be prepared to participate with intensive physical therapy. ACI is only appropriate for patients with small areas of cartilage damage, not widespread wear of the cartilage characteristics of knee arthritis. Young patients with 1-4 cm cartilage defect rather than wear are deserving of ACI. However there are strict prerequisites
Is this technique in India?
new
The technique is not new in India as ThinPrep was available in India from 2009. Day-by-day the awareness is increasing and more cytology labs as well as gynaecologists are referring to LBC- Thin Prep.
How many physicians in India use this technique to detect cancer? The technology LBC on ThinPrep system is used by more than 20 customers
that the patient has to fulfill. The joint should be without deformity and contractures. There should be no evidence of infection and prominent damaging hardware, like in our case, will have to be removed in advance.
Is there any age limit for patients to undergo an ACI? As a norm, ACI is offered to younger patients who would maximally benefit from this procedure. Older patients beyond 50 years can easily be accommodated by a joint replacement surgery which has less demanding pre-requisites and the joint replacement burns bridges anyway.
Could you give us more scope on the use of ACI in India? Awareness of ACI is progressively increasing, and can be applied to the major joints like knee, ankle, shoulder and elbow quite predictably and with reliable outcomes.
Is this a cost effective treatment method? In the past, means for ACI were not available and was also prohibitively unaffordable. With more prolific use and production houses in India it is now within reach of the common man. Although not cheap you must understand that this is a revolutionary procedure that will restore the function of the arm. raelene.kambli@expressindia.com
(cytology/histopathology labs) and they are getting the samples from physicians. It will be difficult to give numbers.
Are there any precautions that physicians need to follow while using this technique? There is no such precautions to be taken by physicians and they found that the sample collection procedure very easy. raelene.kambli@expressindia.com
EXPRESS HEALTHCARE
73
TECHNOLOGY FOR HEALTHIER LIVES EXPRESS HEALTHCARE USER CONNECT INITIATIVE
Bravo Brivo Brivo MR355, a high-end MRI machine offered by GE Healthcare, proves to be an able ally for Dr Naresh Parmar, a Mumbai-based radiologist to expend his diagnostic abilities in the best possible manner
74
EXPRESS HEALTHCARE
www.expresshealthcare.in
SEPTEMBER 2012
TECHNOLOGY FOR HEALTHIER LIVES EXPRESS HEALTHCARE USER CONNECT INITIATIVE
W
ith radiology emerging as very important medical speciality that propagates evidence-based medicine, the role of radiologists in the whole caregiving process has assumed mammoth proportions. However, “With great power comes great responsibility” and hence the onus of ensuring accurate diagnosis of a problem and recommending the right line of treatment often rest with radiologists. So, undeniably it is a job fraught with challenges that can often be overcome only with the help of a powerful ally.
Seeking an ally Magnetic Resonance Imaging (MRI), with its ability to produce 3D images from within the body and offer a non-invasive method for doctors to observe internal
organs, tissues and bones, has become a powerful weapon, a very important diagnostic tool, for presentday radiologists. Yet, choosing a comprehensive, perceptive yet cost-effective MRI system is no easy task. Radiologists are on the look out for a machine that doesn’t compromise on anatomical capabilities or image quality and thus really be the ally that they need in their battle against ailments that invade the human body.
End of the search Dr Naresh H Parmar, a radiologist and sonologist with over 15 years of experience in this field believes that
he has reached the end of his quest and finally found such an ally in Brivo MR355 1.5T from GE Healthcare. He got the high-end MRI system installed at his Parmar CT Scan Centre and has been using it for the past eight months. Yet, even in a very short span of time, the machine has made a positive impact on Dr Parmar on several counts.
Rendering timely assistance He says that one of the first reasons that made him choose the product for his practice was it compactness and further elaborates, “It is a compact system. It doesn’t require a water cooler and hence there is lesser consumption of precious space.” Apart from that, Dr Parmar also likes the product since it enables him to conduct a whole range of clinical applications through Brivo MR355. It includes scanning of various body parts like brain, heart, stomach, spine, breast and joints with complex procedures such as inhance noncontrast MR angiography, diffusion tensor imaging, PROPELLER 2.0, and LAVA abdominal imaging. Moreover, he found that the GE MRI machine is a very handy and user-friendly device whose operations can be handled with ease. He opines that the machine's elaborate graphical user interface is one of the factors that makes the product very user friendly for technicians. The radiologist is also very impressed with the quality of the images produced by Brivo MR 355. He explains that the impressive image clarity is due the OpTix RF technology that the GE machine is equipped with. Elaborating further he informs, “OpTix RF technology is boon in MR. This technology uses fibre optic cables from the magnet to the cabinet of the machine for signal transfer; this helps to reduce the noise produced during the
OPTIX RF TECHNOLOGY HELPS TO REDUCE THE NOISE PRODUCED DURING THE PROCESS AND MAXIMISES THE SIGNAL INTENSITY FOR CLEANER, CRISPER IMAGES Dr Naresh H Parmar
RADIOLOGIST, PARMAR CT SCAN CENTRE
SEPTEMBER 2012
www.expresshealthcare.in
process and maximises the signal intensity for cleaner, crisper images.” “The technology also enables faster communication of patient data”, he further adds. Dr Parmar has been able to screen patients much faster since he got the equipment installed. He explains that Brivo MR355 is designed in such a way that the patients do not need to be repositioned if they require scans of both head and spine. This saves time and results in more people being scanned every day. Though he has been using the the product only for eight months, the doctor informs, “in the studies performed upto date the accuracy has been nearly 95 per cent.” Thus, so far accuracy in diagnosis is also a big point in favour of the machine as far as Dr Parmar is concerned. Moreover, Brivo MR 355,
with its lesser scanning time and an in-built water-cooling technology helps save energy says Dr Parmar. Therefore the machine ensures, as the doctor puts it, “reduced power requirement and hence reduced power bills.” This is likely to be a good point in favour of the machine since energy efficiency is a feature that is given lot of consideration while buying any equipment today.
Peeking into the future Thus, Dr Parmar has been able to use the product very effectively for his practice and recommends it to his fellow radiologists as well. He is completely happy with his decision to get it installed at his scanning centre. But, would the rest of the radiology fraternity also be of the same opinion is something look out for in the times to come. EXPRESS HEALTHCARE
75
Trade & Trends OXYSWING: New age medical oxygen generators Unison Narula Group (India) and INNOVATIVE GAS SYSTEMS Group (Italy) announces a new concept of xygen supply to the medical market, suitable for variable needs of gas flow Page 80
30 MINUTE INTERVIEW
'Hand-carried ultrasound systems help in performing safe nerve and plexus blocks' Dr Surinder M Sharma DIRECTOR, ORTHO-ANAESTHESIA, MEDANTA - THE MEDICITY, GURGAON
When did you start using ultrasound and how long you have been using it?
Are these hand carried ultrasound systems user friendly?
I started using ultrasound in year 2004 but not on a regular basis. Since last two and a half years, I have started using it extensively in almost every procedure. Technological advancements in ultrasound systems are providing great benefits in point-of-care delivery.
SonoSite hand-carried ultrasound system is easy to understand. It boots up very quickly and has excellent image quality with good battery backup. These are the desired key features that a healthcare practitioner always seeks in a system. It is rightly said that you only see what you know. Hence, anesthesiologists need to develop a careful understanding of the anatomical structures involved, and acquire proper understanding of ultrasound technology for the practical skills to visualise nerve structures.
What do you find most useful about Hand-carried ultrasound (HCU) system in POC? The easy portability of the HCU systems is the key distinguishing characteristic. Being lightweight, it can be carried directly to the patients, enabling one to perform safe and efficient nerve and plexus blocks with quicker and more informed diagnostic decisions.
SonoSite hand-carried ultrasound system is easy to understand. It boots up very quickly and has excellent image quality with good battery backup. These are the desired key features that a healthcare practitioner always seeks in a system.
