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ALSO INSIDE Dermaceuticals and cosmeceuticals Tapping new market potential Hospital audit standards Being strategically positioned does matter Solar energy harvesting Cost-saving solutions for hospitals Healthcare marketing Top 10 tips to maximise reach Dr Sujit Chatterjee Chief Executive Officer, Dr L H Hiranandani Hospital
Advancements
in Dermatology
New-age techniques for better drug delivery
Editorial
Treating the TB crisis ndia has the dubious distinction of being home to the highest number of tuberculosis (TB) patients in the world. According to the World Health Organization, the country had 2.2-million cases in 2011, which accounted for nearly 25 per cent of the global populace. In this context, the recent observations of international medical humanitarian organisation, Médecins Sans Frontières (MSF) about the worrying stock out of TB drugs, currently experienced by the country is alarming. In a release, the organisation (recipient of the Nobel Peace Prize in 1999) said that the government must urgently address the persistent issues and almost routine delays of procuring drugs to treat TB. For a country burdened with such high instances of TB, it is quite disturbing and dangerous that there are outages of critically needed drugs to treat children and those with Drug Resistant TB (DR-TB). While India’s scaling up of DR-TB treatment can be a good topic of discussion it is unacceptable to have the current sorry state of affairs, which has led to the non-availability of required medicines for the vulnerable patients, for whom medicines are an utmost necessity. Worse, such drug stock outs could be a reason behind the country’s burdens of DR-TB, known to be the world’s highest. The stock out scenario calls for taking a detailed look at India’s current drug procurement process and many similar issues plaguing various public health programmes. To begin with, a preamble of the currently followed structure will be of help here. For the most part, all anti-tubercular drugs procurement in the country is managed by the public healthcare delivery systems. These systems are mainly in line with the Revised National Tuberculosis Control Programme (RNTCP). The RNTCP, based on the Directly Observed Treatment Short Course (DOTS) strategy, dispenses an array of potent drugs of different protocols to patients, who are at various stages of TB infection and treatment. The procurement programme is led by a single agency - the Central TB Division (CTD) and the drugs are distributed to different states, followed by the providers, from where patients receive these. RNTCP has a detailed manual on drug procurement, distribution and storage for the country. Now the question is, despite having such elaborate and well-defined drug procurement and dispensing system, what could be the reason behind scarcity of life-saving anti-tuberculosis drugs? The need of the hour is to take immediate and sustainable measures to not only restore supplies of these life-saving drugs but also to ensure continuous supply of the required TB medicines in the time to come. This will go a long way in saving many valuable lives.
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Editorial Advisory Board Dr Yash Paul Bhatia MD-Astron Hospital & Health Consultants Pvt (India) Ltd and Member, Editorial Advisory Board, Joint Commission Journal of Quality and Patient Safety, USA
Manas R Bastia manas@network18publishing.com July 2013 I
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Contents
REGULAR SECTIONS
22
05 Editorial
73 Book Review
10 News, Views & Analysis
74 Products
20 Technology & Innovation 83 RX 66 Projects
85 List of Products
68 Tenders
86 List of Advertisers
70 Event List
In Conversation With Dr Sujit Chatterjee CEO, Dr L H Hiranandani Hospital
Special Focus
Dermatology ................................ 25
Automation Trends Healthcare imaging PET-MRI system: A boon for cancer patients ..........54
Advancements in dermatology......................................... 26
Energy Management
Dermaceuticals and cosmeceuticals ................................. 28
Solar energy harvesting Cost-saving solutions for hospitals ............................56
Wound management ..................................................... 32 Interface - Dr Nina Madnani .......................................... 36
Policies & Regulations
Roundtable ................................................................... 38
Need for hospital regulator Transparency and accountability at all costs….................60 Rajendra Pratap Gupta, International Healthcare Expert and President - DMAI
Facility Visit Facility Visit: Godrej Memorial Hospital Quality care and easy access for all
40
Strategy Ambush marketing in healthcare An upstart’s competitive strategy................................62 Sandip Chaudhuri, Freelance Healthcare Writer
Insight & Outlook
Hospital Audit ........................ 43
Hospital audit standards ......................................................... 44 Regular audit practices .......................................................... 46
Tips & Tricks Healthcare marketing Top 10 tips to maximise reach .................................65 Gp Capt (Dr) Sanjeev Sood, Hospital Administrator and NABH Assessor
Hospital waste management ................................................. 48 Interface - Awadhesh C Verma ............................................... 50 Roundtable ................................................................................ 52
Event Preview MEDICALL 2013 A platform to collaborate and upgrade .................... 72
Highlights of Next Edition: Special Focus: Urology/Nephrology Insight & Outlook: Medical Devices Note: ` stands for Indian rupee, $ stands for US dollar and £ stands for UK pound, unless mentioned otherwise Cover Photograph: Neha Mithbawker Model: Shamata Anchan
July 2013 I
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News, Views & Analysis
In Brief Dr Mukesh Batra awarded ‘Global Indian of the Year 2013’ Dr Mukesh Batra, founder-chairman, Dr Batra’s was conferred with the ‘Global Indian of the Year 2013’ award at the 4th Annual India Leadership Conclave and Indian Affairs Business Leadership Awards 2013. The award was hosted by ‘Indian Affairs’ magazine in association with the Ministry of Corporate Affairs at Hotel Leela in Mumbai. A jury comprising eminent personalities, including Satya Brahma, Chairman, Network 7 Media Group declared Dr Batra, the winner in the ‘Global Indian of the Year 2013’ category for his phenomenal contribution in the healthcare space through homeopathy. “I thank the organisers for an award that accords due and deserving recognition to homeopathy – the world’s second-largest medical system. In the past decade, homeopathy has been growing from strength to strength in India and across the world. In fact, it is fast becoming the first choice of treatment for an increasing number of people in India,” said Dr Batra. Further Dr Batra delivered the key note address on, ‘Recent Innovations in Homeopathy: Can India lead the world market,’ which is a case study by the doctor. The award was attended by more than 200 industry stalwarts from diverse sectors across the country. The theme of the 2013 annual leadership conclave was ‘New India, Agenda for Change.’
Fortis Healthcare raises $ 55 million through FCCB allotment to IFC Fortis Healthcare Ltd announced the allotment of 550 Foreign Currency Convertible Bonds (FCCBs) of $ 100,000 each to International Finance Corporation (IFC), on a preferential basis, at an issue price of $ 100,000 per FCCB, aggregating to $ 55 million. Vishal Bali, Group CEO, Fortis Healthcare said, “The healthcare sector in India is poised to witness phenomenal growth. Fortis Healthcare aims to retain its position as a leader in the healthcare sector and as the preferred healthcare provider to patients in India. The investment by IFC will fund the further expansion of hospital beds in India over the next three to five years. It will also enable us to reduce our debt, further strengthening our balance sheet.” With the allotment of the FCCBs, IFC has made a total investment of $ 100 million in Fortis Healthcare by way of participation in the recently concluded IPP, preferential allotment of equity and the allotment of FCCBs.
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UK and India to work together on evidence-informed healthcare policy and practice Dr V M Katoch, Secretary, Department of Health Research (DHR), Ministry of Health and Family Welfare (MoHFW), Government of India signed an Memorandum of Understanding (Mo)U with Sir Andrew Dillon, Chief Executive of the National Institute for Health and Care excellence, UK (NICE) in London. This agreement will provide the framework for strategic and technical cooperation between the two countries, on evidence informed healthcare policy and practice. The agreement between DHR and NICE aims to bring modern health technology to people by encouraging innovations related to diagnostics, treatment methods and prevention, translate the innovations into products/ processes by facilitating evaluation in synergy with other departments of MoHFW as well as other science departments andintroduce these innovations into public health service through health systems research. The UK partner, NICE was set up to reduce variation in the availability and quality of the UK’s National Health Service treatments and care, to generate evidence-based guidance and help resolve uncertainty about which medicines, treatments, procedures and devices represent the best quality care. The MoU creates provisions for exchange of institutional expertise and experience concerning clinical practice guidelines pathways and quality standards, application of health technology assessment and implementation of the decisions of the assessment into clinical policy and practice. To fulfill its objectives and mandate, the agreement delineates activities such as collaborative projects between UK and Indian scientists, strengthening of existing institutions responsible for turning evidence to policy, setting-up of technical pilots to develop technical and institutional capacities, engagement with the health service providers as a key stakeholder and joint awareness raising and policy advocacy through global donors. The next step would be setting-up of a joint steering committee in order to translate the commitments of the MoU to a real, mutually-beneficial partnership and to steer the expertise and enthusiasm of the two countries to create better quality healthcare for their billions of people.
Viroblock introduced new effective face mask to block respiratory pathogens Viroblock SA, a Swiss start-up, presented new data at ICPIC 2013 in Geneva, showing that their face-mask containing proprietary novel cholesterol depletion technology, traps and kills over 99.9995 per cent of H1N1 flu viruses (swine flu), 99.99 per cent of H5N1 flu viruses (avian flu) and 99.997 per cent human corona viruses on pass through air. Aimed at helping protect people from these respiratory pathogens, the mask is up to hundred times more effective than a similar mask without Viroblock technology. The company will now start direct sales in Switzerland and is looking for distributors in other countries. Dr Thierry Pelet, CSO, Viroblock said, Viroblock face mask “Aerobiology tests for face-masks simulate real life situations, in which the user is exposed to viruses coming in. The mask helps prevent transmission from and to the person wearing the mask. The stringent testing demonstrates the efficacy and speed at which the cholesterol depletion technology works.” Dr Jamie Paterson, CEO, Viroblock said, “We believe that our protective face-mask can help protect healthcare, agriculture and security workers effectively, with added advantages of comfort of wear and easy identification.”
RedeďŹ ning our Identity‌ with the new logo Janak Healthcare Pvt Ltd is a recognised and trusted player in the healthcare segment in India and pioneers in delivering quality healthcare solutions employing ethical business practices. Janak’s continuous strive for Innovation makes Janak an expert in the segment it serves. A pulsating and vibrant work culture involving learning, training and development of teammates across the organization and recognizing and rewarding their achievements makes Janak Healthcare a progressive organisation.
MMC (July 2013) 1 Tab-12
News, Views & Analysis
In Brief A private ward at LRS Institute of Tuberculosis and Respiratory Diseases inaugurated for TB patients Shri Ghulam Nabi Azad, Union Minister of Health and Family Welfare inaugurated a private ward at the LRS Institute of Tuberculosis and Respiratory Diseases. This is the first private ward facility for tuberculosis (TB) patients in the government sector of India. Speaking about the LRS Institute of Tuberculosis and Respiratory Diseases, Shri Azad said Lala Ram Sarup Khanna had donated 5 acres of land in 1952. The Government added another 20 acres and gave this land to the TB Association of India for construction of the hospital. With a view to give renewed priority to TB, Government of India has upgraded this hospital into an Institute in 1991 and handed over to the Ministry of Health & Family Welfare. Since then the Institute has been playing a significant role as an apex Institute in the country for prevention, control and treatment of Tuberculosis and Respiratory Diseases. The Institute has constructed a private block for care of patients, who are willing and able to pay for the facilities. This addition in infrastructure will not only help patients avail of the improved facilities but also act as a catalyst for further progress of the Institute. “The Union Government is firmly committed to accomplish the ambitious plans for the 12th Five Year Plan Period and the vision of a “TB-free India,” Azad added.
CureHealth launches new test for cervical cancer detection CureHealth Diagnostics has unveiled new dimensions in early detection of cervical or lower genital malignancies. CureHealth announced a launch of a novel HPV detection technology in India in technical collaboration with IncellDx, a California-based medical health technology company developing advanced molecular diagnostic technologies for detection and monitoring of life threatening diseases such as cervical cancer, breast cancer, HIV/AIDS, hepatitis and organ transplant rejection. The new test named, OncoTect™ being launched by CureHealth Diagnostics for the first time in India utilises a patient’s original Pap test sample for precisely detecting cervical pre-cancer lesions by identifying the oncogenic activity of HPV in infected cervical cells. Unlike a standard Pap test with a reflex to HPV, HPV OncoTect™ gives patients and gynaecologists correct risk assessment capability. Many experts feel that OncoTect HPV Test is an ‘HPV test for the future.’
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CCEA clears plan for setting up MDRUs in government medical institutes The Cabinet Committee on Economic Affairs (CCEA) has approved the plan for setting up Multi-Disciplinary Research Units (MDRUs) in 80 government medical colleges during the 12th five-year plan period. Setting up of these units will approximately cost ` 503.85 crore, and the project is proposed by the Department of Health Research, Ministry of Health and Family Welfare (MoHFW).. Of these, 35 units will be established in 2013-14 and the remaining 45 in 2014-15. This measure will encourage and strengthen an environment of research in government medical colleges and bridge the gap in infrastructure, which is inhibiting health research in medical colleges. It will further improve the health status of the population by creating evidence-based application of diagnostic procedures, processes and methods. One-time financial assistance of upto ` 5.25 crore will be provided to each government medical college/institution for setting up of a modern biological lab/multi-disciplinary research unit. This will include ` 5 crore towards equipment and ` 25 lakh for minor civil works for modifications/renovation in the space to be provided by the state medical college. Additionally, financial assistance of ` 19.23 lakh per annum for meeting recurring expenditure towards staff and ` 15 lakh per annum towards consumables/training/ contingencies will also be provided for a period of five years to each medical college/institution. The state government will be required to provide requisite space (free of cost) for establishment of MDRUs in medical colleges. They will also be required to take over the recurring expenditure liability of the labs after the project period of five years.
Dr Alok Pareek becomes first Asian Prime Vice President of the International Homoeopathic Medical League Dr Alok Pareek has been unanimously chosen as the first Asian Prime Vice President of the International Homoeopathic Medical League officially known as LMHI: Liga Medicorum Homeopathica Internationalis. The international homeopathic medical society Liga Medicorum Homoeopathica Internationalis (LMHI), established in Rotterdamin 1925, represents homeopathic physicians in more than 70 countries all over the world. The purposes of the association are (L-R) Dr Renzo Galassi (Italy)-President, the development and securing of Dr Gustavo (Argentina)-Secretary, Dr Alok Pareek (India)-Vice President, Dr R Hiltner (USA)homeopathy worldwide and the Secretary, Dr Jose(Mexico)- Outgoing President’13 creation of a link among licensed homeopaths with medical diplomas and societies and persons who are interested in homeopathy. It is noteworthy that the LMHI which is the largest and only global body of homoeopathic physicians in the world has always been dominated by Europeans and Americans in its governance and Dr Alok Pareek is the first Asian to be Vice President. This speaks volumes about the stature Indian homoeopathy has acquired the world over and Dr Pareek’s unanimous election by the 70-member International Committee indicates his universal popularity as a homoeopathic authority. The above developments took place in the Annual conference of the LMHI held this year in Ecuador, South America from 4-7 June, 2013. The new executive body has been appointed for 3 years and the next change at the helm may take place in 2016 in Buenos Aires, Argentina.
News, Views & Analysis
In Brief Primary healthcare chain, NationWide opens new clinic in Bengaluru NationWide Primary Healthcare Services, the Bengaluru-based chain of primary healthcare clinics launched its new facility at CMH Road in Indiranagar, Bengaluru. Shashank Kekre, President, Rotary Club Bangalore, and rear admiral Ajit Tewari (Retd), Director, Bharati Shipyard Ltd, were the guests of honour at the inauguration ceremony. The new clinic at CMH Road offers a wide range of services to people including family physicians, senior citizen care, preventive healthcare, woman and child care, home visits, diabetes management, 24×7 doctor-on-call, electronic medical records, lab tests and vaccinations. Highlighting the importance of family doctors in providing healthcare, Dr Santanu Chattopadhyay, Founderand CEO, NationWide Primary Healthcare Services said, “The overall health of a population depends on the strength of the primary healthcare system. The key to ensuring good health for Indians lies in the expansion of the primary healthcare system that is easily accessible to the community. We anticipate that the NationWide chain of clinics will become a very important component of India’s primary healthcare system.” NationWide currently has 18 clinics across Bengaluru, including 5 retail clinics and 13 corporate clinics.
Innovation Working Group appoints Rajendra Pratap Gupta as Co-Chair for Asia Innovation Working Group has appointed Global healthcare innovation and policy expert, Rajendra Pratap Gupta as Co-Chair for Asia. Rajendra Pratap Gupta is internationally recognised as an innovator in healthcare and public policy. Having served in top leadership positions with many of the world’s largest companies, his work has influenced local, national and international healthcare policies. “I am excited to bring the resources, integrity and experience of Innovation Working Group to public sector, NGO’s, healthcare providers and government agencies in Asia, and look forward to working in collaboration with these great organisations,” added Gupta, Co-Chair, Innovation Working– Asia. “Together we will help to build a hub of innovation in Asia to advance the MDGs related to mother and child health.”
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National Network of Laboratories for managing epidemics established The Cabinet Committee on Economic Affairs (CCEA) approved the proposal of the Department of Health Research under the Ministry of Health and Family Welfare for the setting up of 10 regional labs, 30 state level labs and 120 medical college level labs under the scheme, for establishing a network of laboratories for managing epidemics and natural calamities. The scheme is estimated to cost ` 646.83 crore during the 12th fiveyear plan. The expenditure on the establishment of labs at the State level and at medical colleges will be shared between the central and state government.Expenditure on the regional labs would be fully borne by the central government. This major initiative taken by the Government for establishment of a 3-tier network of laboratories across the country will greatly help in building capacity for handling viral diseases in terms of early and timely diagnosis, development of tools to predict viral disease outbreaks beforehand, continuous monitoring and surveillance of existing as well as new viral strains and handling viruses with a potential to be used as agents of bioterrorism. Currently only national apex institutes like National Cooperative Development Corporation (NCDC), New Delhi and National Institute of Virology (NIV ), Pune are mandated to undertake investigations. The regional labs will be equipped with state of the art BSL-3 facilities and the state level labs will have BSL-2 facilities. The lowest tier labs at medical colleges will be equipped with appropriate infrastructure to carry out serology for viruses (ELISA based diagnosis). Each medical college lab will cover a cluster of three to four districts. While medical college labs will be expected to identify all listed common viruses, the viruses/agents which cannot be identified by these labs will be referred to the state/regional labs for identification and / or characterization. All the laboratories will work under the overall guidance of apex institutions like NIV and NCDC through appropriate linkages and networking.
Global Hospitals introduces multi-specialty ‘Organ Specific’ cancer care As a landmark development for cancer patients, Global Hospitals Group at its Chennai facility, Global Health City announced the launch of the Global Cancer Institute. The Global Cancer Institute was inaugurated by Dr Rosaiah, honorable governor of Tamil Nadu in the presence of Mike Nithavrianakis, British Deputy High Commissioner, Chennai and Dr Ravindranath, Chairman and Managing Director, Global Hospitals Group. Speaking on the occasion, Dr Ravindranath said, “ I am personally very delighted that, today we bring to the people of Tamil Nadu, the Global Cancer Institute, equipped with TrueBeam STx. Global Cancer Institute is unique in every way as we will deliver the most comprehensive ‘Organ Specific’ multi-super specialty services to treat a wide variety of cancers in adults and paediatrics. Global Health City is now a complete ‘one-stop’ destination for one of the most advanced organ specific cancer treatments and radiation therapy treatment in the world.” Global Cancer Institute’s team consists of organ specific cancer experts who are super specialists in treating organ-specific cancer. The services include surgical oncology, medical oncology, onco-haematology and bone marrow transplant, interventional oncology, palliative care and pain medicine, and tumor board to formulate the best possible evidence based cancer treatment for patients.
