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India Post News Service
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edical tourism is rapidly gaining popularity in the US because of low cost of treatment abroad plus high quality healthcare. US health care costs are often higher than the combined fee of traveling and receiving medical care abroad. For years, Singapore and Thailand have been the market leaders in Asia, providing medical care to patients across the globe at a fraction of the cost of the West. However, in the last decade, India has emerged as the future of medical tourism industry. Low cost has been a key driver in India's rise as a medical destination of choice. The cost savings can be up to 80-90%. India has one of the best qualified professionals in each and every field, and this fact has now been realized the world over. Cities like Chennai, New Delhi, and Mumbai as the new international medical value hubs providing advanced tertiary care on par with its Asian neighbors. According to an industry-wide study, the Indian market is likely to reap $7-8 billion in revenue by 2020, more than double its current level. Cost, quality, and access are the three cornerstones of an excellent healthcare system. Currently, India is not only offering the best combination, it is also more importantly pushing the boundaries without compromising on the outcomes. A large number of India's doctors have trained and practiced abroad. They are highly specialized in their fields, meaning patients can expect to receive the highest quality healthcare standards in the industry. Alongwith world-class health services at an extremely cost-effective rate is the attraction to vacation in the most scenic locales of India. Going a step further, large private hospital chains like Fortis, Apollo, and Max have adopted a holistic approach to providing care to international patients. Once the patient makes contact with the hospital they are provided with accommodation, round the clock interpreter services and their dietary and cultural needs are taken care of. Most of the patients are looking to get treatments like cosmetic surgery, hip replacement surgery, heart bypass surgery and knee replacement surgery. India remains a much favored destination for dental tourists,
April 7, 2017
offering savings between 60-80% on the procedures. Dental infrastructure in India is moderate to high, with all procedures being done there. In October 2015, India's medical tourism sector was estimated to be worth US$3 billion. It is projected to grow to $7-8 billion by 2020. According to the Confederation of Indian Industries (CII), the primary reason that attracts medical value travel to India is cost-effectiveness, and treatment from accredited facilities at par with developed countries at much lower cost. The
past decade seeking medical assistance. Accurate figures are hard to come by, but in 2014 and estimated 1,50,000 medical tourists were treated in India. The Indian Department of Tourism estimates that the average cost of healthcare in India is about one-fifth that of the West and multi-organ transplants are done for a tenth of the cost in the West. There is 'zero waiting time' for patients which is also a major driver of medical tourism in the country. A bone marrow transplant in India would cost around $26,000 in India, compared to about $2,50,000 in the US.
India is future of Medical Tourism The Indian Department of Tourism estimates that the average cost of healthcare in India is about one-fifth that of the West and multi-organ transplants are done for a tenth of the cost in the West. There is 'zero waiting time' for patients which is also a major driver of medical tourism in the country Medical Tourism Market Report: 2015 found that India was "one of the lowest cost and highest quality of all medical tourism destinations, it offers wide variety of procedures at about one-tenth the cost of similar procedures in the United States."
Among top three According to Biospectrumasia.com, India leads the way in orthopedic and cardiac surgeries. The nation's excellent medical care providers, beautiful beaches and ancient temples have all made India join the race with Thailand and Singapore to be listed among the top three destinations for medical tourism in the world in a survey conducted by KPMG and FICCI. Foreign patients have been streaming in the country over the
"Medical tourism has always been a low hanging fruit for India. The country is one among the most preferred destinations globally for Medical Value Travel," said Mr Vinod Y R. "India offers procedures at competitive cost without compromising the quality of clinical outcomes. There is an increasing thrust among Indian hospitals to go for national and international quality assurance certifications like NABH and JCI which eventually helps to attract international patients." Cardiac care is one specialty that draws patients to India. The country's chain of Fortis hospitals boasts of tending approximately 15,000 international patients annually. Apollo Hospitals Group also has a pan-India network attracting considerable amount of international patients. Cont’d on page 31
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Special Feature:
I
n the resurgent Indian medical tourism scenario, Fortis Hospital has registered a remarkable position as international patients account for nearly 20% of all patient admissions. With the huge expanse of clinical expertise across specialties along with world class medical technology, Fortis has created a niche in providing clinical solutions & tertiary care for medical ailments. Fortis Memorial Research Institute (FMRI) in Gurugram near Delhi, is rated as one of the top two in a global survey to identify 30 most technologically advanced hospitals in the world.