76
EXPRESS HEALTHCARE
How accurate and efficient is HCU in nerve blocks and plexus blocks? What are the benefits of point of care ultrasound? In the past, there were no other modalities available to see the position of the needle and parasthesias were actively sought. Parasthesia for anaesthesia was the order of the day. But blind blocks that relied solely on anatomical landmarks and/or fascia clicks sometimes used to be traumatic and could lead to serious complications during procedure. The usage of HCU reduces the block performance time and enables direct visualisation of the distribution of local anaesthetics. The high quality imaging probes improve the efficiency and www.expresshealthcare.in
help to avoid the complications. This has changed the perception to avoid parasthesia to avoid dysaesthesia. At the time when pain is severe and there is urgent need to infuse the anaesthetic fluid , ultrasound guidance enables the anesthesiologist to secure an accurate needle position to monitor the distribution of the local anaesthetic in real time. In addition, the amount of local anaesthetic needed for effective nerve block can be managed by directly monitoring its distribution.
almost all types of regional anaesthesia. In addition, complications such as intraneuronal injection can be avoided.
How efficient is HCU in putting perineural catheters? I have been putting perineural catheters for quite some time, but since I have started using ultrasound technique, it has made things easier. Use of point-of-care ultrasound guidance can potentially decrease neuraxial damage while correctly placing a perineural catheter.
Does it increase the safety profile of nerve block systems?
Any role of nerve stimulator along with ultrasound?
Yes, it definitely does. Earlier, it was like a blind man even without a stick, but later nerve stimulators improved block outcomes. Now, the introduction of HCU has revolutionised the practice of administering nerve blocks. Needle guidance under direct visualisation helps avoiding vital structures like blood vessels, pleura, peritoneum etc. and injecting local anesthetic more accurately thereby enhancing the safety profile of the nerve block systems. For a successful regional anaesthetic block, anesthesiologists have to make sure the optimal distribution of local anaesthetic around nerve structures.This goal is achieved most effectively under ultrasound visualisation. It can significantly improve the quality of nerve blocks in
Initially, if the physicians are not well versed with the basics of ultrasound imaging they may use nerve stimulator to identify specific nerves, as basic understanding of ultrasound theory is vitally important for the safe use of this technology. The physician’s knowledge of anatomy is fundamental to the safe practice of ultrasound-guided regional anesthesia. However, gradually when the physician has enough knowledge of using ultrasound technique, there is a limited role of a nerve stimulator e.g. in deeply placed nerves. As nerve stimulator causes muscle contractions, often patients may not be comfortable. Soon patients may ask for block with a scanner rather than a blind procedure/nerve stimulator. SEPTEMBER 2012
T|R|A|D|E & T|R|E|N|D|S
Carestream Dental launches the CS 7600 – a Digital Intraoral Radiography System It is based on imaging plate technology; exclusive Scan and Go technology and fully automated, secure x-ray workflow
arestream Dental has launched sales of the CS 7600, its latest digital intraoral radiography system that reinvents imaging plate technology—improving usability, productivity and security with an innovative and fully automated workflow. The CS 7600 includes exclusive Scan & Go technology that uses Smart Plates to prevent plate mix-up and reduce operation time. This feature—another industry first—identifies the plates electronically with patient information, allowing the device to automatically route scanned images to the proper computer and patient file. The system’s user-friendly operation automatically detects improper plate insertion, providing clear instructions for correction on a large-format, color display. Practitioners can easily scan and display single or multiple plates and full mouth series. Afterwards, plates are automatically erased for reuse. Multiple users can work on the system at the same time, as the system is always ready for use, with no waiting time required. As easy to use as film with all the benefits of digital imaging, the CS 7600 requires minimal training or disruption to established work patterns. Its images are among the highest resolution available today and can be previewed on the
C
unit for instant feedback on the success of the exam. Thin, flexible plates, with no attached cable—size 0 to 4—are as easy to place as film and comfortable for patients. “The CS 7600 supports batch scanning of mixed patient plates effortlessly and securely, removing the risk of operator mistakes,” said Edward Shellard, D.M.D., chief marketing officer and director of business development for Carestream Dental. “The CS 7600 goes beyond all the essentials required for top performance, speed and high image quality. Thanks to the Scan & Go
technology, it offers practitioners an easier workflow and an improved user experience.” “With up to 17 lp/mm true resolution, the CS 7600 delivers exceptional image quality for confident diagnoses every time. It is among the fastest plate systems available today with an image viewable in as little as five seconds.” said Pinkesh Garg, General Manager, Carestream Dental—India. Representing one of the most costeffective and compact digital options on the market today for patient imaging, the CS 7600 is designed for chair side and shared use. Its small footprint enables practices to easily install the unit wherever it will best serve patients—on a desktop or mounted to a wall. The unit does not require a dedicated computer to run, which optimises practices’ investment and space, and can be easily connected to a network through an Ethernet connection. A built-in memory function ensures your unit continues to work and store images, even if there’s a network failure during the process. The Scan & Go option automatically restores and sends the images to the appropriate computer when the network is restored. For more information visit visit www.carestream.in.
Carestream's new Vita XE CR imaging system available for order C Affordable tabletop CR system offers throughput of more than 60 plates per hour
SEPTEMBER 2012
arestream launched its new Vita XE CR imaging system, which is now available for order worldwide. The tabletop computed radiography system produces diagnosticquality images at a speed of 60+ plates per hour and is an ideal fit for smaller hospitals, imaging centers, clinics and private practices. This system complement the company’s popular tabletop system the DIRECTVIEW Vita CR System (40+ plates per hour). All Vita systems are designed to produce diagnostic images immediately with the option of completing image optimisation easily according to user preference.
The Vita XE offers a variety of options to enhance productivity and satisfy specialised imaging needs. These options include: long-length imaging, CD/DVD output; modality www.expresshealthcare.in
worklist, Image Suite miniPACS software, and a dental panoramic module. With the introduction of the Vita XE system, the company is discontinuing its
point-of-care 360 and DIRECTVIEW Vita SE systems. All members of the Vita CR family share accessories, software and hardware which allows for seamless transitions from one system to another in a multi-CR facility and/or across multiple facilities using different models. The Vita CR family offers imaging systems that are easy to use and deliver excellent image quality, rapid image availability, flexible upgrades and an affordable price. For more information check www.carestream.in. EXPRESS HEALTHCARE
77
T|R|A|D|E & T|R|E|N|D|S
Olympus: Foraying into the Indian terrain Olympus has plans to expand deeper into India, with the next cities in line being Vijaywada, Patna and Nagpur
78
EXPRESS HEALTHCARE
ith a vision to improving better healthcare facilities, Olympus created the camera that lets medical professionals look inside the human body to help diagnose, treat and undertake therapeutical treatment to prevent life threatening diseases. The products have been instrumental in transforming lives over decades and now Olympus Medical set foot in India directly with a vision to support health care professionals through state of the art products and high standard after sales services. This inspiring journey started on the October 12, 1919 as Takachicho Seisakusho by Takeshi Yamashita, initially specialising in microscopes and thermometers. Over the years, Takachicho Seisakusho transformed into a global Olympus Corporation by graduating into cameras, audio, medical, surgical, scientific and industrial equipment. The Olympus journey in India has been quite interesting. Olympus Imaging India was established with the same direct, single-minded dedication geared towards innovative management and value creation through its high quality products. Olympus has always maintained the highest quality in all of its activities, namely production, service and customer satisfaction, a high quality that can only be attained through an attention to detail, which is also required in the products and services that satisfy the specific needs of customer in different regions. Olympus India now has 16 service sites spread across India which deliver the best services regardless of the location thanks to global ‘service quality evaluation’ standards. The same standards are being incorporated in India at all our service centers. The first years saw some challenges which were overcome owing to the rich experience of the team at the helm. Way back in 2010, when Olympus started operations
W
in India, the first challenge it faced was to make people believe that the same global standards of Olympus would be maintained in India. These global standards were Olympus’s major strength and banking heavily on these strengths a mass marketing
demands also varied. Olympus imparted trainings at leading centres in India and has also been regularly imparting trainings to technicians and nurses on the usage of the technology in accordance with the varying demands.
