IndiaMedToday Oct 2021

OCTOBER 2021, VOLUME 5 ISSUE 10 `200 INDIA MED TODAY

Healthcare Finance and Business Strategy Amid Changing COVID-19 Climate The future is about the ability to be flexible in resource planning

FEATURED EXPERTS IN THE ISSUE Ramesh Kannan, Somerset Indus Healthcare Fund Ganeshprasad S, Genworks health Venkatraman R, Karkinos Rajneesh Bhandari, Neuroequilibrium Bhavik Desai, S Venkat, Practus Shuchin Baja, Ujala Cygnus hospital Rajgopal, Kites Venugopal Ganapathy, Axilor OCTOBER 2021

Shravan Subramanyam, Wipro-GE healthcare Terri Bresenham Abhinav Suri, Strides Ventures Shripad Joshi, Perkin Elmer

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October 2021 EDITORIAL Editor Neelam Kachhap Sub-Editor Abishek Raj editorial@ indiamedtoday.com ART & PRODUCTION ScreeTract Shylesh

Healthcare Finance and Business Strategy Amid Changing COVID-19 Climate

BOARD OF ADVISORS Dr Alexander Thomas

COVID-19 has completely changed our world, since the beginning of

Dr Girdhar Gyani

2020. The impact of COVID-19 pandemic has altered our perception

Dr Prem Kumar Nair Dr Bhabatosh Biswas

of life and its various facets. Healthcare for one will never be the

Dr Alok Roy

same. As healthcare professionals across the world are coping with

Ramesh Kannan

financial cutbacks; revenue loss and capital slowdown, triggered by

CONSULTING EDITOR

the COVID-19 pandemic, many foresee a turnaround in the short

Dr Libert Anil Gomes

term.

Dr Salil Choudhary

In preparing for the impact of COVID-19 on healthcare finance,

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hospitals and care providers must be able to predict the gain or

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loss from related incentives, penalties, volume changes, and other

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factors. Our healthcare finance and business strategy focused issue aims to provide a guide to successfully managing the shift.

The special issue features actionable insights and innovative strategies across the healthcare finance continuum across topics like Strategic Planning, Capital Finance, Merger and Acquisition, Operations Management, Hospital Board – CEO relationship, Identifying next gen Leaders, Leadership mentoring, CEO Succession Planning and Revenue loss and management during Covid.

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Our guest editor for this issue is a dynamic personality, who has over 25 years of consulting

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experience in management, business, finance and strategy of which 20+ years are in healthcare

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devices and equipment); Diagnostics products and services; Healthcare delivery – asset light models and Life sciences .

Kannan is a healthcare strategist, business strategy and catalyst, innovation and transformation

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specialist, is pro-active, participative, has personalised involvement in a company’s affairs and

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enables the company to achieve its objectives. He focuses on fund raising, managing investor

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relations, deal sourcing, evaluation, concluding the deal, monitoring and value addition efforts.

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We would like to thank him for his efforts. Despite his busy schedule, Kannan worked on this IndiaMedToday expressly disclaims liability for errors and omissions in this publication. While we try to keep the information timely and accurate, we make no guarantees. The views and opinions expressed

special issue to bring together the best minds in finance and strategic planning. They collectively provide an invaluable insight into the working of the healthcare universe in India.

in the magazine do not necessarily reflect the official policy or position of IndiaMedToday or the publication. Information on IndiaMedToday should not be used as a substitute for professional healthcare advice. Readers are advised to always seek specialist advice before acting on information contained in this publication.

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4

October 2021

Editor M Neelam Kachhap

October 2021

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CONTENTS

21

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25

24

OPINION

FEATURE ARTICLES

APPROACH

Business Transformation During COVID

Understanding The Correlation Between D-dimer and COVID-19

How Technology Can Help Bring Down the Cost of Healthcare in the Next Five Years

UPFRONT

27 COVER STORY

Healthcare Finance and Business Strategy Amid Changing COVID-19 Climate

04 Editorial 06 Letters 08 Guest Editorial 09 News Roundup 36 Data Analytics 38 Impact 40 Innovate 42 People Matter 44 Pulse 46 Interview www.indiamedtoday.com

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5

Letters Pradhan Mantri Digital Health Mission

T

he COVID-19 pandemic has accelerated the need for the adoption of digital health technologies. The Pradhan Mantri Digital Health Mission (PM – DHM) guidelines envisage the goal of attaining universal care including highest level of health and wellbeing at all ages through increased access and lowered cost of healthcare delivery.

Carlos Montiel - Vice President, Latin America & South Asia, ResMed

The Pradhan Mantri Digital Health Mission (PMDHM) is a welcome step by the government, as it will progress the journey to Universal Health Coverage. It would also enhance transparency in care delivery as well as access to information for all stakeholders, which in turn could help lower the cost to patients.

25-40 years of age. Ensuring a proper diet, exercising regularly

Dilip Jose, MD & CEO, Manipal Health Enterprises

Narayana Health City

The pan-India launch of the Digital Health ID initiative under the National Digital Health Mission is a well-timed and potentially transformational step. The easy digital access to healthcare records is going to be of great value for out-of-hospital care services such as remote monitoring or at home healthcare.

Through the Digital Health ID, healthcare service providers will be able to better understand the patient’s health history and past records of illnesses or special conditions. This will be crucial while delivering care to critically ill patients on the go. At present, a lot of patients fail to get timely or the right care due to lack of information about their medical condition and past treatments.

With the Digital Health ID, this problem will be resolved and doctors will make better informed and precise decisions.

The second wave of the COVID-19 pandemic came as a surprise

Vaibhav Tewari, CEO, Portea Medical

system also helped me detect early warning signs of heart failure

The launch of Pradhan Mantri Digital Health Mission (PM-DHM) is a visionary step of the government to digitise healthcare in the country. With interoperable health environment, patients will now be able to upload and access securely their health records, which could be exchanged smoothly between patients and doctors upon the former’s consent. The Unique Health ID will make it possible for people of the country to avail quality care and gain better access to healthcare facilities. In the later phases, the plan is also to integrate telemedicine and e-pharmacy, which will bring in a lot more inclusivity. The creation of Electronic Medical Records (EMR) will play a crucial role in transforming the way healthcare is delivered in the country. This is an important milestone that marks democratisation of healthcare in a true sense.

and getting health check-ups done at regular intervals can help in not only averting the emergency situation that the disease can cause but also in avoiding the onset of the condition itself.

Dr Praveen Sadarmin, Consultant, Interventional Cardiologist,

to many health experts, who had thought that this form of virus was eliminated. The outbreak started in December last year and cases grew exponentially over the next few months. Chronic heart failure (HF) is a major comorbidity accounting for an increased severity and mortality related to coronavirus. To reduce the risk of COVID-19 in HF patients, telemedicine was encouraged then. When the second wave led to a sharp spike in the footfall of patients, it became very challenging for me to keep up with the number of patients and write proper prescriptions for them. This is when I turned to HealthPlix EMR. Features like Video consultations with excellent video quality, automatic SMS alerts to the patients, and prescription forwarding by email have made my life easy. The EMR among my patients and provide them with the right diagnosis and adequate medical support.

Dr

Indranil

Dutta,

Consultant

Interventional

Cardiologist,

Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata

Dr Harshit Jain, Founder & Global CEO, Doceree Heart disease is one of the major causes of mortality in our country. Until few years ago, the disease was predominantly seen in 40-60 years of age, but now it is increasingly visible even in the younger population aged between 25-40 years of age. In the last two years there has been a rise in incidents of myocardial infarction (heart attacks) reported amongst 25-40 year olds.

Sedentary lifestyle, increased consumption of processed food, lifestyle habits like consumption of alcohol and smoking are the major causes for the rise. The COVID-19 induced stress is also one of the predominant factors that contributes to the increase in heart ailments. At Narayana Health City, we are seeing around six to seven patients per month with Myocardial Infarction in the

6

October 2021

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Guest Editorial

It is a privilege and an honour to be the

healthcare

guest editor for IndiaMedToday one of

technology, opportunities today are

the premier Healthcare publication in

far far more compared to the past and

the country.

with significant monetary and strategic

The magazine has been

doing yeoman service to the healthcare

Kannan Ramesh Partner Somerset Indus Healthcare Fund

community

and

has

adapted

itself

Thanks

to

support.

An enterprise has to evolve into a mature

environment.

organisation and in the given context

Neelam Kachhap has been spectacular in enabling everyone in the country with

people play a very very important role in defining the future of the company.

interest in healthcare and contributing

Be it the Board of Directors, Promoters,

to

Management, Consultants, Advisors all

the

common

good.

determines

Ultimately the

future

and it is so gladdening to see Neelam spearheading this initiative. Healthcare is witnessing a new paradigm shift to

play a role in defining the direction and the future.

Culture determines success.

technology and digital empowerment

In addition to people, compliance to

thanks to covid. This has changed

the regulation and responsibility to

the landscape and provided a great

the public are very important to bring

opportunity to build a bridge between the have and the have nots in healthcare.

Publications like IndiaMedToday are garnering public interest in healthcare delivery

and

helping

those

in

far

in a sense of transparency and trust which is most critical in any business particularly in healthcare.

The

reader

should

reach

out

to

off places to benefit from a digital

potential partners and take advantage

revolution by empowering the provider,

of the given situation and translate the

the payee and the patient on one side

benefits for the ultimate patient. This is

and collaborating with manufacturers, suppliers, service providers on the other. IndiaMedToday is becoming the leading light to help healthcare.

An

eclectic

mix

of

the

author’s

the great opportunity to learn, unlearn and relearn and contribute to healthcare in the truest form Once

again

the

entire

and relevant topics are helping people

mention for the extraordinary efforts

to enhance their knowledge and utilise

to contribute to the benefit of Indian

them beneficially.

Healthcare

by

special

by

I hope you enjoy reading the articles

sharing, knowledge multiplies many

and contribution was written with a lot

time over resulting in immense benefit

of passion and look forward to receiving

to the population at large.

your suggestions and feedback to make

It is important to read, assimilate

the future issues of IndiaMedToday

and

more interesting and rewarding.

understand

disseminating,

a

at

IndiaMedToday

learning,

deserves

team

contributing to various very interesting

By

October 2021

going.

very well to the new emerging digital

knowledge

8

is

where

the

Indian

News Roundup

Sun Pharma launches cough syrup Chericof 12 Sun Pharmaceutical Industries announced the launch of a novel formulation in cough management – Chericof 12 (Dextromethorphan Hydrobromide 30 mg and Chlorpheniramine Maleate 4 mg) in India. Chericof 12, the first prescription cough syrup in India which gives relief for up to 12 hours, is manufactured using Polistirex technology for sustained release of the drug. Chericof 12 is approved for patients of age group six years and above.

The Polistirex technology used in Chericof 12 provides sustained release of the medicine in the body, thus offering up to 12-hour relief to patients with twice-daily dosage.

PM Modi unveils Ayushman Bharat Digital Mission Prime Minister Narendra Modi launched the Ayushman Bharat Digital Mission through a video conference. Speaking on the occasion, the PM said that the campaign of strengthening health facilities that have been going for the last seven years is entering a new phase.

The Prime Minister said Ayushman Bharat – Digital Mission, will now connect the digital health solutions of hospitals across the country with each other. The mission will not only make the processes of hospitals simplified but also will increase ease of living, he added. Under this, every citizen will now get a digital health ID and their health record will be digitally protected.

The Prime Minister remarked that the Arogya Setu app helped a lot in preventing the spread of corona infection. He lauded Co-WIN for its role in making India achieve a record administration of about 90 crore vaccine doses today, under the free vaccine campaign.

recently inaugurated the OPD unit of Composite

Ayush

Karnataka.

The

multi-speciality

Hospital

hospital

successfully

accomplished

planned

in

2020.

opening ceremony had been delayed. For the successful functioning of Ayush OPD (Ayurveda, Yoga and Naturopathy, Unani, Siddha, Homeopathy) and allopathy and in future there would be advanced and special treatment facilities. …launches new unit at Udupi ayurveda hospital.

Sarbananda

Sonowal,

Minister

for

Ports,

and

Ayush,

Waterways

recently

Union

Shipping

inaugurated

‘Rathnashree Arogyadhama,’ a new unit of Sri Dharmasthala Manjunatheshwara Ayurveda Hospital at Udupi, Karnataka.

Shobha Karandlaje, Union Minister of State for Agriculture and Farmers Welfare and Kota Srinivasa Poojary, Minister for

Union Minister for Ayush, Ports, Shipping

unit,

and

Centre and Special Ward.

Sonowal

was

Due to the pandemic of COVID-19, the

Social

Sarbananda

Ayush

and sanctioned in 2016 and has been

Ayush Minister inaugurates OPD unit of Composite Ayush Hospital Mangaluru Waterways

Mangalore,

50-bedded

Welfare

and

Backward

Classes

Welfare, Government of Karnataka were also present on this occasion. The new unit includes the aesthetic medicine unit – Shringara. Deluxe Ward – Health Cottage Dhyana

Mandira,

Panchakarma

Lupin forays into diagnostics business Lupin is foraying into diagnostics to leverage its doctor connect to tap a sector that has low entry barriers, gives high returns on capital employed, and is witnessing double-digit growth. A formal launch is expected next month, sources in the know said. Lupin Diagnostics will be a part of Lupin Healthcare, a 100 per cent subsidiary of Lupin. It is in the process of recruiting the team, finalising franchise partners, and setting up a 45,000 square feet laboratory in Navi Mumbai. The company did not wish to comment on the development. Lupin has already hired an experienced team with a background in the diagnostics sector.

Union minister lauds COVID-19 vaccine production by IIL, BBIL Union Fisheries, Animal Husbandry, and Dairying Minister, Parshottam Rupala lauded the efforts of Indian Immunologicals Limited (IIL) and Bharat Biotech International Limited (BBIL) for their ability to roll out the COVID-19 vaccine drug substance in record time. To date, IIL has already supplied 2 million doses of the drug substance. IIL will produce 3 million doses a month and from December will increase it to 10 million doses. Rupala said that he will extend all possible cooperation to IIL for its future

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9

News Roundup

Parshottam Rupala during his visit to the IIL facility in Hyderabad endeavours. He also expressed his support for innovation in research for both human and animal vaccines in the country. He handed over the COVID-19 drug substance.

