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FEBRUARY 2020 | VOLUME 15 | ISSUE 02
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COVER STORY
Healthcare Leaders Decode Union Budget 2020 ELETS EXCLUSIVE
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Ashwini Kumar Choubey
Jai Pratap Singh
Minister of State for Health & Family Welfare Government of India
Minister, Medical and Health, Family Welfare, Mother and Child Welfare Government of Uttar Pradesh
INDUSTRY PERSPECTIVE
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Atul Garg
Minister of State, Medical, Health & Family Welfare, Mother and Child Welfare, Government of Uttar Pradesh
SPECIAL FEATURE
40 34
Niira Radia
Chairperson Nayati Healthcare
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Dr Madan Mohan Rao Managing Director Hope Children Hospital, Hyderabad
PPP Model Providing Right Impetus to Diagnostic Industry
Editorial Union Budget Enumerates Vision of ‘Health for All’ The Indian Healthcare is on the cusp of transformation with technology and innovations playing a crucial role in resuscitating whole spectrum of care delivery system. In the wake of India facing triple burden of diseases including burgeoning NCDs, lifestyle related issues, and infectious diseases, accessible and affordable healthcare is need of the hour. Despite the fact that the sector is growing in unprecedented manner especially in last two decades, offering huge scope to stakeholders, a lot needs to be done to tackle existing underlying challenges on different fronts. Acknowledging various fault lines in the healthcare sector which need to be repaired on urgent basis, the Government has come up with a series of announcements. While presenting the first Union Budget of the new decade in the Parliament, the Union Finance Minister Nirmala Sitharaman highlighted Government’s vision to create a happy and healthy India. Our latest magazine is based on the similar theme which explores how policy measures would impact the healthcare paradigm in coming years. The cover story ‘Healthcare Leaders Decode Union Budget 2020’ encapsulates analytic viewpoints of healthcare leaders. The experts extrapolate different announcements pertaining to healthcare infrastructure, cess on import of medical devices, and ramping up number of skilled workforce. The latest issue also carries a special feature on Indian diagnostic industry, highlighting various facets including opportunity, challenges and the role of PPP model. It also carries vision on healthcare delivery system shared by policymakers including Ashwini Kumar Choubey, Minister of State, Health & Family Welfare, Government of India; Jai Pratap Singh, Minister, Medical and Health, Family Welfare, Mother and Child Welfare, Govt of Uttar Pradesh; and Atul Garg, MoS, Medical, Health & Family Welfare, Mother and Child Welfare, Govt of Uttar Pradesh at Elets Forum. We also have interviews of Niira Radia, Chairperson, Nayati Healthcare; and Dr Madan Mohan Rao, Managing Director, Hope Children Hospital, Hyderabad, who talk about the various initiatives undertaken to cater masses along with their expansion plans. With this bouquet of articles, special features and interviews, we hope this latest issue will invite an invaluable feedback of our readers.
Dr Ravi Gupta Editor-in-Chief eHEALTH Magazine and Founder Publisher & CEO Elets Technomedia Pvt. Ltd. ravi.gupta@elets.in
Cover Story
Healthcare Leaders Decode Union Budget 2020 In the light of Indians becoming vulnerable to non-communicable, lifestyle related issues, and new kind of infectious diseases, the government has laid out its policy crystal and clear in the Union Budget 2020-21. It has acknowledged the importance of accessible and affordable model of healthcare delivery system and focused on bringing in several key structural reforms paving way towards its goal for universal Health coverage. Mukul Kumar Mishra of Elets News Network (ENN) encapsulates analytic viewpoints of healthcare leaders about measures undertaken in the Budget and wider ramifications of the same.
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Healthcare is one of the biggest contributors to the Indian economy and accounts for six per cent of the GDP India’s healthcare market is set to hit $372 bn by 2022 and is expected to create 40 mn jobs by 2030 The hospital industry in India, accounts for 80 per cent of the total healthcare market, growing at a CAGR of 16-17 per cent Medical tourism market is expected to grow from its current size of $3 billion to $7-8 billion by the end of 2020 At least 2% of the GDP on healthcare required to improve overall condition of the ailing sector India accounts for 20% of the global disease burden with a high infant mortality rate of 40 deaths per 1,000 live births
H
ighlighting the Government’s vision of ‘Health for All’, the Union Finance Minister Nirmala Sitharaman recently announced a series of measures as part of the Union Budget 2020 presented in the Parliament. The first budget of the new decade of 21st century was presented amidst huge expectations of healthcare fraternity pertaining to a substantial increase in health allocation, revision in GST rates on medical equipments, impetus to primary care, and encouraging private players to set shops in tier-2 and three cities by offering
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major incentives and tax breaks. Though the Government has tried to address some of the concerns with announcements like viability gap funding, 5 percent cess on the import of medical devices, setting up PPP mode hospitals in 112 aspirational districts, and expansion of Jan Aushadhi programme, those are not considered enough to fix huge fault lines at various levels of the Indian healthcare delivery system. RS 69,000 CRORE TO BOOST HEALTH SECTOR
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Facing a double whammy-continuing rise in communicable diseases and a spurt in noncommunicable or “lifestyle” diseases Primary healthcare — is in shambles with one center (often manned by one doctor) for more than 51,000 people
COVER STORY
INDIAN HEALTHCARE: A GLIMPSE
Shortage of 50,00,000 doctors against WHO norm of a 1:1000 doctorpopulation ratio and shortage of 160,000 additional hospital beds There are only 0.65 doctors, 1.3 nurses and 1.3 hospital beds per 1,000 people in the country 76 percent of Indians do not have health insurance Out-of-pocket (OOP) health expenses drove 55 million Indians into poverty in 2011-12
A total of Rs 69,000 crore has been earmarked for health including Rs 6400 crores for Prime Minister Jan Arogya Yojana (PMJAY), an increase of 4.1 percent over the previous year’s allocation of Rs 62,659.12 crore. As per the Indian Medical Association (IMA) allocation seems too meagre to have any impact. As per the association, Rs 1,60, 000 cr is needed to provide effective care under Ayushman Bharat only. Moreover, the National Health Policy targets to increasing the health budget to 2.5% of GDP by
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2025. The current health budget (Union and state together) languishes at about 1% of GDP. Increasing it by 2.5x in the next five years would require at least a 25% increase in allocations on a year-on-year basis. VIABILITY GAP FUNDING TO BOOST INFRASTRUCTURE The Government has proposed Viability Gap Funding window for setting up hospitals in underserved areas. Viability Gap Finance means a grant to support projects that are economically justified but not financially viable. In the phase-1, hospitals would be set up in 112 identified aspirational districts to increase accessibility of healthcare services through PMJAY (Pradhan Mantri Jan Arogya Yojana ) to the people who need it most. This would also provide large scale employment opportunities to youth.
FEBRUARY 2020
“We need more in tier-2 and tier-3 cities for poorer people under Ayushman Bharat scheme. It is proposed to set up viability gap funding window for setting up hospitals in the PPP mode,� Sitharaman said in Budget speech. 5 PERCENT CESS ON IMPORT OF MEDICAL EQUIPMENT TO BOOST MAKE IN INDIA With an objective to encourage domestic medical device companies and Make in India concept, a nominal health cess of 5% on imports of specified medical equipment has been proposed. The move is aimed to generate resource for delivery of health services in different parts of the country especially in remote areas. The proceeds are expected to be used for building health infrastructure in aspirational districts. The government will
begin with those districts that do not have an Ayushman Bharat hospital. The Medical Technology Association of India (MTaI), that represents mainly researchbased medical technology companies has termed the move as retrograde, going against the ethos of Pradhan Mantri Jan Arogya Yojana (PMJAY) wherein government wants to provide affordable healthcare to all. The cess imposed by the government on medical devices will lead to an increase in cost of imported products and reduce affordability of healthcare, a statement from (MTaI) said. The move will prove to be detrimental as patients will have to bear the increased cost of the imported medical devices. MOTHER AND CHILD CARE
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COVER STORY
In order to improve the nutritional status of children, pregnant women and lactating mothers, the Government had launched “Poshan Abhiyan� in 2017. Continuing with the objective to ensure good health to mother and child, an amount of Rs 35, 600 crore has been allocated for nutrition-related programmes in the budget. In an endeavour to decrease the maternal mortality rate, a task force will also be set up which will submit its report in six months. ATTACHING MEDICAL COLLEGE TO DISTRICT HOSPITAL TO RAMP UP SKILLED WORKFORCE Shortage of skilled workforce including doctor is glaring issue affecting delivery of healthcare services to people at large. To do away with the same, the budget has proposed to attach a medical college to a district hospital in PPP mode. In addition, it envisages special bridge courses to train nurses, and other paramedic
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staff as they play a pivotal role in whole spectrum of care delivery system. A total of Rs 3,000 crores has been allocated for skill development programmes. More than six lakh anganwadi workers have been equipped with smart phones to upload the nutritional status of more than 10 crore households, the Finance Minister announced in the Parliament. The Government will also encourage large hospitals with sufficient capacity to offer resident doctors DNB/ FNB courses under the National Board of Examinations, said the Minister QUALITY AND MEDICINE
AFFORDABLE
As government embarks to achieve Universal Health Coverage, quality and affordable medicine holds huge significance. In this light, Jan Aushadhi Kendra Scheme will be expanded across country, offering 2,000 medicines
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and 300 surgicals by 2024. FOCUS ON TECHNOLOGY
R&D
AND
The Government has reiterated importance of cutting-edge technology and R & D, to develop robust infrastructure in different fields including healthcare. While delivering speech, Sitharaman highlighted roles of data, AI and ML in facilitating things. She proposed two new national level Science Schemes, to create a comprehensive genetic database. Through genome sequencing methodology, researchers can easily detect the disease related to a genetic disorder. The genome project is also said to improve the techniques of genetic screening for diseases prior to birth. ENCOURAGING ENTREPRENEURIAL SPIRIT The Budget has also proposed
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COVER STORY
single-window Investment Clearance Cell with end-toend facilitation that will provide a boost to the entrepreneurial spirit. The Government will also provide early life funding, including a seed fund to support ideation and development of early stage startups. TB ERADICATION CAMPAIGN The Government aims to wage war against tuberculosis (TB), eradicating it by 2025 - ‘TB Harega, Desh Jeetega’. As per World Health Organisation’s global report in 2019, India is leading the globe in TB cases, and 27 per cent of world’s new infections are found in the country. A report says 10 million people had TB in 2018, and it kills 1.5 million every year. BUDGET FALLS ASPIRATIONS
SHORT
OF
Even if Government has tried to address pertinent issues of healthcare, there are many areas which got least attention in terms of allocation.
