Express Healthcare January, 2013

INDIA’S FOREMOST HEALTHCARE PUBLICATION VOL. 7 NO.1 PAGES 94

January 2013 ` 50

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INDIA’S FOREMOST HEALTHCARE PUBLICATION VOL. 7 NO.1 PAGES 94

January 2013 ` 50

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INSIGHT INTO THE BUSINESS OF HEALTHCARE

Wishing all our readers a very happy & prosperous New Year

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Healthcare INSIGHT INTO THE BUSINESS OF HEALTHCARE

VOL 7. NO 1, JANUARY, 2013

Chairman of the Board Viveck Goenka Editor

Anniversary Special

Market

Viveka Roychowdhury* Assistant Editor Neelam M Kachhap (Bangalore) Mumbai Sachin Jagdale, Usha Sharma, Raelene Kambli, Lakshmipriya Nair, Sanjiv Das Delhi Shalini Gupta

Omidyar Network, TiE organise event

MARKETING

on affordable healthcare for all .........29

Deputy General Manager Harit Mohanty

Expert Speak

Senior Manager Tushar Kanchan Assistant Manager Kunal Gaurav PRODUCTION General Manager B R Tipnis Production Manager Bhadresh Valia Asst. Manager - Scheduling & Coordination Arvind Mane

Dr Srinath Reddy, President of Public

Photo Editor

Health Foundation of India (PHFI) .....32

Sandeep Patil

Suresh Shetty, Health Minister – Maharashtra ......................................34

DESIGN Asst Art Director

The Year Ahead

Surajit Patro Chief Designer Pravin Temble Senior Graphic Designer Rushikesh Konka Layout Vivek Chitrakar

The Phoenix Rises- Dr Parvez Ahmed, Chairman and MD, Aapka Urgicare ….37

Healthcare in 2013-

Seeing healthcare in a new light -Dr Akash Rajpal, Founder, MD & CEO,

looking into the

Ekohealth ....................................................................................................38

crystal ball ......... 50

Protocol for Success- Dr Sabahat Azim,Founder & CEO, Glocal Healthcare ......39 CIRCULATION Circulation Team Mohan Varadkar

Revers(ing) innovation- Nishith Chasmawala, Cofounder-Consure Medical .....40 Executive Entrepreneur- A Vijay Simha, CEO, OneBreath ..............................41 Connecting the missing link- Manish Menda, Director, MYA Health Credit ….42

Express Healthcare Reg. No. MH/MR/SOUTH-252/2013-15 RNI Regn. No.MAHENG/2007/2045 Printed for the proprietors, The Indian Express Limited by Ms. Vaidehi Thakar at The Indian

Wish you a “Sughavazhvu”- Dr Zeena Johar, CEO, Sughavazhvu Healthcare .43 'Base of Pyramid' Entrepreneur- Dr CJ Vetrievel, Managing Director, Be Well Hospitals .......................................................................................44

Express Press, Plot No. EL-208, TTC Industrial

Philanthropy in a Corporate Garb- Nihal and Shyama Kaviratne,

Area, Mahape, Navi Mumbai - 400710 and

Founders, St Jude Childcare Centre ...............................................................45

Published from Express Towers, 2nd Floor, Nariman Point, Mumbai - 400021. (Editorial &

Eye(ing) Growth - Raja T Goel, Co-Founder & CEO, Eye-Q Hospitals...............46

Administrative Offices: Express Towers, 1st Floor,

Mindful & Modest Entrepreneur- Krishna Mahesh, CEO,

Nariman Point, Mumbai - 400021)

*Responsible for selection of news under the PRB Act.

Copyright @ 2011

Moving towards Universal Health Coverage in India .................51

Sundaram Medical Devices ...........................................................................47

Emerging trends in

Tamerlane's Ant- Myshkin Ingawale, Co-Founder, Biosense Technologies .......48

healthcare ...........53

A True Torch Bearer- Arunachalam Muruganantham, Founder, Jayashree Industries ....................................................................................49

The Indian Express Ltd. All rights reserved throughout the world. Reproduction in any manner, electronic or otherwise, in whole or in part, without prior written permission is prohibited.

JANUARY 2013

Regulars Letters.............................................................................................................................................................8 www.expresshealthcare.in

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Editorial

The lucky 13 in '13 ...

2

Express Healthcare's 13th Anniversary issue celebrates 13 Game changers who we think are going to make a real difference in 2013

012 ends on a sombre note with the sad death of the 23-year old gang-rape victim from Delhi but what stays alive is the wave of public support to bring the accused to justice. But the medical community, debated and analysed the sequence of events leading up to her demise in another light: were doctors reduced to pawns in yet another political charade?

The Indian Medical Association was quick to question the sudden airlifting of the girl to Singapore's Mount Elizabeth facility, when her condition at Delhi's Safdarjung Hospital was still fragile. The Association's protest stemmed from the concern that this step could be seen as a lack of confidence in the country's healthcare infrastructure and medical staff to deal with complicated cases. While the politicians were equally quick to retort that this was not the case, the murmur that the Indian government's move was more an attempt to be seen to be 'doing something' after it failed to get its act together from day one, is not going to die down soon.

So it is with a reaffirmation in the talents and dedication of India's medical fraternity that Express Healthcare's 13th Anniversary issue celebrates 13 Game changers who we think are at a tipping point and will make a real difference in 2013. While some are filling gaps in urban settings, others are expanding healthcare into India's hinterland.

Dr Parvez Ahmed set up Aapka Urgicare to take a scaled down version of a hospital's emergency facilities closer to the doorsteps of patients and their relatives. He hopes to save more lives being 'the friendly, neighbourhood, first responder' in the Golden Hour following medical emergencies. Dr Akash Rajpal's Ekohealth aims to build the biggest member ‘value’ network in the country and in doing so, leverage the power of group bargaining to make healthcare facilities and diagnostic services more affordable. Manish Menda's MYA Health Credit is also tackling the same problem from a different angle: by providing patient financing schemes to suit every pocket. Nihal and Shyama Kaviratne, founders of St Jude Childcare Centres provide accommodation and care to children undergoing cancer treatment, using corporate strategy to make a philanthropic effort more sustainable. Most of these children belong to rural backgrounds coming to cities for cancer care so St Judes' is a unique endeavour to serve the needs of the rural patient in an urban setting.

Dr CJ Vetrievel of Be Well Hospitals is yet another visionary who saw the need and the opportunity at the base of the pyramid, and went about creating a chain of secondary care hospitals targetted at Tier II and III cities. Doctor turned IAS officer turned healthcare entrepreneur Dr Sabahat Azim took this focus one step further when he founded and positioned Glocal Healthcare Hospitals as India's first and so far only, rural corporate hospital chain while Dr Zeena Johar's Sughavazhvu Healthcare is envisioned as a chain of rural micro health centres. Arunachalam Muruganantham is a school drop out turned businessman, who introduced thousands of women in rural India to the concept of a sanitary napkin and what's more, closed the loop between maker and consumer by employing rural women at its manufacturing hubs. Rajat Goel's Eye-Q Hospitals does the same with eye care to those in Tier II and Tier III towns, who in the absence of the same, spend time travelling to cities.

A Vijay Simha's OneBreath portable ventilators are an affordable alternative just as Nishith Chasmawala-promoted Consure Medical's device for faecal incontinence addresses an unmet clinical need little thought about, and largely ignored, yet having a large impact. Myshkin Ingawale's Biosense Technologies developed ToucHb, a low-cost, needle-free portable device to diagnose anaemia in patients, will help better and earlier diagnosis of a condition responsible for nearly 40 per cent of maternal deaths. Similarly, Krishna Mahesh of Sundaram Medical Devices will be rolling out affordable medical beds meeting the highest global quality, safety and usability standards.

We know we've only skimmed the surface when it comes to healthcare entrepreneurs who are charting new territory. Do write in with suggestions on who you think deserves to be featured as a Healthcare Game changer in Express Healthcare.

Here's wishing all our readers a very happy and healthy 2013 ...

Viveka Roychowdhury viveka.r@expressindia.com

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JANUARY 2013

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Letters QUOTE UNQUOTE HEALTHCA

REMOST INDIA’S FO

thcare.in www.expressheal

ATI RE PUBLIC

ON

VOL. 6 NO.12

PAGES 90

December 2012 ` 50

“Despite constant efforts by both the government and private sector health providers there is still a huge population without adequate access to comprehensive health facilities. There is a low penetration of healthcare services due to the fact that majority of secondary and tertiary health care facilities are in cities and towns, far away from rural areas, where 75 per cent of population lives.”

ARE S OF HEALTHC THE BUSINES INSIGHT INTO

Hospital Infra al HBII 2012 Speci

Page 41

IT@Healthcare t Janette Benet tor, BT Health Clinical Direc

nal brush-up or ls need the occasio closely at Ageing hospita s Healthcare looks ive and necessary.

13 their market. Expres tions are expens pace in India PAGE Hospital renova competitive within are picking up truction to stay process as they a entire recons and remodelling the renovation

Page 54

UID has great potential very thoughtful article. Indian Healthcare system is at crossroads. We need to learn quickly how the health systems work so efficiently and why we are in such a pathetic state.

UID has a great potential to have organised health data which can be helpful in policy making decisions.

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Ghulam Nabi Azad Union Minister for Health and Family Welfare (Addressing the audience at the India Health Summit in New Delhi)

JP Pattanaik Business Analyst- Healthcare at IBM pattanaikjp@gmail.com

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Healthcare INSIGHT INTO THE BUSINESS OF HEALTHCARE

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JANUARY 2013

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Letters

Year that was June 2012

Febuary 2012 Fount of Information

Achieving universal healthcare

have been regularly receiving Express Healthcare magazine and it was a great pleasure to read it as it gave tons of information which probably compilation of many books would also not give. I was also invited to in Nov 2009 for a conference, which was definitely very enlightening.

our article on 'Building a path to healthcare access' in Express Healthcare, May 2012, was quite insightful as it provided some interesting and diverse views of industry stakeholders on how to achieve universal healthcare. Health insurance alone is not going to achieve this as the number of people needing healthcare services far exceeds the number of taxpayers. People must pay some amount out of pocket to prevent the misuse of insurance and to value the cost of quality care. As such, India is lagging behind to achieve MDGs. Nothing short of drastic reforms on part of the government and some innovative strategies by all players in healthcare can achieve this ambitious goal.

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Dr Bharat N Vakil Medical Director Suvarna General Hospital, Borivali(W), Mumbai 400092

March 2012

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Incentivising for Growth

An enjoyable and informative read hank you for the positive article on Singapore in the August issue of Express Healthcare. I really enjoyed reading the feature article and the comparative analysis you provided.

Ref: 'Learnings from the Lion City', Pg no 13, August 2012 issue

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Angeline Leow Senior Officer Marketing & Communications Singapore Economic Development Board

December 2012 Focus on public health – need of the hour

have gone through your lead article on 'Budget 2012: What's in store for healthcare?' in Express Healthcare’s February 2012’s issue, wherein, some industry experts have opined that healthcare should be accorded infrastructure status, besides other incentives. In this regard, I would like to state that the Government has already conferred infrastructure status on healthcare industry (under Section 10 (23G) of the Income Tax Act) and announced slew of tax incentives and exemptions.

However, the need to further extend and liberalise these tax rebates and incentives, grant of soft loans and depreciation limit cannot be overemphasised to provide much needed impetus to rural healthcare services.

Dr Sanjeev Sood NABH Empaneled Assessor, Hospital & Health Systems Administrator Chandigarh

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Lobbying for affordable health insurance t is high time all other state governments also implement health insurance schemes like Yashaswini for affordable insurance seeking population,as has been implemented by three southern states under Dr Shetty sir's aegis. Express Healthcare will do well to raise this issue as this media directly goes to all citizens and decision makers interested and relevant in healthcare domain in India.

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Dr Sanjeev Sood NABH Empaneled Assessor, Certified Healthcare IT & Qlty Assurance ConsultantHospital & Health Systems Administrator SMC, Air Force Station Chandigarh-160003

May 2012 A suggestion am an avid reader of your Express Healthcare magazine. This is with regards to a topic that might interest you. Time and again your magazine has brought to light the changing scenario within the industry. Corporatisation has played a pivotal role in changing the mind set of the patient as well as healthcare providers.

However, this has not completely changed the way a patient looks at a doctor.

Today, doctors and hospital administrators openly talk about business. This is accepted by patients to a certain extent, but mostly patients still believe that a doctor is not suppose to talk business.

The question that arises here is what role does ethics or a code on conduct for doctors and healthcare providers play while delivering healthcare to the people at large?

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Sanjay Gupta Atharva Business Solutions Indore

October 2012 Rooting for the private sector in healthcare he article (the Edit published in September 2012 issue) builds up on a strong point, something that we had advocated in our study on the status of emergency care in India. A better partnership between the public and the private sector. There are numerous opportunities to do so, have been and we have done so in the past successfully. But only to lose out on the momentum gained. Free markets and competitive organisations are always more efficient than an archaic and red carpet laden system. There are opportunities here that can truly bring about change. It's about having an open mind, and understanding that someone could do healthcare better than the government.

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our lead article-'Mumbai -In need of a Renaissance', makes an interesting read.

While tracing the evolution of healthcare sector since the British era, the article clearly identifies the issues and challenges facing the contemporary healthcare sector and offers possible solutions. With the public health sector lagging behind, it would have been a good idea to take stock of public health activities and initiatives by Municipal Corporation in the areas like vector control, provision of immunisation and contraception to urban slum dwellers. Its the focus on public health that shall make this renaissance a reality.

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Dr Sanjeev Sood NABH Empaneled Assessor, Certified Healthcare Qlty Mgt & IT ConsultantHospital & Health Systems Administrator Chandigarh

Well researched article ery interesting and well-researched (Ref to article: ‘Reused pacemakers: Socially correct, ethically wrong’ published in the October 2012 issue of Express Healthcare). This is where government can come in by funding studies to judge the relative benefits and risks of reusing med tech.

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Gauri Kamath Blogger - Apothecurry

Anunaya Jain, Strategic Healthcare Executive & Emergency Medicine Physician, Sr. Health Project Coordinator University of Rochester

Rishikant Trivedi Healthcare Consultant Meerut

JANUARY 2013

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INDUSTRY EVENT

Medical Technology

Upcoming diabetes summit to explore future Indo-UK collaborations

Abbott brings new bioresorbable vascular scaffold in India The company claims that it has the potential to revolutionise treatment of coronary artery diseases

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bbott has launched a drug eluting bioresorbable vascular scaffold (BVS) in India, a device for the treatment of coronary artery disease (CAD). It works by restoring blood flow to the heart, similar to the working of a metallic stent but then dissolves into the body over time, leaving behind a treated vessel that may resume more natural function and movement because it is free of a permanent metallic stent. Abbott's BVS is made of polylactide, a naturally dissolvable material that is commonly used in medical implants such as dissolving sutures.

The company claims that the potential long-term benefits of a scaffold which dissolves are significant.The vessel may expand and contract as needed to increase the flow of blood to the heart in response to normal activities such as exercising; treatment and diagnostic options are broadened; the need for longterm treatment with anti-clotting medications may be reduced; and future interventions would be unobstructed as it would be by a permanent implant.

Dr Ashok Seth, Chairman, Cardiac Sciences, Fortis Healthcare said, “With the launch of BVS, we can offer our patients a significant advancement in the treatment of coronary artery disease. The structure starts to resorb within one year, allowing the vessel the potential to flex, pulsate and dilate in response to normal activities such as exercise.”

The launch is supported by a clinical trial programme that encompasses five studies in more than 20 countries around the world, including India. It has been implanted in more than 3,000 patients across 30 countries.

EH News Bureau

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The new 15,000 sq ft facility located at 60 kms from Bangalore at Doddaballapur is a state-of-the-art unit with a quality system certified of the highest international standards he upcoming Indo-UK Diabetes Summit scheduled for January 18-19, 2013 in Chennai is set to be the largest bilateral healthcare event ever staged between the two countries.

According to Dr Rajgopal Mani, Consultant in Clinical Sciences, Southampton University, the summit will bring together advances as well as in depth experience in healthcare, academic and industry sectors as applicable to management of diabetes and its complications in both countries, the UK

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and India. Secondly, it offers a rare opportunity for colleagues to assimilate, to present and to discuss in sessions as well as in small groups; colleagues from all sectors will have occasion to meet with those serving in similar and other sectors.

The event is designed to engage healthcare professionals at every facet of the industry. Dr Mani explains that researchers are offered a chance to participate in seminars/discussions gaining specific knowledge and information while for work-

ers from healthcare sectors in both primary (community) and secondary (hospital) and university settings, it will be a platform to exchange information, interact to explore partnership possibilities.

