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VOL.12 NO 6 PAGES 48

Policy Dr Nupur Kohli, Founder Director, Netherlands-India Information Services - NIIS Health JUNE 2018, `50

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CONTENTS MARKET Vol 12. No 6, June 2018


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Experts from the global TB community welcome the government’s move to eradicate TB from India by 2025,but also fear that it is too ambitious | P-12




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June 2018


Warring on multiple fronts


he bidding war for a slice of Fortis Healthcare continues, as the reconstituted board’s request for fresh bids had four suitors stepping forward. The good news is that the process now seems to be more transparent, with bidders allowed 10 days for due diligence with access to the data room. The new round of bidding has safeguards for the shareholders too, as it specifies certain minimum conditions, ensuring a more fair comparison between bids. For one, all binding offers should offer a minimum infusion of `1500 crore via a preferential allotment. Secondly, the bids should lay out a plan to fund the acquisition of Religare Health Trust (RHT) assets. Thirdly, the binding offers should make provision for the exit of private equity investors in SRL, as well as details of a retention plan of the current management and employees. It is interesting that Manipal Hospitals, one of the three bidders for Fortis, as well as its prime rival for the numero uno position, Apollo Hospitals, are two of the bidders for yet another failing healthcare entity, the Seven Hills Hospitals. Struggling with debts of `1300 crore, Seven Hills Hospitals has been part of insolvency proceedings initiated by the National Company Law Tribunal (NCLT) last year. The consortia of lenders, led by Axis Bank and State Bank of India, have reportedly sold 77 per cent of this debt to Bank of America, Merrill Lynch and JM Financial Asset Reconstruction Company. This puts the latter in the driver's seat with majority stakes in the two-hospital group which collectively has 1000 beds. The news must be disappointing for pure play hospital bidders. Media reports mention that Aster DM and Narayan Health, in partnership with the Piramal Group, were other groups which had shown interest in Seven Hills Hospitals. As the tussle for supremacy in India's private hospital space plays out, the country's health system is gearing up for a fight on another front: the Nipah virus. With the death toll already at 13 and counting, the detection, containment and treatment of Nipah virus cases is crucial to prevent further infection, especially as there is no vaccine as yet. There are lessons to be learnt from the Nipah virus episode. Firstly, to ensure healthcare workers use the right procedures and protection gear to protect

As the tussle for supremacyin India’s private hospital space plays out,the country’s health system is gearing up for a fight on another front: the Nipah virus

them from infections. Carelessness of healthcare staff as well as cutting corners on sanitation equipment and processes by hospital managements will cost more lives, especially in a world that is more connected than the world our parents live in. With overseas travel becoming more affordable, Indian tourists could be bringing back much more than duty free goods and souvenirs when they return from global jaunts. Most private hospitals cater to medical tourists from across the world, and this too raises the risk of bugs travelling across continents. Secondly, the Nipah virus also uncovered the double standards of our society. While nurse Lini Puthussery, who died after treating the first patient diagnosed with the virus, received kudos and condolences on social media, the ground reality was quite different. The public shunned others from her fraternity, nurses and healthcare workers, with reports of people refusing to travel on the same bus when they suspected them of treating Nipah infected patients. To serve beyond the call of one's profession, only to be shunned by the very society that one serves, must be truly disheartening for the healthcare fraternity, especially those in direct contact with patients. The only solution to change this mindset is constant communication and awareness campaigns on measures and strategies to prevent such infections. Thirdly, the scary part is how does one prevent what one cannot recognise? Not much is known about such zoonotic infections. Every mutation in a virus could result in a change in symptoms, making it all the more difficult to detect. While fruit bats and pigs were thought to be the source for the Nipah virus which struck Kerala, later reports debunked this theory. Epidemiologists across the world are blaming man's unfettered encroachment on tropical forests into agricultural lands for the virus crossing species from tropical fruit bats to humans. The worry is that if the virus mutates enough to enable it to be transmitted from human to human,we will have a pandemic to deal with. Thus, while Fortis and Seven Hills are a warning to hospitals to be financially prudent, the Nipah virus infection is a red flag to plug the gaps on the infection control side.




June 2018


NIPTmore accurate and safe in detecting chromosomal disorders in unborn babies: Study


nationwide study across 10 hospitals has found that NIPT (noninvasive prenatal screening test), is much more effective, accurate and safe for detecting chromosomal abnormalities in the unborn baby, compared to conventional biochemical tests such as the double marker (first trimester) and quadruple marker tests (second trimester), as well as ultrasound studies. Hospitals which took part in the study are Sir Ganga Ram Hospital (Delhi); All India Institute of Medical Sciences (Delhi); Indraprastha Apollo Hospital (Delhi); Postgraduate Institute and Medical Research Center (PGI) (Chandigarh); Rainbow Hospital (Hyderabad); Amrita Institute of Medical Sciences (Kochi); Sri Ramchandra Medical College (Chennai); Jawaharlal Nehru Institute of Post Graduate Medical Education & Research (Pondicherry); CIMAR Fertility Center (Kochi); Manipal Hospital (Bengaluru), etc. The study, initiated by genomics-driven research and diagnostics firm MedGenome, had Dr IC Verma, Director of the Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital, New Delhi as the principal investigator. The study, published in the Journal of Obstetrics and Gynecology of India, showed that a chromosomal abnormality detected by Non-invasive Prenatal Screening Test (NIPT) was much more likely to be true and present in the foetus, compared to conventional screening tests, authenticating NIPT to be a much more accurate testing method. The study was conducted to analyse the performance of NIPT in Indian pregnant women, especially for diagnosis of abnormalities of chromosome numbers 21, 18, 13, and triploidy. NIPT screening was performed on 516 pregnancies, who had tested intermediate to



June 2018

high risk on conventional screening tests (Double marker, Quadruple marker test along

with ultrasound studies) in the first and second trimester. The results were confirmed through

invasive testing or clinical examination after birth. Over 96.2 per cent of pregnancies were

reported low risk and 3.8 per cent tested high risk on NIPT for the conditions tested.


Healthcare Senate,coming soon The event to be held in New Delhi from July 12-14, 2018, will focus on ‘Healthcare 2.0:Strengthening Values for Sustainable Growth'


xpress Healthcare invites CXOs of hospital chains, medical directors, owners/ promoters of hospitals and diagnostic centres, consultants, thought leaders, industry stalwarts and domain experts to congregate at India's largest private sector business summit to prepare a blueprint based on values that will make healthcare organisations successful both in terms of profitability and goodwill. The first two editions of Healthcare Senate held in Hyderabad served an excellent platform for thought leaders, key decision makers, investors and budget holders to share and exchange strategies that are relevant to the fast changing healthcare environment as well as helpful in running sustainable, responsible and profitable businesses in India. All stakeholders therefore, came together to share their insights on business models that will work for India. The first edition focussed on ‘Value-based healthcare delivery’, while the second edition was ‘Building a future ready healthcare sector for India’. Taking these discussions



June 2018

further and in keeping with the rapidly changing healthcare business environment, Healthcare Senate's 3rd edition, to be held in New Delhi from July 12-14, 2018, will focus on 'Strengthening Values for Sustainable Growth'. The summit and its discussion will emphasise on inculcating the below mentioned core values that will lead healthcare business to create value for all.

Ingredients for a successful organisations: ◗ Integrity: There are no moral shortcuts in the game of business or life. It is the true mark of leadership and so healthcare organisations who wish for sustainable growth will have to instill this principle in all their business dealings; be it patients, employees or partners. Healthcare organisations which operate with integrity and honesty earn immense brand value. At H e a l t h c a re S e n at e 2 0 1 8 industry stalwarts will share their stories of success which speak of goodwill and profitability earned through integrity and honesty in business.

◗ Accountability: This is a virtue that healthcare organisations cannot overlook. Accountability entails the procedures and processes by which healthcare providers justify and take responsibility for their activities. Lack of accountability in healthcare therefore, can cause significant damage to organisations. It can erode quality of care, ruin an organisation’s reputation, and increase the risk of lawsuits. Experts, in their discussion, will deliberate on ways and means to improve accountability of care. ◗ Quality: Quality in healthcare should be more than making the best product or providing the best service. It should extend to every aspect of the business function. A company that recognises quality and strives for it daily has a profound sense of self-respect, pride in accomplishment, and attentiveness that positively affects every aspect of its business. At the conference, healthcare quality experts will share insights on how striving for quality facilitates organisations to improve efficiency and achieve profitable in the long run.

◗ Innovation driven: Industry leaders will explain how innovative companies deliver a consistent stream of market successes via successful businesses and products/services or improved processes that continuously translate market success into economic value. These companies enjoy a competitive advantage and achieve sustained growth. ◗ Adaptability: With changing business dynamics the challenge that healthcare organisations face is keeping pace with these changes. Organisations which can roll with change and still perform well are prime time players and will enjoy sustainable growth. The event will bring forth case studies of such companies which have gracefully accepted change and gained better outcomes. ◗ Strategic Partner Relationships: No business is successful if it is not built on values forged and strengthened by strategic partnerships. Here, experts will highlight the essentiality of striking sustainable partnerships which can help companies gain competitive advantage and credibility.

Topics to be covered during the event are: ◗ Healthcare 2.0: Creating value for all ◗ Creating an inclusive healthcare ecosystem for India ◗ NHPS: Building the right synergies ◗ Growth Agenda: The battle for sustained innovation leadership in healthcare ◗ Access strategies in a era of price control ◗ CEO Round table: Business culture: Why core values matter? ◗ Healthcare's unique treasury management challenge ◗ Regulating trade margins the do's and dont's On the side lines of Healthcare Senate 2018, Express Healthcare will also be hosting Radiology and Imaging conclave and the the Healthcare IT Senate. Both these knowledge platforms will gathers experts from the field of radiology and It to share in depth knowledge on the Future of radiology and the healthcare IT. Contact: Vinita Hassija Email id: Phone no: 98205990053

India will contribute to WHO’s digital health strategy: Nadda India plans to host a global digital health summit in near future with the support of WHO “I AM happy to note that this assembly will be considering and adopting the first WHO resolution on digital health initiative by India,” This was stated by JP Nadda, Union Minister for Health and Family Welfare during his address at at the 71 World Health Assembly, the decision-making body of WHO, at Geneva. “Digital health technology have a huge potential for supporting Universal Health Coverage (UHC) and improving accessibility, quality and affordability of health services. This is a resolution which should be owned by all of us so as to pave the path for a forward looking global health agenda,” he said. The 71st World Health Assembly is being attended by delegations from all WHO member states. Nadda said India is planning to host a global digital health summit in near future with the support of WHO and hopes it would contribute to WHO’s efforts to come up with a comprehensive global health strategy on digital health. Stating that UHC is one of the most powerful social equalisers, he said: “India today is firmly committed to achieving UHC as articulated in its National Health Policy 2017. Our successes in sustaining polio free status and substantially achieving the MDGs have infused renewed enthusiasm to meet the ambitious SDGs and its underlining commitment of ‘Leave no one behind’.” India has fast tracked many initiatives aimed at achieving all the four tenets of UHC that is strengthening health systems, improving access to free medicines and diagnostics and reducing catastrophic healthcare spending, he added. “To translate our vision of UHC, our Prime Minister Narendra Modi has launched an ambitious programme called ‘Ayushman Bharat’ that is ‘Long Live India’. The programme rests on the twin pillars of health and wellness centres for provision of



June 2018

comprehensive healthcare services and the Prime Ministers’ National Health Protection Mission (NHPM),” said the minister.

