RNI No. DELENG/2010/33833
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Volume II || Issue IV || Nov-Dev, 2011
The Gateway to Health & Medical World
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Healthcare IT
Healthcare architecture & Consultancy
Editor speak
Vol.: II Volume-2 Issue 2
Issue: IV July-Aug 2011
Editor Dr. M.a Kamal
Green Hospital & Design
Chief Editorial Adviser Dr. Pradeep Bhardwaj National Head Afzal Kamal Sr. Manager I.A Khurshid Cheif Correspondent SA Rizvi l Dr HN Sharma
W
ithout question, building construction has a significant impact on the environment, not only in terms of how it alters the landscape, but also in terms of material and energy consumption and waste generation. Consider these numbers: over 65 per cent of the electricity is consumed by building construction and occupancy. Globally, more than 40 per cent of the earth’s raw materials are consumed in the name of building construction and occupancy. Statistics like these are responsible for the world’s burgeoning interest in sustainable design and construction. Individuals and corporations are making a concerted effort to learn how to create buildings utilising sustainable technology, renewable resources and systems designed to reduce energy consumption and carbon emissions. There’s no better place to implement these principles than in the design and construction of hospitals and other healthcare facilities. Hospitals generate vast amounts of waste material in the form of food, paper and plastics, the majority of which is not recycled. As a building type, hospitals are relatively heavy users of materials, energy and water. Not only does this heavy usage drive up the cost of construction of most hospitals, it also results in increased operational expenses over the lifetime of the building, especially as the cost of natural resources continues to skyrocket. Of course, research has also shown that environment aids the healing process. Healthier buildings lead to healthier patients and staff. A growing number of hospitals are becoming more interested in a sustainable approach to healthcare design. There seems to be a lot of uncertainty, however, about implementing it. Concerns typically revolve around initial costs, schedule and return on investment. With an educated and organised design approach, implementing sustainable methods is not only becoming less costly, but also more the rule than the exception. Dr. M. A. Kamal (Editor-in-chief) Have an insightful reading. Your suggestions are most welcome! e-Mail: editor@medgatetoday.com
Design and Layout Vikas Sales and Marketing Amjad Kamal Rahul Ranjan Neetu Sinha S.Y Ahmed Khan Subscribtion & Cirrculation Pallavi Gupta All right Reserved by all everts are made to insure that the information published is correct, Medgate today holds no responsibility any unlikely errors that might occur.
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Contents
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16
News Update GE Healthcare set to...
06
Nova Medical Centers...
06
Real-Time Physiological... 08 SARA Felicitation...
IT & Digital Learning for Healthcare Industry
Cover Story
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10
Overwhelming Response... 12
19 46
INTEGRATING MEDICAL EQUIPMENT PLANNING INTO THE CONSTRUCTION PROCESS
26
20 Under One Roof
Green Hospital Overview
36
The Menace of Cut Practice 6
The future of Consultancy
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HOW TO FEED YOUR NEW BORN WHEN BREAST MILK IS NOT AVAILABLE
50 IMPORTANCE OF DRINKING MILK? Nov - Dec 2011
NEWS UPDATE
GE Healthcare set to revolutionize imaging of live cells with launch of super-resolution imaging system l Applied Precision’s OMX Blaze is the world’s first system capable of acquiring
moving images of live cells at super-resolution in all three dimensions•
l New technology will accelerate scientists’ understanding of disease mechanisms at
the molecular level – Applied Precision Inc., a GE Healthcare company, today announced the launch of DeltaVision OMX Blaze™, a research microscopy system designed to reach the next level in the evolution of super-resolution imaging by employing a proprietary, ultrafast, illumination module and the latest advanced high-speed camera technologies. The new DeltaVision OMX Blaze system’s speed of image acquisition enables researchers to follow tagged proteins within the same living cell, over time, in three-dimensional space, at near molecular resolution. This makes it possible to start answering new kinds of research questions about how certain structures in cells behave, what they interact with, and how long the events last. Paul Goodwin, Director of Advanced Applications, API, said, “It’s a pretty extraordinary feeling, to see moving images of live cells at a greater level of detail than anyone has witnessed before. The implications of this advance in imaging technology are hugely exciting for researchers. With the OMX Blaze we can start to answer questions that we never could before.” Dr Amr Abid, General Manager of Cell Technologies, GE Healthcare Life Sciences, said, “We are only at the beginning of what this technology can do. The ability to follow cellular interactions, over time at the molecular level will open up new frontiers in so many areas of life science research. This is a hugely important step forward for cellular imaging.” Researchers at the UC Davis-based Center for Biophotonics Science and Technology (CBST) collaborated early as beta testers for the technology. The system is also being installed at a number of early adopter sites around the world which are expected to go live in the next two months. Dr Frank Chuang, Associate Research Director, CBST, said, “We’re at the point where we need to understand mechanisms of health and disease at the molecular level. The OMX Blaze has tremendous potential as a research tool, and we are very excited to apply this in our laboratory models to observe the response of cancer cells to chemotherapy, the cell-to-cell transmission of HIV and other viruses, and the dynamics of engineered nanoparticles.” In the past ten years, a number of fluorescent microscopy methods have been developed which use computational or optical techniques to exceed the previously assumed limits of optical microscopy. Applied Precision’s DeltaVision OMX super-resolution system uses a technique called 3D-SIM (Structured Illumination Microscopy) which approximately doubles the resolution in all three dimensions, giving an eight times improvement in volume resolution compared to conventional microscopy. For more information about the DeltaVision OMX and to view videos and other images, please click here DeltaVision OMX Blaze™ is for Research Only, it is not a registered Medical Device. About video footage of live cell imaging of microtubulesThe video footage shows the dynamic movement of a protein called EB3 which is found on the ends of microtubules. Microtubules are part of the skeleton-like network which maintains cell structure, provides transport links around the cell, and plays a key role in dividing the chromosomes during cell division. The cell type imaged is HCT-116, a human cell which was originally derived from a colorectal tumor but is now widely used as a model for normal cell function. By treating these cells with drugs that disrupt microtubule behaviour, researchers can potentially determine effective methods for disrupting a cancer cell’s ability to replicate, and use this information to inform the design of new potential cancer treatments. The cell sample used to generate the footage was supplied by Professor Linda Wordeman, professor of physiology and biophysics, University of Washington, Seattle, USA. n
8
Nova Medical Centers strengthens Management Team Nova Medical Centers, India’s leading Ambulatory Surgery Group, today announced the induction of six distinguished management professionals to lead the company into its next phase of growth. Dr. Rajen Ghadiok is joining Nova as Executive Director, Medical Strategy, while Dr. Sameer Khan will be the new COO. Sunil Kapur is joining Nova as Director, Business Development, Mr. Naresh Rao will take charge as the CFO and Malvika Varma as Vice President, Nova. In a related development, Dr. Gayatri Ghadiok is joining Nova Pulse, the IVF business venture of Nova. Speaking on the new appointments at Nova, Mr. Suresh Soni, Chairman and CEO, Nova Medical Centers said, “Nova has extremely aggressive expansion plans both nationally and globally. The addition of this very experienced and extremely talented team reaffirms our commitment to the growth mandate. Nova has, in a short span of time, gained acceptance across the healthcare industry amongst doctors, patients and insurance companies. The new team will now help Nova scale greater heights and enhance its stature.” Dr. Rajen Ghadiok, speaking on behalf of the new team, commented “All of us are tremendously excited to be joining Nova. Nova has demonstrated that innovative delivery of healthcare is the best route to accelerated growth. And we are looking forward to contribute meaningfully to this growth.” Nova has, in a short span of time, gained acceptance across the healthcare industry amongst doctors, patients and insurance companies. With the addition of the Hyderabad Center, Nova now has six fully functional centers, with four additional centers set to be operational by March 2012. And by March 2013, the Nova Group is gearing up to have 25 centers across India and the Middle East. n Nov - Dec 2011