Made at IIL to Dr Krishna Ella, CMD, BBIL

Doceree introduces opti-channel marketing for pharma sector Doceree has launched in India opti-channel marketing for the pharmaceutical sector, in its attempt to accelerate the adoption of digital mediums in an industry which is relatively slow in embracing innovative digital technologies. Doceree created the category of programmatic physician marketing in India with its entry into the market last year. The company is aiming to improve the overall business outcomes of pharma brands on digital with its latest opti-channel marketing approach. Enabling marketers to have tactical insights around a physician’s behaviour and engagement levels is Doceree’s yet another effort towards democratising pharma marketing.

with Acute Myeloid Leukaemia. It is the first drug that will improve survival by almost ten months and bridge a longpending unmet need in cancer therapy.

at the annual meeting of the Society of Minimally Invasive Cardiovascular and Thoracic Surgeons of India (SMICTSI) in Delhi.

Cardiologist Dr Sudhir Srivastava bags SMICTSI Lifetime Achievement Award

BDR Pharma launches BIAPENEM to treat urinary tract infection

Dr Sudhir Srivastava was given the Lifetime Achievement Award for his years of dedication, innovation and hard work in revolutionising the realms of minimally invasive cardiovascular surgery and providing the highest standards of patient care, teaching and research work beyond excellence. The award ceremony was held

Union Health Minister releases post covid sequelae modules

Intas Pharma launches Azadine-O Ahmedabad-based Intas Pharmaceuticals has launched oral azacitidine in India under

the

brand

name

Azadine-O.

Oral Azacitidine is approved for use in maintenance therapy for adult patients

10

October 2021

BDR Pharma has launched BIAPENEM to treat patients with intra-abdominal infections, lower respiratory infections, or complicated urinary tract infections.

The drug will be available in the market shortly. BDR Pharma was the first to identify and develop this product and conducted clinical studies in conjunction with some of the leading players in the critical care segment who co-sponsored these studies. BDR Pharma was also the first one to get the DCGI (Drug Controller General of India) approval for this drug.

Dr Sudhir Srivastava

Union Minister for Health and Family Welfare Mansukh Mandaviya released post covid sequelae modules in the presence of Dr Bharati Pravin Pawar, Union Minister of State for Health and Family Welfare. The modules will help in building the capacity of the doctors, nurses, paramedics and community health workers across India to

deal with the long-term effects of covid.

Expressing his happiness on the release of guidelines, the Union Health Minister said that these have been prepared to guide doctors and healthcare workers to deal with the issue of long-term effects of covid.

He said that proactive and comprehensive treatment of covid is required to ensure minimum side effects and no negative effects of the treatment.

Fujifilm launches new CAD EYE function for real time colon polyp detection Fujifilm India has launched the new software version of CAD EYE, a function that supports real-time detection of colonic polyps during colonoscopy utilising AI technology. The updated function will be essential for colon polyp detection and characterisation, which will be achieved by utilising a type of Artificial Intelligence (AI) called deep learning.

The new detection and characterisation functionality of CAD EYE together with the polyp detection function will be available with software EW10-EC02 and the compatible expansion unit EX-1 in combination with Fujifilm’s ELUXEO systems and colonoscopes. CAD EYE was originally developed to support real-time detection of colonic polyps utilising AI technology. When a suspicious polyp is detected within the endoscopic image, a Detection Box indicates the area where the suspicious polyp has been detected,

Fujifilm's CAD EYE function for real time colon polyp detection

accompanied by a sound signal. The new CAD EYE Detection and Characterisation will assist clinicians by generating a suggested histological prediction by displaying whether the suspicious polyp(s) in the image are hyperplastic or neoplastic.

GE Healthcare to acquire BK Medical GE has entered into an agreement to acquire BK Medical, a leader in advanced surgical visualisation, from Altaris Capital Partners for a cash purchase price of $1.45 billion. BK Medical is an innovator in global intraoperative imaging and surgical navigation, used to guide clinicians during minimally invasive and robotic surgeries and to visualise deep tissue during procedures in neuro and abdominal surgery, and in ultrasound urology. BK Medical is headquartered in Boston and Copenhagen with more than 650 employees and is delivering double-digit revenue growth.

The transaction is expected to create value by further strengthening BK Medical, including through significant synergies with the benefit of GE’s technology and commercial scale. This transaction enables BK Medical’s Active Imaging platform to reach new customers and new markets around the world, and the combination of GE Healthcare’s diagnostic imaging technology with BK’s ability to enable decision-making and surgical visualization in intervention will allow better decisionmaking throughout the care continuum.

Practo forays into secondary healthcare

Each Practo Care surgeon comes with at least 10+ years of experience. The model places an equal emphasis on audit as a tool to improve the quality and efficiency of care provided to the patients. The company plans to facilitate Rs 1000 cr worth of healthcare financing in India over the next three years. Additionally, its partnership with insurance companies is bringing in the much-needed convenience in paperwork support.

Ampio Pharma receives DCGI approval to commence AP-019 Phase II study in India Ampio Pharmaceuticals, a biopharmaceutical company focussed on the advancement of immunology-based therapies for prevalent inflammatory conditions, today announced regulatory approval from the Drugs Controller General of India (DCGI) of the Central Drugs Standard Control Organization (CDSCO) in the Phase II AP-019 clinical trial in India.

The study will utilise inhaled Ampion to treat those suffering from respiratory distress due to COVID-19. Following presentation of Ampion to a Subject Expert Committee (SEC) established by the DCGI, the AP-019 treatment protocol was approved with no recommended changes.

Gujarat govt launches Ayudmla portal for Ayurveda medicines Gujarat has launched an online portal for

Practo has unveiled 50+ Practo Care

Drug Manufacturing License System –

Surgery Experience Centres in six cities

Ayudmla for Ayurvedic Medicines. With

(Bengaluru,

Delhi-NCR,

this, Gujarat has become the first state in

Hyderabad, and Ahmedabad), marking its

India to offer these facilities for Ayurvedic

foray into secondary care in India. Practo

industry. The portal was launched during

is building an omnichannel healthcare

an event of GAAMA – UDAN 2021.

ecosystem for secondary care procedures,

Gujarat Ayurved Aushadh Manufacturers

that will enable users to seamlessly cross

Association (GAAMA) recently organised

over between digital and physical, and

‘GAAMA

out-patient to in-patient environments.

Difficulties, Opportunities and Scopes of

Currently, Practo Care Surgeries is helping

Ayurvedic Industry’ in Ahmedabad. Dr

fulfil 50+ surgical procedures across three

Hemant Koshiya, Commissioner, FDCA,

specialities viz. general surgery, urology

Gujarat,

and ENT, in six cities. The company plans

Commissioner – Ayurveda, FDCA, Gujarat,

to expand its network to 30+ cities, launch

Anand Mehta and Priyanka Shah, Technical

300+ centres, add more specialities (viz.

Officer – Ayurveda, FDCA, Gujarat were

orthopaedic, gynaecology, ophthalmology,

present during the launch. More than 350

to name a few), and onboard hundreds of

Ayurvedic industrialists across Gujarat

surgeons by the end of next year.

participated in the event.

Mumbai,

Pune,

UDAN

Dr

2021:

Kamleshbhai

focusing

Bhatt,

www.indiamedtoday.com

on

Joint

11

News Roundup

Cephalosporin products and has acquired a facility in Mehsana, Gujarat for the same.

The plant will cater to all the Cephalosporin products i.e. Tablet, Capsule, Dry syrup and Injectable. The company is in the process of applying for WHO GMP Certifications for the facility and expects to receive the same by December 2021. There are plans to manufacture 20 plus Cephalosporin products and is planning to start product registration soon for the domestic and exports market.

Ma Subramanian, Minister of Health and Family Welfare during the launch of liver transplant centre at Billroth Super Speciality Hospitals, Chennai

Billroth Hospitals launches liver transplant centre at Chennai

of industry knowledge, provide critical outside-in perspectives and creative ideas, to help the company achieve its vision and strategic goals.

Billroth Super Speciality Hospitals recently performed a liver transplant surgery for a 62-year-old man. With this, the hospital has also marked the launch of a liver transplant centre. The inauguration was done by Ma Subramanian, Minister of Health and Family Welfare, Tamil Nadu. The centre will be headed by Dr Elankumaran, who has performed over 1,700 transplants in his career. The team has highly qualified surgeons such as Dr Sugi Subramaniam, Dr Sivaraj and Dr Sankar Narayanan, Anaesthetists – Dr Kulaseharan, Dr Hari Balakrishnan, Dr Rengarajan and Dr Suresh.

MetroMedi.com ties up with BMS Fit Club

Healthium Medtech appoints Ajay Gupta as Chairman of Board Healthium

Medtech

has

announced

the elevation of board member Ajay Gupta to the Chairman of the Board and has also appointed Namrata Kaul as

directors will continue to guide Healthium Medtech to achieve profitable growth and provide surgeons and patients globally with cost-effective, high-quality medical devices.

The

appointments

will

also

strengthen governance, leverage a wealth

12

October 2021

Insightec, a global healthcare company focussed on transforming patient care, has received market approval from the Central Drugs

Standard

Control

Organization

(CDSCO) for its incision-less neurosurgery platform, the Exablate 4000. The Exablate 4000 (Exablate Neuro) platform uses MRguided focussed ultrasound to precisely

Hyderabad-based MetroMedi.com has tied up with BMS Fit Club to expand its footprint in the remote management of lifestylerelated chronic conditions associated with

ablate a small target deep within the brain without incisions. The approval will enable the treatment of patients in India living with Essential Tremor, Tremor-dominant

diabetes and hypertension and launch a

Parkinson’s Disease and neuropathic pain.

diabetes reversal programme.

medically proven and clinically approved

Mylab acquires majority stake Sanskritech

methods with India’s 1st diabetic reversal

Leading biotech company Mylab Discovery

platform from MetroMedi & BMS Fit Club,”

Solutions has acquired a majority stake in

Uday Lakshmi – Co-founder, BMS Fit Club.

Sanskritech – the developer of Swayam.

Satyanarayana Vaddi, Board Advisor and

Mylab will establish point of care (POC)

Chief Growth Officer, MetroMedi stated,

testing labs at doctor offices, nursing

“Consumer

homes,

“Diabetes’ reversal is possible with our

demands

are

driving

the

community

health

centres,

transition to patient-centric care delivery

airports, etc. through lab partners to

across geographies and socio-economic

enable patients to get test results faster,

groups, with this though this partnership

at a lower cost and without the need to

has taken place. We are expanding pan

wait for hours. Swayam is a portable

India and Our Team is working towards the same.”

an Independent Board member. Gupta and Kaul along with the other board of

CDSCO gives nod to Insightec for neurosurgery platform, Exablate 4000

diagnostic and telemedicine point-of-care system that can be used to create a small

Lincoln Pharma plans facility expansion in Mehsana for cephalosporin products

lab anywhere. Mylab will use its expertise

Lincoln Pharmaceuticals plans to launch

doctor and an even better experience.

in

diagnostic

solutions

development,

biosensors, robotics, liquid handling to further expand the test menu and embed Artificial Intelligence which will facilitate faster reporting and consultation with the

CoSara Diagnostics bags CDSCO clearance for Chikungunya, dengue tests Co-Diagnostics, a molecular diagnostics company with a unique, patented platform for the development of molecular diagnostic tests, announced that CoSara Diagnostics (CoSara, or the JV), its joint venture for manufacturing and sales in India, has received clearance by the Central Drugs Standard Control Organization (CDSCO) in India to manufacture and sell its Saragene dengue and chikungunya RTPCR tests as in vitro diagnostics (IVD).

The Saragene test kits approved by the CDSCO use the company’s patented CoPrimer technology for the qualitative detection of these mosquito-borne viruses.

Team Elite Gynae with filmmaker and director Nandini Reddy

Elite Gynae launches pelvic treatment EMSELLA in Hyderabad Team Elite Gynae led by Dr Manjula Anagani has brought in the latest technology, EMSELLA- a breakthrough treatment for incontinence and confidence.

The unique technology revolutionises intimate health and wellness by providing those suffering from incontinence with a completely non-invasive option. The treatment was inaugurated by renowned filmmaker and director Nandini Reddy. The Emsella chair treatment stimulates and strengthens all the pelvic floor muscles restoring continence and the confidence to enjoy normal daily activities without fear of losing bladder control. Patients can sit comfortably on the Emsella chair for the treatment. Each session is equivalent to doing 11000 pelvic floor exercises but without the hard work.

association

Apollo with

Datri

Hospitals has

Samhita, Cipla to empower Indian pharmacists in building community healthcare Samhita Social Ventures and Cipla have collaborated to tap into the enormous potential of pharmacists as key drivers of community healthcare in the country.

The collaboration was established after

indicates that pharmacists are invested

National

in the health of their communities. 61

Ahmedabad Bench, (NCLT) has approved

per cent of pharmacists stated that they

the scheme of amalgamation of Lincoln

of

over

1,100

pharmacists

titled Future of Pharmacies, conducted

visiting scientist – The Banyan Academy

launched

an upgraded Centre for Bone Marrow Transplant (BMT) and Cellular Therapy in

Ayu Health, a health-tech startup with a network of hospitals providing highquality, affordable healthcare, has raised $6.3M in Series A financing from Vertex Ventures and Stellaris Venture Partners.

The round also saw participation from marquee angel investors including Varun Alagh of Mamaearth, Ashish Gupta of Helion and Rajat Goel of EyeQ Hospitals.

The fund infusion will help Ayu expand its hospital network and build new technology solutions to enable insurance processing, efficient procurement and clinical quality management at network hospitals. Ayu Health expects to grow its business 10x in FY22 and expand its bed capacity to 5000+ beds in six cities by December 2022.

for Leadership in Mental Health. The study

study

shaped by the insights of Nachiket Mor,

in

Startup Ayu Health raises $6.3M in Series A funding

NCLT approves amalgamation scheme between Lincoln Parenteral and Lincoln Pharma

a

by Samhita and Cipla across India, and

Indraprastha Apollo Hospitals ties up with Datri Indraprastha

been strategically conceptualised to manage the required long stay of such patients in the hospital. Similarly, the BMT follow up OPD has been set up close to the Centre for being able to prevent these immunocompromised patients from mixing with other patients and reducing their risk of catching secondary infections.

wanted to improve their medical skills and

its premises. A bone marrow transplant

knowledge to serve their customers better

is a clinical procedure that replaces an

and 76 per cent reported collaborating

unhealthy bone marrow with healthy

with

cells. The new state-of-art-centre has

outcomes in their localities.

healthcare

players

to

improve

Company

Law

Tribunal,

Parenteral and Lincoln Pharmaceuticals under Sections 230 to 232 and other applicable provisions of the Companies Act, 2013. Amalgamation is expected to bring a lot of synergies in terms of operations efficiency, enhance competitive strength,

www.indiamedtoday.com

13

News Roundup

cost-effectiveness and productivity for the combined entity. The order sanctioning the scheme was pronounced on September 14, 2021, and uploaded on the website of NCLT on September 15, 2021. The appointed date of the scheme is April 01, 2019. The scheme will be effective upon the filing of the certified copy of the order of the NCLT with the Registrar of Companies, Gujarat.