Technology & Innovation
Non-invasive first trimester blood test to detect Down’s syndrome and other genetic fetal abnormalities
360 Degree Indigenous Hematology Solutions
New research has found that routine screening using a non-invasive test that analyses fetal DNA in a pregnant woman’s blood can accurately detect Down’s syndrome and other genetic fetal abnormalities in the first trimester. Published early online in Ultrasound in Obstetrics & Gynaecology, the results suggest that the test is superior to currently available screening strategies and could reshape standards in prenatal testing. Current screening for Down’s syndrome, or trisomy 21, and other trisomy conditions includes a combined test done between the 11th and 13th week of pregnancy, which involves an ultrasound screen and a hormonal analysis of the pregnant woman’s blood. Only chorionic-villus sampling and amniocentesis can definitely detect or rule out fetal genetic abnormalities, but these are invasive to the pregnancy and carry a risk of miscarriage. Several studies have shown that non-invasive prenatal diagnosis for trisomy syndromes using fetal cell free (cf ) DNA from a pregnant woman’s blood is highly sensitive and specific, making it a potentially reliable alternative that can be done earlier in pregnancy. An Ultrasound in Obstetrics & Gynecology study by Kypros Nicolaides, MD, of the Harris Birthright Research Centre for Fetal Medicine at King’s College London in England, and his colleagues is the first to prospectively demonstrate the feasibility of routine screening for trisomies 21, 18, and 13 by cfDNA testing. Testing done in 1005 pregnancies at 10 weeks had a lower false positive rate and higher sensitivity for fetal trisomy than the combined test done at 12 weeks. Both cfDNA and combined testing detected all trisomies, but the estimated false-positive rates were 0.1 per cent and 3.4 per cent, respectively.
Trivitron’s recent successes in Lab Diagnostic segment (IVD) is a step towards offering 360 degree indigenously manufactured hematology solutions - Cellenium 19, a blood cell count analyser that has become the first Indian designed, indigenously manufactured Hematology Analyser to receive the CE certificate. Now internationally accredited, the product is export ready. Trivitron is the first Indian company to have manufacturing license for own branded hematology controls CountCelTM . The company plans to offer a complete range of hematology controls backed by best-in-class after sales support.
Philips introduces wireless patient monitoring system Philips Medical Systems to launch a patient telemetry system to monitor ECG readings in hospital, without wires. The key requirements were for a high capacity system working in the Wireless Medical Telemetry System (WMTS) band, with high quality ECG readings and 2 day battery-life. Previous systems had relied upon established analog radio techniques but these restricted the systems to just a few beds and a small physical location. Philips recognised that modern cellular telephony offered potential for larger systems where the patient could move and be monitored wherever they were. Philips launched state-of-the-art patient monitoring system in the newly available WMTS band in US and produced a subsequent system variant which was launched outside US,
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where the frequency band allocations were different. The modular approach to the system design and the overall radio system architecture means that the system can be easily reconfigured for different markets without costly revalidation of each system element. Philips created a system design which allowed for a modular approach to make use of a mixture of industry standard and proprietary systems, which could minimise the cost of development and maintenance of the complete system. The radio section was defined as a standalone modem which could operate at any frequency and with a range of protocols whilst seamlessly fitting into the overall system. The pre-existing DECT telephony IP to be suitable for use with 1000 users in the wireless medical telemetry frequency band was adopted.
Cambridge Consultants, collaborates with EBR Systems to design wireless pacing system
Cambridge Consultants collaborates with start-up company EBR Systems to develop the world’s first wireless pacing system. With cardiac stimulation leads considered the weak point in pacemaker systems, the Wireless Cardiac Stimulation system (WiCS) uses a leadless electrode to convert mechanical energy, wirelessly transmitted from an ultrasonic pulse generator, into electrical energy which is used to pace the heart as part of Cardiac Resynchronisation Therapy (CRT). Current CRT pacemakers or defibrillators are implanted in patients with chronic heart failure requiring both the left and right ventricles to be paced. Such devices require the implantation of three leads into the heart, one of which involves painstakingly threading a lead through a difficult and complex route running from the right atrium of the heart, out of the heart and into the coronary sinus, a vasculature structure on the outside surface of the heart to the left ventricle. WiCS overcomes these problems by leveraging advances in energy harvesting microelectronics.
In Conversation With: Dr Sujit Chatterjee
�
We want to be leaders in labour delivery recovery puerperium
‌says Dr Sujit Chatterjee, CEO, Dr L H Hiranandani Hospital. He shares his experiences on working with the reputed hospital that offers quality healthcare services and his journey towards becoming a CEO, leading the group today.
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Pallavi Mukhopadhyay
Tell us about your journey from a student to a CEO
What got you interested in medicine?
During my initial years, I was not a very good student. I was interested in sports and had the unique distinction of being caned by every principal and vice principal on stage. Academics always came later. However, I somehow managed to pass all exams with a first class. I also cleared the all India entrance test for Armed Forces Medical College (AFMC) and ranked 10th in India. At AFMC, I was the football secretary of my college for a period of
I hail from a family of doctors. My father and sister are both doctors. My choice of career was a natural extension of what was happening in the family. I kept hearing about various medical cases at home. During those years, we had only three options: doctor, lawyer or engineer. I thought it was best for me to go to the family way.
Dr Sujit Chatterjee 4 years. I got married on the day of my graduation. Later, I was selected to become a doctor for the Special Forces but rejected that opportunity and chose obstetrics and gynaecology instead. I continued with the Indian army for 25 years. In the armed forces, I lived in a surreal environment amidst a closed group of select people and civil life came as a shock to me. I tried to set up a private practice but was unable to manage it well enough. I also worked with Healthcare and Wellness Foundation and looked after their healthcare initiatives. I then got an opportunity with the Hiranandani Group.
As a reputed obstetrics and gynaecologist, what are the initiatives taken by you to improve mother and neonatal healthcare? When I was with the armed forces, I worked on a project for the Government that evaluated women who were at early stages of cervical cancer. I was of a strong belief that screening and basic medication would stop the cancer from spreading. I initiated setting up of the department of gynaecological cancer in the armed forces which helped in preventive oncology. At Hiranandani, being a private medical establishment, we perform a large number of deliveries. Based on the concept introduced by the American Society of Obstetrics and Gynaecology (ACOG), coupled with my inputs and from the architect, we have designed a birthing suite, which is first-of-its-kind in Mumbai. The couple can have a private room where the husband can be at the wife’s bedside. We want to be leaders in labour delivery recovery puerperium and set up a family zone well-equipped with all essentials.
Share with us the moments close to heart, during years of your journey at Hiranandani Hospital. I remember, the first day we moved in, the false ceiling broke and water fell on our heads and computers, we were guarding our computers. I had a team of 7 doctors then. L H Hiranandani hospital was inaugurated on 22nd February 2004. Our first inauguration party was memorable.
Also, we were the first hospital to receive the NABH accreditation in 2007, the IMC Ramkrishna Bajaj Award in 2008, and the Asia Pacific Quality award in 2009, which is the gold standard in quality healthcare. These treasured moments will always be a part of my memorabilia.
A judicious mix of clinical acumen and diagnostic tools help maintain quality of care at the frontline, while facilitating cost reduction to the patient.
What do awards mean to you? Awards are means that help put processes in place and validate them. When an external agent validates the hospital’s internal processes and declares them to be noteworthy by conferring the hospital with a prize, it feels good. This helps us render better quality healthcare to the patients. Further on, the impact of the award is not just felt by the hospital but also important for patient safety as well. The experiences of patient during and post treatment, made to be hassle-free with processes in place definitely create an indelible impression on patient’s minds. Awards help us transition from being a good hospital to be a great one.
As a visionary, where do you aim to position the hospital, 5 years from now? We would like to be known as the best in the fields of orthopaedics, cardiology, ophthalmology, dental surgery, reproductive research, obstetrics and gynaecology. We want our processes to be constantly validated and to be recognised as a hospital, wherein the doctors and nurses are on the same platform by working in cohesion as a team, to render quality healthcare to all.
How do you manage large multidisciplinary teams? New initiatives to provide best healthcare
by collaborating with international healthcare service providers are started. We experiment with different business models and believe in collaborative medicine. Hiranandani has collaborated with SRL Diagnostics, who run the radiology department in our hospital with Innovative healing sys from US for hyperbaric oxygen therapy system for wound healing, International Oncology Services Pvt Ltd for radiation oncology and Apex kidney centre for dialysis. These collaborations bring in high-end technology. We have also collaborated with the American college of Cardiology to decipher Asian standards for treatment of heart related ailments. The hospital is currently carrying out research projects in the fields of dermatology, anesthesiology and orthopaedics. We are recognised for plasma rich platelet therapy, a technique that was found in our hospital.
How have technological advancements contributed to the traditional forms of treatment? Technological advancements are required but clinical acumen diagnosis is extremely important. The advent of increasing numbers of diagnostic tests has been instrumental in helping both the doctors and patients in complicated situations. William Osler, the father of modern medicine, made diagnosis by just sitting silently next to the patient. Great Indian doctors did similar practices. However, in the past, doctors made incisions to validate the accuracy of the diagnosis, but at times, they discovered that the patient was suffering from a completely different condition, drawing no similarity with the diagnosis made. Today, advancements in diagnostics help patients undergo sonography, CT scan, ultrasound, endoscopy etc, thus eliminating the need for invasive surgical procedures. Hence, a judicious mix of clinical acumen and diagnostic tools help maintain quality of care at the frontline, while facilitating cost reduction to the patient. (pallavi.mukhopadhyay@network18publishing.com)
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Special Focus
Dermatology Advancements in dermatology New-age techniques for better drug delivery ...................... 26 Dermaceuticals and cosmeceuticals Tapping new market potential ............................................ 28 Wound management New healing technologies ................................................... 32 Interface - Dr Nina Madnani Consultant Dermatologist, Aesthetic Dermatologist, Hair Specialist and Vulvologist, Hinduja Hospital...................36 Roundtable Do anti-ageing products really work miracles on skin? ................... 38 July 2013 I
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Special Focus: Advancements in dermatology
New-age techniques for better drug delivery Dermal drug delivery has long been used in India and world over in the form of ointments, paste and bandages. With increasing awareness on the beneďŹ ts of transdermal drug delivery, as in comparison to the oral or muscular routes, scientists have begun researches in this direction. Here’s a walk through the innovative novel advancements in dermal drug delivery.
Epidermal
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rug delivery is the process of administering a pharmaceutical compound, to achieve a therapeutic effect in humans or animals. Drug delivery technologies modify drug release profile, ADME (Absorption, Distribution, Metabolism, and Excretion) for the benefit of improving product efficacy and safety, as well as patient convenience and compliance. The innovative drug delivery methods increase safety and efficacy levels, while improving the overall performance of the drug. Pharma companies can charge premium due to the improved expediency these novel features provide to patients. To overcome difficulties faced by oral drug delivery mechanisms that include
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poor bioavailability, need for high dosing etc, and the need for development of new drug delivery system is at the forefront. New drug delivery system is also essential to deliver novel, genetically engineered pharmaceuticals (ie, peptides and proteins) to their site of action, without incurring considerable immunogenicity or biological inactivation. Among the methods that are being exploited by companies today, is transdermal drug delivery. This system has made its presence felt but is yet to reach its full potential.
hit in the recent years. While drug delivery is painless, no bulky devices are needed to be able to handle and have minimal gastrointestinal effect. These revolutionary patches have come a long way today. Today, there are 19 transdermal delivery systems for drugs such as estradiol, fentanyl, lidocaine and testosterone. The combination patches contain more than a drug for contraception and hormone replacement, iontophoretic and ultrasonic delivery systems for analgesia.
Use of nanoparticles First-generation transdermal drug delivery systems Transdermal patches, the first generation of drug delivery systems have been a huge
Nanoparticles are 1-100 nm in size and carry ample amount of given drugs to deliver them to the target for a sustained period of time. In nanoparticle-based
Advancements in dermatology
Based on the importance, the development of nanoparticlebased delivery systems is rapidly growing through use of proteins, natural polymers, synthetic polymers, and fullerenes.
Strategies used in 3rd generation dermal drug delivery systems are aesthetic devices that cover indications from acne, pigmentary treatments to skin tightening and rejuvenation applications.
Dr Rajesh Kumar Consultant - Dermatologist, Global Hospitals (Mumbai)
Dr Madhuri Agarwal Consultant-Dermatologist, The Skin Clinic (Mumbai)
delivery systems, the active compound is dissolved, entrapped or encapsulated in the carrier. Additionally, the active compound can also be adsorbed or attached to the nanoparticle. Dr Rajesh Kumar, Consultant Dermatologist, Global Hospitals, (Mumbai) states, “There are two main governing factors for the nanoparticle-based delivery systems: particle size and surface charge. Based on the importance, the development of nanoparticle-based delivery systems is rapidly growing through use of proteins, natural polymers, synthetic polymers, and fullerenes. Important proteinbased delivery systems are available ie, albumin, gelatin, gliadin and legumin. Most prominent nanocarriers are microemulsions, liposomes, micron sized, and nanoparticles.” Dr Kumar adds, “Currently, nanotechnology based dermal products such as moisturisers and sunscreens are available in the market. The major compounds used, such as sunscreen for dermal applications are titanium dioxide and zinc oxide. Another important nanoparticle is Lipid Nanocapsules (LNC). These are basically colloidal carriers that offer controlled-release property as well as better bioavailability. Nanotechnology using nanoparticles has been found to be exceptionally significant for future medicine. Several nanoparticle-based therapeutic and diagnostic agents have been developed for the treatment of cancer, diabetes, pain, asthma, allergy, hepatitis, hypertension, influenza and many more.” Historically, Doxil was the first approved nanoscale delivery system by the USFDA in 1995 for the treatment of AIDS associated Kaposi’s sarcoma. Therefore,
with nanoparticle mediated drug-carrier systems, extended circulation time can be achieved with little immunogenicity, superior biocompatibility, selective targeting of the tissue, and the competent penetration of barriers in human body such as skin, blood brain barrier and vascular endothelium. This further helps in self-determining drug discharge. There are several drugs using nanocarriers available in the market that show reduced toxicity, while improving the therapeutic index of the drugs. In the near future, there is a possibility that the next generation of nanoparticle mediated delivery systems with drugs like topical steroids, antibodies, peptides, antibiotics may be available with improve drug efficacy or reduce drug toxicities.
Third-generation drug delivery systems Dr Madhuri Agarwal, Consultant, Dermatologist, The Skin Clinic (Mumbai) suggests, “The new strategies used in third-generation dermal drug delivery systems are aesthetic devices that cover a range of indications from acne and pigmentary treatments to skin tightening and rejuvenation applications. Some of these latest and emerging dermal drug delivery devices include derma rollers, electroporation machines, jet-based technologies, radiofrequency (RF) and high-impact (iTED) devices. Emerging RF technologies are devices that deliver drugs without pain. Minimally-invasive and natural techniques are becoming more popular including lipolysis technology for fat reduction.” These novel drug delivery systems are poised to create a greater impact on drug delivery as
they target their effects directly onto the stratum corneum.
Transdermal drug and vaccine delivery Transdermal Immunisation (TI) techniques are good alternative to overcome the inadequacies of intramuscular immunisation. It is an innovative investigational technology that could be the efficient and cost-effective means of immunising agent. If successful, TI will permit the transcutaneous delivery of vaccines. These technologies are currently under development by different research groups in the world. The ability to vaccinate transcutaneously will be of benefit to people across the globe and reduce disease burden largely.
Predicting trends Combination between second-generation chemical enhancers and third-generation drug delivery systems will be the way forward. Dr Agarwal predicts, “In the next 5 yrs, despite economic slowdown and a challenging healthcare regulatory environment, it’s going to be inspiring for those in the industry, to be a part of the business that will bring the best of science to physicians and consumers around the world. Another emerging technology, regenerative medicine that includes the use of autologous stem cells for treating wrinkles and rejuvenating skin is set to provide new breakthrough in this field.” Though many researches and studies are being done on improving the efficacy of dermal drug delivery systems today, we can undoubtedly say, a new era has dawned in dermal drug delivery industry. (pallavi.mukhopadhyay@network18publishing.com)
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Special Focus: Wound management
New healing technologies In the past, a wound was allowed to heal itself and the human body was ďŹ t enough to recuperate and support the process of self-healing. The recent lifestyle changes have adversely impacted the healing process. This in turn, has given rise to new advanced wound management practices that facilitate quicker healing without any unease or trouble.
Anubhav Sharma
I
n the recent years, the country has witnessed boom in technological innovations. This evolution while holds good, has its certain share of drawbacks as well. With the incidences of injuries increasing, the medical world needs to get upgraded with the latest technology in wound management. Thus, the industry focus is gradually shifting to wound healing and recovery. This has called for deeper research and studies in the field of wound management.
Wound healing factors Skin being the most accessible organ is subject to trauma. A traumatic injury does affect the metabolism balance and
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immunological parameters that play a crucial role in wound recovery. The natural healing process faces challenges due to medical conditions such as diabetes, hypertension, immune dysfunction, poor nutrition and others. These medical conditions impact the duration taken to naturally heal the wound and the organ takes more than the normal duration to come out of the trauma. Explaining the wound healing process, Dr Sagar Galwankar, Consultant and Head of Emergency Medical Services, Global Hospitals(Mumbai) says, “Trauma has many etiologies and mechanisms that range from mechanical to chemical factors, which cause intense tissue and immunological stress in an individual. These factors play a critical role in wound healing.�
Examining problems In the past, examination and cleaning of the wound using aseptic and anaesthetic techniques will stop the bleeding, while removing all contamination through mechanical cleansing and hair removal. The hair removal is done by clipping and not shaving with needed antibiotics, drains and, if needed, open wound care are emphasised as primary steps to heal the wound better with appropriate care. With an increase in injury rate in the recent times, changing lifestyles present a set of challenges for the healing processes. Various researches and study are being carried out in this direction. Hormonal stress is considered as an important factor in wound healing. Hence, many hormonal agents are being researched for local application to enhance wound healing.
Management
Researches in bioengineering has led to the development of Bioengineered Skin Substitute (BSS) tissues which will replace the injured skin and take over the healing process. Dr Sagar Galwankar Consultant and Head of Emergency Medical Services, Global Hospitals (Mumbai) e different types of new dressings ed, wherein they are coated with cs for local applications and ally, they also act as absorbents s fluid generated from the injured ue. s the normal research and volved into the area of wound ment, there are many other es carried out as well. “There is also research going on in the arena of eering leading to the creative work ng Bioengineered Skin Substitute sues which will replace the injured take over the healing process. Skin om skin banks are already known tic options,” adds Dr Galwankar. of the research and innovation n areas of skin bioengineering and tissue artificial and natural tion technologies, acute, chronic mplex wound dressing techniques chnology, anti-scar strategies, ation biology, burns and healing, control, tissue oxygen, tissue blood new devices and technologies and These advancements are improving nd care processes by using a 360 approach. For faster healing, the ion of the patient to diligently wound care instructions helps uccessful wound healing results.
tions in wound-healing dressings should eliminate dead ontrol exudates, prevent bacterial wth, ensure proper fluid balance,
coverage. Dr Amit A Saraf, Managing Director, FCPS Consultant Physician (Internal Medicine), DNB Medicine Coordinator says, “An acute wound has normal wound physiology and healing is anticipated to progress through the normal stages of wound healing, whereas a chronic wound is defined as one that is physiologically impaired. To ensure proper healing, the wound bed needs to be well vascularised, free of devitalised tissue, clear of infection and moist.”
Wound dressings should eliminate dead space, control exudates, prevent bacterial overgrowth, ensure proper fluid balance, and be cost-efficient and manageable for the patient and/or nursing staff. There are various factors that delay wound healing. To name a few, malnutrition, reduced blood supply, medication such as non-steroidal anti-inflammatory drugs and corticosteroids, chemotherapy, radiotherapy, psychological stress and lack of sleep, obesity, infection, reduced wound, underlying disease-diabetes and many more. Talking about the global position of India in wound management, Dr Saraf says, “Moist wound care is not a wellknown concept in India. The few doctors, who are aware about it, know it either by
There are few techniques available in India for wound management as in new topical antiseptics, the concept of TIME, the use of Biofilms and Negative Pressure Wound Therapy (NPWT). Dr Shweta Tyagi Consultant and Head of Emergency Ca Department, Seven Hills Hospital products like cotton and gauze is rampan Counterfeit and local substitutes a easily available and there is a continuou downward pressure on pricing. Th further drives down the usage of advance wound care products towards tradition wound care.