NHPM is aimed at providing secondary and tertiary healthcare to 100 million families covering 500 million individuals, about 40 per cent of the coun-

try’s population, who will be provided an insurance cover of ` 500,000 per year.Following the overwhelming response at the first World Conference on Ac-

cess to Medical Products in November 2017, India is organising the second World Conference in October 2018 in New Delhi, he added.

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cover )

Experts from the global TB community welcome the government’s move to eradicate TB from India by 2025, but also fear that it is too ambitious By Prathiba Raju



June 2018





June 2018

cover ) T

uberculosis (TB) is a global pandemic and continues to be a huge public health threat in India. It currently has 27 per cent of the world’s new TB cases, which is around 2.8 million. According to World Health Organisation (WHO), the country holds the dubious distinction of being the TB capital of the world as around 480,000 people died due to the disease in 2014. As per Stop TB, 1:4 people with TB worldwide is an Indian. Although the annual incidence of TB has reduced from 289 persons per 100,000 in year 2000 to 217 per 100,000 in 2015, eliminating TB would necessitate a dramatic reduction to less than one person per 10,00,000. Leaders from the healthcare domain inform that eradicating TB is more of tackling social determinants as the risk factors of TB are tobacco use, exposure to secondhand smoke, diabetes, HIV, malnutrition, overcrowded living conditions, under-diagnosis and the use of unclean fuels for cooking and heating. As a large number of people get treated late or are unsuccessfully treated, or remain untreated, the disease become a menace of huge proportions.

Health is being accorded priority, and it is evident from the National Health Policy 2017 and the Ayushman Bharat – National Health Protection Mission (NHPM), which aims to benefit more than 10 crore vulnerable families. These initiatives cumulatively cover all bases and will indeed prove transformational in India’s end-TB efforts Dr Henk Bekedam WHO Representative to India

The world is watching whether India will follow up on the prime minister’s commitment with the substantially increased budget that is required, and rapidly execute the ambitious TB Free India campaign. 2025 is just seven years away and the clock is ticking Prof Madhukar Pai Associated Director, McGill International TB Centre, Canada

We know that it is possible to dramatically reduce TB prevalence – countries like the UK and the USA did so in the last century, and there have been some impressive examples of progress in certain parts of India. India can certainly make significant overall progress in its fight against TB José Luis Castro President and Chief Executive Officer (CEO), Vital Strategies

Ending TB @ 2025 – A collective endeavour Therefore, it is time to get our act together to combat TB. As Prof Madhukar Pai, Associate Director, McGill International TB Centre, Canada, told Express Healthcare, “A big question for the TB community now is this: How do we hold our leaders accountable for their big declarations and commitments? The world is watching whether India will follow up on prime minister’s commitment with the substantially increased budget that is required, and rapidly execute the ambitious TB Free India campaign. 2025 is just seven years away and the clock is ticking.” However, many other health experts are more optimistic and assert that with political will, right systems and partnerships in place, India can make significant overall progress in its fight



June 2018

Every tuberculosis patient should have a drug resistance profile which will determine the best treatment regimen and therefore better treatment outcomes. New drugs are now available and already included in the India TB programme guidelines – it needs scaling up Dr Suvanand Sahu Deputy Director, Stop TB Partnership

99DOTS, is a low-cost approach for monitoring and improving TB medication adherence. The Government of India has fully embraced this method for monitoring TB medication, it was standardised in the National Strategic Plan, 20172025. As of May 2018, over 100,000 patients have been registered and monitored using 99DOTS Sriram Rajamani Distinguished Scientist and Managing Director, Microsoft Research India Lab

against the disease. They indicate that the recently held Delhi END TB summit was a platform set to end the dreaded disease, and inform that appropriate strategies are being implemented in line with the National Strategic Plan (NSP) 2017-2025 for TB Elimination in India. But, the devil is in the details. “India has been fighting TB for a number of years, but now the country has seen a paradigm shift with a new strategy and bold commitments. The battle to end TB will need increased resources, bold policies, innovations, research and unprecedented scale of implementation. We have recently seen the budget for TB going up, and strong policies being enacted on notification, private sector and active case finding. Implementation of policies with uniform good quality in a large and diverse country like India will be a challenge,” informs Dr Suvanand Sahu, Deputy Director, Stop TB Partnership, a global network of organisations working to eliminate TB. Dr Henk Bekedam, WHO Representative to India, informs, “Health is being accorded priority, and it is evident from the National Health Policy 2017 and the Ayushman Bharat – National Health Protection Mission (NHPM), which aims to benefit more than 10 crore vulnerable families. These initiatives cumulatively cover all bases and will indeed prove transformational in India’s end-TB efforts.” Dr Bekedam explains, “A strong political commitment by Government of India recognising TB as a major public health problem and its major public health programme end TB by 2025, five years ahead of the global Sustainable Development Goals (SDG) target of 2030, is a well-defined action plan, backed by the NSP 2017-22 for ending TB, which outlines bold policies and new strategies with a nearly four-fold increase in funding for its implementation. Detect, treat, prevent and build form the key pillars of India’s TB elimination strategy. The NSP, whilst focussing on finding, testing and treating TB, also adopts



a multi-pronged strategy with a special focus on forging strong partnerships, empowering communities and creating awareness, as a step towards behaviour change, including delayed care seeking behaviour, treatment completion.” Echoing similar thoughts, José Luis Castro, President and CEO, Vital Strategies, who had done a mass media campaign ‘TB Cough’ for Ministry of Health and Family Welfare (MoH&FW), says, “We know that it is possible to dramatically reduce TB prevalence – countries like the UK and the US did so in the last century, and there have been some impressive examples of progress in certain parts of India. India can certainly make significant overall progress in its fight against TB.” Experts also emphasise that India should apply lessons learned from the polio eradication programme, as there are similarities and dissimilarities between polio and TB. Like polio, TB also needs a massive and intensive public health response.

Surgical attack on DR-TB

MAJOR STEPS TO END TB ◗ Based on the need expressed in the National Strategic Plan continue to increase the budget for the TB programme at the federal level and also at the state level to ensure no funding gap exists. ◗ Scale up new rapid molecular diagnostics and new drugs and treatment regimen. ◗ Ensure uniform good quality diagnostic and treatment services in both public and private sectors. ◗ Scale up quickly the direct benefit transfers to patients and improve it further to ensure that out-of-pocket costs to patients and their families are reduced. ◗ Implement the comprehensive approach of “search-treat-prevent” which is already in the national strategic plan. More needs to be done to operationalise prevention and preventive therapy for those at risk. ◗ Considering the diversity of India put in place a system for achieving TB-free villages and cities, encouraging health competition between states and local areas. ◗ Prioritise research and innovation, including research into new diagnostics, drugs and vaccine. ◗ Most important of all set up a system of monitoring progress by the state chief ministers

Lessons from polio eradication The polio experience of civil society participation and doing things in a mission mode is something that the TB programme should adapt. Epidemic control measures such as case investigation, laboratory surveillance and protecting susceptible contacts are principles that can be applied to both polio and TB, global experts inform. “There are good lessons India can take from its work to eradicate polio, but TB is a tougher challenge in a number of ways. Most importantly, there is a very effective vaccine that protects people from contracting polio so that they never get sick in the first place, and we don’t have the same kind of effective vaccine yet for TB. Instead, there needs to be a multi-pronged strategy to address TB. Control and elimination of TB relies on making a diagnosis, starting the patient on the right medicines, and ensuring adherence and

RNTCP annual status report, Unite to End TB by Central TB division, DGHS, MoH&FW completion of treatment. There are significant levels of under-diagnosis – estimates say perhaps as many as a million people in India - increasing poorer outcomes and unintended spread of TB. Perceived stigma discourages

some TB sufferers from accessing care, but this isn’t a barrier for polio sufferers. Also, we are seeing an increase in patients with drugresistant TB cases that are both harder to diagnose and harder to treat,” says Castro.

Although learning from its previous polio experiences and success, eradication of tuberculosis in India by 2025 will not be easy — as the emergence of multi-drug resistant TB is a major hurdle, which needs to be addressed.

Drug-resistant TB is an important issue that needs to be addressed within the context of ending TB. As India has the highest number of people with drug-resistant TB. India needs to quickly reach the stage of universal drug-susceptibility testing. “Every TB patient should have a drug resistance profile which will determine the best treatment regimen and therefore better treatment outcomes. New drugs are now available and already included in the India TB programme guidelines – it needs scaling up. Efforts should be made for early diagnosis and effective treatment of drug-resistant TB, as well as preventing further spread by good airborne infection control practices,” states Sahu. As per an estimate by Union Health Ministry, an estimate of 1,47,000 people suffer from MDR TB in India. A month ago, Preeti Sudan, Secretary, Health, MoH&FW, wrote a letter to the Medical Council of India (MCI), to incorporate the obligatory requirement of establishing DR-TB centre at each medical college, as per revised national TB control programme guidelines. A health ministry official, on condition of anonymity, revealed that as of now only 147 MDR-TB treatment centres are available and with the addition of this new clause, the ministry hopes to create enough centres for treatment. The ministry is coming up with several innovative interventions, particularly on drug-resistant TB. The state governments have been asked to identify two blocks in each district to make it TB-free within a year, as a part of its disease elimination strategy. Districts will be ranked on disease prevalence so that an exact idea of disease distribution is mapped. A target of 2025 has been set and the ministry is hopeful to achieve the target.” Meanwhile, the government officials inform that participation of private sector and aid of technology play an crucial role in diagnosis and treatment of TB patients in India.