Lincoln Parenteral is a subsidiary company of Lincoln Pharmaceuticals engaged in the business of small parenteral injection products.

investment programme of SCHOTT through 2025, leveraging the global pharma tubing and packaging business.

Aster DM Healthcare launches 75-bedded ‘Women and Children Hospital’ in Kottakkal, Kerala Aster DM Healthcare has launched a 75-bedded dedicated ‘Women and Children

SCHOTT expands Indian tubing site in Jambusar, invests 70 million euros

Hospital’ in Kottakkal, Kerala. Consisting

SCHOTT is investing a total of 70 million euros in the expansion of its Indian tubing site in Jambusar, Gujarat, following several million investments in the last years.

“Against the backdrop of the growth trend in the Indian pharmaceutical business and the pandemic, we want to commit to secure the supply of pharma glass,” explains Dr Patrick Markschläger, Executive Vice President of SCHOTT’s Business Unit Tubing.

cutting edge multidisciplinary women and

The additional tank is scheduled to go into operation at the beginning of 2023, with the second one following a year later.

The expansion in Jambusar will create new jobs for around 225 employees and is part of a more than $1 billion strategic

of 28 Neonatal Intensive Care Unit (NICU) beds and six Pediatric Intensive Care Unit (PICU) beds, the hospital will offer childcare services that will be steered by highly skilled medical professionals who are dedicated to providing world-class care and the highest safety standards.

The new hospital will cater to the unique healthcare needs of children and women of all ages. The hospital specialises in obstetrics

care

high-risk

pregnancies,

including

normal

and

comprehensive

gynaecological care starting from birth, motherhood to menopause and beyond and complete neonatal and paediatric care including paediatric surgery. The hospital also provides 24*7 paediatric and maternal emergency services.

Menarini India unveils Definisse double-needle threads In response to the growing demand for minimally invasive aesthetic rejuvenation procedures, leading biopharmaceutical company Menarini, and its dermatology and aesthetic medicine arm RELIFE have introduced Definisse double-needle threads in India. Definisse double-needle threads is a revolutionary solution in the minimally invasive techniques as it requires reduced procedural and recovery time, no general anaesthesia with immediate and visible results leading to higher patient satisfaction. The aesthetic procedure using Definisse double-needle threads results in contouring, lifting, realignment of sagging tissue, and reinforcement of the middle and lower thirds of the face and neck.

Medica Cancer Hospital, Rangapani introduces Halcyon machine for advanced treatment Medica Cancer Hospital, Rangapani has introduced a high-end radiotherapy machine Halcyon with Image-guided radiation therapy (IGRT) & Intensitymodulated radiation therapy (IMRT), to its considerable bouquet of advanced services offered.

The Halcyon Radiation Therapy system’s targeted therapy ensures that damage to healthy tissues surrounding the tumour can be further avoided or minimised, which is of great benefit in cases such as cancer of the head and neck, prostate, lungs etc. The precisely delivered radiation with a tight focus prevents damage to healthy tissues and hence reduces the side effects of cancer treatment. The advanced system also ensures the completion of treatment in fewer steps as compared to the older radiation therapy system.

Through the use of intelligent automation, reduces the treatment time and makes the therapy more comfortable for the patient.

Medpho raises $1 M from Cygnus Medicare Group SCHOTT employees during the groundbreaking event at the site

14

October 2021

Medpho, a healthcare technology startup,

has raised $1 million in an angel funding round, led by Cygnus Medicare Group, Probal Ghoshal, Chairman, Amar Ujala, Dr Shuchin Bajaj, Founder & Director of Ujala Cygnus and Raghavendra Prasad, Founder, Project StepOne. With the received funding, the startup aims to focus on strengthening the company’s position in the market, expansion, innovation and provide complete healthcare services to rural and urban consumers.

DTDC with Narayana Health set up oxygen generator plant in Jaipur DTDC and its strategic partner, Geopost SA (DPD Group), owned by France’s Le Groupe La Poste, have associated with Narayana Hrudayalaya Charitable Trust and

Narayana

Hrudayalaya

for

the

successful set-up and inauguration of an oxygen generator plant in Jaipur. The

Biocon Biologics, Serum Institute Life Sciences in strategic alliance

one-of-its-kind oxygen generator plant

Biocon Biologics Limited (BBL), a subsidiary of Biocon and Serum Institute Life Sciences (SILS), a subsidiary of Serum Institute of India announced a strategic alliance. Under the terms of the agreement, BBL will offer approximately 15 per cent stake to SILS, at a post-money valuation of ~$4.9 billion, for which it will get committed access to 100 million doses of vaccines per annum for 15 years, primarily from SILS’s upcoming vaccine facility in Pune with commercialization rights of the SILS vaccine portfolio (including COVID-19 vaccines) for global markets. Under the terms of the agreement, BBL will generate a committed revenue stream and related margins, commencing H2, FY23. Adar Poonawalla will have a Board seat in BBL.

The valuable joint -initiative, installed in

was inaugurated by DTDC CMD Subhasish Chakraborty, in the presence of top officials from DTDC and Narayana Health. the Narayana multi-speciality hospital in Jaipur, is geared to help the country fight the ongoing covid pandemic. The plant can generate medical-grade oxygen at 500 litres a minute.

Abbott acquires Walk Vascular Abbott has acquired Walk Vascular, a commercial-stage medical device company with a minimally invasive mechanical

existing endovascular product portfolio.

Financial terms were not disclosed.

All India Institute of Aryuveda signs MoU with Western Sydney University, Australia All India Institute of Ayurveda under the Ministry of Ayush, signed an MoU in coordination with NICM Western Sydney University Australia, in virtual mode, to appoint an Academic Chair in Ayurveda.

The MoU was signed by Professor Tanuja Nesari, Director, All India Institute of Ayurveda, Ministry of Ayush and ViceChancellor and President, Western Sydney University, Australia, Professor Barney Glover in presence of Vaidya Rajesh Kotecha, Secretary Ayush and Dan Tehan MP, Minister for Trade, Tourism and Investment and Foreign Affairs of Australia. The new academic chair will undertake academic and collaborative research activities in Ayurveda, including herbal medicine and yoga, as well as design academic standards and short-term/ medium-term courses and educational guidelines.

aspiration thrombectomy system designed to remove peripheral blood clots. Walk Vascular’s

peripheral

thrombectomy

systems will be incorporated into Abbott’s

Carlyle to part-exit as Medanta hospital chain files for IPO Carlyle to part-exit as Medanta hospital chain files for IPO Global Health, which operates and manages hospitals across India under the Medanta brand, has filed draft papers for an initial public offering which will see private equity investor Carlyle Group make a part-exit. The IPO consists of a fresh issue of Rs 500 crore and an offer for sale (OFS) of up to 48.44 million shares by promoters and shareholders.The OFS comprises up to 43.34 million shares by Anant Investments and up to 5.1 million shares by Sunil Sachdev.

Swedish-Indian startup Näck launches Immunity Boost Swedish-Indian

startup

Näck

has

launched, Immunity Boost, an antioxidant (L-R) Adar Poonawalla, CEO, Serum Institute of India and Kiran Mazumdar-Shaw, Executive Chairperson, Biocon & Biocon Biologics

supplement Astaxanthin,

formulated the

with

most

Natural powerful

www.indiamedtoday.com

15

News Roundup

Glenmark receives marketing approval for Ryaltris in 13 countries Glenmark Pharmaceuticals has received marketing approval for its fixed-dose combination nasal spray Ryaltris in 13 countries across the EU and the UK. Glenmark is set to launch Ryaltris directly in the markets of the Czech Republic, Slovakia, Poland, and the UK. Ryaltris will be marketed in the rest of Europe by the Menarini Group as part of its exclusive licensing agreement with Glenmark.

Ryaltris (olopatadine 665 μg and mometasone furoate 25 μg), is indicated for symptomatic treatment of seasonal and perennial allergic rhinitis in adults and children over 12 years of age. Ryaltris relieves symptoms of allergic rhinitis, including stuffy nose, runny nose, nasal itching, sneezing, as well as itchy, red and watery eyes.

Natural Astaxanthin antioxidant known to science. This is the second product launch to date following the, formulated with rice and pea protein.

Immunity Boost keeps in line with the brand’s promise to be vegan whenever possible and is sourced entirely from plants. The Immunity Boost is formulated with Natural Astaxanthin that is sourced from microalgae cultivated in Sweden by AstaReal. Various clinical studies have found that when compared with Vitamin C and Vitamin E, Astaxanthin is 550X to 6000X more potent. Astaxanthin has been known to strengthen immune response, enhance antibody production, as well as improve the texture of the skin, boost muscle endurance and also help combat eye fatigue.

Indian hospitals and healthcare centres with four unique products, with varying oxygen output capacity (LPM – litres per minute), designed as per the Indian needs.

The company launched another innovative product that is set to empower hospitals to not only cater to the need of patients during a pandemic but also provide them with 93+-3 per cent pure oxygen.

HCG divests stake in Strand Lifesciences to Reliance Industries HealthCare

Global

Enterprises

(HCG),

announced the acquisition of oncology hospital labs and clinical trials business from Strand Life Sciences as well as

South Korea-based NF Healthcare launches oxygen generators in India

simultaneous divestment of its ~38.5 per

NF Healthcare, a leading manufacturer

in Strand and acquired labs and clinical

and provider of PSA Oxygen generators,

research business through a Business

launched MOSS 1800F product, with a

Transfer Agreement (BTA) from Strand for

capacity of producing up to 1000 + LPM

consideration of ~INR 81cr with a set-off

of medical grade oxygen (with a purity of

of ~Rs 7 crore towards receivables. The

93+-3 per cent), in India. NF Healthcare,

transactions resulted in a net cash inflow

with the support of its South Korea-based

of ~Rs 83 crore for HCG in addition to the

parent company, has been in the Indian

take-over of the labs and clinical research

market for the past two years, supplying

business.

16

October 2021

cent stake (on a paid-up capital basis and 34.5 per cent on a fully diluted basis) in Strand to Reliance Industries group company. HCG received consideration of ~Rs 157 crore for the sale of its ownership

Giuliano Perfetti

Giuliano Perfetti joins Jubilant Biosys as CEO Jubilant Biosys announced the appointment of Giuliano Perfetti as its Chief Executive Officer. Perfetti has more than 20 years of experience across diverse businesses and global markets with expertise in strategy, sales, marketing and business development. He has led business transformation and expansion programmes

working

in

reputed

names

including

Accenture and Astrazeneca among others.

Before joining Jubilant Biosys, Perfetti was associated with Fabbrica Italiana Sintetici (F.I.S) as Chief Commercial Officer and was responsible for strategizing and executing the company’s growth plan and ramping up the global scale-up and commercial service business.

Know-how of saline gargle RT-PCR technique transferred to MSME Ministry Nagpur-based

National

Environmental

MagMAX Dx Prefilled Viral/Pathogen Nucleic Acid Isolation Kits

Thermo Fisher Scientific to manufacture nucleic acid isolation kits in India

Biological E’s CORBEVAX receives DCGI approval for clinical trials

saline gargle RT-PCR technique, used for

Thermo Fisher Scientific will manufacture

testing COVID-19 samples. The saline

its Applied Biosystems MagMAX Dx Prefilled

gargle

simple,

Viral/Pathogen nucleic acid isolation kits in

fast, cost-effective, patient-friendly and

India for the Indian market. The kit is used

comfortable; it also provides instant test

to isolate and purify viral RNA and DNA

results and is well-suited for rural and

from human saliva, nasopharyngeal and

tribal areas, given minimal infrastructure

oropharyngeal swabs, providing a faster,

requirements. The know-how has been

more precise and easier-to-use solution

transferred to the Union Ministry of Micro,

for customers. The MagMax Dx Prefilled

Small & Medium Enterprises (MSME), on

Viral/Pathogen Nucleic Acid Isolation Kit

a non-exclusive basis. This would enable

will be manufactured in Thermo Fisher’s

the innovation to be commercialised and

state-of-the-art

licensed to all capable parties, including

in Bengaluru. The site is currently used

private, government and various rural

to produce CoviPath RT-PCR COVID-19

development schemes and departments.

testing kits for customers in India.

The Department of Biotechnology (DBT) and its PSU, Biotechnology Industry Research Assistance Council (BIRAC) have supported Biological E’s COVID-19 Vaccine candidate from Preclinical Stage to Phase III clinical studies. In addition to receiving financial assistance under Mission COVID Suraksha, this vaccine candidate has also obtained financial support under COVID-19 Research Consortia through National Biopharma Mission, BIRAC. Biological E has received Drugs Controller General of India (DCGI) approval for conducting Phase III Comparator Safety & Immunogenicity trial in adults after the Subject Expert Committee’s (SEC) review of Phase I and II clinical trials data. Additionally, Biological E also received approval on September 1, 2021, to initiate the Phase II/III Study to evaluate the Safety, Reactogenicity, Tolerability and Immunogenicity of the CORBEVAX vaccine in children and adolescents. The candidate is an RBD protein subunit vaccine.

Engineering Research Institute (NEERI) under

the

Council

of

Scientific

and

Industrial Research (CSIR) has transferred the know-how of indigenously developed

RT-PCR

technology

is

manufacturing

facility

CitiusTech appoints Atul Soneja as President – Operations CitiusTech announced the appointment of Atul Soneja as President – Operations.

Soneja

will

CitiusTech’s including

focus

on

delivery its

proficiency

strengthening organisation, teams

and

corporate functions, to drive operational Nagpur-based CSIR institute transfers saline gargle RT-PCR technology to MSME ministry

quality, scalability, and service delivery

www.indiamedtoday.com

17

News Roundup

Senior Consultant Cardiologist, Medanta Moolchand Heart Institute, Moolchand Medicity, Indian Chairman, World Wellness Foundation & WHA, Country Head, AHA, National President, Cardiological Society of India (CSI) & Indian Academy of Echocardiography (IAE) and chief editor of the top ten textbooks on cardiology.

excellence. Soneja has over 26 years of experience in building and scaling technology products and services organizations across the globe. Before joining CitiusTech, Soneja was the Global Head of EdgeVerve, a subsidiary of Infosys that focused on AI and automation products and platforms. Before EdgeVerve, he handled multi-billion-Dollar IT services businesses at Infosys, across multiple industry verticals like financial services, manufacturing and retail.

