Page 1

ResMed introduces next-gen CPAP in India

Aarogyasri to become a centrally-assisted scheme

The Monthly Magazine on Healthcare ICTs, Medical Technologies & Applications Vo l u m e 5 | I s s u e 6 | J U N E 2 0 1 0 | I N R 7 5 / U S D 1 0 | ISSN 0973-8959

Investing in Innovation Trivitron & IIT Madras set up India’s first industryacademia CoE in medical technology research eHEALTH PAGE 21

“Focussing more on R&D to make services competitive and affordable” Ameera Patel CEO Metropolis Healthcare Ltd PAGE 26

Orthopedists’ Delight Digital technologies ensure enhanced patient care by radicaly improving the treatment process CARESTREAM PAGE 28

Healthcare in Bits and Bytes Dr. Ruchi Dass Vice President Lifetime Wellness Rx International PAGE 31


With the Tamil Nadu Health Systems Project now in place, the state government is upbeat about making its public sector health services more accessible to the poor Pg. 8

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CONTENTS w w w . e h e a l t h o n l i n e . o r g | Volume 5 | Issue 6 | June 2010


21 |

COVER STORY Health for All How TNHSP is helping the Tamil Nadu government make its health services more accessible to the poor

16 |

EVENT REPORT Showcasing Excellence in Public Health

ISSN 0973-8959

SPOTLIGHT Investing in Innovation Trivitron Healthcare alliances with IIT Madras to set up India’s first industryacademia CoE in medical technology research

26 |

IN CONVERSATION “Focussing more on R&D to make services competitive and affordable”

A post-event report of the International Conference on Health Systems Strengthening

Ameera Patel, CEO, Metropolis Healthcare Ltd

28 |

TECH TRENDS Orthopedists’ Delight Digital technologies are ensuring enhancement in patient care by radicaly improving the treatment process


31 |

DEVELOPMENT DIMENSION Healthcare in Bits and Bytes

Dr Ruchi Dass, Vice President, Lifetime Wellness Rx International

46 |



June 2010




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June 2010

EDITORIAL Volume 5 | Issue 6 | June 2010

Public Health Par Excellence The public health sector in India, dogged with issues such as low healthcare spend, manpower shortage, corruption and crumbling infrastructure, has always been under the scanner for the credibility of services being offered. India is among the lowest ranked countries in terms of its spend on healthcare with the WHO study of 2007-08 ranking India 171 out of 175 countries in the world in public health spending. While the public sector spends only about 0.9 percent of the total GDP on healthcare, depicting a contrasting picture, the private sector’s spend exceeds 4 percent. In an attempt to strengthen the public health system, the World Bank started funding various state health systems projects in India, since 1996. Aimed at improving efficiency and quality of services and enhancing access to ensure equitable services for the disadvantaged people, the World Bank has been actively involved with the public health sector in 10 Indian states. In this issue, eHEALTH brings you a comprehensive report of one of these projects, the Tamil Nadu Health Systems Project (TNHSP), that was initiated in 2005 and is running successfully since its inception. The insightful report brings forth the success of the TNHSP in strengthening its public health sector through various interventions, in contrast to most of the other Indian states. Considering that Tamil Nadu is among the best ranked states in terms of public health, the report shares best practices under various health systems programmes initiated by the state. Also find in this issue, a report on India’s first industry-acaedemic partnership in the medical technology space with Trivitron and IIT Madras coming together to create a centre of excellence for designing and developing medical technology products. Putting India on the future roadmap for medical technology innovations, the development of the Trivitron Innovation Centre at IIT has taken the country one step closer to its dream of becoming a hub for home grown R&D and manufacturing centre. Going further, we are pleased to inform you that the 6th edition of eINDIA, India’s largest ICT event, will be held this year in Hyderabad during 4-6 August 2010. Being organised in association with, the Department of IT, Ministry of Communications and IT, Government of India; the Unique Identification Authority of India, Government of India; Directorate General of Employment and Training, Ministry of Labour & Employment, Government of India; and National e-Governance Plan; the event will once again bring together key stakeholders from various ICT domains to share knowledge on a unique platform. Read this issue to get more information on the event!

Dr. Ravi Gupta President: Dr. M P Narayanan | Editor-in-Chief: Dr. Ravi Gupta | Managing Editor: Shubhendu Parth | VP - Strategy: Pravin Prashant Product Manager: Dipanjan Banerjee (Mobile: +91-9968251626) Email: Editorial Team: Dr. Prachi Shirur, Dr. Rajeshree Dutta Kumar, Shipra Sharma, Divya Chawla, Sheena Joseph, Yukti Pahwa, Sangita Ghosh De, Subir Dey, Pratap Vikram Singh, Gayatri Maheshwary Sales & Marketing Team: Arpan Dasgupta (Mobile: +91-9818644022), Bharat Kumar Jaiswal (+91-9971047550), Debabrata Ray, Anaam Sharma, Fahimul Haque, Ankur Agarwal, Priya Saxena, Vishal Kumar, Gaurav ( Subscription & Circulation: Astha Mittra (Mobile: +91-9810077258,, Manoj Kumar, Gunjan Singh Graphic Design Team: Bishwajeet Kumar Singh, Om Prakash Thakur, Shyam Kishore Web Development Team: Zia Salahuddin, Amit Pal, Sandhya Giri, Anil Kumar IT Team: Mukesh Sharma, Devendra Singh | Events: Vicky Kalra Editorial Correspondence: eHEALTH, G-4 Sector 39, NOIDA 201301, India, tel: +91-120-2502180-85, fax: +91-120-2500060, email: does not neccesarily subscribe to the views expressed in this publication. All views expressed in the magazine are those of the contributors. Themagazine is not responsible or accountable for any loss incurred, directly or indirectly as a result of the information provided. is published by Elets Technomedia Pvt. Ltd in technical collaboration with Centre for Science, Development and Media Studies (CSDMS) Owner, Publisher, Printer - Ravi Gupta, Printed at R P Printers, G-68, Sector-6, Noida, UP, INDIA and published from 710 Vasto Mahagun Manor, F-30, Sector - 50, Noida, UP, Editor: Dr. Ravi Gupta

June 2010



Health for All

With the Tamil Nadu Health Systems Project now in place, the state government is upbeat about making its public sector health services more accessible to the poor / Divya Chawla

Tamil Nadu has done exceedingly well in improving its health status and ensuring good healthcare services for its citizens. Having achieved the status of a role model state for health, the excellent health of Tamil Nadu is reflected through its improved health indicators including infant mortality rate and maternal mortality rate. The maternal mortality rate in Tamil Nadu witnessed a considerable drop from 145 in 2001-02 to 79 in 2008-09, while the infant mortality rate fell from 49 in 2001 to 31 in 2008. One

of the major drivers for this success has been the implementation of the Tamil Nadu Health Systems Project (TNHSP) in 2005, which aimed at overcoming the numerous barriers to good health

PROJECT PROFILE Funded by the World Bank at a total cost of INR 597.15 crore, the TNHSP was implemented in January 2005 for a period of around five years finishing March 2010. Owing to the success of the project in the past five

years, the World Bank has provided an extended budget of INR 627 crore for the next three years. Targetting to improve the health of the people of Tamil Nadu, especially the poor and the disadvantaged, the TNHSP covers various other aspects that are aimed at improving the overall status of health in the state. Improvement of infrastructure in district and subdistrict hospitals, maintenance of medical equipment, building up a comprehensive health management information system, promotion of public-private partnerships and preventing risk factors for noncommunicable diseases are some of the major aspects that the project looks into.


Enhancing quality of care at various healthcare centres and secondary care government hospitals was the primary issue that the TNHSP aimed at addressing. The project initiated ‘Quality Circle for


June 2010

June 2010


Objectives of TNHSP Increasing access to health services, particularly for poor, disadvantaged, and tribal groups Developing effective interventions to address key health challenges such as non communicable diseases and trauma cases Improving health outcomes, access and quality of service delivery through strengthened management of the public sector health systems and greater engagement of the non governmental sector Increasing the effectiveness and efficiency of the public sector hospital services, primarily at district and sub-district level

“The World Bank’s involvement in the TNHSP has helped introduce new approaches in the way the health sector functions in TN”


The main goal of the TNHSP is to improve the health outcomes of the people of Tamil Nadu, especially the poor and the disadvantaged. As a major initiative, we have improved the infrastructure of all district and sub district hospitals. We have refurbished the district hospitals in Tamil Nadu. The project also focusses on procuring medical equipment for these hospitals. We have appointed biomedical engineers across the state to provide timely and efficient maintenance of equipment. The project supports health partnerships in the implementation of all it components and we have partnered with several non governmental organisations to enhance the services offered. CemONC centres have been created in existing government hospitals to provide comprehensive obstetric and neonatal care, especially to the poor and tribal populations.


June 2010

We have a double burden of diseases in the country, but so far our primary focus has been on public health and communicable diseases. We are not giving much importance to the non-communicable diseases. The two pilots on cancer cervix and hypertension, implemented under TNHSP, would now be upscaled to all districts. Our primary focus would be preventing hypertension and diabetes by supporting them clinically, which is a very massive effort. We also want to link up the identification of these with our insurance scheme – the Chief Minister Kalaignar Insurance Scheme for Life Saving Treatments. We have also started EMRI 108 ambulance services in which we want to add another 200 ambulances to strengthen the emergency transport services of the state. We are planning to create a state data resource centre. We want to strengthen our activities for standardising equipment designs and maintenance. We want to establish state-of-art laboratories in all districts that can network with all other centres. HOW HAS THE HEALTH MANAGEMENT INFORMATION SYSTEMS PROGRAMME, INITIATED UNDER TNHSP BENEFITTED THE HEALTHCARE FACILITIES IN TAMIL NADU. WHAT HAVE BEEN ITS ADVANTAGES IN TERMS OF COST CONTAINMENT AND IMPROVING THE OVERALL EFFICIENCY?

We proposed to link up all the secondary care government hospitals and health institutions in the

state with a comprehensive health management information system. Already, 41 facilities have been fully computerised and the remaining hospitals are currently in the process of acquiring a comprehensive health IT infrastructure. We are looking at introducing HMIS in all government hospitals as well as medical colleges/institutions. We haven’t done any analysis on the advantages of this system, yet. However, there has been a definite decrease in costs as the manual systems are being done away with, because of the government orders. One year from now, we should have enough data available to quantify these benefits. HOW HAS THE WORLD BANK’S INVOLVEMENT AIDED IN THE SUCCESS OF THE PROJECT?

The World Bank’s involvement in the Tamil Nadu Health Systems Project has helped introduce new approaches in the way the health sector functions in the state, such as promoting collaboration with the non–governmental sector, adopting quality assurance mechanisms and addressing the growing burden of non-communicable diseases. Having successfully completed the initial five years of the project at an estimated investment of INR 597.15 crore from the World Bank, the extension of the project for the next three years has received an additional financial support of INR 627 crore from the organisation.

State Health Systems Strengthening Projects Funded by World Bank in India Andhra Pradesh | Karnataka (KHSDP – Completed, KHSRDP – Ongoing) | Punjab | West Bengal Orissa | Maharashtra | Uttar Pradesh | Uttarakhand | Rajasthan (Ongoing) | Tamil Nadu (Ongoing)

“One of the big success stories of World Bank’s work in public health domain in India is the TNHSP” marily used for scaling up the project and continuation of activities. DR. PREETI KUDESIA Senior Public Health Specialist – South Asia Human Development Unit The World Bank PLEASE PROVIDE A BRIEF OVERVIEW OF THE ACHIEVEMENTS OF HEALTH SYSTEMS DEVELOPMENT PROGRAMME OF WORLD BANK, IN VIEW OF TAMIL NADU HEALTH SYSTEMS PROJECT.

One of the big success stories of World Bank’s work in public health domain in India is the Tamil Nadu Health Systems Project. As part of the project, the state has done a commendable job in documenting and filing non-communicable disease details with appropriate facts and figures. Another significant achievement of the project is the development of an excellent information management system, with 41 government hospitals of the state being fully computerised. The project also gained substantial momentum from the hospital system improvement team, which enhanced the quality parameters of healthcare units.


Yes, I do agree with you that government hospitals have many challenges. As a part of the project, we are into the process of advancing the integration of recent development across verticals. Doctors are advised to engage in skill upgradation, team-performance activities and leadership development. But whatever be the changes, it has to be a gradual process. Earlier, there were a lot of irregularities in the process – for instance the NABH accreditation, which was treated as a voluntary act. However, it has now gained momentum among public healthcare institutions. In the second phase of this project, we are actually into the process of getting government hospitals accredited and that too by improving qualities and performance. WHICH OTHER INDIAN STATES IS WORLD BANK CURRENTLY FOCUSING ON AND WHAT ARE THE THRUST AREAS?