Bhavdeep Singh, CEO, Fortis Healthcare
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Fortis leads in treatment of international patients A total of 18 Fortis Hospitals are National Accreditation Board for Hospitals & Healthcare providers (NABH) accredited and four hospitals are Joint Commission International (JCI) accredited. Fortis has also pioneered by adopting ICHOM, a global initiative to bring in objective measurement of clinical cases against a global benchmark. Fortis Escorts Heart Institute (FEHI), India's top rated cardiac care centre in private sector, has registered an impressive ZERO rate for Emergency Coronary Artery Bypass Graft (CABG) against a global benchmark of 1.2%. Fortis Malar Hospital in Chennai is India's largest heart transplant centre with more than 125 successful heart transplants till date. Together with Fortis Hospital, Mulund in Mumbai, which recently conducted its 41st heart transplant surgery, Fortis has done the maximum number of heart transplant sur-
award is published by Medical Travel Quality Alliance (MTQUA) to rank top hospitals in the world for medical tourists. According to Mr Bhavdeep Singh, CEO, Fortis Healthcare, "Fortis offers an integrated world class healthcare delivery system enabling the finest medical skills combined with compassionate patient care. Since our focus is on a patient-centric approach, we provide customized services for international patients."
geries in the country. Given the number of international patients that get treated, Fortis Hospital in BG Road, Bengaluru received International Medical Tourism recognition for fifth consecutive year reiterating its commitment towards our core value of patient care. This
Fortis Healthcare monitors Clinical Outcomes F
ortis Healthcare Limited, is one of the largest integrated, healthcare services providers in the country today. It aspires to drive clinical excellence through continuous improvement and enhancement of its clinical care and services. To strengthen its core value of Patient Centricity, Fortis became the first, privately held, Indian healthcare chain to introduce monitoring of its clinical outcomes - starting with Fortis Escorts Heart Institute (FEHI), New Delhi. This initiative reinforces organizational accountability and transparency towards both, its patients as well as the payers.
Clinical Outcomes are the globally agreed upon, evidence-based measurable changes in health or quality of life resulting from patient care. Reporting of outcomes and its continuous monitoring provides an opportunity for both assessing and improving quality of patient care. A user friendly reporting and monitoring structure leads to greater understanding of clinical outcomes, thereby facilitating rational decision making by patients. FEHI has been part of the ICHOM (International Consortium for Health Outcomes Measurement) Coronary Artery Dis-
List of Clinical Outcomes parameters for PTCA and CABG is as under: PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY (PTCA) Emergency CABG for failed procedure Vascular complication at puncture site requiring intervention (beyond simple compression) Acute vessel occlusion requiring emergency re-intervention Post procedure neurological stroke Post procedure Renal failure requiring hemodialysis Any Bleeding event requiring transfusion/intervention (within 72 hrs.) Delayed vascular complication at puncture site Readmission with acute Myocardial Infarction within 30 days Mortality during same hospital admission References: * US National Registry Data 2013 ** Cleveland Clinic Outcomes Report 2014 CORONARY ARTERY BYPASS GRAFT (CABG) Use of left Internal Thoracic Artery graft Need for a Bail out Intra Aortic Balloon Pump (IABP) Perioperative Myocardial Infarction Post procedure neurological stroke Need of Re-exploration surgery Deep sternal wound infection Predicted mortality (using Euroscore II) Observed mortality