The products have been instrumental in transforming lives over decades and now Olympus Medical set foot in India directly with a vision to support health care professionals through state of the art products and high standard after sales services
campaign was initiated positioning Olympus as leader in innovation, technology and service. Other than the mass marketing campaigns, Olympus started reaching out to its consumers at all prominent medical conferences as well as arranged demos at all major medical institutions to give the customer hands on experience of the Olympus technology. Today, Olympus
One of the major challenges that Olympus faced initially was to make spare parts available at various service centres across India due to licensing and various compliance affairs. A multi pronged strategy was devised by providing brand new equipment as stand by loaners to support at the time when the equipments were down.
One of the major challenges that Olympus faced initially was to make spare parts available at various service centres across India due to licensing and various compliance affairs. A multi pronged strategy was devised by providing brand new equipment as stand by loaners to support at the time when the equipments were down
stores are already functional in Bangalore, Cochin, Delhi, Kolkata, Mumbai, Noida, Pune, while several others are in the offing. With the statistics of various illnesses varying from region to region, the www.expresshealthcare.in
The second stage for Olympus was stabilising its operations in India. This was when a major production facility was severely damaged by the Tsunami in 2011 which dented the confidence and trust of the Olympus cus-
tomer. Again a mass marketing campaign was initiated with a message that whatever the circumstances Olympus always stands by its customers. Back to basics, Olympus now had to ensure that the global standards of customer satisfaction are met. In accordance with the global service standards and benchmarks set by Olympus Corporation, customer service centres were set-up at key locations across India, namely, Kolkata, Mumbai, Gurgaon and Chennai. Smaller customer service centres were also established in Ahmadabad, Bangalore, Cochin and Hyderabad. All customer service centres are fully equipped with latest testing equipment and fully trained technical team to provide immediate and satisfactory resolution to complaints and queries of customers. Olympus made sure that customer complaints were attended in maximum of 24 to 48 hours time. To meet this uphill task new recruitment was done for technical staff and support staff. Japanese technical trainers were permanently stationed in India to provide there rich expertise to Olympus India. To move closer to the customers and increase the reach further, Olympus stationed its resident engineers at Guwhati, Bhubaneshwar, Pune, Jaipur, Lucknow, Bhopal and Coimbatore. The efforts put into the operations by each of the Olympus team member were remarkable and the results showed with lesser and lesser customer complaints. Committed towards growth Olympus doubled its headcount since its inception and is gradually expanding its reach. Olympus’s long term vision and commitment towards innovation and improving lives, it plans to expand deeper into India, with the next cities in line being Vijaywada, Patna and Nagpur. For more information, please refer to www.olympus.in SEPTEMBER 2012
T|R|A|D|E & T|R|E|N|D|S
LED lights from Meditech Electronics Meditech Electronics introduces new LED surgical lights called MEDILITE, which offers better performance than its counterparts
editech Electronics is involved in the business of medical equipment, devices and medical accessories since 2000. Meditech Electronics’ services comprise sale, maintenance, service and repair solutions in the critical sphere of cardiology, anesthesiology, emergency, OT (operation theater) equipment and critical care. The entire range is critically valued for accuracy, high performance and multi-functionality. The company operates in New Delhi NCR, Punjab, Haryana, Jammu, Lucknow, Uttar Pradesh and Rajasthan, Gujarat and its top rated medical equipment comprises: defibrillator, ventilator and patient monitor, syringe pump, X-ray etc.
M
ments or the technique used.
operating
Introducing MEDILITE The company announces the introduction of MEDILITE, a LED surgical light that uses a brand new technology with an optimum light quality that ensures concentrated and safe working. It offers better performance than standard definition LED or conventional surgical lights.
Meditech Electronics’ services comprise sale, maintenance, service and repair solutions in the critical sphere of cardiology, anesthesiology, emergency, OT (operation theater) equipment and critical care
The compactly designed high-performance LEDs with colour temperature are adjustable from daylight quality to warm-white artificial light. In a nutshell, MEDILITE always provides ideal light for cool heads. The unique function enables light field adjustment to the surgical field, giving you the choice between circular and oval illumination. Thus, with MEDILITE you can adjust the light field geometry in accordance with anatomical requireSEPTEMBER 2012
Full spectrum colour rendition MEDILITE is the only surgical lighting with near perfect colour rendition across the full visible spectrum. Natural white light picks out all the visible colours for your eyes so you can clearly see without eye strain. ● Easy to distinguish small differences in tissue ● All the colours are strong and vibrant ● Reduces eye strain by making the light do the work instead of the eye
Red balance control The highest red colour rendition of any other product provides the optimum visualisation of red tissues. Red balance enhancement compensates for our natural weakness in distinguishing shades of red and is user adjustable to fine tune the light to match our own red vision and the surgical conditions. ● Enhanced visualisation of red tissues ● Improved differentiation between tissues of similar colour ● You can adjust the light colour to match your own optical colour response
Slim, compact, powerful Ultra slim and lightweight design enables smooth, fast and precise www.expresshealthcare.in
positioning during procedures. MEDILITE is a compact yet powerful surgical light with an impressive 200,000 Lux output comparable with much larger surgical lights. The surgeon chooses the colour temperature according to individual requirements and preferences ● Light, flexible and easy positioning ● Removable, sterilisable handles ● Uniform illumination across working area ● Colour correction for visual comfort ● Shadow-free in operation field ● Very sturdy construction ● High Lux output/intensity ● Deep cavity penetration ● Sharply focussed, high intensity light pattern Not only are LED light heads whiter and more consistent, provide much better shadow control than halogen lights. A halogen system typically consists of a single bulb and a multifaceted reflector. Unfortunately, each facet is a different shape and is located at a different distance from the bulb. These differences can create unwanted ‘hot’ and ‘cold’ spots within the light pattern. In a typical LED light head, each LED makes the entire spot. These individual spots are then precisely overlapped, so no matter how many LEDs you block, the spot remains round and consistent. As obstructions (e.g. surgeons’
heads) move around in the light field, the pattern does not change. With the consistency of LED light, surgeons are not distracted by shadows moving across the pattern.
Changing the light colour The use of different coloured LED’s makes it possible for the first time in surgery to change the light colours depending on the application. The surgeon has the possibility to choose the optimum light according to the tissue type and the wound field texture. Different colour temperature values can be set, from 3750 to 4750 Kelvin. The setting can be done by remote control. LEDs' reduced consumption allows a remarkable energy saving. The colour temperature always remains constant regardless of the variation in luminous intensity. Unlike the sources of traditional light, LEDs do not contain mercury, toxic gases, filaments or fragile parts. They last for over 50,000 hours and do not burn out, such that the average life of a LED is 25 times greater than that of an incandescent lamp. Contact: Meditech Electronics J-81, Sector-4, DSIIDC, Bawana Industrial Area, Delhi – 110039 Tel: 011-27762484 Mob: +91-9868165949 Email: sbnain@yahoo.com EXPRESS HEALTHCARE
79
T|R|A|D|E & T|R|E|N|D|S
OXYSWING: New age medical oxygen generators Unison Narula Group (India) and INNOVATIVE GAS SYSTEMS Group (Italy) announces a new concept of oxygen supply to the medical market, suitable for variable needs of gas flow
he innovative design of OXYSWING medical oxygen generators allow the end users to expand the system on site, without making any substantial changes to the system and avoiding the risk of contamination inside the oxygen generating towers. The features of the OXYSWING line are such as ● to provide the best advantages in terms of convenience and simplicity ● Pipes, valves and air treatment already sized for utmost extension ● Components from primary suppliers available throughout the world ● Minimum maintenance ● Zirconium cell based oxygen analyser ● maximum reading reliability ● inexhaustible ● no yearly calibration required ● Optional electronic flow meter fitted inside the metal cabinet ● Optional telemetry for remote monitoring and control of the medical oxygen generator
T
The OXYSWING range caters for all requirements and thanks to the addition of modules and the Dual Bank system option, no limits exist to the oxygen supply. OXYSWING generators are manufactured to the quality standards of ISO 13485:2003 and are certified to 93/42/CE Class II B, which makes them fully suitable for any healthcare application.