In the first phase of the project, we invested USD 110.8 million. Out of this, USD 20 million went for rescue and rehabilitation of Tsunami victims and the balance USD 90 million was invested directly into the project over a duration of five years. Ninety five percent of the fund had been utilised with an excellent performance. We have now approved the second phase funding for next three years till 2013, amounting to USD 117.7 million, which will be pri-

We are currently working with three states – Tamil Nadu, Rajasthan and Karnataka. However, we had initiated the process way back in 1996 with 10 states across India. The states are focusing on healthcare systems improvement, quality improvement, information system, infection control, risk management, along with issues related to human resources, infrastructure strengthening, supply chain management and above all the quality of care. In the whole process, we specifically focus more on the access of healthcare for the under privileged population.

Excellence’ across hospitals which encouraged a bottom-up ownership to allow the lowest rung of the staff to interact with their superiors and device solutions for enhancing care provided at the hospitals. The project came out with a handbook and standard treatment guidelines and established poison treatment centres as the state had high incidences of snake bites in tribal areas. ACCREDITATION

A major step undertaken by the project was placing 12 secondary care government hospitals for NABH

“World Bank has now approved the second phase funding for next three years till 2013, amounting to USD 117.7 million, which will be primarily used for scaling up the project and continuation of activities.” accreditation, out of which two hospitals have already completed the final assessment and achieved accreditation thereby matching the global standards of care. The expected changes in all these hospitals include increase in manpower, inclusion of standardised procedures, inclusion of staff safety procedures, patient exit interviews, strengthening of infrastructure, and introduction of HMIS, among others. COMPREHENSIVE EMERGENCY OBSTETRIC AND NEONATAL CARE (CEMONC)

The rising concern for reducing maternal and infant mortality, the TNHSP conceptualised centres for CEmONC in existing government June 2010


Accreditation Status of Secondary Care Government Hospitals Hospital

Accreditation Status

Government District Head Quarters Hospital, Erode, Erode District


Government District Head Quarters Hospital, Usilampatti, Madurai District


Government District Head Quarters Hospital, Padmanabhapuram, Kanyakumari District


Government District Head Quarters Hospital, Tiruppur, Tiruppur District


Government Hospital, Tambaram, Kancheepuram District


Government Hospital, Aruppukkotai, Virudhunagar District


Government District Head Quarters Hospital, Pudukkottai, Pudukkottai District


Government District Head Quarters Hospital, Manapparai, Tiruchi District


Government District Head Quarters Hospital, Cuddalore, Cuddalore District


Government Hospital, Sholingur, Vellore District


Government Hospital, Hosur, Krishnagiri District


Government District Head Quarters Hospital, Namakkal, Namakkal District


Performance of CEmONC Centres (Data Comparison between 2008-09 and 2009-10) Parameter

Phase Phase I

Phase II

Increase in Total Maternity Admissions



Increase in Complicated Maternity Admissions



Increase in Corresponding LSCS Rate



Increase in Referral-in of Complicated Maternity Admissions



Increase in Neonatal Admissions



Increase in Complicated Neonatal Admissions



hospitals. Beginning 1990, with a plan to cover the entire state over three expanding phases, the 51 centres of the first phase were designated in 2004 and process of increasing their capacity to deliver emergency care was completed in 2006. Each CEmONC centre was provided with all necessary equipment for delivery and post natal care and physical facilities such as blood bank, laboratory and neonatal care unit. The centres have done extremely well in improving the maternal and infant mortality rates with Tamil Nadu now has much lower rates of infant and maternal mortality as compared to most of the other states.


June 2010


Prior to implementation of the

HMIS module, the secondary care government hospitals in Tamil Nadu were faced with several challenges pertaining to data maintenance and management such as ineffective record maintenance, manual records maintenance, duplication of records, unnecessary funds towards manual maintenance of records, difficulty in analysing data, and so on. The system provides centralised web-based software solution that minimises technology support and maintenance dependencies. The facilities are connected via Tamil Nadu State Wide Area Network (TNSWAN), which is a 2Mbps dedicated leased line supported by M/s Electronics Corporation of Tamil Nadu Ltd. (ELCOT). The solution is an open source software and is simple and

Civil Work at Secondary Care Government Hospitals Phase

Number of Hospitals

Total Expenditure

Phase I


Rs. 49.53 crore

Phase II


Rs. 215 crore

user-friendly. Implemented by TCS, the software has brought in several innovations by generating unique patient identification numbers, unique institutional codes, unique employee numbers, and so on.

“Tamil Nadu is one of the few Indian states that have adopted best of the IT systems for healthcare” WHICH ARE THE AREAS WHERE THIS

DR. SUMANTH RAMAN Adviser - Life Sciences & Healthcare Practice & Head – Healthcare Innovation Tata Consultancy Services Ltd. TCS HAD BEEN ASSOCIATED WITH TAMIL NADU HEALTH SYSTEMS PROJECT SINCE


Hospitals that needed upgradation and renovation were first identified based on various criteria. Under this process the hospitals underwent several internal and external modifications including structural repairs, refurbishing toilets, improving electricity and water supply system, repairing campus roads and boundary walls, landscaping, and so on. Storage and disposal facilities for waste management were also installed. HUMAN RESOURCE DEVELOPMENT

In a bid to develop human resources, the TNHSP undertook various tasks including manpower strengthening and recruiting, training, post creation and rationalisation of staff norms. Manpower training focussed on improving technical skills, interpersonal communication training, bio-medical waste management training, management training, equipment training, and basic life support training, among others. Rationalisation of manpower was done on the basis of number of deliveries and number of in-patients and out-patients in a particular hospital. The personnel requirement in hospitals was hence standardised based on the results of this analysis. IMPROVING HEALTHCARE SERVICES FOR TRIBAL POPULATION

Almost one percent of Tamil Nadu’s population is contributed



Areas like drug and material distribution, inventorying, purchasing and facility management have largely benefited through use of IT. The application also helps to standardise and define different protocols in the system as and when required. All these synchronise towards a significantly enhanced quality healthcare service.


We are providing the application software in healthcare management and information system and the hospital management system, both of which are integral and critical parts of a smart healthcare system project. The idea is to bring the functions of all departments onto a unified platform from a reporting, data collation and data analysis perspective. If healthcare system is integrated and managed through a proper information and management system, then anybody can get access of it starting from primary healthcare unit to speciality centre, both from patient care and administrative perspective. In the process, it becomes much easier for the government to provide much better healthcare services. The need was already there, but only a few states have actually come up for adopting best of the IT systems for healthcare and Tamil Nadu is one of them. PLEASE ELABORATE THE TECHNICAL ARCHITECTURE OF THE SOLUTION DEVELOPED FOR THIS PROJECT.

The solution is based on open source software with a proprietary database at the backend. The software provides most flexible options in terms of reduced total cost of ownership, maintainability, vendor independency and in addition, it runs on a variety of operating systems. From an architecture perspective, it is extremely scalable and can be easily modified.


In addition to Tamil Nadu, we have worked in Gujarat and Andhra Pradesh as well. We provided hospital management system for 31 hospitals in Gujarat, which is running successfully and actually preceded the Tamil Nadu project. We have also worked for Aarogyasri program in Andhra Pradesh for its scalability in the application of IT. The project is focussed more into insurance oriented IT application, which deals with elements of medical records. IS TCS ALSO INVOLVED IN THE PROCESS OF TRAINING OR CAPACITY BUILDING OF END-USERS OF THE PROJECT?

TCS provides hands-on training at the user level in hospitals. In Tamil Nadu, we have already provided training to 41 hospitals and started with the 42nd one. I must congratulate the state government of Tamil Nadu for initiating and patronising the project so diligently and fruitfully. On the other hand, we are very well positioned in implementing the information and management system in India as the country has got one very good advantage of not having the legacy of organised healthcare system. Therefore, it does not have the threats from the failure factors that could hold it back from the achievements. From technology perspective, none of the factors seem to have much of the challenges. But changing the mindset is the biggest challenge. June 2010


the project undertook several other steps to improve healthcare in tribal areas including providing fellowship to doctors, holding sensitization workshops, and initiating programmes for antenatal mothers, among others. EMERGENCY AMBULANCE SERVICES

EMRI Emergency Ambulance Service

for by tribal people settled across 12 tribal districts. As one of the major initiatives under TNHSP, improving healthcare services to tribal communities was taken up along with addressing issues such as water, food, sanitation and housing services. Prior to the establishment of TNHSP, studies suggested that only one to two percent of the tribal communities accessed hospital facilities; major reasons being inaccessibility and cultural factors. The TNHSP put in place a tribal development plan, under which six interventions were undertaken including mobile outreach services to improve accessibility, diagnosis and treatment of sickle cell anaemia;


June 2010

providing peer counselors; promoting institutional deliveries; providing bed grants and undertaking IEC activities. Counselors from tribal communities, trained at HMDI Salem in November 2008 and March 2009, were appointed at 30 healthcare centres with an aim to increase accessibility of tribal communities to hospitals. The project, in partnership with nongovernmental organisations, also provided mobile outreach services in various districts. In a period of six months (April ‘09 – September ‘09), almost all districts achieved more than 90 percent of planned visits. Through a pilot programme in two hospitals, all inpatient costs of tribals were reimbursed. In addition,

Developing public private partnerships plays a key role in enhancing the services offered, considering which the TNHSP has partnered with several nongovernmental organisations to strengthen its healthcare system. An example of a crucial public private partnership in the state is the establishment of 108 Emergency Services in association with GVK EMRI to ensure efficient emergency management in the state. Since its establishment in September 2008, the 108 ambulance service has saved 4,11,288 lives in various emergency situations including accident and trauma cases, pregnancy cases and cardiac cases, among others. CARDIOVASCULAR DISEASES PREVENTION & TREATMENT – PILOT PROGRAMME

Cardiovascular diseases account for 24 percent of deaths in India, which is expected to rise to 30-40 percent over the next few years. In Tamil Nadu, more than 30 percent of people suffer from diabetes, more than 20 percent of people suffer from hypertension and more than 10 percent of people suffer from other cardiac related disorders. Tamil Nadu has the highest crude mortality death rate due to cardiovascular diseases in India, which is 360 – 430 deaths per 100,000 population. Owing to these statistics the TNHSP implemented a pilot programme on cardiovascular diseases prevention and treatment considering that prevention is the best option to control these diseases. Implemented in 2007 in two districts—Virudhunagar and Sivagangai, the project had a fourpronged intervention of behaviour change communication at schools, work places, communities and clinics.


In India, one woman dies of cervical cancer every seven minutes and every year more than 1,32,082 women are affected, while around 74,118 women die of the disease every year. As early detection of the disease provides an opportunity for treating it completely, the pilot project aimed at early detection of cervical cancer among women. The primary intervention focussed on creating awareness among women and secondary intervention focussed on screening for early detection, referral and management. The confirmed cases were tied up with the Kalaignar insurance scheme for free treatment in the various empanelled hospitals. CHIEF MINISTER KALAIGNAR INSURANCE SCHEME FOR LIFE SAVING TREATMENTS

Recognising the importance of health insurance for enhancing the access and affordability of healthcare services, the Government of Tamil Nadu introduced the ‘Chief Minister Kalaignar Insurance Scheme for Life Saving Treatments’ for the poor, low income and unorganised groups. Implemented in partnership with Star Health Insurance, the scheme is eligible for families with annual income of/less than INR 72,000 and members of unorganised groups in urban and rural areas. Each family is insured of INR 100,000 for a period of four years. Till April 2010, 83,991 patients had been treated through the scheme at an estimated cost of INR 238.03 crore. PROCUREMENT AND MAINTENANCE OF EQUIPMENT

Equipment procurement and maintenance is crucial for providing quality healthcare. Under this programme, based on analysis of requirements at various centres, procurement was done through TNMSC at competitive prices following the World Bank procurement procedures. During the first phase INR 47.9 crore was invested in equipment procurement, while INR 41.14 crore and INR

“Recognising the importance of health insurance for enhancing the access and affordability of healthcare services, the Government of Tamil Nadu introduced the ‘Chief Minister Kalaignar Insurance Scheme for Life Saving Treatments’ for the poor, low income and unorganised groups. Implemented in partnership with Star Health Insurance, the scheme is eligible for families with annual income of/less than INR 72,000 and members of unorganised groups in urban and rural areas. Each family is insured of INR 100,000 for a period of four years. Till April 2010, 83,991 patients had been treated through the scheme at an estimated cost of INR 238.03 crore.”