Innovations from India There are various innovations current springing up in India and especially, in th areas of wound management. Explainin about the few innovative technique Dr Shweta Tyagi, Consultant and Hea Emergency Care Department, Seven Hil Hospital says, “There are few techniqu available in India for wound managemen as in new topical antiseptics, the concept o TIME (Tissue management, Inflammatio and infection control, Moisture balanc Epithelial (edge) advancement), the u of Biofilms and Negative Pressure Woun Therapy (NPWT), pulsed radio-frequenc electromagnetic field, coblation and others The need for better wound managemen is increasing, and various innovations can b expected in the years to come. Explainin India’s dominant position in the glob market, Dr Saraf says, “Constant upgradatio of knowledge by attending Continuin Medical Education (CMEs) or journal will educate doctors about new concep in wound management. Infrastructur improvements will also help.” While every organ needs time to recou at its own pace, the changing lifestyle trend make the natural healing process difficu
Special Focus: Dermaceuticals and cosmeceuticals
Tapping new market potential Changing lifestyle coupled with a desire to look and feel good at all times, has led to the sudden shift in focus of many pharma companies towards the dermaceuticals and cosmeceuticals market. The market is soon gaining momentum with many players from India and overseas, foraying into this segment to provide innovative and cost-effective skincare solutions.
Pallavi Mukhopadhyay
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ncrease in disposable incomes of many households, acceptance of new beauty enhancement concepts, development of novel products for cost-effective skin care regimen along with an awareness among both men and women to beautify the exterior appeal, are amongst the contributing factors for the upsurge and diversifying focus of many pharma majors towards the dermaceuticals and cosmeceuticals segment. The westernised concepts on beauty and importance to look good, is soon seeping into the mindsets of urban India, with media playing a crucial intermediary role
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to promote industry growth and influence changing consumer trends. However, today as in comparison to the West, the segment is at its nascent stages of growth in the country, but the demand among youth and the old seems to steadily increase in the urban locales. Research studies forecast that, the global cosmeceuticals market will reach $ 34.81 billion by 2016. Dr D M Mahajan, Senior Consultant -Dermatology, Indraprastha Apollo Hospitals states, “There is a huge awareness and lifestyle transformation, which are the key growth factors. There are not only pharma companies developing dermatology products but exclusive cosmetic companies entering the fray in India. The global
dermaceuticals and cosmeceuticals market offers huge potential for the Asian countries, such as Japan, China and India that are set to attract major players in the future. India has already made a niche mark in the global cosmetics market and its position in the cosmeceutical segment is effectively improving.�
Increasing focus on male demographics Cosmeceuticals and dermaceuticals are skincare products that endow the skin with pharmaceutical benefits, which may affect the biological function of the skin. Through introduction of new APIs, many pharma majors have successfully forayed
Dermaceuticals and cosmeceuticals
The global dermaceuticals and cosmeceuticals market offers huge potential for the Asian countries, such as Japan, China and India that are set to attract major players in the future.
6NLQ ZKLWHQLQJ LQ $VLD 3DFLÀF alone has crossed the $2 billion mark by 2012. It is not only the elderly population that is interested in anti-ageing, but also the younger generation as well.
Dr D M Mahajan Senior Consultant - Dermatology, Indraprastha Apollo Hospitals (Delhi)
Dr Madhuri Agarwal Consultant - Dermatologist, The Skin Clinic (Mumbai)
into this space in the recent times. While skin whitening, depigmentation, sunscreens and anti-ageing creams are in demand as the market best-sellers, their cost affordability and change in purchase behaviours have propelled the growth of this segment. In these changing times,higher purchasing power among both men and women, and men getting more conscious about the way they look have led decision makers to target the male demographic market too. This has indeed, emerged as a new unexplored frontier for the dermaceuticals and cosmeceuticals industry. With men shedding inhibitions about the purchase of these skincare products from the retail store, this segment is slowly witnessing a growth trajectory. However, currently there are no separate laws governing cosmeceuticals and dermaceuticals.
Anti-ageing products The demand for high-quality, innovative and premium-priced cosmeceuticals are increasing in the Indian market, and there is a gradual shift in people’s choice being observed. From donning ‘a beautiful look’ to ‘looking younger’ there has been a shift, thanks to the usage of cosmetic products. As an outcome of this evolution, antiageing cosmetic procedures have become popular than ever before in India. Myriad range of anti-ageing products such as face creams, eye creams, day and night creams are amongst the fastest growing segments offering tremendous growth potential. The skincare treatments are increasingly going mainstream and hence the growth of this segment will be evident in lower income groups by 2020. Thus, tier I, II and III cities across the country will witness an evident boom in cosmeceuticals in the times to come.
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Prospects of skin-whitening products Sunscreen lotions with novel formulas available in the market today, not just protect the skin from tan and harmful effects of the harsh UV rays, but also helps reduce pigmentation, dark spots and lightens the skin tone. These products enhance the complexion and make the skin look a shade lighter, while assuring consumers with a secret to flaunt fair glowing skin. Dr Madhuri Agarwal, Consultant Dermatologist, The Skin Clinic (Mumbai), talks about the gradual shift and increasing inclination by masses towards cosmeceuticals. Dr Agarwal comments, “Ten years ago, the derma and cosmetic market were in its nascent stages. There was lack of awareness and acceptability amongst the general populace about the various aesthetic procedures and even basic ones such as laser hair removal. It was considered as the domain of the celebrities and the socially active population. However with latest emerging trends, changing lifestyles and increasing awareness, many people from different strata of society are opting for these treatments. Now, there is preference for natural aesthetic procedures. Skin whitening in Asia-Pacific alone has crossed the $ 2-billion mark by 2012. It is not only the elderly population that is interested in anti-ageing, but also the younger generation as well.” Dr Mahajan opines, “Gone are the days when a simple cream, ointment or lotion could meet most needs in the segment. The discerning consumers today and the super-specialised practitioners are pushing the industry to innovate and differentiate, to create products that meet their growing
demands to remain healthy, fit and more productive. Individuals have increased confidence levels and a better social standing, because of improved looks and desirability. They tend to become more social and improvise on their interactive skills automatically.”
Way to go What needs to be understood despite the changing consumer lifestyles and pharma industry shift is at the crux of it all, the market is very dynamic in nature. It demands continual innovation and gains traction globally. In the coming 5 years, despite economic slowdown and changing healthcare landscape with imposition of stricter regulatory norms in place, the cosmeceuticals and dermaceuticals industry will be bringing the best of science to physicians and consumers globally. Dr Agarwal reiterates, “The aesthetic market in India is all about new products. Companies are heavily investing in new and emerging technologies, focussing on autologous injectables, and dermal delivery of injectables, topical and device-based alternatives to neurotoxins for wrinkle reduction, scar therapy, treatment for hair loss, removal of localised fat deposits and treatment of excessive sweating. Market leaders have allocated significant budget for direct to consumer marketing approach.” Another emerging technology trend in skincare, regenerative medicine that includes the use of autologous stem cells for treating wrinkles and rejuvenating skin is set to provide new breakthrough in this field. Skin whitening in Asia-Pacific countries is leading and will continue to grow strong in the next 5 years. (pallavi.mukhopadhyay@network18publishing.com)
Special Focus: Interface - Dr Nina Madnani
“The global market is now recognising the quality of the Indian dermatologists” Anubhav Sharma
How has the Indian dermatology sector evolved in the recent past? The Indian dermatology sector has undergone a drastic change in the past decades. The focus has shifted from being purely scientific to providing healthcare and comfort to patients. The specialty centres also improve the emotive state of patients through cosmetic procedures. The development of super-specialised studies like vulvar dermatology, paediatric dermatology, laser dermatology, dermatosurgery and hair dermatology have all been the positive outcomes of more scientific and serious research.
How do you think technology will influence change in the Indian dermatology sector in the next 5 years? Diagnostic and laser machines are now being launched and available in India, immediately after their launch in the West, which was not possible a decade ago. With better financing from banks and venture capitalists, this dream can now be realised by many. This also leads to the negative consequence of dermatology increasingly being seen more as a business than as a medical service.
What are the common problems hindering the quality of progress of Indian dermatologists? The most common problem we face is the lack of knowledge and awareness by the patients, regarding the need to consult dermatologists. We have to compete with quacks and other ‘pathy’ who have the liberty to do false advertising. Such clinics are mushrooming all over India with unqualified personnel. It is amazing that in the internet age, people are still quite fuzzy about the role of various specialities, especially dermatology. It is
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up to dermatologists and associations to educate the populace on, when to consult a dermatologist and also not to expect the instant favourable outcomes, which are usually promised by quacks and the new age beauty salons, promising an excellent job of ‘selling’ their services.
Where is the Indian dermatology market positioned on a global scale? The global market is now recognising the quality of the Indian dermatologists. We have now become part of many international committees and forums. With globalisation there is an emerging need for the West to learn about Indian skin and the visual recognition of the problems they face. Indian dermatologists also need to be well versed with skin conditions that afflict other ethnic populations, who may be residing in India, temporarily or for prolonged periods.
What regulatory changes could help improve the dermatology sector in India? There should be segregation by regulatory bodies between medical clinics and business establishments, which are more or less beauty salons with an underqualified doctor overseeing the work. All cosmetic work need not be treated as ‘elective’ since the emotional state of an individual has direct bearing on the social well-being of an individual in society. While one can understand that procedures like breast enhancement may be subject to service tax, it would be highly unfair and inappropriate if the same norm of service tax is applied to a similar procedure or service provided to a survivor of mastectomy.
Tell us more about the ‘Vulva Clinic’ and deployment of advanced technology at the clinic. The ‘Vulva Clinic’ was established at the Hinduja Hospital by our Dermatology and
… affirms Dr Nina Madnani, Consultant Dermatologist, Aesthetic Dermatologist, Hair Specialist and Vulvologist, Hinduja Hospital. She sheds light on how the technological advancements have helped position the Indian dermatology sector on the global map and upcoming innovations in the next 5 years. Gynaecology departments with a need to provide proper treatment and management to every woman suffering from a vulvar disease. It is a combined treatment, with both the specialities. We have a special colposcope that can be used for imaging and diagnosing the extent of the vaginal and cervical involvement. The clinic is close to a decade old, and we have relieved thousands of patients. The clinic is the first one in India, and I am the only fellow from India of the International Society for the study of vulvo-vaginal disease. (anubhav.sharma@network18publishing.com)
Special Focus: Roundtable
Do anti-ageing products really work miracles on skin? Increasing awareness about anti-ageing techniques such as use of creams and cosmetic procedures, have fuelled competition among the pharma and cosmetic majors to capture maximum market share. But the underlying question on consumer’s mind prevails. Do these anti-ageing products really help reduce the signs of ageing? Our experts say. Anubhav Sharma
Dr Bindu Sthalekar Dermatologist and Cosmetologist, Dr Bindu’s Clinic (Mumbai)
Dr Chiranjiv Chhabra Dermatologist, Skin Alive Clinic (New Delhi)
Any product that helps in the stimulation of collagen can be termed as good anti-ageing product. Anti-oxidants or Vitamin E & C are used in mild proportions in the products, such that they can be sold over-the-counter (OTC). These products help in repairing the collagen damage. It is important that they should be prescribed by the dermatologist. Although reversing the ageing system is not possible and ordinary creams available in the market are of very little aid. A trained dermatologist can recommend creams to prevent or reverse the signs of ageing. These creams when used facilitate quicker growth of the epidermal skin and do not offer longlasting effects. Botox and Juvederm are amongst the best anti-ageing products used by doctors. A 3D filler procedure for enhancing the skin from within with Botox injections is most sought after. Other treatments used are microdermabrasion, chemical peeling, and intense pulse light, fractional photo thermal light and derma roller.
Anti-ageing products if used as a stand alone treatment will not deliver satisfying results. For tightening the loose skin and treating fine lines, we need to work on deeper layers of the skin, remodel the collagen and stimulate neo collagen. The cosmetic products available in the market have limited role in doing so.. But these creams have nourishing elements and lightening ingredients that prevent ageing. Anti-ageing products with new world technologies like lasers and radiofrequency work the best. The best treatments that reverse the signs of ageing are fractional lasers like affirm fractional, rejuvenation lasers, pulsed dye laser, radio frequency devices like scarlet and thermage, platelet- rich plasma therapy. These modalities work on deeper levels and are very helpful in preventing ageing and also reversing ageing.
Editorial take
Dr Manjiri Patankar Puranik M B B S, M D and Founder, InstaSculpt Anti-ageing creams or products predominantly available in the market are moisturisers, retinoid and products that generally constitute to alpha hydroxyl acids, peptides, coenzymes and anti-oxidants. These help in reduction of expression lines, blemishes, pigmentation changes, discolouration and other related conditions of the skin as sun tanning. The ingredients in anti-ageing products are to mimic nature’s own tissue regenerating process, wherein the young skin synthesises collagen to pad and firm itself. In anti-ageing creams, it is one of the few ingredients that can actually reach the cells with small proportions of collagen molecule to stimulate the production of new collagen in the skin. The anti-ageing products indeed, work to the extent of maintenance and since they are permeable to only up to the first layer of skin, are effective for reduction of hyper-pigmentation, skin lightening and fine line improvement. Certainly anti-ageing creams help you get the vibrant, glowing, healthy and younger looking skin, another tedious step in beauty regime.
Anti-ageing creams can only prove helpful if they have appropriate ingredients in it, without any side effects even to the sensitive skin types. It is always recommended to consult an expert dermatologist, who is aware about the right line of treatment and the appropriate product that will suit one’s skin type best and prevent the signs of ageing.
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Facility Visit: Godrej Memorial Hospital
Quality care and easy access for all Godrej Memorial Hospital is a well-equipped hospital with latest technological advancements. The hospital firmly believes in providing quality treatment and affordable care to all. Anubhav Sharma explores the inner workings of the hospital and the specialties performed on a facility tour. Antiretroviral Treatment (ART) Centre for people ailing with HIV and AIDS. The hospital has further collaborated with the US-based NGO, Smile Train, which provides cleft lip and cleft palate surgeries to the underprivileged kids for free.
Spot the facility
Anubhav Sharma
Peeping into the past
W
ith the rapidly growing population at an accelerated pace, it is becoming increasingly difficult to provide the masses with access to basic amenities. Individuals are unable to access their right to healthy living. In the recent past, Godrej Memorial Hospital initiated to provide the underprivileged with appropriate and quality healthcare at affordable prices. Godrej Memorial Trust is a voluntary non-profit public charitable trust, established in 1984 with an objective to build and maintain hospital, while providing medical relief to the underprivileged or weaker sections of the society. The efforts of the Godrej Memorial Trust are dedicated in its mission to provide affordable quality healthcare facilities to all since years. This motive has given rise to the establishment of Godrej Memorial Hospital.
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Godrej Memorial Hospital commenced operations in September 2004. Through these years, the hospital has been diligently serving the society by treating patients with the latest technological advancements. These advancements facilitate in providing the best possible quality treatment that is the need of the hour. Today, the hospital is amongst the chosen few hospitals to be accredited by the National Accreditation Board for Hospitals and Healthcare Providers (NABH), National Accreditation Board for Testing and Calibration Laboratories (NABL) by the Quality Control of India (QCL). The NABH accreditation was renewed in 2012, which is difficult to get due to their strict regulations. Over the years, the hospital has added various advanced machines and technologies to ensure optimal care and safety to patients. Additionally, the hospital is also involved in many Corporate Social Responsibility (CSR) activities such as
Godrej Memorial Hospital is located at Vikhroli, a suburban hub of Mumbai. Through years since its inception, the hospital has earned recognition among a larger populace for affordable healthcare facilities and services. Initially, the hospital was not well-equipped, but through time, the management brought into the place the use of latest technologies. Delving on the details on the core focus areas of the hospital, Dr Suhas Gangurde, CEO, Godrej Memorial Hospital says, “Our main motive is to serve the society. This is the reason we are expanding slowly. In the years to come, we will have many facilities that will help us serve the society in a much better way.” In a short span of time, the hospital has managed to carve a niche for itself. The hospital is now witnessing a tremendous in pour of patients from across the country and abroad as well. “Patients from various corners indicate that we are doing some good deed. This response is our main motivation and is making us work hard, every day and night, to enhance our capabilities in addressing the needs of society in a much better manner,” says Dr Gangurde. The three-storey hospital is equipped with 110 beds. There are four suites in the hospital that offer you a home like environ for the patients to help speedy recovery. Every suite has a sitting area with a proper bed, television and refrigerator. There are two suites on the first floor and the other two on the second floor. Similarly, there are separate wards for both men and women
Godrej Memorial Hospital
I must say that the doctors are working at a very reasonable compensation and have happily agreed, for they aim to serve the society as well. This motivation and dedication has been of great help to the hospital. Dr Suhas Gangurde CEO, Godrej Memorial Hospital with six beds each in each floor. Also, they have 8 single and 16 twin sharing beds. The specialities offered by the hospital are general medicine, paediatrics, dermatology, ENT, ophthalmology, orthopaedics, cardiology, Neonatal Intensive Care Unit (NICU), Paediatric Intensive Care Unit (PICU) and many more. To avoid spread of infections within the same room of a hospital, the in-house team called the ‘infection inspection team’ maintains a check to ensure that the premises of the hospital, both the interiors and exteriors are maintained hygienic and clean. As the hospital is nearing a decade of servicing, there are many success stories under its belt. This fact is attributed to commitment of expert doctors, who are always on their toes, to ensure prompt care and quality delivery at all times. The dedication shown reflects in the happiness and smile spread among our regular visitors, patient and well-being of the society as a whole. Expressing delight, Dr Gangurde adds, “I must say that the doctors are working at a very reasonable compensation
Patients from various corners indicate that we are doing some good deed. This response is our main motivation and is making us work hard, every day and night, to enhance our capabilities in addressing the needs of society in a much better manner. and have happily agreed, for they aim to serve the society as well. This motivation and dedication has been of great help to the hospital.”
What’s new? For the efficacy of treatment and accurate diagnosis, integration of advanced technology with conventional healthcare
Services at the helm
Cardiac operation theatre
Inside view of the HBOT
practices at a reasonable price is the need of today’s times. To cater to this increasing demand for affordable healthcare, the hospital has incorporated setting up of advanced technological processes that include, the Hyperbaric Oxygen Therapy Centre (HBOT). It is the first private sector hospital to have the HBOT centre with a capacity to accommodate four patients at a given point of time. Through this, the hospital aims to enhance healthcare and facilitate quick patient recovery. On an average, eight people are being at this centre on a daily basis. As recently, the hospital inaugurated the Advanced Cardiac Care Centre and the Cath Lab. The facilities provided at this centre helps patients with cardiac conditions to keep a check on the changes in their arteries. Whereas the Cath lab has technologies such as the Fractional Flow Reserve (FFR), road mapping and hemodynamic monitoring. Furthermore, it is enabled with advanced cardiac care treatment and can be used in neurological emergencies. Shedding light on the growth plans, Dr Gangurde explains, “Initially, when we did not have much technological advancement in place, we used to outsource the treatments. Gradually, we are growing and want to provide the patients with latest advanced technology for accurate diagnosis under one roof. We still don’t have the MRI facility and would plan for it soon.”
HBOT from outside
While apart from the regular service offerings provided by most of the city hospitals, the ART centre of the hospital is playing a pivotal role in promoting growth by catering to patients with HIV/ AIDS. This centre is collaborated with Confederation of Indian Industry (CII) and National AIDS Control Organisation (NACO) in 2009. The hospital has further strengthened it networking activities with various NGOs in and around central suburban Mumbai. Continued endeavours of the hospital have been towards providing easy accessibility to quality healthcare at affordable prices and this continues to be their forte. (anubhav.sharma@network18publishing.com)
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Insight & Outlook
Tier - II
Tier - I
Tier - III
Hospital Audit Hospital audit standards Being strategically positioned does matter ......................44 Regular audit practices Maintaining standards par excellence! .............................46 Hospital waste management Regularise the ecological impact......................................48 Interface - Awadhesh C Verma Chairman, Institute of Hospital Engineers .....................50 Roundtable Should hospitals have different audit criteria for different departments? ...................................52
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Insight & Outlook: Hospital audit standards
Being strategically positioned does matter
Tier - II
Tier - I
Tier - III
Indian healthcare delivery system is complex, diverse and non-uniform. Hospital audit helps maintain minimum standards of patient care. However, taking basic infrastructure facilities available today, into consideration for a specific territory, it is not practically feasible to have uniform audit standards across the entire healthcare delivery chain. The experts opine. Nikunj Kumar
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asic healthcare services are almost inaccessible to a vast majority of populace in India. Healthcare accessibility and patient education are the primary concerns that need to be immediately addressed to realize the dream of universal and uniform healthcare delivery. Dr Ramesh Chandna, DirectorQuality and Lab Services, Asian Institute of Medical Sciences (Faridabad) avers, “What we see today is appalling. The public healthcare services are overburdened in big cities and are in pathetic conditions, in smaller towns and rural areas. Patients are being treated with a ‘one for all’ approach for all types of ailments and if the severity of the condition arises, the doctor elopes
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from the situation and further refers them to a bigger hospital based in the city for treatment. Antibiotics are not only being misused, they are also being abused. This results in a phenomenal increase in the number of Multi-Drug Resistant Organisms (MDROs). World Health Organization (WHO) has warned that the era of safe medication will soon be over. One just needs to look at the number of drug-resistant tuberculosis cases, one of the major killers in India. Patients landing up in tertiary care hospitals from other hospitals (especially the ones in smaller towns) are already colonized or infected with MDROs. There is nothing much that the doctors can then do except, pump exorbitantly priced and highly toxic medications into them.”