care to vulnerable people. The allocation for rural HWCs hasn’t been increased this time which will affect goal to establish 1.5 lakh HWCs in coming years. NATIONAL MISSION
RURAL
HEALTH
Rural HWCs are included under the budget head called ‘National Rural Health Mission’, which includes funding for strengthening other components of public health systems in rural areas. This budget head hasn’t had a hike since last year either. FUND CUT FOR AUTONOMOUS INSTITUTES--AIIMS & NIMHANS The budget has reduced allocations to autonomous institutes such as the All India Institute of Medical Sciences (AIIMS), New Delhi, the Postgraduate Institute of Medical Education and Research, Chandigarh, and the National Institute of Mental Health and Neurological Sciences (NIMHANS), Bengaluru, providing cutting edge research and teaching facilities.
NURSING CARE The Budget has decreased allocations for nursing care. For an example for the ‘Development of Nursing Services’, a total of Rs 16 crore has been allocated in comparison to Rs 50 crore in the last budget. HEALTH AND CENTRES (HWCS)
WELLNESS
Health and wellness centre which provides primary care is one of the components of Ayushman Bharat along with Pradhan Mantri Jan Arogya Yojana (PMJAY) ensuring secondary and tertiary
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FEBRUARY 2020
GRIEVANCES OF MEDICAL EQUIPMENT COMPANIES There are other grievances of medical equipment companies like regulatory framework for all medical devices, curbing MRP and trade margins over imports, restricting imports of pre-owned medical equipments in absence of regulations and preferential pricing for quality products in public healthcare, which have not been addressed. CONCLUSION Ayushman Bharat it seems is key
MAJOR HEALTH ANNOUNCEMENTS ARE VIABILITY GAP FUNDING, 5 PERCENT CESS ON THE IMPORT OF MEDICAL DEVICES, SETTING UP PPP MODE HOSPITALS IN 112 ASPIRATIONAL DISTRICTS, AND EXPANSION OF JAN AUSHADHI PROGRAMME.”
focus area of the Government which will be strategically leveraged in coming years to provide better care to masses. Within a span of couple of years, the Government aims to open hospitals in tier-two, three cities and to fill loopholes on several fronts, in order to bolster care delivery system. Terming the scheme a gamechanger, many stakeholders have aired grievances regarding compensation packages which need to be addressed in pragmatic manner. Overall, the budget has tried to put up a holistic vision for the Indian healthcare system through the Union Budget, though time will tell how these measures will bring the effective change.
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COVER STORY
Budget 2020 Analysis by Healthcare Leaders DR SANGITA REDDY Joint MD, Apollo Hospitals Group Given the constraints that the Finance Minister was facing, this has been a comprehensive statement. The government has done a commendable job and the various measures announced will strengthen India, individuals and industry. By invoking the deviation clause in FRBM act and relaxing the fiscal deficit to 3.8 percent in the current year and targeting 3.5 percent in the next year, the government has underscored its resolve to support the economy at a time when it needs a fiscal boost.
DR ALOK ROY Chairman of Medica group of Hospitals The government has shown its commitment towards healthy India by providing Rs 69,000 crore to the healthcare sector. It has rightfully focused on bringing in several key structural reforms for the nation moving towards that goal. It is heartening to see the Government’s display of commitment and concern towards rural healthcare by announcing more empanelled hospitals under the flagship Ayushman Bharat Scheme in Tier 2 and 3 cities. The budget has rightly outlined by specifically focusing to those areas where there are no hospitals. The proposal to set up Viability Gap Funding window to build hospitals in the public-private-partnership (PPP) model will widen the scope of the government’s flagship scheme, AB-PMJAY and will provide large scale employment opportunities to youth.
RAJIV NATH Forum Coordinator, Association of Indian Medical Device Industry (AiMeD) We were expecting the government to move forward on promised reforms and anticipated conducive measures to boost domestic manufacturing of the medical devices. It is frustrating that against our expectations, the government has not included any measures to help end the 80-90% import dependence forced upon us and an ever increasing import bill of over Rs. 38,837 Crore & promoting growth Indian Medical Device industry. AIMED after going through the fine prints of the budget finds out that only a meagre increase of 0.25% is given whereas the Medical Devices Industry thought 5% cess on Basic so it’s 5+ 5 = 10%.
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DR AZAD MOOPEN Founder Chairman & Managing Director, Aster DM Healthcare The Union Budget, prepared in difficult economic scenario has managed to create opportunities for growth within limited resources. It is good to see that Finance Minister has provided some benefits in the union budget for the healthcare sector. However, it is unfortunate that the allocation of Rs 69,000 cr for the sector is only just 1% of GDP which will be highly inadequate for any major leap forward in the sector. The budget is almost silent regarding NRIs and many of the demands and suggestions to benefit them have not been considered. The Budget has created huge anxiety and significant confusion among the NRI community. While there is no benefits in the budget for the NRIs who send billions of dollars to their motherland to shore up its foreign currency reserves every year, it appears that they Central Government is trying to put them into difficulty through some of the budget proposals.
MANISH SACHETI CFO, Ziqitza Healthcare Ltd This year’s Union Budget has been a positive, holistic and visionary one for the healthcare segment. The allotment of Rs 3000 crore funds under skill development is a positive move by the government since the EMS (Emergency Medical Services) industry requires a high number of skilled individuals in paramedics as they play a vital role in saving lives. There is also a huge potential for job creation in the EMS segment. The announcement by the Government to provide viability gap funding for setting up PPP mode hospitals in areas like tier 2 and tier 3 cities under the Ayushman Bharat Scheme is another positive move.
GAUTAM KHANNA CEO, P.D. Hinduja Hospital & MRC We are delighted with the budget allotment of Rs 3,000 cr for the skill development sector. This will help further hone skill of Indian healthcare practitioners to match the international standards. Also, district hospitals being attached to medical education institutes is a good thought out step by the Government that will help to increase the number of doctors in our country which is the need of the hour. However, we will need more clarity on how the big hospitals will increase its students for the DNB Courses as this will require more professors which is a limitation today. Overall the allotments in total of Rs 69,000 crore inclusive of Rs 6,400 crore of PM Jan Aroyga Yojana will help entrepreneurs and healthcare providers set up care centers which will help to multiply the serves to the population.
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CHANDER SHEKHAR SIBAL Senior Vice President, Fujifilm India The emphasis and outlay for healthcare and education was a much-needed boost to create a healthier and more skilled India. The government’s intent to make a healthy India by expanding its horizon and supporting the “TB Harega, Desh Jeetega” to eradicate tuberculosis by 2025 is a commendable initiative that will yield positive and long-term impact. Rs 69000 crore stimulus to the healthcare sector will provide the required impetus to the sector. Further, the government’s proposal to boost the domestic electronics manufacturing will also impact the healthcare sector encouraging innovation and reducing cost of healthcare. We believe that the government has put forward a progressive budget with a strong vision to take India’s social, economic and overall well-being to greater heights.
DR ALOKE MULLICK Group CEO OMNI Hospitals Proposed allocation of Rs 69,000 cr in the budget towards better healthcare for tier 2 and 3 towns, is a welcome move as it will create employment opportunities and create access to quality healthcare services in those underserved areas. Extending PMJAY to bring more underprivileged within its ambit will ensure better treatment options for the underprivileged. However the budget failed to address the long-pending request to remove/minimize GST slab for health insurance premiums paid. Health insurance penetration being low in the country, change in the GST slab could have driven growth in the number of insured.
SHALABH PALIWAL Chief Financial Officer, Jaslok Hospital and Research Centre Budget 2020 has certainly focused more on the healthcare than previous budget. Government in last two fiscal years have increased budget for healthcare sector from Rs 54000cr to Rs 69000cr mainly aiming to provide more support to schemes like Ayushman Bharat, PMJAY, Mission Indradhanush and more. Government will be concentrating on empanelling hospitals under Ayushman Bharat more in tier 2 cities for the benefit of the poor in these areas. Also in rural areas, where there are no hospitals, government aims to operate on PPP mode hospitals. As a measure to boost local manufacturing of medical equipment government has proposed health cess on import which is going to help in boosting local industries and encourage competition.
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ZOYA BRAR Founder and CEO, CORE Diagnostics It is encouraging to see over 10% increase in the allocation of funds to the Healthcare sector for the budget 2020-21. While there has been no significant announcement pertaining to diagnostics industry, it is good to see the government’s growing focus on PPP mode ensuring accessibility and availability of quality healthcare services in remote locations. We are intrigued about how the government will use the fund of Rs 6400 crores allocated exclusively to Ayushman Bharat to the benefit of the people residing in tier II and III cities. The expansion of government’s existing programme - Mission Indradhanush - to cover 12 new diseases and 5 new vaccines would be extremely beneficial in order to drive immunization across the country. The investment of Rs 8,000 crore for National Mission of Quantum Technology and Application is another noteworthy announcement for the healthcare industry.