NEWS UPDATE
Real-Time Physiological Patient Data Provider Isansys Lifecare Opens Indian Company New Venture Offers India’s Fast-Growing Healthcare Market Access To Isansys’ Innovative Real-Time Patient Information Solutions
I
sansys Lifecare Limited, the provider of complete real-time physiological patient data services and systems, today announces the opening of Isansys Lifecare Systems Pvt Ltd., a new venture that offers access to Isansys’ realtime vital signs data solutions to the fastgrowing Indian healthcare market. The Indian healthcare market is currently estimated at US$56 billion and is expected to reach US$75 billion by 2012 and US$150 billion by 2017. Key trends including rising income levels and a growing elderly population are driving this sector growth, including a burgeoning demand by healthcare providers for innovative, market-ready solutions that can enable remote patient monitoring and telehealth services. The scale of the market opportunity in India – with over 15,000 hospitals, 0.7 million doctors and 1.1 million hospital
beds1 – means that the establishment of an India operation to serve the region’s healthcare providers has been a key priority for Isansys. Isansys’ Director of Business Development, Rebecca Weir added: “India, as the world’s largest democracy, has a very clear agenda to improve healthcare provision for all its citizens. We are now in active discussions with the major hospital
operators that serve the growing middle classes – already numbering more than 300 million – and proving the strong business case our system creates for hospitals and their patients to harness a wealth of new opportunities for improved clinical outcomes, reduced overall costs and increased revenues. We are also working
with companies and organisations developing new healthcare delivery models for the 850 million people who live in rural India. Our scalable and low-cost technology and service models offer clear benefits that make them uniquely suitable for this vast market.” Isansys India’s Managing Director, Bala Kumar: “I am delighted to be able to be involved in this exciting new venture. Isansys’ introduction of its technology and services to India is very timely. The robust and flexible Lifecare Platform, and the strength of the Isansys business model, allow a range of services to be rapidly configured to meet the needs of the many and varied healthcare delivery organisations in our country. I am looking forward to working with my colleagues in India and the UK to make this company the great success that we all believe it will be.” n
Mr.Ravinder Gupta ,Chairmain (AISDA) hosted a gala party on occasion of Diwali celebration
P
arty were given to AISDA members on occasion Diwali.. On . 25th Oct 2011,Mr.Ravinder Gupta hosted a Lunch party at a restaurant with 30 members attending and the who’s who of the healthcare industry was part of the guest list. After lunch,party was concluded with vote of thanks by Mr.Praveen Mata ,(President AISDA),Mr.Vinay Pangasa (Secretary ,AISDA) and Ashok Varma Trasure & Guest of honour Mr.Ashok Sarin, Rajesh Garg and Arun Sharma. n
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Nov - Dec 2011
NEWS UPDATE
SARA Felicitation Ceremony on his 5th Anniversary
Sara given awards to his channel partners and employees on this occasion for his outstanding performances. Sara announce opening of Sara Healthcare offices at Hongkong & USA. Also Launched unique feature nebulizer.
S
ara Healthcare P Ltd is a group of companies involved in manufacturing and marketing of healthcare products for last 40 years. Sara Healthcare P Ltd established in 2006 becomes fastest growing company in surgical, medical & diagnostic products. Sara Healthcare P Ltd offers various surgical, medical and diagnostic products that are used in several clinics, hospitals and medical institutions for improving the quality of life. Sara Healthcare P Ltd has regional offices at Mumbai, Bagnlore and Patna Sara Healthcare P Ltd has wide, strong & reliable network of distributors all over India. Our products are widely accepted in top Corporate and Govt institutions in India. n
Director of Sara Healthcare P Ltd .Mr Kanodia is, not only the Founder and Director of Sara Healthcare but beyond He is known and established force in the field of Social Activities, Member of many Religious bodies ,Consultant and on The Board of Director of 6 , in the field of Communication ,Consumer Healthcare Products and Beauty Products. - Mr Rajesh Kanodia Director, Sara Healthcare President of All India Surgical Dealer Association and eminent businessman rendering his services to the healthcare industry from last 25 years. He is associated with many other social and business 0rganization. - Mr Praveen Mata Prisident, AISDA 12
Chief Guest Dr. Z.S MEHARWAL, Director and Coordinator, Department of Cardiovascular Surgery at Fortis Escorts Heart Institute, is one of the most renowned cardiac surgeons in India with over 7000 surgeries to his credit. Part of the founding team of Doctors at Fortis Escorts Heart Institute, Dr. MEHARWAL has been one of the core team of Doctors responsible for the global recognition earned by Fortis Escorts Heart Institute as a centre of excellence for clinical cardiac sciences. Every month, he performs an average of 6070 open cardiac procedures including coronary artery by pass grafting, value, combined valve and CABG, and aortic surgery.
- Dr. Z. S. Meharwal Director, Fortis Escorts Heart Institute ( Cardiothoracic Surgery)
Director of Sara Healthcare and partner of India Pharmaceuticals, well known name in the field of Disinfectant and Pharmaceuticals business. Their manufacturing units in Uttranchal & Patna. Mr Govind Kanodia is a well known name in the region in the field of Social activities and he is chairman of law & order committee of Chamber of Commerce, Executive Member of Industries Association. - MR GOVIND Kanodia Director, Sara Healthcare
Mr. Suneel Mehra at present working at a senior position in a Fortune 500 HealthCare Company. Mr. Mehra has rich experience is in the field of Market Research, Competition Intelligence, Operations and Medical Education. He has got the Expertise of more than 2 Decades and Handled various responsibilities and he is behind many Successful brands in the Specialty products like Metabolic Disorders, Cancer and various diagnostic & medical devices etc.
- Mr. Suneel Mehra Nov - Dec 2011
NEWS UPDATE
OVERWHELMING RESPONSE TO CII’S FLAGSHIP EVENT ON HEALTHCARE SECTOR
‘‘H
ospital Tech’ and Health & Hospital Conclave 2011’, Confederation of Indian Industry’s (CII’s) first ever flagship Exhibition and Conclave on medical equipments, products and healthcare infrastructure was inaugurated by Shri Jaynarayan Vyas, Hon’ble Minister for Health & Family Welfare, Govt of Gujarat in the presence of Shri P K Taneja, IAS, Commissioner of Health, Medical Services & Medical Education & Ex-Officio Principal Secretary & Commissioner, Health & Family Welfare Department, Government of Gujarat; Dr. Vivek Desai, Chairman, CII WR Healthcare Sub-Committee & Managing Director, Hosmac India; Shri Piruz Khambatta, Past Chairman, CII Gujarat State Council & CMD, Rasna. The event is organized in association with Health & Family Welfare Department, Government of Gujarat. Addressing the inaugural session, Shri Vyas said, “Growing number of population and huge number of middle class having a good purchase capacity offer enormous potential for healthcare industry. More importantly, India is spending about 5.5% of GDP on healthcare and this will be increased in days to come, which also augur well for the industry. The size of the industry is expected to touch the mark of $ 75-80 billion in next five years. But affordability still remains the issue.” Hon’ble Minister also said that, the cities other than metros are far better markets for the industry as the capital & manpower cost is much lower in these areas. On the other hand, demand is higher and number of centers offering advance services are very less. Lower cost makes the services cost competitive 14
and in turn, also makes it affordable. He also announced that Gujarat Government is going to put in place 20 ICU on wheels in near future to make advanced healthcare services accessible in remote areas of the state.