29.38 crore were invested during the second and the third phase of the project respectively. Further, biomedical engineers were appointed at across three districts to ensure proper functioning and minimise the downtime of equipment. The biomedical engineers also ensured that the equipment procured across centres met the required technical specifications. Systematising the maintenance process was taken care of by introducing registers and reports which undergo a periodic analysis to ensure efficiency of the process. INFECTION CONTROL AND BIOMEDICAL WASTE MANAGEMENT

The TNHSP aims at implementing a state-wide biomedical waste management scheme and the first two districts that where the programme was implemented were Dharmapuri and Krishnagiri. At government hospitals (excluding PHCs) at these districts, proper systems for waste segregation, storage, transport and end disposal were put in place, as per the standard biomedical waste handling rules. The government also plans to establish a common treatment facility in five regions of Tamil Nadu that can cover all private and government hospitals. In addition to the above initiatives the TNHSP has formed a strategic planning cell, which is the think tank of the Tamil Nadu Health Systems Project that conducts various surveys from time-to-time to strategise and implement efficient schemes and programmes. The TNHSP also conducts management training programmes to train heads of various healthcare facilities in managerial and administrative skills. Further, the TNHSP has undertaken an intensive ‘Information, Education and Communication (IEC) programme to generate awareness among the masses about various ailments and diseases and the different programmes and schemes offered by the government. With the extension of the project, the next three years would witness improved healthcare services, delivery and reforms in Tamil Nadu. June 2010



Showcasing Excellence in Public Health A post-event report of the International Conference on Health Systems Strengthening hosted by the Government of Tamil Nadu during May 7 – 10, 2010 in Chennai

L-R: Dr. Girdhar Gyani, Secretary General, QCI & CEO, NABH; Mukesh Chawla, Sector Manager, Health Systems Strengthening, The World Bank; Erin Soto, Hon’ble Minister & Counselor for International Development, USAID - India; Shri MRK Panneerselvam, Minister for Health, Government of Tamil Nadu; Prof. K Anbazhagan, Hon’ble Minister of Finance, Government of Tamil Nadu; Dr. Syeda Saiyidain Hameed, Member, Planning Commission of India; Ms. Sujatha Rao, Secretary, Union Ministry of Health & Family Welfare; Mr. VK Subburaj, Principal Secretary, Health & Family Welfare Department, Tamil Nadu; and Dr. S Vijayakumar, Project Director, TNHSP.

Aimed at facilitating the understanding of health systems strengthening, sharing international and national experiences of good practices on health systems strengthening and facilitating national and state policies for improving health systems, ICONHSS witnessed three days of active conferencing and deliberations over the need and ways of strengthening health systems and turned out to be an excellent learning experience for all. The conference was organised in effective collaboration with various stakeholders across verticals and laterals including the Government of India, The World Bank, National AIDS Control Organisation (NACO), United States Agency for International Development (USAID) – India, World Health Organisation (WHO), Tamil Nadu State AIDS Control Society (TANSACS), Indian Council of Medical Research (ICMR), AIDS Prevention and Control Project – Voluntary Health Services (APACVHS), Solidarity and Action Against the HIV Infection in India (SAATHII),


June 2010

National Rural Health Mission (NRHM), the Tamil Nadu Dr. MGR Medical University, Public Health Management Institute (PHMI), and the Chettinad Health City, among others. The conference was presided by Mr. VK Subburaj, Principal Secretary to Government, Health and Family Welfare Department, Tamil Nadu.

PRE-CONFERENCE WORKSHOP: LEARNINGS FROM THE HEALTH SYSTEMS INITIATIVES IN INDIA The oganisers held a preconference workshop on May 6, 2010, the objective of which was to provide an overview of the Tamil Nadu Health Systems Project, its various initiatives and the current status. During the Presidential Address at the inaugural session of the pre-conference workshop, Mr. VK Subburaj, Principal Secretary to Government, Health and Family Welfare Department, Tamil Nadu, talked about the strengths of the TNHSP and the improvements it has brought about in the health sector in Tamil Nadu. The inaugural

address by Prof. Dr. Mayil Vahanan Natarajan, Vice Chancellor, The TN Dr. MGR Medical University, focussed on the need of reviving the medical curriculum in India to include strengthening of healthcare systems as a subject. The role of the World Bank in supporting healthcare systems strengthening projects in various states including Tamil Nadu was outlined by Dr. Preeti Kudesia, Senior Public Health Specialist at the World Bank. The second session at the preconference workshop focussed on providing an overview of the health systems. Dr. Nandraj provided statistics on the current status of health systems in India with respect to all key elements. Dr. Preeti Kudesia’s presentation focussed on the support provided by the World Bank in strengthening health systems in India. The World Bank has supported several state health systems projects in the country in Andhra Pradesh, Karnataka, Punjab, West Bengal, Orissa, Maharashta, Uttar Pradesh, Uttarakhand,

Rajasthan and Tamil Nadu. Focussing specifically on Tamil Nadu, she said that the state had done extremely well in addressing all these issues. The next session of the day focussed on sharing good practices from the World Bank funded health systems projects in India. Chaired by Dr. Preeti Kudesia and Dr. V Kumaraswami, Officer-in-Charge, National Institute of Epidemiology, Chennai, the session brought together representatives of various states’ health systems project to share best practices. The theme of the last session of the pre-conference workshop was on integration of chronic disease prevention and management in public health. The session was chaired by Dr. K Srinath Reddy, President, Public Health Foundation of India (PHFI) and Dr. Thanikachalam, Chairman & Director (Cardiac Care Centre), Professor Emeritus of Cardiology, Sri Ramachandra Medical College & Research Institute.

INAUGURAL SESSION A grand inauguration ceremony was hosted on the first day of the conference, which was attended by Prof. K Anbazhagan, the Hon’ble Minister of Finance, Government of Tamil Nadu; Sri MRK Panneerselvam, Minister for Health, Government of Tamil Nadu; Ms. Sujatha Rao, Secretary, Union Ministry of Health & Family Welfare; Dr. Syeda Saiyidain Hameed, Member, Planning Commission of India; Mr.

Mukesh Chawla, Sector Manager, Health Systems Strengthening, The World Bank; Ms. Erin Soto, Hon’ble Minister and Counselor for International Development, USAID – India; Dr. Girdhar J Gyani, Secretary General, Quality Council of India & CEO, National Accreditation Board for Hospitals & Healthcare Providers; Mr. VK Subburaj, Principal Secretary to Government, Health and Family Welfare Department, Tamil Nadu; and Dr S Vijayakumar, Special Secretary (Health & Family Welfare) and Project Director, TNHSP and Kalaignar Insurance Scheme for Life Saving Treatment. At the onset, Mr. VK Subburaj informed that because of the success of the project in the first phase, the World Bank has provided an additional budget of INR 627 crore for the extension of the project for three more years. Further, Dr. Girdhar Gyani said that, under the TNHSP, Tamil Nadu has taken a lead in opting for accreditation for its government hospitals and was pleased to inform that two government hospitals in the state have already received the prestigious NABH accreditation. Ms. Erin Soto said that USAID is moving towards the health systems strengthening approach to improve the quality of life of the fellow global citizens. The Special Address at the inaugural session was given by Ms. Sujatha Rao, who congratulated the Government of Tamil Nadu for strengthening its health systems. She laid stress on the emergence of health

Prof. K Anbazhagan, Hon’ble Minister of Finance, Government of Tamil Nadu delivering the Inaugural Address during the Inaugural Ceremony

insurance as one of the solutions to making healthcare accessible as almost eight percent people get pushed below poverty line every year because of huge out-of-pocket healthcare spending. Delivering the keynote address, Dr. Syeda Saiyidain Hameed said that the Planning Commission supports TNHSP in all its endeavours as the former considers health systems strengthening as a very important building block for the nation. The Hon’ble Minister of Health, Government of Tamil Nadu, Sri MRK Panneerselvam delivered the Presidential Address, in which he informed that the Government of Tamil Nadu has doubled its health budget from INR 1951 crore in 200607 to INR 3888 crore in the current financial year 2010-11. The Inaugural Address was delivered by Prof. K Anbazhagan, the Hon’ble Minister of Finance, Government of Tamil Nadu. He said that the strategies of the Tamil Nadu government in the health sector are impact making and the government is keen on improving health of pregnant women, children and poor. The inaugural session ended with a vote of thanks, delivered by Dr Vijayakumar.

DAY I Following the inaugural session, the conference proceeded with a session on health systems strengthening in India coupled with financing for universal access. Chaired by Ms. Sujatha Rao and Dr. Mukesh Chawla, the session saw eminent speakers deliberating on strengthening of health systems and the role of financing in the health sector. Renowned Cardiologist, Dr. Devi P Shetty, Chairman, Narayana Hrudayalaya Group of Hospitals, made the first presentation in which he talked about the role of private sector investments in improving access to healthcare in India. Following his presentation, Mr. VK Subburaj shared Tamil Nadu’s experiences on health systems strengthening and talked about how TNHSP’s efforts had brought about a significant improvement in the health of the citizens of Tamil Nadu. Elaborating further on the June 2010


topic, Dr. Mukesh Chawla laid stress on innovations in strengthening health systems. Dr. Ganga Murthy, Additional Chief Economic Advisor, Government of India, described National Health Accounts and its role in tracking the flow of resources, thereby providing evidence base for financing healthcare. Dr. Ravi Duggal, Senior Trainer and Health Analyst, International Budget Partnership said that the key issues in India are high out-of-pocket expenses and low public health spending. The last session on day I focussed on service delivery and was chaired by Ms. Girija Vaidyanathan, Mission Director, NRHM and Project Director, RCH, Tamil Nadu and Dr. K Srinath Reddy. Ms. Kerry Pelzman, Director, Office of Population, Health & Nutrition, USAID India, shared the global experiences of health services delivery, listing the challenges that are faced throughout the globe. Dr. Preeti Kudesia stressed on the importance of quality in healthcare and listed the key quality ingredients. Dr. Prakash, Medical Director, Star Health & Allied Insurance said that insurance can play a key role in enhancing access to quality healthcare. Star Health Insurance runs key health insurance schemes in partnership with the government in the states of Andhra Pradesh and Tamil Nadu. Dr. K Srikanth Reddy talked about the challenges in delivery of services for prevention and control of non-communicable diseases.

DAY II Day II of the conference began with a session on human resources, chaired by Dr. Michael Friedman, US Public Health Service Medical Officer (UPHMSO), CDC, Atlanta and Dr. Mala Rao, Director, Indian Institute of Public Health, Hyderabad. Dr. Michael Friedman, at the beginning of the session, talked about the development of public health workforce and its relevance in India. Ms. Pamela Rao, Senior Advisor – Health Systems Strengthening, USAID also shared her views on the key factors that attract healthcare workers to rural areas. Dr. Kara


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“Ms. Sujatha Rao talked about the role of NRHM for enhancing healthcare services in the country and how ASHAs, the face of NRHM, have proved to be a good model in delivering healthcare in rural areas.” Hanson, Reader, Health Systems Economics, London School of Hygiene and Tropical Medicine talked about the importance of financial and non-financial incentives to attract health workers to rural areas. Dr. Padmanabhan, Advisor, Public Health Administration, NHSRC discussed the topic “Health & Human Resources – Priorities in India”. Linking maternal deaths with the healthcare manpower in a country, he stated that countries with most number of maternal deaths have been noticed to have the least number of healthcare workers. Dr. Krishna Rao, Head of Health Economics, Public Health Foundation of India made an assessment of task shifting in primary healthcare. Following the first session, two parallel sessions were held on human resources and service delivery. The session on human resources was chaired by Dr. KS Jacob, Professor and Head, Department of Psychiatry, CMC, Vellore and Dr. Kara Hanson. Certain key presentations in this session include: innovative methods in medical education by Dr. Vinod Shah, Co-ordinator, Department of Distance Education, CMC, Vellore; availability, motivation and capacity building of nurses: experiences from the private sector by Dr. Lata Venkatesan, Principal Apollo College of Nursing; innovative human resource practices for effective health service delivery: experiences from Aravind Eye Care System by Ms. Preeti John, Senior Faculty, LAICO, Aravind Eye Care System; rationalisation of human resources: Tamil Nadu experience by Dr. (Capt.)