June 2018

cover ) Role by private healthcare players According to healthcare professionals, most of India’s population rely on private healthcare services for treatments and hence the sector plays a major role to diagnose and treat TB patients. Unfortunately, many private practitioners delay treatment of TB patients and a series of tests are conducted, which are mostly inaccurate. In order to put them into order, MoH&FW has recently criminalised non-reporting of TB cases to the government, which is helping to track unregistered patients. According to the new regulations, any clinical establishment, pharmacies, chemists and druggists dispensing antiTB medications should provide details of the patient, prescription and medical practitioners concerned should notify TB cases to the local public health authority, viz. district health officer or to the chief medical officer. If they failed to do it, strict action would be taken against them under Section 269, which refers to a negligent act likely to spread infection of disease dangerous to life and Section 270 to a malignant act likely to spread infection of a dangerous disease. The former hands out imprisonment up to six months and the latter up to two years. “The notification will bring to light the real burden of TB and help each state governments to monitor TB patients,” an MoH&FW official informs, on condition of anonymity. Informing that quality of TB care in private sector varies and in many cases sub-optimal, Castro says, “The Revised National Tuberculosis Control Programme (RNTCP) explicitly attempts to address this challenge by improving reporting efforts from the private sector. Accurate surveillance of all cases in the country, those in the public and private sectors, is key to controlling the disease. India has a large number of private practitioners, and if they could be engaged in the na-



June 2018

diagnostics, adherence support and engagement for patients who are suffering from a curable disease are emerging to join the united effort to end TB. With a strong coalition of a dedicated community in both public and private sectors, with medical and technology expertise, focussing on patient-centric ways to empower programmes to deliver quality care, the mechanisms to combat TB are stronger today than before and continue to evolve,” Rajamani added.

An ambitious goal

RNTCP annual status report, Unite to End TB by Central TB division, DGHS, MoH&FW

tional TB control programme in an effective way, they could contribute significantly to TB elimination.”

Creating a huge impact Not just private practitioners, technology has also played a bigger role and has wider implications to eradicate the disease. In certain innovative projects like 99DOTS by Microsoft Research India has been able to save TB patients with low-cost tech innovations. “99DOTS, is a low-cost approach for monitoring and improving TB medication adherence, using inexpensive augmented packaging and basic mobile phones already owned by a majority of patients. It

takes the treatment to homes and hands of patients,” said Sriram Rajamani, Distinguished Scientist and MD, Microsoft Research India Lab to Express Healthcare. In a close collaboration with the Central TB Division, National AIDS Control Organization, and several implementation partners, 99DOTS has been scaled to every public-sector TB-HIV co-infected patient in India . “Government of India has fully embraced 99DOTS as a low-cost method for monitoring medication, which was standardised in the National Strategic Plan, 2017-2025. As on May 2018, over 100,000 patients have been registered and moni-

tored using 99DOTS. A recent call for collaborators received applications from 10 other countries across the world to pilot 99DOTS in their context and replicate it. Each of these proposals aim to adapt 99DOTS to the local context and deploy with 2,000 patients to demonstrate to national TB programme their impact and scalability,” he said. He also informed that the private sector needs to be invested in supporting government programmes to eliminate TB. The spread of drug-resistant strands is a global health epidemic with implications for countries with and without high prevalence of TB currently. “New technologies for

Experts realise that India’s goal to eradicate TB by 2025 is a tall task. “Although, India has significant strengths like a formidable government structure which can be leveraged, and partnerships with national, international NGOs, community organisations and a large reservoir of expertise in diagnosis and treatment, elimination by 2025 is a very ambitious goal, but it is worth striving for,” Castro highlights. Informing that 2025 target is bold and courageous, Pai said, “Anyone who understands TB knows the 2025 goal is not realistic. But, the international TB community appreciates the ambition displayed by India. It is great to aim high and even if India doesn’t reach that goal, it would still represent progress if the TB Free India campaign is implemented.” However, effective policies, well-trained healthcare workers, awareness, empowered patients, and enabled healthcare workers to identify, counsel and programmes to prioritise and target, will bring in the momentum to end TB menace, voice health experts. We have a long road to traverse before we eliminate an ancient disease that has plagued humans for thousands of years. It is to be hoped that with dedicated commitment from all stakeholders and concerted efforts, we would soon turn the tide against TB and vanquish it forever.


Investing in health has an advantage for India Prof T Sundararaman, Dean, School of Health System Studies, TISS, speak about healthcare trends in 2018 and how these developments will impact the overall Indian healthcare scenario, in a conversation with Raelene Kambli

What are the new trends that you anticipate for the healthcare sector this year? And what changes will these trends bring in? The most hopeful trend that we see in the healthcare sector is the proposed development of the health and wellness centres. These centres are giving huge impetus to comprehensive primary healthcare in the recent times which wasn’t there earlier. It was mentioned in the budget speech, but it did not get picked up in the subsequent dialogue. This trend can be a big driver for change within the sector. A change in perspective for healthcare delivery- a more focussed one on providing value-based care to patients. Can you spell out what health and wellness truly mean in healthcare delivery? Health and wellness centres if they play out well, it would be going beyond the traditional boundaries of providing care. For example, primary healthcare which was largely looked at as women and child health restricted to immunisation and a little aid to women pre and post pregnancy; today, this has transitioned to become more focussed on a wider range of preventive and promotive care - inclusive of both communicable and noncommunicable diseases. So we are talking a lot of prevention — and that too what is called secondary prevention. We are talking about detecting hypertension, diabetes and many more lifestyle related diseases and trying to curb

their rise as well as complications and deaths due to these diseases. Moreover, providing effective screening mechanisms and diagnostic services to patients so that they are assured of early and appropriate treatment which would ensure that their life expectancy is normal. Premature mortality due to these diseases can be averted. How will these trends bring in profitability to healthcare organisations who offer these services? Managing health and wellness centres is not a profitable venture unless we look at it as a vehicle for creating social capital and public good. This type of healthcare is better characterised as a merit good. That is why in this area even the only form of private participation sought by the government in the budget speech is through CSR and philanthropies. At the societal level though investing in health and wellness centres is profitableit usually takes around 10-15 years to get returns. Moreover, investment in healthcare is more likely to ensure a demographic dividend to the country. Demographic dividend refers to the growth in an economy that is the resultant effect of a change in the age structure of a country’s population. The change in age structure is typically brought on by a large cohort of young and productive population that goes along with a subsequent decline in fertility and mortality rates. So how can investment in

Health & wellness centres if they play out well, it would be going beyond the traditional boundaries of providing care healthcare provide demographic dividend? Well, investing in health, has an advantage for India. Since, our country has a huge young population, investing in their health will increase economic ability leading to a phenomenal growth in GDP. Currently, the US and the UK are a having a GDP growth rate of 2-3 per cent and we are at around seven per cent. At the time of their demographic dividend they too had such high growth rates. But if we look at

improving our health and wellness system, we can boost our GDP further and sustain these growth rates for longer.

diagnosis and treatment of cancer and it may be relevant even in all chronic diseases. Yet, it is still at a nascent stage.

Tell us about the innovations that can propel growth for Indian healthcare. There is a world of possibilities with respect to medical devices. We (government and researchers) are looking at a non-invasive haemoglobin measurement device, which can measure haemoglobin level without a prick. Technologies which can identify neonatal deafness and thereby eliminate muteness, microbial cultures that can identify bacterial infections within a short span of time, and a hundred other such technologies are emerging that can have a far reaching positive effect. Point-of-care technologies is another innovative area that has a great scope. There is also a scope in improved systems of health services delivery.

Will genomics add to healthcare cost? What should companies do to make these services cost effective and affordable to all? At present, yes it will add to cost. But if effective cost strategies are put in place, especially in the public health domain, volumes would be driving costs down thus, bringing the values that people are looking for.

You are talking about diagnostic tools and innovations. Do you think this will give impetus to the diagnostic sector? Yes. Especially, diagnostic innovations that are frugal and suits the needs of the Indian population. Such innovations and companies providing such services will have a huge potential to grow in the near future. What is your opinion on genomics then? Well, genomics does have a great potential in India. It will have a lot of relevance in the

What role can behaviour science play in improving healthcare cost burden in India? Behavioural sciences have a tremendous role to play in improving the effectiveness of healthcare delivery. But I am not sure of its contributions to driving down costs. In healthcare, typically outcomes are very uncertain and choice of care is complex. Healthcare markets do not work in the way other industries work for commodities and services. Paying for healthcare at the time of need does not give much room for choice. If you are ill, you will have to pay as there is no choice involved. Behavioural sciences have been used by health management organisations to shape markets for greater consumption of healthcare services. It can play a role in shaping markets for better health practices and more rational use of therapieswhich together should be able to reduce societal costs on healthcare.



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Role of RPA in improving healthcare and insurance industries Optimised RPA drives a faster, more impactful business outcome and RoI, believes Ram Mohan Natarajan, Senior Vice President – Business Transformation, HGS. In an interview with Raelene Kambli, he speaks of its relevance for healthcare organisations What is the rationale behind the concept of robotic process automation (RPA) in improving today’s healthcare payment process? Are there any relevant studies that prove this concept? If you look at the way healthcare companies — consisting of payers and providers — work and interact with their customers/ patients, one would say it’s complex and traditionally been inundated with back office processes that required human intervention to run them. The processes are varied and could range from patient scheduling, billing, claims processing, selling of insurance policies, underwriting and updating database of hospitals. In the last couple of years, although healthcare companies have been automating many of their processes continuously on their own, there are still a huge volume of exceptions that require human intervention. These healthcare companies across the globe and their business process management (BPM) partners have been adopting automation technologies, especially robotic process automation (RPA) to help them streamline some of these manual processes. RPA, as a primary tool for automating processes, is used to automate these exceptional cases within a shorter time span without any huge investments. The objective is to increase efficiency and accuracy, faster turnarounds and enhanced customer relationships. Of course, companies and geographies



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are at different levels of maturity in terms of adoption. With healthcare costs rising year-on-year and the changing demographics towards a huge ageing population, studies and HGS’ own experiences show that RPA can drive significant savings in costs, time and effort. For example, a report by Alsbridge says that a healthcare claim requiring human intervention costs approximately $4 to process while the cost-per-claim with RPA systems can be as little as $1.25. The turnaround time can be reduced by at least 50 per cent. The effort saved on administrative tasks can be instead focussed on front-end activities such as patient care and customer experience. How does one go about choosing the right RPA approach? Although RPA has proved to be beneficial for many healthcare organisations, I would say they are yet to be utilised as per its true potential. Before you start using RPA as a tool to minimise your process-oriented work, you need to first identify and select the processes that need to be automated, understand the type of RPA operating model that will best suit your existing organisational processes, and plan your implementation and execution strategies. Don’t just look at layers. It is critical to assess individual processcentric candidates, score them according to their efficiency and level of complexity, and then prioritise them. Dig deeper and consider factors

such as volumes, number of FTEs used to run the process, average processing time, etc. Evaluate the kind of data and inputs — is it structured or unstructured? Check if the processes are rule-based and heavily relying on human directions, and the number of exceptional cases managed.