For instance, Dr Mani, who is Head of Clinical Measurements and Honorary Senior Lecturer Lead for Research and Innovation in Medical Physics and Bioengineering, and is developing a joint wound healing laboratory with Shanghai Jiao Tong

University, will be reviewing the role of technology applicable to wound healing.

In Southampton, Dr Mani developed the vascular laboratory and applied some of the techniques to diagnostic care as well as research. His research group, nested in the Human Disease & Health Division led by Professor Mark Hanson, is committed to wound repair through prevention and regeneration.

EH News Bureau

COMPANY WATCH

Shrinath Kidney Center and Fresenius Medical Care launch dialysis clinic-‘Shrinath NephroCare’ Shrinath NephroCare is a dialysis clinic which will provide an ideal synergy of nephrology-both clinical and the medical side joint venture of Fresenius Medical Care and Shrinath Kidney Center, Shrinath NephroCare’ has been launched in Jalandhar.

Powered by 10 dialysis machines, capable of doing three treatments per machine per day, as well as round the clock nurses and specialists and 24x7 emergency services, Shrinath NephroCare will provide a wide range of products, facilities and services to the patients. Some of the facilities available at the clinic include:- Quality water

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treatment; Low Flux, High Flux Dialyzers and Tubing Systems and BCM technology that can check excess fluids, since dialysis patients become malnourished as well as monitor patients regular diets both from quality and quantity parameters.

Dhruv Chaturvedi, Managing Director, Fresenius Medical Care India said, “Witnessing the demand for world-class medical treatments in the country, I am glad to announce the launch of our first NephroCare clinic in IndiaShrinath

NephroCare. The city of Jalandhar, which has approximately 500+ dialysis patients, will be the first city to experience our innovative and successful treatments, best clinic standards, technologically advanced productsand services at indigenous prices through our alliance with Jalandhar’s most trusted nephrologists- Dr Rajeev Bhatia and Dr Ajay Marwaha.

This is our first step to bring globally accredited medical standards to the Tier-II cities and we will spread this facility across other parts of the

country as well.”

Elated at the launch, Dr Rajeev Bhatia and Dr Ajay Marwaha said, “We are pleased to be associated with a global dialysis solution provider, and believe that this association will definitely help our ailing patients in this part of Northern India. We look forward to working with modern facilities at Shrinath NephroCare, and further enhance our ability in providing the best possible medical treatment to our patients.”

EH News Bureau

Parth Overseas launches cancer detection kit Called the ‘CanKit’, it is the first cancer detection kit in India arth Overseas has launched a cancer detection kit, ‘CanKit’ in the Indian market.

CanKit is being touted as one of its kind innovative product that is capable of

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detecting cancer through a simple urine test. It conforms to the norms and recommendations of World Health Organisation for cancer detection. The company claims that trials are currently ongoing www.expresshealthcare.in

across various parts of India and has produced efficacy to its users. It has also availed various norms of approvals.

The kit indicates whether a person is suffering from cancer, is it in preliminary stages

or is at cancer risk in the near future. The kit itself contains a 10ml Ampoule of 0.6ml solution, a tray, a stopper, a dropper and an ampoule cutter.

EH News Bureau JANUARY 2013

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INITIATIVE

Chacha Nehru Sehat Yojana brings specialised medical services to Delhi government schools Specialist doctors provide treatment for medical conditions identified during primary screenings in schools under Chacha Nehru Sehat Yojna

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ore than 1,200 students studying in Delhi Government schools of Central Delhi were given free specialised health services such as dental, eye/vision testing, ENT, health/nutrition communication and counselling as part of a district referral mela held under Chacha Nehru Sehat Yojana (CNSY). The event was held at Sarvodaya Bal Vidyalaya, Rouse Avenue at Deen Dayal Updadhyaya Marg in New Delhi.

Launching the drive recently, Kapil Sibal, Union Minister, Communications and Information Technology, described the campaign as a ‘mammoth exercise’ whereby comprehensive health services are being provided to the students at the doorstep. Addressing the occasion, Sibal said, “There is enough evidence to show that healthy children retain higher levels of cognitive functionality and are likely to attend school more regularly and for longer. Inculcating awareness about good health practices at this young age will go a long way in building a healthy nation. I am happy that the Delhi Government is working to achieve the objectives of the programme with the technical assistance from Global Health Strategies.”

Among the dignitaries present were Delhi Health Minister Dr A K Walia and Delhi Education Minister Prof Kiran Walia, Area MLA Sohaib Iqbal, and Municipal Councilor Ramesh Datta More than 7000 students have been provided free spectacles under this scheme in last year.

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EH News Bureau JANUARY 2013

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Hospi News Infant successfully treated for cancer through unrelated stem cell transplant in Karnataka Narayana Hrudayalaya – Mazumdar Shaw Cancer Centre creates awareness about the importance of ‘Stem Cell Donation’ in India

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arayana Hrudayalaya – Mazumdar Shaw Cancer Centre, Bangalore informed that they have successfully treated a six-month-old girl suffering from infantile leukaemia through ‘unrelated stem cell transplantation’.

Dr Sharath Damodar, Consultant Haematologist and Head – Bone Marrow Transplant Unit, Narayana Hrudayalaya-Mazumdar Shaw Cancer Centre diagnosed the baby with acute lymphatic leukaemia, when she was evaluated for a low blood count and was started on chemotherapy.

As this particular leukaemia carries an extremely poor prognosis at this age group with the survival rate as low as 10 per cent, stem cell transplantation was the only possibility. A worldwide search was initiated as it was difficult to find a donor for stem cells in India (the baby being the only child).

After a period of two to three months, a matched unrelated donor from the US was identified and the stem cells reached Narayana Hrudayalaya in Bangalore.

Dr Damodar explained about the importance of stem cell donation. He said, “In India, it is very difficult to find a donor for stem cells. People were dependent on donors from the US and Europe to get such donors. We need to inspire people around the country to come forward for stem cell donation, which is a little more than blood donation and can save several lives.”

This successful case of the little girl is expected to give a new hope of life for many such children who are suffering from infantile leukaemia.

EH News Bureau

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NEW VENTURE

American College of Physicians launches India operations The medical speciality organisation to exchange knowledge and best practices with the Indian medical community merican College of Physicians (ACP), an organisation of internists -- physicians who specialise in the prevention, detection and treatment of illnesses in adults -- announced that it would initiate programmes in India from early 2013. ACP’s mission is to enhance the quality and effectiveness of healthcare by

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fostering excellence and professionalism in the practice of medicine.

According to Dr Phyllis A Guze, Chair of the Board of Regents of the American College of Physicians (ACP), who is currently on a visit to India, ACP India will organise guest lectures, training workshops and conferences with international speakers

to promote exchange of knowledge and best practices. “ACP is known for providing tools and educational resources for physicians to deliver high value cost effective care to their patients. In India, we will be no different,” she added.

Speaking on the occasion, James M Ott, Senior Vice President, International

Programmes, ACP, said, “ACP’s goal is to establish a chapter in India directed by local internal medicine leaders which will lead to regular scientific meetings, educational programsmes, leadership development, networking and participating in the governance of ACP.” EH News Bureau

ACQUISITION

Baxter acquires Gambro Acqusition will enhance Baxter's renal therapies portfolio and expands its role as a global provider of dialysis products axter International has entered into a definitive agreement to acquire Gambro AB, a privately held dialysis product company based in Lund, Sweden, for total consideration of 26.5 billion SEK (approximately $4.0 billion at current exchange rates). Gambro is a global medical technology company focused on developing, manufacturing and supplying dialysis products and therapies for patients with acute or chronic kidney disease. The acquisition gives Baxter a comprehensive dialysis product portfolio, complements Baxter’s global home dialysis offerings, and positions the company to better meet the evolving needs of the large and growing dialysis market.

“Baxter has a legacy of innovation in dialysis, including the development of peritoneal dialysis for the treatment of end-stage kidney disease patients in the home.

This acquisition further strengthens our global dialysis offerings by extending our portfolio in the hemodialysis segment,” said Robert L Parkinson, Jr, Chairman and CEO of Baxter. “This transaction will provide attractive returns and enhance Baxter’s

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sales and earnings growth over the company’s current long-range financial plan.”

Gambro is a global provider of dialysis products and technologies used in hemodialysis (HD) and continuous renal replacement therapy (CRRT), with annual sales of approximately $1.6 billion in 2011. Its portfolio in

load, among others, Gambro offers the Prismaflex system used for the treatment of critically ill patients with acute kidney injury.

“Both companies have a longstanding heritage in kidney care with innovative technologies and a dedication to saving, sustaining and improving the lives of

The acquisition gives Baxter a comprehensive dialysis product portfolio, complements Baxter’s global home dialysis offerings, and positions the company to better meet the evolving needs of the large and growing dialysis market the traditional chronic care segment consists of HD devices including advanced monitors, dialyzers, bloodlines, cyclers and dialysis solutions. Gambro’s in-center HD devices include the Artis system and the AK 96 system. In the acute care segment, which includes CRRT and treatment for fluid overwww.expresshealthcare.in

patients worldwide,” said Guido Oelkers, President and CEO, Gambro. “This acquisition responds to the needs of the nephrology community, healthcare providers and patients seeking a comprehensive dialysis offering of proven products and therapies.”

The transaction is expect-

ed to provide a number of long-term growth opportunities for Baxter around the world. With a broad and complementary dialysis product portfolio, Baxter can accelerate product sales in established markets such as Europe, where Gambro has an extensive footprint. Baxter can also expand Gambro’s reach in high-growth regions of Latin America and AsiaPacific, where Baxter has steadily grown its peritoneal dialysis (PD) business. In addition, Baxter will also build upon its pipeline of investigational home HD and automated PD systems by adding Gambro’s highly innovative and next-generation monitors, dialyzers, devices and dialysis solutions.

The transaction will be financed through a combination of cash generated from overseas operations and debt. Baxter expects to maintain its current dividend payout ratio of approximately 40 per cent. The closing of the transaction is subject to regulatory approvals and other customary closing conditions and is expected to occur in the first half of 2013.

EH News Bureau JANUARY 2013

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AWARDS

HMRI awarded for ‘Innovative Initiative in Healthcare through PPP’ The award was given at the eINDIA Health Summit 2012 for its Health Advice Call Center in Maharashtra

disease summaries approved by the Government of Maharashtra to stan-

dardise care and reduce the need for highly skilled human resources, there-

by decreasing costs.

EH News Bureau

ealth Management and Research Institute (HMRI), an initiative part of Piramal Swasthya programme of Piramal Foundation, has won the ‘Innovative Initiative in Healthcare through PPP’ category for its Health Advice Call Center (HACC) in Maharashtra.

The solution, deployed in partnership with the Government of Maharashtra: ● Leverages over 750 algorithms and disease summaries approved by the Government of Maharashtra ● Reflects Piramal Foundation’s commitment to democratise healthcare and reach out to underserved communities The award was received at the eINDIA Health Summit 2012 held in Hyderabad. The award aims to identify and popularise emerging leaders and innovative projects from different sectors such as governance, education and healthcare. It also helps to identify and recognise a project that exemplifies the kind of implementation that can be easily replicated and at the same time proves efficient and sustainable.

The award winning project, 104 Health Advice Call Centre in Maharashtra, provides specialist advice, directory information, disaster management information, information on government health programmes and referrals to public health facilities to rural health workers of the Government of Maharashtra.

Supported by the Piramal Foundation, HMRI’s objective is to reduce the minor ailment load on public health facilities and provide high quality healthcare at patient’s doorsteps. The target beneficiary for the HACC project is the rural public health worker, who may need support in diagnosing patients. The call centre programme leverages more than 750 algorithms and

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Hospi News Asian Institute of Medical Sciences hosts baby show

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aridabad’s first ever baby show was organised and hosted on Christmas day at Asian Institute of Medical Sciences (AIMS), Faridabad.

The show received overwhelming response with over 200 registrations for participation and around four hundred parents attending the show. There were three categories for participation.

Category one was for infants from age 6 months-12 months; Category B was for tiny tots from age 13 months to 24 months and category C included children from 25 months -36 months.

Dr NK Pandey, Chairman and MD, AIMS said, “Children and child development has a special place in my heart and the AIMS philosophy. With baby show we hosted, this becomes our third such annual initiative. The earlier two annual events dedicated to children are the drawing competition and the debate competition.”

Elaborating further, Anupam Pandey, Director, Purchase and Administration, AIMS said, “The baby show also had a noble cause and a purpose attached to it. There were scholarship prizes for the first, second and third categories of Rs 10,000, Rs 7500 and Rs 5000 respectively. The parents could use this award money for the child.”

The babies were judged on several parameters such as child development, vaccination status, milestones, overall development and growth, look and dress style.

Other interesting side categories for judging babies and parents included babies having the sunniest smiles, most sparkling eyes, most active baby, friendliest baby, fittest moms and most “baby knowledgeable” parents. The small category gifts included toys worth Rs 2,000. There were goodie bags for all participants and free expert advice for mothers and babies at hand.

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GOVERNMENT POLICY

More state governments urged to adopt Clinical Establishments Act 2010: Azad Minister claims that implementing the Act will ensure quality services, affordable fees and check malpractices in the states he Minister for Health & Family Welfare Ghulam Nabi Azad, urged more state governments to adopt the Clinical Establishments Act 2010.

In written reply to a question in the Lok Sabha, the Minister clarified that as health is a state subject, it is primarily the responsibility of the State Governments to adopt the Clinical Establishments (Registration

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and Regulation) Act 2010 (CEA 2010). Implementing the provisions of the Act will ensure quality services, affordable fees and check malpractices in private hospitals and nursing homes in the States, he informed the House.

The Minister said that the states of Arunachal Pradesh, Himachal Pradesh, Mizoram and Sikkim and all Union Territories have already

implemented CEA 2010 with effect from 1-3-2012 while Uttar Pradesh, Rajasthan and Jharkhand have adopted this Act. He informed that other state governments have been requested to adopt this Act. Under this Act, clinical establishments would be required to adhere to minimum standards of services, to be determined by the National Council of Clinical

Establishments. Similarly, under the Central Rules, the establishments would be required to display the rates of the services, and shall charge the rates within the range of rates, to be determined and issued by the Central Government from time to time, in consultation with the State Governments.

EH News Bureau

ACQUISITIONS

Transasia acquires Drew Scientific and JAS Diagnostics This is the fifth acquisition made by Transasia in the year 2012 ransasia Bio-Medicals, India’s leading IVD company, as part of its global expansion plan acquired two more US-based companies - Drew Scientific and JAS Diagnostics from Escalon Medical. The acquisition was done through Transasia’s subsidiary, Erba Diagnostics US. It has acquired the entire business assets including plant and intellectual assets, which will become a direct whollyowned subsidiary of Erba Diagnostics.

Transasia Group’s acquisition of Drew Scientific marks its entry in the fast growing segment of diabetes

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management worldwide. It would benefit with the capabilities to offer proprietary liquid chromatography-based glycated haemoglobin analysers and reagents to the laboratories worldwide.

JAS Diagnostics is a manufacturer of clinical chemistry reagents. It supplies chemistry reagents that it has developed indigenously. It offers solutions in different formats of systems packs, liquid reagents and powder reagents.

Suresh Vazirani, Chairman and Managing Director, Transasia Bio-Medicals stated, “The acquisition was a natural consequence of its focus on

the challenges posed by the vast and fast growing diabetes monitoring segment.” He further added, “It is also to address the lack of quality solutions and supply options in India specifically and worldwide in the monitoring of long-term glycemic control.”

Transasia is already a leading player in the field of autoimmune and infectious diseases testing in North America with proprietary Mago platform and Immunosimplicity range of Immunoassays. With this acquisition, Transasia will also foray in the physician/doctor’s office seg-

ment of clinical chemistry, haematology instruments and reagents in North America.

The company also has plans to expand its markets for existing range of diabetes management, haematology and clinical chemistry in the rest of the world, leveraging its direct presence in US, Italy, Eastern Europe, Russian Federation, Turkey and its distribution partners in 90 countries worldwide.

Transasia plans to offer range of automated solutions in clinical chemistry in the North American market.

EH News Bureau

MARKET WATCH

Fortis to sell stake in Dental Corporation to Bupa The deal is being finalised for Aus $270 million ortis Healthcare International, a subsidiary of Fortis Healthcare is selling its 64 per cent stake in Dental Corporation Holdings (DC), Australia, to Bupa, for Aus $270 million. The deal is expected to be completed in March 2013 subject to shareholder and regulatory

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approvals.

Malvinder Singh and Shivinder Singh, Executive Chairman and Executive Vice Chairman, Fortis Healthcare, said, “As a premier healthcare company we are quick to assess the competitive landscape, the opportunities for growth and emerging trends.