AACIO confers Special Award to Delhi-based doctor The American Association of Cardiologists of Indian Origin (AACIO) has honoured Dr HK Chopra for his outstanding contribution of publishing ten textbooks on various aspects of cardiology in over ten years.

Dr Chopra has made India proud by achieving this feat of eminence by his hard work, passion for serving humanity and scholastic aptitude. Dr Chopra is a

AstraZeneca with Tricog rolls out ‘Project Heart Beat’ in India together

with

health-tech startup, Tricog, rolled out a programme called ‘Project Heart Beat’, which is focussed on an early and accurate diagnosis of heart attack patients, thereby reducing the mortality rates. It is currently deployed in Tier-I, II towns and villages that lack access to quality healthcare.

The project addresses the unmet need for

early

diagnosis

for

patients

with

a

and

intervention

18

October 2021

patient

The initiative also aims to upskill the physicians and technicians at the primary and secondary care centres to better manage Heart Attack patients, by following

centres for better treatment outcomes.

Larsen & Toubro Infotech forms partnership with eClinicalHealth Larsen & Toubro Infotech, a global technology consulting and digital solutions company has entered into a strategic partnership with eClinicalHealth to accelerate digital innovation in the R&D Clinical Trials Management process for patient-centric drug development. The partnership will help clients decentralize clinical trials setting new benchmarks of excellence in the clinical research space.

The significance of the tie-up is based on the fact that 86 per cent of clinical studies are delayed due to challenges in patient engagement – mainly involving recruitment and retaining patients, which is a time consuming and expensive process. The pandemic has further aggravated this challenge. It is in this context that eClinicalHealth, which is focused on developing innovative clinical trial solutions, launched a cloud-based patient-centric SaaS solution, Clinpal – which improves patient engagement for each clinical trial journey.

API Holdings appoints independent directors API Holdings, the parent co of digital healthcare brand, PharmEasy has made fresh appointments of five independent directors to its board, in line with the highest standard of corporate governance.

heart

The fresh appointments bring a great

attack by enabling cloud-based artificial

amount of cognitive diversity to the board,

intelligence (AI) supported interpretation

with luminaries from the world of public

of

service,

electrocardiograms

suspected

(ECGs),

routing

patients to the nearest cath Labs or Dr HK Chopra

improving

and early referral to the tertiary care

With this acquisition, Healthium strengthens its portfolio of patented products through the addition of CareNow’s advanced wound dressing which has patents across the US, Europe and India. Further, the acquisition adds to Healthium’s manufacturing and R&D capabilities. CareNow’s manufacturing facility in Coimbatore is US FDA registered and will count as the 8th manufacturing facility for Healthium.

India

ultimately

outcomes.

Coronary Syndrome) treatment protocols

Healthium has acquired CareNow Medical, strengthening its product portfolio with patented and differentiated products in the advanced wound management and infection prevention segments.

Healthium’s product portfolio covers surgical consumables, urology and arthroscopy products. Its manufacturing facility at Bengaluru is registered with the US FDA.

AstraZeneca

and

the guideline-recommended ACS (Acute

Healthium acquires CareNow

Atul Soneja

accurate diagnosis and timely treatment

fibrinolysis

centres,

thereby

ensuring

technology,

pharma,

medical

fraternity, and the consumer sector.

Vineeta Rai, IAS (Retd) Officer was the Ex-

Revenue Secretary of India.

• Subramanian Somasundaram recently retired as the CFO of Titan Company.

• Ramakant

Sharma,

Founder

and

COO, Livspace and one of the most successful angel investors in India.

• Dr

Jaydeep

Tank,

a

leading

gynaecologist based in Mumbai is the Secretary-General, FOGSI. • Deepak of

Vaidya,

experience

with in

the

pharmaceuticals,

decades field

of

micro-Finance,

healthcare and private Equity.

MoU signing ceremony

IT veteran Vrajesh Shah joins Zing Health as CIO

CIL in MoU with Assam Health Dept

Zing Health, a physician-led, tech-enabled Medicare Advantage plan focussed on underserved communities, has named Vrajesh Shah as its new chief information officer. Shah will shape Zing Health’s technology and data architectures to strengthen the health plan’s commitment to information management and

Coal India Ltd (CIL), under the Ministry of Coal, has signed an MoU with the Department of Health & Family Welfare, Government of Assam for strengthening the health infrastructure at the Silchar Medical College & Hospital, Silchar, the only medical college and hospital in Barak Valley Region, Assam. In this new CSR initiative, CIL will contribute Rs 5 crores towards setting up an ICU facility and medical gas pipeline in the Silchar Medical College & Hospital which will benefit over 40 lakh people of the state.

Ayush minister launches Yoga protocol app ‘Y-Break’ Union

Minister

of

Ayush

Sarbanand

Sonowal launched the ‘Y-Break’ mobile application at Vigyan Bhawan. The five-

minute Yoga protocol, specially designed for working professionals to de-stress, refresh and re-focus at their workplace to increase their productivity, consists of Asanas, Pranayam and Dhyana.

The event was attended by Kiren Rijiju, Union Minister of Law and Justice, Dr Jitendra Singh, Minister of State (I/c) Science & Technology and Earth Science, Meenakshi Lekhi, Minister of State for External Affairs and Culture and Dr Munjpara Mahendrabhai Kalubhai, Minister of State for Ayush and Women & Child Development.

Union Minister Dr Jitendra Singh launches जनCARE Union Minister of State (Independent Charge) Science & Technology; Minister of State (Independent Charge) Earth Sciences; MoS PMO, Personnel, Public Grievances, Pensions, Atomic Energy and

Vrajesh Shah population health analytics.

A 25-year innovator in managed care health IT, Shah comes to Zing Health after a seven-year stint at AmeriHealth Caritas.

As a chief technology officer and data strategist, he created a holistic vision and path forward for digital transformation, building

next-generation

technology

platforms to support cost-saving, wholeperson models of care.

Launch of ‘Y-Break’ mobile application at Vigyan Bhawan

www.indiamedtoday.com

19

News Roundup

from existing investors, Stellaris Venture Partners, SBI Group Japan, SBI Ven Capital Singapore, Heritas Capital, Prime Venture Partners, Y’S Investment and Alteria Capital.

MFine aims to build one of the Largest Virtual Hospitals in the world and make high-quality healthcare more accessible and effective with the use of AI and mobile technologies. Towards that vision, MFine is enabling clinical decision support Union Minister Dr Jitendra Singh during the launch of जनCARE Space, Dr Jitendra Singh recently launched the AmritGrand Challenge Programme titled ‘जनCARE’ to identify 75 start-up innovations in telemedicine, digital health, mHealth with BIG Data, AI, blockchain and other technologies.

for doctors using AI and bringing vitals

delivery. Both AFPI and Eka Care will work closely towards the common goal of uplifting medical practice and enhancing health outcomes.”

Eka Care will be the preferred technology provider

for

AFPI

member

doctors

monitoring and health management to consumers’ smartphones.

Centre enhances financial support to open Ayush colleges in North Eastern states

AFPI in MoU with Eka Care

providing

telemedicine, and payment solutions for

The central government has increased

The Academy of Family Physicians India

its members. This collaboration will also

the financial support from Rs 9 crore

(AFPI) has signed a Memorandum of

help members with appointments, Google

to Rs 70 crore to ensure more Ayush

Understanding (MoU) with a connected

listings, and SEO. On Eka Care, doctors can

colleges are opened. This statement was

healthcare

to

become part of their local network and will

made by Union Minister for Ayush and

developing

also be able to connect their patients with

healthcare

Ports, Shipping & Waterways, Sarbananda

super specialists through this agreement.

work and

platform,

mutually implementing

Eka

towards digital

Care

services

engagement,

health

such

as

records,

patient EMR,

technology. Dr Raman Kumar, President,

Sonowal. The minister was addressing

MFine raises $48 m in Series C funding

a conference on ‘Diverse and Fulfilling

that by going digital not only would we

MFine announced a $48 million Series C

the North-Eastern states’ in Guwahati. The

be moving closer to our patients but also

funding round co-led by Moore Strategic

Union minister said that there are only a

be much more effective around clinical

Ventures and BEENEXT with participation

few Ayush colleges in the North-East and

AFPI said, “We have tied up with Eka Care to drive the next wave of much-needed tech transformation. We firmly believe

Career Paths in Ayush Systems: Education, Entrepreneurship & Employment Focus on

the Indian traditional medicine systems can

only

available

be

popularised

more

qualified

by

making

practitioners.

“For this purpose, more Ayush teaching colleges may be required to come up in the North East States. Earlier under Centrally Sponsored Scheme of National Ayush Mission provided financial support of Rs 9 crores to state governments to open new Ayush colleges. Now, the Government of India has enhanced this amount to Rs 70 crore. States may identify the land and manpower for this purpose and avail this opportunity as per the guidelines of the (L-R) Dr Raman Kumar from AFPI with Dr Neelesh Kapoor, Head Medical Affairs Eka Care

20

October 2021

NAM,” Sonowal said.

Opinion

What Can Finance Leaders Do to Help Clinicians During the COVID-19 Crisis?

Advice to healthcare CFOs on how they can help ease the burden on clinicians in the ongoing battle against COVID-19

is no doubt about the fact that if we stand up together against the battle with COVID-19, we certainly have a better chance to combat the effects of the COVID-19. Having the capability to share equipment and supplies would allow us to do so without being cluttered with supplies.

Shuchin Bajaj, Promoter and Director, Ujala Cygnus Hospital

As finance leaders, we have to ensure our clinicians that we are providing them with every kind of support in such unprecedented times. This not only boosts the morale of the clinicians but also helps them strengthen their relationship with the organisation. Being able to provide the proper equipment to prevent healthcare workers from getting sick is also part of our mission.

This is why we’re working on addressing the shortages of protective equipment.

When there is a surplus of supplies, distributing the protective equipment in the areas where there is a need is also a task. We need to pool these supplies and equipment with other healthcare CFOs in the other regions so that they can be shared across the country. There

Since India has a poor doctor-patient ratio, the need of the hour is to deploy more staff members, who have relevant experience in critical care including ventilation therapy. We can also think of recruiting retired nurses, clinicians, physicians to ease out the burden as they don’t need any special training to treat critically ill patients. Physicians, who so far have been taking care of the elective surgeries, could be used in triaging patients. Keep your emergency deployment plan handy.

Let’s talk about testing

about the whole pandemic management was that some of the highly-developed countries in the world with the highest healthcare spend per capita was way less sophisticated than countries like South Korea or even China in that regard.

Role of CFOs if their organisation are not yet immersed in crisis management As a CFO, you can also prepare a set of clear and actionable guidelines and checklists to guide your organisation through the various scenarios that may arise if the situation worsens. Set up telehealth facilities to reduce the patient load. Ask your non-essential workers in the hospital to work from home and avoid visiting hospitals in worse scenarios to minimise their exposures.

In general, try to reduce the patient

Have you ever wondered why the mortality rate was low in Germany as compared to India? It’s because they took part in an aggressive testing process, which helped them to identify the asymptomatic carriers. They had tested each and everyone and put the positive ones under strict quarantine for two weeks.

footfall and other traffic to the hospital.

Rigorous testing is beneficial for healthcare staff too as it allows the carriers to stay out of hospitals or in a special ward. Initially, everything looked haphazard. The most shocking thing

clinicians to understand their immediate

Postpone any projects that are not essential right now, such as renovations, construction, reorganisations and so on.

Once you’re experiencing an increase in the suspected covid patients in the organisations, this is the moment when you need to take care of the patients as well as the clinicians. Talk to the needs. Take prompt action against all the needs suggested by them and at the end of the day do check how many issues got mitigated.

www.indiamedtoday.com

21

Opinion

Business Transformation During COVID Despite numerous challenges posed by COVID-19 pandemic, the change of circumstances and new requirements has inspired innovation from companies like Genworks Health

GaneshPrasad sengamalam, Founder, MD and CEO, Genworks Health

For a distribution organisation like ours

customers and to continue to engage

with a large direct employee base, the

with them for supporting their needs.

lockdown due to covid was a huge issue

We ramped our digital ecosystem and

to solve; we had two tasks cut out as

ensured

how we will support our customers and

enabled without any glitches. Customer

keep the employee morale high during

engagement

this difficult period. The pandemic was

from

new to everyone and within two weeks

engagement

there was a major disruption that

marketing to build expectations on our

threatened lives and lockdown impacted

solutions and followed up through one

livelihoods. The senior management

to one product sessions. We built our

came together and within two weeks

E-store, the B2B commercial transaction

of the announcement of lockdown took

engine,

some very important steps to connect

transactions.

to the teams, give them the confidence that their livelihoods will not be affected and most importantly the teams were asked to stay home and stay safe.

22

October 2021

that

remote

dramatically

personal

to

working

meetings

that

was

changed to

remote

included

digital

support

contactless

By staying connected to our customers we quickly identified the new normal needs and created a new pandemic care solutions vertical that included enabling

A work from home policy was discussed

remote care for patients, supporting

and announced to stay in touch with

the customers remotely through online

The constant connection with customers and our workforce, building a digital commercial

transaction

capability

that replaced conventional in-person engagement, adding new portfolios for covid, expanding our digital portfolio, expanding into more care areas as chronic care, building a connected care portfolio for every care area, launching our e-store and acquiring a growth business

in

Invitro

diagnostic

and

engaging with customers with more e-learning

opportunities

helped

the

business rebound and grow faster than the past.

Healthcare as a service is undergoing a massive transformation and is moving to 'Point of Care' to where the patient is and to the neighbourhood. Connected Care, prevention, early health is the new normal and we are ready. Healthcare is through

moving to the point of care, to where the

our e-store. The most important thing

patient is and the movement of patients

that we did during this period was to

will only be for acute care. Chronic care

connect with teams and to keep their

has to move to where the patient is or

morale high, constantly communicating

to a neighbourhood healthcare facility.

the support and ensuring no major

Primary care should be omnipresent

platforms

and

transacting

disruption to their livelihoods. The senior

team

members

took

pay

deferrals to reduce the financial stress

Critical care has to be staged; at one

on the company and leveraged the

level remotely managed and supported

government schemes for deferral of

and as another well equipped with

EMI and PF withdrawal to manage the

technology. It will be very interesting to

six months of cash flow.

think about how quickly our customers

The workforce was kept protected and constantly motivated to stay safe and stay connected to customers remotely to keep them engaged. Over 10000 online demos and product support was provided The young service team members were supported to ensure they were safe when they had to attend breakdown calls. We acquired new business and added new streams of business during the first and second wave and played a significant role

adapted to a common goal called saving lives in the last 18 months. We are geared up to support this change with

new

pandemic

care

solutions

that include enabling remote care for patients,

supporting

remotely

through

the

customers

online

platforms

and transacting through our e-store.