A McKinsey report on emerging and disruptive technologies has predicted that automation technologies such as RPA will have a potential economic impact of nearly $6.7 trillion by 2025

Will RPA mean lesser human intervention? The idea behind implementing RPA is to help organisations to automate their repetitive manual processes, reduce costs incurred, and enable faster and accurate processes. However, it does not mean that implementing RPA will negate the need for human workforce. While RPA is likely to replace certain tasks performed by people, humans will still be required to complete these processes, especially where decision-making is critical or interaction with customers is needed. It is more like a combination of robots and human brains working together, something we refer to as ‘Bots and Brains’ at HGS. As industry experts, what we predict is redistribution of the jobs performed by humans that need more analytical skillsets, strategic decision making, and most importantly, maintaining customer and client relationships. Thereby, the nature of jobs will change. Does RPA positively affect real-time business needs? Although RPA is primarily considered to be a mid- to longterm solution, it can also be a powerful tool to positively

affect your real-time business needs. With RPA, your business processes are automated to help you to get the work done more quickly at reduced cost and more accurately. In a contact centre, typically agents will have to refer multiple applications to answer a query where RPA can help make it easier for the agent and help resolve queries faster. How can organisations design strategic human expertise with end-to-end process automation? A 2017 Ernst & Young report revealed that between 30-50 per cent of RPA projects fail in its initial trials. This could be due to choosing the incorrect RPA candidate process, lack of proper governance or disconnect between the business processes. In order to ensure that strategic human expertise is made an integral part of the end-to-end process automation, you need to smartly bind the suggested automation steps with that of human-driven processes and the aligned decision-making. While there are steps that can be completely automated, there are also certain processes that are not rule based and require decisionmaking strategies to complete the process. In such scenarios, it is important for the organisation to understand the working equation of robots and human brains, and use them to have a bigger and higher impact on the business. How does optimised RPA

impact a healthcare organisation’s business outcome and RoI? Can you share some relevant case studies and examples? RPA does offer immense business value. In fact, a McKinsey report on emerging and disruptive technologies has predicted that automation technologies such as RPA will have a potential economic impact of nearly $6.7 trillion by 2025. As a healthcare organisation — be it payer or provider, don’t just go with the hype and trend. Be sure to evaluate which of the processes are suitable for automation and how automating these will result in increased productivity of your existing workforce along with utilisation of their skillsets to resolve complex tasks and increase business value. As for examples, healthcare providers need advanced automation solutions for assisting in tasks such as billing, claims processing etc to make them more efficient, eliminate paperwork and reduce time for completing the task. This has also resulted in increased levels of customer satisfaction. This sector has witnessed a gradual transition from being a provider of services through human labour to one offering quality services through technological intervention. How HGS' RPA solutions are contributing to the healthcare insurance sector? How does this add value? HGS’ back-office automation solutions are designed with an end-to-end intelligent automation approach that leverages design thinking. Our solutions include self-service and RPA along with cognitive learning and natural language processing, which drive significant process improvements, error reduction and speed. Our solutions are technology agnostic and leverage analytical insights to improve complex processes. With healthcare being our biggest vertical, HGS has implemented these solutions for several existing US-based



June 2018

clients who are looking for cost transformation and enhanced customer experience. This goes beyond the much needed transaction-based engagement to more proactive, preventive healthcare assistance. To give an example: we have partnered with a top five US

healthcare payer to transform the way our engagement with them is operating, including finding ways to re-engineer existing processes by eliminating, simplifying and automating multiple processes through RPA. Result: More than $3 million in annualised

cost saving, over 99 per cent accuracy in transaction quality and 40 per cent reduction in FTE requirement across queues. Another example is HGS helping the international arm of an insurer to improve member engagement and adopt an agile operational

model through a combination of RPA and advanced analytics. We have also developed Centers of Excellence in both automation and analytics to create a bigger impact for the clients we serve.


Medipta app aims at urban and rural healthcare management by providing e-health facilities at very affordable cost We are flooded with various health apps that target patients and healthcare providers both. Each of these apps promise to bridge the access gap within the sector. However, which one of these really solve the healthcare issue and how many of these can make it big? These are some questions that health start-ups are usually faced with. Rahul Bojalwar, Founder & CEO of Medipta Solutions answers few of these questions in an interaction with Raelene Kambli

Digital technologies are playing a key role in the prevention and promotion of health and wellness. Where does Medipta fit into this? Nowadays digital technology is used in every field. Digitalisation has changed our lifestyle. Likewise, healthcare is also using advance digital technology to provide quality healthcare services. Digitalisation in healthcare has improved availability and affordability of not only medicine but also all healthcare related services. Medipta is an ultra-modern healthcare platform where every entity in healthcare is a beneficiary. Medipta has a facility of telemedicine and is promoting preventive health check-ups and e-health services with the help of health screening devices. This app aims at urban and rural healthcare management by providing e-health facilities at very affordable cost. What is your vision for healthcare delivery in India? Medipta app is here to offer the most reliable, hassle-free, transparent, convenient and cost-effective healthcare solutions to you. We are currently working on different projects to serve the urban and rural population. We are also working with various public sector units on



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health check-up plan which can be availed for ` 30, ` 50 and `75. Medipta believes that it will generate more than 5000 jobs in the next coming years. Very few really solve the healthcare issue and many can’t make it big or even sustain their business model for long. What is your say? True that is. Healthcare is a vast sector in India and it has many challenges at every level. I cannot comment on other players, however, we got into the market only after a comprehensive research which has helped us to come up with a sustainable model in the existing market with our existing resources. Our research entailed us to come up with a 360 degree umbrella for healthcare where associations and collaborations would be the backbone of the business model and it will sustain as every player of the ecosystem would want to sustain. And we are strive not only to sustain but to make it a big for everyone. Tell us about your app and how it is solving India’s healthcare needs? Medipta is a web-based mobile app for all healthcare services. It is helpful for patients as well as all the entities involved in healthcare industry. ◗ Patients can get all healthcare

Medipta believes that it will generate more than 5000 employment in next coming years through their different projects

services right from finding the right doctor, booking an appointment, medical insurance, to getting your medicines delivered right to your doorsteps. ◗ Doctors can get access to patient’s information and guide them accordingly. They can also maintain records of patient’s prescriptions. ◗ Chemists/pharmacists can supply medicines to patients at door step and maintain eprescription for patients. They can also get stock inventory information on this app. ◗ Test labs/ radiologist/ diagnostic centres can provide lab tests and diagnostic facilities to patients and upload reports online. ◗ Stockiest can supply medicines to chemists as per necessity. They can track their order as well. ◗ Insurance agents get customers through direct inquiry. ◗ Blood bank can update stock so it will be easy for everyone. ◗ People can connect with ambulance and blood banks any time and the ambulance can reach with the help of Google Maps. ◗ Fitness experts can give tips, tutorials and guidance for healthy diet through personal chat facility. ◗ Woman can track monthly period cycle. And at the same time complete pregnancy to

understand baby’s growth week by week. Is this your first venture? Medipta is the 3rd venture in technology and 1st in healthcare. Before this, we have successfully managed six ventures in the span of 10 years. Explain to us your business model? Why is it different or unique? Medipta app is free for patients and doctors. We can avail free ambulance service, blood banks as well. Chemists, retailers, labs, hospitals, distributors and insurance agents are charged. Medipta sells diet plans also. Telemedicine and health screening devices enabled by mobile Bluetooth is an additional feature of this app. Medipta is using this feature for Arogya Setu which will promote rural healthcare management by offering affordable services at very cheap cost. Medipta is an app where all the entities of healthcare services are getting connected with user-friendly digitalisation. Medipta app is available on mobile and web for healthcare providers to give services. Everything will be saved on cloud and it will be easy to share online reports, prescriptions. It will save time of healthcare providers as well as of patients.

Why do you call yourself a 360 degree platform that serves healthcare needs? We are serving anything and everything in healthcare services. Medipta connects patients, doctors, diagnostic labs, chemists, hospitals, blood banks, ambulance, insurance agents, fitness experts, telemedicine and preventive health check-up devices. We also customise the best healthcare packages understanding your financial conditions. And not just that, this smart platform also offers suggestions for your family’s stay at hotels near the hospital. It provides data on doctors, appointment booking, cost analysis and best available treatments in addition to an exhaustive database on pharmacies and diagnostic labs nearest to you. A virtual cloud fed with all your medical records can be accessed by your doctor, pharmacist and lab technician to ease your hassles with paperwork and repetitive visits. Tell us about the funding and revenue? Medipta is completely based on my bootstrap money so far. There is some small strategic investment by e-Zest Solutions. How does bootstrapping help a start up to be sustainable? I am a serial entrepreneur. My experience says, one of the considerable challenge for a start- up is finding reliable ways for funding. Using your own capital to make your start-up grow, is also very much challenging. I chose bootstrapping. It may limit my plans for initial few years, but at the same time you need not worry about the demands of outside investors. If you have skill to manage your finance then you can sustain in the market. Can you tell us about e-Zest Solutions’ investment share or how they are involved with your company? e-Zest Solutions invested money in Medipta as a strategic investor one year back. They found some unique features in Medipta and its expansion plan,



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and that is why they are helping us for our product strategy. What are your strategies to create brand awareness? We have launched this product recently. To increase awareness of the app, we are using social media optimally. Electronic media ads would be out soon.

Simultaneously, we are aggressive on strategic partnerships. Association with MSCDA is an outcome of it. Few more partnerships for larger reach and brand awareness is in pipeline. Every healthcare service provider player in the market is our potential partner and we

welcome them to associate for mutual benefit. In near future, our new project called ‘Aarogya Setu, part of Medipta, would soon be out in public domain. How are you building more partners for your business? Medipta is an app with unique features. We are not those who

pitch their products to investors. We are those who are open for partnerships. Medipta considers every other healthcare provider as a colleague who are serving in the industry, and we welcome them to partner on different fronts for a larger benefit of all.