We are decisive in our www.expresshealthcare.in

response and bold in our actions. The move is good for Fortis as it aligns the company with its current strategic priorities. This will help consolidate our presence as one of the fastest growing healthcare companies in the region.”

Fortis had entered DC in January 2011 and has since then it has grown from 140

dental practices to 190 dental practices in Australia and New Zealand. The model however has remained confined to the two countries and in-spite of exploration and backing has found limited acceptance in other Fortis geographies, as originally envisaged.

EH News Bureau JANUARY 2013

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COMPANY WATCH

Convatec launches operations in India It will market and distribute medical products to Indian hospitals and healthcare providers

ted to meeting the needs of healthcare professionals and

patients in India with unique products that promote heal-

ing, improve guard against

care and infection,”

added Shirur.

EH News Bureau

onvaTec, a leading developer of innovative medical technologies, has launched operations in India. It has opened an office in Bangalore at the World Trade Centre, which will serve as the headquarters for the company’s Indian operations.

The company has also set up a warehouse at Nelamangala on the outskirts of Bangalore, and expects to expand across the country.

“We are excited to begin our operations in India. With a fast-moving economy, India is on the cusp of exciting times, and ConvaTec is committed to growth and a longterm presence in the country,” said Ken Berger, CEO of ConvaTec. “We look forward to bringing innovative healthcare technologies and treatments to the Indian market, ” he further added.

ConvaTec will market and distribute a variety of medical products to hospitals and other healthcare providers in India.

These include advanced wound dressings for patients with acute and chronic wounds such as burns, diabetic foot ulcers, pressure ulcers, and venous leg ulcers; and products for those with an ostomy following surgery for colorectal cancer or inflammatory bowel disease. In addition, the company will provide a wide range of hospital products, including catheters and other products used to manage incontinence and support critical care.

“India is making rapid strides towards world-class healthcare, and ConvaTec is uniquely positioned to address these growing needs,” said Anand Shirur, Managing Director for ConvaTec in India. “We are bringing affordable, hightech solutions to hospitals and wound clinics, enabling easy access and benefits from the latest medical technologies.” “ConvaTec is commit-

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PRE EVENT

MEDICALL 2013 Gujarat: Beyond Hospital & Medical Equipment MEDICALL 2013's focus is on taking Indian medical technology to the next level and will be held at Gujarat University Exhibition Hall, Ahmedabad, Gujarat edicall 2013 is being touted as the concrete prescription for accelerating your business success.

The organisers assure that they are committed and passionate to be preferred healthcare partner towards crystallising remedies in healthcare products and services. Medicall 2013, the 10th edition of the event, slated to be held at Gujarat University Exhibition Hall from February 8-10, 2013 in Ahmedabad promises to be a definitely ‘must-attend’ and memorable event in 2013. It is expected to be an ideal B2B platform for manufacturers, buyers, traders, distributors, as well as government dignitaries and offer a golden chance to meet the market leaders.

Medicall 2013 will be attended by industry leaders like Philips, Godrej, Sai Infosystems, Mahindra and Mahindra Ambulances, Vissco India etc.

The event at Ahmedabad will offer myriad deliberations by industry doyens and networking sessions with pre scheduled opportunities

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between key stakeholders, buyers and sellers. It intends to be a perfect business setting for the healthcare fraternity.

Medicall organisers invite you to flaunt your products and services at the event.

The profile of exhibiting equipment/services are varied and include ambulances, consumables, energy saving equipment, healthcare consultants, laboratory equipment, dental equipments, OT and ICU equipment, patient monitoring systems, physiotherapy and orthopaedics, refurbished equipment, surgical instruments, telemedicine, wound care products,

life support systems, laundry equipments, implants, housekeeping solutions, healthcare IT solutions etc.

The Indian healthcare industry is poised to reach $79 billion in 2012 and $280 billion by 2020, and create increasing demand for specialised and quality healthcare facilities. Further, the hospital services market, which represents one of the most important segments of the Indian healthcare industry, is expected to be worth $ 81.2 billion by 2015. The 10th edition of Medicall is expected to give a boost to the growth in the healthcare sector.

MEDICALL as a brand continues to draw a high percentage of decision makers, hospital owners, doctors, medical directors and purchase heads in addition to being a proven and highly successful platform for attracting affluent producers, dealers and suppliers. The fact that its previous hosting attracted over 430 exhibitors and over 8250 quality visitors mostly from the its core target group, adds to its allure.

To facilitate the continued growth of the healthcare industry, Medicall is also organising conferences on ‘Good to Great’ which transform your family owned

good hospital into a great healthcare institution. Other value added conferences are on ‘Hospital Material Management’ and ‘Internal Audit’.

For three days, Medicall in Ahmedabad will serve as the nerve centre of the healthcare business in India, and is expected to surpass the 10,000 footfalls from last year. The steady growth in participation at Medicall every year, in terms of numbers already achieved, is an indication of the benchmark it is about to set in terms of business volumes and visitations, claim the organisers.

The steering team for this show is piloted by Dr S Manivannan, CEO, Medicall, K Sundararajan Project Director and Yogita Panchal, Manager – Corporate Marketing.

Medexpert, organisers of Medicall are also conducting the Medicall conference in Sri Lanka from March 15-17 2013 at Colombo.

For more details: www.medicall.in

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PRE EVENT

iPHEX 2013 to showcase Indian pharma exports; R&D capabilities Over 400 international buyers and regulators expected at iPHEX 2013

he Pharmaceuticals Export Promotion Council of India (Pharmexcil), has announced the launch of iPHEX 2013, India’s own pharmaceutical show under the support of Ministry of Commerce and Industry, Department of Commerce, and Government of India. iPHEX 2013 shall be held in Mumbai from April 24-26, 2013 and over 400 leading Indian companies are expected to showcase the best of pharma products at the event.

The organisers claim that iPHEX 2013 will see the presence of 5,000 business visitors including overseas buyers and drug regulators. Huge business opportunities are expected to emerge during the event. Further, the presence of large number of drug regulators from overseas market is expected to help Pharmexcil and its members to promote the quality and affordability aspect as envisaged in ‘Brand India’ pharma campaign. The campaign has been initiated by Ministry of Commerce and executed by Pharmexcil in association with IBEF. Elaborating on the strengths of the Indian pharma industry, Dr PV Appaji, Director General, Pharmexcil says, “India is the third largest player in the world with 500 different APIs and ranks fourth globally in terms of production volumes; and 13th globally in domestic consumption value. The country is the largest exporter globally of generic formulations in volume. It exports vaccines to 150 countries and produces 40-70 per cent of the WHO demand for DPT and BCG and 90 per cent of measles vaccines.” Besides domestic

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companies are accredited with 851 CEPs, 845 TGA and 513 manufacturing sites, registered with US FDA. They have been granted 90 per cent of APIs approvals for ARVs, anti-tubercular and anti-malarial. India also ranks highest with 35 per cent share in filings of DMF filed with US FDA and it sells 15 per cent of generics by volume in US.” iPHEX 2013 aims to be a complete value chain show and Pharmexcil is creating a sustainable pharma industry platform with a special focus on exports market development. “The exports growth story is one to be proud of,” says Appaji. “Total exports during the last five years have grown by 16 per cent CAGR, growth during the last financial year, 2011-12 was 23.34 per cent in USD terms.

North America continues to be our best destination with a CAGR of 25 per cent and 33 per cent growth during 201112. Exports to EU has grown exceptionally well during 2011-12 with 28 per cent considering the fact that a single digit CAGR was recorded during the last four years.

Exports to Oceania have also grown well with a growth of 43 per cent but the overall turnover is small and considering the fact that Australia and New Zealand are not yet fully tapped, higher growth rates can be expected,” he mentioned.

With increasing R&D spends, Indian pharma sector has become a cost-effective centre for world class

research as also for contract R&D. Indian companies in recent years have produced many cost-effective drugs that are affordable to the masses, said Ashutosh Gupta, Vice Chairman of Pharmaexcil. “We are making concerted efforts to promote India’s status as the manufacturing hub of the world,” added Gupta.

Pharmaexcil informs that India is a favoured pharma hub since it is technologically strong and totally self-reliant, has low costs of production, low R&D costs, innovative scientific manpower, strength of national laboratories and an increasing balance of trade. They also inform that Indian pharma industry today is ranked world class, in terms of technology, quality and range of medicines manufactured. From simple headache pills to sophisticated antibiotics and complex cardiac compounds, almost every type of medicine is now made indigenously. The industry today can boast of producing the entire range of pharma formulations, i.e., medicines ready for consumption by patients and about 350 bulk drugs, i.e., chemicals having therapeutic value and used for production of pharma formulations.

Pharmexcil also highlights that more and more Indian companies are investing in research and development (R&D). They are working overtime to improve the overall quality of their existing product and services lines. India has steadily

(L-R) Dr PV Appaji, Director General at Pharmexcil India and Bhavin Mehta, CoA Member Pharmexcil and Committee Chief of iPHEX emerged as a major global R&D hub despite starting late.

The country with a spending of $30 billion globally ranks eighth. India has moved up in the pecking order which includes leading innovators like China, Japan, Germany and South Korea. The average R&D expenditure by Indian pharma companies is close to six per cent.

The Government has prepared a ‘Pharma Vision 2020’ document for making India one of the leading destinations for end-to-end drug discovery and innovation.

Through this, the government provides support by way of world class infrastructure, internationally competitive scientific manpower for pharma R&D and venture fund for research in the public and private

domain. The Government is also embarking on a major multi-billion dollar initiative with 50 per cent public funding through a public-private partnership (PPP) model to harness India’s innovation capability. The vision is to catapult India into one of the top five pharma innovation hubs by 2020, targeting to achieve a global niche with one out of every five to ten drugs discovered worldwide by 2020 originating from India.

“The Government has also been taking various policy initiatives for the pharma sector. These include taxbreaks to the pharma sector and weighted tax deduction at 150 per cent for the R&D expenditure incurred. Steps have also been taken to streamline procedures cover-

ing development of new drug molecules, clinical research etc. Indian Government has launched two schemes—New Millennium Indian Technology Leadership Initiative and the Drugs and Pharmaceuticals Research Programme—specially targeted at drugs and pharma research,” says Appaji. “iPHEX 2013 will be the biggest industry exposition in India showcasing the diverse range of products and will include formulations, APIs, Ayush, nutraceuticals, health services, biotechnology and biotechnology products, R&D services etc,” informed Bhavin Mehta Committee Chief of iPHEX and CoA member, Pharmexcil.

In addition to a world class exhibition and meeting place for Indian companies and global buyers, Pharmexcil plans to organise several thematic seminars and conferences on the sidelines as well. “These shall include pharma sector investments, R&D and innovation, overseas market entry strategies etc,” mentioned Mehta.

The Ministry of Commerce, has launched a series of initiatives to promote Brand India Pharma and iPHEX 2013 is expected to offer a perfect opportunity for international buyers and regulators to come to India and evaluate how well structured and regulated the Indian pharma industry is.

Visit www.pharmexcil.com for more details.

Nominations invited for Healthcare & Pharma HR of The Year, HarNeedi TREE Awards 2012 Instituted to honour HR professionals in the healthcare and pharma fraternity, HR of the Year, HarNeedi TREE Awards 2012 are the vision of HarNeedi.com, with Padmashree Dr DY Patil University as Knowledge Partners and Express Healthcare and Express Pharma as exclusive media partners xpress Healthcare, Express Pharma and Padmashree Dr DY Patil University along with HarNeedi.com have teamed up to honour the HR professionals who have contributed relentlessly and continue to

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propel Indian healthcare and pharma industries on a growth path.

As India’s number one jobsite for healthcare and pharma professionals, HarNeedi.com is an offering from Makro Group launched www.expresshealthcare.in

in 2007 to address crucial manpower solutions to these two industries.

Through keen observation of recruitment trends over the years, HarNeedi.com has acknowledged the immense challenges and con-

tributions of HR professionals and therefore instituted the HR of The Year HarNeedi TREE Awards 2012.

Explaining the thought process behind the awards, Mahesh Malneedi, Chief Executive Officer, JANUARY 2013

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HarNeedi.com said, “Today HR plays a dynamic role to hunt, recruit, manage and retain human resources for an organisation. In fact HR is like a tree, supporting thousands of professionals who dwell and grow along and get introduced, impacted, mentored and climb on the ladder of success.” Dr Sanjay Oak, Vice Chancellor, Padmashree Dr DY Patil University opine, “HR plays a silent and vital role in both healthcare and pharma industries. Such events will not only boost the HR leaders but also provide an excellent platform to discuss current and future HR problems and solutions. Gaurav Malhotra, Managing Director and Chief Executive Officer, Patni Healthcare, also a member of panel of judges explained the crunch, “Talent attraction, retention and development are key challenges in healthcare today and it would be exciting to see and analyse how the HR managers successfully manage.”

The panel of judges comprises Dr Sanjay Oak, Gaurav Malhotra, Viveka Roychowdhury, Editor, Express Healthcare and Express Pharma and Sudhir Bahl, Co- Founder and CEO, Irene Healthcare, Kawaljeet Oberoi, Chief Nursing Officer, Gleneagles Khubchandani Hospitals, Biblob B Banerjee, GM HR, GSK, with more confirmations in the pipeline.

Nominations are invited from the pharma and healthcare fraternity nationally for various categories. The nominations will be put through a stringent procedure where they will be screened on various parameters by the panel of judges. “The entire healthcare and pharma community is invited to nominate HR professionals. Here I see an opportunity for industry to display its solidarity by honouring our HR professionals. We hope the HarNeedi TREE Awards 2012 will serve as an appreciation and salutation to help our HR colleagues shine and grow into a much bigger tree to accommodate more and more talent,” mentioned Richard D’silva, Senior Marketing Manager, HarNeedi.com explaining the process and procedure followed for these awards.

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“Being associated as knowledge partners with HarNeedi TREE Awards 2012, we stand to applause the selfless work being performed by HR personnel in both the sec-

tors,” stated Dr Nitin Sippy, Asst Professor and Course Incharge - MBA Health and Hospital Management, DY Patil University. The awards will be announced and given

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away during the conference focussing on HR issues prevalent in the healthcare and pharma sectors. Dates and venue will be announced shortly.

For nominations and more details visit: http://www.harneedi.com/in dex.php/hr-awards EP News Bureau- Mumbai

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HospiArch 2012 elicits good response in 2012 India’s well known conference series on Hospital Planning, Design & Architecture fared very well at Chennai, Hyderabad, Mumbai, Bangalore, Kochi and Delhi in 2012. HospiArch 2013 kicks off from Vijayawada on January 24, 2013 he demand for hospital beds in India is expected to be around 2.8 million by 2014 to match the global average of three beds per 1000 population from the present 0.7 beds. India needs 100,000 beds each year for the next 20 years at over $10 billion per year. Understanding these statistics, two young healthcare entrepreneurs felt the need to conduct a series of conferences on hospital planning, design and architecture across the country and succeeded.

HospiArch, the brainchild of Paniel Jayanth and Tarun Katiyar, founders of AMEN and HOSPACCX India Systems repectively, was designed to create a platform for doctors, entrepreneurs, consultants and architects etc. who are aspiring to build new hospitals. The conference series covered six places in 2012 namely Chennai, Hyderabad, Mumbai, Bangalore, Kochi and Delhi. The first HospiArch Conference was conducted at Chennai in January 2012 and continued to Hyderabad in April, Mumbai in June, Bangalore in August, Kochi in September and Delhi in November. Each conference saw a participation of more than 150 delegates comprising entrepreneurs, hospital promoters, CEOs, administrators, architects and students.

The topics, strategically designed by Paniel, were one of the main reasons for the success of the Conference series as they brought about efficient speakers to present on them and prolific discussions within the audience.