News Recently the modular OXYSWING PSA medical oxygen generators from IGS Italia reached another important milestone. After an
Example layout of the system
80
EXPRESS HEALTHCARE
www.expresshealthcare.in
extensive internal verification, the Romanian Ministry of Health has officially registered this innovative product line as authorised medical devices according to its publication no. 92/2007 and the Governmental Decision no. 911/2005. Oscar de Groen, Managing Director of IGS Italia, commented, “This important result not only will give our modular OXYSWING PSA medical oxygen generators a strong market position in Romania, but will also have strategic value for our activities in other European countries. As a matter of fact, the modular OXYSWING PSA medical oxygen generators have already been certified as Class IIB medical devices to the European directive 93/42/EC. Only Class IIB certified medical oxygen generators are suitable for the oxygen supply to patients whose vital functions are directly and constantly depending on a higher oxygen concentration in the breathing air.” IGS Italia has been awarded through its local dis-
tributor with a contract for the supply of OXYSWING PSA medical oxygen generators to several hospitals in Colombia. In total 12 OXYSWING systems of various sizes with oxygen flow rates up to 1.100 litre/min will be supplied with a total order value of one million euro. The first set of units has already arrived at destination. Laura Ammiraglia, Marketing and Sales Manager, IGS Italia comments, “We are extremely delighted with this order as it demonstrates again that our OXYSWING PSA medical oxygen line is the preferred solution for an increasing number of new customers in various parts of the world, despite tough local and international competition. Beside the excellent product quality and the unmatched system flexibility of the modular OXYSWING PSA medical oxygen generators, our customers especially appreciate the superior efficiency of our products as a consequence of the increasing energy prices.” Innovative Gas Systems is one of the world’s major suppliers of on-site air separation plants for the production of nitrogen and oxygen. IGS’ technologies for the production of nitrogen and air drying by Hollow Fiber Membranes and for the production of nitrogen and oxygen by optimised Pressure Swing Adsorption processes (NITROSWING and OXYSWING) set new market standards in terms of performance and efficiency. IGS has production facilities and numerous sales and service centers in North America, Europe, Russia, Middle East, Asia, The People’s Republic of China and now in India in partnership with Narula Udyog (India), an integeral part of Unison Narula Group. For more details, contact: Unison Narula Group Narula Udyog (India) A-75, Naraina Industrial Area, phase-1 New Delhi – 110028 (India) Tel: +91-11-4247 3777, 4106 3888 Fax: +91-11-4141 8777 Email: sales@medikraft.com Site: www.nuipl.com SEPTEMBER 2012
T|R|A|D|E & T|R|E|N|D|S 30 MINUTE INTERVIEW
‘We have designed facilities for many leading service providers in the healthcare industry’ Girish Deshpande FOUNDER, FOCUSZ DESIGNS
S
tarted in 1997 by architect Girish Deshpande, Focusz designs is an architecture and interior design consulting firm. It provides project management services and undertakes turnkey jobs as well. With 15 years of experience and more than 150 projects to its credit Focusz designs is a leading company in the commercial, industrial, retail and healthcare segment. Girish Deshpande, Founder, Focusz Designs informs about his company, its offerings and future plans
Please brief us about your bundle of service offerings. We offer services in Architecture, Interior design, project management and design and built. In architecture we offer design of healthcare, residential, commercial and industrial buildings. In
interior design we specialise in conceptualisation and complete design and execution of corporate offices, healthcare and diagnostic centres, Franchise-based establishments such as restaurants, clinics, jems and jewellery showrooms, life-style stores etc. We also provide design and build services for interiors. We offer project management services for large scale works where we supervise and control time cost and quality of the project.
What is the core competency of Focusz Designs in the healthcare industry? Our core competency is designing interiors for large scale corporate offices, diagnostic centres and healthcare BPO’s. We have designed facilities for many leading service providers in the healthcare industry such as Sandoz,
Cipla, Ottobock orthopaedic, Transasia bio medicals, latest being a 30,000 sft. facility for Infinx healthcare services.
What are the opportunities and challenges that you foresee in Indian healthcare industry? Low level healthcare expenditure by the government, public sanitation standards, shortage of power, water, traffic congestion, medical and paramedical staff, low level insurance coverage, accreditation of healthcare facilities are few of the challenges faced by the Indian healthcare industry. Expecting Indian healthcare industry to touch $150 billion by 2017, there exist a big opportunity for the Indian infrastructure industry. Majority healthcare players are now expanding to tier II and tier III cities and many semi urban areas have demand for high quality
healthcare services. Many healthcare majors are targeting new segments such as primary care and diagnostics, bio surveillance, healthcare tourism, medical transciption, Medical insurance outsourcing and so on. We feel architecture and interior design services will be required to set up large hospitals, medical transcription centers, BPOs, diagnostic centers etc.
Please share with us the vision that you hold for Focusz Designs in future We are focusing on becoming a leading player in the healthcare industry. We want to expand our portfolio by providing our architectural services to hospital projects coming up in tier II and tier III cities and also to concentrate on many new segments such as healthcare tourism, medical insurance outsourcing etc.
Enhancing ECG with Schiller's CARDIOVIT MS-2015 Schiller India launches advanced tablet ECG machine called CARDIOVIT MS-2015
high risk patients to diagnose cardiac abnormalities, acute myocardial ischemia and infarctions. This will be one of the best tools for cardiologists and is totally different from Normal ECG Machines.” Features of CARDIOVIT MS-2015: ● 15" high resolution color display ● 12 lead high-end ECG system ● Instant on and A4 size ECG printout in less than 3 seconds ● High-end electrocardiograph to support DICOM standard ● Schiller interpretation and Thrombolysis software for adults, paediatric ans neonate patients ● Storage upto 350 ECGs ● Full disclosure storage of ECG upto 4 minutes ● Upgradable to Exercise ECG and Spirometry
chiller India, a leading Swiss joint venture company in the field of medical diagnostics, has launched an advanced tablet ECG called CARDIOVIT MS-2015, a 12 lead high-end ECG System. It has a 15” high resolution colour display with touchscreen, inbuilt A4 size printer and is upgradable to Spirometry. An Exercise ECG option will be available in the near future. According to V Balakrishnan, Sr Vice President,” CARDIOVIT MS-2015 is the “New Horizon” in ECG Technology, which will be very useful in scanning the
S
SEPTEMBER 2012
www.expresshealthcare.in
For details contact: Sharon George –sharon@schillerindia.com/ Pradhnya Meshram – pradhnya@schillerindia.com Schiller Healthcare India Pvt. Ltd. Advance House, Makwana Road, Off Andheri-Kurla Road,Marol, Andheri (E), Mumbai - 400 059 Phone: 022 61523333 / 29209141 Fax: 022 29209142 Website: www.schillerindia.com Toll Free: 18002098998 EXPRESS HEALTHCARE
81
T|R|A|D|E & T|R|E|N|D|S
Multi-function beds from Medilit Medilit’s BDE—105, a multi function bed offers great features which ensure the patients’ comfort
Continuous R&D also helps to improve the products and services. The prices of the company's products are very competitive in comparison with similar products in the market.
One of its products is
ediliit Medical Furnitures is a professional joint stock company specialising in the production and marketing of healthcare equipment. Their product range includes all type of electric bed and manual hospital beds, transfer trolleys, over bed dining tables, bed side cabinets, electric home care beds and portable field beds. The company is abundant in technique and resources. With its in-house facility for manufacturing blow molding
M
82
EXPRESS HEALTHCARE
components and expertise in steel fabrications, Mediliit products undergoes rigorous inspection and quality audit.