M Kamatchi, Expert Advisor, TNHSP; development of emergency medical technicians cadre by Dr. GV Ramana Rao, Executive Partner, GVK EMRI; and more. The parallel session on service delivery, chaired by Dr. DCS Reddy, NPO-HIV-AIDS Surveillance, WHO and Dr. ES Krishnamoorthy, Secretary, VHS, Chennai, saw eminent speakers deliberating on the various aspects of service delivery and how it can be improved in India. The key presentations made during this session included: access to healthcare for vulnerable populations: experience from Andhra Pradesh by Ms. Lipika Nanda, Director, Family Health International, Andhra Pradesh; care at time of critical emergencies by Dr. Gurusamy, CEO, TNHSP; under-reported deaths and inflated deliveries: making sense of health management information systems in India by Dr. Upendra Bhojani, Faculty, Institute of Public Health, Bangalore; self-help groups for filarial morbidity management by Dr. Sairu Philip, Associate Professor, Department of Community Medicine, TD Medical College, Alappuzha; citizens help desk at hospitals: empowering the public with information and guidance by Mr. S Selvakumar, Project Director, Karnataka Health Systems Development and Reforms Project, and many more. Chaired by Dr. Mukesh Chawla and Dr. Sunil Nandraj, the final session on day II focussed on the various aspects of healthcare financing. At the beginning of the session, Dr. Chawla gave an overview of the global perspective of healthcare financing and the relevance it has in India. Following Dr. Chawla’s presentation, Dr. Gerard La Forgia, Lead Health Specialist, the World Bank, India highlighted the various aspects of performance based funding. Dr. Muraleedharan, Professor, Department of Humanities and Social Sciences, IIT, Madras brought in a benefit incidence analysis of public spending in healthcare in the states of Orissa and Tamil Nadu. Highlighting case studies from these two states, Dr. Muraleedharan stated that there is a need for deeper analysis of the


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extent to which public policies have been efficiently designed to make them pro-poor and the emergence and role of private providers needs further study. The second half of this session saw a panel discussion with Dr. Devadasan, Technical Advisor, Institute of Public Health, Bangalore; Dr. Indrani Gupta, Professor, Institute of Economic Growth, New Delhi; Dr. Sakthivel Selvaraj, Health Economist, PHFI; and Mr. Babu A, Chief Executive Officer, Aarogyasri Healthcare Trust came together and deliberated on the various options for health financing. The key pointers discussed included public, private, community and public-private financing options.

DAY III The third day of the conference began with a session on Governance, chaired by Dr. CAK Yesudian, Dean, School of Health Systems, TISS and Ms. Meena Gupta, Former Health Secretary, Orissa. During the introductory remarks, Dr. Yesudian talked about healthcare governance in India; its evolution and determinants. Sharing global perspectives on health governance, Ms. Pamela Rao defined health governance as ensuring strategic policy frameworks exist and are combined with effective oversight, coalition-building, the provision of appropriate regulations and incentives, attention to system design and accountability. The next presentation by Mr. PWC Davidar, Secretary, Information Technology, Tamil Nadu Government revolved around the role of information technology in health governance. Taking Tamil Nadu’s example, Mr. Davidar discussed the IT current infrastructure of Tamil Nadu, its implementation and the various stakeholders that have been a part of all these projects. Mr. Abhay Shukla, Coordinator, SAATHI – CEHAT, India talked about community based monitoring of health services: an evolving model of people cenetred health systems governance. He said that community based monitoring is a process for changing the power balance. The second part of the


June 2010

session comprised a panel discussion on planning, human resource policies, management, corruption, regulations and monitoring. Positive synergies between health systems and global health development initiatives was the focus of the second session of the day. Chaired by Mr. Chandra Mouli, Secretary, Department of AIDS Control and DG, NACO and Mr. Prasada Rao, Director, UNAIDS Support Team for Asia and the Pacific, UNAIDS; the key speakers at this session included Dr. Edward Addai, Director, Monitoring and Evaluation, GFATM; Dr. Badara Samb, Coordinator, WHO, France; and Dr. Preet Dhillon, Senior Scientific Officer, SANCD, India. The session also comprised a panel discussion on translating recommendations of positive synergies into action. Discussing recommendations from the positive synergies initiatives, Dr. Badara Samb said that the financial allocations for diseases can be effectively used to strengthen the entire health system. While, Dr. Preet Dhillon concentrated on a framework for integration of chronic diseases as part of public health services, she said that the main challenge was that chronic disease prevention and management do not form a central part of the existing health systems. Health systems research was the focus of the last session of the day that also comprised of a panel discussion on priorities for health systems research in India. Chairing the session, Dr. Vishwa Mohan Katoch, Secretary to Government of

“Talking about Global Funds in India, Dr. Addai said that Global Funds was set up to fight against HIV, TB, Malaria with an investment of USD 19.3 billion in 144 countries. In India, the Global Funds have been active since 2002.”

India and Director General, ICMR and Dr. S Venkatesh, DDG, NACO focussed on generating interesting discussions revolving health systems research, priorities and the role of data in decision making. Dr. Kara Hanson provided an overview of the methods and approaches for health systems research. She said that the purpose of health systems research is to understand the current state of knowledge systematic literature review, access current performance of health system/ policy/intervention and evaluate health systems interventions. Dr. TP Ahluwalia, DDG, Division of Health Systems Research, ICMR said that the Government of India has recently recognised the crucial role of health research by providing a departmental status to research in the Health Ministry. Dr. Venkatesh gave the example of the effective and timely use of data at all levels is a key necessity for controlling the HIV epidemic, thereby stressing on the role of data in decision making.

VALEDICTORY SESSION The International Conference on Health Systems Strengthening ended with a valedictory function on May 9, 2010, which witnessed the release of the Chennai Declaration, urging the government to take some crucial steps towards strengthening health systems in the state of Tamil Nadu. Present at the ceremony were Mr. KS Sripathi, Chief Secretary, Government of Tamil Nadu along with Mr. VM Katoch, Mr. Chandra Mouli, Mr. VK Subburaj and Dr. S Vijayakumar. Mr. Sripathy said that while Tamil Nadu had done fairly well in uplifting its healthcare sector, the state still needs to focus on key areas such as controlling water and air pollution to enhance the health of its citizens. Mr. Katoch mentioned that to achieve the millennium development goals, India needs to control the spread of epidemics with a greater focus on generating adequate manpower. Mr. Chandra Mouli also shared his views on how healthcare in the country can be made better by better implementation of available resources.


Investing in Innovation Trivitron Healthcare alliances with IIT Madras to set up India’s first industry-academia CoE in medical technology research The global healthcare industry is growing at a rapid pace than ever before. One of the key components driving this progress is the advancement of medical technologies. Experts opine that medical technologies extend and improve life, and thus, they have become an inseparable part of the modern healthcare process. However, medical technologies have also resulted in higher cost for healthcare. The industry is not unaware about the situation, and as such, efforts are always there to create advanced healthcare technologies at lesser cost. In the backdrop of this need based analysis, an innovation centre has recently been set up by Trivitron Healthcare in IIT Madras to conceptualise, design, and manufacture innovative and cost effective medical technology solutions for India and other emerging countries. Established in 1997, Trivitron Healthcare, one of the largest medical technology manufacturing companies in India, has initiated the process in signing a Memorandum of Understanding (MoU) with IIT Madras to set up and name it as ‘Trivitron Innovation Centre.’ This is going to be the country’s first industry-academia partnership in the USD 3.3 billion medical technology industry that includes manufacturing right from gloves to MRI scanners.

THE BACKDROP According to Trivitron, India imports more than 85% of its medical equipment requirements from abroad, while the domestic medical devices and equipment market is growing at 15% per annum. Surging population, lifestyle diseases and the recent access to better medical services are the prime factors contributing to increasing demand for diagnostic equipments, surgical devices, imaging and other devices

Dr G S K Velu, Managing Director, Trivitron Group Signing the MoU with Prof Job Kurian, Dean, IIT Madras (From L to R: Sameer D Saral, Deputy Managing Director, Trivitron, Prof M S Ananth, Director, IIT Madras, Prof R Krishna Kumar, Head, Department of Engineering Design, IIT Madras, Dr Balakrishnan, Consultant Cardio Thoracic Surgeon, Malar Fortis Hospital, Chennai)

and further to that the medical technology market is expected to boom due to the increased investments in health care in India. But due to the lack of medical innovation and coordinated efforts between medical & engineering institutes and medical technology manufacturers, equipments are getting costlier and adding to the soaring healthcare cost. Therefore, the objective to create a center of excellence (CoE) was to focus on inventions in medical technology, invent new concepts, design unique products and obtain patents, with an access to brilliant

scientists and academicians of IIT Madras. As per the effort goes, Trivitron also plans to take the opportunity of the designed and developed MT products in the CoE for their own business needs and becomes a design, manufacturing and development partner to its joint venture partners and other top medical technology players world wide, offering innovation in medical technology to the country and emerging markets globally. Exclusively funded by Trivitron, the newly set up centre, in phase one, will start designing and developing medical devices products in the

“The research and development in manufacturing the biomedical equipments needs the involvement and expertise from across the fields of engineering. For the newly opened ‘Trivitron Innovation Centre’ the project can see the participation of the best minds from all the departments of IIT Madras. We will work on innovating the best design along with the cutting edge technology for the biomedical equipments, for the people of India. I congratulate Trivitron for its confidence to come forward for this alliance,” Prof R Krishna Kumar Head, Department of Engineering Design, IIT Madras

June 2010


“TIC will put India in the global map for innovation in biomedical research” DR G S K VELU Managing Director Trivitron Group of Companies BROAD VISION BEHIND SETTING UP THE ‘TRIVITRON INNOVATION CENTRE’ (TIC) AT IIT MADRAS.

India has the capability of bringing out innovative medical devices and instruments with its own R&D initiatives if academia, industry and doctors work together. Hence the concept of Trivitron Innovation Centre was born and there is no better place to house it than IIT Madras which has one of the best talents available in the world for engineering design. THE INVESTMENT PLANS FOR RUNNING AND UPGRADING THIS

doctors in the innovation centre to work on phase one and the same will be enhanced as the project progresses. The centre will invite and professors of all major departments of IIT Madras as advisors and leaders in the project and the students in the research. TECHNOLOGIES AND PRODUCTS THAT WILL BE THE THRUST AREAS IN THE CENTRE.

Imaging technologies, critical care instrumentation, laboratory instrumentation, renal care technologies and cardiac devices, as of now.


Trivitron will be investing 15-20% of its profits in R&D initiatives. The centre will be adequately funded by Trivitron. In phase one around two - three crores is being invested for creating an Biomedical Engineering Design Lab within Department of Engineering Design. Trivitron will house six to eight exclusive scientists and over 10

area of critical care, renal care, lab diagnostics and imaging diagnostics. Present into the industry of healthcare providers for over 13 years with a range of over 500 products for over 20 medical specialties, Trivitron has also set up South Asia’s first Medical Technology Park in Tamil Nadu, India. On the other hand, IIT Madras, which has an impeccable record of producing some of the world’s best talents in the fields of engineering design with application in various fields of Technology, also has an infrastructure of advanced Bio Medical applications for Medical Technology Products. Now the new innovation centre can groom its students to conceptualise commercially viable medical devices and bring into the market through the already existing business modules of Trivitron’s engineering, manufacturing & support team. On the aliance, Dr M S Ananth, Director, IIT, Madras says, “Trivitron Innovation Centre project will


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This is the first of its kind of initiatives in India and we are hopeful that such initiatives will put India in the global map for innovation by bringing in cost effective biomedical devices, instruments and diagnostics products over the next three to five years time.

draw resources from all the core departments of IIT through its professors and students. The joint initiative will also help students to get a deeper insight in to the Medical Technology market and make them better prepared to become an expert Design and R&D engineers.” Prof R Krishna Kumar, Head, Department of Engineering Design, IIT Madras will be the coordinator of the centre and will draw diverse talents and resources available within IIT. In the project, Trivitron will be investing 15-20% of its profits in R&D initiatives of the project. “After the initial funding poured in by Trivitron, we might need to access the DBT (Department of Biotechnology) and DST (Depart of Science and Technology) funds for some specific basic research projects,” says Dr G S K Velu, Managing Director, Trivitron Group of Companies. As per his say, in phase one around two to three crores is being invested to supplement and upgrade the existing infrastructure for creating a biomedical engineering design lab within the Department

of Engineering. Initially, six to eight scientists in the innovation centre will be involved in the first phase of the project and the team will grow as and when the project progresses in demand. The centre will involve over 10 doctors and professors of all the major departments of IIT Madras as advisors in the project. IIT students will also participate in the Research Projects. “We are hopeful to see if this effort puts India in the global map for innovation by bringing in cost effective biomedical devices, instruments and diagnostics products over the next three to five years of time,” observes Dr Velu. Trivitron is also planning to develop a comprehensive centre in its Trivitron Medical Technology Park at Sriperumbudur near Chennai for cross utilisation and expansion. In due course, Trivitron Innovation Centre at IIT Madras will be transformed into a common platform for the Indian medical device manufacturers as well as the global as an outsourced design and development centre.