There is certainly an increased prospect of enhanced cooperation between the two countries Netherlands, being the fifth largest FDI investor in India had recently deliberated on working together on the National Action Plan on AMR. The discussion was part of the recent visit of the Dutch government to strike business partnerships in the healthcare and pharma sector between the two countries. Dr Nupur Kohli, Founder Director, Netherlands-India Information Services, NIIS Health, elaborates on the synergies between the countries and how it was provide impetus to India, in an interaction with Prathiba Raju Why is India an important partner for the Dutch government in terms of healthcare and pharma sector? Update us on the key developments in the IndoDutch healthcare partnership? India is an important business partner of the Netherlands. About one fifth of India’s export to Europe enter through the Netherlands. The bilateral trade between Netherlands and India is $7 billion. The Netherlands is also the fifth largest FDI investor in India and about 200 Dutch companies are present in India. Healthcare and pharma are specifically recognised by both governments as one of the prime areas of cooperation. The Netherlands is renowned for its affordable and effective public-private healthcare system delivering quality care, which constantly is ranked high internationally. Innovation in healthcare devices, systems and services is key to high quality of Dutch healthcare. The Netherlands ranks in the top five of the Global Innovation Index. What is the focus of the Dutch government’s visit this year? Did any partnerships were finalised between the Netherlands and Indian companies? The Prime Minister of the Netherlands has brought a delegation of 28 healthcare companies to India. The delegation interacted with



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Indian counterparts and several MoUs were signed between the Dutch and Indian companies, for example to increase cooperation on new vaccines and affordable medical devices. At the government level, the importance of collaboration in the global fight against Anti-Microbial Resistance (AMR) and the joint efforts made by the relevant health departments and agencies of the two countries in identifying areas of cooperation under India’s National Action Plan on AMR was discussed. The leaders of both the countries also took note of the selection of the Krishna district in the state of Andhra Pradesh for the implementation of a pilot project using the ‘One Health’ approach under the IndoDutch collaboration on AMR. With the decision to relocate European Medicine Agency (EMA) from London to Amsterdam (Netherlands), how will the partnership between India and the Netherlands provide impetus to the pharma sector in both countries? EMA is being relocated from London to Amsterdam. Cooperation with the Netherlands in healthcare and pharma sector will be a winwin situation for both the countries as the agency grant can provide access to Indian companies in the European market. There is certainly an increased prospect of

How do you see the new Ayushman Bharat - National Health Protection Scheme (NHPS). Do you think it will change the Indian healthcare system?

enhanced cooperation in the pharma segment between the two countries. Why is India an important partner for the Netherlands — specifically in terms of cost-effective vaccine development? India, known for world’s leading generic drug exporter, is emerging as a sought-after location for sourcing low-cost vaccines. Vaccines made in India are already an integral part of immunisation programmes all over the world through UN agencies. Indian expertise and vast data can also be used for research and innovation. Indian companies are also using costeffective technologies to improvise the vaccines to withstand possible adversities in hostile climates to ensure efficacy.

The Dutch Prime Minister spoke about it in his speech at the recent trade mission to India. He said that the Netherlands is committed to help India in achieving the objectives of Ayushman Bharat - National Health Protection Scheme (NHPS). He emphasised Dutch companies to take part in the projects related to this scheme and the Dutch Government will provide the much needed support. How much has Brexit helped the Netherlands to woo players in the healthcare and pharma industry? The relocation of The European Medicine Agency (EMA) from London to Amsterdam will play a big role in attracting pharma industry to do business with the Netherlands. Also after Brexit, many multinational companies serving mainland Europe find it easier moving across the border to the Netherlands where English is an acceptable language. It is expected that in near future both for healthcare and pharma industry, the Netherlands will emerge as a gateway to Europe. Any projects proposed by the Netherlands in non-

communicable disease viz areas such as elderly care, diabetes, hypertension and mental health? This area needs to be explored further. My purpose was to be a part of the delegation and explore these areas. Discussions were held with several key players. After preparing a report, a proposal will be sent to the Dutch Government highlighting further possible course of action. Tell us about Indo-Dutch Living Lab for e-health which is currently under development in Bengaluru. What are its benefits? The Indo-Dutch Living Lab provides a bilateral platform between the Netherlands and India, public organisations and higher education institutions from both the countries. The overarching theme chosen for the Living Lab is ‘access to affordable healthcare via means of eHealth.’ Three sub-themes are defined – diabetes and hypertension, mental health and elderly care. A call for research proposals under various sub categories is initiated. A letter of intent (LoI) was also signed with Government of Karnataka on exchange of research students. In the next phase, research projects will start involving various stakeholders from both the countries.



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‘We are well prepared to respond to healthcare challenges in India’ Daniel Mazon,Vice Chairman and Managing Director, Philips Indian subcontinent, in an interaction with Express Healthcare, talks about the Indian market, PPPs and new product offerings What kind of transformation you would like to see in Philips India Healthcare, under your leadership. Share your Latin America experience. Philips has been in India since 1930; that is almost 88 years in the country. In these years, the company has grown into a trusted home grown brand. With R&D, manufacturing and service assets, we believe we are well poised to further build on our India capabilities and positively influence the lives of 500 million people in our region by the year 2025. With the government’s focus on healthcare in India, there is a lot that companies like ours can help healthcare become more accessible, strengthening the hands of the government. As part of this transformation we have been category creators in the personal health areas, with many new product introductions and new and innovative healthcare solutions to increase access to care, tuned to Indian needs. Coming from Latin America, I find many similarities. We share similar values like joint families, as well as celebration of our specific culture and customs. At the same time, like in most emerging markets, we need a lot more infrastructure and a systematic approach to extend healthcare to all. As a country, India is fascinating with so much diversity and boundless energy. To harness this positive energy, we need a holistic approach to healthcare - one that takes into account acute care and the rise in chronic diseases. Today, in the metros, one has access to excellent



June 2018

healthcare; there is a lot of awareness of the health benefits of cancer screening, air purifier or, say, an air fryer. The challenge here is to extend these facilities, infrastructure and awareness in tier-II and III cities. In the healthcare area, the doctor patient ratios are low, access to care is a challenge. We cannot do this alone and will have to collaborate with very capable organisations, prime among them being the government. With Public Private Partnerships (PPPs), we can overcome challenges and positively affect the country’s population. We have a lot of global experience in PPPs and believe that this transparent and resultoriented approach can be truly game changing. This is the kind of transformation that we are looking at. What are the ways in which you are planning to boost healthcare in the country by using innovative technology? Healthcare in India is expected to grow multi-fold. Philips is no longer a large multi-industry conglomerate, but a focussed health technology company. With our innovative and technology driven offerings across the healthcare continuum, we are well prepared to respond to healthcare challenges in India. With products for healthy living, prevention, diagnosis, treatment and homecare, we are positively impacting lives in India. Be it with our products for sleep apnea or our low dose imaging technology, we are truly ahead of the curve when it comes to enabling access to

healthcare. Across cardiology, oncology, sleep and respiratory care, critical care and patient monitoring, with better technology, we enable great clinical outcomes for both care givers and patients. This is the power of innovation in healthcare – the ability to ensure great outcomes!

subsidiary of Philips India, focusses on improving people’s health and enabling better outcomes across the health continuum from healthy living and prevention, to diagnosis, treatment, and home care. To provide these services, Philips maintains a team of nurses, para-medics, respiratory therapists and other trained personnel, who is monitored remotely by doctors. Some of the key services provided include personalised care plan under supervision of doctors, home care visits by medical professionals, monthly, half yearly and yearly care plans with devices, remote patient support and efficient care delivery through technology. The patients benefit from improved quality of life through better clinical outcome and cost-effective treatment. Home care is very well suited for patients suffering from chronic respiratory illnesses like Chronic Obstructive Pulmonary Diseases (COPD).

How important is the home healthcare business in India? How do you see the growth of the Philips Home Care Services (PHCS) segment? Philips entered into the home healthcare business in India by floating a new entity Philips Home Care Services and is currently present in six cities namely, Delhi NCR, Bengaluru, Hyderabad, Mumbai, Pune and Chennai. It is a high-quality health service, offered to an extensive range of healthcare settings at a patient’s home, to make them feel comfortable. The new entity, a 100 per cent

Philips India has been doing a lot of PPP with the state governments. How and why PPP is prioritised? PPPs are critical for us because they represent a way for us to work with the government and other partners to propose solutions to some of the outstanding challenges in healthcare. We have worked on this model globally to great success and we are replicating the same success in India. Our approach is to identify PPPs in areas in which we excel – cardiology, oncology, respiratory diseases and pregnancy and parenting. We

want to impact both at the preventive stage and at the later treatment stage. The watchword here is value, which really is the outcome of all our efforts. With PPPs, we can create healthcare access, lower costs and ultimately bring better healthcare to tier–II and III India. It is not only about bringing in the technology. It is also about the supporting infrastructure, the connectivity, productivity, the maintenance capabilities, the staff and the training among others. All these are required for sustainable and transformational growth. We have to be ready to respond to evolving and changing challenges if we are to effectively collaborate with the government and our customers. With more than 30 ongoing PPPs in the country, this calls for sustainable and transformational growth. Can you give us details on usage of AI-based solution in healthcare, how Philips solutions is helping the patients at large? AI-based solutions have a huge potential to improve patient outcomes and care efficiency. At Philips, we use the term ‘adaptive intelligence’ to talk about applying artificial intelligence in a meaningful way that improves people’s lives. Adaptive intelligence combines artificial intelligence and other methods with knowledge of the clinical, operational, or personal context in which they are used. Adaptive intelligence supports solutions that adapt to people’s needs and extend their capabilities – helping

healthcare providers to achieve better outcomes at lower cost, and helping consumers to live healthy lifestyles. A few solutions that have been developed from Philips Innovation Campus, Bangalore are: ◗ Philips HealthSuite Insights the HealthSuite Insights platform is a set of tools and technologies to address the advancing adoption of analytics and artificial intelligence in healthcare. The platform addresses the complete ‘end to end’ process of analytics and AI asset creation, deployment, and support. It reduces the logistical challenges of installing AI-based solutions in research and clinical set-ups. It

accelerates the development of analytics solutions, and reduces development and total cost of AI solutions. ◗ AI can be used in the automatic screening and early detection of some of these diseases. Take for example tuberculosis. Highly effective models that have been trained on millions of data sets can identify the positive cases from a simple chest X-ray with a high degree of confidence. This can be an effective tool that can be used by clinicians in rural India for early screening, thus enabling early intervention and positive outcomes. ◗ Philips Mobile Obstetrics Monitoring (MOM) is a software solution that helps unite information and action to identify and manage a highrisk pregnancy by bringing

care to where it is urgently needed: primary health centres and patient homes. MOM empowers community caregivers to capture vital information during home visits, enabling antenatal risk stratification, diagnostic assistance, and progress assessment through mobile applications. Is the investment in India made by Philips bearing fruit? What is your opinion about the Indian market as compared to the other markets that you operate? What will be the Philips investment in the next few years? As mentioned above, we are a very strong and homegrown brand with a local presence of more than 88 years spanning

back from 1930. Over the years, we have built significant assets in the country including strong product portfolios across lighting (which we hived off in 2015), healthcare and personal health. Today we are a healthcare technology company with a very strong presence in India including innovation and manufacturing centres. We offer some of the most comprehensive portfolios stretching across healthy living, prevention, diagnosis, treatment and home care. These investments, which we have made in technology, in innovation, in people and in expanding our presence in India, have put us in a very strong position to positively affect the lives of 500 million

people in the region by 2025. This it is a testimony to our success in India and a pointer to the importance of India in the global pie for Philips. What is your growth outlook for India? We are very positive about India and will continue to invest in the country. Going forward, we will focus on ‘Make in India’, localise our solutions, hire more staff and continue to innovate from the country. The government’s initiatives encourage us and the recent budget’s focus on healthcare is the way to go forward. At Philips, we will continue to transform and grow in collaboration with our partners like the Government of India to the country’s outstanding healthcare challenges.