“The Gujarat Government is committed to bring in quality improvement in Public Sector Healthcare Institutes. Apart from that, the State Government is considering a project on telemedicine in near future for providing healthcare services in rural areas. To make the services affordable and accessible in all areas, technology is a must and this exhibition and conclave will play a crucial role in application of the technology,” said Shri Taneja, CII’s Hospital Tech 2011, the first of its kind exhibition in Gujarat on the Medical Equipment and Hospital Infrastructure Sector has received an encouraging response with over 80 companies from
India & overseas displaying their cutting edge technologies for this sector. Some of the leading companies like Siemens, Philips Healthcare, Johnson & Johnson Ltd, B Braun, Maestros, Ashok Leyland, Godrej Interio etc…participated at this mega event. The new concept of ‘Hospital on Wheels’ designed & displayed by Ashok Leyland was the key attraction of Hospital Tech 2011. The captains of the Healthcare Sector visited the Exhibition to learn about new & emerging technologies as well as interact with the Healthcare fraternity. After receiving and overwhelming response, CII has announced the 2nd edition of Hospital Tech 2012 along with Health & Hospital Conclave - on 27 & 28 October, 2012 at Gujarat University Exhibition Hall, Ahmedabad, Gujarat. n
Dr. Desai said, “Healthcare sector is one of the fastest growing sector and also a government priority sector. It is also hot favourite among investors including private equity funds and has potential for employment generation in large numbers. But the fact remains that the demand supply mismatch is very huge. So this conclave will discuss these issues and facilitate development of the sector to the best extent possible.”
Dr. Vivek Desai Director, Hosmac
Nov- -June Dec 2011 May
HEALTHCARE
IT
Exleaz launches MediEaz – cloud solutions for healthcare industry l First cloud-based Hospital Management System in India l Helps slash carbon emissions with blue-sky thinking l Saves businesses up to 95% of carbon emitted by on-premise server Exleaz Consulting Ltd, a growing customer relationship management (CRM) applications specialist launches web-based Hospital Management System MediEaz at Hyderabad. It is the first cloud-based HMS in India and helps businesses save up to 95% of carbon emitted by on-premise servers. The solution was launched in the presence of British Deputy High Commissioner to Southern India - Mr. Mike Nithavrianakis and officials from Govt. of Andhra
Pradesh, Indian Medical Association (IMA) and healthcare professionals in Hyderabad. Exleaz designed the innovative web-based HMS that enables healthcare professionals to look at a complete patient record from any location. MediEaz software has
been designed following extensive research into the various aspects of hospital functionality. It is the first Cloud-based, Software as a Service (SaaS); to support all the major features required by a hospital, and its modular architecture allows
a high level of scalability and flexibility. Mr. Sambamurthy Margam, Managing Director – Exleaz Consulting Ltd, said “The growing Indian healthcare industry needs innovative solutions to address numerous challenges and needs. We developed one such solution, MediEaz, a software package, and it makes the delivery of healthcare both effective and efficient and to address the industry needs – by improving safety and staff management. It also helps keeping costs under control by eliminating duplicate tests and other redundancies, streamlining the billing process, and maximizing bed utilization. It is an evolutionary product for healthcare industry in India.” n
MediEaz – The first cloud-based Hospital Management System l Software as a Service and Cloud solutions for Healthcare Industry MediEaz is the first Cloudbased, Software as a Service (SaaS), hospital management system in India to support all the major features required by a hospital, and its modular architecture allows a high level of scalability and flexibility. MediEaz has a modular approach to cater to the requirements of the various departments of a hospital. 16
You can choose only those modules that are applicable to meet your end-to-end enterprise-wide requirements. Some of the modules that comprise the MediEaz solution include: l Appointments and Scheduling
l Out Patient Management l In-Patient Management l Laboratory Management l Radiology Management l Operation Theatre Management l Pharmacy Management l Stores Management l Billing (Cash, Credit and Insurance) l Security and Administration l MIS and Department Reports l Medical records l Personnel and Payroll Nov - Dec 2011
HEALTHCARE
IT
IT & Digital Learning for Healthcare Industry
I
Pranay Upadhyay
MBA, PGDM, BE(E&C)
“With the increase demand for quality healthcare and medical services, the medical practices are constantly in demand for IT and digital learning” 18
nformation Technology (IT) has the potential to improve the quality, standard, safety, and efficiency of health care and medical education. Healthcare has gradually started to adopt new and modern methods to impart knowledge and resources. With the increase demand for quality healthcare and medical services, the medical practices are constantly in demand for IT and digital learning. Healthcare IT and digital learning has been found to increase efficiency and cost savings. Implementation and adoption of IT and digital learning in healthcare industry improves the work processes and cultures. Digital learning & interactive classrooms tools, hospital management systems (HMS), electronic health records (EHR), computerized provider order entry (CPOE), clinical decision support system (CDSS), picture archiving and communications system (PACS), bar coding, radio frequency identification detection (RFID), biomedical attendance system etc are some of the IT applications used to improve the
quality, standard, safety, and efficiency of hospitals and medical education. Digital learning & teaching in healthcare education has a number of advantageous than conventional way of teaching and learning. Thanks to the computers, laptops that have ease the system and now there is an interactive way of teaching by e-beam devices. eBeam Edge is a new age device that is tailor-made for educational institutes. It is a mobile interactive whiteboard system that scores heavily over the conventional methods of imparting lessons. Loaded with intelligent features, it makes lecturers and sessions interactive and infinitely more interesting for the students. Apart from that innovative biomedical learning software that has interactive way of teaching technologies and methodologies with a lot of pictures and animation explanation clears difficult concepts, methodologies and algorithms related to medical education. The device can be used in hospital conference halls for the board meeting, training, brainstorming sessions. Such interactive devices provide users delightful experience rather than satisfactorily and normal experience. We have recently designed and developed such courses for biomedical engineering students according to syllabus of their universities. Scientech Knowledge Universe (SKU) is a personalized online tutoring portal that redefines the learning experience in biomedical engineering. The same can also be delivered on handheld devices. For an example study and teaching of ‘digestive system’ or ‘anatomy of eye’ in classrooms Nov - Dec 2011
HEALTHCARE
IT
on conventional chalkboard or in books is very difficult but with the animations and interactive pictorial views one can understand very well. Internet might be a great source of learning for a healthcare professional. But internet provides quantitative information which may lead to the time consuming. Electronic health record is an automated order-entry and patient-tracking system providing real-time access to patient data, as well as a continuous longitudinal record of their care. Computerized provider order entry (CPOE) is a medication ordering and fulfillment system and some advanced include lab orders, radiology studies, procedures, discharges, transfers, and referrals. Clinical decision support system (CDSS) provides physicians and nurses with real-time diagnostic and treatment rec-
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ommendations. Picture archiving and communications system (PACS): This technology captures and integrates diagnostic and radiological images from various devices (e.g., x-ray, MRI, computed tomography scan), stores them, and disseminates them to a medical record, a clinical data repository, or other points of care. In Bar coding an optical scanner is used to electronically capture informa-
tion encoded on a product. Initially, it will be used for medication, for example, matching drugs to patients by using bar codes on both the medications and patients’ arm bracelets, but other applications may be pursued, such as medical devices, lab, and radiology. Radio frequency identification (RFID) technology tracks patients throughout the hospital, and links lab and medication tracking through a wireless communications system. Biometric time attendance systems used to track each and every person coming to your place is actually who he claims to be or not with its time and other details. It uses a face recognition system to verify a person’s identity and record its time-in and time-out with all required details. It is widely used in Hospitals to integrate to payroll systems, account systems and billing system. n
Nov - Dec 2011
PRODUCT LINE
IDEAL SOFTWARE FOR HOSPITALS
A
arogya Infotech & Management Systems Pvt. Ltd. (formerly AarogyaSoft) is a leading provider of Solutions, Systems & Services to Healthcare Providers since 2004. The company has a successful track record of implementing its Aayush range of software products to entire spectrum of Healthcare Providers. Features The software was first implemented at Choithram Hospital & Research Centre, Indore (a 350 Bed tertiary care hospital) in 2004. Today this proven solution has a large customer base with nation-wide presence. Intuitive user interface, consistency in GUI design, user defined reporting system and online help has made it easily acceptable among end users. Reliability, lower TCO, compliance with standards, proactive training & consultation by implementation team, configurable design and relevancy due to continuous upgrades for contemporary business practices and latest technologies have made it a Hospital Management System of choice. Functionality It is a comprehensive solution for Administrative, Clinical and Financial aspects of hospital management. A set of fully integrated 40 modules, covers all departments and functional requirements of mid-size or large hos-