“Focussing more on R&D to make services competitive and affordable” As one of the leaders in corporate chains of diagnostic laboratories in India, Metropolis Healthcare marks its presence with great value and trust in pathological testing. Backed by strong technological support, the company is offering the best of the services and focussing into research and development. In conversation with Sangita Ghosh De of eHEALTH, Ameera Patel, CEO, Metropolis Healthcare Ltd, shared her insights into the current industry scenario of diagnostic laboratories in India and challenges faced by the sector. WHAT IS YOUR PERSPECTIVE ON THE INDIAN HEALTH SERVICES MARKET VIS-AVIS THE GLOBAL MARKET?

In the US, about 20 years back, there were at least 30 thousands laboratories but today there are top 4-5 major chains of organised laboratories, which constitute around 30% of the total market of pathological testing. Now the Indian market dynamics is also changing drastically the way US did. With more than 3000 labs and 90% of the total market share currently, the unorganised laboratories are growing at the rate of 10 – 15 %, while the


June 2010

organised corporate chains having less than 10% share of the total market are growing in a much faster rate at 25 – 30%, annually. In the scenario, Metropolis is also growing at a rate of 35 – 40% currently. Besides, in our country there is no regulation by the government to ensure the quality and authenticity of the pathological labs. Therefore, there is high risk of improper diagnosis by the doctors who bank upon the pathological tests’ results. In US there is CAP (College of American Pathologies), which is one of the expensive accreditations in the world and all the laboratories abide

by the accreditation. But in India, we are still awaiting a set of regulations, and as such currently we are bound to set our own standard to match up to the quality. We have also created an Indian Association of Pathology Labs in view to represent the industry to the government under the umbrella structure of CII (Confederation of Indian Industry). PLEASE GIVE US AN OVERVIEW OF METROPOLIS HEALTHCARE.

Since its inception in 1981, Metropolis has always been on its growth path, and uptil now has

expanded to 55 laboratories - 45 across India and 10 in countries like Sri Lanka, Bangladesh, Seychelles, UAE, Thailand, Africa, etc. having more than 350 collection centres all across. In India there is a very localised market in pathological testing where one has to trust on the partnership model relying on the credibility of the local laboratories. Therefore, Metropolis prefers to work on partnership model and joint ventures. Metropolis is one of the leading corporate chains of diagnostic centres in India and has conceptualised on growing as an institution while standardising the norms in the growth trajectory. Being organised in structure, Metropolis has always an edge over in giving uniform results and identical reports of any test in any of its centres, across the regions. As per my vision our aim is to expand as an organised chain of laboratories not only in the growing market in India but also in Africa, Middle East and South Asia.

the leading pathological labs in northern India with a solid network, knowledge of the market and a trusted name to the patients. As we wanted to strengthen our presence in north India we considered Final Diagnostics as the best option to tie up with for our further expansion. WHAT ARE THE NEW TEST FACILITIES METROPOLIS IS BRINGING IN?

We have the capacity of 4000 test in our laboratories collectively. We add on to three to four hundreds of variety of tests every year. We keep innovating and adding new tests that are valuable and required in the Indian market. For the diagnosis of a single disease, Metropolis has the provisions of testing it in multiple ways for a confirmation. Recently Metropolis has been into the process of promoting three more tests viz. He4 (Ovarian Marker – Gynecological), Hair DX (Genetic hair loss – Dermatological), DNA paternity test, for the Indian citizens.



Besides growing by the top line profit, Metropolis is also looking forward to offer the best of the services and focussing more on research and development. Our own R&D will enable us to drastically cut down on cost of materials, chemicals and equipments, thus making our services competitive and affordable. We are also trying to extend our service to doctors by providing them value added information at the level of diagnosis and consultation on probabilities of lab test results. We are looking forward to 30-40% growth on top line, 60-70% growth on profit, and adding 10 more laboratories and at least 100 collection centres in our existing span of presence in the financial year 2010 - 2011. We are also intending to add value to our existing services and products by providing the up-to-date status to our patients across our centres.


ICT plays a very important role in this industry because of its complicated process and huge volume. ICT bridges the gaps by automating of the entire process of testing started from the on-line patient booking to the registration of the sample and then finally getting the report digitally signed in. after the analysis of the sample. Had the entire process done manually, the possibilities of human error would have been higher in risk of errors. In Metropolis, we try and avoid as much as manual intervention in the testing process. In the future, ICT will play an important role in data mining of information in pathology and diagnostic industry which is already growing leaps and bounds. PLEASE GIVE US A GLIMPSE OF THE KEY






The challenge lies in the underdevelopment of the primary






healthcare in the country. Therefore, for us it becomes an unfavourable situation to expand and function in the rural and suburban areas. We have been contemplating about how to start our operations in the rural and semi urban areas where healthcare needs a lot of modernisation and upgradation. But lack of proper infrastructure and minimum requirements are forcing us from refraining back. We want government’s support in that. At our our end we are working on the low cost model to have a work-out in those places but that still awaiting a proper kick off in the process. In between, we are trying to manufacture and working out to cut down the cost of the equipments and chemicals so that the local model can be run in distant parts of the country. WHAT ARE THE FUTURE PLANS OF METROPOLIS?

We want to expand to become a sustainable chain of laboratories both nationally and internationally as well. Internationally we want to extend in Africa, Middle East and South Asia, looking forward to Oman, Iran, Kuwait, and Abu Dhabi in UAE. In Africa we want to explore in Nigeria, Tanzania, Kenya, Egypt, Sudan and Ethiopia. In India we have a strong presence in south and west India and now we are planning to expand in north, east and north east India. In the east, we are present in West Bengal with a central lab in Kolkata and now planning to expand all across the state. In the north east we plan to expand in Guwahati in Assam. We also have our presence in Orissa, Bihar, Uttar Pradesh, Rajasthan, Haryana, Bihar, Himachal Pradesh, Punjab, Jammu & Kashmir, Madhya Pradesh and Chhattisgarh in terms of having our collection centres. As of now we have five laboratories in north India in Bikaner, Agra, Noida, Delhi and Kolkata. and the plan is to increase it to 10 in numbers. We will also come out with our own research findings and publications to address the latest trends in the industry. June 2010



Orthopedists’ Delight Digital technologies are ensuring enhancement in patient care by radicaly improving the treatment process

Orthopedic practices are shifting with the changing demographics. As our population ages placing pressure on our healthcare facilities, it becomes increasingly important to implement a cohesive healthcare strategy. The most effective way of creating this is through the introduction of a digital workflow. In order to optimise patient care, it is essential for orthopedic specialists to acquire, review, distribute, share and archive all the information necessary for a patient to be diagnosed, treated and monitored on an ongoing basis, if needs be. Digital methods are now widely recognised as providing the most complete solution to these needs. Carestream Health provides a complete suite of digital solutions, ranging from entry-level computed radiography systems for image capture to scalable digital storage solutions, which ensure patient

records are kept secure and readily available for follow-ups and further treatments. The move from film to a partial or completely digitised environment offers a whole host of benefits, the most obvious being the removal of physical storage space, chemistry, and processors for reproducing and sharing conventional X-ray film. Digital records can be accessed remotely and shared quickly and easily, enhancing patient care and improving communication and consultation methods. Through its ongoing research and collaboration with orthopedic specialists, Carestream Health is delivering solutions that work, are easy to install and effortlessly user friendly. Mirna Bassil, Marketing Manager, Middle East and Emerging Markets, Carestream Health explains, “Orthopedic practices are becoming more and more independent in providing with a full diagnosis and treatment

Diagnosis and treatment program on the spot, without delays or intermediaries


June 2010

program to the patients on the spot, without delays or intermediaries. The needs of the patients are important to us. Therefore, we have focused our efforts on developing a complete workflow solution that delivers efficiencies to every area of the practice.” The first step in the digital transformation comes with the introduction of computed radiography (CR). CR can enhance operational workflow as well as provide major reductions in film and consumable costs. Many studies have shown that substantial reduction in radiation doses can be achieved, with a significantly reduced chance of overdose, and the removal of chemistry and consumables from the working environment is seen as a major benefit. Overall, the drastically reduced required time slots and enhancements in patient care can radically improve the practice landscape. Marco Riolfo, CR Business Manager, Emerging Markets says, “We’ve developed solutions to fit with any size practice, understanding the different budgets and workflow needs of our customers. The Carestream Directview Classic CR System is considered our flagship product but for many small practices, a simple, adapted solution suits.” According to him, the Kodak Point of- Care CR360 System with its small footprint and high capacity is an ideal entry-level product and provides fast and easy capture of quality images at an affordable price. “We’ve further enhanced our CR offering, particularly for orthopedic practices, with the introduction of Long- Length Imaging to provide

June 2010


View and diagnose long bone images within seconds with Long Length Imaging option

a flexible solution, which enables orthopedic specialists view and diagnose a wide-range of long bone images within seconds,� he adds further. Carestream Health breaks the digital workflow into five distinct stages, viz. Capture, Diagnosis, Planning, Surgery, and Distribution. Besides, through its Computed Radiography, PACS, laser printing systems, and business consulting and professional services offers authentic, scalable solutions to suit any sized facility. In the planning and surgery phases, minimising OR time is crucial, therefore, powerful solutions for pre-operative planning and digital templating are required to enhance the diagnostic and procedural process. Carestream Health adopts an open standards philosophy to product development, selecting and integrating industry leader Orthoview Orthopedic Digital Imaging Solution to provide the best planning and templating option available. Orthoview is seamlessly linked with Carestream PACS through


June 2010

the Carestream PACS MX-Ortho viewing system. Digital templating offers increased accuracy and more precise measurement; it facilitates more creative planning, with a massive range of possibilities able to be played out using intuitive software and over 30,000 digital templates. Through the MX-Ortho, workstation practices gain on demand access to images and instant, robust storage and archiving solutions. Carestream Health completes its orthopedic portfolio with a range of business solutions including small footprint, high resolution, laser imaging desktop printers, disaster recovery protection, and practice management options to improve cash flow and complete the cycle. Increasing sub-specialisation and a drive towards earlier diagnosis of conditions are being supported by ever more intelligent products, such as those in the Carestream Health portfolio, and with a predicted shortage in orthopedic surgeons performing joint replacement surgery expected in the coming few years, the ability to make considerably earlier diagnosis and solve orthopedic problems with less invasive procedures will become increasingly important. Increasing

sub-specialisation and a drive towards earlier diagnosis of conditions are being supported by ever more intelligent products, such as those in the Carestream Health portfolio, and with a predicted shortage in orthopedic surgeons performing joint replacement surgery expected in the coming few years, the ability to make considerably earlier diagnosis and solve orthopedic problems with less invasive procedures will become increasingly important.


Quantum leaps in diagnostic technology mean that patients are benefiting through identification of conditions that can be treated with minimally invasive procedures, creating substantial savings for the industry and increasing patient throughput in busy hospitals. Any practice will know that it pays to be ahead of the market when it comes to technology, but selecting the right technology takes confidence and skill. Predictions for an increase in electronic medical records implementation and a more cohesive digital workflow are already becoming a reality. The most progressive practices are setting themselves apart through early adoption of digital workflows that benefit their patients and themselves. The digital vision is fast becoming a reality but far from it being a point to be concerned about, through partnering with knowledge loaded solutions providers like Carestream Health, the transition can be made simple. Practices can convert, either in one hit or through a strategic long term plan, to running hybrid integrated solutions Technology helps in placing the complicated steps in a simple that best suit their automated process needs.


Healthcare in Bits and Bytes Mobile Healthcare is the buzz – Technology and Telecom go hand in hand


To reach out to the maximum dimension, the new buzz word is ‘Mobile Health’, in simple words it means access to valuable information and consultation for preventive and post treatment advice targeted at doctors and end users. The idea is to use Telecom as a backbone tool to leverage the current brick and mortar model of healthcare delivery across the country.