Customers need participation to build efficiency and scale for this change to democratise healthcare, which has already begun and is here to stay.

to support our customers to support

The empathy during the difficult times

patients during the pandemic with

and agility to go above and beyond

products and solutions that emerged as

the

the need. Cost actions that would build

capabilities to democratise healthcare

efficiency but not affect any employee

by leading with commitment will I am

were taken that included giving up

sure overcome the revenue loss and

office space and reducing travel to the

has made us stronger to support this

barest minimum.

healthcare transformation.

transaction,

demonstrating

www.indiamedtoday.com

our

23

Feature Articles

Understanding The Correlation Between D-dimer and COVID-19

Jatin Mahajan, MD, J Mitra & Co

The D-dimer test helps to gauge and monitor the patient's progression to COVID-19 related cytokine storm and triggers timely medical intervention to reduce fatality. An insight by Jatin Mahajan, MD, J Mitra & Co D-Dimer, a test hitherto not known to many outside the medical fraternity, has suddenly gained prominence and become a household name during the corona pandemic.

After the difficult breathing and respiratory complications associated with COVID-19, doctors have discovered another severe risk posed by the SARSCoV-2 virus. Blood clotting is a newer and rarer symptom of corona infection that can lead to life-threatening strokes, heart attacks, and pulmonary embolism.

Blood clotting is an essential and natural process that prevents us from losing 24

October 2021

too much blood in an injury. Typically, our body's natural defences dissolve the clot once the wound has healed.

However, with a blood clotting disorder, clots can form when you don't have an apparent injury or don't dissolve when they should. This condition of blood clotting can be severe and even life threatening. In addition, it is potentially dangerous because the clot can restrict the flow of blood within the blood vessels, leading to complications like stroke or heart attack.

The D-dimer test looks for D-dimer in

As per research by the National Institute of Health, the US medical research agency, 31 per cent of critical ICU patients experienced complications related to blood clots.

the body starts to degrade that clot and

As per a Lancet study, the platelets of people hospitalised with COVID-19 were found to be hyperactive, having increased activation and aggregation (clumping). COVID-19 appears to cause increased activation of cells that are responsible for initiating the clotting process.

The D-dimer test in such cases helps gauge and monitor the patient's progression to COVID-19 related cytokine storm and triggers timely medical intervention to reduce fatality.

blood. D-dimer is a protein fragment (small piece) formed when a blood clot dissolves in your body. D-Dimer is one of the many fibrin degradation products. When a body part is damaged or

bleeding,

our

internal

defence

system stops the bleeding by joining the cells together to make a network.

This network is formed from a protein - fibrin and causes a blood clot. That blood clot is due to the crisscrossing of fibrin. When the healing is complete, break down the fibrin. When the fibrin breaks down, it forms fibrin degradation products or FDPs. And one of the FDP is D-Dimer.

D-dimer tests are conducted if a patient is showcasing symptoms of blood clots, such as: • Pain, Swelling, warmth, and changes in skin colour • Sharp chest pain, breathing issues, blood in cough, and a faster heartbeat • Nausea and vomiting, Bleeding gums, muscle pain, seizures, severe stomach pain, and decreased urine At J Mitra, we have the D-Dimer

D-dimer tests are conducted to monitor for blood clotting issues, which may lead to health problems, such as:

Microlisa test kit for in-vitro quantitative

• Stroke • Pulmonary embolism (PE) • Deep vein thrombosis (DVT) • Disseminated intravascular coagulation (DIC)

principle, the test has an accuracy of

determination of D-Dimer in human plasma. Based on the Sandwich ELISA more than 99.5 per cent. The D-Dimer test adds to our long list of covid-related test products and is our endeavour to fight against the pandemic.

Approach

How Technology Can Help Bring Down the Cost of Healthcare in the Next Five Years Insight on how convergence of multiple technologies will exponentially amplify the impact bringing down the costs and improving access to healthcare

Rajneesh Bhandari, Founder, NeuroEquilibrium

"An ounce of prevention is worth a

help in finding out the medical "Root

pound of cure" - A large proportion

Cause Analysis." Thus these devices,

of chronic diseases are preventable,

enabled

by

AI-driven

providing an opportunity to exploit

insights,

can

help

prevention as a strategy and reduce

their health and make more informed

disease burden.

decisions, directly reducing long-term

Wearable smart devices can monitor health

parameters

like

ECG,

actionable

people

manage

healthcare costs.

pulse,

Wearable technology can make healthy

oxygen saturation, sleep parameters,

living a cult and help reduce chronic and

gait parameters, etc. The list is endless.

lifestyle diseases. Startups like Curefit,

Smart wearable devices can monitor

which focuses on better eating and

one's health in the real world, at work,

fitness, are targeting 90 million health-

at home, or during sleep. These devices

conscious individuals in India.

www.indiamedtoday.com

25

Approach

In

India,

hospital

infrastructure

is

inadequate, with only 1.5 nurses and 0.7 beds per 1000 population. "Home healthcare," enabled by technology, will save 40 per cent of costs compared to hospitals. More importantly, patients have a faster recovery cycle with the love and care of family and a comfortable

environment.

It

also

reduces unnecessary hospital visits by 65 per cent. Technology-driven 'Home healthcare'

could

reach

90

million

households by 2025.

For first

any

healthcare

interaction

with

provider, patients

the to

understand their symptoms is a massive undertaking. It requires patients to visit the hospital physically and clearly articulate their condition and doctors to diagnose symptoms and provide treatment. The overuse of specialists for Digital

therapeutics

(DTx)

provide

scientifically proven software-driven therapeutic interventions to help people change their habits, prevent or manage the disease and thus reduce their risk of chronic disease. For example, more than 30 per cent of people in the US do not take their medications as recommended, resulting in 125,000 deaths annually.

Digital therapeutics, using AI tech, can help improve patient adherence to taking medicines.

Handheld

consults in the next five years, mainly

initial diagnosis makes healthcare very

under a subscription model.

expensive. Artificial Intelligence (AI)

The top 10 causes of death in India

and chatbots can help make the initial

require

diagnosis to direct the patient to the

treatment

by

a

super-

specialist doctor. However, there is

correct specialist.

an acute shortage of super-specialist

AI-driven teleradiology can reduce the

doctors. For example, we have just 800 endocrinologists for 72 million diabetic patients, while as per the US or

European

standards,

we

should

have 30000 endocrinologists. Similarly, for 1.3 billion people, we should have

smartphone-connected

40000 neurologists but have just 4000

dramatically

neurologists. Technology will have to be

decrease diagnostic costs and increase

a force multiplier to solve problems of

accessibility.

accessibility and affordability. Remote

screening

devices One

will such

example

is

Butterfly iQ, the world's first handheld, smartphone-connected,

single-probe

whole-body ultrasound system, which came

into

the

limelight

recently

when the device was used to perform ultrasound in space aboard a SpaceX spacecraft.

diagnostic platforms, enabled by AI, can dramatically reduce the marginal cost of providing super-speciality services.

NeuroEquilibrium is one such super-

marginal cost of interpreting an MRI or a CT scan to near zero. For example, technology developed by Zebra Medical Vision can read millions of scans in a day at less than $1000 a day. Possibly in five years, a medical image will be reviewed by a radiologist only after it has been pre-analysed by a machine.

Similarly, today artificial intelligence can interpret pathology slides better than

pathologists.

Computer

vision

products like PathAI claim a lower error rate than pathologists.

speciality remote diagnosis platform

Medicine will advance more in the

for

disorders.

next ten years than it did in the last

NeuroEquilibrium provides service in

100 years. The convergence of these

vertigo

and

balance

over 125 hospitals across India. Super-

multiple technologies will exponentially

Teleconsults are the new normal and

specialist doctors, sitting in a central

amplify the impact bringing down the

will disrupt hospital OPDs in the future.

location, assisted by computer vision

costs and improving access. This new

As

report,

and machine learning, help in diagnosis,

era of care will be revolutionary as we

telemedicine will replace at least 30

treatment planning, and rehabilitation

move from sick-care to healthcare, from

per cent of OPD in India, saving over $5

of these patients, thus reducing cost and

reactive to preventive, from episodic to

billion. According to the projections, 50

increasing access to super-speciality

predictive, and from one-size-fits-all to

million households will be doing virtual

healthcare.

personalised.

26

per

a

recent

October 2021

McKinsey

Cover Story

Healthcare Finance and Business Strategy Amid Changing COVID-19 Climate The future is about the ability to be flexible in resource planning

www.indiamedtoday.com

27

Cover Story

Capital Finance Money is always available in plenty, it comes with cost, commercials and structure which needs to be understood very well

Kannan Ramesh, Partner, Somerset Indus Healthcare Fund

In a burgeoning healthcare market, where technology is key there are many choices for a provider of capital finance.

It is important to understand that every option comes with its challenge and it is very important to pick and choose the right option. In my limited learning over nearly 30 years the key is to understand what you can do and then decide what is the best option to have. A lot of people spend a significant amount of time worrying about the cost of funds rather than the outcome based on the utilisation of funds. Also, we have to be very clear whether we are going to put money into expenses or we are going to put money into a business that will determine the risk and the resultant reward.

Banks – Provide term loan, external commercial borrowing, letters of credit, personal loan, mortgage loan, equipment loan etc., These depend on the cost of the project, the means of finance, cash flows, collateral security, personal guarantee etc., we have to pick and choose the option most suited to us in terms of the repayment period, moratorium, structure and repayment and the cost.

NBFC’s – Are a little expensive but more flexible and digitally empowered to meet the requirements be it term loans, equipment loans, lease, demand Loan etc., it is advisable to use this loan more for business with increased turns to pay for the cost and also benefit to accrue.

Development finance institutions – Play an important role in enabling benefits to the community at large. The size may be a little large but the terms are more palatable and the purpose is not only economics but also empathy to the patients. The flexibility offered and the varieties are worth exploring. A lot of

28

October 2021

international players are in vogue Private equity – Largely driven

by Returns and Exit. These two determine the purpose of investment.

A company with adequate turnover and profits willing to grow to size and scale including acquisition could be a potential target. A sense of maturity in the promoter is required to handle private equity and in today’s context, ESG (Environment Social Governance) is increasingly becoming very important.

Venture capital – Is focused more on technology and the quantum can be smaller compared to private equity and their ability is that much higher and the idea takes precedence over revenue and profit. This is a good option for health tech companies.

Family officers - Play an important role in helping in seed-stage investment with some traction on the business and a need for money to help in Technology / People etc.

Ultra net worth individuals – Play an important role in supporting seed-stage companies to find their moorings before they approach a family office.

Accelerators – A play a very important role in identifying potential opportunities and supporting deserving companies with mentoring, networking etc.

RBF (Receivable based financing) – This is a new development today where companies are funded based on the consistency and regularity of revenue.

The costs are high but the process is very quick and can act as a boost before the company approaches funding.

Invoice discounting – This is a facility offered based on the comfort of the debtor to discount the Invoice/Bill

leading to receivable financing to help meet the obligation. Technology plays an important role in enabling improved cash flow, reduced cost of funds, no collateral, avoiding debts on the books.

Venture debt – This is a more established form of fundraising and has been very successful in India where leveraging debt, without diluting equity one can build scale and then approach the private equity/others.

Public issue – A recent phenomenon has been a rush towards going public to raise the sources, provide exits for investors and retire debts. Healthcare is seeing a big boon where many companies are taking this route.

SPAC (Special Purpose Acquisition Company) – is again a new development now (though existing for some time).

This is leverage to acquire companies in a given geography.

Lease – In particular operational lease in addition to capital lease is becoming an increasing trend where providers are allowed to earn and then pay. By structuring the expectation of the borrower and the comfort of the lender is established and turns out to be a winner for both. This is an interesting option which the companies should explore.

SAAS – This is a new trend catching on with healthcare companies where solutions and services are provided on a model which enables pay per use basis.

This is very advantageous to companies who can define the usage based on the availability While the options to raise money is enormous and customisable the key is to pick and choose the best possible option at a given point of time to ensure comfort and convenience without adding too much stress In today’s world collateral security has been largely replaced with cash flow’s pledge of shares, personal guarantee, security cover etc., thereby freeing the entrepreneur from a load of collateral security, significant margins etc.

Money is always available in plenty, it comes with cost, commercials and structure which needs to be understood very well. Technology is playing a very important role in ensuring the speed of completing the transaction with minimal hassle.

Manufacturers and suppliers of equipment too are contributing by offering payment terms that enable the provider to earn and pay. Particularly in IVD market equipment’s are placed in the provider’s premises and reagents are supplied and returns are made without investment by the provider.

To sum it up, every provider needs to assess and understand the opportunity to grow, expand, diversify and accordingly raise the most suitable form of funding.

www.indiamedtoday.com

29

Cover Story

Debt, A Powerful Tool to Manage Working Capital Outlay Best practices advice from organisations that have a strong track record of success in managing their venture capital programme term debt structure can be used for

customers. Debt has also been used by

instance to extend the runway and

such medical equipment providers and

reach a certain operational benchmark

hospitals for the purchase of high-value

viz. revenues, several customers etc.

equipment and machines.

and then raise an equity round at the desired valuation. A

revolver debt

structure can be used effectively to finance working capital viz. inventory,

Abhinav Suri Partner Strides ventures

receivables. The revolvers continue as

While looking for growth capital, a lot of successful new-age businesses are increasingly taking a round of venture debt along with equity or in between equity rounds. The size of debt varies depending

on

the

business

the company without any onerous need for collateral or personal guarantees, and also carries a warrant component

can be continuously financed through

in addition to the interest cost. It is

debt. This also creates a successful

important for founders to time the debt

credit track record and can help in

round appropriately, after the business

future debt raise from cheaper sources

model has been proven, operations

like commercial banks as the business

have scaled with a positive contribution

matures and achieves profitability.

margin and there is adequate equity

Future cash flows protected by contracts

and maturity of the businesses and

with a high degree of certainty, can be

is typically 5-20 per cent of the total

a good debt use case and appropriate

capital raised for new-age businesses

debt structures can be built around the

that are yet to achieve profitability.

same.

Venture debt can be effectively used

Debt has been a powerful tool for

with the following objectives in mind:

many B2B companies in managing their

• Extending runway between rounds

secured by all the business assets of

long as there is working capital and

model

• Protecting equity dilution

The venture debt raised is typically

capital. Raising debt too early or in excess can put undue stress on the balance sheet and can be counterproductive. As a thumb rule, cash flows with a high degree of predictability are best financed through debt.