Current audit standards The national hospital audit standards currently established, have taken into consideration many factors. There are various options to choose from, which include, Indian Public Health Standards (IPHS) and National Accreditation Board for Hospitals (NABH) guidelines that can be adopted for tier-I and tier-II city hospitals in India. These guidelines are different from each other in various aspects. Also, NABH has introduced the accreditation standards for Small Health Care Organisations (SHCO) to certify small hospitals. IPHS also defines standards for all public healthcare facilities, which are suitable for tier-I and tier-II cities as well. Jagruti Bhatia, Senior Advisor, Healthcare Practice, KPMG India
Hospital audit standards
Antibiotics are not only being misused, they are also abused. This results in a phenomenal increase in the number of Multi-Drug Resistant Organisms (MDROs). Dr Ramesh Chandna Director-Quality and Lab Services, Asian Institute of Medical Sciences (Faridabad) opines, “There should be different audit standards subjected to the available resources and essential requirements for patient safety. Different audit standards will enable healthcare organisations to maintain the required norms of a hospital without altering the basic DNA of operational parameters. The parameters that affect the clinical care of the patient should not be compromised. However, other service parameters such as space per bed, technology, parking space, canteen facility can be relaxed. For eg, tier-I large tertiary care hospitals may have 800 sq ft/bed to 1400 sq ft/ bed, while tier-II hospitals may have about 450 sq ft/bed to 800 sq ft/bed and tier-III hospitals that are generally very small hospitals or referral units with basic support, may have 200 sq ft/bed to 400 sq ft/bed.” Practices that impact clinical outcomes like infection control activities should be maintained same across all hospitals, irrespective of their location in tier-I or tier-II cities of India. These include policies for utilisation of antibiotics, hand washing, containing cross infections, care of immune compressed patients, drug policies, resuscitation protocols, sanitation etc, are some basic safety indicators to be adhered uniformly. “The benchmark for audit standards should be maintained, taking local conditions into context. This requires a fair bit of clinical and administrative understanding of hospital processes and the value additions should be borne on mind, when conducting internal audits across healthcare institutes of varied genre in these towns,” Bhatia states.
The decisive factor Audit standards are bifurcated under two categories ie, medical and service standards. Medical standards must be same for all regions. Dr D P Saraswat, Chief Executive Officer, Action Group of Hospitals suggests, “The location and place should not be the decisive factor for the
Practices that impact clinical outcomes like infection control activities should be maintained same across all hospitals, irrespective of their location in tier-I or tier-II cities of India. IPHS also defines standards for all public healthcare facilities, which are suitable for tier-I and tier-II cities as well. quality of care delivered in a particular healthcare facility, as patient’s health cannot and should not be compromised under all circumstances. For example, if a neurosurgery is performed at a hospital in a metro, tier-II or a tier-III city, the standards of medical care should remain equally stringent across. Among the three levels of healthcare that include primary, secondary and tertiary, some service parameters can be relaxed, but for tertiary healthcare levels, no relaxation exists. Talking about the care standards in hospitals, three things should remain uniform across all levels of healthcare that include, Care of Patient (COP), management of medicine and hospital infection control. However, service oriented parameters such as
Three things should remain uniform across all levels of healthcare that include, Care of Patient (COP), management of medicine and hospital infection control. Dr D P Saraswat Chief Executive Officer, Action Group of Hospitals
canteen, parking, mess etc, can be different for different locations.” In case of audits performed after setting up of the parameters, the audits need to maintain the same level of sincerity irrespective of varied parameters across hospitals. The protocols cannot be different for treating a particular disease, or carrying out equipment sterilisation, quality of patient care and safety, and infection control. It cannot be based on the location of the healthcare facility. Insisting on uniform standards of audit across the entire chain of healthcare, Dr Chandna affirms, “We need Standard Operating Procedures (SoPs) for each and every process, performed in a healthcare facility across the country. While, there will be deviations at times depending on the situations and scenario, overall the processes need to be standardised, defined and documented. Although, we have NABH, an autonomous body under Quality Council of India, it is not mandatory for healthcare facilities to get accreditation. We also need to strengthen the accreditation board, NABH and not let it be like, what Medical Council of India has become. If India is to achieve the goal of health for all by 2020, it is high time that we set the minimum standards for healthcare delivery, irrespective of the location of a hospital. These treatment protocols and the outcomes should then be benchmarked across the country. For this to happen, we would need an institution like the National Institute of Clinical Excellence (NICE), which will strictly monitor the treatment protocols with their outcomes in different settings.” (nikunj.kumar@network18publishing.com)
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Insight & Outlook: Regular audit practices
Maintaining standards par excellence! Regular audit practices are voluntarily adopted by large hospitals or corporate healthcare chains to exhibit and maintain best standards of patient care. Smaller healthcare facilities also need to realise the importance of regular audits to grow and contribute towards quality care, through active participation.
Nikunj Kumar
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he healthcare delivery systems in the recent times are acquiring patient-centric approach. With the introduction of newly improved quality standards for the healthcare industry in the form of ISO, NABH, JCI and many more, a concern that’s raising many eyebrows in the healthcare sector is, if these standards of healthcare delivery imply only to large hospitals or are they standardised to be mandated across the entire healthcare delivery value chain? Dr Rajiv Malhotra, Unit Director, Rockland Hospitals reiterates, “One of the definitions of Clinical audit (NHS), defines medical audit as the systematic analysis of the quality of healthcare, including the procedures used for diagnosis, treatment and care, the use of resources and the resulting outcome or the quality of life for the patient. This definition includes three vital elements, namely (i) the procedures used for diagnosis, treatment and patient
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care (ii) the judicious use of resources (iii) the resulting outcome from the patients’ point of view. These three components of healthcare delivery are relevant for all types of healthcare providers and not just restricted to large hospitals. If outcomes are the endpoint of healthcare delivery, then the relevance of quality standards and their periodic audit to ensure compliance to these standards are equally relevant for all healthcare providers, irrespective of their size.”
How do regular audits help? India needs appropriate scaling of quality parameters to make the audits relevant for different types of healthcare institutions. However, the need to constantly improvise on the existing quality standards continues to be an endeavour. “Audits are a necessary tool of assessing systems, protocols, outcomes etc, and hence they should be used across the entire healthcare sector including the
practitioners of alternate systems of medicine. In addition to direct patient care, all related aspects of healthcare delivery including the health insurance industry, the pharmaceutical industry and others have to be brought under the ambit of such regular audits. For healthcare delivery system to improve and become more efficient and cost effective, it has to be governed by a scalable set of quality parameters against which a periodic audit should be carried out. Currently, we need an organisation like the Quality Council of India (QCI), which has already taken a lead in this direction to ensure compliance, but eventually a system of self-governance can be brought in,” Dr Malhotra suggests.
Drawing focus A hospital audit report must incorporate a specific action plan that can be easily implemented, based on the basic procedures complying with the established standards and laws. Regular hospital
Regular audit practices
If outcomes are the endpoint of healthcare delivery, then the relevance of quality standards and their periodic audit to ensure compliance to these standards, are equally relevant for all healthcare providers, irrespective of their size. Dr Rajiv Malhotra Unit Director, Rockland Hospitals audits are an ardent proactive tool to prevent any misconduct and enhance the level of patient care. It is important for all healthcare organisations to maintain uniform practices on few parameters such as biological waste management, sterilisation, patient safety and patient care. Dr Pinki Yadav, Medical Superintendent, Action Group of Hospitals defines a set of parameters for uniform audit practice that include, segregation of healthcare facilities according to their location in tier-I, tierII and tier-III cities, to meet the scope of services offered, adherence to NABH
standards, to encourage small hospitals towards quality consciousness and participate in regular audits to improvise on their brand value. For better patient care and patient safety in adherence to the standard ethical guidelines, it is important that the entire healthcare sector be monitored, to achieve certain levels of quality standards, as per the scope of services being offered by nursing homes, small centers or diagnostic centers. According to a recent article in The Hindustan Times, the health department’s initiative to conduct
For better patient care and patient safety in adherence to the standard ethical guidelines, it is important that the entire healthcare sector be monitored to achieve certain levels of quality standards Dr Pinki Yadav Medical Superintendent, Action Group of Hospitals death audit in government hospitals, to probe and establish the cause of patient’s death and further inquire about the negligence on behalf of the hospital or doctor was directed towards curbing the repetitive incidences of medical negligence in government hospitals. However, regulations alone may not offer solutions to change the paradigm of healthcare standards. Only voluntary acts from all stakeholders in the healthcare value chain will promote growth. (nikunj.kumar@network18publishing.com)
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Insight & Outlook: Hospital waste management
Regularise the ecological impact
Hospitals can be the potential hazard creators owing to the daily release of a huge waste stream consisting of contaminated and infectious articles and disposables. If hospital waste management practices should be regulated and prioritised during hospital audit, is an issue of concern on which, the industry awaits answers.
Nikunj Kumar
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iomedical Waste (BMW) has been detected in streams, rivers and lakes, which raises environmental concerns and poses threat to ecological balance. These can prove to be really dangerous and fatal to human and aquatic health. Even flushing down the drain can contaminate water bodies and have adverse effects on environment. Dr Prashant Kulshrestha, Unit Director, Rockland Hospital states, “About 80 per cent of the waste is general (comparable to the domestic waste) and can be effectively minimised to facilitate savings. Another 20 per cent is ‘biomedical’ in nature. It is hazardous and carries immense potential of resulting in ill health to those exposed.” The disasters and ecological threats that biopharmaceutical waste can pose are quite obvious. Hence, implementation of appropriate strategies to prevent ecological harm is the situational demand. Jagruti Bhatia, Senior Advisor,
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Healthcare practice, KPMG India and Ex-Member of the Advisory Committee on Biomedical Waste (BMW), Ministry of Environment and Forests (MoEF), Maharashtra states, “Biomedical waste standard management and handling rules are now being implemented in all hospitals. Most towns now have central treatment facilities with adequate transportation. Hospitals are keen on abiding with the biomedical waste disposal norms, as any kind of unlawful activity will defame their facility. There is also a penalty clause and non-bailable offence for the leader of the institution or any responsible authority of the hospital in case of non-compliance.”
Regulatory scenario Medical wastes that falling under the umbrella of non-hazardous industrial solid wastes are governed by section ‘D’ of the RCRA. In India, biomedical waste accounts to around 1-2 per cent of the total municipal solid waste stream.
“Any good healthcare practice should focus on proper treatment of biomedical waste as it impacts the society, patients, community, rag pickers and the staff working in the premises. Therefore, waste management should form an essential part of the audit. The spread of HIV amongst healthcare workers and rag pickers was mainly attributed to the bad treatment of sharps in biomedical waste of hospitals apart from transmitting other serious infections,” avers Bhatia. Legislations such as Environmental Protection Act 1986 in India had a very limited applicability to tackle the pharmaceutical and biopharmaceutical waste. Hence, it was amended consequently in 2002 and 2003 for bettering the hazardous waste management rules. Deep burial, autoclave and microwave treatment, secured land-filling, incineration and shredding are some methods of treatment stated in the rule.
Hospital waste management
About 80 per cent of the waste is general (comparable to the domestic waste) and can be effectively minimised to facilitate savings. Another 20 per cent is ‘biomedical’ in nature. Dr Prashant Kulshrestha Unit Director, Rockland Hospital “The rules also provide different treatment options that can be adopted for tier-II and tier-III cities. The infectious waste needs to be autoclaved, but due to lack of continuous electricity supply issue in these towns, it is difficult to operate autoclaves round the clock. In such cases, the law allows chemical disinfection and deep burial as an alternative method,” Bhatia suggests.
Measures to reduce BMW Eliminating waste from the outgoing stream in the best possible manner requires process
compliance with the existing standards and waste management guidelines established by the global and national regulatory bodies such as the Food and Drug Administration (FDA), Central Drugs Standard Control Organization (CDSCO), World Health Organization (WHO), CPEB and European Medicines Agency (EMA). “A waste audit is a valuable tool for understanding hospital’s waste management practices, while providing a basis for planning of waste-reduction programme, to improve on the existing waste-management practices and manage
Hospitals are keen on abiding with the biomedical waste disposal norms, as any kind of unlawful activity will defame their facility. Jagruti Bhatia Senior Advisor - Healthcare practice, KPMG India and Ex-Member of the Advisory Committee on Biomedical Waste (BMW), Ministry of Environment and Forests (MoEF), Maharashtra State waste management contractors. Audits are the best way of feedback control on the processes and to ensure that the input-output ratios are maintained with optimal resource utilisation,” Dr Prashant suggested. Ecological impact invites both cost issues and regulatory concerns, apart from skilled users to adopt an accountable strategy that sustains the environmental parameters. However, all these factors must be weighed for their pros and cons of advanced concepts over conventional procedures. (nikunj.kumar@network18publishing.com)
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Insight & Outlook: Interface - Awadhesh C Verma
“Energy awareness in Indian hospitals is yet to attain the global professional standards” ...says Awadhesh C Verma, Chairman, Institute of Hospital Engineers. In a brief interaction, he sheds light on the major factors that should to be taken into account for conducting an effective energy audit in hospitals. Also, some useful measures to improve the energy efficiency of healthcare facilities in India are suggested. practices. Reliable and procedurally-correct maintenance and operation system helps maintain a clean clinical environment, which facilitates infection control and enhances the patients’ recovery process. To facilitate regular monitoring, in-house engineering staff must be trained to carry out regular walk-through audit to minimise over-dependence on external energy auditors.
Are there any government guidelines to improve hospitals’ energy performance?
Nikunj Sharma
What are the factors an energy auditor should bear in mind, while auditing a healthcare facility? Hospital energy audit is a specialist activity. No compromise on functional requirements can be made in a hospital due to various code stipulations related to indoor environment. Minimising energy use in a healthcare facility without compromising on other objectives is a real challenge. Also, hospital engineering services are complex systems with special lighting needs, unique process requirements, stringent air-conditioning parameters, special ventilation requirements and pre-dominance of medical and diagnostics equipments. Hence, energy auditors with experience in hospital engineering, planning, operations and maintenance practices should be preferred for energy audit in hospitals to achieve optimum energy savings.
Are regular energy audits helpful in monitoring the hygiene and patient service standards in hospitals? Yes, it is. An energy audit ensures compliance to correct operation and maintenance
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Energy Conservation Act 2001 stipulates that energy audit will be mandatory for the designated consumers, as and when notified by the Government. Energy Conservation Building Code (ECBC) has become mandatory in couple of states, while others are in the process of notifying its implementation. ECBC compliance mandates energy audit of the buildings having minimum hundred kilowatts electric load. Hospitals generally come under this category. Government of India has also directed that, all of its buildings which also include hospitals that have minimum threestar GRIHA certification. Similarly, hospitals in private sector are also going for green building certification. NABH accreditation of hospitals will also lead to improvement in the hospital’s energy performance.
Do organisations voluntarily participate in energy audits? Hospitals have very high-energy consumption levels from 8,000-25,000 kWh/bed/year in private multi-speciality
urban hospitals to 200-400 kWhbed/year in rural government hospitals. Hospitals in India are now voluntarily going for energy audits to improve their bottomline. Awareness about the positive gains of energy audit is fast spreading among the hospitals.
Do we have sufficient energy auditing workforce to handle all the healthcare facilities? Currently, there are not sufficient energy auditors available. A large pool of energy auditors with exposure to hospital planning and operations are an increasing need, if hospitals have to comply with ECBC and green norms. Due to efforts of the Bureau of Energy Efficiency (BEE), the number of energy auditors and managers is scaling up every year. However, much needs to be done to upgrade the skills of energy auditors, technicians and the frontline engineering staff in hospitals.
What can be done to create greater energy awareness and better audit skills among hospital engineers? Energy awareness in Indian hospitals is yet to attain the professional standards of developed countries. The reason is lack of professionalism among hospital engineering staff. Sustaining green hospitals will be a major challenge unless better professionalism prevails among the hospital engineering staff. With number of hospitals and their energy demand increasing, hospitals will have no choice but to adopt best practices to benchmark their energy performance to BEE standards. (nikunj.kumar@network18publishing.com)
Insight & Outlook: Roundtable
Should hospitals have different audit criteria for different departments? Hospital is a place which collectively carries out the service activity. The interdependence of various departments within a hospital has signiďŹ cantly increased. This brings us to a question, whether an auditor should audit the entire hospital or different audit experts should carry out the processes for different departments. Experts speak. Hardik Ashar
Dr Narendra Karkera Director - Operations, Hosmac
Dr Rajeev Boudhankar Vice President, Kohinoor Hospital
I would suggest the audit of an entire hospital by a single auditor. A hospital is an institution comprising of different departments, who collectively work together for the betterment of society. There are some departments that generate revenue, while others offer service to customers and other departments. By carrying out different audit for different departments, we will be separating them from each other. This is not possible as every department is interlinked and interdependent. We certainly cannot give importance to a single department over the other. Hence, it will be difficult to carry out separate audits for a department. An auditor should have a team of experts from various departments such that auditing the entire hospital becomes easy. This in no way means that one cannot carry out the audit of different departments by different people, but it is not what I will suggest.
With the evolving healthcare sector, the industry has managed to attract the attention of various stake holders in a focussed manner. With such strategic investments, quality has become the supreme goal for everyone. To raise the level of service offerings, hospitals are now audited on various quality parameters such as clinical, nursing, administrative, patient satisfaction, support services and many more. Management consultants have now entered the arena and are providing consultancy on audits or conducting audits. However, a single agency may not have the expertise under one roof to audit various parameters of quality. We will require experts specialising in their core areas of competency for clinical parameters, nursing parameters, engineering services, water management, etcHence, it makes more sense to have experts conducting audits on specific departments with their specific expertise.
Editorial take
Daisy N Raj General Manager, Hospital Operations, Godrej Memorial Hospital Audit for an entire hospital can be comfortably carried out by a well-trained and experienced auditor or assessor. Hospitals today have realised that non-clinical processes play an equally important role in enabling the physicians to provide safe healthcare to the patient. While effectiveness, by way of clinical outcomes will be the primary quality factor, efficiency in managerial and support processes are an equally important guiding factor in ensuring safety and quality of healthcare. The hospital focusses on the patient and healthcare requirements in the form of preventive, curative, promotive and rehabilitative care. An audit therefore has to encompass all these areas comprehensively. Hence, every area or facility that caters to patient care, has to be audited at a single go because they are interdependent, interrelated and complement each other to provide comprehensive quality and safe service to patients.
The audit of an entire hospital by a single auditor can really ease the process, only if the auditor has a good team of experts who understand the function of every department in the hospital. Due to interdependence of departments, that pose various problems, an individual expert can carry out the audit of the particular department. Ultimately, the hospital has to decide the right practice that suits.
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Automation Trends: Healthcare imaging
PET-MRI system A boon for cancer patients
Image courtesy: Indraprastha Apollo Hospitals
Latest technological advancements have undoubtedly contributed to the boom witnessed by the healthcare sector. The imaging techniques used along with advanced imaging machines have influenced this change, and their deployment in hospitals has helped in better healthcare delivery to patients.
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oday, it is difficult for most of us to imagine the advent of the first Magnetic Resonance Imaging (MRI) technique, which took more than 4 hours to reconstruct the image. Today, advanced colour rendered 3D images from an MRI machine can be made available within seconds. It is almost 35 years, since the first MRI examination took place. MRI has now become one of the most important examinations in diagnostic radiology. Approximately, 50-million MRI examinations are performed every year worldwide and this phenomenal growth has been achieved by the ever-increasing number of diagnostic applications developed for MRI technology and the radiation free application to patients.