India is the second most populous country of the world and has changing socio-politicaldemographic and morbidity patterns that have been drawing global attention in recent years. Despite several growth-orientated policies adopted by the government, the widening economic, regional and gender disparities are posing challenges for the health sector. About 75% of health infrastructure, medical manpower and other health resources are concentrated in urban areas, where only 27% of the total Indian population stays. The majority of the population actually resides in the rural areas of India with a much lesser facilities in every sector including health. To reach out to the maximum dimension, the new buzz word is ‘Mobile Health’, in simple words it means access to valuable information and consultation for preventive and post treatment advice targeted at doctors and end users. The idea is to use Telecom as a backbone tool to leverage the current brick and mortar model of healthcare delivery across the country. The scope of Telecom as well as technology to disseminate valuable and personalised health information is now evolving. Better practices are expected to rely heavily on telecommunications services. Most of the high costs inherent in the current system are related to the proximity of the patient and provider, as well as to the archaic administrative systems used to manage records and exchange information. Telecommunications can bridge these proximity gaps as well as provide a normalised set of baseline data that can remain secure and yet be shared among healthcare workers. While a major step was taken

by Dr Brilliant to eradicate even the smallest remnants of small pox from India, digital technology was used to predict and prevent this infectious disease depending on information that fed in from the grassroots. Teledensity in India is increasing at a phenominal rate and soon mobile handsets will emerge as a mass targeted medium, and hence various health awareness and information programs can be penetrated amongst the end users using the same. Today, 90 % of operator’s revenues come from Voice and Rentals service. Of the balance 10%, about half comes from Person-to-Person (P2P) SMS. So, VAS (Value Added Services) accounts for only about 5% of revenue. Operators have primarily focused on voice. I see a new breed of companies emerging who will create direct-to-consumer services and focus exclusively on VAS. They will have multiple revenue streams, not just from subscribers, but also from advertisers and business houses. 3G will be a big enabler for richer services, and can actually drive higher ARPUs (Average Revenue Per User). Consumer will sit at the locus, and healthcare services will become more consumer oriented, consumer driven and on demand. The major need gap which can be addressed to, using mobile based information is preventive healthcare i.e. measures taken to identify and minimise risk factors for disease, improve the course of an existing disease and screening for early detection of disease. It had been said that by the end of 2009 three fourth of the Indian population shall be covered by a mobile network, many of these new subscribers are from rural India and hence the next possible market for derived revenue June 2010


The picture shows the intervention of technology in communicating a particular disease in steps

and penetration for healthcare is the rural and semi urban population along with the urban saturated market which will possibly grow with VAS. An SMS on your mobile phone is more personal and targeted, it forces you to take a moment to think and may be act. The Consumer advantage scenario will take into account the seven major considerations of Cost, Quality & Relevance, Reach, Real time, on demand and Convenience. Nominal subscription fee of say INR 30 per month for healthcare information and tips on mobiles will be perceived as far more relevant when compared to spending the same on ring tones, jokes or entertainment. The challenge here lies in creating awareness as to how an early detection of disease will control a pateint’s health insurance premium and lower down his hospitalisation costs. Also, a continuous follow up of an already detected disease using subscribed health information will reduce frequent doctor visits and in turn incurred cost. The quality of information dispensed should be from a reliable source, should be relevant and of local disposal. Partnership sources should include private and government


June 2010

Early detection of a disease always pushes early response and management. The information provided should enable the end user take informed decisions as a part of primary healthcare module. Thus the whole process of mobile healthcare not only requires knowledge of applicable requirements but also a thoughtful combination of technology, laws, policies, insurance, procedures, appropriate contract provisions and regulations.

participation using a strong and well branched out data collection network and a team of doctors. People in rural areas usually have basic handsets, where literacy concerns are not paramount text messaging offer significant advantages in terms of convenience and flexibility. Information dispensed in local language with the ability to store and send data on ways to stay away from the possible ailments is the key as is the distribution and prevalence of certain ailments, so are the demand options, for e.g. Ulcerative Colitis is common in Punjab in north India, Cardiovascular diseases are more common in South India. Therefore, either data taken from the consumers can be utilised to develop an on-demand service or MOHFW or WHO information base can be used to target risk factors in a particular community. An interesting publication in WHO Global Infobase indicates high prevalence of Multiple Coronary risk factors in Punjabi Bhatia community. Convenience is probably the signature mega trend of the next era since the consumer desire for time saving plus the insistence on simplifying complexity coincides with technology developments able to deliver precisely the desired information in real time. Early detection of a disease always pushes early response and management. The information provided should enable the end user take informed decisions as a part of primary healthcare module. In this model, consumer convenience and rights to access the information is the major gap, which needs to be bridged. The whole process of mobile healthcare not only requires knowledge of applicable requirements but also a thoughtful combination of technology, laws, policies, insurance, procedures, appropriate contract provisions and regulations. Maximising the mobile and technology benefits in the coming era will offer effective healthcare Management at the commencement of such a venture and beyond.

india’s Largest ICT Event 4—6 August, 2010

Hyderabad International Convention Centre Hyderabad, India



Venue eINDIA 2010 HICC Hyderabad



Host State Partner

Country Partner

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Dr K Rosaiah Chief Minister Government of Andhra Pradesh

I am happy to know that Hyderabad is hosting the sixth edition of eINDIA 2010, South Asia’s largest ICT event. The Andhra Pradesh Government, which has taken up several path breaking initiatives in ICT, e-Governance, e-Education, e-Health, e-Agriculture and related fields, is glad to host this prestigious event in Hyderabad. Andhra Pradesh has emerged as a preferred destination for knowledge-driven and high-value investments. Hyderabad, capital city of Andhra Pradesh, offers immense potential for IT companies in terms of its advance business infrastructure and best IT & ITES practices, highly skilled workforce, and supportive government policies, etc. Within a short span of few years, Hyderabad has transformed itself into the most lucrative ICT destination in the Asia Pacific region. I hope that the ‘eINDIA 2010’ would highlight the leadership of Andhra Pradesh and Hyderabad in ICT not only in India but also globally. On behalf of the Government of Andhra Pradesh, I welcome you all to ‘eINDIA 2010’ and wish the event a grand success.

In serving its citizens, Government of Andhra Pradesh has embarked on practising e-Government and leveraging the tools of Information & Communication Technology. Hosting of eINDIA 2010 in Hyderabad, symbolises the government commitment of achieving the goal of citizen centric, clean and good governance. eINDIA witnesses participation from government, international developmental agencies and the service providers in e-Governance. Exhibition at eINDIA 2010 will facilitate synchronisation of demand and supply in terms of adoption of right technology and process, towards enabling e-Governance. To maintain the pace of growth and consistent progress in this sector, eINDIA would go a long way.

eINDIA has been an excellent platform for bringing together stakeholders to exchange ideas and to get to know the possibilities of new innovations that have come into the field of technology. eINDIA has made the entire process very exciting, and I must compliment that every time I have attended the event, I discovered newer and better innovations. It is an insightful and learning experience and will be a good eye opener for those who are not aware of these ICT trends. eINDIA has been instrumental in bringing together potential partners, not just in the ICT in education field but also those in the health, governance and telecentre domains. It has helped support the fact that technology can extend developmental opportunities and facilitate the teaching process further. Smt D Purandeswari Minister of State Ministry of Human Resource Development, Government of India

Shri Komatireddy Venkat Reddy Minister for Information Technology & Communications, Youth Services and Sports, Government of Andhra Pradesh, India

It has been quite a spectacular journey and has always been an outstanding show growing from year to year. I feel happy to be associated with this mega conference, because it is one event that reflects under one roof, the amazing breadth and depth of the transformation, that is overtaking the country across multiple sectors, inside and outside the government, in every single sector. Besides, the participation in eINDIA has been growing. This is the time where we are actually growing and therefore, we need to address the issues, and think in a more mature way before we go forward. Beside bringing the technology providers we also need to bring the other stakeholders on the centre stage. I am sure that this event would continue to contribute in this absolutely exciting national journey. Shri R Chandrashekhar Secretary, Department of Information Technology, Ministry of Communications & Information Technology, Government of India Patron, Programme Advisory Board, eINDIA 2010

On behalf of the Government of Andhra Pradesh, I invite delegates from India and across the world to eINDIA 2010. The conference will help participants further their understanding of ICT in governance, education, health, agriculture, and the impact on the society. SMT K Ratna Prabha Principal Secretary-IT, Government of Andhra Pradesh


Why attend?

Centre for Science, Development and Media Studies (CSDMS) and Elets Technomedia invites you to join the India’s largest ICT event cum exposition eINDIA 2010. The conference aims to explore the diverse opportunities of integrating ICT in different spheres of life. eINDIA 2010 is also a platform for sharing knowledge, assessing the already existing initiatives, and planning creation of technology enabled society. The sixth annual ICT forum will be convened at Hyderabad International Convention Centre, Hyderabad along with Government of Andhra Pradesh as Host State partner. As an international event, the eINDIA 2010 Conference and Exhibition aims to bring together 5,000 high level representatives of the ICT industry, government, civil society, academia and private sector from all across the globe to share the best practices and digital opportunities for development, to discuss, to exchange knowledge and ideas that will shape the future of the global ICT development.

South Asia’s largest ICT event. Meet key decision makers, experts, leaders & stakeholders in ICT arena at one platform.

Meet service providers, IT vendors, telecom vendors, consulting firms, government agencies and national-international development organisations in the domain of ICT. Great networking opportunity with bureaucrats, policy makers, analysts, experts, ICT entreprenuers and NGO on innovative e-Gov implementations, technology issues and people’s need from India, Asia and beyond. A platform for engaging with colleagues and experts handling similar ICT projects, dealing with transformation and GPR challenges, automation of back office processes and integration. Benefit from in-depth conferences more than 50 in the area of e-Governance, e-Learning, eHealth, eAgriculture and Telecentre. Participants will get numerous opportunities to witness innovative solutions from within the Indian ICT industry and beyond. High RoI for stakeholders from diverse fields: government, civil society, academia, corporate and many more,through ample opportunities to nurture business skills, enhance citizen service delivery and deliver innovative solutions for the consumers & community. Supported by various state governments, government agencies and industry associations. Delegates to the event will have an access to the eINDIA exhibition which will showcase cutting edge developments in ICT.

about eINDIA Awards are the premier accolades given to innovative endeavours made in assimilating technology in developmental concerns. The award nominations are invited for the following Six categories from individual participants, government organisations, non-governmental organisations (NGOs), private institutions and enterprises who have transformed social development opportunities into a sustainable social enterprise through innovative use of ICT.