The

Indian

startup

ecosystem

has

working capital outlay. For example,

come of age over the last few years

startups working with hospitals have

across several sectors including health

realised

care

which

has

seen

pay over some time for their use of

acceleration

due

to

consumables, surgical, diagnostics etc

Venture debt as an asset class has also

and such working capital is effectively

gained significant ground in light of this

plugged through debt. Similarly, medical

and will continue to grow as businesses

The repayment structure of the debt

device distributors have realised the

scale. Founders should use this source

should ideally correspond to the end-

potential for debt to build inventory

of growth capital judiciously and save

user objective in mind. An amortising

and provide end financing to their

dilution.

• Financing working capital mismatch • Financing capital expenditure and acquisitions • Create a credit track record

30

October 2021

that

hospitals

prefer

to

considerable

the

pandemic.

Identifying Next Gen Leaders It is extremely critical that one continues to be fully abreast of the latest that is happening in the world and make efforts to learn and stay ahead of the curve

An

interesting

topic

that

has

the

potential to not only determine the future of a company but also the future of our country. As Kouzes and Posner mention in the very famous The truth about leadership, leadership is an affair of the heart. I very firmly believe in this adage and think that to be an effective Shripad Joshi, President, Perkin Elmer India and South Asia

leader, one needs to put others before self and this perhaps is the most important trait one should look for while we go about identifying the next generation leaders. At the end of the day, leaders should know that it is the people who make the difference.

of brilliance.

Such people must be encouraged to express themselves without fear of failure. Such employees will go on to play a pivotal role in the growth of the company in future.

Passion and Commitment While having a sane head is very important,

it

is

equally

critical

to

identify people who display unhindered passion

and

commitment

towards

what they are doing. The ability to believe

that

achieving

something

that has not happened in the past is

A lot has been written about leadership

possible and marching towards it with

by very eminent writers over the years.

undivided attention is a very important

What has personally worked for me

characteristic. Such people go on to

in these years to identify and groom

achieve incredible results through their

the next generation leaders include identifying the spark, their passion

passion and commitment to a cause.

and commitment, vision and strategy,

Vision and Strategy

empathy and culture, knowing your

It is important to dream big and

customers, seamless execution and the

believe in what you are setting out to

ability to constantly learn and upgrade yourself.

along collectively with your vision and

Identifying the spark This

is

achieve. And the ability to take people

the

fundamental

strategy sets out successful leaders step

in

generation

apart from others. People

of

who display these traits, can positively

leaders. It is not so much about the

influence all the key stakeholders and

number of years one spends at work but

display informal leadership and have

more importantly what one has learnt

the respect of peer groups need to be

in those years that is more important.

watched closely by the organisations

Quite often we do see some very young

and such people should be encouraged

and new employees who display sparks

with higher responsibilities.

identifying

the

next

www.indiamedtoday.com

31

Cover Story

Empathy and Culture Empathy and culture could very well be on top of my list. This has assumed even greater proportions in recent times with the impact of the pandemic that has been felt across the globe.

Unless one understands others well and is empathetic towards others, it is impossible to be recognized as a

customers

in

the

next

generation

leaders.

Execution While all the traits mentioned above are important towards identifying the next-gen leaders, one also needs to see their ability to execute the plans. A plan,

and values as a leader get tested during

vision and strategy can be rendered

trying times. It is in these times that one

useless if not executed properly.

needs to be on top of his/her game. So

Constant learning

next-generation leaders are and the

With the pace at which the world is

kind of culture one is creating in the

changing, one cannot sit on the past

organization. A culture of transparency,

laurels or assume “ I know it all”. It is

openness, effective communication and

extremely critical that one continues

walking the talk is important.

to be fully abreast of the latest that is

Knowing your customers

happening in the world and make efforts

Customers could be external or internal.

Conventionally norms are challenged

Unless one understands the needs of

constantly and as a leader, if you do

the customers very well, it is impossible to succeed. It is not so much about meeting metrics, SLAs and deadlines

October 2021

Yes, one must see that passion towards

credible leader. I believe your character

one must know how empathetic your

32

is going to come back to you for more.

to learn and stay ahead of the curve.

not understand this, it is not possible to build your organisation for the future.

but it is more about what positive

Simon Sinek’s Leaders eat last resonates

impact your work is leaving with your

very well with what I think should be

customers. And whether your customer

looked for in next-generation leaders.

Operations Management The healthcare ecosystem is dynamic and driven by external and internal forces

The healthcare ecosystem is varied and complex, reliant on environmental, socio-economical, technology and human factors. At the heart of healthcare lies the human element, which defines the patient and doctor relationship.

R Venkataramanan, Founder and CEO, Karkinos Healthcare

Healthcare hosts a diverse pool of stakeholders ranging from doctors, clinicians, nurses, management, administrative personnel, emergency and paramedical support, interns and others who come together to provide the needed care for patients. The healthcare ecosystem is dynamic and driven by external and internal forces such as technology advancements, ageing, changing disease patterns, improved patient care and access, shifting patient demands and the need for data-enabled decision making, among others.

With the current pandemic situation, there has been a lot of focus on the right health care support and 24x7 availability of clinical services. The rising cases and demand of health facilities have seen healthcare leaders use a blend of management, clinical, social, behavioural and business competencies to address demand and rise to meet the situation. There is no one size fit for all models for healthcare management. However, a combination of existing models that fit the culture and work practices will foster efficient management. The goal is to get everyone moving forward together to a similar beat and to keep that pace over time.

The operations management needs to be supported by a trust-based governance model integrating patient empathy with

managerial governance. The power distance between management and clinical staff often becomes a road map to rigidity and resistance as clinical staff perceive that any successful change must have a purpose and consider on-ground challenges. Since the clinicians, nurses and support staff share an emotional connection with their patients, they feel more connected with the operational changes when they perceive they are involved and can influence change.

Lack of shared purpose and understanding of value will bring resistance to change. A change with a strong, relatable purpose helps care staff understand and adopt new ways of working. Based on the culture of the health care organisation, the purpose can be defined together by management and critical care staff or communicated by leadership in multiple formats and forums.

The key building blocks for operation management are • Leadership engagement Engagement of department leaders/ stakeholders helps to achieve alignment.

The building block will be one of the cornerstones for success, as leadership commitment and engagement will help establish a strong business case and implement a structured change approach.

• Culture Understanding the culture of healthcare institutions will be essential to crafting tailored actions. The correct assessment

www.indiamedtoday.com

33

Cover Story

of the cultural attributes will help set the right change tempo while personalising and incentivising change for the staff.

•

Communication

A robust and relatable purpose translated into a clear communication plan will create a value story for the dashboard strengthening interest and staff commitment for the change initiative.

•

Staff training and handholding

Training will be another cornerstone for success to show the functional, behavioural, and social aspects to bring more patient-centric care.

•

34

October 2021

Benefit management

resource

department

and

have

a

rigorous hiring process to facilitate quality hiring. The senior leadership should spend significant time ensuring that any new person hired has the right cultural fit in the organisation and has a solid commitment to the cause they are working towards.

Lastly, it is important to keep the flow of information as fast and accurate as

possible

to

stakeholders.

A

structure thereby

and

all

flow

creating

the

clear

concerned governance

of

information,

transparency

and

visibility across the organisation is essential. The operations management team

should

continue

the

initial

momentum and highlight leadership

A change plan with clearly defined outcomes will assist in measuring and monitoring progress while showcasing the return of investment.

commitment

One of the most significant aspects of delivering a project is hiring the right people and getting a lean team in place with all the required capabilities. It is essential to set up a strong human

and quantitative measures can track

compelling

to story

the

vision

and

with

a

value-centric

communications, that is promulgated across

the

departments.

Qualitative

these operational outcomes to help periodically

improve

the

patient

experience and bring strong cohesion among the stakeholders.

TM

Safety Needle with Sharps Injury Prevention SIP SHIELD

Safety from Accidental Needle Injuries

taking care of those who take care of us Hindustan Syringes & Medical Devices Ltd.

Website: www.hmdhealthcare.com, E-mail: info@hmdhealthcare.com

Data Analytics

Do Indian CFOs Use Financial Decision Support Tools How owners, boards and managements at healthcare service providers like hospitals and diagnostic chains can leverage data analytics to improve cash flow and profitability to technology-driven analytics is highly democratised and more readily available and deployable than you think • Analytics is not expensive. You can expect a Return of Investment (RoI) range between 3X and 12X within 12 months i.e. Analytics projects pay for themselves, usually within the first 12 months Bhavik Desai, Engagement Partner and Healthcare Sector Champion

Analytics is not an ‘Accounting’ or ‘Finance’ project.

• It is a business performance improvement initiative, that might be driven by the CFO, but needs to be co-owned by all functions, including clinical, marketing, support teams etc Analytics is not outcomes alone.

S Venkat, Founder, Practus Analytics projects deliver between 3X and 12X Return on Investment and improve net margins between 2 per cent-8 per cent. Analytics are the ‘GPS’ that Healthcare CXOs use to measure and monitor performance, navigate their business, take corrective actions and most importantly improve predictability about the future of their enterprises.

Let's first bust some myths!

• Analytics is not just for larger, more ‘sophisticated’ companies. Access

36

October 2021

about

financial

• Cashflow, profitability etc are only outcomes. It is critical to measure the drivers of the business (called ‘lead indicators’) like footfall, customer return rates, Average Length of Stay etc

Do you need analytics?

Regardless of what the age, maturity, size, spread and nature of your business is, you need to know •

•

•

•

whether you are generating cash flow or not, whether the Return on Capital employed is adequate or not, where and how your profits are being generated, where the revenue leakages are etc.

In other words, in today’s dynamic

business world, the pilot (you) need the dashboards in your cockpit (analytics) for the plane (your enterprise) to navigate the skies (business environment) successfully.

When is analytics useful?

The point of analytics is that it is real time.

If underlying data entry is timely and accurate, real-time analytics can help you pick up deviations from plans faster, red flags quicker and therefore quicker pivoting of corrective actions.

The days of seeing MIS at the end of the month are long gone; you (and more importantly your teams) need to know what’s happening in your business now.

How does analytics help you?

The objective of analytics is not ‘data for the sake of data’ but to aggressively drive cost reductions and cash flow improvements in the business. If done well, you should expect your analytics project to drive between 2 per cent-8 per cent improvement in net margins and between 10-40 days improvement in cash flow, from the reduction in working capital (Days Sales + Days Inventory) In a healthcare services context, here are some examples of what you can do with analytics • Comparison between metrics of two locations (say two different centres of a diagnostic chain), helps in benchmarking of best practices. The root cause of why

one unit does better than other helps improve performance of the ‘laggard’ location • RoCE calculations help understand if capex is being ‘sweated’ enough and if the return is higher than the interest cost to the Bank • Input-Output consumption norms helps track wastage or theft of high value consumables • Departmental profitability identifies ‘laggard’ specialities and triggers rectification actions in the form of pricing improvements and/ or cost control • Real-time visibility into consumable inventory levels across specialities and locations, avoid over-ordering in purchases, reducing the blockage in working capital • CRM analytics helps monitor and improve customer retention rates and revenue optimisation through timely reminders for follow up visits/ checks etc • Doctor payment analytics lead to timely settlement of doctor dues improves Doctor satisfaction rates

What to measure?

The first step in the analytics journey is to determine the dimensions on which data will be analysed. Here are some examples of what a hospital can measure By speciality: cardiology, gastrology, oncology, paediatrics, maternity, orthopaedic, urology, etc By revenue-generating support services: Scanning, X-ray, pathology, pharmacy, etc By revenue type: Consulting fees, use of facilities, consumables, medicines etc By location: in the case of multi-location hospitals For each of the above, analytics will give you these financial metrics: •

• •

Revenue, direct expense, allocation, profit Working capital (AR and inventory) Capital employed (including capex)

and return on capital employed

Analytics will also give you these Operating metrics: • • • • •

•

Bed occupancy Rates Average revenue per bed per day Average length of stay Inpatient to outpatient ratio Number of doctors and para- medical staff Classification by risk level, by Male : Female, Insured vs Direct

On a time dimension, analytics will give • •

• •

Current Month vs Previous Month Current Month of this year vs current month of Last Year Year To date Actual vs Budgets

Over a while, these data ‘cuts’ become more detailed (‘granular’), insights become richer and the business ‘call to action’ very specific.

What tools can you use?

Healthcare service enterprises have a wide variety of tools, suiting every budget and stage of maturity of accounting and reporting practices.

Advanced Excel, Power BI, Qlikview, Qliksense, Tableau, Hyperion etc. Most tools are on the SaaS model, i.e. they are available on a ‘per user, per month’, ‘pay as you go’ model.

If done well, most Business Intelligence (BI) tools can pick up data from more than one source. For instance, you might have some data in a hospital management system, some in a CRM, some in excel. Any industry standard tool can help you pull data from all of these sources and can provide you with a ‘single window of truth’ into your business.

In the first phase, most enterprises get to anywhere between 30 per cent and 70 per cent of the ‘end-state’ that they need to be at. Getting to 90 per cent of the end-state can be a 12-18 months process.

Have patience and stay the course.

What are the pre-requisites?

Commitment.

Commitment.

Commitment. From our experience, Analytics projects fail not because of availability of technology or budgets, its because companies ‘lose steam’.

Commitment needs to be demonstrated first by the leadership to treat analytics as a key business project and to see the implementation through.

Most importantly, post implementation, leadership needs to use the analytics tools themselves to ‘set the tone at the top’ and lead by example to encourage a faster adoption. There is resistance to change in every company; have a zero tolerance to these to avoid the analytics project getting derailed.

In summary You don’t need to be a finance or IT expert to use analytics. There is enough choice of tools, affordability, ease of implementation and a strong business case for the adoption of analytics.

There are enough past use cases of healthcare service providers who have leveraged the power of analytics to improve their financial performance.

How much time does it take?

Depending on the scale and complexity, a typical analytics project takes about one to four months to go live and between three to six months to fully stabilise with all metrics, on all dimensions

How to start?

The key is to start! Analytics projects are not a one-off ‘event’. It’s a process.

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37

Impact

Strategic Planning in Healthcare Strategy is a commodity but planning and execution is an art

Rajgopal, Co-founder & CEO, KITES Senior Care

I like the slogan Strategy is a commodity but planning and execution is an art

most organisations spend time defining

The vision of an organisation defines the goal and purpose for which they exist; strategy defines how we go about achieving this goal both in the near term and longer-term. Formulating a sound strategy and setting long term goals is very important to any organisation and you will have experts to help you with this. However, if these goals are to be achieved, executing various steps as planned is very critical.

is devoted to what actions will need

Spend adequate time in planning

patient/client in mind. If you are a new

Healthcare is a complex environment with many moving pieces. To start with, every organisation needs to be aware of their SWOT (Strengths, Weaknesses, Opportunities and Threats). While 38

October 2021

their strategy, not much importance to be taken to achieve these goals.