Some of the key topics were: ● Architectural challenges involved in building a new hospital ● Planning and designing a new hospital ● Re-planning and redesigning an existing hospital ● Budgeting and financial planning for a new hospital project ● Quality standards applicable to hospital planning ● Planning a green hospital ● Manpower planning for a

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Tarun Katiyar , Principal Consultant, Hospaccx India Systems

Paniel Jayanth, Founder & Chief Strategist, AMEN

new hospital ● Planning and designing lab and other diagnostic areas of the hospital Some of the key speakers included: Dr Alexander Kuruvilla, CEO, Medica Synergie, Bangalore; Anil Maini, Executive Director, Moolchand Medicity, New Delhi, Dr Anilkumar Mulpur, VP & Clinical Director, Narayana Hrudayalaya, Hyderabad, (Hony) Brig Dr Arvind Lal, Chairman and Managing Director, Dr Lal Path Labs, New Delhi; Dr Arun Sharma, Medical Suptd., Govt Hospital, Jammu; Asoka Katakam, Architect, Katakam Associates, Hyderabad; Dr Chandrashekar R, Chief Architect, Central Design Bureau for Medical & Health Bldg., Ministry of Health & FW, Govt of India. New Delhi; Gaurav Malhotra, Managing Director and CEO, Patni Healthcare, Mumbai; Jagruthi Bhatia, Director - Lead Healthcare Advisory Services, KPMG, Mumbai; Lakshman Gowda TL, CEO, The Cradle, Calicut; Dr S Manivannan, Joint Medical Director, Kauvery Hospital, Chennai; Dr (Wg Cdr) MD Marker, Medical Director, Bhagwan Mahaveer Jain Hospital, Bangalore; Monika Kejriwal, GM, Healthcare Planning, Chaithanya Projects, Bangalore; Nagappan, GM Materials, Apollo Hospitals, Chennai; Dr Parvez Ahamad, Group Medical Director, Rainbow Children's Hospital, Hyderabad; Dr

Pradeep Bhardwaj, CEO, Six Sigma Healthcare, New Delhi; Radhakrishna, CEO, Narayana Hrudayalaya, Hyderabad; Dr Rajeev Boudhankar, Vice President, Kohinoor Hospitals, Mumbai; Ratan Jalan, Founder & Principal Consultant, Medium Healthcare Consulting, Hyderabad; Dr PS Reddy, G M Hospital Administration, Kamineni Institute of Medical Sciences Hospital, Hyderabad; Sandeep Shikre President + CEO, SSA Architects, Mumbai; Dr Sanjeev Singh, Medical Suptd., Amrita Institute of Medical Sciences, Kochi; Dr N Sethuraman, Chairman, Meenakshi Mission Hospital, Madurai; Sujayanti Dasgupta, Associate, HKS, Chennai; Susee Papinazath, Managing Director, Skydome Designs, Chennai; Dr Varma Vagesna, Vice Chairman & MD, Lazarus Hospitals, Hyderabad; Dr Vivek Desai, Managing Director, HOSMAC India, Mumbai.

“Owing to the success of the series and immense motivation gained from more than 700 participants, 25 sponsors and partners across the country in six cities, we are glad to announce HospiArch 2013, and spread our knowledge platform of perfecting architectural designing and meeting the numbers needed to match the growing need in patient care,” announced Paniel. HospiArch 2013 would be held at 12 different places of the country in 12 months starting from Vijayawada on

Dr Alexander Kuruvilla, CEO, Medica Synergie

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Dr Vivek Desai, Managing Director, HOSMAC India

(Hony) Brig Dr Arvind Lal, CMD, Dr Lal Path Labs

Dr Chandrashekar R, Chief Architect, Ministry of Health & FW Jan 24, 2013. The list include: Vijayawada, Chandigarh, Pune, Coimbatore, Kolkata,

Ahmedabad, Indore, Guwahati, Lucknow, Jammu, Jaipur, Trivandrum JANUARY 2013

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64th Annual Conference of CSI & SAARC Cardiac Congress highlights need for public awareness The four day conference on cardiological interventions, attended by 4000 delegates from international universities and cardiac institutes, emphasised on the need to create public awareness at different levels of the society and implement a school curriculum on preventive measures

n an effort to expand its horizon in the field of cardiology, Cardiological Society of India (CSI) had organised its 64th Annual Conference in association with SAARC Cardiac Congress, one of the biggest and celebrated affairs in the medical fraternity. The conference which was inaugurated by the Vice President of India, M Hamid Ansari and the Chief Minister of Delhi, Shiela Dixit and attended by a congregation of 4000 eminent national and international delegates, ended on a successful note.

The focus of the four day conference, ‘Cardiology in India-Prevention & Intervention,’ was aimed at raising public awareness on cardiac diseases at different levels of the society and laid emphasis on the need to take up preventive measures at the primary level.

Considering the need to combat cardiac diseases at an early stage, CSI offered to have a memorandum of partnership with the State of Delhi to make the city a 'Happy Heart State' through creating public awareness campaigns regarding heart diseases, heart attacks and its prevention. CSI also proposed a movement to spread ‘heart health awareness’ amongst school children through creation and implementation of a school curriculum related to

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prevention of heart diseases.

The society also requested to promote heart healthy diets and tiffins in addition to regular health checks in the schools of the city.

Delhi CM, Sheila Dixit said, “I am happy to accept the memorandum submitted to me by CSI and would be keen to put a road-map to this with the leading cardiologists of the country.” Speaking on the occasion, Dr Ashok Seth, Organising Chairman, CSI said, “It is the responsibility of the CSI to bring out the best from the cardiologists of today and be t h e incubator to create the cardiologists of tomorrow. We need to do more public education, be involved in corrective heart care, government heart health policies, and we need to be an audible voice in the country. To make our efforts successful, we must encourage public health camps, media outreach initiatives on creating awareness and acceptance on healthcare technologies.”

Dr Ashok Seth speaking at the CSI Conference Sharing insights on coronary artery diseases (CAD), Dr KK Aggarwal said, “Incidence of CAD has doubled over the last two decades. The risk of CAD in Indians is four times that of

white Americans, six times that of Chinese and 20 times that of Japanese. In order to prevent cardiac diseases in India CSI has suggested government to ban tobacco in India.”

During the valedictory session, Dr Seth thanked everyone who participated in this conference and expressed his gratitude for their contribution in the field of cardiology.

First WISC in India concludes on a note of caution Calls for concerted action to control the rising incidence of food and other allergies he WAO International Scientific Conference (WISC 2012), which for the first time was held in India under the patronage of the Ministry of Health and Family Welfare, Government of India and was organised by the World Allergy Organization (WAO) from 6-9 December in Hyderabad, concluded with a Patient Forum held at Apollo Hospital that stressed the need for high-quality allergen extracts and allergen-specific IgE tests for Indian foods, and celiac reagents/tests. It also called for additional training of paediatricians, allergists and other clinicians to help combat the impact of this growing health problem.

The experts emphasised the need for additional data and labeling policies which are considered essential to enable consumers and exporters of Indian food and

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packaged products to take informed decisions.

The conference was attended by more than 1,000 representatives of universities and scientific organisations from across the country and the globe. The conference spanned four days offered an enlightening range of educational sessions for physicians and allied health care professionals.

Global medical experts who participated in the WISC shared their ideas and new information on the emerging science of allergy and treatment for serious diseases such as asthma, allergic rhinitis and allergic skin diseases.

The World Allergy Organization also featured the WAO White Book on Allergies – an advocacy document that offers high-level recommendations toward creating a more integrated www.expresshealthcare.in

and holistic approach for diagnosis and management of allergic diseases which are fast assuming alarming proportions and pose a major threat to public health. The publication was distributed to policy makers in the Indian Ministry of Health, The Indian Council of Medical Research, patient organisations and other medical associations.

The WISC also concluded with an agreement of WAO to work in collaboration with Ministry of Health and other medical associations, with the aim of establishing implementation groups in India to improve medical practices for the betterment of quality of life for patients affected with allergies. To raise awareness among children a painting competition on the theme “What do allergies look like?” was also held at Apollo Hospital on last

day of the conference.

“As the prevalence of allergic disease and asthma rises in countries around the world especially among children regardless of their economic status, so do the socio-economic costs both direct such as interference with breathing during day or night, emergency department visits, and hospitalisations, and indirect such as reduced quality of life, reduced work productivity and absenteeism,” said Professor Ruby Pawankar, WISC Conference President and President of the World Allergy Organization. “This is an issue that calls for all countries, irrespective of their economic status, join forces in addressing a major global challenge that threatens health of the people at large and national economies alike”, she added.

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Clean India Show held at Bengaluru The event showcased the most advanced cleaning equipment and received a good response from visitors pan India he Clean India Show was recently held in Bengaluru with newer technologies and cleaning solutions for industries, institutions, municipal corporations, hospitals, hotels and retail segments. The event was supported by the Department of Urban Development, Government of Karnataka, the Central Pollution Control Board, Bengaluru Municipal Corporation and National Environmental Engineering Research Institute. The threeday event was inaugurated at the KTPO Exhibition Complex by Dr CS Kedar, Additional Chief Secretary to the Government of Karnataka, Karnataka Urban Infrastructure Development and Financial Corporation (KUIDFC).

Inaugurating the event, Dr Kedar said, “The movement towards mechanisation is going to happen in future, which is very well reflected here at the expo. I think the

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infrastructure is quite receptive towards this.” He further said, “It is important that the tourism industry takes a lead in introducing these equipment in maintaining the surroundings of heritage structures and places of tourism importance.” On the occasion, Ashok Jain, General Manager, KUIDFC said, “The modern equipment and mechanised sweeping of the streets is most cost effective to implement.”

The showcase at the KTPO venue included mechanised solutions for commercial cleaning, industrial cleaning, city cleaning, waste management, waste-water and sewage management, laundry, pest management and housekeeping. The show covering an area of 2,246 sq m with participation from experts/companies from India and abroad displayed over 150 brands including cleaning equipment like street sweepers, vacuum cleaners, high pressure jets,

ride on sweepers/scrubber driers, carpet cleaning machines, concrete maintenance machines, etc. Also on display were chemicals and hygiene products, cleaning tools and laundry solutions.

Clean India Show, which started in 2005, has now grown to become one of the largest cleaning shows in Asia. This year’s show had exhibitors like Sealed Air India (Diversey India), Karcher Cleaning Systems, Eureka Forbes, Charnock Equipments, Ion Exchange India, Pest Control India, Lanxess India, Unger India, Bosch , 3M, SuriePolex, TSM , Best Practices, Inventa Cleantec, Haylide Chemicals and others.

Mangala Chandran, Director, Virtual Info Systems, said, “This is a giant stride for us to acquire participation from leading companies and support from Karnataka Urban Development Department, Bengaluru Municipal

Corporation and many organisations from different states.

The show has been specially tailored to help address the pressing issues and importance in cleaning across industries. We are working together with participating companies to equip industries with the necessary knowledge to address critical issues that hinder productivity improvement for cleaning.

Lastly, we would like to thank all the participating companies for their support.”

At the venue, seminar on ‘Hospital Hygiene’ and ‘Waste Management and Recycling of Municipal Waste’ was held on the inaugural day. Topics like industrial cleaning and building service industry were discussed in the subsequent days. Another highlight was the show on laundry section for the first time with seminar sessions on laundry. The seminars were addressed by experts from the respective fields.

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Fellowship on Health Technology Assessment (HTA) in India HTA organised by Amrita Institute of Medical Sciences, Kochi received a good response mrita Institute of Medical Sciences, Kochi had organised the first International fellowship on Health Technology Assessment (HTA) from 9-16 December 2012, in association with Joanna Briggs Institute of Evidence Based Medicine, University of Adelaide, Australia with faculty from University of Toronto and University of Liverpool. This fellowship was privileged to have Healthcare Technology Innovation Centre, IIT Madras and National Accreditation Board of Hospitals & Health Care providers as technical collaborators.

118 participants from different parts of the country attended having varied backgrounds ranging from clinicians, hospital administrators, nursing, biomedical engineers, pharmacists etc. HTA has been practiced extensively in UK and US from macro level policy decision making to institution level application for best evidence based resource utilisation. It is a new and innovative concept and it was heartening to see that even India is ready with implementation of a useful objective tool in healthcare.

HTA is a multidisciplinary activity that systematically examines the safety, clinical efficacy and effectiveness, cost, cost-effectiveness, organisational implications, social consequences, legal and ethical considerations of the application of a health intervention/technology – usually a clinical or surgical intervention, drug or medical device.

In UK, HTA broadly focuses on clinical effectiveness (how do the health outcomes of the technology compare with available treatment alternatives) and cost effectiveness (are these improvements in health outcomes commensurate with the additional costs of the technology.

The learning objectives of the eight day- structured course was: to impart training to the future torch bearers of healthcare professional on

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HTA, understand ethical, social and legal aspects of intervention selection, conduct systematic reviews to collect evidence for each interventions/technology, do economic modelling and learn harm-benefit assessment and finally to do impact assessment of any new methods.

The course was inaugurated by Dr T Sundaraman, Executive Director of NHSRC who is very keen to start HTA at Ministry of Health and has already included HTA as one of the 12 priority items for the planning commission to look for. He gave insights into HTA’s application in government decision making which will help to come out of policy paralysis and allocate adequate resources for better equity and access. Dr Gayatri, Director NABH was the Guest of Honour, reiterated the importance of HTA in accreditation, patient safety and improving outcomes. Dr Mohanshankar, Director, HITC, IIT Madras, gave an explicit presentation of various innovative healthcare delivery work, which IIT Madras has initiated with healthcare industry. He also presented mobile eye clinic work done with Sankara Nethralaya. Dr Prem Nair, Medical Director, AIMS made important contribution of HTA at institutional level and AIMS is using this tool for early decision making.

Dr Sanjeev Singh, Medical Superintendent, AIMS presented about national database and how national and state benchmarks have been achieved for essential quality indicators and moderated the sessions. Dr Jitendar Sharma, Clinical faculty from University of Adelaide and NHSRC helped understanding application of HTA in today's context in Indian Healthcare and quoted various success stories on HTA from other countries. He was also a facilitator for the whole course.

Dr Arun Patel, Consultant, NHS, UK taught regarding ethical and social applications www.expresshealthcare.in

and importanc at SCTIMST. Dr Jitendar and Dr Sanjeev took sessions on how to make healthcare safe using HTA as a tool and to do critical analysis of patient safety practices. They also introduced impact assessment templates for direct observation and application of eenewer technologies and always make that crucial decision on balancing cost v/s outcomes.

Dr Anil Srivastava, Director Institute of Statistics taught basic principles of health statistics for non statisticians, data mining and data warehousing.

Dr Niranjan, Clinical Engineer from Sree Chitra talked about role of medical technology assessment in technology innovation and on methods of technology assessment in technology selection and surprised the audience with domestic production of medical devices happening at SCTIMST. Dr Jitendar and Dr Sanjeev took sessions on how to make healthcare safe using HTA as a tool and to do critical analysis of patient safety practices. They also introduced impact assessment templates for direct observation and application of evidence available in healthcare and use HTA for better effectiveness.

Dr Krishna Rao, Chief Healthcare Economics at PHFI took sessions on economic evaluation, role of ICER, QALY, DALY in healthcare; conducting cost effectiveness, measuring costs and effectFeand gave various

group work on economic modeling in healthcare delivery. Dr Rumona Disckson, Chief HTA at University of Liverpool talked about overview of evidence synthesis, various randomised control trails, studies conducted for gathering best evidences and touched upon observational and diagnostic studies.

Dr Prakesh Shah, Paediatric Intensivist from University of Toronto, shared his experience on defining research questions, developing a protocol, formats of scientific reviews, types of intervention, outcome measures, statistics on systematic reviews, search strategy and assessment of risks in healthcare practices.

Participants were very positive and participative. The feedback has been good and various requests were made to have joint groups to take HTA forward in India.

HTA offers an innovative basket of tools which can help policy makers decide which intervention/technologies are effective and which are not, and define the most appropriate indications for their use.

HTA is expected to eliminate interventions that are unsafe and ineffective or whose costs are too high compared with the benefits. HTA has to take into consideration all aspects namely ethical, social, legal, scientific review (evidence), cost effective analysis and impact assessment that might be influenced by the technology as well as those influencing the technology.

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HBII 2012: A grand success More than 3,000 trade visitors attend the event he 3 rd edition of India’s premium event on hospital infrastructure, planning, supplies and healthcare developmentHBII 2012 had a successful conclusion.

The event attracted over 3,000 trade visitors consisting of CEOs, medical directors, hospital administrators, medical superintendents, bio medical consultants, healthcare architects, project management consultants, developers, PE firms, and many senior decision makers and healthcare professional.

The burgeoning opportunities and technological advancements in the Indian hospital infrastructure sector were also highlighted at the three-day exhibition and technical conference.

A strong line up of speakers and industry illuminati shared their expertise and discussed the technological advancements and the way forward in the industry. The three-day conference was broadly categorised into three technical sessions; starting with Leaders in Healthcare Winning Strategy in the New Regionalised Multinational Healthcare Market Place. The second session was titled Hospital Build, Design and Upgrade Designing and building safe, functional, effective architecture and infrastructure. while the third was Quality Of Care - Leap over the Quality Chasm through Redesigning Healthcare Quality Model. Attractive panel discussions, from internationally acclaimed companies and influential healthcare personalities from India served as an excellent catalyst to the entire conference programme.