G2C Initiative of the Year G2B Initiative of the Year G2G Initiative of the Year mGovernance Initiative of the Year ICT Enabled PSU of the Year ICT in Financial Inclusion Initiative of the year Private Sector Initiative of the Year

ICT Enabled Hospital of the Year Government Policy Initiative of the Year Civil Society/Development Agency Initiative of the Year ICT Enabled Diagnostic Service Provider of the Year Health Insurance Initiative of the Year Private Sector Initiative of the Year

Innovative Grassroots Telecentre Initiave of the Year Private Sector Initiative of the Year

Digital Learning


ICT Enabled School of the Year ICT Enabled University/Higher Education Institute of the Year ICT Enabled Business School of the Year ICT Enabled Engineering College of the Year Skill Development Initiative of the Year Open and Distance Learning Initiative of the Year Private Sector Initiative of the Year

ICT Enabled Agriculture Initiative of the Year Private Sector Initiative of the Year


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Municipal IT ICT Enabled Municipal Initiative of the Year Private Sector Initiative of the Year

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Key Speakers at eINDIA 2010 D Purandeswari Minister of State Ministry of Human Resource Development (HRD) Government of India

Dr K Rosaiah Chief Minister Government of Andhra Pradesh

Sam Pitroda Advisor to the Prime Minister Government of India

Shri Komatireddy Venkat Reddy Minister for Information Technology & Communications, Youth Services and Sports, Government of Andhra Pradesh, India

R Chandrashekhar Secretary Department of IT Ministry of Communications & IT Government of India

Dr N Jadhav Member, Planning Commission Government of India

Sudhir Krishna Additional Secretary Ministry of Panchayati Raj Government of India

RS Sharma Director General Unique Identification Authority of India, Government of India

Shankar Aggarwal Joint Secretary Department of IT, Ministry of Communication & IT Government of India

N Ravi Shanker Joint Secretary Department of IT, Ministry of Communications and IT Government of India

Smt K Ratna Prabha Principal Secretary, IT Government of Andhra Pradesh

Prof V N Rajasekharan Pillai Vice Chancellor Indira Gandhi National Open University

CD Arha Chief Information Commissioner Andhra Pradesh

J Satyanarayana Principal Secretary, Health, Medical and Family Welfare Government of Andhra Pradesh

Subhash C Khuntia Joint Secretary Ministry of HRD Government of India

Sharda Prasad Joint Secretary & Director General Employment & Training, Ministry of Labour & Employment, Government of India

Dr S Vijay Kumar Project Director, Tamil Nadu Health Systems Project

Dr Rajeev Sharma Director General Centre for Good Governance

Michael Riggs Knowledge and Information Management Officer FAO, Rome

Sherif El Tokali Assistant Resident Representative Poverty Reduction, MDGs and Private Sector Team Leader, UNDP

Kapil Mohan Director Ministry of Power Government of India

Dr Sameer Sharma Commissioner Greater Hyderabad Municipal Corporation

T Krishna Prasad IGP & Director Police, Communications Government of Andhra Pradesh

U K Ananthapadmanabhan President, Kovai Medical Centre & Hospital

Dr Ashok Kumar DDG and Director Central Bureau of Health Intelligence Government of India

Dr Latha Pillai Pro Vice Chancellor Indira Gandhi National Open University

Dr SS Jena Chairman National Institute of Open Schooling (NIOS)

Wg Cdr (Dr) Sanjeev Sood, Sr Medical Officer, Indian Air Force

Shakila Shamsu Joint Advisor (Education) Planning Commission Government of India

Dr R Sreedhar Director Commonwealth of Learning

Dr Karanvir Singh Consultant Surgeon Sir Ganga Ram Hospital

Ashish Garg Regional Coordinator Asia Global e Schools & Communities Initiative

A Babu CEO, Arogyasree Health Care Trust Government of Andhra Pradesh


more opportunities Public Safety and Security India is planning for a GDP growth of 8-10 per cent every year and it is imperative for law enforcing agencies to deploy advanced security and intelligent solutions so that citizen’s safety and security is not compromised. The session will focus on: ICT in policing, intelligence gathering and sharing (CCTNS and NATGRID), IP based video surveillance and secure communication systems cyber security, disaster management– preparedness and response and capacity building.

Special Session on UID Governments today are facing information overload and there is a need for conducting information audit to have a clear view of whether information is up to the mark and social schemes are reaching the right audience. The session will focus on: Comprehensive strategy to manage information across different departments, policies and guidelines for access, storage and security of document and information, deployment of Unique ID numbers pan India, dashboards and scorecards for analysis, monitoring and evaluation.

eINDIA workshops GTZ workshop on l ICTs for SMEs l International best practices in e-Governance Copenhagen Business School workshop on l Co-creation of new technologies Global e-Schools & Communities Initiative work shop on l ICTs in education Euro-India Spirit workshops on l ICT addressing societal challenges— governance, public services, health, inclusion, mobility, environment, energy l Audio visual, media & Internet l Emerging technologies and e-Infrastructures

“I have seen eINDIA from its inception and thereafter growing like an institution in itself. I congratulate the eINDIA team for its tremendous effort in putting together this outstanding conference.”

R S Sharma Director General, UIDAI

Cloud computing While the global cloud computing market expected to cross $70 billion by 2015 and India is ideally poised to address this growing opportunity—both as the solution provider to the world and the biggest consumer at the enterprise level—Government Cloud or “G-cloud” is yet to become part of the mainstream e-Gov discussion in the country. However, while the cloud computing is expected to allow government departments share applications or server power, and treat IT as a ubiquitous, on-demand service and to flexibly consume as much or as little as is needed, it also comes with a fear of the cyber-threat that could pose a major national

eIndia 2010 Knowledge Series is a unique platform for knowledge sharing among all stakeholders in the government space be it bureaucrats, technocrats, academia, industry and civil society. The Knowledge series will help in bringing together ICT experts, practitioners, business leaders and stake holders on to one platform through peer to peer learning, thematic workshops, and exhibitions. eINDIA 2010 Knowledge Series will have six tracks focusing on e-Gov, digital learning, eHealth, e-Agriculture, Telecentre Forum and Municipal IT. In all these tracks there will be multiple thematic sessions.

security risk. The session will focus on: general governance, management and legal challenges in adopting cloud computing, privacy, security and business continuity issues.

Power IT The Government of India is presently implementing the Restructured Accelerated Power Development and Reforms Programme (R-APDRP) during the Eleventh Five-Year Plan period, which is worth US $12 billion project and is aimed at IT-enabling power distribution system in India. The session will focus on: smart metering, smart grids and energy data management, GIS mapping of power distribution network, achieving superior customer services and profitability and operational excellence.

challenges with urbanisation are to provide better transportation, integrated public infrastructure, increase human capital, long term planning, sustainability, citizen centricity, and distribution of equal economic opportunities and poverty alleviation. Moreover, to make urban centres better planned, livable, connected and smarter, citizen centric is with judicious blend of good governance; the use of ICT is paramount. The session will focus on: integrated urban infrastructure, GIS and city planning, transport and traffic management, efficient handling of work, transparency in dealing with citizens, property tax management including records management, municipal accounting system, e-Procurement and payment of utility bills.

e-Panchayat e-Panchayat, one of the Mission Mode Projects (MMP) under National e-Governance Plan (NeGP) aims to empower the panchayats and improve the internal management processes at the local level with the use of Information and Communication Technology (ICT). The computerisation of the panchayats will ensure decentralised database and bring in transparency at the local governance by providing on-line monitoring of the various rural development schemes. The session will focus on: computerisation of the panchayats, capacity building of the panchayats, addressing challenges in e-Panchayat programme–connectivity, power supply, infrastructure.

Financial Inclusion Banks have centralised their operations, and have started new delivery channels with the usage of IT such as AT Ms, Internet banking, smart card based products, mobile access and using IT for customer relationship management, customer transaction pattern analysis, credit profiling and risk management. The main objective of financial inclusion is to bring these people in the mainstream of the banking industry. The session will focus on: financial inclusion of people who are out of ambit of formal banking systems, role of ICT solution for financial inclusion, pilots and case studies.

ICT in Urban Governance Urbanisation, is the engine of growth, socio-economic development and most importantly is a tool for poverty alleviation. The key

Agriculture, as an important sector, with a huge work-force engaged, it is in fact the backbone of India’s rural economy. Technology has the potential to change agriculture landscape for the better with a pre-condition to bring all the stakeholders in the ambit of the exponential age, leveraging on the power of networking, collective wisdom and shared information, in order to align efforts and change attitude. The fruits of technology can only be availed by addressing challenges in meeting this precondition. Modern farming practices and technologies have been implemented in many parts of the world, which need to spread out to the areas untouched by it. Both the communication networks and supporting infrastructure have to reach out to rural areas to enable the biggest entrepreneur community i.e., farmers to deliver its best and consequently build a stronger nation and economy.

The Indian Telecentre Forum 2010 is going to do just that by providing an opportunity to telecentre stakeholders, both regional as well as global, to meet and deliberate on the issues facing the telecentre movement. The session will focus on: review of the CSC programme, telecentre movement in India: issues, lessons and best practices, capacity building, telecentres in the age of mobile phones, knowledge sharing among the telecentre stakeholders, sustainability concerns in the telecentre domain, localisation of content, services and grassroots innovation.

The initiative this year is to bring together India’s top-notch educational entrepreneurs, CEOs and private players from different walks of life. In K-12 sector the focus is on school principals and top executives. In the higher education sector the focus is on deans, directors and top executives along with policy and decision makers at national level. Skill Development and Vocational Training Programmes will focus on capacity builders as India requires a lot many experienced professionals if it is planning to grow at a GDP growth of 8-9 percent.

K-12 The track on K-12 will focus on Rashtriya Madhyamik Shiksha Abhiyaan, strategising and implementation of policies on usage of ICT in leveraging learning, merging ICT in learning and training through open schooling, challenges in developing e-Learning and role of ICT in advancing inclusive education. Principal’s Conclave: Discussion on different education models, pedagogy and andragogy in ICT mediated classroom.

Higher Education The track will focus on systemic enhancement of learning and teaching, innovation, research and development, education governance in universities, collaborations with world class higher education players and quality standards.

“Conferences like eINDIA have the potential to create awareness about the stupendous possibilities that e-governance harbours within itself for overall improvement to the life and especially in the context of governmental activities.” Subhash C Khuntia Joint Secretary, Ministry of HRD, Government of India Co-chair, Programme Advisory Board, eINDIA 2010

“I congratulate the CSDMS and Elets team for organising an event that would go a long way in helping the country achieve the MDG objectives of education and health… IGNOU is happy to partner with eINDIA.”

Prof V N Rajasekharan Pillai VC, IGNOU

IGNOU Workshop l Strengthening capacities of educators: The ICT way l Vice Chancellor’s Conclave: discussion on emerging issues in ICT integration and higher education

Skill Development & Vocational Training The track will focus on skills and information literacy, PM’s national skills mission, skills development and training, certification and quality assurance across education sector, role of training centres in providing youth employability, best practices in vocational education system, assessment methodologies of future skills demand and how to connect skills to markets requirements

Advancement in modern information and communication technologies (ICTs) are revolutionising healthcare systems, by transforming health administration, service delivery and care management. Rapid market maturity, heightened consumer expectations, increasing cost pressures and emerging medico-legal/regulatory requirements are driving the need for ICT solutions that could bring substantive value -add through improved efficiency and enhanced business performance. Availability of intelligent healthcare information systems, high performance communication networks, advanced analytical tools and powerful computing gadgets are promising to achieve all of these and even more. ‘eHEALTH India 2010’ – the most definitive Indian event on healthcare ICTs, technologies and applications will once again bring together the entire community of health IT professionals, practitioners, end-users and decision-makers to engage over three power-packed days of active conferencing and networking, along with a vibrant exhibition to showcase some of the latest technologies that are on offer.

KEY SESSIONS l Envisioning Healthcare Reforms: Role of ICT in healthcare transformation l Hospital CIO Conclave: Technology strategy for next generation hospitals l Health Insurance Conclave: Leveraging technology for efficient health insurance administration

“With the help of ICT, India is ushered in a new paradigm that looks promising than ever before and the healthcare service is nowhere exception in that. We are planning to open community service centres to access as many people as we can, but it seems to be a challenge.”

Secretary-level Officials such as head of various departments, Chief Secretaries, Principal Secretaries, Additional Secretaries, Joint Secretaries, Deputy Secretaries and Directors from Central and State government departments Key officials from IT, Health, Education, Urban Development, PWD, Agriculture, Rural Development, Home, Planning, Power, Finance, Transportation and Taxation departments and es from s, gat ippine sh, institutes from dele , Phil ade pt states and central ngl ean Egy a, Ba rop k ministries Lan d Eu Sri an an on Uni Sud Key


KEY TOPICS & THEMES l National Health IT Infrastructure l  Healthcare Reforms through ICT l Hospital Automation & Systems Management (HMIS & ERP) l EMR Applications & Medical Informatics l  Medical Imaging, RIS & PACS l Shared Services Infrastructure & Hosted Models l Clinical, Bio-Medical & Drug Information Systems l Telemedicine & Tele-health l Online and Mobile healthcare l Technology Standards and Interoperability

Delegate Profile of

Key Participants l  MDs/CEOs of Leading Healthcare Organisations l  Hospital Directors, Medical Superintendents & Chief Administrators l  CIOs/CTOs/GM-IT/ Head-IT/Manager-IT l  Central & State Health Officials & Policy Makers l Technology Vendors & Solution Providers l  Industry Analysts & Healthcare Consultants l  eHealth Researchers & Academicians

stakeholders and elected representatives Key decision makers from educational institutions - VCs, Registrars, Principals, Directors and Heads of organisations Key officials from Districts and municipalities Representatives from the judiciary and legal experts Key people from various chambers of commerce and associations Industry representatives and experts Representatives from NGO and other civil societies Consultants and research agencies

Dr Ashok Kumar DDG & Director, Central Bureau of Health Intelligence, Government of India

The three-day eINDIA 2009 attracted more than 4,000 delegates from across 50 countries providing a very high RoI to over 150 exhibitors—from IT, to e-Learning, e-Health and e-Gov solution providers, e-Content majors, education sector specialists, medical technologies, medical equipment and healthcare application companies—making it the largest ICT for development Exhibition in the entire South Asia region. Going ahead with the success, eINDIA 2010 has earmarked a 3,000 sq meter area aimed at enabling the companies, state governments and departments, as well as PSUs to showcase the best in breed technologies and projects implementation.