Rakesh Kumar Singh Director, Healthcare-IT
Nov - Dec 2011
pitals. Excellent domain knowledge with deep understanding of practical problems faced by Hospitals has resulted in a system which leads to a less-paper, automated work environ-
ment. Changing with times, the latest release of AIMS range of software have been designed specifically for Accreditation & Certification requirements like NABH & NABL Technology AIMS-HIS is a web enabled, NTier application developed on .NET platform. It has been designed for distributed computing environment with SOA. The application can connect to multiple databases simultaneously and can be integrated with other software easily. Tertiary care hospitals generates huge amount of data which needs to be managed routinely for performance & security. Hence the software is implemented with Oracle 11g as database. Although the client terminals and application server require Windows OS, it can be implemented with Linux as Network OS and Oracle on Linux. Highly scalable, easy to implement & easiest to maintain, the software is a real friend of System Administrators. Business Model The software is available as onpremise SaaS. Instead of buying the software license the hospital pays a monthly subscription charge for concurrent user licenses. Hospital gets the entire set of modules for the same charge. De-linking of software cost from number of modules makes it highly cost effective. The hospital
not only gets the regular updates & upgrades for free but also eliminates customization charges. Ideal software for any hospital which wants to l Upgrade existing system without investing in License Cost again l Going for Standardization & Accreditation l Bring Automation & Efficiency in its processes l Cut Costs & Control Expenditure l Implement rule based administration l Remain Flexible & adaptable to change l Move from capital expenditure for Software License to Operational expenditure in new project It is amply clear that to get the most out of IT systems, a holistic approach in needed. If Resources and processes are not exactly mapped with IT Systems it will only create bottleneck. True to its motto “Better Systems for Better Healthcare”, the objective of AIMS-HIS is to provide a well planned, fully integrated and automated workflow approach for implementing Management Policies & Procedures. “Our company does not offer just software but a complete Hospital Management System. What initially started as a healthcare software product has been transformed into an integrated IT & Management System for Healthcare Providers” says Rakesh Singh, Director Healthcare-IT. n Aarogya Infotech & Management Systems Pvt. Ltd. 302/27, Aditya Nagar, A.B. Road, Indore 452001 Tel. : +91 731-4066043/9826017970 sales@aarogyahms.com www.aarogyahms.com 21
PRODUCT LINE
Under One Roof The future of Consultancy
‘I
f you wish to develop a healthcare center, primary secondary, super specialty, Healthcare Institute or Nursing college, how many consultants would you need?’ There is absolutely no need to count on your fingers now, listing the feasibility experts, the budget experts, the planners, the PMC, the Equipment consultants, the Building services, the Mechanical services, the specialized hospital services, etc. The answer is ‘ONE’. Consultancy services like DDF healthcare Consultants(
DDFHC) are providing healthcare services for the novice entrepreneurs and the established groups based on the clients requirement to get all required services under one roof. Dr. Ashish Roy, ( MBBS ) Director DDF Healthcare consultants with an experience of more than 20 years brought this idea to reality after understanding the new age mantra of TIME MANAGEMENT. “In our experience of setting up healthcare centers, hospitals and Medical colleges, we felt bringing all under one roof will not only ease the pressure off the client of interacting with 7-8 different consultants but would also ensure timely delivery of projects with an integrated approach.” Dr. Ashish Roy, Director DDFHC The brave new modern world and changing face of India, has seen integration in all forms, this is the new face of consultancy. n
Dr. Ashish Roy Director, DDFHC
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Nov - Dec 2011
COVER STORY
S
uccessful project planning is a dynamic process involving an entire team, typically comprising clinicians, architects and project managers, who are tasked with balancing the needs of patient care, available health care technology, and the realities of the design and construction process. Medical equipment planners perform a balancing act among those forces, while ensuring that all team members have the latest information available on the state of medical equipment in the project. Much like the design and construction process, medical equipment planning is iterative, meaning it starts with a highlevel view of clinical services anti -cipated and then over time focuses on details. Typically, planning should commence no later than the project’s design-development phase to bring the best information on medical equipment to the project team. Few pieces of equipment are model- and manufacturer- specific at this time, but just as the design increases in detail so does the medical equipment list. During the early stages of design, general function and requirements of spaces and equipment are identified, similar to the space-planning process. For example, facilities need to plan out the types of procedures to be performed when designing for a new hybrid operating room. Additionally,
Integrating medical equipment planning into the construction process 24
Nov - Dec 2011
COVER STORY
As health care technology advances, a flexible design and construction process is important to a health care organization looking at trends in future patient care.
medical equipment-planning input during master-space programming is helpful, particularly when a project involves technology-intensive spaces such as radiology or surgery. As the project moves into the late design-development and constructiondocumentation phase, information on site-specific drawings, utilities and installation requirements is fleshed out, enabling the construction team to complete its work. Changes in the Nov - Dec 2011
equipment list must be communicated to the construction team quickly so potential issues can be identified and managed before costly change orders are required. As health care technology advances, a flexible design and construction process is important to a health care organization looking at trends in future patient care. Significant milestones Medical equipment planning tends to have
three significant milestones during the health facility construction process. First among these typically is preliminary budgeting for financial approvals or certificate of need. The medical equipment planner, at this point, develops a budget figure based on a space program and early discussions with project ad - ministration on the vision and expected services for a project. This data then is incorporated with the drawing or space program package that goes to the appropriate governing authority (e.g., board of trustees, state approval agency) to green-light or hold the project. A second notable milestone, or series of milestones, are the document submissions associated with the design process (e.g., end of schematic design, end of design development). The medical equipment list should be progressing in concert with the archit at each submission point should be available for issuance to the appropriate parties. This is not always as seamless as it should be. Occasionally, project 25
COVER STORY
departments or spaces lag behind the design, often due to delayed decision-making about a particular piece of medical equipment. Obstacles can arise when clinician consensus is required or the facility needs budgetary review on highcost equipment. This is where professional medical equipment planners really stand out. It’s their job to notify project administration of potential issues before they represent a hard stop on a construction schedule. They’ll shepherd the decisionmaking process through to conclusion. Document submissions frequently include equipment placement on architectural drawings. However, with the increasing prevalence of building information modeling (BIM) in health care projects, the traditional process of document submissions blurs. While document submissions of the equipment list are still vital, that process as it relates to BIM is still in transition, and may vary in style and content from project to project. Both architectural firms and medical equipment planners still are identifying roles and responsibilities in projects utilizing BIM, because the overall project model requires a new way of creating, updating and maintaining the equipment list. A significant amount of work is involved in updating the list, particularly when clinicians change from one manufacturer and model to another and a completely new object must be created. The third major milestone involves
user and project management sign-off of medical equipment lists and plans. This is a vital point for a number of reasons. First, sign-offs can finalize selections on medical equipment that may have been delayed for various reasons. Second, having the surgical lights and booms). Decisions on major medical equipment selection cannot be delayed without impact to the schedule. In many instances the space and utilities are driven by a specific manufacturer’s requirements. All too often, health care facilities put off equipment selection while they negotiate pricing or attempt to wait for the next technology advances. The medical equipment planner must ensure that the project team knows the perils of delaying or changing decisions (e.g., change orders, schedule delays, increased costs of acquisition) associated with Group 1 and 2 equipment.