Renowned dignitaries who stamped their presence and shared their views at the event included Dr Chandrasekhar R, Chief Architect – Ministry of Health & Family Welfare,

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Government of India; Dr Sujit Chatterjee, CEO, LH Hiranandani Hospital; Dr Vishal Beri, COO, Hinduja Healthcare Surgical; Vishal Bali, CEO, Fortis Global; Dr Rajeev Boudhankar, Vice President, Kohinoor Hospital; VP Kamath, COO, Wockhardt Hospitals; Gaurav Malhotra, MD and CEO, Patni Healthcare; Dr Ganapathy, President, Apollo Telemedicine; Manpreet Sohal, CEO, SL Raheja Hospital; Abhishek Singh, Associate Director, PwC India; Dr Sameer Mehta, Director-Projects, Hosmac India; Marcelle Mc Phaden, Regional ManagerAsia, Accreditation Canada International; Gaurav Chopra, MD, HKS India and Frederic Nantois, Architectes Ingenieurs Associes-France.

One of the major highlights of this edition was the announcement of the first Hospital Build & Infrastructure Awards to felicitate the best efforts in the healthcare facility and to recognise leaders within the industry who have devoted their efforts in building hospitals that help improve healthcare services and raise the bar in providing world-class patient care.

The HBI awards, India was organised in line with the International Series of Hospital Build & Infrastructure Awards which is conducted by its other portfolio of events like Hospital Build Middle East, Dubai.

To further add value to the platform, new initiatives like a business match making service was also introduced in addition to the industry specific conference tracks, product demonstrations, seminars and display of leading hospital infrastructure products, technologies and services. The exhibitors included hospital consultants, healthcare architects, planners, developers, medical equipment www.expresshealthcare.in

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suppliers, hospital furniture and interiors, flooring, roofing, lighting, clean room partitions, hospital paints, modular OTs, bedhead panels amongst many more.

Around 100 exhibitors from India and abroad, showcased the entire gamut of hospital infrastructure products, medical equipment/technology, and hospital solutions all under

one roof.

The exhibiting brands were Tata Motors, Godrej Interio, Modular Concepts, Allarch India, TAPHI Pty Ltd, Draeger Medical India, Mindray, HLL Lifecare, Sio Vassundhara International, Portalp International, Mehta Tubes, Zebra Technologies, Hospaccx India T M, CR Medisysytems, KGD Architecture, Attune

Technologies, Hill-Rom, Alvo, RAM Metal Industries, Knauf RAK FZE, Linet, Hospaccx India Systems, Bluestream Manufacturing Services, Agora Climate Control Systems, Aeropure Systems, Light & Magic Automation, Eubiq India, Archetype, American Institute of Architects, STH Architects, Bowman Riley Architects, Bioni Paints

India, Helix Corporation, Edifice Medical Systems, Barco, Cosign India, RMG Polvinyl, Tata Consultancy services, Redsun Communication, Pratiba Medinox, Piercing Systems, Studex, CAEM India, Carefusion, Cosign India, Knauf Rak Fze, Everest Industries, Hosmac India, Ziqitza Healthcare to name a few.

Exhibitors’ feedback BII 2012 was a great platform for people from healthcare fraternities to meet and showcase their products/services to delegates/attendees to drive the growth.

HBII 2012 for Ziqitza Health Care has proved to be good as it gave us a platform to connect on large spectrum with like minded people. It indeed made us aware on the trends in the healthcare sector. We got a good response from the visitors .We hope to cater to them post understanding their needs.” — Ziqitza Health Care “HBII 2012 is a fabulous event which can provide total solutions to the healthcare industry under a single roof. It can play an imperative role in providing innovative solutions. HLL being a total healthcare solution provider got an opportunity to showcase our services through HBII 2012.” — HLL Lifecare “HBII 2012 has provided a unique platform to the solution providers as well as key decision makers for the hospital and medical fraternity. This would go a long way in raising the overall quality of infrastructure in healthcare, thus providing medical facilities to the patients at the best of quality and affordable costs.” — Draeger Medical India “HBII is an appropriate exhibition to showcase new concepts in the hospital industry, i.e., we have the decision makers attending the exhibition. More importantly, no general visitors attend the exhibition.” — Zeco Environmental Solutions “HBII is a good show and the right platform for manufacturers/suppliers of hospital construction/interior/technical products and the right place to showcase the product range to the hospital owners, decision makers, architects, consultants etc. The show was organised well.” — RMG Polyvinyl India “We are glad that we took part in this great show. The quality of the visitors and the enquiries we received was really good.” — Modular Concepts “HBII 2012 has successfully delivered us a unique platform consisting of multidisciplinary healthcare providers and planners in India. Allarch Healthcare was able to capitalise through our presence and collaborate directly with business decision makers.” — Allarch Healthcare Technologies “I would strongly recommend this exhibition and conference for every healthcare decision maker in India. All topics have been carefully chosen with correct speakers. I would say the star product of this event has been the awards, which has been well received by all. We need such organisations to bring the industry closer and bridge the gaps.” — HOSMAC “We have achieved what we have aimed for – introduction of our products to the medical fraternity. We had a bonus, clicked two clients in the show itself.” — CAEM Shelving India “Knauf Middle East’s experience at HBII 2012 was outstanding, looking at the feedback and the quality of visitors. The exhibition brought together the decision makers and providers for the region. We are looking forward to participate again at HBII 2013.”

— Knauf Middle East “HBII turned out to be a great exhibition with specific clientele. We met a lot of project owners and similar leads.” — Ram Metal ( Profex) “We thank HBII for organising an excellent healthcare conference bringing in all the industry experts under one roof. We are positive that all exhibitors and delegates really benefited from it. We look forward to 2013.” — KGD Architecture “It is all about the three ‘E’s, Excellent Exhibition Experience.” — HOSPAXX India

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Winners of the HBII Awards, India ◆ ◆ ◆ ◆ ◆ ◆ ◆

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Kohinoor Hospital – Best Sustainable Hospital Project Hiranandani Hospital – Best Healing Environment Apollo Telemedicine – Best Technology Initiative Fortis Memorial Research Institute – Best Initiative to Improve Design Standard for Healthcare Larsen & Toubro – Builder/Construction Company for a Project Medanta – Best Physical Environment Award Archimedes - Architect/Designer of the year for a Project

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‘Envisioning affordable healthcare for all’ The Omidyar Network and the Delhi branch of The Indus Entrepreneurs (TiE) organised a conference to bring eminent panelists from the healthcare sector under one roof for a discussion on ways and means to achieve the goal of healthcare for all

ven as Obamacare rings in ‘affordable healthcare’ as a buzzword worldwide, it has been doing the rounds in India for quite some time, with the Indian government having constituted a high level expert group to put together the plan for universal health coverage.

Private sector efforts along with public private partnerships, entrepreneurs and NGOs have pushed the cause a notch further. However, there are lessons to be learnt, including going back to the drawing board, brainstorming ideas and coming up with unique solutions that address the equally challenging needs that a country such as India presents. It was with this in mind that the Omidyar Network and The Indus Entrepreneurs (TiE) organised the ‘Affordable Healthcare Summit’ in New Delhi that brought together various stakeholders from the industry, academia, entrepreneurs and Government to ponder, rethink, debate and share their opinions and learnings.

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The Government’s role Opening the session, Sanjeev Bhikchandani, Founder and Vice Chairman Naukri.com and President of the Delhi chapter of TiE, revealed that TiE no longer represents only IT entrepreneurs, healthcare is an emerging domain. He lauded Omidyar for its model of being a for profit and doing social good, a role traditionally left to non-profits. “My perJANUARY 2013

sonal belief is to really build a scalable model, you have to be a for-profit, otherwise you are constantly seeking funds from outside,” he added.

Jayant Sinha, Partner, Omidyar Network, then gave the audience a background of the networks activities and its inception. An initiative of eBay founder Pierre Omidyar, the network has invested $600 million in the last eight years since its inception across both for profits and not-for-profits out of which $100 million have been so far invested in India. He stressed on a sector-based approach and how it can be used to take healthcare to a completely new trajectory.

Following this, Arun Maira, Member, Planning Commission cited healthcare as a next big opportunity where innovation and new solutions could change the game altogether. Health is a fundamental right that even the poor should have access to and hence the need to find solutions specific to the needs of the country, is imperative, he stressed. Talking about the government’s role in healthcare, he added that innovations are needed on the process side to have efficient healthcare delivery mechanisms that ensure both healthcare providers and provisions being accessible, new medicines and devices on the product side and also newer ways of providing insurance to people. While advocating the role of regulations in the medical devices, Maira was www.expresshealthcare.in

optimistic about the sector, which has a huge potential for growth. He urged for ‘People Public Private’ solutions and models that bring together the government, industry and civil societies keeping the needs of the common man in mind. “So let’s work together to see what each of our roles is in devising the process of continuing to learn together, because we won’t get the innovation right the first time,” he concluded.

Representing the Medtech industry, Ajay Pitre, Managing Director, Sushrut Surgicals, stressed the need for the right regulations, citing them as fundamental for those in the industry. However, there needs to be prioritisation and then sensitisation to these along with an influx of investment and adequate technology, he added. “The industry needs to put in a huge input in terms of training and development which requires an all rounded approach from all stakeholders, some of whom currently undermine the relevance of the sector,” he opined. This in turn would help enhance medtech outcomes and directly benefit the end user. Talking about Department of Biotechnology’s innovative schemes, which although help develop IP, do not fund it, he praised DBT’s openmindedness to suggestions to improve the same. Pitre outlined the role of the Indian medical device sector when he said, “Medtech is about contribution and not about profit.”

Nachiket Mor, Chairman of the Boards of Directors, Sughavazhvu Health Care, on an optimistic note for the role of the private sector, said, “Unlike other sectors, the government is a small player in healthcare and therein lies an opportunity for us.” He stressed the need to find out ways the Government can mobilise funds currently being utilised in secondary and tertiary centres, towards

primary healthcare centres.

This needs to be followed with evidence-based screening alongwith guidelines and protocols behind it, he added.

Drawing from his experience at Sughavazhvu Health Care which is trying to make healthcare accessible to the rural poor in Tanjore, Tamil Nadu, Mor added that the Government should commission a group giving them a set of problems and then direct them to solutions. “There is a need for clarity for vision. For instance, what do we need to do at primary healthcare level, build capacity there to deal with emergencies then and there.”

Even the Government-run Rashtriya Swasthya Bima Yojana (RSBY) scheme has its challenges, he said, facing them and learning from them is the road ahead.

“If we do not address the disease burden it will show up sooner or later, thus also increasing the utilisation of resources at the ground level vis-a-vis the projected figures.

Hence, the Government needs to give the vision and leave the execution to the private sector,” he concluded.

Rethinking access This session had an interesting mix of panelists, sharing their experiences on how to make healthcare accessible to the populace. Zeena Johar, President, IKP Centre for Technologies in Public Health (ICTPH), the research arm behind Tamil Nadu-based Sughavazhvu Health Care expressed the excitement and challenges of starting the venture six years back. “Initially we started out thinking that if we systemise the supply side, we will be able to create a good business model.

However, during the course of time, we learnt that demand side generation is even more important.” A systematic understanding of the community they operate in, its requirements and sustained efforts to make a difference in the lives of these people were EXPRESS HEALTHCARE

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some of the driving factors behind Sughavazhvu which has a user fee driven model till now.

Rajat Goyal, Co Founder, and CEO of EyeQ, a chain of eye care hospitals in Tier-II and III cities, echoed Johar’s thoughts restating that it takes initial years to breakdown the problem, understand it and then automate the process.

He talked about the opportunities that lie for secondary models to be created in rural areas. Building the patients trust, understanding their needs while taking care of infrastructure, training and manpower were some of his learnings. The impact of the company can be gauged by the fact that 40 per cent of EyeQ’s patients come from households with income less than R`s 10,000 per annum and 30 per cent of the total surgeries performed are done for less than ` 5000. Sheena Chabbra Chief of the Health Systems Division, USAID, pointed out that the limited role donor agencies can play given that less than one per

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cent of the funding in healthcare comes from them. A total market approach then is the best way, she suggested.

Commenting on the role of NGOs, Alkesh Wadhwani, Deputy Director, Avahan, an initiative from the Bill and Melinda Gates Foundation, highlighted that scalability is a challenge for non-profits as they drive towards self-sustenance. Most of the large agencies in the field will continue to be foreign civil society NGOs. The panelists agreed on use of technology to increasing access. To this effect, android-based platforms, open source technologies and aggregation of such solutions and deploying them to the end user was suggested.

Ruchi Dass, CEO, Healthcursor Consulting Group emphasised on funding more models centered around mHealth commending India for being the best adopter as per a PriceWaterhouseCoopers (PwC) report. Asif Saleh, Director-Strategy, Communications & Capacity Division, BRAC, an organisation in Bangladesh that started 50 years ago with a vision of providing ‘low tech, high touch’ care talked about using information, communication and technology to change people’s behaviour so that they are aware enough to protect themselves. Citing the fact that the country was able to increase its immunisation rate from two per cent to a current high of 85 per cent. He said that the process innovation is then the key. Talking about the challenge of relocating doctors to rural areas, Goyal from his experience suggested that providing amenities such as schools, residential facilities etc helps physicians to consider working in such areas.

Debunking a few myths on innovation Pitre of Sushrut Surgicals of set the tone by suggesting that the methodology for innovation needs to be repetitive and it needs to move from an art to a science.

“We need to ask if a costeffect relationship can be established. When this inadequacy is treated as a learning, only then can innovation be unearthed,” he added.

A patient-centric approach when designing a www.expresshealthcare.in

product was of consensus across the panel. Bhaskar Bhatt, Coordinator (Product Design), National Institute of Design, (NID) Ahmedabad put it in words when he said, “Design is about humanising technology.”

Nish Chashmawala, CoFounder, MD and CEO, Consure Medical, a start up that focuses on fecal incontinence stressed how difficult it is to commercialise a simple product. Sudhakar Mairpadi, Director, Quality & Regulatory (Health Care Sector), Philips Electronics India noted that although the patent act does not support incremental innovation, Ministry of Health and the Department of Science and Technology are now realising the capability of the medical electronics industry through the new manufacturing policy. The lack of mentorship in the industry as a gap that needs to be addressed was also mulled upon.

Closing session The concluding session saw Dr AK Shiva Kumar, Member, National Advisory Council, concerned with growing scepticism in the Government about the private sector, urging it to get its act right and become more transparent and accountable since it needs to join hands with the Government as per the Universal Health Care (UHC) plan. He emphasised the need for affordable care at primary, secondary and tertiary level that reaches the interiors of the country while also pointing out the demand for 5 million to 10 million health workers who need to be trained as paramedics and technicians to make this a reality.

“Lack of capacity in the Government to deal with training and certification requires healthcare professionals to take up the mantle,” he said. Payment through insurance and prepayment thus reducing out of pocket expenditure at the point of service and integrating primary and secondary healthcare, were pointed out as the two pivotal points of a well performing healthsystem, by Mor. Stating that we can have affordable healthcare at $30 per capita, he stressed the need for greater Government funding and ini-

tiatives by the public sector in this regard.

Sinha of Omidyar added to the above saying that the market and the state need to work in harmony to ensure equitable distribution. Dr Kumar further elaborated that the emphasis is to provide universal primary care, and most of secondary care in order to reduce the expenditure of those who cannot afford it, so that tertiary care is only needed when required.” The Government is open to experimentation, innovation and piloting. The scope for public private partnerships is huge,” he enthused. The caveat is that there has to be genuine interest from the private sector, only then can they be given the task of contracting the services. The discussion then veered to the role of state vs the centre with health not being a priority subject in political circles and a tussle of funds between the state and the centre. While the centre lacks the political will and has the funds, the constitution mandates that health is a state subject. This coupled with state governments having a better understanding of their respective situations, the future would see more autonomy to the states. And hence what we need is more than just high end insurance schemes, we need a people’s movement that pushes for primary care, universal immunisation, lowering maternal births, thus demanding greater accountability from the healthcare system, concluded Dr Kumar.

The day-long event saw huge participation from close to 190 participants from the healthcare domain, including eminent panelists who helped delve into pressing issues that need to be addressed at the earliest to ensure that the millions of people at the base of the pyramid get the benefits that are overdue. While answers to all questions cannot be readily found, the day saw some tough questions being asked and equally tough answers given.