BDE—105: A fivefunction electric bed is built to last for years. It combines the comfort of hospital bed with the mobility of a stretcher. This rugged motorised bed with remote control handset offers outstanding safety, patients'
Specifications of BDE 105 Back section articulation Knee section articulation Minimum height Maximum height Safe working load Platform dimension approx Its products are designed specifically for durability, high serviceability and end users' comfort of operation.
www.expresshealthcare.in
: 0 through 700 : 0 through 400 : 500 mm : 750 mm : 200 kg : 2060 mm (L) X 900 mm W) comfort and quality.
The features of this bed are as follows
●
Head board, foot board, bed board and side rail of the bed is made of high strength engineering plastic (HSEP). ● Head board and foot board are easily removable, which allows rapid access to the patients' head/feet. ● The bed has a retracting side rail design shields the patient and help prevent the patient entrapment and fall. At the same time side rail can be easily lowered to aid both routine and emergency nursing tasks. ● The bed board has smooth surface and removable panels by six plastic head bolts to facilitate steam or chemical cleaning and decontamination. ● The frame of the bed is made of heavy-gauge CRCA tubular section duly powder coated. This makes the bed durable, sturdy and long lasting. ● Caster size is 125 mm dia twin wheels with double ball bearing in each wheel ensures stability, safety and durability.
SEPTEMBER 2012
Express Healthcare Business Avenues
SEPTEMBER 2012
www.expresshealthcare.in
EXPRESS HEALTHCARE
83
Express Healthcare Business Avenues
Experiment With The Truth Deep Freezer Blood Bank Refrigerator Bacteriological Incubator Cooling Incubator
ISO 9001:2008 Autoclave Vertical Model Horizontal Model
Cooling Incubator Blood Bank Refrigerator
Deep Freezer
Incubator
Autoclaves
Address: B-44, New Empire Industrial Premises, Kondivita, J.B. Nagar, Andheri (E), Mumbai - 400 059 Tel.: +91-022-28320880/ 28390487; E-mail: info@osworldindia.com; Website: www.osworldindia.com
84
EXPRESS HEALTHCARE
www.expresshealthcare.in
SEPTEMBER 2012
Express Healthcare Business Avenues
SEPTEMBER 2012
www.expresshealthcare.in
EXPRESS HEALTHCARE
85
Express Healthcare Business Avenues
86
EXPRESS HEALTHCARE
www.expresshealthcare.in
SEPTEMBER 2012
Express Healthcare Business Avenues
速
SEPTEMBER 2012
www.expresshealthcare.in
EXPRESS HEALTHCARE
87
Express Healthcare Business Avenues
88
EXPRESS HEALTHCARE
www.expresshealthcare.in
SEPTEMBER 2012
Express Healthcare Business Avenues
SEPTEMBER 2012
www.expresshealthcare.in
EXPRESS HEALTHCARE
89
Express Healthcare Business Avenues Medical Grade
SILICONE TRANSPARENT TUBING
90
EXPRESS HEALTHCARE
www.expresshealthcare.in
SEPTEMBER 2012
Express Healthcare Business Avenues
Looking for foodservice solutions for your kitchens, canteens & cafeterias? The Restaurant and Catering Show is a unique trade event that caters to those owning, operating and working in industrial canteens, catering companies, restaurants, hotels & dining pubs across India
SEPTEMBER 2012
SHOW HIGHLIGHTS Meet over 100 companies exclusively serving the Catering & Restaurant Industry Nationally
Access the latest in food service equipment, bulk cooking solution, commercial catering, refrigeration technology, tableware & food products RECA Business Knowledge Seminar – Be it a start–up or an existing unit, learn from industry experts critical aspects of running a successful restaurant business operation A professional competitions for practicing chefs in restaurants / catering institutions
FOR MORE INFORMATION CONTACT:
ORGANISED BY
Mumbai: Chetan Salvi, Tel: +91 (22) 2495 5356/76, Mobile: +91 98213 31426 Email: chetan@hospitalityfirst.in Delhi: Aashish Kohli, Mobile: +91 9810172099, Email: aashish@hospitalityfirst.in
w w w . r e c a t r a d e s h o w . c o m
www.expresshealthcare.in
EXPRESS HEALTHCARE
91
Express Healthcare Business Avenues
92
EXPRESS HEALTHCARE
www.expresshealthcare.in
SEPTEMBER 2012
Express Healthcare Business Avenues
SEPTEMBER 2012
www.expresshealthcare.in
EXPRESS HEALTHCARE
93
Express Healthcare Business Avenues
94
EXPRESS HEALTHCARE
www.expresshealthcare.in
SEPTEMBER 2012
Express Healthcare Business Avenues RADIOLOGY WORKSTATIONS
advanced clinical fMRI solutions x BOLD, DTI and Perfusion analysis software x tumor volume, segmentation and evaluation software
DTI
DTI BOLD FUSION
PERFUSION
BOLD
DIFFUSION
MYRIAN® FAMILY OF MODULAR WORKSTATIONS: BASE PLATFORMS
SPECIALITY CLINICAL MODULES
o
PRO (Basic CR/DR Workstation)
XP-LIVER
XT-CARDIAC MRI
o
ADVANCED (Double oblique MPR /
XP-LUNG
XT-BRAIN MRI
MIP, CPR, etc.)
XP-LUNGNODULE
XP-VESSELS(CT/MRI)
o
EXPERT (3D Workstation)
XP-FUSION
XT- DENTAL
o
EXPERT VL (3D With Volumetry)
XP-COLON
XL-2D/3D STITCHING
o
XL-REGISTRATION (Elastic Registration)
XP-COLONCAD
XP-ORTHO
o
XL-4D NAVIGATOR
XL-ONCOLOGY(RECIST 1.0, 1.1, CHESON)
For more details, please contact :
JIGISH B MODI 4/102, DEEP SUNIL, GARODIANAGAR, GHATKOPAR(E),MUMBAI 400077. PH: 2506 5664, 93248 09990, email: modimedicare@gmail.com SEPTEMBER 2012
www.expresshealthcare.in
EXPRESS HEALTHCARE
95
Express Healthcare Business Avenues
96
EXPRESS HEALTHCARE
www.expresshealthcare.in
SEPTEMBER 2012
Express Healthcare Business Avenues
SEPTEMBER 2012
www.expresshealthcare.in
EXPRESS HEALTHCARE
97
Express Healthcare Business Avenues
LIFE LINE COMPACT & MK - IV MAJOR PLUS
LIFE LINE COMPACT
MK- IV ANAESTHESIA MACHINE
Manufactured by
G S Health Care Products Pvt Ltd
98
EXPRESS HEALTHCARE
www.expresshealthcare.in
SEPTEMBER 2012
Express Healthcare Business Avenues
SEPTEMBER 2012
www.expresshealthcare.in
EXPRESS HEALTHCARE
99
Express Healthcare Business Avenues
100
EXPRESS HEALTHCARE
www.expresshealthcare.in
SEPTEMBER 2012
Express Healthcare Business Avenues
CENTRALIZED MEDICAL GAS PIPELINE SYSTEM
Main Activities z Execute turnkey project of centralized medical gas pipeline system (CMGPS) for hospitals z Undertake annual maintenance contract of CMGPS for Hospitals z Undertake complete design and manufacture and installation of single / double arm O.T. Pendants and single arm ICU pendants z Manufacturer of Hospital Furniture z Conducts safety audit of CMGPS in Hospitals z Render consultancy services on CMGPS Hospital Furniture
ICU BED
Stretcher Trolley
ICU BED
Having Strength of Qualified Highly Experienced Personnel & Having own well equipped workshop
B. S. MEDICAL INTERNATIONAL An ISO 9001 : 2008 Certified Company
21/3, Central Park, Jadavpur, Kolkata 700 032Tel : 033 2425 0036 M : 98319 46352 Email : info@bsmedicalinternational.com Website :www.bsmedicalinternational.com
SEPTEMBER 2012
www.expresshealthcare.in
EXPRESS HEALTHCARE
101
Express Healthcare Business Avenues
102
EXPRESS HEALTHCARE
www.expresshealthcare.in
SEPTEMBER 2012
Express Healthcare Business Avenues
SEPTEMBER 2012
www.expresshealthcare.in
EXPRESS HEALTHCARE
103
Express Healthcare Business Avenues
104
EXPRESS HEALTHCARE
www.expresshealthcare.in
SEPTEMBER 2012
Express Healthcare Business Avenues
SEPTEMBER 2012
www.expresshealthcare.in
EXPRESS HEALTHCARE
105
Express Healthcare Business Avenues
USP for Bailida Medical Carts First time in India, steel body carts z High grade powder coating z ABS top and bottom for more usage z Many colors available, with stickers prints also z Best quality castors, noise free z 5 yrs mfg defect warranty z Single lock system z 3 sizes available z Made & imported from Taiwan z
U N I F O R M S
MEGA HEALTHCARE SERVICES P-11, Chitpur Spur, 3rd Floor, Kolkata - 700 007, India Phone : + 91 33 2270 0669, 4061 2071. Fax : + 91 33 2270 0559, 2461 2072 E-Mail : uniformkariwala@gmail.com Website : www.megahealthcareservices.com
106
EXPRESS HEALTHCARE
www.expresshealthcare.in
SEPTEMBER 2012
A riveting read Ratan Jalan, Founder and Principal Consultant, Medium Healthcare Consulting reviews GD Kunders' book 'Designing Hospitals of the Future' and finds that it makes for an informative and enlightening read
Page 109
The altruist entrepreneur On a mission to change primary healthcare delivery, Dr Santanu Chattopadhyay, Founder and CEO, NationWide Primary Healthcare Services, has innovated the way GPs function in India. He shares his vision and more with M Neelam Kachhap
Stint at UK
e took the untrodden path of an entrepreneur, leaving behind his cushy job in England, to set up shop at Bangalore, close to his idol, the legendary Narayana Murthy. Meet the enthusiastic, Dr Santanu Chattopadhyay, Founder and CEO of NationWide Primary Healthcare Services. He believes in the “purpose of life” ideology and wishes to leave behind a mark in the society like his idol. Dr Chattopadhyay's altruism is influenced by the teachings of Swami Vivekananda and Rabindra Nath Tagore and a heightened sense of righteousness. A true Bengali, who has an affinity for a cup of “chai” and anything intellectual, Dr Chattopadhyay is quite modest—I discover—as we settle down to talk at his simple Koramangala office.