ICHOM supports Value-Based Health Care Delivery framework for transforming world health care systems through standardized measuring and reporting of patient outcomes. Fortis Healthcare has now tied up with VitalHealth™, an ICHOM certified software provider for use of its Quest Manager software for reporting clinical outcomes data. This ensures that data collection and reporting methodology at FEHI conforms to the highest international norms and standards. Introduction of Quest Manager has added the feature of Patient Reported Outcome Measures (PROMs) to the Fortis outcomes Jan'16 - Jun'16 Benchmarks reporting initia0.00% 1.2%* tive, to ensure greater objectiv0.00% 1.1%* ity by adding the 0% Voice of Con0.06% 0.284%** sumer into the en0.13% tire initiative. 0.51% 4.0%* The ICHOM Standard Set for 0.00% Coronary Artery 0.13% Disease, imple1.34% 1.7%* mented at FEHI measures and monitors Clinical Outcomes for 2 Jan'16 - Jun'16 Benchmarks procedures, 80.25% 74.20%* namely: 0.31% • Coronary 0.00% 0.96%** Artery Bypass 3.40% 0.80%* Graft (CABG) 0.46% 3.50%* • Percutane0.15% 0.20%* ous Coronary In2.2% tervention (PCI, 2.01% PTCA)
ease Steering Committee and has become the first Asian hospital to implement the ICHOM Coronary Artery Disease set. This requires monitoring and reporting of internationally accepted outcomes for monitoring clinical quality, example, incidents of post-operative complications (kidney failure, heart attack, wound infections) in patients undergoing Cardiac Bypass Surgery. ICHOM is a non-profit organization founded by three esteemed institutions: • Harvard Business School • The Boston Consulting group • Karolinska Institutet
Jul'14 - Dec'14 0.07%
Jan'15 -Jun'15 0.06%
Jul'15 - Dec'15 0%
0% 0% 0% 0% 0.07% 0% 0% 0.26%
0.06% 0% 0.13% 0% 0.06% 0% 0% 0.97%
0.07% 0% 0.13% 0.07% 0.07% 0.07% 0% 0.26%
Jul'14 - Dec'14 78.50% 1.31% 0.16% 0% 1.97% 0.33% 2.24% 2.30%
Jan'15 -Jun'15 77.36% 0.99% 0.50% 0% 3.31% 0.50% 2.21% 1.82%
Jul'15 - Dec'15 79.01% 0.64% 0% 0.48% 3.50%* 0% 2.25% 2.54%
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India Post April 7, 2017
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India Post News Service
O
rthopedic surgeries are the 2nd most popular category of medical procedures undertaken through medical tourism today. Patients from across the globe prefer travelling to countries such as India, Malaysia and Thailand to undergo orthopedic treatments at much lower prices than that charged in their home countries. The orthopedic centers in India bring focus to patient-centered care, interdisciplinary medicine, modern infrastructure, cutting edge technology and investigative research. You will receive top-notch treatment and the benefits of skilled surgeons and staff dedicated to getting patients back on their feet. Orthopedics is concerned with injuries in the musculoskeletal system, which is made up of bones, tissues, ligaments and joints. Orthopedics involves the use of both surgical and non-surgical means to cure spine diseases, infections, tumors and degenerative and sports injuries. The most common procedures performed are: knee arthroscopy and meniscectomy, shoulder arthroscopy and decompression, carpal tunnel release, knee arthroscopy and chondroplasty, removal of support implant, knee arthroscopy and anterior cruciate ligament reconstruction, knee replacement, repair of femoral neck fracture, repair of trochanteric fracture, debridement of skin/muscle/bone/fracture, knee arthroscopy repair of both menisci, hip re-
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Orthopedic 2nd most popular category Orthopedics is concerned with injuries in the musculoskeletal system, which is made up of bones, tissues, ligaments and joints. Orthopedics involves the use of both surgical and non-surgical means to cure diseases placement, shoulder arthroscopy/distal clavicle excision, repair of rotator cuff tendon. Shoulder/hip replacement and bilateral knee replacement surgery using the most advanced keyhole or endosopic surgery
and anthroscopy is done at several hospitals in India including the Fortis, Apollo, Sir Ganga Ram, Bombay Hospital, Leelavati and Hinduja Hospital in Mumbai and the Madras Institute of Orthoepaedics and
Trauma Sciences. A knee joint replacement costs about $6300 in India where's in the US, a similar surgery using the same implants and medical consumables costs around $20,000.