Although we are still far away from the reality of affordable healthcare, such dialogue is a beginning in the right direction. shalini.g@expressindia.com JANUARY 2013

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EVENTS UPDATE Green lean six sigma certification training for healthcare Date: February, 6-8, 2013 (Yellow belt training) 11 – 16, 2013 (Upgradation to green belt training) Venue: Bangalore Last date to register: January 18, 2013; Friday 5:00pm Upgradation to Black Belt: follows tentatively in June

ical engineers, medical colleges, health care services, investors for health care industry, purchase managers Contact details: Medexpert Business Consultants Pvt Ltd C-3, Shree Vidya Apartments,14 Balakrishna Street, West Mambalam, Chennai - 600 033 Tamilnadu, India Phone: 91 44- 24718987 Contact: Yogita R Panchal (panchal@medicall.in) Mob: +91 9360727424

iPHEX 2013

Date: March, 1-17, 2013 (Fridays, Saturdays and Sundays only) Date: April 24-26, 2013 Last date to register: February 6, 2013; Wednesday 5:00 pm Upgradation to Black Belt: follows tentatively in July Venue: Delhi Summary: This programme module is specially designed for hospital managers and other healthcare professionals and shall focus on six sigma methodologies, lean concepts in healthcare systems and service delivery. The uniqueness of this programme is in it's module that smoothly integrates healthcare service delivery with six sigma, lean management concepts and in its ability to build six sigma professionals to cater to three most important aspects of healthcare service delivery (safety, efficiency and efficacy) and at the same time maintain an equilibrium with customer satisfaction, costs and sustain the quality achieved.

Organisers: AUM MEDITEC, A hospital planning and management consultancy organisation Participant profile: Hospital CEOs /COOs, management executives, hospital operations managers, quality in charge, MHA/PGDHA/MBA (Hcm) final year students Contact: Meeta Ruparel meeta@meditecindia.com, meetaruparel@hotmail.com

Medicall 2013 Date: February 8-10, 2013 Venue: Gujarat University Exhibition Hall, Ahmedabad, Gujarat Participant profile: Doctors, hospitals owners, diagnostic centres, medical directors, biomed-

JANUARY 2013

Venue: Mumbai Organiser: The Pharmaceuticals Export Promotion Council of India (Pharmexcil) Topic: iPHEX 2013 is expected to be an industry exposition in India showcasing diverse range of products and will include formulations, APIs, ayush, nutraceuticals, health services, biotechnology and biotechnology products, R&D Services

Imaging in Cancer Drug Development Date: March 13-14, 2013 Venue: The Copthorne Tara Hotel, London, UK Organiser: SMi Group Topic: The event will focus primarily on oncology imaging modalities and applications in preclinical case studies, clinical imaging applications and innovations in imaging technology Speakers: Experts like Bert Windhorst, Head Radiopharmaceutical Chemistry, VU University Medical Centre; Francois Lassailly, In-vivo Imaging Specialist, Cancer Research UK; Peter EggletonMedical Director, Merck; Prash Krishna, Director - Oncology, Clinical Development, Eisai and Werner Scheuer, Research Leader Preclinical Imaging, Pharma Research and Early Development, Roche Diagnostics Contact: UK Office, Opening hours: 9.00 - 17.30 (local time) Tel: +44 (0) 20 7827 6000 Website: http://www.smi-online.co.uk Email: events@smi-online.co.uk

Website: www.pharmexcil.com

The Annual Conference of the Indian Society of Interventional Radiology

AIIMS-MAMC-PGI imaging course on "Recent Advances and Applied Physics in Imaging" Date: March 29-30, 2012

Date: February 14-17, 2013 Venue: AIIMS Venue: Kovai Medical Centre and Hospital, Coimbatore Organiser: The Society of Interventional Radiology (USA) Topic: The Society of Interventional Radiology (USA) will be co-partnering this meeting and a full delegation will be representing the American Society to help postgraduates in india connect to centres in US for fellowships and training. there will be hands-on training exclusively for post graduates students which will be co-attested by both SIR and ISVIR Contact: Dr Mathew Cherian Email: isvir2013@gmail.com Website: http://isvir13.com/

www.expresshealthcare.in

Organiser: Department of Radiodiagnosis, AIIMS Topic: Recent advances and applied physics Speakers: Eminent speakers from AIIMS, MAMC, PGI Contact: Dr. Sanjay Sharma, Dr. Ashu Seith Bhalla, Organising Secretary, Department of Radiodiagnosis, AIIMS, Ansari nagar, New delhi-29 Tel: 011-26594889, 011-26594925 Email: aiimsmamcpgi2013@gmail.com

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EXPERT SPEAK

‘We proposed a minimum of 2.5 per cent of GDP towards healthcare’ Dr Srinath Reddy PRESIDENT OF PUBLIC HEALTH FOUNDATION OF INDIA (PHFI)

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s the Chairman of Planning Commission’s High Level Group on Universal Health Coverage, Dr Srinath Reddy has set new goals for healthcare. The President of Public Health Foundation of India (PHFI), in a free wheeling chat with Shalini Gupta, talks about how India can get its act together in public health

What is your vision for Public Health Foundation of India (PHFI) and what efforts are underway to realise the same?

The reason I gave up my Chair of Cardiology at All India Institute of Medial Sciences (AIIMS) and came to PHFI is because I believe that India needs to build a lot o f capacity in public health. We need to create institutes dedicated to capacity building, reorient existing courses at medical institutes and colleges towards public health, do good public health research which is policy and programme relevant and promote interdisciplinary public health education.

We are delivering shortterm training courses to healthcare professionals since the last four years through our institutes in Delhi, Hyderabad, Bhubaneshwar and Gandhinagar. We plan to start a fifth centre in Shillong soon.

Our flagship programme, Diploma in Public Health is closely aligned to National Rural Health Mission (NRHM) as a part of which we are training a number of district and block level medical officers.

Our Health Communication Division along with Health Systems Support unit is working closely with Central and State governments to help strengthen the health systems in terms of design and opera-

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tion. Engineers at the Affordable Technologies unit are trying to find ways to increase the capacity of nonphysician providers to point of care diagnostics at primary healthcare centres.

Swasthya slate, a tablet computer and an android phone rolled into one, that can help diagnose diseases on the spot is being tested out in Andhra Pradesh. In a nutshell, we are working on multiple fronts, right from education to technology to advocacy for public health.

Government funding in healthcare is perhaps the lowest in India. It is set to increase towards the end of the 12th plan after the recommendations made by the high level expert group led by you. How is it going

of essential drugs free of cost.

Therefore, we proposed a minimum of 2.5 per cent of GDP towards healthcare for present plan period and three per cent by the next plan period.

However, a financial protection mechanism alone will not suffice unless it is backed by a delivery mechanism which is accessible and efficient. This, in turn, demands infrastructure, a competent motivated health workforce, equipment, drugs, vaccines and technologies alongwith a managerial system which ensures best utilisation of all available resources: human and financial. The approach has to take into account a package of services, not piecemeal.

Unfortunately our system has had defects in each and

Even with increased public funding in healthcare, there would be little or no absorption of these funds in the absence of adequate number of doctors and nurses, hence building the capacity of the health system is important to help?

Social determinants of health such as water, sanitation, nutrition and environment are important but public health financing is pivotal to provide financial entitlement in terms of purchase of services so that the out of pocket expenditure is taken care of. It is also needed for expansion of health workforce- for building better infrastructure and provision www.expresshealthcare.in

every one of these. A weak public sector infrastructure and a severely constrained health workforce both in numbers and skills further compounds the problem. We need to set right all of this.

Public financing thus would only solve part of the problem then?

Even with increased public funding in healthcare, there would be little or no absorp-

tion of these funds in the absence of adequate number of doctors and nurses, hence building the capacity of the health system is important.

Our view is that primary healthcare both in rural and urban areas need not be doctor intensive. Substantial number of non-physician health providers, like trained community health workers, auxiliary nurse midwives (ANMs), male multi-purpose health workers, mid-level health workers or even AYUSH practitioners with bridge training can create a cannon of mid-level health workers suited to be positioned at sub centres.

These sub centres are functioning as static centres with only one auxiliary nurse midwife (ANM).

Each sub-centre should have two ANMs, one multipurpose male health worker, one mid-level health worker, one lab technician cum dispenser and this should in turn become an outreach facility that can cover 30005000 people in remote areas.

Such a system ensures preventive healthcare right at the primary level.

So basically a bottoms up approach to healthcare starting at the district level?

We need to strengthen district hospitals, make them training centres for new medical and nursing colleges and courses such as Bachelors of Community Health.

People trained here would be well acquainted with primary and secondary healthcare and well equipped to handle all problems at the district level reducing the dependency on tertiary care (corporate hospital or medical college). Creating referral linkages from primary healthcare to secondary to tertiary would help build a credible, coherent, well-organJANUARY 2013

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ised system which is currently fragmented.

In districts where there are still gaps, public health providers can be contracted on a payment basis to perform the same services under the UHC system on terms set by the public sector. This has to be decided by the district health system manager. The idea is not to use private sector as a substitute to the public sector but as a supplement to it, where the public sector needs some additional hands.

How do you see provision of essential drugs for free, augmenting the cause?

Providing essential drugs free of cost helps reduce out of pocket expenditure, most of which comes from outpatient care and medicines. Recently, the Government has decided to provide drugs for TB for free, but the ambit of such drugs needs to be increased.

Free distribution of drugs through public facilities helps increase public trust in such facilities, examples of which can be seen in Rajasthan and Tamil Nadu. The state can use its power for pooled procurement of unbranded generics or generics at low cost, eliminate middlemen, so that drug manufacturers will be able to reduce the rates thus reducing dependence on branded drugs, while ensuring quality. An essential healthcare package should be available to every citizen free of cost, given that current insurance schemes do not pay for outpatient care, primary care and supply of medicines over a long time.

While the government has been the major player and is doing good through Rashtriya Swasthya Bima Yojana (RSBY), Arogyashree and other schemes, the focus has to be less on funding tertiary care and secondary care, but more on improving overall population health outcomes.

Integration of these schemes into the overall framework of Universal Health Coverage (UHC) needs to worked at.

Primary care has been neglected so far, even in urban areas, that trend needs to be reversed, it has to be the first priority.

So, this package would only cover primary healthJANUARY 2013

care?

It should cover secondary care alongwith some elements of tertiary care. For e.g., a child with leukaemia should not be denied treatment, as a young man with a snakebite who may die without ventilator support in a village and also a woman who has had a mishandled delivery with a ruptured uterus, such elements from tertiary care need to be fitted into the essential healthcare package. The

and health management cadre should be created. We also need a spirit of Partnerships for Public Purpose (PPP) wherein we define the public purpose, say what needs to be delivered, who will deliver it, find complimentary roles for the parties involved and hold them accountable.

What are the public health challenges of India? What role can preventive healthcare play?

At the end of 12th five year plan, I would like to see most states investing heavily alongwith Central government support in primary healthcare and out of pocket expenditure come down to 50 per cent from the current 71 per cent

money needs to come from tax-based financing, additional amount can be paid by employer based insurance or private insurance if elements outside of this package need to be purchased.

What is your view on government regulations and their role in healthcare?

Recently, Ministry of Health is ordering drug quality to be tested not only from samples lifted from the shops but also from manufacturing hubs, however, we need more drug testing labs across the country. The Clinical Establishment Act is only adopted by four states, even that still has some lacunae.

Drug regulation is relatively on the weaker side, particularly w.r.t. state drug authorities, so we need to strengthen our drug regulatory system.

For all common clinical conditions, standard management guidelines should be evolved through expert consensus and become mandatory.

Accountability should improve so that people can address their grievances at the block level. A public health cadre www.expresshealthcare.in

We have a mixed challenge for years to come.

While infectious diseases such as malaria, HIV,TB, neglected tropical diseases and a lot of parasitic diseases inflict the population on one hand, NCDs are galloping fast expanding their reach to rural areas.

Better quality of water, sanitation and environment will prevent a lot of infectious diseases. Fundamentally, we need to lay the foundations of good health across the whole life span of an individual.

Prevention can be done at different levels at the onset preventing risk acquisition, then when one has acquired the risk factors and is on the verge of developing the disease and finally preventing those with the disease from developing complications or recurrence. At the same time we also need to gear up our health system for early detection and management of risk.

What should be the approach to achieve preventive healthcare?

A multi-sector approach is needed where in we work with sectors such as water, sanitation, nutrition urban

design, agriculture and food processing etc.

Policies and programmes in other sectors have quite an impact on health. So just as we are aligning policies towards environment to assess the environmental impact, it is also important to align those policies towards health, be it reducing the amount of unhealthy fats in processed foods or ensuring greater production and availability of fruits and vegetables. There is health beyond healthcare.

Let me give you an analogy. In automobile industry, if cars are going out of order, we try and build sturdier models, then we see if road conditions are good, or have potholes, try and repair them and finally educate drivers for better repair of cars.

Building a car repair shop at every corner does not help.

Similarly, human beings can also be built sturdier through better nutrition, creating better environmental conditions through safe water, better urban planning and finally make people health aware. Building hospitals and nursing homes everywhere is not the solution.

How do you envision the country’s healthcare system in the coming years?

At the end of 12th five year plan, I would like to see most states investing heavily alongwith Central government support in primary healthcare and out of pocket expenditure come down to 50 per cent from the current 71 per cent, a drop in the indicators such as infant mortality and maternal mortality, a substantial improvement in child undernutrition and anaemia in adolescent girls, essential medicines given free across the country, public health cadre in every state along with the health management cadre and a strong regulatory system set up to ensure appropriate care delivery and accountability.

I do not expect all of UHC to be implemented in the next five years, that will take 10 years, but I would like to see us moving quite well along that path. shalini.g@expressindia.com

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EXPERT SPEAK

‘Maharashtra needs to increase proper healthcare infrastructure’ Suresh Shetty HEALTH MINISTER – MAHARASHTRA

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he transition of Maharashtra's healthcare sector from a static and inconspicuous industry to an increasingly dynamic and significant industry is noteworthy. Suresh Shetty, Health Minister – Maharashtra, elaborates on the transitions in healthcare system within the state, its achievements, short comings and the way to go ahead, in a tète-à-tète, with Raelene Kambli

Maharashtra has been at the forefront to provide good healthcare services.

What, according to you, are the areas where the healthcare structure has improved over the last few years and which areas need more attention?

The healthcare sector in the state of Maharashtra is growing year on year. The sector is mainly divided in two major components - the government sector and the private sector. The government sector comprises municipal hospitals run by the Corporation and Zilla Parishad healthcare centres within the rural areas run by the village Zilla Parishads. Whereas, the private sector in Maharashtra functions in various ways i.e. through hospitals, diagnostic centres and other healthcare delivery models. Maharashtra's healthcare sector has seen growth in both private and government sectors, but the private sectors have been in the forefront, especially within metro cities. The private sector is also setting up hospitals in various small towns and cities.

On the government front, we have introduced many schemes that have helped us uplift the healthcare scenario within our state. Healthcare services in our state have improved over a period of time, especially in our rural areas.

We have upgraded our primary healthcare centres and govern-

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ment hospitals throughout Maharashtra.The only problem in the government sector is that not many funds are allotted to the corporations, a big issue in itself. The other areas that need attention is the lack of healthcare infrastructure, especially within rural areas of Maharashtra, and shortage of trained healthcare professionals.

What are the most important prerequisites to enhance the healthcare system in Maharashtra ?

The state of Maharashtra needs to increase proper healthcare infrastructure, especially in the rural areas.

The other aspect that needs urgent attention is the shortage of trained professionals in the healthcare sector. The patient-to-nurse ratio is quite less. We also need trained paramedics to run our ambulance services efficiently.

Human resources is a problem not only in our state, it is a national problem as well.

Recently, I visited an international conference where we learnt that countries such as Sweden, Canada and China are also facing a shortage of trained healthcare professionals. For this we need more educational institutes introducing medical and healthcare delivery based courses.

There seems to be a large mismatch between demand and supply when it comes to quality healthcare. What strategies are the government adopting to bridge this gap?

The Government of Maharashtra has introduced many schemes to increase accessibility and affordability of healthcare services. We are soon going to establish four institutes for mental health, incorporate vocation training for emergency services in our medical colleges and are also www.expresshealthcare.in

looking for collaborations with private sector players to build more hospitals, especially in the rural areas.

Tell us about the nature of the healthcare initiatives that have been taken by the Maharashtra government.

Also shed some light on the way you see the actual impact of these initiatives.

The Public Health Department of the Government of Maharashtra, is making constant and concerted efforts to formulate and execute schemes in line with the National Health Policy to ensure adequate healthcare services to the people of our State. Some of schemes are mentioned below: ● National AIDS Control Programme ● National Programme for Control of Blindness ● National Rural Health Mission ● Reproductive & Child Health II ● Revised National Tuberculosis Control Programme ● National Leprosy Eradication Programme ● Rajiv Gandhi Jeevandayi Arogya Yojana While implementing these schemes, steps are being taken to make improvements in the healthcare system of the State to cater to the health needs of the people in the rural areas, particularly in the tribal and backward regions of the State.