H
Early life Born and brought up in Kolkata, young Dr Chattopadhyay enjoyed growing up in a joint family. A big turning point in life came at the age of 10 when he was packed off to a residential school. It was here at the Ramakrishna Mission school that he imbibed the teachings of Swami Vivekananda. Dr Chattopadhyay enjoyed the freedom of being away from parents and used his time at school to indulge in extracurricular activities, topping the competitive ones. Having finished his schooling, Dr Chattopadhyay returned home to finish his higher secondary studies and enrolled himself at St Xavier's College, Kolkata. “I was bored of hostel life and its restrictions and wanted to be at home,” he informs.
had never occurred to Dr Chattopadhyay during his growing years. He came from a middle-class family and at that time a successful person was either a doctor, engineer or an IAS officer. “These professions brought respect to the person and the family and were regarded as the only path in life,” Dr Chattopadhyay remarks. Initially, he wanted to be an engineer but his father guided him towards medicine. “He pointed to some family doctors and showed me the respect they had earned in the community. This left a lasting impression on my mind and I turned towards medicine,” Dr Chattopadhyay explains. He went on to study MBBS at the prestigious National Medical College, Kolkata.
Life's choices
Medicine and youth
Becoming a entrepreneur SEPTEMBER 2012
Having
acquired
good
www.expresshealthcare.in
grades in MBBS finals, Dr Chattopadhyay realised that he would have to go the specialist way. “At that time I realised that the GP profession was on the decline and it was fashionable to become a specialist,” comments Dr Chattopadhyay. This propelled him towards MD Medicine and he got into PGIMER, Chandigarh. Soon after completing his MD, Dr Chattopadhyay got a job at the Indian Railways, but he did not pursue it even after repeated requests and discussion sessions from family and friends. An adamant Dr Chattopadhyay went to work for Assembly of God Hospital, Kolkata. “My first job was with Indian Railways, I rejected it as I did not want to do a government job. I do not like certainty,” opines Dr Chattopadhyay.
After an year, he went to work at Bromley Hospital NHS Trust, Kent, UK as Senior House Office in General Medicine/ Cardiology/Geriatric Medicine. He worked there from 1997 to 1998, earning his MRCP in 1997. He then moved on to St Bartholomew’s and the Royal London School of Medicine & Dentistry, London to be a Research Fellow and Lecturer in Medicine and Gastroenterology, for an year. He spent the next year at Norfolk & Norwich University Hospital, Norwich as Specialist Registrar, Gastroenterology and Hepatology & Internal Medicine. Following this, Dr Chattopadhyay spent the next four years at the University Hospital of Leicester as Specialist Registrar of Gastroenterology/Hepatology and Internal Medicine. It was during this time that he was bitten by the entrepreneurial bug.
Coming home Even though Dr Chattopadhyay was well settled at UK he wanted to come back to India. “I was so homesick that immediately after returning from work, I would switch on Star News just to hear someone speak Hindi,” he recalls. He had already spent seven years at NHS UK and an year at J&J and he felt that the time was ripe for him to return to India.
Off the beaten path His entreprenurial sojourn began one restless night at Leicester, UK, where the certainty of the life of a doctor was staring at him in the face. Afraid of the routine life ahead, he decided to spice it up with some risk, a business EXPRESS HEALTHCARE
107
L|I|F|E
perhaps. However, at that time he did not have the skill or the experience to start on his own. It was 2003, he had already spent six years in UK and was doing well as Specialist Registrar, Gastroenterology/Hepatology & Internal Medicine. He incubated the idea and decided to work towards becoming an entrepreneur. The first step towards his dedicated cause was a fulltime MBA course. Dr Chattopadhyay took a sabbatical from work to go to INSEAD, France. There he honed the skills needed to be
a businessman, however he still lacked experience in the real world. After completing his MBA, Dr Chattopadhyay gave up his clinical practice and joined J&J, as Territory Manager/Medical Liaison Physician, Janssen-Cilag, UK. From 2004-2006 he worked at UK. He moved to India in 2007 still working with J&J. Having worked at a multinational firm he had gained enough experience to run a business. However, he wanted to work with a start-up company to experience the highs and lows of setting up a new business.
His search for a start-up led him to Indegene Lifesystems, a Bangalorebased KPO, which he joined in February 2007, to start a new business unit called Competitive Intelligence and Business Intelligence Practice. He built this completely new business vertical from scratch. Under his leadership, the Competitive and Business Intelligence team scaled up from two to 95 in less than three years and established long-term business relationships with several international pharmaceutical companies. Apart from business growth,
The venture and beyond
The Mixed Bag ●
●
● ● ●
●
●
● ● ● ● ●
108
EXPRESS HEALTHCARE
he was credited with setting an example of complete cultural transformation in terms of quality, ethics, integrity and transparency. By early 2010, Dr Chattopadhyay felt that he was ready to venture out in the business world. In March 2010, Dr Chattopadhyay finally took the plunge, and along with his batchmate Dr Shantanu Rahman, co-founded a newage primary healthcare service provider known as NationWide Primary Healthcare Services (NWPHS).