Decisions on major medical equipment selection cannot be delayed without impact to the schedule. In many instances the space and utilities are driven by a specific manufacturer’s requirements. 26
Key points of success There isn’t a guaranteed formula for successful medical equipment planning. However, a number of steps can be taken to improve the chances of a successful project and mitigate failure. Above all else, communication is vital among all team members as the project progresses. It ensures everyone has the most complete information regarding medical equipment in the project, and can mitigate or avoid costly problems in construction. Except for sensitive issues as noted by project administration, such as project budget status, communication should be as transparent as possible. This can defuse issues that arise from rivalries between departments or clinicians, and greatly reduce misunderstandings regarding project goals and decisions. Strong project management with a clear vision can make a tremendous difference in a project, particularly where physician preferences intersect with medical equipment selections. While the medical equipment planner can guide particularly difficult decisions on healthcare technology, the project management team must be the final arbiter of those decisions. The wish list mind-set is an ever-present problem with medical equipment planning. A weak project manager will find it difficult to contain the pressure from clinicians with strong opinions on vendors and models to include wish list equipment. One good way to manage this problem is by having the medical equipment planner incorporate equipment standards, group purchasing organization contract items and other hospital-identified models and manufacturers. This can accelerate the process of planning, and remove potential issues regarding clinician preferences when they are at odds with the overall hospital procurement philosophy. n Nov - Dec 2011
COVER STORY
Green Hospital Overview G
reen Buildings are a model of sustainable development. They use resources efficiently to ensure that future generations are not deprived of them. They are all the more important in view of fast depletion of natural energy resources and threat of global warming. Besides natural resources, green buildings lay a lot of stress to the health of the end user. Hence green buildings with energy saving windows are not only environment friendly, but also a healthy place to work. Green Building Ratings LEED (Leadership in Energy Efficiency and Design) is the most widely accepted rating system on Green windows world wide. It comprises a total of 69 credit points can be attained on the following basis. Green Building Certification LEED (Leadership in energy Efficiency and Design) is the leading rating system adopted in India and the world to certify green buildings. The rating has a total of 69 credits that can be availed on 6 different parameters. These include sustainable sites, water efficiency, energy and atmosphere, materials and resources, indoor environment quality and 28 28
innovation and accreditation professional inputs. If you follow LEED Rating system, the use of energy saving windows can contribute to valuable credit points under the following parameters: l Energy and Atmosphere: Superior sealing saves energy l Material and resources: They are recyclable and require lesser energy in production
Experts on ‘Green Windows’ have concluded, “Properly designed energy saving windows in an air conditioned building can save nearly 30% energy.”
Indoor environment quality: Do not require any painting Save up to 30% energy and reduce air conditioning costs Experts on ‘Green Windows’ have concluded, “Properly designed energy saving windows in an air conditioned building can save nearly 30% energy.” In their view “an energy saving window consists of (i) a heat insulating framing material, (ii) double-glazing and (iii) proper sealing between wall and window as well as between the opening and fixed framing of the windows.” is the only window in India that fulfills these energy saving criteria. The U-Value of PVC is the lowest of all window-framing materials, which means minimizes energy loss. n l
Nov - Dec 2011
COVER STORY
Interior Designi ‘I
Ms. Poornima Alexander Interior Designer Mediac Synergie
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nteriors’ refers to any space within an enclosed structure that is inhabitable and human centered. These spaces include residences, offices, institutions, schools, hospitals, theatres, restaurants, hotels and resorts, airports and the like. This context also spills onto the structures’ extensions such as porches, entrances, swimming pools, landscaped areas, decks, patios etc. Interior designing is the designing of the interiors of a space, including flooring, windows, doors, walls, lighting, furniture and decorative material. Every design starts with a goal to make the space comfortable and aesthetically
pleasing. In a hospital, many stake holders are involved i.e. patients, patient attendants, medical staff, ancillary staff, administrative staff, medical representatives, vendors, visitors and so many other kinds of people who come in contact with the hospital and its premises numerous times. All these stake holders belong to various levels of social strata and have different likings, moods, tastes, personality and conduct. No other active buildings which we see around us in our daily life require catering to such vast & complex network of entities. Hospitals are no more considered Nov - Dec 2011
COVER STORY
ing in Hospitals as buildings having a sole purpose of treating/reviving/rehabilitating ill patients. Hospitals have evolved in terms of infrastructure, the facilities they house, the technology which is used in healthcare, the patients they cater to etc. With rising costs of healthcare, patients expects more than just treatment for their ailment when they walk into the hospital. The concept of ‘holistic treatment’ roughly sums up to medical interventions assisted by pleasing environment. It has been scientifically proved that light, colors, plants and sound help in recovery of patients if they are used in a scientific manner. Nov - Dec 2011
Having cited the myriad of complexities involved in the hospital, it poses a unique and spirited challenge to the interior design of a hospital. A hospital comprise of numerous spaces which are constructed to suit a specific function, medical or support.
The use of these spaces can be by one person or multiple persons. Hence each of the space has to be designed keeping in mind the kind of people who will eventually use it or rather spend most of their time in those spaces. Hospitals are the only buildings which house so many varieties spaces with specific minimum dimensions. A great deal of creativity and compassion is therefore involved in designing hospitals. The additional goals of reducing and controlling environmental hazards and risks, preventing accident and injuries, maintaining safe conditions for patients, staff and visitors; maintaining an environment sensitive to patient needs; 31
COVER STORY
equipments, tools, instruments, furniture which are used to treat the patients. These spaces should be designed in a manner which will not intimidate the patients. Also, as these spaces are classified as critical areas of the hospital, designing should be in a manner which will minimize the potential hazard of ‘Hospital acquired Infection’. Areas like Pediatric Units, where children with ailments are admitted, should be designed accordingly which would make the surroundings playful as well as keep the children occupied. If the inpatients especially ICU patients have the view of outside, he/she stay oriented to the surroundings, this has a huge impact on the early recovery. l Staff Zone : Staff zones are often the most neglected areas in terms of designing. But, these areas deserve lot of attention because hospital staffs have one of the most stressful jobs in the world. Their work places should be designed to bring in calm and relaxed feeling. Use of furniture, colors and sound proofing prove quite useful while designing such spaces. l Service and Storage Zones : This includes all building support spaces like communications, electrical, air conditioning, CSSD, Laundry, Dietary, utility spaces etc. Designing of these zones should be in a manner which minimizing environmental stresses for patients, staff and visitors also contribute to the job of the interior designer. Functional Zones within a hospital; l Public Zone : This zone encompasses porch, lobby, waiting areas, cafeteria, retail space, spiritual space, conference halls, seminar halls, registration, admission & discharge areas. These are the areas which creates the first impression on the minds of a patient, visitor or a guest. For e.g. A hospital waiting room could be designed in a manner which offer a 32
view of nature or be surrounded by calming colors and pleasing sound that can soothe patient’s/visitor’s anxiety and stress. This zone can have soothing music, television, reading material, ergonomic chairs etc. which would provide the patient/visitor comfort and recreation while waiting. l Patient Zone : This zone encompasses areas like wards, ICU’s, Operating Rooms, Treatment Rooms, examination Rooms etc. These are the space which contains various
‘Hospital acquired Infection’. Areas like Pediatric Units, where children with ailments are admitted, should be designed accordingly which would make the surroundings playful as well as keep the children occupied. Nov - Dec 2011
COVER STORY
would facilitate and not obstruct people movement, orientation & ease of movement. Aspects already mentioned like noise, color, lighting, flooring and signage play an important role in enhancing the aesthetic value of the hospital. An effective soundproofing of the hospital from the traffic outside (considering most of the hospitals are located in the vicinity of main roads) will help the patients in the lobby remain calm. Also the acoustics within the hospitals should be given consideration which will contribute to the peacefulness within a patient’s room. Use of color in hospital designs can help patients have a sense of orientation; color is used to give different hospital areas a sense of place. Color has also been known to be associated with mood. It is important to use the right colors in waiting areas, examination rooms, hallways and patient private rooms; it can have a definite affect on patient motivation and stress levels. Lighting needs to be functional and it should enhance the visual appeal of 34
the built environment. Well-planned layering of ambient, task and accent lighting is critical in creating effective, efficient and aesthetically pleasing lighting. In a hospital however bringing in the maximum of natural light can expedite the healing process. Flooring in a hospital cannot be the same in all zones, each zone requires different specifications. The public, staff, storage and service zone do not have special requirements besides durability, ease of maintenance, not too soft or too hard and ability to impart a positive image. Patient areas and treatment areas on the other hand call
Use of color in hospital designs can help patients have a sense of orientation; color is used to give different hospital areas a sense of place.