Tips to de-stress for patients with CKD Dr Shabana Mohammed Shamsuddin, Senior psychologist, DaVita Care (India), gives an insight on the need for proper guidance to treat patients with chronic kidney disease BEING DIAGNOSED with any kind of chronic illness leads to inevitable changes in the lifestyle and emotional makeup of people. Proper guidance and a will to live life to the fullest with whatever resources available can help patients to reduce their stress levels. The ability to cope with stress when on treatment for kidney disease depends on various factors such as relationship status, working life (professional or homemaker), support systems and financial dependence, among others. These factors affect the outcome of various measures taken to cope with the disease. Other influencers of stress while dealing with chronic kidney disease (CKD) include resources at hand and the ability to take appropriate action to cope with the disease. The following tips may be useful to help manage stress related to CKD.

Accept the illness

you can rely can help you tide over the situation.

Accepting your illness is the first step towards managing your chronic condition.

Ask for help Communicating your needs to your family, friends and your team of doctors can help you bring down the stress levels.

Prioritise your own health Do not feel guilty to prioritise your health and happiness.

Have realistic expectations Be happy if your expectations are reciprocated; if not, learn to take upsets in your stride. The goal is to become self-dependent.

Understand that it’s okay to feel sad Be mindful of what's going within you, accept your feelings and overcome your lows.

Talk to someone willing to listen Sometimes it helps when we talk out our problems to people who are non-judgemental.

Do not look for external

Adherence to treatment validation Take charge of your health and make your own decisions. Know when to seek professional guidance.

Go for dialysis sessions regularly and stick to the treatment plan to help reduce the chances of complications that may arise out of non-compliance.

Stay active

Reschedule work hours

Participating in joys of life can add to improving the quality of your life.

Adjust your work hours to accommodate dialysis sessions or visits to the nephrologist.

Demarcate finances for treatment

Ask questions

Have a support system

Speak to your doctor and seek help in managing specific health issues. It is important to pay attention to your emotional and sexual health to achieve an overall sense of well-being.

Staying connected to your friends and family on whom

Acknowledge the efforts of caregivers

Judicious planning of finances can help you better manage your stress-levels.

Acknowledging the efforts of your caregivers and understanding their limitations can reduce friction and induce positivity.

Seek professional help to cope with stress, if necessary Whenever you feel overwhelmed or not able to cope with your situations/problems, do not hesitate to seek professional help. Educating yourself about your disease condition and treatment plans, making the necessary changes needed to lead an active life and taking responsibility for cutting down stress levels can help you to adjust to new conditions. Do not feel guilty about prioritising your health and its needs. Disclaimer: This article is for informational purposes only and is not intended to be a substitute for medical advice or diagnosis from a physician.



June 2018


Afull range of capabilities for printing needs Praveen Rajgopal, General Manager, Medical Film and Printing Solutions, India Cluster, Carestream, elaborates on Carestream’s innovative solutions FOR MORE than 100 years, Carestream’s innovative solutions have helped make our customers more successful with a complete portfolio of solutions for medical imaging. We pride ourselves on being a company of firsts — the world’s first packaged X-ray film, the first medical dry laser imager and the first proven wireless digital radiographic detector are all part of our heritage. With more than 800 patents for medical and dental imaging and information technology, Carestream remains a worldwide leader dedicated to exceeding our customers’ expectations and delivering solutions that support improved patient care and physician satisfaction. Carestream’s Dryview Laser Imagers offer a complete diagnostic imaging portfolio. This portfolio includes medical printing solutions for the entire imaging chain including computed radiography, digital radiography, HIS/RIS, PACS, hardcopy digital output and traditional film. Having pioneered the use of dry laser imaging technology in India, the Carestream DryView Laser Imagers have established a market leadership position in better diagnostics, treatment planning and record formulation. DryView image quality is legendary for its ability to consistently deliver exceptional diagnostic image quality. It uses dry laser imaging technology that exposes each pixel with light rather than heat, resulting in consistent film quality and less need for service. Combined with our Automatic Image Quality Control (AIQC) technology that automatically calibrates film and imager settings to meet specific user preferences, and offers consistent film quality no matter how many films are printed.

simplify instruction, operation and user training. ◗ Easy film loading with cartridge technology. Each cartridge holds 125 film sheets to minimise loading frequency. Film size changes are made easy by simply exchanging film cartridges. ◗ Different film sizes and types, online at the same time, which can reduce the need to refill films or change cartridges to accommodate mammography or other types of imaging. Choose from a full line of medical printing systems to find the laser imager best suited to the needs.

The DryView Laser Imagers simplifies the user experience as it offers several advantages: ◗ The intuitive user interface includes a touch-screen user panel with built-in help interface to

Legendary medical image quality, innovation ◗ Flexible, high-quality laser imaging ◗ Tabletop printing convenience ◗ Low total cost of ownership



June 2018

films—which provide the aesthetic and diagnostic qualities you expect from Carestream Health. DryView films offer a popular cool, black image tone. Reduced glare and light transmission creates a familiar look and feel for the film and improves perceived image contrast. With low noise, superb density uniformity and excellent visibility of subtle detail, DryView Film delivers the precision and consistency one needs to make confident diagnoses. DRYVIEW DVE Laser Imaging Film offers distinct advantages that are clear to see. ◗ Offers extended shelf life with 24-month dating to avoid aging inventory issues and costs. ◗ A printed virtual notch provides smooth film edges, properly orients the film on view boxes and helps the film more easily slide into envelopes for storage. ◗ Simple film reloading – DryView Film cartridges load easily in full light and use minimal packaging. ◗ Many film sizes – With one of the largest film size selections on the market, a DryView Film is available to meet your specific imaging needs ◗ Lifetime (100+ years) archivability for printed films

Core detector


DRYVIEW 6950 Laser Imager Exceptional image quality, ultimate performance ◗ Fast speeds for fast-paced high-volume environments ◗ Flexibility to be used for a wide variety of applications ranging from traditional. CT, MR, CR & DR applications to more demanding full-field digital mammography and CR-mammography. ◗ Optional 5-bin film sorter


World-class service and support


◗ Built-in mammography capabilities ◗ Industry’s broadest solutions portfolio

CARESTREAM DRYVIEW 5700 Laser Imager Exceptional affordability meets great simplicity ◗ Innovative tabletop medical imaging system

◗ Offers simplicity and affordability for healthcare facilities of all sizes. ◗ A simplified installation process and easy operation DRYVIEW DVE Laser Imaging Film – Quality you Expect DryView Laser Imaging Films combine the advantage of dry laser imaging with high-quality

Carestream partners with customers to keep their equipment running at peak performance. Through Carestream Smart Link remote management services, the company provides technical support anytime, anywhere with remote monitoring and diagnostic solutions that track the status of our laser imager around the clock. Customer’s need is the topmost priority. Carestream’s focus has always been on developing a wide range of innovative products and solutions to meet every printing need of its customers with the best image quality.


Quality healthcare and beyond – PSRI perspective Dr Dipak Shukla, CEO, PSRI Hospital, gives an overview of how PSRI provides quality PUSHPAWATI SINGHANIA Hospital & Research Institute (PSRI Hospital) is a nationally and internationally reputed tertiary health care institution promoted by JK Organization. Institute started in 1996 with the Super Specialities of Gastroenterology, GI Surgery, nephrology and urology including kidney transplant surgeries. In last one year, PSRI Institute has added cardiac sciences, neurosciences, orthopaedic and joint replacement and liver transplant programme as the new four super specialities along with general medicine, general surgery, gynaecology, ENT, psychiatry and clinical psychology etc. were added to the institute. Apart from all these speciality, PSRI Hospital is equipped with world class state-of-the-art 42-bedded critical care unit. Since the inception of the institute, quality in healthcare has been central through the planning and operations of all the clinical disciplines and support services. To ensure quality and well defined patient care protocols, institute was accredited by ISO 9001:2008 in the year 2007. Subsequently institute got accredited by NABH for all the

HEAD OFFICE Express Healthcare® MUMBAI Douglas Menezes The Indian Express (P) Ltd. Business Publication Division 1st Floor, Express Tower, Nariman Point, Mumbai- 400 021 Board line: 022- 67440000 Ext. 502 Mobile: +91 9821580403 Email Id: douglas.menezes@ Branch Offices NEW DELHI Sunil Kumar The Indian Express (P) Ltd. Business Publication Division Express Building, B-1/B Sector 10 Noida 201 301 Dist.Gautam Budh nagar (U.P.) India. Board line: 0120-6651500. Mobile: 91-9810718050

clinical disciplines in 2012and NABL Accreditation for the Lab Medicine department in the year 2010. It is quality conscious approach, which enabled the institute to attain levels to have these prestigious quality accreditations, in due course of time. PSRI understands that an exceptional work culture is equally important for professional excellence in every sphere of the service imparted by the healthcare institutions. PSRI is known for a highly employee-centric and patient-centric work culture. Not many institutions are sensitive and demanding about a work culture which makes the employees proud and helps in inculcating sense of belonging while discharging their professional role through various portfolios. This approach has given outstanding outcomes to the institutes, across the world. Mayo Clinic and Cleveland Clinic are glaring examples which follows well-structured institutional culture. PSRI work culture has been aptly reflected in its vision and mission statement which are displayed in various locations of the institute. It ensures patients and visitors about their safety, security and professional handling at

Fax: 0120-4367933 Email id: CHENNAI Kailash Purohit The Indian Express (P) Ltd. Business Publication Division 8th Floor, East Wing, Sreyas Chamiers Towers New No 37/26 (Old No.23 & 24/26) Chamiers Road, Teynampet Chennai - 600 018 Mobile: +91 9552537922 Email id: BENGALURU Kailash Purohit The Indian Express (P) Ltd. Business Publication Division 502, 5th Floor, Devatha Plaza,

Dr Dipak Shukla, CEO, PSRI Hospital

PSRI. Institutional work culture is also reflected in the form of value system. PSRI has a unique value system.

The values are: ◗ Pursuit of service rather than profit ◗ Patient is first in planning and monitoring of all services ◗ Ensuring ethical approach in patient care ◗ Transparency of patient care at every level ◗ Pursuance of education and research for professional excellence and patient care

Residency road, Bangalore- 560025 Board line: 080- 49681100 Fax: 080- 22231925 Mobile: +91 9552537922 Email id: HYDERABAD E Mujahid The Indian Express (P) Ltd. Business Publication Division 6-3-885/7/B, Ground Floor, VV Mansion, Somaji Guda, Hyderabad – 500 082 Board line- 040- 66631457/ 23418673 Mobile: +91 9849039936 Fax: 040 23418675 Email Id: KOLKATA Ajanta Sengupta The Indian Express (P) Ltd.

◗ PSRI is team oriented This unique value system reflects the work culture at PSRI which has resulted into exceptional employee retention and leadership development at all levels. On one hand quality systems have helped in improving the procedures and flawless patient care at every level and on the other hand an exceptional work culture has projected PSRI team on the healthcare map of the country, as an institution committed for excellence in healthcare. Research academics and world class teaching and training programmes have further strengthened this culture. Therefore, we firmly believe that it is not only quality healthcare but beyond that which helps to make you different.