Your best prize in life so far- Clearing the MRCP exam in the first attempt and within few months of starting, working in UK. Most people take several years and several attempts. Getting into INSEAD and PGI Chandigarh were equally rewarding. None of this actually gave me a prize but each of them gave me extreme sense of achievement as these are all world class institutions. The toughest decision you have taken- To leave a cushy job and set up a start-up with an unproven business model, that too an area (primary health care) where traditional big healthcare players has stayed way. Your happiest moment in life- Taking the decision to come back to India after a long stint abroad with a view to give something back. Three things you cannot do without- My small collection of selected Rabindrasangeet, my family and constant thought on how to leave a mark in the society The first time you fired somebody- In my last job, I recruited someone as second in command but soon realised it was a wrong decision. It was a difficult call as the person concerned was having some major personal problems as well. Your first day at work- That was the first day as an intern in medical school in 1990, but I was far more excited on the first day of my work in the corporate world that was Johnson and Johnson (J&J) in 2004. The best childhood memory- I grew up in a residential school and it was so much fun to be around all the times with friends- whether it was studying, playing or just simply playing pranks. One trait you would like to change about yourself- I have to force myself to do physical exercise. I wish I was more naturally inclined to it. Fav food- Basic pasta with lot of olive oil and grilled vegetables and posto vada (a Bengali speciality made of fried poppy seed) Fav book- Better India Better World by NR Narayana Murthy Fav TV show- Not a regular viewer of any TV show. Mostly see news and documentaries Fav Movie- 3 Idiots. We used to have a lot of fun in medical school like they showed in the movie and I always had an "anti-herd mentality" and believed in following your passion rather than what normal wisdom. This trait of mine has made me what I am today.
www.expresshealthcare.in
NWPHS runs a group of clinics offering complete dayto-day medical requirements for subscribers. The company is looking to revive the forgotten family doctor and home visits. “Primary healthcare is a neglected sector in India and we want to completely organise this sector,” offers Dr Chattopadhyay. At present there are three full-service clinics and four satellite clinics in Bengaluru. In the near future, the company plans to open more clinics in Bangalore and move to other cities in India. Dr Chattopadhyay is at peace now as he feels that he has fulfilled a simmering desire to work for the masses by providing a necessary service and creating opportunities. “I feel a sense of achievement as I feel all the dots are now connected. Through NWPHS I have been able to make a positive impact on society and changed the way healthcare is delivered,” he summarises.
SEPTEMBER 2012
L|I|F|E BOOK REVIEW
A riveting read Ratan Jalan, Founder and Principal Consultant, Medium Healthcare Consulting reviews GD Kunders' book 'Designing Hospitals of the Future' and finds that it makes for an informative and enlightening read
Title: Designing Hospitals of the Future Author: GD Kunders, Consultant, Hospital Management Publisher: Prism Books Pvt Ltd Pages: viii + 414 ISBN : 978-81-7286-683-9 Price : Rs 2400/Reviewed by: Ratan Jalan, Founder and Principal Consultant, Medium Healthcare Consulting
RATAN JALAN
Founder & Principal Consultant, Medium Healthcare Consulting
SEPTEMBER 2012
apping on the experience of experts, the book titled 'Designing Hospitals of the Future', presents a large number of illustrations, examples and designs on both basic and advanced subjects in hospital architecture; right from examination, treatment and nursing care to green building and Vaastu. The book has a wealth of photographs and floor plans on some of the best designed hospitals, not only in India but also abroad. The entire book facilitates easy comparison of different hospitals in terms of size, function and design approach. In a time, when there are quite a number of books available on healthcare architecture, Designing Hospitals of the Future takes a visionary approach on the entire space of healthcare architecture and takes a fresh perspective on the overall design guidelines for the hospital. As rightly pointed out, the book presents an example of designing hospitals that may be considered the most consummate way of designing hospital that meets holistic – physical, emotional and psychological – needs of patients, their families and visitors, not to mention the needs of staff and workers.
T
The entire book stresses on the element of creating an optimal healing environment and rather than aesthetic approach, takes a completely functional approach to the entire hospital design. The book starts with an excellent piece on Planning Hospitals of the future by Richard Sprow, AIA, Principal of Perkins Eastman with more than 30 years experience in healthcare planning and design. The ‘ten ideas driving new hospital planning’ provide basic framework to conceptually design a new hospital and helps any planner take a more holistic approach to design a facility in which the entire environment is geared towards healing. In addition, the first chapter also mentions the space plan of some futuristic hospitals. To help in project planning and execution, the chapter describes different stages in the construction of a hospital building. The book discusses in detail the circulation and traffic plan of a hospital (both inside and outside. Specific traffic flows in relation to some major services such as nursing services, surgical suites and labour and delivery suites have also been elaborated. Creating a healing environment, characterises a patient-centric hospital, which is the need of the hour. In fact, it goes a step further and highlights the fact that today patients too demand that they be treated in their totality and not simply as 'medical cases'. In pursuance of this concept, the new age hospitals feature natural light, gardens, fountains, aquariums and music to meet the emotional needs of the patients. One of the key strengths of the new edition is that it includes contributions from outside the mainstream hospital design, for instance the sections on hospital branding and logo provides very clear guidelines on creating a hospital brand. Another key highlight of the book is the section on evidence based architecture. It essentially describes the parameters to be assessed and has been supported by illustrations. In times, when more and more people are www.expresshealthcare.in
About the author
G
D Kunders is known professional hospital administrator and a recognised healthcare facilities planner. He has a background and experience in hospital administration having worked for many years in some of the leading hospitals in India and United States. G D Kunders has written a number of articles on management of hospitals and they have been published in leading healthcare journals. A prolific writer, he has also authored quite a number of books on planning and designing hospitals. His first book, Hospitals: Planning, Design and Management won him accolades from leading healthcare professionals in healthcare and architectural fraternities. Based in Bangalore, Kunders currently offers his services as a consultant in hospital facilities planning and hospital management. He can be reached at gdkunders@gmail.com
About the reviewer
R
atan Jalan founded Medium Healthcare Consulting when he realised the need for bold and innovative solutions in the Indian healthcare sector. Prior to this, he was the CEO of Apollo Health and Lifestyle Limited, part of the Apollo Hospitals Group. He created some of the most successful and innovative healthcare facilities in the country such as a nationwide network of The Apollo Clinic and The Cradle, South Asia's first boutique birthing centre, both based on the franchised business format. He is well known figure in the healthcare industry and was awarded the Marketing Impact Award by S P Jain Institute of Management.He hasalso been nominated as one of the 50 most influential professionals in retailing. Ratan is an alumnus of IIT Kharagpur and Harvard Business School. He can be reached at ratan.jalan@med-ium.com.
talking about infection control, the book does ample justice to the topic as well, including its implications on the hospital design. The book is divided in eighteen distinct chapters and covers fresh elements such as emerging trends in healthcare, green hospital movement: building ecofriendly hospitals and Vaastu in a healthcare setting. The chapter on emerging trends in healthcare covers latest equipment and also some of the latest surgery techniques such as robotic surgeries. It also talks about palliative care, acupuncture and ambulatory care centres. Unlike other literature on green buildings, the chapter on green buildings and eco friendly hospitals talks about tangible benefits that such a hospital can achieve. It also covers LEED accreditation in much greater detail. The book takes an extremely scientific approach on Vaastu and the importance of five elements in the design – water, fire, sky, earth and air. The chapter on Vaastu also highlights the importance of type of soil
and treatment of various areas such as reception, consultation rooms, operation theatres, pharmacy and others. The chapter on Feng Shui: Home and hospital healing using Feng Shui is extremely interesting. In today’s context, Feng Shui is commonly used to locate houses or change the atmosphere inside a building or home. The way author has related Feng Shui with quantum physics and ultimately with designing a caregiver environment brings in a lot of richness in the content. It is based on the fundamental belief that the land is more important than the house and the house or hospital is more important than the occupant, therefore setting up the environment for healing is extremely important in supporting the occupant in the process of healing. Some of the applications of Feng Shui in hospital relate to sound, incense and lighting. Interior design for healthcare, Chapter 18 in the book describes the key points to consider when designing the EXPRESS HEALTHCARE
109
L|I|F|E
interiors of the hospital. The author has grouped all parameters under eight concepts to consider when creating a healing environment. Most of us while designing a hospital fail to understand some of the unique challenges in interior designing, which the chapter captures in a fresh perspective. The chapter takes an entirely functional approach to interior design and covers areas such as cleanliness and infection control, utilisation of nature, designing a noiseless environment and appropriateness of colors and applications and their effect on patients. Apart from this, it also covers the nature and type of material and the texture to be used in different
zones in the hospital. Throughout the book, every chapter is interspersed with illustrations, which include actual layouts, designs and photographs of some world-class facilities. The case studies of New York Hospital Queens, New York, Embassy Medical Center, Colombo, Brigham & Women’s Hospital, Tata Medical Center, Kolkata and Medanta Medicity, Gurgaon among others help the reader better understand every detail discussed in the book. In fact, all these keep the reader highly engaged, are truly refreshing and help the reader actually visualise an ideal facility. The last chapter of the book on rejuvenating and
modernising ageing and antiquated hospitals is particularly relevant to people who are willing to modernise their set up to keep up with the time. It basically answers the question of what do we do with hospitals which are ageing and are saddled with out of date equipment and facilities and how to reenergise them to meet the requirements of the present times. The chapter talks about some of the classic examples of hospitals across the globe that have set examples on economising resources, particularly energy conservation when compared to some of the best new age hospitals. The chapter talks about a couple of detailed case stud-
People Dr LH Hiranandani receives 'Lifetime Achievement Award in Healthcare' by FICCI
D
110
ies as well. The section on retrofitting antiquated hospitals is particularly interesting. In fact some of the examples illustrate the fact how even existing hospitals can be refurbished and recharged to meet the requirements of modern medicine and NABH/JCI standards without sacrificing functionality or demolishing existing structures. The book serves as an invaluable guide and a quick reference for different stakeholders in healthcare who are willing to understand more about modern healthcare architecture. The book in fact makes healthcare architecture simpler for different people willing to start their own set up.