Technology advancements in imaging Taking imaging capabilities to the next level of advancement, Positron Emission Tomography (PET) and MRI were combined for the first time in a single scanner. Both of the imaging modalities are logically complementary. PET is a functional modality that reports about biological processes, while MRI offers information about tissue structure. As
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PET-MRI suite
the name suggests, combination of PET with MRI images on single equipment is a novel idea. It has lot of advantages despite the fact that the initial investment and maintenance costs being relatively higher. The combined scanner can provide accurate PET and MRI images at the same time. It enables the doctors to correlate the structure of a tumour by MRI with the functional information from PET, thus enabling them in determining everything that is happening inside a tumour. The combined scanners, which are currently available in the market, comprise a combination of ComputerAssisted Tomography (CAT) and PET.
Advantages of PET-MRI The PET-MRI is the only machine that produces imaging, captures anatomical, functional and simultaneously biochemical parameters in a single
test and enables viewing every possible detail like location, size, extent, type, sub-type and behaviour of the cancer possible. This establishes complete diagnosis in place, while carrying out accurate treatment planning. The PET-MRI system is a boon for cancer patients, as the radiotherapists can now deliver highly precise radiation dose, for they are aware of the true extent of the disease. Furthermore, this system also facilitates physicians to truly assess the tumour in greater details and be certain of the happenings within the patient’s body. Other than its application in cancer, PET-MRI also plays a greater role in understanding various disease processes in cardiology and neurological diseases. The ‘zero’ radiation exposure from the machine (unlike CT), makes it the ideal choice for evaluation in paediatrics,
Healthcare imaging
in cardiology and neurological diseases. The ‘zero’ radiation exposure from the machine (unlike CT), makes it the ideal choice for evaluation in paediatrics, reproductive age group women and for patients requiring repeated scans, for disease follow up. PET-MRI establishes a new understanding of the previously unknown interrelation between different measures of pathology and physiology in human body. With its highly advanced and enhanced ability to explore correlations between structure and function, perfusion and metabolism, tissue diffusivity and cell proliferation, the PET-MRI potentiates doctor’s ability of gaining new insight into the progress of a disease while unlocking new paths to treatment or even opening up new avenues of research.
How does PET-MRI work? The PET technology injects targeted radioisotopes into the body, and the scan detects metabolic process of breakdown
PET is a functional modality that reports about biological processes, while MRI offers information about tissue structure. As the name suggests, combination of PET with MRI images on single equipment is a novel idea.
of these chemicals into the body, to identify the functional processes. CT and MRI scans correlate it, by helping in its localisation and detect structural changes in the body caused due to pathology. Doctors say the switch from CT to MRI, combined with the PET facility, has significantly reduced the radiation exposure to patients. The MRI combination with PET also detects soft tissue lesions better and is considered to be the investigation of choice for organs such as the brain, head and neck, spine,
abdomen, pelvis and joints, which are poorly observed on a CT scan.
Access for deeper diagnosis Country’s only PET-MRI facility is deployed and available for detailed diagnosis at the PET SUITE of Indraprastha Apollo Hospital, New Delhi. The ‘PET SUITE’ is a unique concept and the first-of-itskind in the world, wherein a PET-MRI is installed along with high-end PET-CT. This state-of-the-art, 427 slice /sec, Ultra HDPET-CT with highly specialised 4D respiratory gating software is a boon for cancer patients. Also, the radiotherapists can now deliver highly precise radiation dose, synchronised with patients’ breathing pattern. (feedback@apollohospitals.com)
Dr Shubham Sogani CEO-PET Suite, Indraprastha Apollo Hospitals
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Energy Management: Solar energy harvesting
Cost-saving solutions for hospitals With mega-scale 24X7 energy requirements, modern hospitals and facilities are required to be energy guzzlers. The hospitals need to reduce their carbon footprint as much as possible. To manage uninterrupted operations in healthcare facilities and decrease costs, solar energy could prove to be an effective solution to meet the power demand challenges.
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ospitals and healthcare organisations require continuous, stable and good power quality to run critical and sensitive equipments, sophisticated machinery, tools, operation theatres, security areas, etc. The input quality and efficiency of energy supply for the healthcare sector cannot be compromised. Also like any other professional organisation, the healthcare institutions need to reduce operational costs and hence, budgeting measures are an inevitable mandate for the administrators. With India poised to explore the benefits of alternative and renewable
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energy, solar is an easy and inexpensive option. With solar power reaching grid parity levels for commercial usage, the healthcare sector needs to urgently exploit the opportunities on anvil. They can divert 30 per cent of their energy requirements to solar power and also avail substantial savings along with depreciation benefits. There is a growing need for quality and innovative energy saving solar technologies in the healthcare sector with complete understanding of the customer requirements to reduce grid dependence and make way for smooth switch to solar.
Global quality products and engineering solutions made to meet Indian customer preferences and conditions are chosen by professional solar system integrators today. Care should be taken to ensure that all solar installations adhere to global standards of health, safety and environment protection, especially when the site involved is a hospital or a medical facility. Outlined here is an on-grid system installation in a hospital in Bengaluru, Karnataka. The hospital is generating solar photovoltaic power from its 15kW rooftop plant. The solar power generated is being
Solar energy harvesting consumed captively by the hospital load. The solar power was supplied by ArrayTech Technologies Pvt Ltd, Bengaluru for the RMV Hospital in the city. The installations in Phase-I were 5kW was installed in July 2012 and Phase-II of 10kW was recently installed in February 2013. After detailed load and civil site analysis, 15kW on-grid system installation was suggested and hence, the working of solar PV on-grid system after evaluation of the company’s PV system simulation results, was installed in two phases. The client had online Uninterruptible Power Supply (UPS) for hospital sensitive loads and they were also aware of the maintenance issues involved with the battery systems. Hence, ArrayTech engineering team suggests a ‘battery-less’ system.
solar power as a prime source of energy and grid. The DG power will supply remaining part of the requirement. The consumption of solar power directly makes difference in the monthly electricity bill, thereby saving money and using green energy.
Working principle of solar PV grid system
Synchronisation
The solar modules when exposed to sunlight generate DC electricity. The DC power goes through a solar inverter which is a critical component in a solar PV grid tied system. The solar grid tied inverter performs the conversion of the variable DC output of the PV modules into a clean sinusoidal AC power. The inverter needs a synchronising power that will be either grid or DG. The solar current will be given lead angle in the synchronisation process and it will be forcefully injected into the bus bar of loads. The loads will be supplied with
With India poised to explore the benefits of alternative and renewable energy, solar is an easy and inexpensive option. With solar power reaching grid parity levels for commercial usage, the healthcare sector needs to urgently exploit the opportunities on anvil.
The inverter measures grid (voltage, frequency, phasing) and uses this information to synchronise the internal regulation. It means the inverter starts up with an open grid contactor and with a grid independent frequency. Then the controller changes the internal frequency, voltage and phasing so long as this is absolutely identical to the given values from the grid. Now the electronic will close a soft start contactor to pre-magnetise the internal transformer. Few parts of a second later, the main grid contactor will close and the inverter will feed in. If the grid values are changed during the inverter feeds
in the grid, monitoring will detect it and the controller will adjust the internal regulation such that the inverter is synchronal to the grid during the whole phase.
How to protect the solar system? Direct Current (DC) side modules are given with SPD, DC disconnector switch which will protect the solar system. For all kinds of faults, the solar inverter will react first and isolate itself from the system in microseconds of time.
Advantage of solar system It is a simple and safe system that offers direct savings in the electricity bill. The system is load independent and most efficient with least-loss probabilities and is maintenance free. The system provides 25-years of guaranteed power generation with a payback period of around 5 years. 1kW of solar power plant generates 5.5units of electricity per day. During the period between 1st July 2012 to 31st Jan 2013 – ` 52,378 is the approximate savings for 5 KW and ` 1, 57,132 is approximate savings for 15 kW. This was calculated when the tariff was at ` 8 per unit
Limitations of the system Every system comes with its share of limitations, and because solar power is directly utilised, there is no backup facility. Further, it needs a synchronising power for feeding ie, when the power goes off, the grid or DG inverter will isolate from the system, stop feeding and the solar power will go waste. However, if the load is less, the solar power generated will start feeding back to the grid. It is important to conduct a site survey before installation of the solar PV grid system, as this helps in designing the system at its optimum without wasting solar energy and keep the operations of load safe utilising the solar PV energy. A ‘shift to solar’ for tangible savings and reduction of carbon footprint is the way forward. (info@arraytechindia.com)
Ratnadip Bhattacharjee CEO, ArrayTech Technologies Pvt Ltd Solar PV grid /on-grid system for captive consumption
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Policies & Regulations: Need for a hospital regulator
Transparency and accountability at all costs Do we really need a hospital regulator? With the help of a few case studies this article enumerates and emphasises on the need for a hospital regulator in the complex healthcare settings, to simplify the processes involved during treatment and reduce sudden medical burden.
W
ith the increasing technology advancement and huge medical expenses, the emerging trend calls for the need of a hospital regulator. In the last few weeks, I came across three new cases of hospital admissions. All of them hold a common ground and voice out a clear message, as to our needs and demands, when it comes to hospital care.
Experience matters A past colleague’s mother suffering from cardiac problems developed a clot on her leg and it turns blue. On taking the patient to a cardiologist, she was advised to visit a topnotch hospital in Chennai and on visit, was asked to deposit ` 30,000 as an initial payment for all the diagnostic tests that include colour doppler and others. After examination, within 30-40 minutes, the patient was further asked to shell out ` 70,000 for an emergency surgery to avoid amputation. The payments were made using credit card that had a limit of ` 1.00 lakh. By the time, the patient was discharged, the total bill amounted to ` 3.00 lakh. Consequently, the patient was called in for repeated check-ups with each charged ` 1500-` 2000 on every visit. A point to note, during this entire scheme of things was that the patient was having no insurance and happened to be the mother of a heathcare research organisation employee. They were given
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no time to think to deposit a huge sum and the diagnosis that started at ` 30,000 scaled to a total of ` 3.00 lakh. Another case happened in my family, when my father-in-law was rushed to an emergency room around midnight, with high BP (220 / 140). Initial deposit demanded during admission was ` 50,000 and the patient was under observation in the ICU unit to ensure stability in blood pressure and sugar. Surprisingly, the next morning while the patient’s B P and sugar, was in control, he was rushed for a cardiac surgery. And further on, the family was informed by a nephrologist, that within span of a week, a surgery has to be undertaken for blockage in the kidney. We decided to wait and consult for second opinion after the first surgery. Had we given in to doctor’s pressure, the surgery would have been done immediately, with costs estimating to around ` 2.00 lakh. On second opinion, we were being told that the surgery to be uncalled for, it was unnecessary and unwarranted on the patient who had fantastic renal diagnosis. The consecutive bill ran to ` 3.80 lakh. Weeks after this incident, when we met our cardiologist, we were being informed that no cardiologist was called upon during severity in the hospital and the patient was just being treated to bring his blood pressure under control. If cardiologist was present, an immediate angiography would have been taken and according to the doctor, the patient was not provided timely
appropriate care. Anything could have gone wrong, thanks to destiny here. In a private healthcare facility, while every doctor visit is charged for, we have been charged without doctor visit. The medical superintendent accepted this and agreed to ‘adjust’ the excess billing in the subsequent bills or surgery. Even if you find a doctor outside and he generally asks about your health, it is considered a ‘visit’. A patient has no control over such charges. There were no calls from hospital as a followup of post-surgical care, to ensure that the patient is in stable condition of health and subsequent visits to doctor, the charges levied were ` 2,000 per visit. Though the hospital had access to patient’s insurance details, the hospital staff did not inform of the details of the treatment that the patient was entitled and the patient ended up paying about ` 1.80 lac from his pocket. On a third case study analysis, a senior IT professional, on his way to office complained about chest pain and was promptly brought to a hospital in Hyderabad at 18:45 hrs on 20 May, 2013. The duty doctor checked on him and advised ECG to be performed. There were 10 ECGs taken between then and 20:30 hrs. All of them showed indications of heart attack. The duty doctor did not read the symptoms or the reports. While this was going on, he was asked to pay his bills and the duty doctor advised discharge. When the colleagues of the patient, were leaving towards the reception area to settle the bill, the patient seated on
Need for a hospital regulator the chair collapsed and fell down. There was no pulse detected by the doctor and the patient was declared dead. No efforts were made to resuscitate and save him. The very intent of illustrating these live case studies, is that we often see such occurrences happening in cities, towns and also remote parts of the country that are an outcome of doctor’s negligence. At times, the patient’s are overcharged or demanded huge deposits, with no fair idea that their total bill may approximate to lakh and more.
Industry speaks Dr S V Nadkarni, former Dean, L T M Medical College, Mumbai says, “The medical practice or the healthcare delivery system is also an industry governed by industry rules that must apply to the healthcare system.” The healthcare is most unregulated, thereby leaving the patient very little choice, but to approach the consumer forum. Initially, the industry held huge hopes that the private sector competition would establish self regulation, but the private sector at max could offer is to set
‘service benchmarks’. Also, insurance sector was considered to bring in some change in driving outcomes, but the fact is that, insurance sector through TPAs (Thirdparty Administrators) have formed a group to negotiate prices.
Plan of action It is time for the health ministry to think on the plight of the patients and come out with HRAI (Hospital / Health Regulatory Authority of India), to safeguard the interest of the patients. Today, if I can complain about the pharmacy to FDA, nutraceuticals to Food Safety and Standards Authority of India (FSSAI), doctors to Medical Council of India (MCI), why should we not have a hospital and clinical regulatory body? Some of the suggested steps could include: Hospitals disclosing the rate card of services to patients before admission and the estimated ‘best’ and ‘worse’ case scenarios. All hospitals must report the success rate of their treatments to the National Health Portal.
All hospitals must disclose the average billing per patient for all procedures done in their hospitals in the past year to provide approximation of costs to patient. Also, adverse reactions / failures must be anonymously reported on the National Health Portal in the ‘practitioners’ section. Patient charter released by DMAINABH last year must be made mandatory in all clinics and hospitals in regional and national languages. It is high time to have transparency and accountability in healthcare with patient’s interest above all to ensure that the ‘treatment’ is not worse than the ‘disease.’ (office@rajendragupta.in)
Rajendra Pratap Gupta International Healthcare Expert, President, DMAI
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Strategy: Ambush marketing in healthcare
An upstart’s competitive strategy While the debate regards ambush marketing approach in healthcare continues, the industry has been opting this strategy to overcome and battle competition in some form or the other. This feature outlines the possible thinking pattern in upcoming corporate hospitals, who would like to be the game changers and challenge the established players.
A
mbush marketing has gained prominence as a competitive strategy during major sporting events. Hence, it has been moved away from the narrow confines of cause-related marketing. Now, even when a company steals the thunder from a competitor’s campaign it can be seen as ‘guilty’ of ambush marketing.
Rebel at birth Birth order arguably affects personality. In the family dynamics, the youngest child is often pampered a lot. While this may hold true to a certain extent for a public sector hospital, which the government tries to build as a showpiece unit. A new private sector hospital is understandably left to fend for itself. The upstart’s irreverential demeanour probably stems from it.
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A new hospital in a metro city has several pain points to overcome such as growing taller than it’s peers, emerging as a preferential brandand gaining voice as a representative force of the city. While it is difficult to ensure long-term success of a hospital brand by relying on marketing orientation alone, ambush marketing can be used as a tool to achieve crowd-splitting differentiation. The good thing about ambush marketing is that it actually forces you to think and act different. By breaking the linear lines of thought, it can shake up firmly entrenched competitors and ensure a disruptive topsey-turvey competitive landscape.
Battle of the billboards The easiest place for starting off would be the billboards and this country
has seen quite a few slugfests in this space (though in other industries). The preliminary task is to identify target and location. The following could be the likely targets: The accepted market leaders: This could be an audacious challenge for the upstart and a left-handed acknowledgment of sorts, for the former’s popularity and excellence. However, if the pitch can work on the weaknesses of these big guns, then not only does the upstart gain sympathy as the hard-working underdog but also scores further brownie points by voicing popular discontent. The bureaucratic organizations: Their ‘slow to decision, slow to action’ disposition opens them up for ambush by a nimble footed competitor. A simple example of sloppiness would illustrate this
Ambush marketing in healthcare point. If you find a billboard, where the ‘bureaucratic’ hospital continues to wish the citizens, ‘Happy Pujas’, when the city is getting dressed up for Christmas, you are well entitled to ask your competitor to wake up and smell the coffee! Sitting ducks: Then, there are hospitals that come across as easy pickings through glaring anomalies in their marketing campaigns. While this might not happen often with the top brands, this approach of institutionalised aggression would at least, instill a sense of fear in lesser equipped competitors and reinforce the upstart’s abrasive brand identity.
Stand out of the crowd There’s a fine line of difference between competitive intelligence and corporate espionage. As long as you are on the right side of the line, you can use ambush marketing to take the wind out of your competitor’s sail. An upstart which invests time and resources in developing ‘sympathetic moles’ would look to put to use ‘advance knowledge’ of the competitor’s plans. For an ambitious upstart staying abreast of the competitive information is imperative to offset the experience and credibility handicap. Established healthcare providers look to leverage on their existing competence levels and ensure the maximum Return on Investment (RoI). The upstart may choose to blur their campaign edge with similar core messaging. And precise timing is at the core of this blurring attempt. The bigger challenge for the upstart arises, when the secure competitor chooses to undertake new capacity building. Ambush marketing can come in handy, when it becomes clear that matching the competitor’s offerings, feature-to-feature is not possible in the immediate term. The upstart can think of launching ‘Operation Doubtstorm’ at this stage. The high-decibel campaign as the name suggests, would be aimed at creating enough doubts in the minds of the consumer. If done reasonably well, the competitor is left to grind it out, instead of rejoicing the arrival of a clear winner.
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Event escapade There are certainly no events in healthcare sector that are of Olympian proportions. But there are events, which are quite big in the industry’s context. Every year, the sponsorship amounts tend to go northwards arguably without any perceivable increase in benefits. Hence, the drive for ambush marketing in such events could be because of sheer financial factors such as a mutual meeting of minds of the finance and marketing functions in the organisation. Ambush marketing in events can be planned along two distinct trajectories, either by an exhibition or conference strategy. If exhibition strategy is being carried out, personnel ambush can be tried out in the form of easily identifiable groups with the right kind of ‘war attire.’ In a crowded B2B exhibition, a vibrant chromatic and cohesive mass making could draw a fair bit of attention with stronger engagement prospects of the contingent. This makes the ‘visibility strategy’, a potent weapon.
For an ambitious upstart staying abreast of the competitive information is imperative to offset the experience and credibility handicap. Established healthcare providers look to leverage on their existing competence levels and ensure the maximum Return on Investment (RoI). While a personnel ambush can also prove quite effective in conference strategy, the job of an upstart is made much easier with the help of a strong brand ambassador. As with every strategy, there’s a flip side to things. Herein, the impact gets a bit diluted through conscious filtering of an organisational overture. The better approach would be to use the advocacy of keynote speakers carrying no visible of signs of surrogacy. To illustrate with an example, let’s assume that a mother and child superspecialty hospital decides to make a splash with an international conference in the city. The upstart’s areas of interest in the
event brochure would be the speaker’s list (to pick the potential targets) and then the prohibitive sponsorship tags (to rationalize the resource mobilisations against possible savings). Through embedded content harping on a mixture of experiences and references, a brand connect can be established by ‘influencing the influencer’.