ARINDAM HALDAR CEO, SRL Diagnostics The allocation of Rs 3000 crore for skill development of teachers, nurses, paramedical staff and care givers is an excellent step, well-trained resource has always been one of the major concern for the healthcare industry. But what’s still missing is a healthcare scheme that provides cover for outpatient department (OPD) and diagnostics expenses. Ayushman Bharat, being the world’s largest government-funded insurance scheme, could have brought in diagnostics under its ambit, as the Indian healthcare spends huge amount under out-of-pocket expenditure.
NITIZ MURDIA Marketing Director, Indira IVF Increased budget allocation will definitely help the healthcare sector to grow. Better healthcare facilities were needed for tier 2 & tier 3 cities. The step to provide medicines at affordable rates is the need for the hour especially for the economic weaker section of the society. But the insurance coverage remained poor leaving higher expenditure struggle for people. The accessibility of the healthcare services for people will increase with focus on the infrastructure. More was expected from the government for the healthcare industry as it is directly related to the citizens’ existence.
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GAURAV GUPTA Co-founder, Navia Life Care From the healthcare sector perspective, accessibility issues were addressed and setting up of more hospitals in tierII and III cities under the PPP model for expansion of the Government’s Ayushman Bharat scheme is a step in the right direction. It would definitely assist health-tech startups like Navia to expand its reach to Tier-II and Tier-III cities.
KR RAGHUNATH Senior Chairman, Jindal Naturecure Institute We are not going to be able to achieve universal health coverage with traditional approaches alone. We also need to harness the preventive health benefits of alternative medicine systems to tackle the rising NCD surge. Even the WHO has talked about the need to promote standardized and regulated practice of alternative medicine in conjunction with conventional medicine to tackle chronic conditions. It is high time the government seeks the expertise of the stakeholders in the industry and come to a decision on the regulatory policies and standardization protocols that will promote judicious use of alternative medicine. It will also promote research, randomized control trials and help lay the foundation for integrating them into the traditional healthcare setting so that patients stand to reap their benefits.
NIVEDITA DAS GUPTA India Country Head, Miracle Foundation India The Finance Minister’s announcement in the Budget 2020, with its three-pronged focus on aspirational India, economic development for all, and the emphasis on building a more compassionate society is encouraging. The fact that the nutritional status of more than 10cr households has been recorded by Anganwadi workers is remarkable, and the Rs 35,600cr proposed for nutrition-related programmes is a necessary development. A systematic, standardised framework will be essential for its effective implementation. Further, the Rs 28,600cr allocation for women-linked programmes is of particular importance in terms of reducing maternal mortality rates, and we welcome this proposal wholeheartedly.
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‘1.5 lakh Sub Centres to be Converted into Wellness Centres by 2022’
H
ealth is the biggest wealth one could ever have. Human health is priceless. Even if one has amassed a huge amount of wealth, it proves to be futile exercise if he or she doesn’t maintain good health, Ashwini Kumar Choubey, Minister of State for Health & Family Welfare, Government of India, said while delivering a speech at the Annual Healthcare Summit held in New Delhi. Speaking on this occasion, he cited five elements of which a human body is made of and what role does our environment play to keep us healthy. “Human body is made of five elements— kshiti, jal, pawak, gagan
and samira. These five elements are a part of environment & nature which play an important role in nourishing human health. Environment protects human being in its own ways and it must not be challenged at any cost,” he said. Heaping praise on Elets Technomedia for bringing together experts to share best practices, he said, “I am delighted that Elets Technomedia along with eHealth Magazine has organised the twoday summit where dignitaries and healthcare experts from different parts of the country have participated. The conference would chalk out different ways to offset challenges
Ashwini Kumar Choubey Minister of State for Health & Family Welfare Government of India
and deliberate upon how every single citizen would avail accessible and affordable care.” INDIAN HEALTHCARE Bihar had NDA government in 2005. As a Health Minister, I travelled to many villages and implemented many programmes related to cleanliness and health. We organised health fairs to make people aware about health issues. Health has been a priority sector for the Government and several measures are being undertaken to provide affordable, accessible, and quality care to masses. With support from State Governments, we are scaling up different health schemes and initiatives. In recent years, the Indian
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best facility in big hospital like Medanta which otherwise will be a dream for him. A total of 1,300 types of packages are available in the scheme. India will become happy and healthy country only when every single citizen will have access to better care.
AYUSHMAN BHARAT Ayushman Bharat is one of its kind initiatives in the world which guarantees ‘right to quality healthcare services’. In order to make India happy and healthy, the scheme enables poor people to avail quality tertiary care of worth Rs 5 lakh. Around 20 thousand government and private hospitals have been empanelled with the scheme. Around 70 lakh people have been benefitted till date. As many as 13 crore golden cards have been distributed to facilitate care through empanelled hospitals. We are striving towards Universal Healthcare. This scheme enables a poor man to avail
INDIA TO BECOME TB FREE COUNTRY BY 2025 While 2030 has been the set target to end TB for world countries, we have taken a pledge to make India TB free country by 2025. We have plans and strategies in place for the same. We are going to start 22 AIIMS to increase the number of doctors. Both UG and PG seats have been increased to meet huge requirement in terms of skilled workforce especially doctors. More than one lakh sub centres will be converted into wellness centres to provide best facility to people residing in villages for whom out of pocket expenditure is major constraint. The target is 2022.
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HEALTH HAS BEEN A PRIORITY SECTOR FOR THE GOVERNMENT AND SEVERAL MEASURES ARE BEING UNDERTAKEN TO PROVIDE AFFORDABLE, ACCESSIBLE, AND QUALITY CARE TO MASSES. WITH SUPPORT FROM STATE GOVERNMENTS, WE ARE SCALING UP DIFFERENT HEALTH SCHEMES AND INITIATIVES.
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healthcare sector has evolved a lot and credit goes to cutting-edge technology including telemedicine and artificial intelligence and lots of innovative works. Government’s objective is to make healthcare preventive, progressive promotive, and qualitative.
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‘Govt Working on War Footing to Improve Health Infrastructure’
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ttar Pradesh has a population of 230 million. Its sizable amount of population is equal to many countries in the world. We are like a country in terms of population. 60 percent of population thrives on agriculture in the State. They need accessible and affordable healthcare and the Government is striving for the same, said Jai Pratap Singh, Minister, Medical and Health, Family Welfare, Mother and Child Welfare, Government of Uttar Pradesh, while delivering a speech at the Annual Healthcare Innovation Summit held in New Delhi. Referring to the previous governments, he said, “Uttar Pradesh has not been managed well in the last 20 years administratively and technically to improve overall care. It becomes a little difficult to align bureaucracy with our vision. This is happening in the country as well. It makes a lot of difference in policy put up by the Government of India.” Talking about existing infrastructure in UP, the Minister said, “We have 175 district hospitals, 853 community health centres, around 3,621 primary centres and around 20,521 sub centres. With this infrastructure in place, we try to provide services to the poorest of poor who visit our centres looking for affordable and quality care. Over the years the services from doctors to patients have deteriorated for a number of reasons. It becomes
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frustrating at times for the doctors who don’t able to replicate things in a similar manner as they were taught in medical colleges.” JAN AASUDI KENDRA IN DISTRICT HOSPITALS Over the last two and a half years, we gave free medical services like CT scan, MRI, haemodialysis, ultrasound, digital x-ray, and cheap medicines to entire population. We have Jan Aasudi Kendra in district hospitals which makes people available good quality medicines at an affordable price. The Government ensures supply of the medicine to the lowest level like primary and sub centres. TRAUMA CENTRES ON NATIONAL HIGHWAYS In the wake of rising incidents of road accidents on national highways, we have opened trauma centres on almost every 50-100 kilometers on NH. We have a total of 2200 ambulances which can be availed at 102 and 108. SKILLED WORKFORCE We have a shortage of about 7,000 doctors today. As per 2001 population census, we require 18,000 doctors but we have only 12,000. As per 2011 census and WHO standard, we should have 36,000 doctors available to provide optimum care. In this light, the State Government has opened 29 medical colleges in last two and a half years. Out of
Jai Pratap Singh Minister, Medical and Health, Family Welfare, Mother and Child Welfare Government of Uttar Pradesh
these, 11 colleges have already started MBBS courses. Others are under construction and will be ready by 2022. With these colleges and 13 existing one, we will have 3 lakh doctors. They will help to provide inclusive care to masses. TECHNOLOGY We are also aiming to upgrade technology to enable better delivery of care. Technology on front of housekeeping, operational management, and disease related apps are being explored. We are working on telemedicine concept which will facilitate expert doctor’s advice from metro cities to a person living in remote villages. This will fill gaps on front of skilled workforce.