So far, we have invested Rs 2900 crore in upgrading our current hospitals, primary healthcare centres and other medical institutes all over Maharashtra.

Our Rajiv Gandhi Jeevandayi Arogya Yojana (RGJAY), launched by the Maharashtra government enables families with annual income of less than Rs one lakh to avail free medical facilities worth upto Rs. 1.5 lakhs. The

scheme is implemented throughout the state of Maharashtra in a phased manner for a period of three years.The insurance policy coverage under the RGJAY is meant for the eligible beneficiary families in eight districts i.e.

Gadchiroli, Amravati, Nanded, Sholapur, Dhule, Raigad, Mumbai and suburbs. The scheme provides for 972 surgeries/therapies/procedures along with 121 follow up packages in 30 different specialisations. The scheme works in collaboration with some private hospitals and is doing really well. We have completed 20,000 surgeries so far. For us, this is a great achievement.

In September 2012, you had planned to set up a vigilance squad to audit National Rural Health Mission (NRHM) funds.

What are the findings of the audit so far?

Yes, we set up a vigilance team to ensure that the NHRM funds are used effectively and there is no scope for misuse in the wake of the misappropriation of funds which came to light in some areas such as Dhule and Gadchiroli. We have already taken the culprits into custody and will be punishing their act.

Apart from this, you would be glad to know that Maharashtra has been rated as one of the leading states for optimum utilisation of NHRM funds. This year, Maharashtra was allotted Rs 1900 crore under NHRM and for the forthcoming year, the government has already announced a 30 per cent increase in the NHRM funds for our state. With this increase we will strengthen our medical services in the rural areas within Maharashtra.

High maternal mortality rate (MMR) is one of the biggest problems within Maharashtra's rural areas.

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initiatives to curb this problem?

We have really worked hard to bring down MMR in our state and have been successful in doing so.

Maharashtra has become one of India’s most progressive states with regards to infant, child and maternal mortality rates. We have collaborated with various NGOs and healthcare organisations to facilitate training and medical aid to women living in the rural areas of Maharashtra. This initiative within the rural areas of the states has helped us increase the number of deliveries within hospitals. We also conduct regular audits of maternal deaths in an effort to bring down the maternal mortality rate in the state.

Speaking about PPPs in healthcare, it is said that few other states in India seem to be doing better as compared to Maharashtra.

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How do you plan to promote and sustain PPP models within the state?

PPP is a very complex subject, it needs both parties to work in sync. Having the PPP model we are very soon going to come up with four institutes for mental health and vocational training centres in our state. We are always looking out for healthy partnerships with the private sector. We have the land we want, the private sector can provide us with their expertise in healthcare delivery. We are also trying out another unique model called the built operate and transfer (BOT) wherein we will provide the land and our private sector partner will build the facility and help us in operations as well.

There still seems so be a digital divide within the healthcare sector in our state. What are your plans to provide impetus to the

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healthcare IT sector here?

on this issue?

I do not agree that there is a digital divide in Maharashtra where healthcare IT is concerned. Our state has been in the forefront of adopting IT in healthcare. We have our National e-Governance Plan (NeGP) to provide services to the rural population at their doorstep at an affordable cost. Under the NeGP plan, the state government provides for telemedicine services to the rural areas of our state. Apart from this, our Director of Health sector's office is completely paperless.

We have a strong struck inventory system in place.

The Clinical Establishment Act only speaks about registering a clinic. It has rules and guidelines for registering a clinical establishment. There is nothing like what the Indian Medical Association claims.

There are plans to introduce the Clinical Establishment (Registration and Regulation) Act in the State but Indian Medical Association (IMA) is opposing it since they feel it will unleash a "licence raj" in the state. What is your opinion

What is your agenda for 2013?

In the year 2013 we would be working towards creating more infrastructure for healthcare within our state and also increase skilled manpower in healthcare. Apart from this, we would be establishing 10 blood banks across the state and introducing blood storage units pan-Maharashtra. The blood bank and storage units will work as a service wherein blood would be collected at the door step of the donor by just dialling 102. We would be the first to introduce this service in the Satara and Sangli districts. raelene.kambli@expressindia.com

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DR PARVEZ AHMED Chairman and MD, Aapka Urgicare

THE PHOENIX RISES

A healthcare veteran, Dr Parvez Ahmed started Aapka Urgicare in August 2012 and and is investing Rs 2.25 crores per centre to set up the first four centres and a total cost of Rs.12 crores. With an increasing number of accidents, emergency care is a pressing need and reaching injured patients to a hospital is an immense challenge, which Dr Ahmed sees as a huge opportunity. He intends to bridge the gap by creating a new concept: setting up a chain of Urgent Care Centres (UCCs) positioned as friendly neighbourhood first response healthcare providers.

Uniqueness He believes that his UCCs can change the present healthcare scenario by providing high quality immediate medical care through highly trained professionals close to their homes or work places. Patients and their relatives do not have to wait for ambulances to take patients to far off hospitals. They don’t have to fight the traffic to reach emergency rooms, they don’t have to wait for hours in OPDs for minor medical needs, they do not need to pay through their teeth for unnecessary hospitalisations – Dr Ahmed says that the nearest UCC is equipped to take care of all these hassles.

Thus the chain of UCCs are positioned to bridge the gap between the primary care doctor and hospital emergency rooms. For instance, in JANUARY 2013

Delhi, they fill the gap due to the lack of a proper ambulance network in the city and will help save lives by providing care during the crucial Golden Hour.

Business Model Dr Ahmed says that his business model is to provide accessible and affordable immediate medical care of highest quality in the neighbourhood through his UCCs. The model is the first of it’s kind in India, bridging the gap between the primary care doctor and hospital emergency rooms. Dr Ahmed says that his business model is a unique asset light model which will make the centres more affordable. This is another plus point from the capex point of view as well.

There is a great need for this service in India. His model can be easily adapted across geographies and can be tweaked to cater to local health profiles.

Aapka Urgicare centres will help in decreasing the load of minor cases from hospital emergencies and help them concentrate their resources on sicker ones. The urgent care concept will definitely change the present healthcare scenario.

Dr Ahmed says that they hope to raise the standards of emergency medical care in the local area and eventually whole of city.

doctors, nurses and paramedics has been their constant challenge as the field of emergency medicine is a nascent field in India. So they started out their own training module for them.

Despite these hurdles, their major challenge has been educating the consumers and other healthcare providers on the concept of UCCs. As it is the first-of-itskind emergency care service in India, people have to be convinced that a UCC could be relied on as a first responder in a healthcare emergency. Door to door visits in local neighbourhoods to educate the consumers on the advantage of using the UCCs have helped overcome this challenge.

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Our unique services can change the complete healthcare scenario by providing high quality immediate medical care by highly trained professionals close to home or work place

to the Delhi population. Thus is is important for the UCC team to serve what they promise. The UCC leadership team has to play a critical role to implement the processes and quality standards to set the benchmark for upcoming new centres.

Dr Ahmed says that as they are a customer centric service, it will be important to incorporate customer needs and expectations into business planning and strategy. 2013 will be the year where we will focus on further understanding customer needs so we can offer services that not only meet but exceed customer requirements, he promises.

Future plans In the coming year Dr Ahmed has ambitious plans for Aapka Urgicare. His agenda for the year ahead is to set up 18 Urgent Care Centres in the Delhi NCR region and deliver quality care to the neighbourhood population.

2013 is the year when their UCCs will grow in numbers and will become visible

Major challenges Non-availability of suitable ground floor locations in densely populated areas was a major challenge for Dr Ahmed's team. They overcame this by opting for a combination of ground floor and basement. Another area of concern was lack of trained manpower. Dr Ahmed says that lack of emergency

Speaking about his driving force, he says that what kept him motivated during difficult times was being focused on his vision to set up a new urgent care delivery model which was unique to the Indian scenario and was the need of the hour. Eliminating negative thoughts, celebrating small achievements and a never-give-up-attitude helped to keep the entire team motivated.

He wishes that the local population will trust UCCs as their first choice for all immediate medical needs and the healthcare community understands and supports the concept of UCCs. He also wishes to receive government support for UCCs. His growth plan for the future is to have 34 centres in NCR Delhi in next two years and a total of 110 centres in North and East India in the next four years.

Here's wishing him luck!

M Neelam Kachhap mneelam.kachhap@expressindia.com

www.expresshealthcare.in

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DR AKASH RAJPAL Founder, MD & CEO, Ekohealth

SEEING HEALTHCARE IN A NEW LIGHT

I ndian healthcare has made tremendous progress in the last few decades. However, it does not mean that the basic health of Indians has kept pace with the developments. Even today, the country battles with various adversities which are quite capable of upsetting the growth. Lack of accessibility, affordability, growing disease burdens and lack of insurance penetration are the most obvious ones, but the solutions to these are few and far from the reach of the common man.

Health insurance is one tool that has the potential to solve a lot of problems. Nonetheless, insurance in India is still facing teething problems. There are many patients who refrain from getting an insurance cover. The problem worsens due to lack of information related to cost comparisons, lack of transparency in rates of surgeries and referral fees charged by hospitals which can go as high as 60 per cent of patients’ bill. With all these issues, it seems more like a jigsaw puzzle, doesn’t it?

Tiding over these issues, Dr Akash Rajpal has crafted an interesting model- Ekohealth, in order to change the way Indians approach healthcare.

With this healthcare service, Dr Rajpal strives to build the biggest member ‘value’ network in the country to create a group bargaining power for consumers which was not envisioned before. Though not an insurance product, his service aims at reducing health expenses and works as an adjunct to insurance or as a respite for those who are not capable of

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bearing high medical expenditure. Dr Rajpal claims, that this model can bring in transparency in medical billing and reduces healthcare bills by 30 to 50 per cent.

The model manages to generate revenues through sale of annual family subscriptions which costs a fee of Rs 1,000 for a family of four and Rs 365 for each additional member.

What’s impressive about Ekohealth is that despite going through many rough patches this venture, which started in November 2011, has managed to assemble a service provider network of around 2,500 highquality providers in 12 metros across the country.

It all started like this....

Lessons learnt from the past have been his inspiration.

While working in the healthcare sector as a hospital administrator for 13 years, Dr Rajpal discovered that patients with chronic and critical illnesses like diabetics, people who are on renal dialysis and cancer patients did not have the provision for insurance. Apart from this, he also saw that a lot of unethical practices such as referral practice are being followed by healthcare providers.

These issues kept lingering on

his mind time and again. He then decided to quit his healthcare consultant’s job and start a venture that would be instrumental in tackling these issues.

Making it happen This wasn’t a cakewalk for Dr Rajpal. Setting up a venture that revolved around patient satisfaction and would be viable in the long run needed a lot of toil.

When he started, Dr Rajpal was turned down on many occasions. He received a good response from patients, but convincing healthcare providers to tie-up was the biggest hassle.

However, his tireless efforts paid off, when providers such as Nova Medical Centres, Seven Hill Hospital, Medanta Medicity, Hinduja Hospitals, Vasan Eye Care, Lifecare and many others came forward to partner with him. He invested Rs 25 lakh initially from his own pocket. But this wasn't enough. To get the ball rolling he adopted some interesting strategies to attract members.

So, he established a network of medical centres at first and then utilising the multipronged customer acquisition strategy, he offered negotiated discounts and value adds to prospective patients. To expand further, he established a call centre in Pune

WORDS of

WISDOM

'Let’s have a cleaner and ethical medical practice with a good intention, reducing healthcare costs by 30 per cent'-

for strategic database lead generation and customer support which is run by Zensar Technology. Additionally, he has set up an insurance agent network that would sell Ekohealth’s service to insurance-denied patients.

Leaping forward Dr Rajpal has already set his vision for 2013. He is going to strengthen Ekohealth’s SMSbased generic drug substitution application, e-commerce capability, and marketing programmes that will sufficiently support its network of 10,000 insurance agents. Further plans include developing an effective internal communication system to disseminate information between service providers and patient members, and developing a product called Reverse Health E-auction wherein patients can post their surgery and price concerns online and Ekohealth can help them as per their requirements. In the next five years he hopes to enroll 10 million patients as members.

Brickbats and bouquets While Dr Rajpal’s strategies are directed towards the right goal, has he chosen the right path?

The positive feedback from his clients only proves that his concept is well understood by both patients and providers.

However, the long term profitability of this business model seems questionable at this stage. Since this model mainly generates revenue from patient memberships will it be sustainable in the long run?

Well, that’s something that only time can tell. But looking at Dr Rajpal’s determination and vision, the venture positively has the potential to change the way healthcare is perceived.

Raelene Kambli raelene.kambli@expressindia.com

www.expresshealthcare.in

JANUARY 2013

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DR SABAHAT AZIM Founder & CEO, Glocal Healthcare

PROTOCOL FOR SUCCESS

Q uality, affordability and accessibility! Issues in Indian healthcare that have been debated and deliberated upon, time and again, without arriving at workable solutions, especially in the rural areas.

However, there are two kinds of people in this world – sayers and doers and Dr Sabahat Azim belongs to the latter ilk. So while the debates continued unabated, Dr Azim, a doctor and IAS officer turned entrepreneur, suited actions to words and started his own venture, Glocal Healthcare in July 2011, to provide quality and affordable healthcare to the rural masses in the country.

The inception The idea for his venture took root when Dr Azim was serving as an IAS officer in the remote areas of Tripura.

Those days brought him, as he calls it, an important ‘take away’ that there is no worthwhile healthcare service available to most of the people across the country. He found that there are either dysfunctional public sector hospitals or very expensive quarternary-tertiary corporate hospitals.

He also realised that an average rural Indian spends over a thousand rupees per year on healthcare and that about 3.3 per cent of the country’s population falls below the poverty line due to this expenditure and laments that it is quite unnecessary since it is very much possible JANUARY 2013

to deliver high quality healthcare below these costs. Glocal Healthcare is an attempt to prove exactly that.

Laying the foundation One might argue that there are several other players who are attempting to achieve the same goals, so what makes Dr Azim’s venture different from the rest of them? Well, the uniqueness lies in the fact that Glocal Healthcare Hospitals are the only rural corporate hospitals in the country. System and protocol are virtues that Dr Azim imbibed during his days as an IAS officer and he incorporated these qualities to good effect in his entrepreneurial endeavour as well.

He has attempted to replicate the principles of the highly successful ‘Toyota Production System’ in healthcare i.e. to design out overburden and inconsistency, and to eliminate waste.

Hence, his business model is based on creating a fully functional healthcare system that estimates the disease load and creates protocols for diagnosing and managing them.

His hospitals run on an inhouse developed IT system with built in artificial intelligence known as Medical Diagnosis & Management System (MDMS). Dr Azim claims that this system offers 92 per cent accuracy in diagnosing diseases and giving pre-designed management protocols. The health outcomes achieved through them are measured constantly and the results are titrated to tweak protocols as per requirements. This helps the hospitals to function smoothly and systematically, reduce unnecessary investigations and interventions and reduce the cost of delivery

of healthcare.

Dr Azim informs that their artificial intelligence system has opened up a huge opportunity for growth and that when their prototype gets completed they will be proficient to enable healthcare diagnosis and management across the world from subSaharan Africa to Mongolia without the need for human capital. His words gain credence from the fact that in a year and half his venture has gone from one hospital to a chain of five hospitals.

Growing to the next level Dr Azim has huge plans for his undertaking and intends to take some pivotal steps towards achieving his goals in the coming year. His strategy includes investing Rs 400 crores to build 50 new hospitals across six states i.e. Bihar, UP, Chhattisgarh, Jharkhand, Orissa and West Bengal. He aims to raise the funds through a mix of both debt (65 per cent) and equity (35 per cent), just as he had raised funds for his first hospital. This move is expected to increase Glocal Healthcare hospital bed count to 5500 by

WORDS of

WISDOM

“The only way to ensure healthcare to everyone is to enrol everyone in health insurance plans like RSBY or microhealth insurance. This will enable delivery of healthcare at lower costs by hospitals and will remove poverty due to healthcare expenditures.”

the end of 2014. Thus, 2013 is going to play a very crucial role in his entrepreneurial journey.

Making Glocal Healthcare Hospitals one of India’s largest healthcare providers, in terms of number of beds and number of patients treated, is his vision for the next five years.

Plugging the loopholes Glocal Healthcare’s founder has set himself a very worthy goal but achieving it would be no cakewalk. He himself admits that getting adequately skilled manpower is a huge challenge. Since his model is all about working efficiently and eliminating wastage by reducing time and space, having the right professionals, though few, is of paramount importance. Recognising this he has set up his own skill development centres in all hospitals where nurses/technicians passed out of government colleges are trained and equipped with the appropriate skills.