Awards ◗ Best Leading Multi-Specialty Healthcare Provider Award at elets Healthcare & Wellness Submit Conference Award 2018 ◗ Best Hospital Management & Operations Award at 8th MT India Healthcare Awards 2018 ◗ Swachh Hospital Award at South Delhi Municipal Corporation, South Zone ◗ Best Multispeciality Hospi-

Business Publication Division JL No. 29&30, NH-6,Mouza- Prasastha & Ankurhati,Vill & PO- Ankurhati, P.S.Domjur (Nr. Ankurhati Check Bus Stop) Dist. Howrah- 711 409 Mobile: +91 9831182580 Email id:

tal Award at Six Sigma Healthcare Excellence award ◗ Best Super Speciality Hospital for Nephrology & Urology Award at Times Achievers Award Delhi NCR 2017 ◗ Best Super Speciality Hospital for Gastroenterology & G.I Surgery Award at Times Achievers Award Delhi NCR 2017 ◗ Best Multi Speciality Hospital by Times Achievers Award at Times Achievers Award Delhi NCR 2017 ◗ Best Multi Speciality Hospital Award at 7th Healthcare Leaders Forum 2017 ◗ Most Trusted hospital (Editor Choice) Award at 7th MT India Award 2017 ◗ Best Super Speciality Hospital Award at 6 th MT India Health Care Award 2016 ◗ Best Hospital in Gastroenterology Award at 6 th MT India Health Care Award 2016 ◗ Best Multi Speciality hospital for patient satisfaction Award at World Wide Achiever International Award 2016 Best Hospital & Facility Management & Hospitality of the year Award at 5th MT India Award 2015 ◗ Best Hospitality Award at DOC N DOC 2014 ◗ Energy Conservation Award by Government of India 2014

AHMEDABAD Nirav Mistry The Indian Express (P) Ltd. 3rd Floor, Sambhav House, Near Judges Bunglows, Bodakdev, Ahmedabad - 380 015 Mobile: +91 9586424033 Email Id:

Important: Whilst care is taken prior to acceptance of advertising copy, it is not possible to verify its contents. The Indian Express (P) Ltd., cannot be held responsible for such contents, nor for any loss or damages incurred as a result of transactions with companies, associations or individuals advertising in its newspapers or publications. We therefore recommend that readers make necessary inquiries before sending any monies or entering into any agreements with advertisers or otherwise acting on an advertisement in any manner whatsoever.



June 2018


Liver transplantation at PSRI Hospital: Fulfilling dream of liver care for everyone! Dr Vasudevan KR, Sr Consultant - Head Liver Transplant & GI Surgery, PSRI Hospital Dr Neeraj Chaudhary, Consultant - Liver Transplant & GI Surgery, PSRI Hospital Dr Manoj Gupta, Consultant - Liver Transplant & GI Surgery, PSRI Hospital


your body can tolerate.

◗ Credible liver care - trust earned more than 20 years. ◗ Experienced team - handle any complication, making treatment safe ◗ Cost effective - personalised care in serene environment

What if we do not have a compatible live donor? ABO incompatible transplant are performed with results nearly as good as conventional compatible transplant. Organs from brain dead patients (Deceased donor transplant) makes a life saving transplant possible when there is no donor in the family.

Why a new liver programme? State of the art infrastructure has been developed to provide comprehensive care, even in very complicated liver disease. Our aim is to help make possible a transplant operation to every patient who need it!

How are we different? Small changes to the process have made the procedure very cost effective! A transplant operation is now more economical than one done 15 years ago! Though the costs have reduced, the safety has improved and results are getting better. Today 90-95 per cent success is the norm.



June 2018

What is ‘The Ascites Support group’? Dr Vasudevan KR Sr Consultant - Head Liver Transplant & GI Surgery, PSRI Hospital

Dr Neeraj Chaudhary Consultant - Liver Transplant & GI Surgery, PSRI Hospital

Dr Manoj Gupta Consultant - Liver Transplant & GI Surgery, PSRI Hospital

ELABORATE ON PSRI’S CONTRIBUTION TO CURE LIVER DISEASES What makes PSRI special? Liver care coordinator will be with you along your journey to attend to your treatment related needs! Removes the

anxiety, making recovery smooth. Constant support from patients who have previously undergone the procedure reduces the pain of the journey.

Can I avoid a transplant operation? Our medical specialists working with the transplant team will help manage liver disease with medication for as long as

PSRI started Ascites group to bring patients together having ascites, their care givers and those who have recovered from ascites, to form the Ascites support group. Members share their experiences, tips and tricks they used to navigate the disease. Most members find the support of the group and reassurance from the patients who have recovered as useful as the medication itself!


HMD launches Dispovan Insulin Pen Needle The needle is a precision engineered, yet affordable sterile single use pen needle, which can be universally fitted on all international brands of insulin pens

HINDUSTAN SYRINGES & Medical Devices (HMD) manufacturers of disposable syringes and auto disable syringes has launched ‘Made in India’ Dispovan Insulin Pen Needle to provide better comfort for people with diabetes at the Fourth Medical Expo Indore 2018. The Dispovan Insulin pen needle is a precision engineered, yet affordable sterile single use pen needle, which can be universally fitted on all international brands of insulin pens. With features like, ergonomic shape for improved skin contact and grip, extra thin wall, multi-bevel, tapered point, Dispovan Insulin Pen Needle is designed and manufactured by HMD with intent to offer a much less painful injection experience for diabetic patients. According to Rajiv Nath, Jt.Managing Director, HMD, “We are particularly excited about the prospects of our latest offering Dispovan Insulin Pen Needle manufactured in our state of the art manufacturing facilities, which will end India’s import dependency and the monopoly of BD. Patients will now be able to access an affordable quality product, which they need not reuse because it is expensive. We have received excellent feedback and clinical acceptance from the end users of a comfortable injection and glad that our investments in high end technology are giving us a competitive edge.” “With the launch of Dispovan Insulin Pen Needle we will contribute towards our ongoing commitment of making healthcare affordable for common people in India” said Pardeep Sareen, Chief General Manager-Marketing, HMD . Dispovan Insulin Pen Needle is manufactured at HMD’s Faridabad-Ballabgarh plant. The new plant is spread on an area of 5.5 acres and will have

Dispovan Insulin Pen Needle is manufactured at HMD’s Faridabad-Ballabgarh plant.The new plant is spread on an area of 5.5 acres and will have the capacity to initially produce over 100 million units per annum of ‘Dispovan Insulin Pen Needle’to meet the rising export for its new technology the capacity to initially produce over 100 million units per annum of ‘Dispovan Insulin Pen Needle’ to meet the rising export and domestic demand for its new technology. Every Needle point is checked online by a Digital Vision Camera System for a defective, blunt needle point and such needles, which can be potentially painful are rejected automatically on line,

he explained. The proprietary dry silicon coating used by us makes the needle surface slippery to ensure comfortable injection. Dispovan Insulin Pen Needle has needle gauge option of 31G & 32G with needle length of 5mm & 4mm respectively and comes in purple and green colour shade to enable visual recognition of needle size.



June 2018


OPTIMAlife science completes complex turnkey project The large turnkey line is one of the most complex projects that Optima Life Science has built PRODUCING, PACKAGING, and cartoning of wound dressings. The Optima MDC300 advanced delivers a high performance system and has been in operation since October 2017. The large turnkey line is one of the most complex projects that Optima Life Science has built. Due to the high output of the line, the customer is able to double their production capacity. This is the third converting system that the customer has

tomer, “Our customer was looking for an extremely high output machine. With the MDC300 advanced machine we were able to offer him the appropriate solution.” The customer already has several wound dressing lines but the capacity is insufficient to cover the demand of the market.

“The machine has a very high

The complexity of the project mostly stems form the number of process steps, reports the project manager. 100 functional modules were required. The cartoning machine places the product into a ready-to-sell

entrusted to OPTIMA. The system is equipped with more than 100 functional modules and can achieve run rates of up to 600 packs per minute. These are the impressive numbers of the wound dressing production and packaging machine that doubled the production of an Optima Life Science customer. In addition to manufacturing the product and primary packaging into bags, the line also handles secondary packaging into cartons. Web converting machines are very impressive due to their complex functionality and their sheer size. The project, completed in October 2017, however, is also very special for the Optima Life Science experts. The machine is processing post-surgery wound dressing – a well-established product. Therefore, the output is paramount and the right choice was made with the MDC300. Florian Härpfer, Project Manager, described the most important requirement of the cus-

output and at the same time is also very efficient,” says Härpfer. “We integrated an automatic splice table on each unwinding station. Therefore, the machine does not need to be stopped to change a film roll this provides an uninterrupted production process. As soon as one roll is empty, the machine automatically engages the next roll and continues with production. Optima Life Science is a specialist in manufacturing multi-layer wound dressing machines with the so-called web converting and designs laboratory and small batch machines, as well as high output machines such as the MDC300 advanced. Optima has proven their expertise with turnkey solutions through this project. Besides the manufacturing and packaging the product into bags, a secondary packaging machine is also integrated in the line. The customer received the benefit of having all processes provided from one

folding carton after they are counted and collated. Due to the different product sizes and formats this can take place while the product is laying or standing. For example, wound pads cannot be stacked upright since they would be too high for the carton. Therefore, different stackers had to be integrated into the line. The technology was supplied by Optima France and adjusted to the specification requirements by Optima Life Science, e.g. the control unit. The variety of products makes this an exceptional project. Five different products in different variations, can be processed on the MDC300 advanced and 13 different set of change parts are required since the post-surgery wound dressing are manufactured with or without wound pad. In addition, bandages for catheter applications are produced on the machine also with or without wound pad. Within certain product dimension, several ad-



June 2018

Autosplicer for continuous operation

supplier. A single-point contact at Optima Life Science guarantees a thorough coordination and a short decision path.

Turnkey solutions for web converting

ditional formats are possible. A format change is quick and easy with the Optima OPAL-system with detailed and illustrated instructions on the machine’s HMI. Since the cutting tools are changed with drawer-system the time for a format change is reduced to a minimum. The MDC300 advance also provides a small footprint, considering the number of functional modules. The 32 metre long line will fit perfectly into

this extremely large Optima Life Science project. The user profits from integrated automatic table splicers that guarantee a high availability and minimise downtimes. Due to the high output the machine satisfies the high demand. Last but not least, the flexibility makes this project with its five products in different variations, very special to all participants. This is another example of Optima Life Science showing

the existing assembly hall of the customer. The installation of the line was completed within four weeks. How was that possible? The modular design of the machine allows for easy disassembly and reassembly during installation, explains Härpfer.

its capabilities to design individual machines and complex turnkey lines.