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ccountability and work management coupled with robust strategy can do away major issues affecting the delivery of healthcare in Uttar Pradesh, said Atul Garg, Minister of State, Medical, Health & Family Welfare, Mother and Child Welfare, Government of Uttar Pradesh, while delivering a speech at the Annual Healthcare Innovation Summit, held recently in New Delhi. Feeling little sad about the current situation in Uttar Pradesh, he said, “I have identified problem areas in UP’s healthcare delivery system in the last four months since taking the reins in hand. I found that problems can be solved as it is not as difficult as it seems to be. We have Rs 8,000 crore healthcare budget for Uttar Pradesh. 25 percent of total population has been covered by Ayushman Bharat. It is not difficult to cater to the rest of the poor people as approximately Rs 1500 crore
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would be required for the same. But it is not happening at the moment.” Holding coordination gap and mis-management major factors, jeopardizing delivery of healthcare services, the Minister, said, “Recently I visited a 30-bed PHC. There were two anesthetists at the centre, despite the fact that not a single patient was there for the treatment. There should be coordination between distribution of work and expertise.” “There is a gap on front of accountability, distribution of work and expertise. Some experts doctors are found to be in management role which they shouldn’t supposed to do. Ideally, they should handle emergency medical patients.” On this occasion, he made an appeal to private players to come with innovative ideas to bolster UP’s healthcare delivery system. The Government needs better and
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‘Accountablity, Management & Strategy Key to Bolster Patient Care’
Atul Garg Minister of State, Medical, Health & Family Welfare, Mother and Child Welfare, Government of Uttar Pradesh
innovative ideas so that every single citizen of the state gets affordable and accessible care. We need to use resources in a prudent manner. Referring to work done in the last two and a half years, he said, “In last two and a half years, there has been a substantial progress in the delivery of health services. We have a robust 108 ambulance network in the State. Ambulance takes on an average 15-17 minutes to reach at the particular location. HR and IT department can tackle works related with distribution of work allocation and management.” The Minister also heaped praise on Elets for organising the grand Summit and bringing up top stalwarts of the healthcare fraternity together. “Uttar Pradesh will definitely be benefitted from the Elets Annual Healthcare Innovation Summit Conference which has witnessed participation from spectrum of thought leaders from policymakers to international experts and industry leaders,” he said.
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‘Need to Recalibrate Strategy to Tackle NCDs, Lifestyle Diseases’
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e must understand that health sector presently is looking in a very transitive state. “The government policies have very clearly defined that we are moving from a pure health to health & wellness. That is why we have come up with the concept of health and wellness centers,” says Nitin Madan Kulkarni, Secretary, Department of Health & Family Welfare, Government of Jharkhand. No more primary health center ad community health centers but we are looking at ‘Health and Wellness,’ center now. As soon as we use the term wellness, it broadens the perspective because health is just curative part but when you say wellness, it increases the gamut of it without limits. As a state level stakeholder
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in policy making and implementing the policies, we are looking at changing pattern of diseases. The pattern of disease is changing and so is our problems. Earlier we were looking at healthcare from a preventive aspect, as far as it was particularly more concerned about the maternal and child health. Now we are more concerned about the non-communicable diseases. Earlier our focus was only rural areas while now the focus has been shifted to urban areas now. Most important part which most of us are neglecting is the mental health component. Nobody used to think that mental health is also equally important if not less than the curative health. And now, finding mental health professionals has become a tough challenge for the
Nitin Madan Kulkarni
Secretary, Department of Health & Family Welfare, Government of Jharkhand at the Annual Healthcare Innovation Summit, Delhi, 2019
state governments as well as the central government. In health sector, we are having acute shortage of resources, be it manpower, infrastructure or even technological component. To handle this, we require lots of process innovations, system innovations and more importantly we have to come out with some easy solutions where we can provide at least basic services to our citizens at the farthest point of place. Right now goal of the state is mainly to reduce ‘out of pocket expenditure.’ In India, almost 70% of the health expenditure is out of pocket and it is from the family revenues that the income is being generated.’ According to a study, ‘almost 7% of our population is just on the verge of poverty line, only because of few catastrophic health events. Therefore, our main focus is to reduce this out of pocket expenditure.
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S Suresh Kumar Joint secretary and Additional CEO, Government e-Marketplace (GeM), Ministry of Commerce, GoI at AHIS’19
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ike in all other countries, in India too health sector plays a very pivotal role, in the sense that we have almost over 1.3 billion of population and the health sector in India is considered to be one of the critical sectors where there is still large scope of innovations. There is need for large investments and government spending as well. S Suresh Kumar, Joint Secretary and Additional CEO (GeM), Ministry of Commerce, GoI at AHIS’19 was seen pretty clear headed in his thoughts upon the expected role of govermene in maintaining and improving India’s present day healthcare system, while delivering speech at the Annual Healthcare Innovation Summit, Delhi (AHIS). The good news is that over the time, the government spending in health sector is actually increasing, though very gradually. From 1.2% five years back to almost 1.5% of the GDP is what we are spending on. If you take a look at the total procurement which takes place in
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the health sector, as far as the devices and the equipments are concerned it is estimated that almost to the tune of about 1lakh crore per year which is almost about 15 billion dollars per year is the procurement which happens in India. And if we add the drugs, vaccines and other items to it, it will be another 50 thousand crore; maybe another 7-8 billion dollar. So 25-30 billion dollar is the current procurement which happens in the health sector. This is actually contributed by the private sector as well as the public sector. The estimated value of public procurement in the health sector is 30-40 thousand crores per year. All the multi-specialty hospitals starting from AIIMS in Delhi to the PHCs (public health centres) in a remote village in the country, if you take the entire spectrum, the procurement of medical equipment devices is around 30-40 thousand crores. Added to it there is another 25-30 thousand crores of drugs, vaccines and other consumerables which are also being procured. Current procurement system of our country with regards to government holds the perspective that their procurements are not efficient, not transparent, lot of corruption and lot other issues as well. Government e-Marketplace is one initiative which government of India had launched in 2016 to transform the public procurement in our country; not specific to health but the overall public procurement in the country. Government e-Marketplace is an online platform like any Amazon or Flipkart. From the private sector, industry and manufacturing sector, government department procures
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many items. As far as the overall procurement is concerned, today GeM has transformed the public procurement through basically 3 aspects; 1. Bringing in transparency It’s an online platform and a marketplace, so anybody who is registered onto the portal, be it a buyer or a vendor, or even not registered also; anybody can actually go onto the portal and see what are the products available, what is the place offered, and what are the specifications. 2. Efficiency and speed - In a manual procurement system, whenever we want to make huge procurement, the general system is that a tender will be floated, a bid will be invited, quotations will be invited and the evaluation will be done by a technical committee within the department. But the scope of evaluation is limited to the limited number of tenders and bids received in that particular office. 3. Quality Assurance - end to end tracking from the place where it is manufactured to the last delivery point, we need to have end to end tracking, which is very difficult in a manual system. Today we have technology like block chain technology and AI. Maybe medical and health sector is going to be the first sector where we are going to employ AI and block chain technology to ensure the tracking of the medical equipment including drugs and other items. To all the manufacturers who are still not registered on the GeM portal, please get registered, as the process is pretty easy and seamless.
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GeM — Transforming Public Procurement System
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‘Technology Playing Pivotal Role in Enriching Healthcare Experience’
Dr Neeta Verma
Director General, National Informatics Centre, MeitY, GoI at the Annual Healthcare Innovation Summit, Delhi, 2019
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rofessionals in healthcare have been leveraging technology in various dimensions of healthcare right from research and development, be it new treatment, technique, diseases, virus, bacteria, and to discovery of new drugs. “Technology has been playing a significant role in enhancing and improving the present day healthcare system,” claims Dr Neeta Verma, Director General, National Informatics Centre, MeitY, GoI . Infact, if you look back in last 2 decades there has been a significant development in medicine science as a whole and has really progressed at a fast pace. You can look at the intervention of lasers at almost all kinds of treatments and the kind of convenience and simplification it has done in terms of procedures is something marvelous. Now we are beginning to see the use of robots, which has not only helped doctors doing more and more precision, but it has have huge potential of addressing a problem in our country where we are asked upon how we provide quality healthcare to our country’s residents and people in the remote parts of our country.
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Management of healthcare also has also seen a huge intervention of technologies; be it patient services, to hospital management; not only the front desk services but even the backend services. Access to healthcare which is unique to our countries and may be to all other developing countries where government has been always focusing; how do we provide this quality healthcare which is easily accessible to people in these big cities to all those people who are sitting in rural parts or tier 3 or 4 cities for that matter. Telemedicine is a big name to happen, all thanks to those broadband and data networks which we have been able to see even on mediums like whatsapp as well. It has been particularly effective for the follow-up part where the patient doesn’t have to travel all the way to the hospital just for the follow-up purpose and therefore people are finding this technique to be very effective. Lately we have also been seeing this AI intervention into it. AI based models are really helping the healthcare professionals in early detection disease , designing a précised and personalized treatment for each patient. We have already seen some good efforts from startups as well as from some big hospitals in collaboration with IT giants in terms of detection of diabetics, cardiac interventions and conditions, pulmonology and now we are also seeing that how these technologies such as AI can also help early detection of cancer. And we all know that the early detection of cancer can really make a huge change in whole course of the patient’s life. At NIC we have been associated with all these dimensions of healthcare
for over 3 decades. Our journey or association with healthcare began much before even internet came into picture. We had a program in 1980s which was called MEDLARGE program; where we used to provide access to medical literature published worldwide to the professionals in India because at that time internet and all such things weren’t there. We were also helping building the corpora of research done within India as lot of good research was already happening. Going from there we worked with government in managing the large government health programs, not only with central government and also with many state governments right from beginning at programs like INDRADHANUSH of children’s immunisation to this Mother and Child Tracking System, which is even today where they track a child’s growth even before it is born. The intervention of IT in this as we have progressed has not only made sure that these benefits are reaching to last mile who really need to be benefitted from these programs of immunization, nutrition, etc. It has also helped the government in looking towards the ‘Current Status!’ During this process, we also happened to build a software for the hospital management system called E-hospital. This is the software which not only takes care of OPD, IPD or OT part of management, it also takes care of all the backend operations which laundry, dieticians and all other HR related jobs of the hospital. This e-hospital software is presently working in over 300 hospitals in India which also includes premium hospitals like AIIMS, KGMU Lucknow, PML hospital and many other AIIMS of the country.