The ambush appeal Ambush marketing is a rare commodity in healthcare. The reasons are not difficult to understand. In an industry where ‘marketing should not appear as marketing’, any provocative posturing or directly taking on a competitor, is generally considered as a ‘taboo territory’. In a country with one of the lowest bed-per-population ratios in the world, the question arises whether there is really that level of cut-throat competition, which characterises some of the other consumer industries. The reality is that intense competition exists in private healthcare despite the demand-supply mismatch because everybody tries to tap into the upper-end consumer segment. Corporate healthcare providers look very closely at the ‘cash cows’ for improving their financial health. Branding efforts directed to woo this money-spinning segment holds out the promise of good returns. The ambassadors of ambush marketing would point to its defining ability to create a unique brand personality, a certain confident cockiness which might strike a chord with this group. The debate regarding the ethics of such an approach has never really died down. But this did not deter organisations from trying ambush marketing in some form or the other. It wouldn’t be a surprise in the near future if hospitals, especially the new entrants into the healthcare space find this a viable strategy at various inflection points. (sandiffthin@gmail.com)
Sandip Chaudhuri Freelance Healthcare Writer
Tips & Tricks: Healthcare marketing
Top 10 tips to maximise reach
A
fter years of grudging acceptance, healthcare marketing has now come of age and gained recognition as a legitimate healthcare function. It has matured beyond traditional advertising and ‘word of mouth’ and is unlike commodity marketing. Marketing is the process of planning and executing the
conception, pricing, promotion and distribution of ideas, goods and services to create exchanges that satisfy individual and organisational objectives. All healthcare organisations (HCO) including those in public sector need to be ‘marketing savvy’. The top 10 tips and tenets for effective healthcare marketing, if adopted by healthcare organisations
1
A successful marketing will enable healthcare organisations to gain insight into its strength, weaknesses and analyse any opportunities and threats. It can help shape and control professional reputation better, for a carefully managed reputation and disciplined consistency is better.
2
Remember that no amount of slick marketing campaign can replace the product, the first and most important of 4Ps of marketing mix, followed by price, place and promotion. As more and more hospitals compete to attract patients, assurance of quality becomes the real differentiator.
3 HCOs should aim to offer innovative pricing and packages (the 2nd P), for senior citizens, poor patients, medical tourists, womb to tomb care and on-executive health checkups. Marketers need to consider innovative strategies like tying up with matrimonial web portals for a premarital blood group check on compatibility and others.
4
Effective marketing helps build awareness about the hospital’s new facilities and services. It exposes target audience to its capabilities so as to enhance its visibility, reputation and branding-the attributes which is important for continuous stream of patients, improving revenues and market share.
5
Marketing will enable the HCO to understand its customers and the factors that influence their demand for better healthcare. It eventually enables the HCO to profile and segment their clientele, meet their latent and diverse needs by communicating more through positive promotion.
can help grab larger market share. (doc_ssood@yahoo.com)
Gp Capt (Dr) Sanjeev Sood Hospital Administrator and NABH Assessor
6
Healthcare marketing should be discreet, researchbased and customised to address the needs of the local community and catchment area of the HCO. It should fuse marketing with corporate communication and public relations. To offset competition, HCO should take an aggressive approach to establish a position in the market, while avoiding marketing wars at all costs.
7
Healthcare organisations should use multiple channels to reach out to their clientele leveraging strengths of each medium to create a comprehensive marketing strategy. Social media, mobile apps and smart devices have become predominant means of communication in today’s life as organisations look for more ways to reach patients.
8
Should HCO plan its marketing strategy based on its star physicians, accreditation or the strength of hospital? It is fine to market hospital services initially based on the reputation of star physicians. As the processes, systems and other assets like technology and accreditation become established and reputation of the hospital overtakes that of people, the marketing campaigns should be based around hospital strengths and not star physicians.
9
Healthcare marketing is an ongoing process that needs to be undertaken at all times, by ensuring that opportunities are aligned with the organisational strategy, rather than an episodic event to be undertaken on launch of a service or sponsorship of an event.
10
Successful image of a HCO attracts potential employees and internal marketing keeps the employees satisfied and improves the retention rate .Eventually it is the loyal employees, who prove to be the strongest ‘sales force’ of the marketing organisation.
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Projects New projects and expansion activities are the barometers of industrial growth. These also present business opportunities to service providers like consultants, contractors, plant & equipment suppliers and others down the value chain. This feature will keep you updated with vital information regarding new projects and capacity expansions being planned by companies in the healthcare sector.
A new state-of-the-art general hospital in Hambantota Project type New facility Project news Ministry of Health will start construction of a new state-of-the-art general hospital in the southern port city of Hambantota in Sri Lanka. The 650-bed hospital will be built at a cost of Rs. 7-billion with the financial assistance from the government of Netherlands. Project location Hambantota, Sri Lanka Project cost ` 7 billion Implementation stage Planning
Project location Dhirkot tehsil of Bagh (AJ&K) Project cost NA Implementation stage Planning
Dickoya near Hatton in the Central Province of Sri Lanka The hospital will be constructed under grant by the Government of India. It has been allocated an amount of Rs. 47.27 crore for setting up of the hospital.
Contact details United States Agency for International Development Ronald Reagan Building Washington, DC 20523-0016, USA Telephone: (+1) (202) 712 4810 Fax: (+1) (202) 216 3524 Email: pinquiries@usaid.gov
Project location Dickoya, Sri Lanka Project cost ` 47.27 crore Implementation stage Planning
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Construction of four-storey 200-bed ward complex in Vavuniya
Contact details Ministry of Health Suwasiripa No 385, Rev Baddegama Wimalawansa Thero Mawatha, Colombo 10 Sri Lanka Tel: +91-11-2694033, 2675011, 2675449, 2693493, 2675280, 2669192 Email: postmaster@health.gov.lk ----------------------------------------
Construction of 50-bed facility at Dhirkot Hospital Project type New facility Project news A big sub-district hospital in Dhirkot, tehsil of Bagh (AJ&K) is under construction, which is expected to serve 150 to 200 patients daily and benefit 80,000 populations from the nearby areas. It is a 50-bed facility having 63,668 square feet area and 6 wards including emergency ward, gynaecology ward, ICU, paediatrics and outpatient department with six rooms for consultants.
Contact details: Ministry of External Affairs South Block, New Delhi -110011 Tel: +91-11-23011127, 23011165 Fax: +91-11-23013254, 23011463 Email: eam@mea.gov.in ----------------------------------------
Project type New facility Project news Construction of a four-storey 200-bed ward complex at the District Hospital, Vavuniya.
Construction of 50-bed hospital in Federal B-Area, Block-13
Project location Sri Lanka Project cost ` 200 million Implementation stage Planning
Project type New facility Project news Construction of 50-bed hospital in Federal B-Area Block-13 is currently underway. Construction of both the hospitals in the current fiscal year would be completed.
Contact details Government of Sri Lanka 160/24, Kirimandala Mawatha, Colombo 05, Sri Lanka Tel: +94-11-236 9100 Fax: +94-11-236 9091 Email: bhagyak@icta.lk ----------------------------------------
Construction of 150-bed hospital at Dickoya Project type New facility Project news Construction of 150-bed hospital at
Project location Pakistan Project cost ` 165 million Implementation stage Ongoing Contact details Karachi Metropolitan Corporation 1st floor, Civic Center Gulshan-e-Iqbal, Karachi Pakistan Office Tel: +91-21-99232400/99232401-2 Fax No: +92-21-99232406 Email: administrator@karachicity.gov.pk
Information courtesy: www.tendersinfo.com 1, Arch Gold, Next to MTNL Exchange, Poisar, S.V. Road, Kandivali (W), Mumbai - 400067, India Tel: s Fax: s Email: parmeet.d@tendersinfo.com
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An invite that rewards as well...
Dear Reader, ‘Modern Medicare’ solicits original, well-written, application-oriented, unpublished articles that reflect your valuable experience and expertise in the pharmaceutical industry. You can send us Technical Articles, Case Studies and Product Write-ups. The length of the article should not exceed 1,500 words, while that of a product write-up should not exceed 100 words. The articles should preferably reach us in soft copy (either E-mail or a CD). The text should be in MS Word format and images in 300 DPI resolution & JPG format. The final decision regarding the selection and publication of the articles shall rest solely with ‘Modern Medicare’. Authors whose articles are published will be sent a complimentary copy of that particular edition. Published by Network18 Media & Investments Ltd, ‘Modern Medicare’ is one of the leading monthly magazines on healthcare, and related equipment & technologies. This monthly magazine was launched in December 2004 and provides the latest and most apt updates exclusively for the medical fraternity. Moreover, ‘Modern Medicare’ acts as a sourcebook that facilitates buying decisions for this key sector hospitals, specialty clinics, pathology labs, nursing homes and doctors - and brings out highly useful business information on various healthcare facets such as surgeries, procedures, technologies, equipment et al. So get going and rush your articles, write-ups, etc… Thanking you, Yours sincerely,
eck 0 ity ch I ` 10 r a real e.co.in me fo edicar rtal: Ti lth Po ww.modernm ea H l w na 13 I Natio ? 20 : s S n PLU No 7 I June tatio I pec Vol 9 e ex
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Manas R. Bastia
th up to ` 100 live n I get Bud are.co.i ion e Un rnmedic th id e is: D w.mod alys w t An 3 I w 1 dge t Bu rch 20 a Pos M I No 4
Senior Editor Modern Medicare
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: All India Institute of Medical Sciences (AIIMS) TRN : 16708973 Desc : Supply of horizontal autoclave system BOD : 22 July, 2013 Loc : New Delhi BT : Domestic (NCB)
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Comfo respirator, disposable face mask Org : Department of Atomic Energy TRN : 16646574 Desc : Supply of comfo respirator 5000 in numbers, Disposable Face Mask 50000 in numbers, radiation symbol (12-inch and 12-inch) BOD : 25 July, 2013 Loc : Mumbai, Maharashtra BT : Domestic (NCB)
Pacemaker Org : Eastern Railway TRN : 16643766 Desc : Supply of set of temporary pacemaker BOD : 26 July, 2013 Loc : Kolkata, West Bengal BT : Domestic (NCB)
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: All India Institute of Medical Sciences (AIIMS) TRN : 16708982 Desc : Supply of camera for existing EEG machine for recording BOD : 22 July, 2013 68
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: East Central Railway (ECR) : 16667635 : Supply of multipara monitor : 23 July, 2013 : Hajipur, Bihar : Domestic (NCB)
Hospital and endocrinology items Org : Medical Education Department TRN : 16691507 Desc : Supply of hospital and endocrinology items. BOD : 24 July, 2013 Loc : Kerala BT : Domestic (NCB)
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Org
Medical equipments Org
: Employees State Insurance Corporation (ESIC) TRN : 16888090 Desc : Supply of medical equipments such as general spine instruments, cervical
retractor system, cervical dislractor system, operating microscope for eye, a-scan ultrasound machine, tmt machine. BOD : 12 August, 2013 Loc : New Delhi BT : Domestic (NCB)
Lipid profile analyser, cardiac marker, air steriliser Org : Gajraraja Medical College TRN : 16865420 Desc : Purchase of lipid profile analyser, cardiac marker, air steriliser. BOD : 13 August, 2013 Loc : Gwalior, Madhya Pradesh BT : Domestic (NCB)
Surgical consumables and nonconsumables (dental) Org
: State Pharmaceuticals Corporation of Sri Lanka TRN : 16714411 Desc : Supply of surgical consumables and non- consumables (Dental): cheek and lip retractor with flexible plastic connector, small size. BOD : 14 August, 2013 Loc : Colombo, Sri Lanka BT : Global (ICB)
Surgical consumables Org
: State Pharmaceuticals Corporation of Sri Lanka TRN : 16707949 Desc : Supply of surgical consumables: skin stapler with 15 staplers, 0.58dia x 3.9mm, sterile packed individually and labelled accordingly. Pack size: 01/10 BOD : 15 August, 2013 Loc : Colombo BT : Global (ICB)
Org: Organisation’s name; TRN: Tendersinfo Ref No; Desc: Description; DSLD: Doc Sale Last Date; BOD: Bid Opening Date; Loc: Location; BT: Bidding Type
Information courtesy: www.tendersinfo.com 1, Arch Gold, Next to MTNL Exchange, Poisar, S.V. Road, Kandivali (W), Mumbai - 400067, India Tel: s Fax: s Email: parmeet.d@tendersinfo.com
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Event List
NATIONAL 2nd Indo UK Pain Management Conference Indo UK Pain Management Conference is dedicated to beginners and freshers offering courses related to ultrasound guided procedures. Apart from the interactive session, this conference will have quizzes, demonstrations, workshops and group discussions. Globally recognised professionals will be present at the conference. The conference will emphasise on new ways of pain management treatment and anesthesiology, advance technologies and the applications used along with medications and preventions. Certain relevant issues will also be highlighted. Date: August 9-11, 2013 Venue: Max Super Specialty Hospital, New Delhi Organiser: Anaesthesia Co-ordinator Tel: +91-9811944856, 09818773083 Email: maxsua2013@gmail.com  Website: www.indoukpainconference.com
International Conference on Holistic Medicine 2013 International Conference on Holistic Medicine is organised with an aim to develop a holistic approach for the treatment of various diseases. It will deal with other bilateral research programmes between Department of Science and Technology (DST), India and rest of the world. It will provide a platform
Date: September 6-8, 2013 Venue: Kottayam, Kerala Organiser: Institute for Holistic Medical Sciences (IHMS) Tel: +91-9847460331, 9447223452 Email: holistic@macromol.in Website: www.holistic.macromol.in
Conference of the Asian Federation on Intellectual Disabilities (ID) This conference will hold discussion panels, poster presentations and abstracts. A special session will be included in the conference that will emphasise on resource mobilisation, family mobilisation, non-discrimination or social acceptance, innovative habilitation practices. It will also emphasise on community mobilisation and family mobilisation. Women with ID, leisure and recreation will be other topics that will be covered in the conference. Social issues will also be raised. Date: October 7-11, 2013 Venue: India Habitat Centre, New Delhi Organiser: KW Conferences Pvt Ltd Tel: +91-124-4636700 Email: afid2013@kwconferences.com Website: www.afid2013.in
CHENNAI
JAIPUR
LUDHIANA
AURANGABAD
INDORE
KOLKATA
AHMEDABAD
Maharashtra January 10-13, 2014
Madhya Pradesh Jan 31 – Feb 03, 2014
West Bengal February 21-24, 2014
PUNE Maharashtra October 18-21, 2013 India’s premier industrial trade fair on products and technologies related to Machine Tools, Hydraulics & Pneumatics, Process Machinery & Equipment, Automation Instrumentation, Packaging & Auxiliaries, IT Products, Electrical & Electronics, Material Handling and Safety Equipment.
for visitors to gain more knowledge about the theme and the topics that will be discussed. The conference will see attendance of various eminent personalities sharing important views with the interested candidates.
Punjab Tamil Nadu Rajasthan November 14-17, 2013 Nov 29 - Dec 02, 2013 December 20-23, 2013 Gujarat March 07-10, 2014
For details Network18 Media & Investments Ltd
Ruby House, 1st Floor, J K Sawant Marg, Dadar (W), Mumbai 400 028. R5 &95fhh5iffi5jlkg5R5 295fhh5iffi5jjoo5R5 ' #&95 (! 2*)H( .1),%gn*/ &#-"#(!8 )'
Indian Orthodontic Conference Indian Orthodontic Conference is a platform wherein various innovative ways on most recent orthodontic issues will be discussed and attendees will get valuable insight on dentofacial orthopaedics. This is the summit which will be attended by reputed dentists, scientists and professionals to discuss and debate on the most recent challenges encountered as well as available solutions to face them. The conference will also ensure updated strategies to develop perfect collaboration through the proper execution of networking breaks thus optimising learning needs and fostering new research. Date: November 22-24, 2013 Venue: Gujarat University Exhibition Hall, Ahmedabad Organiser: Cimglobal Tel: +91-7926670720 Email: info@48ioc.com Website: www.48ioc.com
International Dermatology
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International Congress of Dermatology will be a meeting ground for dermatologists from all over the world to explore the current advances in the field. It will organise ‘Meet the Experts’ sessions with specialists from specific areas such as phototherapy, telederm and health informatics, urticaria and photosensitivity disorders. The conference will be a good forum for discussion and sharing of information and research results. Date: December 4-7, 2013 Venue: Ashok Hotel, New Delhi Organiser: Neumech Events Tel: +91-11-26593217, 26594224 Fax: +91-11-26588663 Email: secretariat.icd2013@gmail.com Website: www.icddelhi2013.com
The information published in this section is as per the details furnished by the respective organiser. In any case, it does not represent the views of Modern Medicare
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Event List
INTERNATIONAL 5th Asian Congress of Health Psychology (ACHP) The theme of the 5th Asian Congress of Health Psychology (ACHP) is ‘Health and Happiness’. Eminent scholars, promising researchers and students will present their recent findings and share their insights on health and happiness. Psychologists from around the world will exchange knowledge and the latest research findings on their subjects. This conference will play a pivotal role in helping people become healthy. Date: August 22-24, 2013 Venue: DCC Daejeon, Korea Organiser: Korean Health Psychological Association Tel : +82-42-472-7462 Fax : +82-42-742-7459 Email: reg@achp2013.org Website: www.achp2013.org
2013 International Conference on Biological and Medical Sciences The main objective of the 2013 International Conference on Biological and Medical Sciences is to provide a platform for researchers, engineers, academicians as well as industrial professionals from all over the world to present their research results and development activities in biological and medical sciences. Date: September 23-24, 2013 Venue: Cape Panwa Hotel, Phuket, Thailand Organizer: Asia-Pacific Chemical, Biological & Environmental Engineering Society (APCBEES) Tel: +86-28-86528465 (China Branch) Email: icbms@cbees.org Website: www.icbms.org
Targeting ocular disorders With the ageing population, the need for treatment of ocular diseases has become more critical than ever. Increasingly high incidences of Age-Related Macular Degeneration (AMD), glaucoma, diabetic retinopathy and ocular inflammatory diseases demand better, more effective and innovative treatments. This conference will
address drug targeting, novel and emerging treatments that hold promise in treating these crippling conditions. The topics include new disease pathways, alternative drugs, anti-inflammatory drugs, biologics, combination therapies, novel therapeutics, antiangiogenics and kinase inhibitors. Date: September 26-27, 2013 Venue: Seaport World Trade Centre, Boston Organiser: Cambridge Healthtech Institute Tel: +781-972-5400 Fax: +781-972-5425 Email: customer.service@ barnettinternational.com Website: http://www.healthtech.com/ Targeting-Ocular-Disorders/
1st International Conference on Orthofacial Surgery and Orthodontics Opinion leaders in orthodontics, maxillofacial and oral surgery from Europe, Latin America, South Africa, and Russia will present lectures and master class during this world-scale event. Contemporary approaches to the treatment of patients with dysgnathia and other skeletal abnormalities of face will be demonstrated by means of presentations and live discussions. The master class will be held before the conference for those who are interested in peculiarities of treatment plans for patients with different categories of deformities. Date: October 11-13, 2013 Venue: Cosmos Hotel, Moscow, Russia Organizer: LIVE CO, Scientific Events Organizers Tel: +370-689 07071 Email: info@orthofacial2013.info Website: www.orthofacial2013.info
29th Annual Echocardiography in Paediatric and Adult Congenital Heart Disease This four-day symposium focuses on the basics of recognising, understanding, and imaging patients with congenital heart disease. It will provide a comprehensive
understanding of the anatomy, clinical aspects, imaging, and management of patients with congenital heart disease. The symposium features distinguished faculty of paediatric and adult congenital cardiologists, and surgeons with expertise in treatment, diagnosis, and management of patients with congenital heart disease. The format will include lectures, video examples, workshops and panel discussions. Date: October 13-16, 2013 Venue: Leighton Auditorium, Mayo Clinic, Rochester, MN, USA Organizer: Mayo Clinic Tel: +800-283-6296 (toll free) Email: cvcme@mayo.edu Website: www.mayo.edu/cme/ cardiovascular-diseases-2013R015
16th Asia-Pacific Regional Conference (APRC) of Alzheimer’s disease The conference is co-organised by Alzheimer’s Disease International (ADI) and Hong Kong Alzheimer’s Disease Association (HKADA), in collaboration with Macau Alzheimer’s Disease Association (MADA). The conference will bring together medical professionals, experts in dementia care researchers, family caretakers and people living with dementia from across the globe. It will be a unique opportunity to learn about dementia care in different perspectives, the latest developments in dementia policy and training, approaches to building a dementia friendly living environment and different collaborative model of dementia clinic. Date: December 11-13, 2013 Venue: Hong Kong, China Organiser: 16th APRC of ADI 2013 Conference Secretariat Tel: +852- 2911 7915 / 2911 7930 Fax: +852-2572 9841 / 2570 8185 Email: aprc-hongkong@mci-group.com Website: http://www.aprc2013-hongkong. com/en/index.php July 2013 I
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Event Preview: MEDICALL 2013
A platform to collaborate and upgrade MEDICALL 2013 slated to be held from 2nd August to 4th August in Chennai is expected to serve as a great platform for both national and international buyers and sellers dealing in hospital equipment. Here’s a sneak peek into the latest technology trends in hospitals and medical facilities to house advanced equipment in store.