Breaking down the various processes needed to achieve the goals and the influence of people and technology of these processes need to be evaluated in detail. Allocation of resources is a key part of this process. It is important to reference all stakeholders in this process most importantly keeping the organisation, it may be worthwhile to

appoint

a

consultant

to

guide

you through this process. Else your internal key members, with their rich experience, will be able to support the planning process

Balancing the need of healthcare professionals and patients Patients and Healthcare professionals (doctors, nurses, paramedics etc) are key stakeholders in the healthcare delivery system. Healthcare delivery is still an intense industry. The strategic planning process has to accommodate

the

organisation

by

implementing

the strategic plan, we will encounter situations wherein we may have to rethink the agreed processes. Medical Technology is changing at a fast pace and is an important aspect that will influence the resource allocation and execution process. The pandemic has also taught us how we need to be ready

the needs of these stakeholders and

to relook at our strategies in a short

that is where the business leader needs

time which will eventually lead us to

to take a balanced view in terms of

replan. So, any plan needs to have the

resource

ability to be flexible to accommodate

allocation

and

technology

implementation.

such external changes. There needs to

Strategic planning and quality function

be openness to accept these changes.

Quality function within an organisation

Strategic planning is beneficial

plays a pivotal role in ensuring that the

A well construed and executed strategic

organisation stays on course with their plan, to that extent, every strategic plan once approved by the board shall be ingrained into the quality processes wherever

applicable.

Through

this,

plan has many benefits. Firstly, there is clarity amongst all stakeholders of the plans and decisions. It increases the operational efficiency wherein there

constant training of personnel can be

is clarity of action and allocation of

undertaken which will improve the

resources and budgets is easier. This

outcomes which can be monitored

helps to achieve the business finance

through the review mechanisms.

goals as well wherein the organisation

Of course, any strategic plan needs to have flexibility As we move towards the goals of

sees the benefits in the form of increased doctor

and

patient

satisfaction,

reduced cost and eventually increased profitability.

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39

Innovate

Future of Healthcare is Vertical Innovations in healthcare that allow us to improve access, affordability and effectiveness

Venugopal Ganapathy, Co-founder and CEO, Axilor

The most common metaphor to assess

In the last few years, with consumer

one's optimism is whether a glass is

adoption of digital technologies, the

seen as half-full. Unfortunately, that

incumbents have either met tough

metaphor does not work if one were

competition from 'neo-banks' or struck

to apply it to healthcare in general.

partnerships

The more accurate one will be a near-

to leverage. This has made consumer

empty glass, leaving very little room

access,

for optimism. The data points are

easier, be it in banking, credit or

depressing across the board. In every

investments. Slowly with time, the

discipline, the availability of doctors

acquisition models are ceding ground to

or specialists is at least one-tenth of

full-stack models, a logical consequence

what we need and even that is poorly

of success and scale.

distributed. When it comes to access, the difference

is

stark with more

than 40 per cent of the doctors in the

and

platforms

on-boarding

Increasingly, within our portfolio and outside, we are witnessing interesting possibilities of improving access and

disease burden of non-communicable

affordability for key care verticals with

diseases is galloping and treatment

these hybrid models (with the right mix

effectiveness is lagging. In cancer, two

of digital and physical). These models

out of three diagnosed with cancer do

are vertical-specific, leverage digital

not live. In cardiovascular diseases, the

reach while complementing existing

mortality is almost one in four within

healthcare infrastructure to achieve

the first year of diagnosis. Efficient and

better capacity utilisation. Working with

cost-effective elective surgeries are

these innovative companies, I could

available in less than 20 per cent of

identify a few innovation vectors that

the hospitals, mostly confined to urban

could significantly impact health care

areas, aggravating the economic burden

outcomes.

of innovations in healthcare will allow us to improve access, affordability and effectiveness?

October 2021

acquisition

digital

country being in just four states. The

to the larger population. So what kind

40

with

The first vector is simply utilising existing infrastructure better. A good example is what we are seeing in the elective surgeries space. Companies

One good place to start is to look at what

like Medfin, have made it easier and

is happening in other traditional sectors

affordable for people to get elective

with similar problems and apply them.

surgeries. They do this by utilising

The financial sector has a lot to offer.

excess operating theatre capacity of

existing hospitals and by aggregating

A good example of this is in chronic

patient demand through their digital

conditions like cardiovascular disorders

reach, thus making it efficient for

where post-incident or post-operative

surgeons as well. This model at scale

care and lifestyle changes contribute

can deliver better utilisation of existing

to ensuring recovery and reducing

infrastructure,

throughput,

mortality. And a lot of this can be

reduce costs and enhance the patient

achieved by a complementary model

experience.

to support the cardiologist involving

improve

The second vector is disaggregating the

periodic

monitoring

and

treatment

care spectrum into discrete components

adherence with a low-cost pyramid of

and digitally stitching this. A good

care. The same applies to most chronic

example is cancer care. With almost 1.2

conditions where this model can be

million new cancer patients added every

offered digitally thereby neutralising

year, offering equitable access to cancer

the disadvantages of geography, a

care is not possible with the existing

problem faced by 80 per cent of the

number of oncologists, largely confined

country.

to urban areas. The care spectrum for

Digital access has rapidly increased

cancer-like illnesses is long, complex

during covid times. Patients have shed

and expensive - starting with diagnosis

their inhibition to consult a doctor online

and extending to medical, radiation

and prefer having the first chat online.

and surgical oncology interventions.

By disaggregating this care spectrum and stitching its distinct components intelligently it is possible to improve efficiency, expand access, and most importantly enhance patient outcomes.

Counter-intuitively, this digital access has improved an element traditionally missing in the healthcare ecosystem - trust. When we look at this year, we either have an opportunity to treat it as a blot that exposed the inadequacy

The third vector is building a pyramid

of our healthcare infrastructure or as

of care thereby reducing the load on

a pivotal moment when we began to

specialists, who are fewer in number.

reimagine new possibilities. Carpe diem!

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41

People Matter

CEO Succession Planning Succession planning is good for business

Terri Bresenham, Co-Founder, Forte Health Advisors Former, CEO, GE Healthcare, Sustainable Healthcare Solutions (Bangalore) I’ve always believed a hallmark of

the reason, consider why embracing

an exceptional leader was the calibre

succession is good for your business

of talent they’d attract, and how well

and your career.

their direct reports got developed, promoted and made an impact. A talent pipeline and succession strategy are not just a CEO’s obligation, it should be viewed by the CEO as the lifeblood of an organisation’s sustainability and agility; its fuel for the future. But there are many reasons organisations, and

customers

and

investors.

According

to 2020 data, over 65 per cent of CEO successions came from internal candidates. of

a

Even

pandemic,

in

the

internal

disruption talent

is

still preferred. The exception is in a distressed or turnaround situation. In

and don’t invest in carefully thinking

these cases, an outsider’s perspective

through their succession needs. Maybe

can be more advantageous. So, if most

succession planning is a low priority

CEO successions are home-grown, what

where you work since it’s beyond the

are some of the guiding principles to

quarterly pressures. Or perhaps it’s

ensure success?

process can overshadow succession’s strategic

October 2021

to the overall success of the business,

their leaders, don’t create a great bench

primarily an HR led concern where the

42

CEO succession is particularly critical

element.

For

some

CEOs,

For me, there are many factors to consider, but here are two critical ones:

maybe it’s their fear of being replaced

P Future Needs Assessment

that keeps the topic muffled. Whatever

P Succession Accountability

Accountability In my experience, an incumbent CEO should be the primary person accountable for leading the identification, planning and transitioning to a successor. Yes, the Board, Investors and HR team have important contributing roles, but the incumbent CEO is the most familiar with the needs of the job; customer relationship dynamics, mastery of the business, operations, culture, cadence, competition and frankly, appreciation of the inherent challenges. The exception to this rule is if the CEO is struggling.

Then the Board and HR, often with external search help, should lead the blueprint of what the company needs in its next CEO. Incentives

should

emphasize

the

be

aligned

importance

to of

leadership’s role in creating a robust pipeline. From my own experience, each time I had the opportunity to hire

Future state

business needs in the next 5-10 years

someone for my team, I would consider

should be a rolling review, led by the CEO,

the candidate’s development potential.

with the Board and HR team. Recruiting

With good coaching, experiences and

and talent development should also

exposure, I’d ask myself, “How soon

align around these needs. Attracting,

would they be ready to become the

coaching, and retaining talent that fits

next CEO or be ready to take on a

this ‘To Be’ model should be rewarded

significant leadership role in another

through incentives and recognition of

part of the business?” I often made

leaders who do it well. An example of

hiring decisions based on someone’s

being future-ready is experience with

potential. I also would measure myself

‘what worked today, won’t tomorrow’

data science and embedded automation

on the impact people I hired would

rings true. So searching or grooming

of a company’s products and business

have across the organisation and on

someone to mirror the existing CEO

models with machine learning (ML),

business results over time. Developing

may bring a measure of security, but

even deep learning (DL). Percolating in

the reputation as someone who coached

it risks stagnating the business. To

the rank and file today are many future

and developed leaders, became an

successfully compete in the future,

CEO’s who will bring their intrinsic ML/

companies need to evolve and address

DL/AI experiences to bear. Likewise,

needs that can be radically different

someone who's lived experience as

from today’s scenario. While all CEO’s

an independent contractor or virtual

believe they’re adaptable and agile, CEO

employee is in a better position to

succession benefits from writing out a

shape the 21st-century workforce than

job description to capture the future

someone who has spent 15+ years as a

needs (or the ‘small signals on the

traditional, office-bound employee at a

horizon’) and avoid emphasising what

single company. Anticipating the future

is immediately in front of the company.

needs of an organization and business

CEO succession planning also needs to

talent pipeline around those needs, and

needs to be an explicit activity to have

takes

a clear-eyed view of preparing the

including

For example, it may be relevant to

business for the future and developing

on a great opportunity to attract the

emphasise hyper-growth skill sets over

relevant talent for the business as well

best

excellence in operational systems and

as a pool for selecting an optimal CEO

consequently,

margins. Thinking ahead to what the

successor.

sustainable, business outcomes.

In

today’s

world

of

accelerated

changes in markets and competition, CEO succession planning starts with thoughtful assessment and anticipation of what strengths the organisation needs matter

to

be

‘future-ready.

expertise,

Subject

connections,

and

interactions change as the market and business models evolve. The adage,

consider the cycle of the business.

advantage in attracting great talent, both internally and externally. This reputation is something I believe paid massive dividends in being able to build successful businesses.

Conclusion A CEO who emphasises understanding his/her company’s future talent needs, measures the effectiveness of a robust accountability their

talent,

own,

ensure drive

for

succession,

is

capitalising

continuity, better,

and more

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43

Pulse

Winning Formula Why healthy Board-CEO relationships are vital for hospitals

Dr Shravan Subramanyam, Shravan Subramanyam CEO - GE healthcare India and South Asia MD - Wipro-GE healthcare

The board of directors in a hospital or any organisation exists so that it can hold the CEO accountable for performance. The primary role of a board is to hire a CEO and, if required, discontinue their services if targets aren’t reached. The board essentially has only one employee – the CEO – and the latter must report to only one employer – the board.

The relationship between the two parties is extremely complicated.

While the hospital Board and the CEO are tactical partners working together towards a common vision, they also share a relationship of an employer and employee. And for any hospital or healthcare reforms to take place, it is critical to have a healthy and honest CEO-board partnership.

44

October 2021

Power partners While the board does employ the CEO, it is essential to recognise the CEO as a strategic partner. Often, the CEO of a hospital, usually a senior physician, is more up to speed about the hospital business and the markets around it than the board members who come from diverse sectors. So even while keeping accountability, the board needs to give the CEO free rein in certain matters.

What happens if this board-CEO equation is made mutually accountable?

This reciprocity, or mutual openness, only stands to benefit the CEO, the board and, eventually, the organisation.

Both parties should simultaneously be facilitators and force multipliers.

A study published in the Healthcare

Management Review explored changes in the relationships between the CEO and the board, reviewing 90 California hospitals during the late 1980s. It found that constructive participation of both partners proved to be an effective governance mechanism, improving the hospital’s performance.

build a stronger company. Leadership

How? By reciprocal accountability

board. Forming informal relationships

Mutual accountability and open communication require shared regard and support between the board and the CEO. This symbiotic relationship cannot be prescribed in any job description or HR handbook. It must be earned over time.

meetings sometimes helps establish an

Trust is an essential pre-requisite. A CEO should feel that the board truly has his or her back and the board should have faith in the CEO’s abilities and vision to drive the organisation forward devoid of self-interest.

guru Brene Brown puts it best: “Only when diverse perspectives are included, respected, and valued can we start to get a full picture of the world”.

It is in the hospital’s best interests for the CEO to willingly seek advice from the with the board outside of official open, professional environment. These casual engagements often touch upon matters that lie outside the formal agenda.

Effective engagement in succession planning Turmoil in a hospital setting often stems from changes at the top. The exit of a hospital CEO can sometimes disrupt operations, particularly when the leader

But this mutual trust does not come easy and entails a substantial level of honesty and openness on everyone’s part. It is confidence at the highest level that helps companies succeed. At the Global Leadership Summit 2021, Leadership Consultant Patrick Lencioni shed more light on this, saying “The only way to build trust is to overcome our need for invulnerability… teamwork begins by building trust”.

departs without handing over the baton

Trust between the board and the CEO only develops from working in close coordination in the troughs of the hospital boardroom. This is exemplified by common regard and discussion. It grows when collective views or interests are geared towards a shared purpose.

American Hospital Association Trustee

Being open to diverse ideas

instil confidence in the leadership. It

In recent years, it is physicians who have been taking up CEO or top management positions at hospitals. This is bound to improve clinical outcomes and improve healthcare delivery. However, a chunk of hospital work involves financial planning, compliance, and strategy building. Elected boards have members from diverse ranges of skills, expertise, and perspectives.

Taking advantage of this diversity can complement one’s knowledge and help

to a successor. Most healthcare set-ups need clear indications regarding the successor, especially as the business is both brisk and complex.

Despite

the

succession

established

planning,

need

most

for

hospital

boards push this agenda to the backburner. A 2019 survey conducted by Services showed that 49 per cent of hospitals and healthcare boards lacked a formal CEO progression plan.