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aking the audience through a journey of developments in Mauritius, J Goburdhun, GOSK, Commissioner of the Republic of Mauritius to India, was delivering a speech on the healthcare scenario of mauritius and showcasing a difference as to how is it different from India’s present day healthcare situations. There has been a lot of development in the health sector. Be it government or private sector, we are proud of the innovation which has been done and for serving people in the best possible manner. But I would like to say that we have failed in giving health to the population throughout the world. In 30’s and 40’s there existed the problem of Malaria along with other communicable diseases and we have managed to work very hard and almost eliminate the problem. But for the last 50-60 years we had the non-communicable diseases which have been widespread and the management has worked very hard to help the diseased get over from those diseases, including cancer. For the last 60-70 years we have had WHO performing a commendable job. Even the 175 policy of health for all was a successful venture but still they have failed to provide health to the overall population and that is why we have an epidemic proportion. Taking this in mind, I would like to say that all of us need to work together. We are all living in one world ‘Vasudhaiva Kutumbakam,’ so why think divergently and not for all. The ministry is doing their task solely, private companies are doing solely but how are we including the people for whom we are working towards? Very proudly I can claim that we have served our country pretty well in Africa. I got the people involved
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and doubled the primary healthcare services within 2 years. Mauritius being a country where health is free and medicines are free, food is free, ambulance is free but it could all happen because of the mingling of people. Now we can say Mauritius is best in Africa, first country in democratic economy and we are proud to have been contributing, keeping up as a welfare state. Making a country free of cost for education from pre-primary to university, healthcare, as good as Singapore or any other country, all these facilities have been provided in the name of giving good healthcare to all citizens. So, we have failed in all these aspects here and we all have to collectively work towards it and can provide health and wellness to all. Good health you don’t get in hospitals or with the intake of medicines or by taking appointments from doctors; good health you can best avail at home. And talking about wellness, India possesses one of the great Prime Ministers of times who has actually came up with a real ministry of health, AYUSH. It
WITH THE INCOMING OF AYUSH, IT DOESN’T MEAN THAT WE DON’T REQUIRE PRIVATE TECHNOLOGIES OR SUPER-SPECIALTIES, BUT WE ALL NEED TO WORK TOWARDS A COMMON GOAL HAND-IN-HAND.
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‘Collective Efforts Needed to Ensure Well-being of Masses’
J Goburdhun, GOSK
Hon’ble High Commissioner of the Republic of Mauritius to India at AHIS’19
is the real, most innovative, effective, promotive and creative initiative. With the incoming of AYUSH, it doesn’t mean that we don’t require private technologies or super-specialties, but we all need to work towards a common goal hand-in-hand. Talking about health and wellness, there are 2 main components into it Yoga/exercise and intake of good food. From last 60-70 years we have been taking the most poisonous food. You are eating food which is cancerous, mixed with the spray of pesticides and insecticides. And this is not the best Indian technology being utilised, as you have better than this but you are not utilizing it optimally. with mere one cow you can plant multi-acre of cropped farm lands and this initiative too has been taken by your Prime Minister and has been applauded globally. We need to follow our own culture and traditions to lead a healthy lifestyle. Pesticides too are important but they can be substituted with natural ones like cow’s urine and neem leaves. Therefore it’s important to include natural farming methods in order to get access to healthy food.
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‘Big Data and AI Helping to Optimise Healthcare Processes’
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he aim of Finnish health policy is to lengthen the active and healthy lifespan of citizens, to improve quality of life, and to diminish differences in health between population groups. Ritva Koukku-Ronde, Hon’ble Ambassador, Embassy of Finland, threw light upon the much talked about healthcare scenario of Finland. “Healthcare system in Finland is practically free and open for everybody. We very much believe upon the philosophy that health and well-educated people and kids are our future. We are a small country and we cannot let anybody stand outside of the society. I wish to share with our the Finnese experience in particularly
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digital healthcare transformation and in creating a global hub for medical innovation. Our national character and northern heritage have posted us to the top of numerous country ranking. In many respects, Finnese healthcare is state of the art among many countries. We are global leaders in digital health. Finland ranks among the 3 strongest health technology economies in the world, while digital health is our largest high-tech expert,” claims Ritva Koukku-Ronde, Hon’ble Ambassador, Embassy of Finland. IT in healthcare is a new trend being followed, with the introduction of digital healthcare system. Ritva is of the view that, “Big data and Artificial intelligence will help to optimize
Ritva Koukku-Ronde
Ambassador, Embassy of Finland, New Delhi at Annual Healthcare Innovation Summit, Delhi, 2019
healthcare processes for ultimate resource, efficiency and human well-being. Smart usage of Data will play a decisive role in future health management. We need an enabling and innovative environment and also global partnerships.” “Talking about how we have got Finland to the forefront of healthcare digitalisation, we have several strengths which have helped up to get onto this level. 30 years history of sample collection, single unique national identification number used by authorities. In healthcare, 100 % Finesse patient record are available in digital format. Finland’s public healthcare system boosts electronic healthcare record penetration at 100% paperless referrals. Finland is amongst first of the many countries in the world which covers both public and private healthcare sectors. All
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Finnese citizens now have an online access to repository services such as e-prescription history. Soon people can also upload personal health information and choose the current access of your own data or other health professionals. Secondly, we have universal free healthcare and continuous care guidelines. Thirdly, one of our strength is isolated population. Instead of forming an obstacle, Finland isolated the population which became one of the reasons for our success in health. Fourthly, secondary use of health and social data permitted in 2019. The Finnese parliament approved this year in march and bill was constructed several times to cure a safe and ethical way to transparently access Finnese health and social data,” claims the Finland Ambassador. With the onset of healthcare facilities at your doorstep, ensuring high quality of care for entire population with triple-fold costs, the healthcare systems need complete makeover. “We need to develop preventive health report with easy home diagnostics and self-monitoring solutions to affect elastic behavioral change. Home diagnostics, data on nutrition, exercise and a generous status of health can be used to create
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personalised profiles that function as the basics for participatory lifestyle coaching. By combining home diagnostics with genetics information, we can provide important and more accurate insights into the person’s health trends and risks, while reducing health across and improving quality of life. To give you an example from Finland; when it come to smart phone applications, we can go well beyond measuring heart rates and daily activity levels. The technical research centre of Finland together with Finnese private sector have developed artificial intelligence based analysis methods that are now used in a commercial smart phone application for health monitoring. Combining Big Data with individual system, the application can estimate health users risks and if necessary, guide them towards a healthier lifestyle. With all this in mind, it is not surprising that Finland has strong partnership with leading international actors in medicine and healthcare like IBM, Mahindra, Pyer, etc. This is a great example on how we can find new information that are concretely valuable to both citizens, healthcare professionals and companies by analyzing large and diverse data masses,” said Ritva.
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‘Indian Healthcare System Inspiring Latin American Countries’
Hector Cueva Jacome
Ambassador, Embassy of Ecuador in India at Annual Healthcare Innovation Summit, Delhi, 2019
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he Latin American region has seen significant social and economic changes over the past 50 years. However, it is a region with high variation in terms of economic development and health profiles among its population. Hector Cueva Jacome, Hon’ble Ambassador, Embassy of Ecuador in India, explains the over hiked prices of healthcare facilities in his country Ecuador and other Latin American countries. “Normally in Latin American continent we used to think that the technology needs to come from developed countries like Europe, the US, Canada, Japan, etc. But with time we realised that India can provide us affordable, accessible and adaptable technology. After living for almost 5 years in Mumbai and almost 2 years in Delhi; I can assure you that India has the technology that can develope and not only change my country but also worldwide healthcare. Since the time I have been living in India, over the time I have developed 2 great passions; one is agriculture and another is healthcare. So I have spent a lot of
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time in researching, visiting hospitals, pharmaceutical companies and many such related states and cities in India. And absolutely India possesses great knowledge of providing solutions to healthcare issues. I want to throw light on the scenario of my country and few others in Latin America by quoting few examples. Treatment for hepatitis costs around 60 thousand US$ and in India it is for only 4500$. The cost of monthly medicines of Hepatitis Prosthetic Cancer in Ecuador costs 4500$ and here in India it costs 900$,” said Hector Cueva Jacome, Hon’ble Ambassador, Embassy of Ecuador in India. Basically the paradigm shift towards adopting of Indian healthcare practices is all a game of numbers. When they are able to receive quality and affordable treatments and medicines in India then why pit a hole in own’s pocket! Jacome is of the view that, “here you can see and realise that the cost difference is almost twice the Indian
cost on an average, which accounts for enormous difference. Also the difference of surgeries and treatments is huge. Therefore our major concern is the high treatment cost and even higher medicinal costs. In 2013, I happened to meet a guy from Chile and in 2014 he called and told me that he was suffering from hepatitis A and asked me to send him medicines. For me, the most obvious and convenient idea which I gave to my friend was to visit India, get an appointment from a doctor, who in turn which prescribe you medicines which you can buy and go back to your country. But, because he was very badly affected with the ailment and was waiting for a liver transplant to happen, therefore he urged me to send him medicines at the earliest. The medicines and treatment in Chile costs more than $60,000 and here in India it’s only $4500. So at the end I sent him medicines and as of today he is completely healed.” Between 2005 and 2015, public
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health expenditure as a proportion of GDP increased in all countries. During this time out-of-pocket health expenditure also increased in Colombia, Ecuador, Panama, Peru and Uruguay, along with the comparator countries between 2005 and 2015. “According to the specialists in US, Obamacare will disappear in next 3-4 years as this act isn’t a sustainable one. Also, Trump wanted to eradicate Obamacare act but if you are aware of the history of this act, the person who helped this act survive was John McCain,” claims Jacome. So in future, few specialists claim that Obamacare is going to disappear as Trump claims this act to be non-sustainable in near future. Just the way Dubai is known for its exquisite tourist attractions, similarly Jacome wishes to have a country amongst Latin American continent, which would be a catering to all kinds of affordable and accessible healthcare facilities. “Having visited over 30 hospitals in India, I found that majorly they all are providing the unit of medical tourism facility. A month ago, I happened to visit Medanta Hospital
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and asked if they had patients from Western America, US, Latin America, Europeans etc. to get themselves treated in Medanta or for medicines and to which they replied that they only possessed 1% only. So what is the perspective of the business of healthcare in Latin America as the costings are huge there and treatments too tend to cost higher because of high priced medicines. For one percent, the generic medicines in the US come from India only. But, what is happening in few Latin American countries is that we purchase only one percent of India medicines for our public and private social security. There is no sense of buying medicines from the US and Europe as they ultimately buy medicines from India. So we need to build a bridge and change the scenario as we are not buying mere clothes or toys, it’s a matter of life and death. So basically we should try and build up a city in Latin America which will be catering to the nearest countries so that they don’t have to travel from Latin America to India only in the name of healthcare.”