for specific types of flooring; seamless flooring is the most appropriate. A number of existing hospitals do not have the architecture to effectively deliver patient care. They have been mainly designed when patients were considered more an object on the scene rather than focus of design and thus were delineated from the hospital architectural planning. In a major paradigm shift, sensitivity to people’s feelings and their need for sensory input has impacted the hospital facility planning and design. Hospital designing must focus on improving the quality of environment for the care providers and recipients of healthcare. A hospital must evoke a positive response and the design should support the processes carried out in it. Today’s world is not the disjointed geographical areas of the centuries gone by. It is well connected, well educated and constantly strives to improve. Hospitals, staff, equipment and procedures are all rapidly transforming to ensure just one thing – shortest possible time to recuperate a patient to a healthy state once again! n Nov - Dec 2011
Lub Dub Medical Technologies Pvt. Ltd. 68, Ellai Amman Koil Street, Shastri Nagar, Adyar, Chennai - 600 020. India Tel: +91 44 24463030 Fax: Extn 111 Mobile: 098410 98009, Email: lubdub@vsnl.com
www.lubdub.in
EXPERT VIEWS
Ask a Question from Healthcare Industry Expert “Medgate Today, introduce a Special Section :Ask a Question from industry expert in Hospital & Healthcare Planning, Operations, Management, Quality, Medical Education, Medico Legal & Materials Management”.
Dr. Pradeep Bhardwaj CEO, Six Sigma Health Care
O
UR EXPERT : DR. PRADEEP BHARDWAJ, CEO & Executive Director, Six Sigma Healthcare Limited, Delhi will answer your questions through his expertise knowledge & experience in Hospital & Healthcare Management. He is an expertise Healthcare Planning, Management, Medico Legal Consultant, Author’s and Visiting Professor & Faculty in leading Healthcare Management Colleges / Universities like Harvard, IIM – Lucknow, IIM-A, ISB – Hyderabad, Amity University, Symbiosis International University, AIIMS, National Board of Examinations etc. He is also Board of Advisory in many healthcare organizations / management institutes / universities. . Dr. Bhardwaj is renowned hospital and healthcare management expert, recipient of many prestigious awards like Rajiv Gandhi Award -2010, Best Medico Legal Expert – IBN 7 36
Q . My specialization is Medicine . I am working in a government hospital at Chandigarh. Can I do private practice? - Dr. P.K Yadav, MBBS, MD – Medicine, Chandigarh
Expert View : Private practice by a government doctor dose not amount to corruption or crime, the supreme court has ruled out in a recent judgement. Recently a bench of Justice Katju and G.S Mishra said that government doctors engaged in private practice can not be prosecuted under the prevention of corruption act (PCA) or other penal laws. According to the Supreme Court : The demand/receipt of fee while doing private practice by itself cannot be held to be an illegal gratification as the same obviously is the amount charged towards the professional remuneration. Q. Is there is any bans on advertisement by doctors in the Punjab? Please clarify.
- Dr. S. P Singh , MD, Punjab
Yes, Punjab Government announced a ban on advertisements by doctors from Allopathic, Ayurveda and Homeopathy streams offering treatment of various diseases. Punjab Government has issued direction to initiate action against all those doctors who were advertising through various media including radio, print, broadcast and outdoor media for the treatment of various ailments. Punjab Medical Council has adopted a new code of medical ethics Advertisement in the form of strips on the cable T.V., electronic media is not allowed. Q. India is a favoured destination in Medical Tourism. What is the current size of Indian medical tourism sector and what is the scope by 2015 in Medical Tourism? Can you suggest any medical speciality, where the growth will be maximum ? Nov - Dec 2011
EXPERT VIEWS
- Vikramjeet Singh, GOA
The market size of Indian medical tourism sector is likely to more than double to Rs=10, 800 crore from Rs=4500 crore present. The inflow of medical tourists in India is also likely to cross 34 lakh by 2015, from the current level of 8.5 lakh. Top healthcare facilities like Cardiology, Joint Replacement, Orthopaedic surgery, Cosmetic surgery, Transplant and Urology at low price are certain key factors making India a favoured destination in medical tourism. Q. We have purchased a land of 5 Acre in Jhansi. The trust is very keen to establish a Nursing & Para Medical Institute at Jhansi. Please guide us the requirement and guideline to open the Nursing Institute ? Is there is any website from where we can download the Application Form ? Is this a good idea to take help from the consultant ? - Prof. K.V Gupta, Jhansi
Nursing courses are skill oriented and high in demand. Before applying to Indian Nursing Council, First you are required to obtain NOC from the State Government. The nursing institute should be associated with 120 bedded hospital within the radius of 30 KM. Indian Nursing Council has resolved the following calendar of events for 2012-2013 academic year, The last date will be 31st January 2012. l 1st Oct 2011 to 31st Jan 2012 Submission of New Proposals to INC l 29th February 2012 Late Fee of Rs. 15,000/- as n penalty
Q . Question: What are the departments which we can outsource in a upcoming hospital? Do you feel outsourcing HR department of a hospital is a viable option? - Neeraj Jha, Head HR, Umrao Hospital, Mumbai
Expert View : The outsourcing of certain departments of the hospitals has shown significant improvements in the hospital operations which are non core area of the hospital . The departments that can be outsourced are Pharmacy, radiology, lab, optical shop, cafeteria, security, housekeeping etc. if one really wants to outsource HR activities, then payroll and recruitment can be outsourced. As human resource department plays a vital role in bonding with the manpower in the hospital, having no effective control on it from the people within the organisation will create more problems than benefits. Q. What is the best strategy for trust based eye hospital to market themselves against the corporate giants and to attract the paying patients? - Ms.Kanu Bhargav, Deputy ManagerOperations, Vasan Eye Care
Expert View : The best strategy for a trust based eye hospital is to focus on preventive side of the eye care, affordable cost and diseases related to posterior segment of the eye For an eye hospital, around 60 per cent of the cases are related to anterior segment of the eye such as cataract, myopia, hypermetropia etc and hence diseases related to posterior segment of the eye gets unnoticed. By adding certain value added ser-
Mr. Tarun Katiyar Principal consultants
vices, they can also target the paying capacity people. As the hospital will be charging less amount from the patient, the volume of patients will be more which will in turn benefit the hospital. Q. What are the recent marketing trends applicable for Health care facilities ? - Mayank Solanki, Dr.Solanki Eye hospital, Banglore
Expert View : Traditional ‘interruption’ marketing (hoardings, pamphlets, TV/radio ads) is losing its charm as people tend to tune it out very rapidly. It is now the age of ‘Permission Marketing’, where you do good for people (in terms of preventive health services for free, for example) turning ‘strangers into friends’ and then turn these ‘friends into customers’. eg: conducting of health check up camps in Hospital: and then selling tablets to the patients diagnosed with a problem. eg: doing a rigorous patient education programme like minimally invasive surgery exists to relieve symptoms that they took for granted! n
You can mail your query at editor@medgatetoday.com Nov - Dec 2011
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EXPERT VIEWS
The Menace of Cut Practice Cut practice, incentives, commissions are a few words that are the bane of the growing healthcare industry.