Why Participate

Meet and network with key domestic and international government influencers.

Explore new business avenues in government, education, health, agriculture and other development sectors.

Check out the latest technologies, solutions and products at the eINDIA special experience zone.

The high-powered delegation including MPs and MLAs from the North Eastern states attending a demo session at the eINDIA 2009 exhibition.

eINDIA 2009 Partners 4,120 Visitors




Speak ers


Conference Tracks


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india’s Largest ICT Event 4—6 August, 2010

Hyderabad International Convention Centre Hyderabad, India



Registration fee includes taxes as applicable

Pre Registration Fee Spot Registration Fee

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Three major hospitals in Pune implement SoftLink’s HIS For more than a decade SoftLink International has been developing cutting-edge products in the field of healthcare IT and medical imaging for its clients in India, USA, Middle East and Asia Pacific. Founded in 1997, today SoftLink has an impressive installed base of 175 plus clients in 15 countries, making it one of the fastest growing Healthcare IT MNC with Indian origin. Recently, SoftLink released a .Net version of Panacea HIS, which is an instant hit with 3 major hospital in Pune and another international hospital in

Zambia is deciding to implement it for their respective hospital. Panacea which is in its 5th release is a multicentric and multi-branch HIS with a combination of client server, as well as Web base technology. The latest version, branded as ‘Panacea.Net’ has all good features of the original Panacea with added advantage of latest .Net technology. Joshi Hospital, Ratna Memorial Hospital, as well as Poona Hospital and Research Center decided on Softlink HIS after evaluating HIS from number of vendors from different parts of India.

Experience of more than decade in Hospital IT and an impressive product portfolio of SoftLink International comprising of a fully integrated suite of HIS/CIS/RIS/PACS, has helped them win these deals against competition. A “one-stop shop” for an end-to-end IT requirement in Hospital makes SoftLink a preferred vendor against competition.

ResMed introduces next-generation CPAP series in India ResMed, a leading developer, manufacturer, and distributor of sleep and respiratory medical equipment introduced its new cutting-edge sleep apnea therapy platform called the S9 Series in India. The S9 Series combines a sleek design with superior functionality and more comfort. Combined climate control and humidification delivers unsurpassed comfort to the patient by controlling both the temperature and humidity that the patient breathes. The S9 Series is expected to not only help more sleep apnea patients adhere to the treatment, but also help sleep professionals make more informed decisions. The most effective treatment for sleep apnea is Continuous Positive Airway Pressure (CPAP) therapy. In this noninvasive treatment, air is pressurised by a small device and delivered to the airway of the patient through a mask that fits on/over the nose, or nose and mouth. The pressurised air keeps the upper airway open and helps the person experience a restful night’s sleep without interruptions caused by apneas. The S9 Series is designed to deliver unsurpassed comfort to the patient by automatically controlling the pressure,


June 2010

temperature and humidity of the air that the patient breathes. The temperature as well as the humidity is controlled through input from five different sensors, including sensors close to the mask, a feature unique to the S9 Series over any of its competition. Optimal humidification is then achieved automatically. A new enhanced Easy-Breathe motor also reduces the conducted noise offering the quietest mask and machine combination available on the market. S9 Features: • Optional automatic climate control - this is a true paradigm shift in CPAP therapy. • Easy-Breathe Technology for significantly reduced mask and machine noise levels (radiated and conducted). • Enhanced Easy-Breathe EPR reduces the work of breathing during exhalation and adapts to the patient’s breathing cycle.

The S9 identifies both obstructive and central apnea events and the S9 AutoSet responds accordingly. Innovative design and interface increases ease-of-use and patient acceptance. SlimLine and ClimateLine tubing offers a significant advance in patient comfort with 35 percent less volume than competing tubing systems. Summary of compliance and efficacy data for up to 365 nights including mask leak, AHI, and central apnea statistics. Sleep quality information storage on SD-card, colour LCD screen for convenience as well as remote monitoring options.

June 2010


Healthsprint wins Outstanding Smarter Planet Industry Solution award Healthsprint wins the IBM Beacon Award 2010 in the Outstanding Smarter Planet Industry Solution by an ISV category held in Rome in May. Each year, IBM recognises the best solutions business partners deliver across businesses and around the world. Beacon winners were selected by leading industry journalists, analysts, and IBM executives for the 21 award categories as leaders who focus on deep skills and solutions Selected from hundreds of nominations from around the world, Healthsprint has set the standard for business excellence, innovative solutions, ingenuity and client satisfaction.

Aarogyasri may soon become a centrally-assisted scheme The Andhra Pradesh Government has requested the Government of India to adopt the Aarogyasri scheme as a nationally-assisted healthcare scheme for poor and low income people. The Government of India while appreciating the scheme, will study the scheme to decide about the assistance. If the proposal of the state Government is accepted, Aarogyasri will become a centrallyassisted scheme. The Chief Minister Dr K Rosaiah, who has taken up this issue with the Planning Commission has been insisting that the Government of India should assist such a noble and gigantic healthcare scheme. Dr. Rosaiah discussed the latest progress of the Aarogyasri scheme with Chief Secretary, SV Prasad;


June 2010

GE Healthcare forms strategic alliance with CardioDx GE Healthcare and CardioDx, a pioneer in cardiovascular genomic diagnostics, recently announced that the companies have entered into a strategic alliance to advance and co-develop diagnostic technologies to improve the care and management of patients with cardiovascular disease. Building on the alliance, the GE Healthymagination Fund, a new equity fund that makes investments in highly promising healthcare technology companies, has invested USD 5 million in CardioDx as part of a Series D round that the fund is leading. The alliance between the two companies aligns with GE’s healthymagination initiative which focuses on reducing cost, increasing access and improving quality in healthcare. This also marks the first investment for the Healthymagination Fund. CardioDx develops genomic tests to aid in the assessment and tailoring of care of individuals with cardiovascular diseases such as coronary artery disease (CAD), cardiac arrhythmias and heart failure. GE Healthcare is a world-class provider of advanced technologies for cardiovascular imaging and monitoring. The strategic fit between the two businesses combined with expanded capabilities in product research and development will accelerate the development of new high-value integrated technologies for the diagnosis and care of patients with suspected heart disease. This alliance also reflects GE Healthcare’s continuing interest in opportunities to

Principal Secretary, J Satyanarayana and CEO, Aarogyasri Trust, Babu A. The Chief Minister is hopeful that once the Planning Commission studies the scheme in depth, it would definitely help Andhra Pradesh in the successful continuance of the scheme. Aarogyasri is the unique healthcare scheme launched by the former Chief Minister Dr YS Rajasekhara Reddy for providing quality healthcare and treatment to the poor and low income in corporate hospitals without spending any money.

combine in vivo and in vitro diagnostic technologies to improve patient care. CardioDx’s initial product, Corus™ CAD, is a clinically validated non-invasive genomic test that uses data such as gene expression levels and other patient characteristics to assess the likelihood that a patient has obstructive coronary artery disease (CAD). Today, patients with suspected CAD are diagnosed through a combination of non-invasive and invasive procedures. Corus CAD uses a simple blood test to quantify the likelihood of CAD, helping cardiologists make more informed decisions on how best to diagnose and treat their patients. The Healthymagination Fund is part of GE’s USD 6 billion healthymagination initiative, a global commitment to deliver better healthcare to more people at lower cost. The USD 250 million Healthymagination Fund targets three broad areas for investment: broad-based diagnostics, healthcare information technology, and life sciences.

Aarogyasri scheme has already become very popular with other states and in other countries as well. The transparent and unique online treatment and payment scheme which is being monitored 24x7 by a team of expert doctors are to be replicated by many other states like Karnataka, Maharashtra and Tamil Nadu. Even other countries have evinced keen interest in launching the scheme for providing quality healthcare to their under-privileged people.

Phase II of National Initiative for Patient Safety commences at its second workshop Honorable Health Minister Shri Ghulam Nabi Azad inaugurated the second in series of workshop of NIPS (National Initiative for Patient Safety) in presence of other dignitaries from Government of India, Director of AIIMS, WHO Representative of India and many more. The Department of Hospital Administration, AIIMS in collaboration with the World Health Organization (WHO), INCLEN Trust and supported by knowledge partner BD, has commenced phase two of NIPS. The comprehensive three day workshop aimed to bring on a single platform reputed clinicians, nurses and hospital administrators from 12 leading public and private hospitals and promote the culture of patient safety under the umbrella of NIPS. NIPS is an initiative conceptualized and spearheaded by Dr. Shakti Kumar Gupta, Head of Department- Hospital Administration, AIIMS. NIPS has been set up with the objective to sensitise

the various healthcare institutions on the concepts of patient safety and healthcare associated infections, identify the prevailing infection control processes being followed across the medical colleges/hospitals of India through baseline assessments of infection control processes, identify the gaps prevailing in the realm of patient safety and thereby help the hospitals take measures to improve the care being imparted to the patients. It also sensitizes the healthcare delivery system on various issues of medication management, surgical safety and patient communication. The second workshop of NIPS (National Initiative for Patient Safety) marked the continuity of the series of comprehensive workshops providing a platform for national experts to share their experience in the implementation of patient safety practices; as well as interact and learn global practices on patient safety including infection

control from internationally renowned experts on patient safety. The core areas of focus for NIPS II were the WHO – Global Patient Safety Challenges. The participating teams of six experts from each institute/hospital are expected to propagate the concepts of patient safety by formation of functional committees on surgical safety, infection control including hand hygiene, medication management, patient communication and hand offs and setting up surveillance and monitoring mechanisms. As the only corporate body to become the Knowledge Partner to NIPS, BD India’s key role is to provide international knowledge on infection control and patient safety thereby enabling better delivery of care. BD would also help NIPS carry out the baseline and end line assessments of patient safety guidelines in the hospitals that agree to undergo the assessments.

June 2010


Schiller India launches Truscope Elite, a modular patient monitor Schiller India, a leading Swiss Joint Venture Company in the field of medical diagnostics, has launched a new modular patient monitor called Truscope Elite. It consists of a host monitor and an Emergency Mobile Server (EMS), which is connected to the host monitor. Various configurations of the EMS module are available as per customer requirement. According to V Balakrishnan, Sr. Vice President, Truscope Elite is the first patient monitor with a display on the module itself and is an ideal monitor for operation theatres. Truscope Elite provides DVI connectivity through which the monitor can be connected to the big plasma LCD

screen. CIS connectivity enables the user to see digital images such as digital X-ray, CT, and MRI digital images on the bedside on Truscope Elite if the same has been stored in digital format on the hospital central server. Features: • Basic monitor • 17” color TFT LCD display with 13 touch buttons • 3/5/7 lead ECG display (12 lead display optional) • Nine different screen configurations • ST and arrhythmia analysis’ • 96 hours graphical and tabular trends • Drug dose calculation and OXY-

• • •

CRG software External video (VGA) output Built in battery with backup of 1 hour Connectivity to wired CNS

Emergency Mobile Server (EMS) Seamless transport solution meeting the clinician’s demand • Providing fast and convenient monitoring during the patient’s transfer with display, battery alarm and storage capability • Patient data gets transferred automatically when connected to the base unit • Compact design, convenient to carry, allowing patient to move freely • 3.5” color TFT LCD display • 8 hours of graphical and tabular trends • Battery back-up : 1 hour • Parameters available in module: ECG, RR, SPO2, NIBP, 2 Temperatures, 2-4 IBP, ETCO2, Multigas, Cardiac output

Honeywell HomMed and eDevice expand connectivity solutions for telehealth HomMed, a world leader in telehealth and remote patient care, announced the expansion of its partnership with eDevice to bring extended connectivity to its LifeStream remote patient care system and Genesis DM monitor. The Genesis DM telehealth device measures vital signs such as heart rate, blood pressure, weight, and SPo2, and provides customizable subjective disease-related queries for a more complete picture of an individual’s health. Automated and secure transfer of medical and vital signs records is made using eDevice eHealth data communication terminals and modules. Designed for use at a patient’s home for continuous health monitoring, it provides greater access to health information, enhancing efficiency and improving patient outcomes.


June 2010

HEALTH FOR ALL : June 2010  
HEALTH FOR ALL : June 2010  

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