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‘Tapping the Untapped Potential Healthcare Market’
Moe Kyaw Aung Ambassador, Embassy of The Republic of the Union of Myanmar at Annual Healthcare Innovation Summit, Delhi, 2019
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conomic growth and greater healthcare awareness demands efficient innovations in the healthcare segment. To tackle the health related issues, international collaboration is a must to deliver the tangible growth result in both economic and developmental aspect. To enhace the same, Moe Kyaw Aung, Embassy of the Republic of the Union of Myanmar was seen collating the main aspects and projecting his country’s healthcare policies with ambassadors of other countries. Against the background I would like to brief on the mass effort to pursue universal health coverage which has also become a global priority in recent years. With regards to health aspect of Myanmar, I would like to take the opportunity to brief a glimpse on Myanmar to promote healthcare for its citizens. In Myanmar all health activities are implemented in conformity with the following strategy laid down by the Ministry of Health
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and Sports; • Widespread dissemination of health information and education to reach the rural areas • Enhancing disease prevention activities free of cost • Providing effective treatment of prevailing diseases Myanmar government adopted national policy in 1993. The policy has placed the health of all goal as a prime objective using primary healthcare approach. One of the prime objective of this policy is to strengthen collaboration with other countries for national health development. The objective of the policy is in line with the ministry strategy to achieve universal health coverage which all people have access to receive serviced healthcare. India and Myanmar enjoy good time tested friendly relations. Comprehensiveness of the relations also cover health sector collaboration through capacity building assistances to Myanmar.
Training and technical assistance in health sector to Myanmar are welcome. Moreover, increasing number of Myanmar patients have been travelling to India to get themselves medically treated, especially in transplant. I am confident that this is a promising sign of collaboration of medical tourism between 2 countries. A number of healthcare institutions and companies are also showing interest to reach out to Myanmar where healthcare market potential is largely untapped. I am also delighted to say that more Indian hospitals and health institutions are proposing to collaborate with Myanmar counterparts. As India is in the midst of healthcare transformation, promoting collaboration poised to compliment each other’s health sector’s development. In this context innovative technology in health sector is essential to leverage both country’s collaboration in building healthcare ecosystem.
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G
abon is on Africa’s west coast with a population of 2 million people, with 9 states which we call as Province. In terms of healthcare innovation the Government of Gabon has taken a large programme of innovations. Serge Thierry Mandoukou Ombegue, Cultural Counsellor, Embassy of Gabon was seen in full zeal in projecting the innovations brought about in the healthcare segment in Gabon. One of the main innovations is the Gabon Project. We have 2 components in this. In order to strengthen the national health information system, improving the ongoing population rate and improving the quality care and also boosting ICT skills. The second component is to address broader economy by promoting development of content upright and services related putting health information on line. All those drastic measures taken by the government in order to transform the healthcare in Gabon. In accordance with some expert of the world bank,
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the new standards and systems have improved the quality of healthcare in the country by providing physicians, nurses and healthcare workers with the information needed to perform better diagnosis and treatment of patient’s conditions and also allowing the information to be shared with other health professionals. The information in terms of innovations, system, communication, software and programme are competing to improve continuity, efficiency and timeliness. Gabon has validated a strategic master plan of health information system of Gabon by the committee in 2017. It was necessary to develop those pillars as Legal Frameworks. In terms of cooperation of India, we need their support in order to improve our healthcare system. Gabon also plans to digitise its health system. The government of Gabon is preparing new legislation to develop health services or so. This project was initiated to control the healthcare costs and also aimed to foster emergence of
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ELETS EXCLUSIVE
‘Striving to Improve the Landscape of Gabon’s Healthcare System’
Serge Thierry Mandoukou Ombegue Cultural Counsellor Embassy of Gabon at Annual Healthcare Innovation Summit, Delhi, 2019
digital healthcare ecosystem. Gabon has undertaken a vast reform of its system since 2000. Those programmes integrate 3 axis namely the reform of the government of the health sectors. The reform of health financing and the improvement of the supply and quality of care through the modernisation of infrastructure and the development of human resources. The objective of these reforms is to offer people universal health coverage but also quality care. The presidential will was again manifested in January 2018 with the free deliveries Cesarean section and neonatal care in all public health facilities to extend even more health coverage. All of this has enabled Gabon to strengthen equity in access to care by significantly contributing to the protection of the population against financial wrecks.
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ELETS EXCLUSIVE 32
‘Major Health Problem in Argentina, Related to Equity and Efficiency’
A
rgentina is an upper middle income country with a population of 44 million and more than 90% of whom live in large cities. In many aspects, we have a highly developed health system particularly in comparison to low and middle income countries standard, says Daniel Chuburu, Embassy of Argentine Republic. The healthcare system performs well on several key indicators. However, without its outcomes, it lacks behind in country’s potential. We are one of the leaders in the region with respect to the healthcare spending, per-capita and human development assured. The major health problems in Argentina today are related to both equity and efficiency along with many other countries in Latin America. Any of Argentina’s healthcare shortcomings arrives from fragmented and explorative system divided into 3 large sectors; public, social security and private sector.
FEBRUARY 2020
The Public sector funded by taxes means that the health cost is 0, is decentralized to the provinces which are clearly doing all to win over states, giving the federal ministry of health a narrow but strategic role in national health policy. Public health funds usually flow from national to provincial and to local budgets. The social security sector is a dominant health sector in Argentina and consists of many different funds. They provide health coverage for more than 14 million people, which means 1/3rd of the total population. In addition to these, there is one for the overall state and government union and this covers another 7 million people out of the 24 districts. Finally 5 million elderly and people with disabilities are covered by a nationwide social health insurance fund for retire workers, called PAMI in spanish; broadly comparable to medicare in the US. Overall the social insurance sector provides coverage to 60% of
Daniel Chuburu Ambassador, Embassy of the Argentine Republic at Annual Healthcare Innovation Summit, Delhi, 2019
the 45 million people that we have. The private insurance sector covers 6 million people where 4 million comes from contracts of private firms and 2 million are on individual basis through direct of voluntary pre-payments in approximately 200 private insurance or prepaid health plans. The dimensions of Universal health coverage as defined by organizations run along 3 main aspects. Population and health services are covered by pool funds. We have achieved many of the universal health coverage goals and the country already faces some of the challenges of the more developed and matured healthcare systems. Associated with these, we have the pharmaceutical industry. The top labs have developed a pharmaceutical industry which has taken up the position of leadership in markets across Latin America. Pharma sector is the most dynamic in Argentina’s economy is now an engine of economic growth.
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‘Our Mission is to Take Tertiary Level Care to the Masses’
With the perfect blend of technology, robust infrastructure, coupled with skilled workforce, Nayati Healthcare is carving niche in healthcare delivery space. It believes that people should have equal access to quality care irrespective of his economic condition or the remote location he lives in, says Niira Radia, Chairperson, Nayati Healthcare, in conversation with Arpit Gupta and Mukul Kumar Mishra of Elets News Network (ENN).
Q
With four Mobile Medical Units (MMUs) and a team of 36 paramedics and doctors, Nayati Healthcare came into existence in 2012. Tell us a little about its journey and mission. Our journey started from the holy grounds of Badrinath in 2012 to provide medical aid to the residents and pilgrims. Working across these regions, we came across with the grim reality of healthcare in our country which is metro centric. Nayati believes that good healthcare should be sans boundaries and seamless across the country. Its mission is to make tertiary healthcare accessible, affordable and accountable for people living in tier II and tier III cities of India, which has been long neglected. A sweeping study conducted from Jammu to Jamshedpur led us to set up our first hospital in Mathura, Uttar Pradesh. The study found that while North India is the most populated part of India, its infrastructure is among one of the most underserved. With wide healthcare disparity and huge disease burden, the need for care and cure is nowhere greater than in Uttar Pradesh. Nayati Medicity, Mathura, commissioned in 2016, is the most
FEBRUARY 2020
advanced and the only quaternary care multi super speciality hospital in the region with 377-bed, covering 22 specialities. It is the first hospital in a tier III city to receive NABH accreditation. It is the only NABH approved blood bank in Uttar Pradesh. The facility extends end-to-end cancer care including radiation and bone marrow transplant. In 2017, we expanded to Agra with Nayati Hospital, a 60-bed facility. We forayed into Delhi NCR with the strategic acquisition of Primamed hospitals and Sundar Lal Jain Hospital in 2018. Primamed added two hospitals to our portfolio including the iconic Neuro Sciences Centre, 150-bed Vimhans Nayati in Nehru Nagar, Delhi and upcoming 600-bed facility, Nayati Super Speciality Hospital in Golf Course Road, Gurugram. The hospital in Gurugram will work as the strategic hub for talent mobilisation, knowledge sharing and also act as the center for our growing international patient cache.