Mr. Vivek Shukla 38
A
t the onset, let me clarify that it is illegal and unethical for a doctor to solicit patients by offering any kind of incentives. The 2002 amendments to the Indian Medical Council Act 1956 clearly states in section 6.4.1.- A physician shall not give, solicit, or receive nor shall he offer to give solicit or receive, any gift, gratuity, commission or bonus in consideration of or return for the referring, recommending or procuring of any patient for medical, surgical or other treatment. Inspite of the law, the epidemic of cut practice still is still unabated. Let us look at why this is happening. First and foremost, the doctors who run hospitals and nursing homes are not qualified marketing professionals. Unfortunately, they do not have the access to the brand building and ethical marketing techniques. Business management is not taught in medical colleges. Then there is the hunger for instant rewards. Some people are oblivious of the virtues of patience. They want results and they want it yesterday. In the rush for creating a successful institution/practice, they forget that they are inward bound to a no entry zone. Another reason for this widespread practice is that everyone seems to be doing it. It seems they have reached a point of no return. Doing what everyone
else is doing sometimes sounds a valid excuse for indulging in sinful activities. ‘What can I do?’ Remark some doctors. ‘Everyone else is getting away with it and
also making money in the process. Why should I lose out?’ The multi crore rupee hospitals are being held to ransom by a handful of ‘referring’ doctors. They demand, they bargain and they blackmail. ‘It is not a nice feeling’ says a gynaecologist who had been recently approached by a village quack who was convincing her to perform a caesarean section on a pregnant woman who may have delivered normally if give a fair trial. He had the nerve to tell me that the patient party has decided by themselves that they want a caesarean only’ laments the doctor who has been in practice for almost three decades now. ‘And when I said that I will decide after examining the patient whether there is an indication for surgery, the quack left the OPD and walked across to the nursing home across the road. Nov - Dec 2011
EXPERT VIEWS
The horror stories do not end here. A hale and hearty doctor in Punjab was pronounced long dead by an auto driver. The reason was that the orthopaedic patient who had just alighted from a bus had hired him to go to that doctor. ‘You don’t know? He passed away a few months ago’ said the auto driver non-challantly. ‘But don’t worry, I will take you to another good doctor. You will get a discount too’ he hastily added. Needless to say the auto drivers are also enjoying the ‘cuts.’ Another popular way of ‘diverting’ a patient is by announcing that the doctor preferred by the patient has gone abroad for a long training or a conference. I don’t think there is an end to it. As things keep going in this direction, there will be more lies and more ‘hitting below the belt.’ The percentages of commissions will keep increasing to an extent that the quality of care will go down as there will not be sufficient margins left for the hospitals. What is the way out? How does one get out of this vicious circle? I get mails and calls almost daily from people asking this question. Most of them are doctors running their own hospitals. And my answer to them is this- ‘Direct to customer approach through brand building is the answer.’ Almost everyone who hears this answer exclaims‘What? What did you say?’ Can you explain what it means? Can you tell me how it works?’ The response is not surprising. Given that doctors are not familiar with the territories related to branding. Not only you enjoy higher profit margins, you also reduce your dependency on others for business. Business strategy wise, it is always better to have strategy which is not easy to replicate. Giving commissions, needless to say, is a no brainer as far as strategy is concerned. Building a brand is something that not everyone can do successfully. Another thing to be considered is that a hospital’s credibility is lost without a chance of gaining it back, if someone blows the horn on its unethical practices. Imagine if someone comes out with a sting operation [something that we are all witnessing every other day on TV at prime time], about a hospital striking a 40
deal with the GP. Let’s face it, people are increasingly becoming aware and educated about their surroundings these days. With the rise in the awareness levels, it is just a matter of time before someone blows the horn on this mode of doing business. A well branded hospital finds it easier to convert its OPD patients to indoor patients than a referral dependent hospital. By the sheer power of the brand, people feel it is safer to get admitted in a hospital than a lesser known one. This term is known as conversion rate [the percentage of patients who actually get admitted to a hospital]. Also consider the word of mouth for branded hospitals. Research shows that good and strong brands are spoken about more than others. If you had an ultrasound done at Apollo hospital, you are more likely to tell it to your friends than if you
The transition from referrals to brand building is not an overnight phenomenon. Nor does it take donkey’s years to build a brand. It takes perseverance and out of the box thinking to get the job done.
had it done at an unknown hospital. In hospital marketing, there is no stronger tool than word of mouth marketing. It would be a big loss if deliberate efforts are not made towards reaching the customers directly with a strong value proposition. Research also points out that strong brands enjoy stronger customer loyalty. Not only your patients come back for their repeat appointments, they also suggest your name to other hospitals. Marketing professionals have always been raving about how it is far cheaper to retain a customer than to create a new one. A retained customer is also easier to serve than a new customer as the latter is more likely to complain about the services than the former. Another point I wish to make here is the impact of a strong brand on staff loyalty. Attrition is a big challenge for the healthcare industry today. If your nurses, technicians and doctors are leaving you frequently, consider building a strong brand. I have talked about how to build a brand in my previous article. You need to start by creating a value proposition which only you can provide and which differentiates you from the rest of the pack. Once the value proposition is in place, you need to work diligently on ensuring a consistent delivery of the proposition. For example, if you create a proposition called- the hospital with minimum waiting time, you need to ensure that you actually deliver on the brand promise. You will need to create systems and structures which ensure that. Once you have gained mastery in consistent delivery of the proposition, you then need to tell the world about it through various innovative methods. Once this is achieved, a successful brand is created. The transition from referrals to brand building is not an overnight phenomenon. Nor does it take donkey’s years to build a brand. It takes perseverance and out of the box thinking to get the job done. First and foremost it takes the willingness to embark on the journey. I would want to end by strongly recommending that if you have been indulging in kickbacks; it’s time to recreate your business plans. n Nov - Dec 2011
COVER STORY
Why Choose LED lamps over CFLs?
L
ED lamps typically use less power (watts) per unit of light generated (lumens). A good LED lamp can generate twice as many lumens per watt as a CFL (50-100+ versus 40-80). l less greenhouse gas emissions from power plants l lower electric bills LED lamps last much longer than CFLs, as much as 10x longer (50,000 hours versus 5,000 hours). l fewer spent lamps in the landfill l less frequent lamp purchasing/ changing, especially important for hard-to-reach lamp locations LED lamps generate less heat than CFLs. l decreased load on Air Conditioning systems l reduced danger of burns from touching lamps l reduced fire hazards LED lamps typically are RoHS compliant, meaning that they have no or at most negligible amounts of hazardous substances within the scope of that compliance (lead, cadmium, mercury, ...). CFLs on the other hand all have 1mg-5mg of Mercury (even more in tubular fluorsecent lamps), and no doubt many people are not properly disposing of spent CFLs, resulting in Mercury making its way into the environment, with serious consequences. And if a CFL were to break in your house you might be exposed to Mercury. l virtually no risk of environmental contamination l no risk of personal exposure to hazardous materials LED lamps tend not to have unpredictable failure modes. There are stories of CFLs catching fire, emitting smoke and odors, exploding, etc. The ballast circuitry in CFLs can fail in a variety of ways, some not so pleasant for anyone in the same room/house. This is especially the case when market pressure causes the designers to cut corners to save production costs. LED drivers are not nearly as unstable and usually fail by just no longer supplying power to the LEDs themselves. l virtually no risk of fire/smoke/odor LED lamps emit no Infrared or 42
Ultraviolet radiation. CFLs (and tubular fluorescent lamps) generate light by exciting the Mercury vapor inside the lamp with electricity, generating Ultraviolet radiation, which stimulates the phosphor coating on the inner surface of the glass bulb, causing it to re-radiate most of the Ultraviolet radiation as visible light. LED lamps generally create “white” light by using blue LEDs and a phosphor coating which re-radiates some of the blue light as longer wavelength light (yellow range of the spectrum), together appearing as white. l no personal exposure to Ultraviolet radiation, which can cause cell damage l artwork and other sensitive items are not degraded as a result of exposure to Ultraviolet radiation
LED lamps are not sensitive to frequent power cycling. The lifetime of CFLs (and tubular fluorescent lamps) is reduced by turning them on/off more than a certain number of times per day. The “rated” lifetimes of such lamps are usually based on assumptions that they will be left on, say 3-4 hours, each time they are turned on, rather than having that 3-4 hours be spread out over many on/off cycles. The actual lifetime of a fluorescent lamp will suffer compared to its “rated” lifetime if this “on-time” assumption is not adhered to. This can lead to people thinking they should not turn off their lights as often as might be best for energy conservation purposes, leading to wasted energy.