A candid discussion between the board and the CEO on prospects goes on to showcases both parties’ willingness to remain invested in the organisation’s success.

Recognising each other as strategic partners, sharing goals and receptivity towards learning is crucial to nurturing competent CEO-board partnerships. An exchange built on trust, openness and mutual accountability are what will enable effective hospital governance in

References: The Unique Relationship Between CEO and the Board (wsu.edu) Essential Elements of an Effective CEO-Board Relationship | Russell Reynolds Associates The Board - CEO relationship Forde Advisory 4 Best Practices for Hospital CEO-Board Relationships (beckershospitalreview.com) Every Hospital Board Needs a CEO Succession Plan. Half Are Failing. | HealthLeaders Media

the current environment of change.

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45

Interview

A Solid and Efficient Cold Chain System is Critical to Deliver Current Vaccines Even though we have one of the largest immunisation and vaccination programmes in the world with budgets of more than $500 million every year, the Indian infrastructure has visible evidence gaps. Sanjay Jain, Director at Elanpro, reveals more

Optimal cold chain infrastructures are vital if vaccines are to reach healthcare facilities at temperatures where their efficacy remains unchanged.

Could you tell us about the cold chain infrastructure available in India?

The cold chain network in the country has been the backbone to ensure storage at different stores and supply of vaccine between the nodes of storage and to the outreach sites at the recommended temperature

for

administration

to

the target population. Further to this, due to the rise in vaccines due to the global COVID-19 pandemic, the Indian cold chain market reached Rs 1425.49 billion in 2020.

A solid and efficient cold chain system is critical to delivering current vaccines at high quality and prepare the routine immunisation/vaccination

system

to

accommodate newly available vaccines.

Currently, the majority of the cold supply chains in India are in the range between 2-8°C. Even though we have one of the largest immunization and vaccination programmes in the world with the 46

October 2021

following aspects of the vaccination system: 1.

Inadequate vaccine storage system:

The vaccine storage system has always been a considerable concern about the wastage of vaccines to a substantial number.

Every

vaccine

comprises

different temperatures, and the grave issue is inadequate and inefficient vaccine freezer and cold storage units.

2. Inappropriate

transportation

system: Every vaccine has a different set of compatibility that must be maintained throughout the transportation process.

Two

major

factors

during

vaccine

transportation that can jeopardise drug safety are vibration and shock, which can either alter the vaccine chemically or shear off part of the molecule,

Sanjay Jain, Director at Elanpro

reducing its efficacy. budgets of more than $500 million every year, the Indian infrastructure has visible evidence gaps in the following: •

Lack of primary data in cold chain

status in India based on which the projection for vaccine storage space and dry space can be developed •

Lack of primary data on quality of

temperature maintenance at the cold chain points

The COVID-19 pandemic has not only highlighted the disparities in vaccine rollouts around the world but the logistical hurdles that can arise when transporting and storing medical equipment at ultralow temperatures. Could you elaborate on these challenges?

About 50 per cent of the vaccines are locally or regionally distributed and widely transported via road, making the chain's overland transport system a crucial part. While it is cost-effective and

can

reach

remote

locations,

the biggest issue is maintaining the temperature and safety of the drug.

For places with improper roads and

Vaccine wastage is defined as vaccines

infrastructure, transportation becomes

discarded, lost, damaged, or destroyed

a grave issue. Air cargo is also one

on

the

according to the WHO. There are two

of the essential parts of any global

related

to

phases where vaccines are exposed to

vaccine drive through its established

immunization/vaccination logistics and

wastage – opened and unopened vials.

global time- and temperature-sensitive

opportunities for improving the system

Unopened vials are mostly wasted

distribution

due

to

cannot be attained successfully without

and

incorrect

• Lack

of

determinants,

•

primary barriers

data

Lacks systematic analysis on the

expiration,

heat

exposure,

systems.

However,

this

open

proper temperature control mechanisms

vials are primarily wasted through

and a fully trained staff to manage the

contamination. Even though a certain

uploading and offloading of the drugs.

Focusing on reducing this gap, the

amount of wastage is expected given

Environment

Ministry of Health and Family Welfare

the nature and complexity of vaccine

Environmental

in partnership with UNICEF developed

campaigns, the annual vaccine report by

critical for any vaccine, as exposing

the web-based National Cold Chain &

WHO reveals an estimate of as much as

them to incorrect temperature and

Vaccine Management Resource Centre

50 per cent of vaccine wastage across

humidity levels can lead to depleting

to monitor the cold chain system

all

drug efficiency and efficacy. In the

real-time setting across the country.

vaccines alone are estimated to record

case

of

The tool helps in planning and taking

a wastage of approximately 70 million

are

highly

doses by the end of 2021. This data is

frequent monitoring of these vaccines

quite alarming considering the ongoing

is of utmost importance to reduce any

pandemic and the fact that we have

vaccine wastage or its efficacy.

requirements for expanding its cold chain for future adoption of vaccines

management decisions based on realtime information, as a monitoring tool for current equipment status, as a repository of cold chain equipment for the country, and as a platform for future

vaccines

inventory,

every

year.

and

COVID-19

advanced technologically yet face such gaps in the healthcare system.

Control/Logistics: parameters

COVID-19

Vaccines

temperature

are

which

sensitive,

Lack of trained staff: Vaccine storage and transportation requires a definitive

innovations in cold chain and vaccine

Elaborating

the

set of skills and manpower to ensure a

management.

significant issues exposed were in the

safe, reliable and efficient vaccine drive.

on

the

challenges,

www.indiamedtoday.com

47

Interview

A lack of skilled and trained personnel

the freezer can also be used for other

most important aspect and a challenge

is one of the crucial aspects that need

vaccines. Another beneficial feature

to

to be addressed holistically. Hence,

of the product is that it can easily be

management. Vibration and shock can

proper training, ensuring staff's safety

converted into a refrigerator.

either modify the vaccine chemically

and following mandated requirements for storage facilities and transportation needs be on the list of priorities.

What sets Elanpro's refrigeration units apart from similar products on the market?

We have also developed a remotedata

monitoring

device

‘Thingy(y)’

in response to the Indian industry's inadequate and unmonitored cold chain.

This temperature-monitoring system is not only cost-effective but also allows the user to receive an alert when

affect

is

precise

temperature

or shear off part of the molecule, lowering its efficacy. These are two key variables that can risk drug safety during vaccine delivery. As a result, the mode of transportation plays an equally vital role in limiting vaccination toxicity. Around half of the vaccines are distributed locally or regionally

Elanpro has been providing various high-

there is a change in the temperature.

end solutions for the pharmaceutical

Currently, only a small percentage of

sector. At the beginning of this year,

the cold chain used for immunisation

system a critical link. While it is cost-

we at Elanpro launched two portable

in India is being checked for potential

effective and can reach remote regions,

COVID Vaccine Freezer – an IoT-Enabled

breaches. As a result, the device collects

maintaining the drug's temperature and

Portable COVID Vaccine Freezer with

data from a variety of sensors and aids

safety is the most significant challenge.

a temperature range from 2⁰ C to

in real-time decision-making.

Also, transportation becomes a major

-20⁰ C and a Portable COVID Vaccine

What key challenges have you experienced related to transporting vaccines in in-hospitable regions?

concern in areas with poor roads and

Freezer maintaining temperature only at – 86⁰ C. Designed to store and distribute

vaccines

at

maximum

strength and effectiveness to hospitals,

Considering

enabled Portable covid vaccine freezer

challenges,

is

emphasise bringing a strong ecosystem

versatile

product.

The

newly

the

and

can be installed easily. Additionally,

reduce any longer complexity. The

October 2021

products

that

also

launched product is lightweight and

48

developing

geographical

manufacturers

the network's overland transportation

infrastructure.

clinics and pharmacies, Elanpro’s IoTa

India’s

and largely delivered by road, making

will

Aside from storing the COVID-19 vaccine, what are some other existing or potential applications for ultralow temperature freezers in healthcare?

Ultra-low temperature freezers usually

have a temperature range of -45 degree C to -86 degree C. These freezers are used in blood banks, hospitals, epidemic prevention services, research institutes, and biomedical engineering facilities, among others. Additionally, other than COVID-19 Vaccines, these freezers are also used for the storage of tissue samples, enzymes, bone marrow and

other

biological

materials

in

laboratories. There are several designs for

ultra-low

temperature

freezers

which vary depending on how much storage is required.

Can you tell me about some of the work that Elanpro has been doing alongside policymakers and national authorities to ease the rollout of the COVID-19 vaccine?

Elanpro has rolled out the complete range

of

vaccine

refrigerators

and

Freezers and also portable freezers for outreach programmes so essential for

time-bound

coverage

of

the

masses without real investment in the infrastructure. Apart from that, we are also performing on a baseline by

improving

the

infrastructure

in

corporate sector have examined the ecosystem and are working to develop solutions that will not only have broader implications but also provide effective outreach. In India, the vaccine storage system has always been an enormous concern pertaining wastage of vaccines to a considerable number.

Every vaccine consists of various temperatures and therefore the grave issue that exists in India is insufficient and inefficient vaccine freezer and cold storage available here.

Vaccine storage and transportation, however, requires a definitive set of skills and manpower to make sure a secure, reliable and efficient vaccine drive. The scarcity of skilled and trained personnel is one of the crucial aspects that require to be addressed holistically.

Hence, proper training, ensuring staff's safety and following mandated requirements for storage facilities and transportation needs get on the list of priorities.

Additionally, the pharmaceutical and healthcare industries' futures are being defined by their adoption of new technology.

upgrading people’s skills.

Understanding

the

region

and

its

requirements, we've gone ahead and designed refrigerators that will work on solar energy, kerosene or LPG. For instance, a village near Cherrapunji, experiences rain most of the time of the year, and hence, a solar-powered refrigerator won't work but kerosene or LPG would Additionally, this product is embedded with a dual technology that is depending on the requirement one can switch to kerosene or LPG and it'll still maintain the temperature.

Is it possible that the distribution and supply programmes put in place for the COVID-19 vaccine could be implemented when devising immunization campaigns against other diseases?

Yes, it is possible and it is necessary to learn from the COVID-19 vaccination drive.

Recognizing

the

gravity

of

the problems, the government and

www.indiamedtoday.com

49

Interview

In response to this outbreak, there has

It is essential to consider that the

been a considerable increase in demand

refrigerator/ freezer has a temperature

for tech-enabled goods that are both

monitoring system ensuring that your

effective and efficient. As a result,

commercial

items

such

as

biomedical

freezers

and cold chain storage are in high demand. According to the healthcare and

pharmaceutical

industry,

using

technologies like AI and IoT seems to

refrigerator

is

keeping

products at the correct temperature.

Every product requires a different set of temperatures. For instance, in the healthcare sector - a blood bank

be the foremost promising which can

refrigerator does require a particular

not only streamline the accessibility but

temperature to store the blood bags.

also enhances the automation process

In terms of vaccination storage, every

so that there's less human intervention.

vaccine/injection requires a particular

AI and IoT enabled devices also allow

temperature for storage. Cancer drugs,

user to receive a timely alert if there’s

AIDS drugs, and IVF drugs are precise

any variation in temperature, humidity

temperature drugs that can't be stored

or pressure.

in a domestic refrigerator. Hence, it is

What should consumers look for to ensure that they are purchasing a high-quality refrigeration solution which is compliant with the appropriate regulations?

Medical freezers and refrigerators are guided by CE (Medical Device Regulation (EU) 2017/745 and Medical Device Directive 93/42/EEC, and all the medical devices are therefore labelled with the

a necessity to store these bio-medical drugs in bio-medical refrigerators to ensure the effectiveness and efficacy of the vaccine.

Efficient

and

Timely

Servicing/

Maintenance– Commercial refrigerators are

designed

to

offer

précised

performance, efficiency, and durability.

Hence, on a timely basis, the unit requires cleaning and maintenance. An

CE or CE0123 markings if Class I or Class

efficient and certified technician can

II respectively) or USFDA, these are

help the unit to again function properly.

important to ensure that basic qualities and temperatures are maintained. This becomes all the more important in the absence of any BIS standards in India.

The

standard

covers

specifications

such as dimensions, equipment’s used, temperature

ranges

for

commercial

refrigerator manufactures and sold in the country. Consumers looking for the product should ensure that the product is compliant with the CE and USFDA

Appropriate interior dimension or size – Depending on the need or requirement the

storage

unit

to

be

selected

preserving the necessary products/biomedical drugs Energy Efficient Unit – It is important to have units that comprise energy efficiency ensuring quality and are yet affordable

standards. Bureau of Indian Standards.

Tech-enabled features and technology

Additionally, buying a new commercial

- Artificial Intelligence (AI) is paving its

pharma refrigerator or replacing the

way in this segment aggressively and

existing one, is of utmost importance

have been useful in keeping track of the

for a consumer to pick the right product

temperature and its quality

which caters to the users' requirements.

Below are a few aspects to be considered in buying commercial refrigerators: Temperature 50

October 2021

Monitoring

System

Today, brands are focusing on producing high-quality units which are embedded with user-friendly technology and are

–

available at a reasonable price.

The Evolving Cybersecurity Landscape Remote working has increased cyberthreats.

But even after the global pandemic is over, it’s going to be important to take actionable steps to combat the sizable security risks.

Customized MVISION Device-to-Cloud Suites MVISION Advanced

|

MVISION Premium

|

MVISION Complete

We Recommend:

Implement a cloud-based secure web gateway

1 2 3 4 5 6

Require multi-factor authentication to reduce risks of credential theft

Set policy in the cloud for routine device checks

https://www.mcafee.com/enterprise/en-us/assets/reports/restricted/rp-carr-wfh.pdf https://www.mcafee.com/enterprise/en-us/assets/reports/restricted/rp-carr-wfh.pd Source: https://www.darkreading.com/cloud/as-cloud-adoption-grows-dlp-remains-key-challenge/d/d-id/1335000 https://newsroom.ibm.com/2020-07-29-IBM-Report-Compromised-Employee-Accounts-Led-to-Most-Expensive-Data-Breaches-Over-Past-Year https://www.gartner.com/smarterwithgartner/is-the-cloud-secure/ https://media.nominet.uk/wp-content/uploads/2019/02/12130924/Nominet-Cyber_CISO-report_FINAL-130219.pdf

8 https://www.mcafee.com/enterprise/en-us/assets/reports/rp-cloud-adoption-and-risk-report-work-from-home-edition.pdf McAfee and the McAfee logo are trademarks or registered trademarks of McAfee, LLC or its subsidiaries in the US and other countries. Other marks and brands may be claimed as the property of others. Copyright © 2020 McAfee, LLC. 4619_0920 SEPTEMBER 2020