Separate counters to assist medical tourists NEW DELHI: India has decided to liberalize e-visa regime from April 1 by increasing the time limit for seeking the entry permit from existing 30 days to a maximum of four months. The duration of stay for foreigners, coming into the country through select categories of e-visa, has also been extended to two months from existing one month, the Union Home Ministry said in a statement. Separate immigration counters and fa-
cilitation desks to assist medical tourists have been provided at Indian airports namely, Delhi, Mumbai, Kolkata, Chennai, Bengaluru and Hyderabad. There will be three new sub-categories for grant of e-visa, i.e. e-tourist visa, e-business visa and e-medical visa. In addition, two more new categories Intern or (I) visa and Film or (F) visa - will be granted for foreigners seeking internship in non-government organizations, and those seeking to shoot movies in India, respectively. Also, both business and medical visas will be granted within 48 hours of application upon urgent requests, it said. "The liberalization of the visa regime will considerably facilitate entry of foreigners into India for tourism, business and medical purposes. Consequently, the arrival of foreigners in India is expected to go up substantially in the coming years. "This will in turn give a boost to tourism, medical and business sectors resulting in substantial
increase in direct and indirect employment in these sectors," the statement said. Under the e-visa scheme, an applicant receives an email authorizing him or her to travel to India after it has been approved. The tourist can travel with a print-out of this authorization. On arrival, the visitor has to present the authorization to the immigration authorities who would then allow the entry into the country. E-visa facility has been extended to the nationals of 161 countries for entry through 24 airports, up from 16 airports allowing such entries, and three Indian ports i.e. Cochin, Goa and Mangalore to tap the potential of cruise tourism from different countries. "This service will also be provided from Mumbai and Chennai seaports shortly," it said. The window for application under e-visa scheme has been increased from 30 days to 120 days and duration of stay on e-visa has been increased from 30 days to 60 days with double entry on e-tourist and e-business visa and triple entry on e-medical visa, the statement said. The multiple entry tourist and business visas for a period of five years will now be available to nationals of most of the countries. Nine-four Missions having bio-metric enrolment facilities have started giving fiveyear tourist and business visas with effect from March 1, 2017. The remaining Missions will be providing this facility in due course. A new category of visa titled Intern or
(I) visa has been rolled out with effect from March 1, 2017 to a foreigner intending to pursue internship in Indian companies, educational institutions and NGOs, subject to certain checks and conditions. Another new category of visa, titled Film or (F) visa has also been introduced with maximum duration of one-year with multiple entry facility. -PTI
'Medical tourism grew 25 pc in 2 years' NEW DELHI: Medical and wellness tourism in the country has increased by up to 25 per cent in the last two years, the government told the Rajya Sabha. Tourism Minister Mahesh Sharma said the tourism sector has grown by over 10 per cent and in the last month, by over 15 per cent, which is much above the global average. He said a Medical and Wellness Tourism Board has also been set up for development of the sector. Responding to a question about Maharashtra, he said several projects including Bollywood city in Konkan, Zero Garbage for Mahabaleswar project, coastal circuit etc were in the pipeline. -PTI
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Dr Guleria is new director of AIIMS NEW DELHI: The country's premier medical institute, the All India Institute of Medical Sciences here, has got a new director with the appointment of Dr Randeep Guleria. Dr Guleria, who joined AIIMS as an assistant professor in 1992 and has been the HoD of the department of pulmonary medicine and sleep disorders since April, 2011, has taken charge of his office. "The Appointments Committee of the Cabinet has approved the appointment of Randeep Guleria, professor and head, department of pulmonary medicine and sleep disorders, at AIIMS, New Delhi to the post of Director, AIIMS," a DoPT order said. He has been appointed for five years
from the date of assumption of charge or till attaining the age of 65 until further orders, it said. "I will strive to take AIIMS to newer heights and will work collectively, taking everybody along," Dr Guleria said. His predecessor Dr M C Mishra retired from the post of AIIMS director in January after serving for over three years. Dr Guleria has worked as a personal physician to former Prime Minister Atal Bihari Vajpayee and has also treated Union ministers like Sushma Swaraj and Arun Jaitley. Guleria is the first Indian to get a Doctorate of Medicine (DM) in Pulmonary and Critical Care Medicine.
India, US price comparisons
S
ignificant cost differences exist between the US and India when it comes to medical treatment. India is not only cheaper but the waiting time is almost nil.