Q
What are the hallmarks which define Nayati’s delivery of accessible and quality care to masses. Nayati works in a hub and spoke model of taking treatment closer to
Niira Radia Chairperson, Nayati Healthcare
the masses. We have strategically looked at locations which enable us to cater to the maximum number of population in the hinterlands. Our flagship, Nayati Medicity, Mathura is the only quaternary care hospital in the region catering to 18 districts covering a population of over 55 million people within a 200 kms radius. With Nayati Hospital, Agra and Nayati Hathras OPD service as the effective spokes, the last mile accessibility to some of the most remote locations is being provided by our fleet of 17 mobile medical units (MMU) and a team of 100 workers.
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NAYATI MEDICITY HAS END-TOEND INTEGRATED APPLICATION WHICH MAKES IT A PAPERLESS HOSPITAL. THE HOSPITAL’S REGISTRATION, OPD, IPD, ER, DAYCARE, DIAGNOSTIC ARE TIGHTLY INTEGRATED FOR PATIENT TO EXPERIENCE FACILITIES ON REALTIME BASIS
INDUSTRY PERSPECTIVE
Q
In the light of patient becoming more informed in the age of internet today, what initiatives have been undertaken by Nayati to live up to their expectations and to ease of clinical processes? The most important aspect of hospital services today, is to provide transparent and real time information to the patients. We have put together a robust system through our patient portal, mobile app, website and social media channels to facilitate communication. All these mediums carry extensive real time information about our hospitals, the areas of excellence we offer and the availability of doctors. Patients can make real time appointments, access their reports, make payments, share their feedbacks
about our services. We have dedicated teams looking out for the feedback shared by our patients which is then acted upon to make them feel valued. We send out reminders, in the form of automated texts, emails and calls to our patients to make sure the patient is following the prescribed plan of care. At Nayati, we believe communication is an integral component of patient care. Good doctor-patient communication has a huge impact on better health outcomes and higher patient and clinician satisfaction. We have adopted a distinct process of counselling patient/ patient relatives on the progress of the treatment, twice a day across all hospitals. These sessions not only address their queries, but also helps build trust and maintain a positive atmosphere.
Q
As an enabler technology has facilitated delivery of care. AI, mHealth, Telemedicine will prove to be game changer in coming years. How do you read the statement in context of Nayati? Telemedicine has traditionally been used by hospital groups to facilitate healthcare for international patients.
However, for us it is an effective tool to reach out to people at the grassroots level. E-ICU Nayati Medicity, Mathura is India’s first hospital to adopt a cloud-based Digital Intensive Care units (eICU). The technology allows clinicians to monitor multiple critically ill patients round the clock, alerts ICU staff to any issues, and ensure early intervention to improve outcomes. It relies on reinforcement classification, a technique used in Artificial Intelligence to process millions of records in a fraction of a time by building a seamless connected system. EMR Nayati Medicity has end-to-end integrated application which makes it a paperless hospital. The hospital’s registration, OPD, IPD, ER, Daycare,
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INDUSTRY PERSPECTIVE
diagnostic are tightly integrated for patient to experience facilities on realtime basis. EMR helps in patient safety and better clinical outcomes. It also helps to improve communication and patient care, improve data tracking and workflow management. MHEALTH Nayati focuses greatly on the mobility aspect. Apart from the generic mobile app for patients to book appointments, access reports, making payments and sharing feedback, we have mobile apps for doctors as well. Through this app, the doctors can perform following functions without sitting in front of a computer on a nursing station: • Put clinical notes • Put medicine and investigation orders • Put referral for other doctors to see their patients • Verify discharge summaries and make corrections • Put orders for nursing
Q
Apart from Nayati Mathura and Agra, tell us more about its other hospitals across country and
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carefully, considering the access gap and the potential coverage area.
WE HAVE DEDICATED TEAMS LOOKING OUT FOR THE FEEDBACK SHARED BY OUR PATIENTS WHICH IS THEN ACTED UPON TO MAKE THEM FEEL VALUED.
expansion plans. We are focusing on extending healthcare facilities to Varanasi with a 675 beds facility - 500 beds are to be commissioned in FY 2022, Nagpur with a 400 beds facility – 250 beds to be commissioned in 2023, culminating our North India expansion with Amritsar in 2024. All locations have been chosen
Q
How do you summarise 2019 in terms of opportunity, challenges and growth. What are your plans for the next year? 2019 saw us consolidate the acquisitions made the year before and strengthen our position further as a group. The most humbling part of 2019, is that through our extensive outreach programme, Nayati has been able to touch over 3 million lives across remote villages of Western Uttar Pradesh, Eastern Rajasthan and Uttarakhand. The year marks our entry into Eastern Uttar Pradesh with the launch of Shri Kashi Vishwanath Nayati Arogya Mandir, a free OPD-cum stabilisation centre in the premises of Shri Kashi Vishwanath Temple at Varanasi. I firmly believe 2020 will be a defining year for us with the launch of Nayati Sundar Lal Jain Super Speciality Hospital in Ashok Vihar and Nayati Super Speciality Hospital, Gurugram. We look forward to create new standards in the healthcare dynamics of the country.
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Hope Children Hospital— Ensuring Holistic Affordable Care to Children Started in 2001, the Hope Children Hospital has come a long way, serving patients with quality and affordable care. In today’s cut-throat competition era, children must not undergo undue pressure, which affect their overall health and well-being. They need ample time to unwind and to be themselves, says Dr Madan Mohan Rao, Managing Director, Hope Children Hospital, Hyderabad, in conversation with Gopi Krishna Arora and Mukul Kumar Mishra of Elets News Network (ENN).
Q
Kindly elucidate the journey behind this venture. The main purpose of starting Hope Children’s Hospital was that I wanted to have a hospital where I could deliver the treatment and care on my choice & terms, wherein I can do only the necessary tests required for the patients. Moreover, I wanted to help those patients who face below poverty line situation and can’t afford costly medical facilities. The maximum care which I can give where I don’t need to ask anyone and that was the prime motive behind starting this hospital.
Today, we have a number of patients who are getting treatment almost free of cost. Earlier, I had to ask for basic things which I didn’t feel like asking. Also, I wanted to have the management in a certain fashion. Only the right treatment should be catered to the patient including right investigation which wasn’t happening back then. In my hospital, I am the owner and CEO and I need not to ask anyone about anything as far as the patient’s safety is concerned. Today, with god’s grace, my patients are receiving the best of care in a very
Dr Madan Mohan Rao Managing Director Hope Children Hospital, Hyderabad
affordable cost which was my dream back then. We might not be having all the latest technology and gadgets, but with what we have, I feel proud to say that we provide the best care to our patients.
Q
In today’s time, we are getting dependent on technology more than what is required. What is your take on the same? There are a couple of issues I would like to throw light upon as far as the technology part is concerned. I believe
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that technology has today become more of a gadget or an element of competition among hospitals. For example, if an A hospital has certain technology, it is by default expected from others irrespective of the fact whether it is needed or not, just to be at par with other hospitals. Since technology doesn’t come at a reasonable price, it takes toll on financial health of the hospital. Once we invest in costly technology, we have to use it irrespective of whether patient requires it or not. Another issue is that sometimes the interpretation may not be right through technology. Practicing as a doctor for many years now, I personally feel that the human clinical examination and clinical history are mainstays of the treatment. Unfortunately, the young doctors are getting dependent more upon technology thereby they are becoming handicapped for some reasons. I feel technology shouldn’t be used as a substitute but as a support for clinical examination.
Q
What is your take on lack of awareness pertaining to obesity among kids and mental illness etc? People talk about physical health a lot but they are found averse to touch mental health subject. What is your viewpoint? We attend so many patients every day, especially the school going children. At least 60-70% of kids going to high-end schools face challenges in their day-today routine. They spend most of their time in travelling to high-end school at far off places. In addition, they are bombarded with so much of stuff in schools and at homes that they hardly get time for basic things. For an example, a school going child needs some decent amount of time to unwind, to play, and have natural exposure to the environment. I feel that not even 10% of my children patients are exposed to playgrounds, which is very sad situation. This is going to be very hazardous to the
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mental and physical health of the child. Therefore, we are finding a common issue of obesity among kids. The issue has witnessed a sharp increase in today’s times to what it was 15-20 years back. Kids don’t have time to mingle. Moreover, the food being offered to them contains high level of junk. There are no outdoor activities for them. They are found to be either in school or tuitions and not able to follow a healthy lifestyle. If media, government, and doctors don’t act upon this issue, we are not far away from having disabled school kids.
Q
Do you think that educational institutions in collaboration with healthcare segment can come together and put in collective effort to resolve this problem? We all need to pay urgent attention to the issue and act on the same as earliest. I sincerely urge schools, government and the medical fraternity to work together and formulate principles pertaining to the issue. There should be some strict guidelines where a child could get certain amount of rest every day. Due to lack of sleep the kids are landing up to diseases like autism, hyperactivity, etc.
Q
Kindly let us know about the footprints of Hope hospital in Hyderabad and its expansion plans. We started in a very humble way in 2001. Since then, we have added many specialities to our existing setup. I have also started a child growth clinic where we want to monitor the growth of the child, not in terms of physical height and weight only, but to take care holistic aspect in order to make them healthy. Our objective is to treat those kids suffering from either short stature or obesity. It is one of the premier centers in the city where we cater to newborns and adult kids who come with some sort of mental disability. We also cater to child’s behavioral and emotional problems. In next 3 months, we are going to have an exclusive superspeciality hospital where we will be focusing on specific areas. We will have top-class specialists for child’s intensive care and top of the line operation theatres at the centre.