MEDICALL 2013 will bring together the best in the business of ICU and operation theatre equipments, refurbished equipments, trolley, wheel chairs, cots and other furniture, hospital linen and laundry, hospital charts and stationary, medical disposables etc. Dr S Manivannan, CEO, Medicall Expo says, “This edition will host an interesting seminar on running family owned hospitals. The seminar will attract various hospital owners. The expo will also house 250 international exhibitors and 300 national exhibitors. We are expecting a footfall of 8,000 visitors including hospital owners, distributors and others. Further, the expo will cater to all segments of hospitals. We have 30 per cent new participation this year. We are looking forward to host MEDICALL 2014 in Colombo.”
The show stealers A glimpse from the previous edition of MEDICALL
Pallavi Mukhopadhyay
T
he hospital industry is an important component of the value chain in the Indian healthcare system rendering services to the masses at large. The healthcare industry in India is growing at an annual rate of 15 per cent and is positioned at $ 36-billion today. The healthcare segment, more popularly known is expected to upscale to a whopping $ 280-billion by 2022. With the integration of world economies, high-quality treatment is now available at a fraction of the cost, as in comparison to the western countries. This makes India, an ideal healthcare destination for highly specialised medical care and medical tourism. The need for qualified nurses and doctors in 2013 in India stands at 1 million and 500,000 for the latter respectively. The country needs at least 750,000 extra beds to meet the demand for inpatient treatment in 2013. Moreover, India also needs to strengthen basic infrastructure like airports, power, roads etc, to support these initiatives. Additionally, changing demographics, disease profiles and the shift from chronic 72
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to lifestyle diseases in the country has led to increased spending on healthcare delivery. Medical tourism contributes towards the changing face of traditional healthcare industry in India. As a result, India’s cost advantage and explosive growth of private hospitals, equipped with latest technology and skilled healthcare professionals has made it a preferred destination for medical tourism. The shift has set a perfect backdrop and initiated the need for a comprehensive insight on hospital industry. MEDICALL, India’s premier Medical Equipment Expo and the first real ‘supermarket’ for hospital equipment and supplies is set to invite participation from industry leaders at the Chennai Trade Centre from August 2-4, 2013. The comprehensive range of exhibits include hospital information system, solutions, surgical and examination furniture, rescue and emergency equipment, diagnostic/laboratory, operation theatre, dental/ophthalmology equipment, medical disposables and cleaning equipment. Having remarked its presence successfully for the second time in Ahmedabad in February 2013, the 11th edition,
B2B buyers and sellers meet will be organised during the expo wherein exhibitors can meet the delegation on a one-to-one basis by fixing a prior appointment. There is also an expo titled ‘Archimedes’ dedicated entirely for healthcare infrastructure. Since there are hospitals mushrooming across the country, there is a growing demand for construction material used specially in the construction of hospitals and the expertise required to ensure compliance with existing standards. The MEDICALL Innovation in Healthcare Awards will be presented to the most innovative manufacturers in the medical field. Hospitals will be invited to be a part of this awards function. The concurrent conferences with MEDICALL 2013 under the banner of ‘Everything they failed to teach you at medical college’ will help hospital owners to update their management skills. MEDICALL will commence its visitors and exhibitors promotion in countries like Africa, Sri Lanka, China, Vietnam, Bangladesh, Nepal, Europe, UAE through international exhibitions. Representatives from countries like Germany, China, Taiwan, South Korea, Pakistan, Malaysia and more are expected to participate. (pallavi.mukhopadhyay@network18publishing.com )
Book Review Marketing Health Services
and as, Richard K Authors: Thom ichael  Calhoun, M 8 Price : ` 6,32
Healthcare marketing has risen to a new level of prominence. Increased competition has driven healthcare providers to better understand the market in which they operate their customers and their motivations. Marketing is now a recognised as a legitimate function in most healthcare organisations. This book covers the new approach to healthcare marketing in this era of internet and social network that has far reaching implications and much greater impact on the providers and consumers of healthcare. This book explains how marketing strategy has to be aligned with strategic planning and business development operations for the pivotal role it can play beyond promotion. It introduces healthcare leaders to the concepts, they need to understand to plan and launch an effective marketing initiative. The book provides a comprehensive view of the marketing process, from evaluating market needs to developing a marketing campaign by evaluating marketing efforts. This second edition characterises, how the forces that are changing the healthcare and marketing industry, are chronicles in transformation of the healthcare marketing enterprise. It introduces readers to the nature of healthcare markets, the consumers who populate them, and the factors that influence demand for healthcare services. It provides guidance to the practical aspect of marketing process by using research in healthcare. The topics in this book include use of consumer engagement techniques, measurement of returns on investment of marketing dollars and use of social media to inform and educate consumers. The case-studies presented in this book provide real-world exposure to the field with updated glossary of the latest terms and sections illustrating techniques used to assess market and healthcare needs.
Publisher: HAP
Marketing Matters: A Guide for Healthcare Executives This book does an outstanding job of explaining all aspects of an effective marketing program. The authors clearly review the value of marketing, explain how that value can be measured and demonstrate how marketing can be used to enhance the performance of a healthcare organisation. This book provides any healthcare executive with a better understanding of marketing function in healthcare and greater appreciation of the contribution that marketing makes to healthcare organisations. Overall, this concise book helps readers to become a better marketer, not in the sense of developing marketing campaigns but using marketing as a tool to shape and control an organisation’s reputation. This book covers key areas on the marketing process, senior manager’s role in marketing, market positioning and strategy development, the promotional toolbox, the changing marketing paradigm while measuring the effectiveness of marketing initiatives. This book will serve as a good reference guide for healthcare marketers, administrators, planners and research scholars.
as, Richard K Authors: Thom Michael and Calhoun, 195 ` : Price Publisher: PHI Reviewer: Gp Capt (Dr) Sanjeev Sood, Hospital Administrator and NABH Assessor serving in Chandigarh. He is a prolific writer on healthcare matters. Email: doc_ssood@yahoo.com
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oducts Products
Looking for a specific product? Searching and sourcing products was never so easy. Just type MMC (space) product name and send it to 51818
eg MMC OT Lights and send it to 51818
NATIONAL Nurse-call system Electronic Nurse-Call System is a modern microprocessor based digital system. Its features have been designed to cater hospital practices prevailing in India. Hence, the basic audio-visual arrangement has been deliberately simplified through an easy to understand redyellow-green lamp mode with easily recognisable audio chimes. The system is modular, comprising a central display console at the nurse-station counter (optionally, also with ward graphic displays), a bed-unit module behind each patient’s bed and a handset that can be reached by the patient through a lengthy flexible cable. A door display unit can also be mounted at the room entrance with nurse presence registration. An emergency alert unit can be mounted within the toilet or also within the shower stall. Optional features include nurse help request, patient-nurse intercom, additional call signals, instrument alarm relay, IV-drip alert, code-blue alert, call transfer facility, multifunction handsets, corridor display modules, nurse call response monitoring and sms alert facility for selected calls to be forwarded directly to cell phones. CR Medisystems Pvt Ltd Mumbai, Maharashtra Tel: +91-022-23094416, 23004930 Fax: +91-022-23061903 Email: medisystems@vsnl.com Website: www.medisystems.in
Ventilator system This machine is compact-sized and has integrated medical grade air compressor. It is also equipped with microprocessor controlled with audio visual alarms ensuring safety. This machine features continuous flow of 40 l/ min3.5-7kg/ cm2, pressure with ion peak flow of 180l/min, low noise and vibration with power input: single
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phase 220v 50 Hz. It also comes with in-built battery module offering upto 2-hours of ventilator use and optional battery pack offering upto 4 hours of ventilator use. Medion healthcare Pvt ltd Mumbai Maharashtra Tel: +91-22-61566565 Fax: +91-22-61566556 Email: sales@medicon.co.in Website: www.medicon.co.in
Hydraullic fitness machine This machine features hydraulic cylinders that can automatically and continuously adjust itself to the strength, power, speed, output and the need of the person using it. Opposing muscle groups therefore are alternately exercised during both flexion and extension without injury, damage or soreness as the user is not tied down to a pre-set speed of movement and never meets more resistance than he/she can handle. To make fitness easier, eye-level read out gauges in a panel allows the individual to see precisely how much force he/she is exerting exactly where in the body and at what point of the exercise. This machine can also be used by people having back problems without any fear of having any complications and it’s one of the most comfortable sitting positions for workout. This machine is free standing and quiet, with no chains, pulleys, cams, cranks, water buckets, air hoses, cables or weights. It is also economical, durable and virtually maintenance-free. Resistance is variable by the twist of a control knob provided on the left side of the seat. Also a seat belt is provided for getting proper body hold on the machine. Fluid-Tech Fitness Mumbai, Maharashtra Tel: +91-22-28478855 Fax: +91-22-28478855 Email: sales@fluidtechfitness.com, fluidtechfitness@gmail.com Website: www.fluidtechfitness.com
Products
Urine fluorescence flow cytometer Fully-automated urine flow cytometers, UF-1000i and UF-500i employ high performance, laser-based Fluorescence Flow Cytometry (FCM) that gives reliable quantitative results. These systems improve laboratory turnaround time and offer worry-free urinalysis tool that you can totally rely on. FCM is a Sysmex core competence. It has been employed in X-class haematology analysers and its accuracy and reliability have been proven for many years. The analysers also offer value added clinical information of UTI, red cell morphology, and conductivity, and are able to accurately detect RBC, WBC, epithelial cells, casts, bacteria, crystals, yeasts and sperm in urine sample by using three different scatters. Forward scattered light-information on cell size, side scattered light-information on internal cell structure and side fluorescence light information on RNA / DNA contents. UF series offers excellent capabilities for the best differentiation and quantification of urine particles. It provides standardisation in urinalysis that complies with ISLH guidelines by analyzing uncentrifuged native urine sample. Sysmex India Pvt Ltd Mumbai, Maharashtra. Tel +91-22-2822-4040 Fax +91-22-2836-5068 Email: sysmex@sysmex.co.in Website: www.sysmex.co.in
for archiving the audio signal. Variable phasing, slow-motion mode and frequency pre-selection are adjustable with foot switch. Readings of voice frequency and sound pressure level is easy to read on a LCD display. Atmos MedizinTechnik GmbH & Co KG Bangalore, Karnataka Phone: +91-80-41172227 Website: www.atmosmed.com
Digital mobile radiography system RollX DR is a new variant of the cost effective mobile DR system. This unique model was launched at IRIA 2013, Indore where it received a very encouraging response. The system has been specially designed to meet the demand of a cost effective mobile digital radiography system. With its unique fully integrated image acquisition system, IntegraX, the specialist can set the imaging factors and also review the image acquired then and there. This machine feature 15 KW generator (MARS-15) with 17” touch console, Integra X - Integrated image acquisition system and 14”x17” Flat Panel Detector (Wired / Wireless). The system operates on just 15 Amps/ 230-volt standard wall socket full DICOM 3.0 connectivity.
Syringe infusion pump This machine is easy-to-use microprocessor controlled with a syringe status indicator. Wide range of syringe selections from 10 ml to 50 ml are available. Automatic identification of syringe size is loaded. Syringe calibration function allows any brand of syringe to be used to ensure high accuracy at effective cost. Convenient front-loading system allows easy access to clamp syringe plunger. It supports upto 3 levels of adjustable occlusion pressure along with a powerful battery that helps it run for more than 6 hours.. Medx Technologies Pvt ltd Surat, Gujarat Tel: 0261-2275949, 9920404079 Fax: 0261-776003 Email: jinesh@medxtechnologies.ca Website: www.medxtechnologies.ca
Stroboscopy Noiseless stroboscopy with strobo 21 LED technology without reduction. This machine can perform vocal-fold diagnostics with jitter-free white-light at freeze image. It features slow-motion mode and pilot light by LED technology. The machine also has an integrated audio output
Allengers Medical Systems Ltd Chandigarh Tel: +91-172-3012280/84 Fax: +91-172-2621913 Email: sales@allengers.net Website: www.allengers.com
Regius CR This product is a new-generation CR that consumes 90 per cent less power. Regius desktop CR emits no sound, while in stand-by mode and poses no obstacle to medical examinations even when located in the same room. The product consumes power of only 100VA which is less than 10 per cent of the X-ray improcessors. This machine is an environmentally conscious product that saves electricity and prevents global warming. Konica Minolta Healthcare India Pvt Ltd Mumbai, Maharashtra Tel: +91-22-61916912, +91-9969388214 Fax: +91-22-61916996 E-mail: bhushan@mi.konicaminolta.in Website: www.konicaminolta.in
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Products
Autoclaves and steriliser
Haematology analyser
The sterilisers are compact having elegant design, high performance, reliability and safety from operational angle for small and medium hospitals, clinics and laboratories. Water level check can be done. Low water alarm indicator with buzzer is present. Pressure door auto-lock device is present which makes sure the door cannot be opened if chamber pressure exceeds 0.2 kg/cm. The sterilisers have an auto error indication system installed.There are other special function selectors for PRION, BOWIE-DICK, and liquid sterilisation function for optimum sterilization result.
The machine is designed to enhance clinical values. The XN series plays an important role in evolution of haematological conditions and diseases, providing data in screening of anaemia and infections. The analyser, on identifying abnormal samples, flags relevant information and showcases the abnormalities in the scatter grams. This helps in early detection of bone marrow abnormalities and aids haematologists in their clinical investigations and further channelises the future course of treatment. The modular integrated transportation system comprises an automated haematology analyser along with an SP-10 slides operation unit, thus enumerating clinically relevant parameters and enhancing complete flexibility during comprehensive diagnosis. The XN series from XN1000 to XN9000 embraces the modular concept and scalable system laboratory with 50 or >500 CBC samples a day and allows the combination of multiple analysers, transport system, slides preparation system and other instruments to cater from small to large workloads.
Devine Medihealth Pvt Ltd New Delhi Tel: 1800-11-3383, 011-40523020-21 Fax: 011-26816330 E-mail: sales@devinemedihealth.com Website: www.devinemedihealth.com
OPD patient-call systems OPD Patient-Call Systems are the ideal solution for queue management in busy crowded OPDs. They are configured based upon the number of consulting rooms and waiting areas of the OPD. The system consists of a Main Display Unit for the waiting area; door display units and desk units for the consulting rooms. Main Display Units have high visibility LED audio-visual displays for the main waiting area and one or more slave displays for additional waiting areas. These displays can be wall or ceiling mounted with 40 ft of visibility. Desk units sit on the Doctor’s desk with provisions to enter calls. Door display units are mounted outside the consulting room door. Door units indicate the Doctor’s call status as ENTER or BUSY. Both door and desk display units have backlit LCD displays. The receptionist or cashier can also be connected to this system with additional desk units. The system scrolls all un-answered calls and can also remind for any unattended calls. A lower programmable display line can carry social or promotional messages for the hospital. Bilingual displays can also be given. The system once installed is user-friendly, cost- effective and needs minimal support.
Transasia Bio-Medicals Ltd Mumbai, Maharashtra Tel: 022- 4030 9000 Fax: 022-2857 3030 Email: transasia@transasia.co.in Website: www.transasia.co.in
CR Medisystems Pvt Ltd Mumbai, Maharashtra. Tel: 022-23094416, 23004930 Fax: 022-23061903 E-Mail: medisystems2@gmail.com Website: www.medisystems.in
Zepter International India Pvt Ltd Bengaluru, Karnataka Tel: 080-26792625 Fax: 080-26792624 Email: sales@zepter.co.in Website: www.bioptron.com
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Light therapy device The light therapy medical device BIOPTRON 2 is primarily designed to be used by health professionals. The length of each treatment session is easily preset to up to 95 minutes, dividable into minute steps and controlled by an integrated softstart/soft-stop electronic switch. Its angled shape makes it easy to position the device in different ways, so that the patient’s whole body can be treated. The filter diameter of the BIOPTRON 2 is approx. 15 cm. Different stands are also available (professional and Y stand) to assure the best fitting solution for every need.
Products
Bariatric patient mobiliser/hoist system
Unisex portable urinal
This machine is an automatic remote-control operated, patient lifting system, ensuring maximum patient safety and comfort. The electric operated automatic hoist system is mobile on lockable wheels and capable of lifting a bariatric patient with ease and shifting onto the bed or chair. Caretakers appreciate the ease of operation ability to work in tight places. It has a built-in emergency lowering device and overload warning system. It has a 300 kg safe working load capacity. Operation Theatre (OT) equipment like fully automatic remote-controlled multi-procedure C-arm compatible operation theatre tables (Indian and imported), operation theater lights, latest technology multicolour LED OT lights and shadowless halogen lights, OT & ICU pendants and specialised bariatric OT packages.
The Uriwell portable mini urinal is a toilet for every contingency. Answering nature’s call cannot be postponed. The Uriwell urinal is a flexible, reusable, cylindrical corrugated polypropylene container, which can be extended and collapsed to suit the needs of the user. A unisex adapter makes it suitable for both male and female users. It can be used in any posture, sitting, lying or standing. It comes in attractive colours. The adult model is 150 mm long and can extend upto 350 mm to hold 750 ml of fluid. The children model is 120 mm long and can extend upto 200 mm to hold 350 ml. It is easy to store and use. It is spill-proof and odour proof when closed. Useful for long car and train journeys for children and adults, in hospitals, emergency rooms and ambulances after abdominal, spine or hip surgery, and in wheelchair and bed-bound individuals as of December 2009 Uriwell became available on the National Health Service in the UK. Doorstep delivery of product is available.
Magnatek Enterprises Hyderabad, Andhra Pradesh Tel: +91-40-66668036/ 65501094 Fax: +91-40-66668037 Email: sales@magnatekenterprises.com Website: www.magnatekenterprises.com
ADL Neurotech Chennai, Tamil Nadu Tel: 044-24939640, 09444049390 Email: enquiry@adlneurotech.co.in Website: www.adlneurotech.co.in
Anti-gravity treadmill
Silicone transparent braided hose
The Alter G anti-gravity treadmill offers a revolutionary approach to rehabilitation. The ability to defy gravity and work towards regaining function like never before. Alter G’s unique differential air pressure technology provides accurate, safe and comfortable partial weight-bearing therapy, while promoting normal gait patterns. The treadmill expands the concept of “weight bearing as tolerated” by offering precise unweighting in one per cent increments to as low as 20 per cent of patient’s body weight. Alter G’s unique precision gives patient’s ability to set the precise point where, exercise becomes pain-free and provides clinicians a way to accurately measure patient progress. This machine is used and recommended by leading physical therapy clinics, hospitals, colleges and pro sports teams.
Polyester-reinforced silicone transparent braided hoses are made for food, pharma, chemical, medical, heavy engineering, thermal power stations and PSUs. These braided hoses are made of 100 per cent pure silicone rubber by using fully automatic state-of-the-art machines and technologies. The product already caters to all the major pharmaceutical companies in India and is also exported to overseas customers. Medical grade braided hoses are manufactured under stringent quality control and have the following distinguished features: made of medical grade silicone rubber, temperature-resistant from -80°C to 250°C (-110°F to 480°F), non-reactive to body tissue and fluid, unaffected by most water-soluble materials, sterilisable by steam, dry heat, ethylene oxide and gamma radiation and indefinite shelf life. It is available in sizes from 6 to 60 mm ID.