Odisha doctor selected for Damien-Dutton Award-2012 Ahmedabad-based, Leo Mavely wins Samsung Innovation Quotient Award
r LH Hiranandani, Chairman of Dr L H Hiranandani Hospital, Mumbai received the "Lifetime Achievement Award in Healthcare" presented by the Federation of Indian Chambers of Commerce and Industry (FICCI). Dr LH Hiranandani is a renowned ear, nose and throat (ENT) surgeon and he received the award in recognition of his contributions to the healthcare industry, not just in India but across the world. This award was presented at a ceremony during FICCI Heal, 2012 in New Delhi by Minister of Health and Family Welfare, Ghulam Nabi Azad. The award aims at felicitating individuals for their exceptional contribution to the healthcare industry for increased efficiency and improved performance of healthcare delivery globally. Accepting the award, Dr Hiranandani said, “I truly feel honoured to receive this prestigious award. I foresee India as a healthier nation emulating global healthcare standards. Health has to be interpreted as a total quality of life. By setting up one of the best hospitals providing quality world class medical treatment, my endeavor has always been to set new benchmarks in patient care by making world medical care available to a larger segment”. Dr Hiranandani was the first Indian to be appointed as a member by the American Society of Head and Neck and has written many insightful journals and books which have been acknowledged by the healthcare industry across the world. Dr LH Hiranandani is also the recipient of the prestigious Padma Bhushan by the President of India in 1972. He has also been awarded with the SAARC Doctor of the Millennium award and first person to be honoured with the Golden Award by the Board of International Federation of Otolaryngology and Head and Neck societies. In the year 1988, he also received in Dhanvantari Award and became the first person in the field of ENT to receive this award. He was also appointed a member of the Advisory Committee by the Government of India, for opening of private medical colleges in Maharashtra.
eo Mavely, from Ahmedabad-based Axio Biosolutions Company received The Samsung Innovation Quotient Award for developing India’s first emergency haemostatic dressing - AXIOSTAT. It stops profuse traumatic bleeding in just a matter of few minutes after application and thus stabilises the victim at the accident site. AXIOSTAT has been approved for use in India. Made from bio-degradable materials, it is 100 per cent natural dressing that reacts immediately to blood and forms a thick layer. It comes off easily without causing any pain to the user while the clot remains. It is being used by few major hospitals and paramilitary. The price of each unit of AXIOSTAT dressing isRs 300 to 400 and its shelf life is three years. Mavely’s invention emerged the winner from six shortlisted candidates based across the country, which comprised a host of innovative social ventures like geothermal based air conditioning systems, multi-utility tractors, electronic public toilet, mosquito trap, navigation system for visually impaired people and emergency haemostatic dressing. The first runner up award went to Ganesham Pogula from Secunderabad for Herbi Sprayer and the second runner up award went to Arun Shenoy from Mumbai, for his innovation GIBBS. The winners were given a cash prize of Rs five lakhs, Rs three lakhs and Rs two lakhs respectively. Based on the concept of 'Innovation for Development', Samsung Innovative Quotient recognises unique innovators with creations that benefit society at large and pave the way for development through a comprehensive approach.
EXPRESS HEALTHCARE
www.expresshealthcare.in
L
D
r PKB Pattanaik has been selected for the prestigious Damien-Dutton Award-2012 in recognition of his more than 25 years of dedication to the victims of leprosy in India and for his direct involvement in making the multi-drug therapy available to the people affected with leprosy in pursuance of his goal to eliminate leprosy in Odisha, according to a PTI report. "I am happy that the people have recognised my work. We have to work hard to make rest 16 districts leprosy free," said Dr Pattnaik. Congratulating Dr Pattnaik, State Health Minister Damodar Rout said, "Other doctors working in the field should learn from the dedication of Dr Pattnaik." Dr Dharmendra was the first man from India to get this award in 1970 followed by Muralidhar D Amte (Baba Amte) in 1983, Mother Teresa (1984), Dr K V Deskan (2000), Eliazar T Rose (2005) and Dr E P Fritschi (2006).Dr Pattnaik has become the eighth person from India to be selected for the prestigious award for the year 2012. Damien-Dutton Society for Leprosy AID INC was founded by Staff Sgt Howard E Crouch, Medical Corps US Army in 1944. It presents yearly award to a notable person who has made a significant contribution towards the conquest of Leprosy and has got worldwide recognisation.Since 1953, total 60 persons have been awarded with this prestigious award, it said. Dr Pattanaik, presently working as State Leprosy Officer, Odisha and State Nodal Officer NCD programme at Directorate of Health Services, Bhubaneswar, is also Honorary Secretary, Hind Kustha Nivaran Sangh, Odisha State Branch since 1996.
SEPTEMBER 2012
PETCT
With NUECLEAR, your dream can come true!
Machines
Ans
Nueclear Healthcare Limited offers franchisee concept. We give you
we rf
o
r e c an C r
Consumables Marketing support Operational support
If you are interested in the Partnership or wish to know more details about it, please feel free to write or call
VISIT: www.nueclear.com
Powered by Nueclear Healthcare Limited D-37/3, TTC MIDC, Turbhe, Navi Mumbai - 400703. CALL: 022- 3090 3010 / 3090 3020 or E-MAIL: info@nueclear.com
REGD. WITH RNI NO.MAHENG/2007/22045. REGD.NO.MH/MR/SOUTH-252/2010-12, PUBLISHED ON 8th EVERY MONTH & POSTED ON 9, 10 & 11 EVERY MONTH, AT IND.EXP.PSO.
$ - 3 0 67
! " # ,$ 9 5 - 5 6 , /:9 5 - 5 9 - 9 , 1 5 - 5 $ - 0 3 , , : -- , , 9 0 , 9- 0 ; --0 9 ' 90 , 1 9 1 , ,
! " 7 -
,$ 8 9 1 $ % &' ()** &' + ()** , " &' - &' ()** &' . " # 7 $ - ,0 2 < $ , , 0 =- - , > ,$ 5 ,$ , , 3 0 $ , 0 - ,$ - 0 - ' $ - , , 1 , ; - 0 $ , 5 $ $ ,$ - 0 9 5 9
!!!" #$ %& '(('()!!)!)! () & *!( ()!"* "+ , - !. /'( + #$ ) $ # 0 1 - 2 3 , - ". #$ %& '.!'(.+*)!)! / - 4 40 $ 555
= 31? 555
) -