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PPP Model Providing Right Impetus to Diagnostic Industry In any modern healthcare system, laboratory diagnostics play a crucial role for effective functioning of the overall care delivery system. Pathology and radiology have withnessed huge transformation in the last decade thanks to technological advancements and innovative practices. Elets News Network (ENN) explores all the aspects of the Indian diagnostic industry--huge underlying opportunity, challenges and how PPP models have driven the market.
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40
ith the rapid growth of the Indian economy in recent times and the changing demography and socio-economic mix of the Indian population, there has been an immense change to the healthcare requirements in the country. Over the years, the public and private sectors have helped in addressing the health needs of the country, paving way for India’s progress on key health indicators like life expectancy and infant mortality. Diagnostics is one of the primers of the whole spectrum of healthcare delivery system, paving path for enriched healthcare experience to masses.
the diagnostic service industry. The country has become one of the major destinations for various diagnostic services. The diagnostic market in India is around Rs 75000 crore market divided into two parts -- private and government. Out of this, pathology and radiology in private sector is about Rs 45000 crore and government sector is for about Rs 2700028000cr. 80% of Indian diagnostics is unorganized and if we look at the market share tier-wise then Tier 1 city has 40-50% share and remaining comes from tier 2 and tier 3 cities.
SIGNIFICANCE AND MARKET OF DIAGNOSTICS Diagnosis is the first step to disease management, as without accurate identification there is no possibility for accurate treatment. India is a land full of opportunities for players in
MANAGEMENTÂ CHALLENGES The pathology has got three components, pre-analytical (before the sample reaches the lab), analytical (its reaches the lab) and post-analytical. So in pre and post area a lot of things are happening. In analytical the
FEBRUARY 2020
automation happened in the last couple of years, more and more automation is happening every year. The area where it is happening is pre-analytical that means right from where the samples are picked up, reaches the lab, and barcoding. Management is becoming more focused to take care of pre-analytical errors. Analytics errors, of course, that exist for last so many years. Post analytical error is where the report reaches the doctor, whom it is delivered, how fast it is delivered, what would be the analysis of report, what are the interpretations of report, and how do they apply report interpretation in a way which is holistically applied to a patient, that is where the whole diagnostic management is focusing on. Right from the report comes from equipment and how to get the sample as fast as possible and without having any kind of pre-analytical error. A lot of focus is happening in sample
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logistics, cutting down the cost because it is price sensitive market. So it is about how to bring down the cost per reportable test and make sure more the volume is picked up less is the cost and better offering in the market. Biggest challenge to management is as there is no accreditation, no regulation as of now so anybody probably now can open a lab. Pathology labs are almost like barber shops as they have come out in every possible market and we don’t know who is running these shops whether is it a technician or a doctor or what quality controls they are following. This is creating challenge to how to good quality labs to stand out amongst all this. PPP MODEL IN DIAGNOSTIC MARKET Diagnosis is the first step to disease management, as without accurate identification there is no possibility for accurate treatment. India is a land full of opportunities for players in the diagnostic service industry. The country has become one of the major destinations for various diagnostic services. Also, India’s thriving economy is driving urbanization and developing an expanding middle class, with rising disposable incomes to spend on healthcare. PPPs are fast becoming a preferred mode of delivery across various geographies of the country. There are enough examples of this model generating the desired level of services at affordable price which have led the government and the private players to work more closely and deliver better results. In fact, the government of Jharkhand has rolled out PPP for both Radiology and Pathology for all districts of the State and Healthmap, SRL and Medall are the service providers. Currently, approximately 24 states, including the north eastern states of India are delivering radio diagnosis through PPP module. As a result some large players like Manipal Group (through its
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group entity Manipal Healthmap) Medall, SRL etc have focused their energies on this collaborative mode of delivery system. These services have not only been successful in providing quality and affordable scans to the masses, but a larger chunk of the population is now showing confidence in these services. PPP is poised to take giant leap not only in radiology but even beyond as well and the Central and State Governments along with the private players are trying out innovative models to carve out a truly inclusive vehicle for a more comprehensive coverage of the complete healthcare cycle. GOVERNMENT INTERVENTIONS The government has enacted the Allied and Healthcare Professions Bill, 2018 towards standardizing and regulating the education and services by allied and healthcare professionals. However, the diagnostics industry that is critical to tackling rising NCDs still needs policy intervention towards standardization and regulation of services provided to ensure quality and efficacy. While we appreciate the Government’s efforts thus far, estimates indicate about 1% of all diagnostic labs have some kind of accreditation. The industry is in dire need of an autonomous body that regulates the quality of services provided by the sector and sets the rules as the industry evolves and faces newer and more complicated challenges. While the government is in the midst of overhauling the current healthcare system through schemes like Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and Mission Indradhanush, there needs to be increased focus on shifting the mindsets of citizens from curative to preventive healthcare. As diagnostics is the first step towards diagnosis and treatment choice, the industry needs to be given adequate impetus and consequently become the focal point of healthcare in India. The ambitious scheme holds a lot of promise and has the right intent, but I do hope government authorities take the right partnership approach to broad base participation. With enough investment, the diagnostics sector can drive early diagnosis that is known to help in improving chances of curing the condition or preventing it altogether and thereby eliminating the need for tertiary
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treatment. An effective PPP model within the wellness outreach where diagnostic test providers can participate effectively will go a long way towards the overall vision of health for all. The fact that these are preventable needs the focus and investment of the government, especially in diagnostics. It is only through better partnerships with the private industry experts that the country can achieve the vision health for all by 2022, the 75th anniversary of independence. ROAD AHEAD There is Clinical Establishment Act, which has been adopted by 4-5 states. Everybody and anybody can open a diagnostic centre. There is no quality kind of regulation. There have been some accreditations like NABL, they are voluntary in nature and not regulatory or mandatory. Government has no
actual regulation to control on what kind of reports to be delivered. They tried it through CEA but there are lots of challenges in that and it has not been adopted by the states. Government is looking very seriously into this to make sure that reports are driven quality, trying to impose rules and regulations. But imposing the cost etc is not easy as balancing out for them in private players is difficult as cost in Delhi and remote area is different. IVD MARKET The Indian IVD market is forecast to grow at a CAGR of 7-8 percent from 2019 to 2023. IVD has witnessed several changes and additions to its gamut of offerings in the recent past. There has been a paradigm shift from traditional diagnostics to a new generation diagnostic that works on the gene level. This change was possible only due to the inclusion of advanced technology,
Source: https://www.ibef.org/industry/healthcare-india
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FACT BOX • The diagnostic industry is growing at a CAGR of 15%. Medical supplies and disposables market is dominated primarily by domestic Indian manufacturers, whereas highend medical equipment and devices are largely imported into the country by large multinationals. • The Diagnostic Services Market is expected to grow at 27.5% in next five years • With the rise in health consciousness in the society and the rising burden of chronic diseases, this market will swell to approximately Rs 860 bn in revenues market this year • The future growth of the Indian In-Vitro Diagnostic market will be driven by tier-II and Tier-III cities and that is where the price of the products and testing consumables will matter the most. such as genetic testing, molecular diagnostics, polymerase chain reaction (PCR), and next-generation sequencing (NGS). Fast turnaround, reliability, user-friendliness, and predictability of predisposed diseases are a few significant qualities that are making these technologies attain their share in major offerings of diagnosis providers around the world. Though a major portion of diagnostic business is being managed by the so called unorganized sector, the diagnostic service market is expected to become much more organized and consolidated with a lot of small and independent laboratory players becoming franchisees for the larger players. In order for clients and interested companies to enter this industry, our report provides an indepth analysis of the cost assessment comparison of most common pathological and radiological tests among Tier I and Tier II cities.
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INDIA’S LARGEST DIGITAL & PRINT PLATFORM TO REACH OUT HEALTHCARE STAKEHOLDERS
Public Healthcare
Telemedicine
Medical Tourism
Well-being
FOCUS SECTORS
Smart Hospital
CATHLAB
Pharmaceutical
The high technological and functional content makes this Cathlab a reference Medical Medical product for all thInsurance e applications having high diagnosticEquipment content such as: Ÿ Electrophysiology Studies
Ÿ Neuroradiology Health Ÿ General Surgery & Medical Ÿ Traumatology Education Ÿ Interventional Radiology
Ÿ Angiographic Procedures
Diagnostics
Ÿ Vascular Surgery
Ÿ Endovascular Applications Ÿ Urology Procedures
Ÿ Orthopaedic
Ÿ Catheter Procedures
OUR DIGITAL REACH
Monthly Page views
Monthly Unique Visitors
Newsletter Subscribers
Print Reach
2 Million
0.80 Million
0.22 Million
35K+
Readership
0.15 Million
OUR SOCIAL MEDIA REACH Facebook
8.8 K
5.8 K
2.7 K
Conferences Conferences
37+ 41+
RADIUS XP Mobile Cathlab Hospitals Engaged Hospitals Engaged Hospitals Engaged Partners Speakers Hospitals Engaged
400+ 500+
1,000+ 1,500+
1,000+ 2,000+
For enquiries contact : sales@schillerindia.com | Website : www.schillerindia.com | Toll-Free No. : 1-800-2098998 Swiss H.Q.: SCHILLER AG, Altgasse 68, P. O. Box 1052, CH - 6341 Baar, Switzerland. ehealth.eletsonline.com Indian Corporate Office: SCHILLER Healthcare India Pvt Ltd., Advance House, Makwana|Rd, #eletsHealth O . Andheri Kurla Road, Marol Naka Metro Station, Andheri (East), Mumbai - 400 059. Branding and61523333/ Promotional Activities Contact: Gopi Arora | +91 95828 92293 Tel.: + 91- For 09152380310, +91-22 29209141 | Fax: +91-22-29209142 Factory : No. 17, Balaji Nagar, Puducherry 605010 CIN : U33110MH1997PTC111307 All registered trademarks acknowledged
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