Fit and Spa Solutions Pvt Ltd Bengaluru, Karnataka Tel: +91-80-25723894, 9916904256 Email: info@fitandspasolutions.com Website: www.fitandspasolutions.com
Ami Polymer Pvt Ltd Mumbai, Maharashtra Tel: +91-22-28555107/631 Fax: +91-22-28555378 Email: amipolymer@vsnl.com Website: www.amipolymer.com
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Products
INTERNATIONAL Reclining wheelchair LY- EB 2 0 7 Bronco is using T-green on the appearance and has a streamlined design, that you can be so cool while riding the bronco and feel increased selfconfidence. Users can sit to reclining of step less adjustment and increased foot depending to achieve the effect of the hip decompression to reduce bedsores generated probability. It is also equipped with a 12V x 62AH battery with high capacity to improve product life. Front wheels are 9” and rear wheel 16” large-size, and the design of rear suspension significantly enhances the climbing obstacle capability and comfort. Comfort Mobility Corp Chia-Yi, Taiwan Tel: +886-5-2892093 Fax: +886-5-2890070 Email: info@comfort.com.tw Website: www.comfort-mobility.com
Electric hospital bed The bed ES-12DW ICU follows the new standard of IEC 60601-2-52 and it is specialised for ICU usage. The bed also has X-ray cassette for the backseat and a quick release for emergency CPR. There are two angle indicators for the back and trendelenburg with a central locking system. Drop-down side rail has an integrated weight scale system with a unique designed layout. This bed also holds certificates (ISO 13485, IEC 60601, IEC 60601-1-2, CE marck, FDA registration). Joson Care Enterprise Co Ltd Taoyuan, Taiwan Tel: +886-3-3290925 Fax: +886-3-3290921 Email: overseas_mb@joson-care.com.tw Website: www.hospitalbed-josoncare.com
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Standing wheelchair The Wing shape design is used to guard the patient. Users can make step less adjustment while sitting only. The process of lifting can promote blood circulation and improve heart and lung function, by exchange of the pressure points to reduce the chance of bedsores generated. The development and design of the electric standing wheelchair, allows users to be adjusted at various sitting. The angel is an ergonomic of standing wheelchair. Comfort Mobility Corp Chia-Yi, Taiwan Tel: +886-5-2892093 Fax: +886-5-2890070 Email: info@comfort.com.tw Website: www.comfort-mobility.com
Medical gas fitting Push-Fit is a revolutionary new push-fit fitting with speed, ease of use and wide applications. It is unique as it is suitable for a wide variety of tube types including copper, carbon steel, stainless steel, PE-X and PB in sizes 10, 15, 22 & 28 mm. It is manufactured with a corrosion-resistant body in dezincificationresistant natural brass finish with only two internal components: a high grade EPDM o-ring and a stainless steel grab ring. The unique grab ring ensures the fitting is firmly orientated but not fixed, allowing turning for system alignment. The fitting also maintains electrical continuity on metallic pipe systems. PushFit is demountable and reusable up to 20 times with the use of a professional release tool. It is incredibly versatile across a wide range of applications for the professional plumber, including hot and cold drinking water, heating and chilled water systems. IBP Conex Ltd United Kingdom Tel: +44 (0) 121 557 2831, Fax: +44 (0) 121 520 8778 Email: salesuk@ibpgroup.co.uk, technical@ibpgroup.com Website: www.ibpgroup.com, www.ibpconex.co.uk
Products
ing The consumer must priotitise products accord are to their needs and purchase only those which incur essential, as ordering many products may ses. additional expen
Robindeep Singh (Owner) Basant Mechanical Works
Public access defibrillators HeartSave public access defibrillators (PADs) are based on safe, tried and trusted technology. Model Automatic HeartSave AS adds another dimension to the PRIMEDIC range of AEDs. Rescue procedure is outlined by readily understandable spoken instructions in various languages in line with the new Guidelines 2010 and clear display symbols. Metrax GmbH Rottwell – Germany Tel: +49-741-257248 Email: taniya.mahajan@primedic.com Website: www.primedic.com
Dental suction units Dental-Evac handheld dental suction units are reusable and consist of two canisters with suction pump, filter, wide bore soft yankauer, saliva ejector, carry bag, etc. The suction pump weighs 143 grams, and has a volume per stroke of 30 ml with peak pump vacuum > 600 mmHg (>24” Hg). RMS Medical Products New York – USA Tel: +1-845-4692042 Email: info@rmsmedicalproducts.com Website: www.rmsmedicalproducts.com
ENT workstation The ATMOS S 61 Servant modular ENT diagnostic and therapy system is equipped with basic workstation for integration of essential functions, visualisation tower, ergonomic solution for instrument management, diagnostic devices module for e.g. RF surgery, smoke evacuation, system for LED microscope, instrument storage, image visualisation and diagnostic results. The machine also features, high power LED technology, contactless filling level control, electronically controlled endoscope management, ease of maintenance, powerful suction equipment with direct docking system, variable configuration, stable steel casing offers required sturdiness and perfect utilisation of space by the modular concept. ATMOS Medizin Technik Lenzkirch, Germany Tel: +49 7653 689-660 Fax: +49 7653 689-690 Email: atmos@atmosmed.de Website: www.atmosmed.com
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Products
Silicone products
Pulse oximeter for iOS devices
The product range includes: external breast prosthesis & enhancer, silicone mannequin at 70B/C/D & 100D, prosthetic liner for amputation stump, silicone gel & air seat cushion, mattress, pressure relief pad for operating table using, foot insoles, rehab supports and other silicone gel commodities. External breast prosthesis and mannequin are designed and shaped according to the body database to present a human being proportion. Silicone gel is soft to match body curve and is naturally shown in body movements.
The device is designed so that you can check your blood oxygen saturation levels at home or on-the-go to make sure that your blood contains the right amount of oxygen for normal bodily function. Your heart can be pumping right, but if the oxygen levels in your blood are not normal, then there is cause for concern. Masimo just launched the iSpO2™, a pulse oximeter cable and sensor for use with the iPhone, iPad or iPod Touch through the 30-pin connector. With the iSpO2 hooked up to your Apple device, you can now check your blood oxygenation (SpO2), pulse rate and perfusion index measurements easily. Why is this important and where can this be used? Blood oxygenation levels may fall below optimum when someone remains at a high altitude for extended periods of time (eg hikers, climbers, pilots, passengers etc). Low oxygen saturation levels, or hypoxia, can lead to life-threatening situations in many cases. In other cases, hypoxia can also be due to anaemia or over exertion at the gym. The iSpO2™ is designed to allow easy identification of declining blood oxygenation levels, and it seeks to provide consumers with a useful tool that can save lives.
Jing Yun Plastic Co, Ltd Taipei - Taiwan Tel: +886-2-6816766 Email: service@jyplastics.com Website: www.jyplastics.com
Electric plaque cleaner It is designed for superior dental care. The movement of bristles at frequent helps more effectively to remove plaque, stains and prevents gum disease. It helps to clean every part of the mouth. The flexible brush head equalizes pressure. Impulse dental brush head is adapted to the natural shape of the teeth. Vibrating motion of electric tooth brush is beneficial for the gums as it gives gentle massage to stimulate healthy blood circulation.
Masimo Corporation Irvine, CA 92618 Tel: (949) 297-7000 Fax: (949) 297-7001 Website: www.masimo.com
Cardio renal panels Trisa (Impulse) Switzerland Tel: +91-11-43211234 Website: www.healthkart.com
Mass spectrometric detector The MSQ mass spectrometric detector is used for a wide range of applications. It is compact and involves M path triple orthogonal source technology that virtually eliminates neutral noise and background. It has Loc probes that provide simple and rapid mode changes. All features are fully supported in its MS software. Full scan and selected ion monitoring (SIM) allows rapid screen and target compound analysis. Also available are the ion focusing region with low mass option, precision-engineered quadruple analyser, ion bright detector system, advanced auto tuning wizard includes full system optimisation and mass scale calibration. Dionex Corporation California - USA Tel: +1-408-7309403 Email: webmaster@dionex.com Website: www.dionex.com
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Triage cardio renal panel is the point-of-care test that combines BNP and NGAL to aid in the real-time assessment of cardiac and renal status. The assay is run on the Alere Triage MeterPro using anticoagulated whole blood or plasma specimens and provides results in 15 minutes. A number of recent studies123 have shown that the early diagnosis of acute kidney injury might significantly improve patient outcomes by enabling more timely treatment decisions that prevent further renal damage. Alere Inc Massachusetts - USA Tel: +1-781-6473900 Email: alere@alere.com Website: www.alere.com The information published in this section is as per the details furnished by the respective manufacturer/distributor. In any case, it does not represent the views of
Rx
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List of Products
Looking For A Specific Product? Searching and sourcing products were never so easy. Just type MMC (space) Product Name and send it to 51818
eg, MMC OT Lights and send it to 51818 Product
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24 hours ambulatory blood pressure monitoring................... 53 247 diagnostic station .....................................................................53 5th annual India healthcare excellence awards 2013 ..................42 Adult pediatric transport ventilator .......................................... 17 Air bed & BP monitor nutec............................................................6 Analyser...............................................................................................3 Anesthesia ventilator .........................................................................8 Anesthesia workstation ...................................................................49 Anti-gravity treadmill......................................................................79 Autoclaves and steriliser ..................................................................76 Bact- viral filter with HME (adult) ...........................................BC Bact- viral filter(adult) disposable bacterial/ viral filter ............BC Bariatric OT table .......................................................................14,15 Bariatric patient mobiliser/hoist system .......................................79 Bed head panel.................................................................................81 Bed side locker .................................................................................57 Billi flux led phototherapy unit .....................................................37 Biphasic defibrillator .......................................................................17 Blood pressure cuffs(clinical grade BP cuffs) ..............................53 Blood pressure recorder ..................................................................17 Breathing circuit system (adult) disposable breathing circuit ..BC Bubble humid tier ...........................................................................63 Cardiac OT table...................................................................... 14,15 Cardio renal panel ...........................................................................82 Cardio thoracic product .................................................................49 C-arm OT table ..........................................................................14,15 Catheter holder ................................................................................81 Catheter mount / guided airway ...................................................63 CFL double surface phototherapy .................................................37 Clinical chemical analyser...............................................................13 Consulting couch & table ...............................................................57 CPAP mask .......................................................................................63 CPAP tube ........................................................................................63 Critical care ventilator .......................................................................8 Customised modular OT solution ................................................33 Defibrillator .................................................................................. 49 Delivery beds ...............................................................................14,15 Dental suction unit..........................................................................81 Desiccant compressed air dryer .....................................................39 Desktop pulse oximeter ..................................................................17 Digital mobile radiography system ...............................................75 Disinfectant products ......................................................................51 Disposable bacterial/ viral filter with heat and moisture exchanger .........................................................................................BC Dual syringe infusion pump ..........................................................17 Education institute....................................................................... 29 Electric hospital bed ........................................................................80 Electric Plaque Cleaner ...................................................................82 Electric ventilator ...............................................................................8 ENT treatment unit.........................................................................35 ENT workstation .............................................................................81 Epoxy flooring............................................................................... BIC Examination chair ......................................................................14,15 Excellent bed ....................................................................................57 Fetal monitor ................................................................................ 17 Fogging machine..............................................................................83 Fumigation .......................................................................................83
Product
Pg No Product
Gynec examination coach ........................................................... 47 Gynecology treatment unit.............................................................35 Haematology analyser ................................................................. 76 Halogen lights .............................................................................14,15 Hi-tech caster wheels & trolley wheels for furniture ..................83 HMEF filter ......................................................................................63 Home health care product .............................................................49 Hospital beds including pediatric bed ..........................................81 Hospital consultancy .......................................................................19 Hospital equipment & furniture................................................. BIC Hospital furniture ..................................................................47,83,84 Humidification chamber ................................................................63 HVAC system ................................................................................ BIC Hydraullic fitness machine .............................................................74 I.V pole........................................................................................... 81 Ice bag ...............................................................................................63 ICU bed ............................................................................................47 ICU pendant ...............................................................................14,15 Imported pendant ......................................................................14,15 Infusion pump stand.......................................................................81 Injection moulding machine........................................................FIC Intensive care ventilator ..................................................................17 It & networking system................................................................ BIC LED light ................................................................................................. 14,15 LED phototherapy stand ................................................................37 LED phototherapy stand with trolley ...........................................37 Light therapy device ........................................................................76 LV critical electrical system ......................................................... BIC Manufacturers of hospital furniture ......................................... 61 Mass spectrometric detector ..........................................................82 Material handling trolley ................................................................83 Medical breathing air dryer............................................................39 Medical equipment..........................................................................83 Medical gas fitting ...........................................................................80 Medical gas system ....................................................................... BIC Medicall 2013 ...................................................................................24 Mobile light .................................................................................14,15 Mobile OT light ..........................................................................14,15 Modular operation theatre .......................................................... BIC Monitor stand ..................................................................................81 Multi parameter defibrillator .........................................................17 Neo natal intensive care radiant warmer .................................. 37 Neonatal & pediatric equipment .....................................................4 Neonatal transport ventilator.........................................................17 Neurology OT table....................................................................14,15 Nurse call system .......................................................................... BIC Nurse-call system .............................................................................74 OPD Patient-Call System ............................................................ 76 Operation table (height adjustable) ..............................................47 Operation theatre equipment ...................................................14,15 OR halogen light.........................................................................14,15 OR LEDlight................................................................................14,15 OR light........................................................................................14,15 OR pendant .................................................................................14,15 OR table .......................................................................................14,15 OT and ICU pendant......................................................................81 OT equipment..................................................................................57
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OT light ( imported ).................................................................14,15 OT product.......................................................................................49 OT solution ......................................................................................21 OT table & medical equipment .....................................................84 OT table ( imported ) ................................................................14,15 Oxygen generator.............................................................................39 Oxygen regulator .............................................................................63 Patient information & entertainment system .......................... 81 Pedal suction ....................................................................................31 Pediatric OT table.......................................................................14,15 Pendant ........................................................................................14,15 Platinum cured silicone transparent tubing.................................83 Power column ..................................................................................81 Professional pharmacy storage solution .......................................59 Proton intensive care ventilator .......................................................8 Public access defibrillator ...............................................................81 Pulse oximeter for iOS device ........................................................82 Radiology & cardiology product ................................................ 49 Rapid endotoxin detection system ................................................83 Reclining wheelchair .......................................................................80 Recovery bed ....................................................................................47 Regius CR .........................................................................................75 Respiratory products .......................................................................49 Respiratory tract suction devices ...................................................35 Rubber hot water bag/ digital thermometer ...............................63 Silicon mask & oxygen mask ...................................................... 63 Silicone product ...............................................................................82 Silicone transparent braided hose .................................................79 Silicone transparent braided hoses ................................................83 Silicone transparent tubing ............................................................83 Spot light......................................................................................14,15 Standing wheelchair ........................................................................80 Stool...................................................................................................57 Stroboscopy ......................................................................................75 Suction jar holder ............................................................................81 Suction machine ..............................................................................84 Surgical light.....................................................................................84 Surgical suction device....................................................................35 Syringe infusion pump ...................................................................75 Tango m2 stress BP ...................................................................... 53 Thoracic drainage system ...............................................................35 Tracheotomy mass ...........................................................................63 Treatment chair ...........................................................................11,12 ULV fogging machine .................................................................. 83 Unisex portable urinal ....................................................................79 Urine fluorescence flow cytometer................................................75 Ventilator system .......................................................................... 74 Ventilators-ICU transport anesthesia............................................49 Ventun mask 61 ...............................................................................63 Ward care bed ............................................................................... 57 Ward care bed -plain.......................................................................57 Ward care equipment......................................................................57 Wired nurse call system ..................................................................81 Wound drainage system..................................................................35 Yancuer section set ....................................................................... 63
BC-Back cover, BIC- Back inside cover, FIC- Front inside cover
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List of Advertisers To know more about the advertisers in this magazine, refer to our ‘List of advertisers’ or write to us at mmedit@network18publishing.com or call us at +91-22-3003 4640 or fax us at +91-22-3003 4499 and we will send your enquiries to the advertisers directly to help you source better. Advertiser’s Name & Contact Details A. B. Industries T: +91-265-2310289 E: max@max-ventilator.com W: www.max-ventilator.com Ami Polymer Pvt Ltd T: +91-22-28555107 E: amipolymer@vsnl.com W: www.amipolymer.com AMS Solutions Inc. T: +91-044-22450321 E: sales@amssolutionsinc.com
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Advertiser’s Name & Contact Details
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Advertiser’s Name & Contact Details
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Ignisol Mediplas Corporation T: +91-23432238 E: ignisolmed@gmail.com W: www.ignisol.com
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Orange Medical T: +91 866 666 5667 E: info@orangemedical.in W: www.orangemedical.in
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International Trading Co T: +91-33-22379476 E: info@lifeplusmedical.com W: www.lifeplusmedical.com
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Quali Surge Surgical Pvt Ltd T: +91-020 - 24270287 E: qualisales@hotmail.com W: www.bharatsurgical.com
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Janak Healthcare Pvt Ltd 11, 12 T: +91-22-49153000 E: pankaj@janakhealthcare.com W: www.janakhealthcare.com
Radiant Enterprise T: +91-79-26449120 E: radiant_enterp@rediffmail.com W: www.fogstarindia.com
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Samsung India Electronics Ltd T: +91-1800-266-8282 E: hme.marketing@samsung.com W: www.samsung.com
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Anand Medicaids Pvt Ltd T: +91-11-25225225 E: sales@anandind.com W: www.anandind.com
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Jyoti Architectural Products Pvt.Ltd T: +91-022-24621004 E: info@jyotiarch.in W: www.jyotiarch.in
Atmos Medizintechnik Gmbh & Co. Kg T: +91-9945283248 E: vikram.sinha@atmosmed.com W: www.atmosmed.com
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Lakshmi Life Sciences Limited BC T: +91-422 2360163 E: medicalmarketing@lakshmilife.com W: www.lakshmilife.com
Schiller Healthcare India Pvt Ltd T: +91-22-66920520 E: rita@schillerindia.com W: www.schillerindia.com
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Charles River T: +91-80 - 25588175 E: india.customercare@crl.com W: www.charlsriverindia.com
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Lonza India Pvt Ltd T: +91-22-43424000 E: prajakta.sonavane@lonza.com W: www.lonza.com
Shuter Enterprises India Pvt. Ltd. T: +91-44-3240-7116 E: sales@shuter.in
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Creative Healthtech Pvt Ltd 33 T: +91-0120-4547383 E: creative.medical@rediffmail.com W: www.creativemedical.co.in
Magna Tek Enterprises 14, 15 T: +91-40-6666 8036 E: sales@magnatekenterprises.com, W: www.magnatekenterprises.com
Stephan Design and Engineering Ltd T: +91-40-2370 6355 E: sales@stephanmed.com W: www.stephanmed.com
Frost & Sullivan E: indiahcawards@frost.com W: www.frost.com/hcawards2013
Medexpert Business Consultants Pvt Ltd T: +91-9840326020 E: Panchal@medicall.in W: www.medicall.in
Tata Institute of Social Sciences T: +91-22-25525510/5000 E: epgdha@tiss.edu W: http://www.tiss.edu
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Geeta Steel Furniture T: +91-79-65413092 E: info@gitasteelfurniture,com W: wwwgitasteelfurniture.com GMP Technical Solutions Pvt Ltd T: +91-02266083700 E: enquiry@gmptech.net W: www.gmptech.net
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BIC
Meditek Engineers T: +91-09822092808 E: info@meditekengineers.com W: www.meditekengineers.com
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Transasia Bio-Medicals Pvt Ltd T: +91-22-40309000 E: transasia@transasia.co.in W: www.transasia.co.in
Meelan Hospital Steel Furniture T: +91-20-24262562 E: sales@meelanhospicare.com W: www.meelanhospicare.com
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Trident Pneumatic Pvt Ltd T: +91-422-2400492 E: sales@tridentpneumatics.com W: www.tridentpneumatics.com
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Vital Bio Systems Pvt Ltd T: +91-44-26549335/36 E: sales@vitalbiosystems.com W: www.vitalbiosystems.com
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Hi-Tek Ots Pvt Ltd T: +91-011-26801059 E: hitekmedical@yahoo.co.in W: www.hitekmedical.co.in
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MRK Healthcare Pvt Ltd T: +91-22-23748371 E: info@mrkhealthcare.com W: www.mrkhealthcare.com
Hospaccx India System T: +91-22-41232233 E: info@hospaccx.in W: www.hospaccx.in
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Neocraft Medical Pvt Ltd T: +91 80 4210 4183 E: info@neokraftmedical.com W: www.neokraftmedical.com
BC-Back cover, BIC- Back inside cover, FIC- Front inside cover
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Woojin Plaimm Co Ltd FIC T: +91-9810043265 E: in@wjpin.com; greenyc@wjpim.com W: www.plaimm.com NA-Not available
Our consistent advertisers
Vol 9 No 8
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