l no concern about how often you turn on/off your lights LED lamps have better control over the direction(s) in which their light is emitted. This is advantageous in applications where you only want the light to go in one general direction (unidirectional) rather than in all directions (omnidirectional). Think of recessed ceiling lighting where any light not directed downward is wasted. LEDs tend to generate light in one direction. By using lenses in the LED lamp, this light can be spread out to achieve various specified beam angles. To do that with incandescent or fluorescent light sources, which emit light in all directions, a reflector must be used (the ‘R’ part of ‘PAR38’ for example), and these reflectors are never perfect, causing some light loss in the process. This further increases the efficiency advantage of LED lamps over traditional light sources. l less wasted light LED lamps turn on instantly (reaching full brightness immediately). CFLs tend to have a warm-up period which may range from a few seconds to over a minute. During this warmup period they are not as bright as they eventually become. This can lead to problems ranging from having to wait for light levels to increase to a useful level, wasting your time, to turning the lights on before you really need them, in anticipation of the warm-up period, wasting electricity. l no wasted time or electricity LED lamps can be used in colder temperatures than CFLs. Most CFLs will not turn on or will only emit very low levels of light in the cold (near freezing). I have not heard of a low-temperature limit for LED lamps although there may be one, but I’m sure it’s much lower than that of CFLs. l effective in cold temperatures LED lamps are typically far more robust than CFLs. CFLs, with their thin glass tubing, are easily broken, such as by dropping them on a hard surface from just a few feet up. LED lamps are solid-state devices, and as such can handle impacts with far less risk of breakage/damage. l much less easily broken n Nov - Dec 2011
POST SHOW
Deputy Director General of the Dubai Health Authority inaugurates 37th edition of the World Hospital Congress
T
he three-day event at the Atlantis Hotel is held under the guidance of His Highness Sheikh Mohammed bin Rashid Al Maktoum, VicePresident and Prime Minister of UAE and Ruler of Dubai. During the congress held under the patronage of HH Sheikh Hamdan Bin Rashid Al Maktoum, Deputy Ruler of Dubai, UAE Minister of Finance and Chairman of the Dubai Health Authority, experts in the medical field will discuss and exchange their views on the status of public health and n medical industry in UAE.
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Nov - Dec 2011
DOCTOR SPEAK
HOW TO FEED YOUR NEW BORN WHEN BREAST MILK IS NOT AVAILABLE Dr. Rajiva Kumar Child Specialist
If your Baby is lactose intolerant, then the baby should be feed a lactose free formula. 48
Nov - Dec 2011
DOCTOR SPEAK
W
hile breast milk is the best choice but when mother milk not available, or Contraindicated due to any reason. Then the baby should be given infant formula Milk. While choosing a formula Milk, use a brand recommended by your Baby's Doctor. Types of formulas:v Powder : Which is least expensive; v Liquid concentrate : more expensive than powder v Premned Ready to feed : Most Expensive but also the most convenient. If your Baby is lactose intolerant, then the baby should be feed a
lactose free formula. What Nutrients are in infant Formula: Infant Formula contains 'protein, Fat. Vitamins A. C. D, E, K, Iron, Calcium, Nucleotides and many Nov - Dec 2011
more ingredients. Preparing Formula : When using a Liquid or Powder Formula, read the directions on how much. water and formula to use. Follow the direction carefully. Measuring every time. i.e. measured spoon in one ounce = 30m1= 6tsf of water. Water should be preboiled and cooled. Formula milk after preparing should be given by spoon & Bowl, (sterlized). If a bottle is used then it along with nipple should be strerlized by boiling the bottle & nipple in water. Glass bottles is the best and can be used for longtime. Silicone
nipples with different shapes can be used. Nipple should be replaced regularly. How much should I feed my baby: During the first month the baby will take about 2 to 3 ounces of formula at each feeding and will take every 2 to 3 hrs. After the list month your baby will take about 4 ounces of formula every 3 hrs. The amount of formula will gradually increase as your baby gets older. The flow rate of formula coming out of the nipple will also change as your baby gets bigger. For the first few months the flow rate, should be one drop per second. When can I switch my baby to whole milk. You can start feeding whole milk instead of infant formula around his or her first birthday. n 49
HEALTH & FITNESS
Importance of Drinking Milk?
?
Full-fat milk may be associated with constipation but new research suggests that drinking fat-free milk could be a way of solving irregularity problems.
M
ilk is a rich source of the minerals, calcium and phosphorus that our body needs to build and maintain strong bones and teeth and assist in the proper contraction of our muscles. Milk is also a valuable source of high quality protein which complements the protein value of breads and cereals. It also provides fair amounts of vitamins A, B, and D, all of which help promote proper growth and development. Make milk an integral part of your daily diet. Drink a glass of milk everyday to ensure us of strong and healthy bones and build our defense against osteoporosis and other bone disorders in our twilight years. Take a second look and
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develop a liking to this food once more. scientists investigated the effects of fatfree milk supplementation on constipation and levels of motilin and ghrelin – both of which affect intestinal mobility. Studies have suggested that excessive milk consumption leads to constipation as unabsorbed fatty acids left in the intestines bind to calcium on the intestinal lumen, forming soaps. But the scientists behind this latest study claim that fat-free milk may have the opposite effect, actually helping to relieve constipation. . Method In the research, individuals with constipation were supplemented with
Nov - Dec 2011
HEALTH & FITNESS between 400 ml and 800 ml of fatfree milk daily, according to the severity of their cases. Meanwhile, healthy control subjects were administered 400 ml of fat-free milk, which was followed a month later by of 400 ml of whole milk for 3 days Correct Those Wrong Ideas about Milk Are you one of those who believe that milk is a perfect food? Or are you one of those who have stopped drinking milk because of certain beliefs you have associated with milk? If so, it’s about time to correct these wrong ideas about milk or its products. Milk is a nutritious food rich in essential nutrients for our body’s daily needs. Milk, however, is not a complete or perfect food as others tend to believe. The truth is no single food contains all the nutrients our body needs. Milk contains negligible amounts of vitamin C, niacin and iron. Thus, an individual needs other food sources for a more adequate daily supply of these important nutrients. Other people avoid drinking milk in the belief that this makes them fat. Milk or any other food is not fattening if taken in moderate amounts. If one is weight conscious or on a reducing diet, one can choose to take skim or non-fat milk or products prepared with this type of milk. These are very much available in the market. Often milk is also disliked because of its flavor. The lingering milky taste is said to be caused by fats that coat the mouth when one drinks milk. If you have a distaste of the “milky” flavor, then you can 54
take skim or non-fat milk since these will not produce this aftertaste. There is also a lot of milk now with wide variety of flavorings. Others also avoid milk believing it causes constipation. Milk, however, is no more constipating than any other food. When one relies more on milk and excludes other foods rich in fiber, then milk is misinterpreted as the cause of constipation. The effect of drinking milk,
however, varies from one person to another. Others may experience loose bowels; still others may not be even bothered at all. Some people may experience diarrhea, s t o m a c h discomfort, bloating or abdominal cramps after some time of not drinking milk. If you are one of those persons who cannot tolerate milk at this time, you may overcome this by gradual drinking of milk in small amounts. Soon you will be surprised that you can tolerate milk once more and you will no longer experience such symptoms. Try milk once more. It is too nutritious to be excluded in your daily diet. Milk is a rich source of the minerals, calcium and phosphorus that our body needs to build and maintain strong bones and teeth and assist in the proper contraction of our muscles. Milk is also a valuable source of high quality protein which complements the protein value of breads and cereals. It also provides fair amounts of vitamins A, B, and D, all of which help promote proper growth and development. Make milk an integral part of your daily diet. n Nov - Dec 2011
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