Four camera systems guarantee product safety The product quality was also very important to the customer. Therefore, Optima installed four camera systems. As soon as one camera catches an error of one of the products, it will be marked and is rejected at the end of the system. The completely integrated cartoning machine produces ready-to-sell folding boxes including application of an expiration date and batch number. The secondary packaging equipment is designed for a maximum output of up to 120 cartons per minute with five products per carton. Reliability meets high performance – this is the motto for

OPTIMA OPAL – for an efficient production The abbreviation OPAL stands for “Optima Process Automation Library”. The Industry 4.0 solution consists of two functional modules. OPALmonitor is a pre-configured system that records the production data, process them and provides a report (OEE-calculations, alarm messages). A profound basis for a target oriented production process. OPALmanage is an individual configurable line management system that depicts and controls the actual machine structure and its processes. OPAL is an important tool to optimise production planning and to get as close as possible to maximum efficiency. A recipe and a user management system, as well as an audit trail guarantee additional safety of validated products.


DiaSys Immunoturbidimetric reagents — Accurate measurements of specific proteins DiaSys Diagnostic Systems immunoturbidimetric test portfolio offers more than 20 ready-to-use, stability optimised reagents for routine and special diagnostics with outstanding performance. An insight by Dr Rajesh Rengarajan, Product Manager-Clinical Chemistry, DiaSys Diagnostic India SPECIFIC PROTEIN testing are important markers for various diseases for example microbial infections, cardiac risk, inflammatory response and even cancer. The complement system is a family of proteins that is essential for the destruction of bacteria, viruses and is a most important part of the immune system. The measurement of proteins in the blood assists in the evaluation and diagnosis of various conditions.

Specific protein testing market: Drives and restrains The specific protein testing market is anticipated to grow in the forecast period with the increasing geriatric population. Among all protein testing methods, specific protein testing has gained significant amount recognition

in recent times. These kind of testing helps in the diagnosis of various health disorders including immune system disorder, such as rheumatoid arthritis. The effectiveness of the testing outcome is the major driver for the global specific protein testing market. The specific protein testing is an in vitro testing procedure that offers benefit to the specific protein testing market over the globe. The less popularity of the test, overall cost of the specific protein testing and the lack of trained professional are the major reasons restraining the growth of specific protein testing market globally. The measurement of protein concentration in plasma such as the activity of enzymes, the amount of transport proteins, hormones, cytokines, clotting factors and complement pro-

teins has proved useful in the diagnosis and management of various diseases. Most plasma proteins are not present within cells, unless they have been synthesised within the cells or taken up by specific receptors. There are a variety of analytes generally classified as ‘specific proteins’ that have wide ranging clinical

utility. In the past, specific proteins were analysed using radial immunodiffusion, immunoelectrophoresis and dedicated immunonephelometric or immunoturbidimetric methods. Automation of specific protein testing offers rapid analysis, random access, high volume testing, and cost reduction. Shifting of specific protein analysis to a clinical chemistry platform result in reduced turnaround time for these tests and can allow for consolidation of testing and elimination of more specialised individual analysers. DiaSys Diagnostic Systems immunoturbidimetric test portfolio offers more than 20 readyto-use, stability optimised reagents for routine and special diagnostics with outstanding performance. DiaSys immunoturbidimetric tests are available

in different vials and kit sizes for manual and automated use in various common clinical chemistry analysers. DiaSys reagents, in combination with DiaSys instruments, optimised applications, calibrators and quality control material form a harmonised system for highest laboratory demands.

Salient features ◗ Liquid-stable, ready-to-use reagents ◗ Widest measuring ranges. No sample pre-dilution ◗ High prozone security ◗ Excellent on board stability ◗ Extended calibration stability ◗ Standardised to international reference material or reference methods ◗ Applications available for a variety of common automated systems

Meeting healthcare IT Requirements with Nutanix Enterprise Cloud Platform EVEN AS they work to provide and improve patient care, healthcare providers worldwide are under constant and growing financial and regulatory pressures. Healthcare providers need to become more agile while maintaining lower costs in order to adapt to this rapidly changing landscape. Nutanix’s next-generation datacentre technology aligns with the needs of healthcare systems — locally, regionally, and even at the national scale — by increasing flexibility, reducing complexity, and improving performance while lowering both initial and long-term costs. VDI for total user mobility – Nutanix Enterprise Cloud Platform is best suited for healthcare IT teams to deliver consistent user experience, security

and anytime, anywhere access across all devices in all locations. As a result, desktop users, mobile users, follow-me desktops and clinician desktops gain immediate access to all applications at the point of care. Nutanix solutions are Citrix Ready and validated for XenDesktop/XenApp on Nutanix AHV, Microsoft Hyper-V and VMware ESXi. Nutanix joint reference architectures for VMware Horizon 7 and Horizon DaaS accelerate app and desktop virtualisation deployments for customers. Unique performance architecture maximises resource availability – Converging server and solid state storage yields faster application response times and overall operational performance. Logins are

faster and data access is accelerated. Nutanix appliances also deliver optional acceleration of graphics-intensive services for high speed delivery of PACS images and rendering of 3D imaging applications. Out-of-the-box deployment for server virtualisation and private cloud – Ideal for distributed environments and branch or satellite facilities, Nutanix nodes deploy in 30 minutes or less, providing standardised — yet powerful — infrastructure for healthcare locations lacking onsite IT specialists. Nutanix is ideal for multi-site health systems with tens to thousands of sites. Lower costs for operations and equipment – The Nutanix Enterprise Cloud Platform reduces the expense and manage-

ment overhead from SAN and NAS arrays. Pay-as-you-grow— adding resources one node at a time — enables growth to match business demands, supports data retention requirements and eliminates major CapEx hits. Standardised, nonproprietary hardware components assure ease of management and lower costs. Superior disaster recovery capabilities – The Enterprise Cloud Platform delivers exceptional disaster recovery (DR) and continuity of business capabilities via native backup and replication for any hosted VM. Patient data is 100 per cent protected via full replication. All data is de-duplicated and transmitted with byte-level granularity for maximum efficiency and space savings. Regu-

lations — such as HIPAA, HITECH, PIPEDA, and the requirements of national healthcare systems—can be easily satisfied. The ideal platform for virtualisation to address healthcare it needs - The Nutanix Enterprise Cloud Platform leverages web-scale engineering and consumer-grade design to natively converge compute, virtualisation and storage into a resilient, software-defined solution with rich machine intelligence. With a simple scale-out architecture, Nutanix delivers cost savings and predictable scalability for even the most intensive workloads. Nutanix’s advanced architecture delivers high availability across all system components so critical applications are always available.



June 2018


nice Neotech Medical Systems launches unique features and benefits nice Neotech Medical Systems has launched the following products mentioned below.

These blenders are suitable for respiratory applications including routine therapy, ventilator gas supply, Bubble CPAP, SiPAP, Resuscitator and critically limited NICU procedures. nice Neotech offer different models with multiple outlet ports that deliver the same highly accurate selected FiO2. Most models can be customised to include the flowmeter attachment with a variety of flow rates available. The blenders contains an audible alarm which warns the user if either of the gas sources changes by more than 30PSI from the other. Medical air and oxygen blenders require a bleed for accuracy. The bleed on a blender is activated by the knob which is placed on the right port. This avoids the blended gas being into the air when the blender is not in use.

Features Safe, controlled and precise Peak Inspiratory Pressure (PIP) The Hornpuff Infant Resuscitator will safely inflate the baby's lungs and provide optimum oxygenation by delivering consistent PIP with each breath avoiding the risks associated with under or over inflation at uncontrolled pressures.

Anil S, Senior General Manager, nice Neotech Medical Systems

Flexibility in operation The HORNPUFF can accept and deliver oxygen concentration from 21 per cent to 100 per cent coming from a flow meter or a blender. The patient T-Piece can connect to neonatal masks or endotracheal tubes.

Precise Positive End Expiratory Pressure (PEEP) The HORNPUFF Infant Resuscitator helps establish and maintain Functional Residual Capacity (FRC) by providing a consistent PEEP throughout the resuscitation process.

Mounting options

nice 5020 Infant T Piece Resuscitator

The HORNPUFF can be easily mounted to each bed of the NICU with an IV Stand or optional roll stand, It ensures quick and easy access to the patient.

Save gas, time and money

Unique features

A perfect mixing of O2 for a variety of application THE quality reliability and versatility of OxyM Blenders are designed as per the standard to meet the ICU & NICU requirements.

◗ nice 5005 and nice 5010 have gas savings ON/OFF bleed feature ◗ Available in very low to high flow capability ◗ Suited to speciality and general needs ◗ Mounting solutions for all situations ◗ All blenders are equipped with an audible alarm

Dual flow meter Precise pressure delivery An accurate manometer provides constant reassurance of mask seal and delivered PIP and PEEP.

Alternate temporary respiratory support Consistent PEEP can be delivered to assist with breathing during transport or ventilator circuit change.

Face mask Different size of face mask which provides flexible in usage for different babies

Compact and handy Small in size, less weight and innovative technology incorporated into a compact design.



June 2018

The OxyM Blender with integrated flowmeters specifically designed for use in the NICU. The 0-15LPM flow meter on the left can be used to connect to a Resuscitator. The flow meter on the right, which can be fixed in 0-15, 0-3.5 or 01.0 LPM, can be used to connect an infant nasal cannula.

Bleed Turn On/Off The OxyM Blender's unique features let turn the bleed required for low on and off simply by pushing in and rotating the right hand flow meter. It is saving time and reduce frustration, because there are no parts to disconnect and mis- place, and the OxyM B is always ready to use.

Blender with resuscitator ◗ To provide continuous supply of air and oxygen blenders gas for Bubble CPAP and TPiece Resuscitator.

nice 5010 Cascade Flow Meter

nice 5010 High/Low Flow


Versatile dual range blender. Ideal for equipment needing flows from 2-120 lpm, yet also capable of increased accuracy even at a low flow range.

OxyM Medical Air/O2 blenders combine compressed Medical Air and Oxygen to de- liver blended pressurised gas at a precise oxygen concentra- tion (FiO2) firm by the user. Some models are equipped with a unique gas bleed ON/OFF switch to increase accuracy when needed, con- serve gas, save money and time.

nice 5005 Low Flow Blender Perfect for NICU and New born nursery or for a flow of 30 lpm or less. Increased ac-curacy at even the lowest flow range.

Contact details nice Neotech Medical Systems No: 85, Krishna Industrial Estate, Mettukuppam, Vannagaram, Cheannai - 600 095. Tamil Nadu Tel: +91 44 2476 2594 / 2476 4608 M: +91 98408 73602 / 98408 74902 Web:


Profile for Indian Express

Express Healthcare (Vol.12, No.6) June, 2018  

India's Foremost Healthcare Magazine

Express Healthcare (Vol.12, No.6) June, 2018  

India's Foremost Healthcare Magazine