This is due to the surge of the private sector which comprises hospitals and clinics with the latest technology and best practitioners
"The Department of Pulmonary Medicine and Sleep Disorders was created under his leadership in 2011 and was ranked as the best department in pulmonary medicine in 2014, 2015 and 2016 by the Nielsen survey published in Week," AIIMS said in a statement. Guleria received 'Padma Shri' award in 2015 and 'Dr BC Roy award' in the category "Eminent Medical Person" in 2014. This time, the appointment of the AIIMS director was mired in controversy with the Prime Minister's Office (PMO) seeking a clarification from the health ministry on the process followed in shortlisting of
names for the top job. The PMO had asked for the explanation after several senior faculty members of the medical institute approached it with a complaint that seniority has been bypassed in choosing the names for the director's post. Out of 53 applicants, the Institute Body, which is AIIMS' top decision-making body headed by Union Health Minister J P Nadda, had recommended HoD of pediatrics department Dr V K Paul, HOD of pulmonary medicine and sleep disorder Dr Randeep Guleria and professor of cardiology Dr Balram Bhargava for the top job. -PTI
India is the future of Medical Tourism industry
Cost Comparisons on some major procedure between India and US Procedure
US ($) approx.
India ($) approx.
Bone Marrow Transplant Liver Transplant Heart Surgery Orthopedic Surgery Cataract Surgery Smile Designing Metal Free Bridge Dental Implants Porcelain Metal Bridge Porcelain Metal Crown Tooth Impactions Root Canal Treatment Tooth Whitening Tooth Colored Composite Fillings / Tooth Cleaning
$2,50,000 $3,00,000 $30,000 $20,000 $2,000 $8,000 $5,500 $3,500 $3,000 $1,000 $2,000 $1,000 $800 $500 $300
$69,200 $69,350 $8,700 $6,300 $1,350 $1,100 $600 $900 $600 $100 $125 $110 $125 $30 $90
BREAST: Mastopexy Reduction Mammoplasty Mammoplasty Augmentation Replacement Of Implants
$7,500 $8,000 $8,000 $6,500
$2,800 $3,300 $2,750 $3,000 Cont’d from page 27
FACE: Blepheroplasty (Upper & Lower) Facelift Dermabrasion Total face) Canthopexy w/Orbicularis suspension Hair Transplant Endoscopic Brow lift Neck lift Otoplasty(For prominent Ears)
$6,000 $6,500 $5,500 $6,000 $50 Per graft $5,800 $6,100 $4,700
$2,000 $2,800 $2,150 $2,200 $3 Per graft $2,300 $2,400 $1,500
NOSE: Primary Rhinoplasty Tip Rhynoplasty
$7,300 $6,300
$2,900 $1,300
BODY CONTOURING: Abdominoplasty Thigh Lift (Bilateral) Total Lower Body Lift(Belt Lipectomy) Liposuction (One Region)
$7,700 $7,200 $9,500 $6,100
$3,200 $3,150 $6,000 $1,750
NON - SURGICAL PROCEDURES: Laser Hair Removal Laser Resurfacing/ Wrinkle Reduction Laser Acne Treatment Laser Scar Treatment Botox
$550 $550 $575 $500 $70 Per Unit
$225 $225 $230 $210 $8 Per Unit
* These costs are an average and may not be the actual cost to be incurred
The hospitals in Delhi, Chennai and Hyderabad have JCI accreditation. Popular among foreigners in India is Max Healthcare that has a chain of 11 hospitals in North India. Spread across 43 acres with 45 operating theatres, Medanta Medicity is another state-of-the-art center located in North India that offers a holistic approach to healing with its Ayurveda centers. "Our hospital offers 30 multi-specialities under one roof and we tend to approximately 5,000 international patients annually. Patients seek minimally invasive cardiac surgeries including CABG, Valve Replacements, Robotic Transplants, Gamma Knife, Radiation Oncology, knee/hip replacements," said Mr Navneet Malhotra, vice president and head, International Patient Services, Medanta. Wockhardt has a chain of super speciality hospitals in India and receives a considerable number of medical tourists annually. "Wockhardt has outpaced industry growth in the last two years and we are
strengthening our relationship with institutions like Partners Medical International to continuously match best global benchmarks in healthcare service delivery. Countries are recognizing that medical travel to India is not only economical but also with quality benchmarked to the best in the world," said Ms Zahabiya Khorakiwala, MD, Wockhardt Hospitals.
Recuperative Services Since India is the country of their origin, natural treatment methods such as Ayurveda, Naturopathy, and Yoga are provided here. These techniques are extremely relaxing and perfect for post-treatment recuperation. Josef Woodman, the author of "Patients Beyond Borders" confirmed that for a good experience, it is essential to research available doctors, inquire about success rates, and learn about the facilities beforehand. Medical tourism for USA citizens is a safe and affordable alternative when the necessary research and precautions are taken prior to the journey.