Again, he has plans to expand across the country and expansion needs a constant inflow of funds. Raising them would be another issue that he will have to tackle. He also needs to guard against any hitches in his working system since they can derail the entire process and putting it all together would be very time-consuming and tedious, thereby defeating the whole purpose of his venture. But all said and done, it is undeniable that Dr Azim has managed to put together a good working solution for the dearth of quality and affordable healthcare in the rural areas of India.

Lakshmipriya Nair lakshmipriya.nair@expressindia.com

www.expresshealthcare.in

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NISHITH CHASMAWALA Cofounder-Consure Medical

REVERS(ING) INNOVATION�

E ven as newer and better cardiovascular stents and insulin pumps hit the market targetting an ever burgeoning population of diabetics and cardiovascular patients, there are certain lone rangers, who are beginning to redefine medical devices and in doing so bring innovative solutions, to lesser known patient populations. Take fecal incontinence, for instance.

Zeroing upon an unmet clinical need Not many might be aware that fecal incontinence, a condition characterised by a loss of bowel control affects close to 16 million patients in India and 100 million worldwide. The numbers however were not the primary motivation for Nishith Chasmawala, Cofounder of Consure Medical, who has developed a unique solution fo the same. Having worked in the medical devices sector for almost seven years in the US, he always wanted to lay down the foundations of his own company. He was briefly associated with a start up Kyphon, until it was acquired by Medtronic in 2007. Standford Biodesign programme had by then positioned itself as a structured fellowship helping fellows understand the India's unmet clinical needs and how can they be met with innovative medical devices. Joining the programme in 2008 helped shape his ideas further. As a part of the programme, he and his colleagues spent a few months observing medical care being delivered at tertiary, village and community hospitals

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in India. It was during this time while understanding the existing lacunae in healthcare delivery, that they zeroed upon 300 unmet clinical needs that should be addressed. However, since all of them cannot be solved, hence zeroing upon one was a tough process, and although quantitative metrics such as the market size, complexity of the disease and others were assessed, it was a passion for the cause itself that led them to the final decision, says Chasmawala.

ward as possible and showing momentum to the investors are the two things that help improve the odds as far as getting funds is concerned advises Nishith. As far as the design of the device is concerned, he says that userfriedliness or consumer friendliness has been one of the topmost priority towards this disruptive device while also ensuring its hygienic and reduces dependence on hospital staff. Its simple to use, yet sophisticated when it comes to technology.

Getting the groundwork done

The road ahead

A good beginning is half the job done, however, the journey of a start-up is saddled with hurdles, funding being the most important. For the first two years of its inception, the company bootstrapped with support from Department of Biotechnology, (DBT), Johnson&Johnson, Corporate houses and Stanford India Biodesign. During this time, they did an efficacy study, filed patents and built a proof of concept model. The company received Series A funding in August this year and has also received a grant from Grand challenges Canada subsequently. Advancing ideas as fast for-

The device which is projected to be launched in the fourth quarter of 2013 has competition from adult diapers, which are used widely by the patient population but lead to hygiene issues, increased hospital stay and infection. The pricing of the device at larger volumes can be cost effective and can compete with adult diapers, informs Chasmawala.

Meanwhile, it is on the road to commercialisation. The company has completed its 'firstin-man' safety study and is currently executing its clinical and regulatory strategy. This would be followed by short clinical studies in different

MADE in INDIA

Innovation is the buzzword but it is taken lightly. What the country needs now is made in India products that are novel, low cost, simple, have patents, serve the Indian markets first, but are adaptive enough for the global market

geographies to demonstrate health-economic value proposition.

The bar is raised higher in a healthcare start-up vis-a-vis an e-commerce venture, a device might backfire in an individual, hence the elaborate process of safety assessment.

Simplify innovation Chasmawala says that founding the company has been one of the most challenging yet rewarding experiences in his life till now, despite all the hardships.

Realising the vision with which they started off right in front of thier eyes is unparalleled, he adds. For those planning to start their own ventures, he advises to spend a few years learning the nuts and bolts at a start up and then take off. When asked what does innovation mean to him he defines it as a novel, simple and cheaper way of doing something that is already being done or is not being done at all. Termed as reverse inovation, he is of the opinion that this is far more difficult and the need of the hour as compared to complex scientific solutions.

Early days The device addresses an unmet clinical needs little thought about, and largely ignored, yet having a large impact.

Technologically advanced, it is consumer centric and easy to use, improving clinical outcomes. However, its adoption by the patients remain to be seen, just as the innovators have been ingenious so far.

Hopefully they'll be able to find a way around this and also a cost-effective pricing to eventually beat competition and emerge as the choice of care.

-Shalini Gupta shalini.g@expressindia.com

www.expresshealthcare.in

JANUARY 2013

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A VIJAY SIMHA

Chief Executive Officer, OneBreath

EXECUTIVE ENTREPRENEUR

A fountainhead of ideas that would positively impact the quality of millions of lives.

This is what Vijay Simha wishes to become. His new venture, OneBreath that manufactures portable ventilators is going to do exactly that positively impact the quality of millions of lives. An inexpensive portable ventilator, the device costs just a fraction of the cost of a low-end conventional ventilator, runs on a 12-volt battery for six to 12 hours at a time, and is smaller than a toolbox so it can be easily deployed wherever needed. Originally designed

by Dr Matthew Callaghan, a consulting professor in Surgery at Stanford University who holds undergraduate degrees in Product design and Biology; the ventilator promises to put the power of managing acute respiratory distress syndrome (ARDS) and chronic disease management to the front-line care workers.

Plans for 2013 This new ventilator is awaiting clearance from regulating authorities and will be ready to market in 2013. Simha reveals that the year 2013 is when the first generation of products for clinical use would be ready for the market after the regulatory clearance from two major market blocks would be done with.

He informs that the product needs to clear the regulatory requirements in various countries. Those needs have been factored or harmonised into the design. He adds that JANUARY 2013

moreover, the paperwork and the accuracy of translation into a number of languages are both time consuming and also expensive.

Simha further elucidates that the product took shape at the Stanford Biodesign Labs in San Francisco in 2008 and has undergone a series of testing under different use case scenarios. The shape and the software enhancements were incorporated to address aspects of human factors who will be operating under constrained resource settings of power, compressed air supply and low skill levels of operating technicians.

He intends to raise approximately $3.0 million, in their first round, to fund and get the product to market.

USP of OneBreath According to Simha, OneBreath came into being by the active participation of a number of stakeholders. He claims that the uniqueness of the business model at OneBreath is the active participation of a number of investor/stakeholders who represent the value chain, from participating product designers and engineering services to potential market partners, potential institutional and government users and investors to participate in the initial development of the company and adds that he is very happy to gain such a high degree of goodwill for the efforts.

There is a huge demand f o r a low-cost ventilator. Simha informs that the projected $ 3.6 billion global demand for mechanical ventilators is driven by the growing incidence of chronic respiratory diseases and the need for emerging healthcare markets

where high acuity care is growing at a seven to 14 per cent per annum. He adds that, besides the growing use of respiratory support equipment in home care and transition care, various governments have recognised that the recurrence of viral pandemics such as SARS, H1N1 would require literally hundreds of thousands of mechanical ventilators to manage such large scale disasters.

There is a concern that refurbished ventilators who have lived beyond their rated lifetimes find their way into ICUs and operating theatres across some of the poorer regions may compromise quality of healthcare delivery.

OneBreath provides a solution to this challenge and offers sophisticated technology, sometimes at a cost lower than that of the cost of refurbishing!

Hurdles to overcome Simha faced many challenging issues handling this venture elaborates that medical technology is a very strategically sensitive knowledge domain and IP intensive discipline as well as a highly regulated industry in most parts of the world. The most frequent question that the investor

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The most important is the constant energy and enthusiasm is essential in a start-up team to start every day with challenges that needs to be overcome. This aspect of the human capital is the essence of millions of years of evolution; and being a part of it is exhilarating

community asks is ‘how would they protect their IP’, followed with the challenges of communicating issues regarding market adoption in a market that is very brand conscious.

However, with more than 20-years of experience in the healthcare technology domain and a keen grasp of technology as well as strategic thinking, Vijay is well equipped to overcome such hurdles. He says that the disturbing trend that projections pertaining to the increased prevalence of acute respiratory distress syndrome and chronic obstructive pulmonary disease are turning out to be real has propelled him to do something in this field.

Moreover he says that having personally spent a lot of time in public fora advocating and proposing a number of ways to make healthcare more inclusive; this is one niche area where one could impact that significantly.

Future plans Simha says that the technology promises to address the issue of affordability much sooner than what was expected. Its impact on healthcare will be felt, especially in the markets where growing aspirations for quality healthcare are high.

In future, Simha plans to develop similar products in the respiratory segment since the IP platform could be exploited to develop a family of other respiratory support products. He intends to address the markets with a range of products and services that would assist chronic patients to carry out a reasonably good quality of life.

M Neelam Kachhap mneelam.kachhap@expressindia.com

www.expresshealthcare.in

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MANISH MENDA Director, MYA Health Credit

CONNECTING THE MISSING LINK

R ecently, a Mumbai resident had a sudden heart attack. When rushed to a nearby hospital her family was told that the patient suffered from atrioventricular block (AVB) and immediately needed a pacemaker costing around Rs 1.8 lakh. Now, the agonising part is that this patient belonged to a middleclass family which could not source the amount right away.

This is just one example.

Similarly, there are millions of families who on various occasions come face to face with this harsh Indian reality: the lack of affordable healthcare.

Well, affordability of healthcare is one of the major problems in India. Thanks to mounting healthcare costs and increasing high-deductible medical-insurance plans; more and more patients are finding it difficult to pay their medical bills; especially, when it comes to major surgeries. Bridging this gap between affordability and accessibility, Mya Health Credit operates in a unique manner.

It is one-of-its-kind patient financing model and a remarkably new concept in India.

Through its financing schemes, Mya Health Credit helps patients who may not be able to bear their treatment costs all at once by facilitating loans at low interest rates per year which can be paid in equated monthly installments (EMI).

Mya Health Credit’s vast network covers a wide range of specialities and procedures at several locations including some of India’s leading healthcare companies, hospitals and clinics. Through Mya, patients

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can apply for medical loans for pre-planned medical procedures such as: fertility treatments, orthopaedic, gynaecology, ophthalmology and dental procedures, hair transplants, urology surgeries, ENT surgery, bariatric surgery and plastic surgery.

Unlike mediclaims and other insurance schemes, patients availing Mya Health Credit receive medical loan in a hassle-free manner without driving them down into debts due to heavy interest rates. The medical financing loans are provided through their associate financial institutions such as Tata Capital. All that a patient has to do is apply for a medical loan through the empanelled hospital and healthcare institutions and the payment is disbursed directly to the hospital or clinic where he is being treated. For the patient there are no extra charges in the hospital. A patient only needs to bear the financing charges for the loan to be paid over a period of time. What’s more interesting about this concept is that in short span of time it has impressed reputed healthcare providers such as Hinduja Hospital, Nova Specialty Surgery, Smile Care and Global Smiles who have joined hands to partner this initiative.

the number of well reputed providers entering the Indian healthcare market, at the same time he also found out that the middle class patients in India were not able to easily access these providers nor could they afford to avail the highly priced surgery packages instantly.

So, it was this realisation that directed him to begin a venture that would make a difference. A lot of backbreaking work and meetings with financial institutes as well as healthcare providers led to the birth of Mya Health Credit.

Toil, tears and sweat Menda began his journey a year ago. He knew he had to be different so, he adopted a competitive strategy that would incorporate the EMI mode- a scheme that the middle-class in India is well versed with. This move facilitated him to put his strategic plan heading in the right direction- be it tie-ups with hospitals and day care centres or tapping funding partners such as Tata Capital.

With this, Menda introduced this service in Mumbai.

Taking his venture to the next level, Menda has set his

The dawn of a new trend This concept was brought to India by Manish Menda, a young entrepreneur who aspired to spark a new trend in the Indian healthcare system.

After completing his MBA in the US, Menda started studying the healthcare markets in various countries including India. His research uncovered significant facts about the Indian healthcare sector.

Elaborating on his research findings, he informed that there is an immense dearth in

WORDS of

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The key will be consumer choice in the future

agenda for 2013 and plans to facilitate loans for as many patients as possible. 2013 will be a crucial year for Mya, informs Menda as their focus for the year ahead would be on quick expansions into various geographies trying to cover as many specialities as possible.

He wishes to start facilitating loans to cover emergency procedures as well.

Looking for a better tomorrow In the light of the fact, that patient financing in India can be an effective tool to bridge the gap between accessibility and affordability, the venture seems to be quite impressive.

Incorporating the EMI mode is definitely a good idea since it will surely attract patients to avail this service and will help them pay off their healthcare dues easily. Having said this, Mya is still a new kid on the block and is yet to prove its mettle. Menda’s biggest challenge is to educate patients about Mya and its services.

For overcoming this, he has undertaken several initiatives such as conducting workshops in collaboration with empanelled healthcare providers. In addition, he has also set up an information desk at some of the healthcare provider’s premises to answer patient queries as well as give information. But that’s not all. In order to make a bigger impact, Menda will have to adopt strong marketing and branding strategies that will help them increase visibility, especially among patients. Going

by Menda’s vision for his dream project, if he covers emergency procedures, then for sure Mya will bring in the winds of change in the coming years.

Raelene Kambli raelene.kambli@expressindia.com

www.expresshealthcare.in

JANUARY 2013

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DR ZEENA JOHAR CEO, Sughavazhvu Healthcare

WISH YOU A “SUGHAVAZHVU”

S uperspeciality hospitals might be dotting the skylines in metros, armed with best doctors and treatments for critical conditions, but the situation is far more bleak in India's interiors.

Most often villagers flock thousands of miles for the right treatment in the absence of facilities in their immediate vicinity. So how do you provide basic healthcare to those at the bottom of the pyramid that is effective in the long run? A chain of clinics in Tanjore, Tamil Nadu may have the answer.

place in Singapore. An effort was also made to understand the flaws that blocked the efficiency of some of these models and what lessons could be learnt from them. As the Founding Member, Johar led the incorporation of SughaVazhvu Healthcare and IKP Centre for Technologies in Public Health (ICTPH) as Section-25, not-for-profit organisations. While the latter works as the research arm playing a role in policy making as well as advocacy, the models and protocols developed are then implemented on ground through a network of rural micro health centres (RMHCs) under the umbrella of the former. The aim was to plan a systemic way of providing healthcare to the rural population at the same time sharing best practices with others, she says.

Taking the plunge When Zeena Johar returned from Zurich in 2007 after finishing her PhD in Biochemistry, she was not ready to settle into a research career. Instead, she wanted to do something challenging that would help create value. It was at that time that Nachiket Mor had left ICICI bank to work with the ICICI Foundation in the area of rural development. Health was an emerging area and she identified with his vision. She wanted to get involved in an endeavour that can help her make interventions which have a larger impact, she informs talking about the choice she made.

They started trying to define primary care, the mechanics of such a system and its scalability. Various models of health delivery and their merits were studied such as: the Thai frontline workforce of community healthworkers and nurses, Sri Lanka's focus on centres of excellence through tertiary care and the financial incentives in JANUARY 2013

Preventive primary care The first RMHC opened in 2009 with a free check up for all. A thorough physical examination of a first time patient is conducted at the clinic. An assessment tool has been developed which records the details of the patient at the clinic, thus helping track any patterns of disease or foretell high risk conditions for which he/she may need to be referred to a sec-

ondary care centre. This helps the primary centre be a referral base and also helps standardise care alongwith setting a prevetive model in place.

However, Johar informs that within a few months of operations they realised a limitation in terms of prescription services and intervention. Which is when, a partnership with the School of Nursing at the University of Pennysylvania was inked in the form of a bridge training course. This could help integrate Ayush practitioners into mainstream for care delivery.

The network has expanded to seven RMHCs, all in Thanjavur, each catering to a population of close to 10, 000 people. Each RMHC, to which a villager has to walk for atleast 45-50 minutes, has a health extension worker and an alternate physician who see 10-15 patients a day. Patients have access to drugs and diagnostics along with opthalmological tests, cervical screening etc.

Standardised protocols cover 70-80 basic disease conditions.

Six of the clinics operate on a user fee based model currently at Rs 15 per person. The money covers consultation charges with drugs and diagnostics being charged at the market price.

LESSONS to LEARN

“Sustainability is core to us, the intent is to demonstrate that there are sustainable ways of providing care, with the larger objective of establishing a sustainable system in the long term.

One needs to create cohesion with a vision.”

Replicating the model In the three years since its operations, Sughavazhvu has touched the lives of 15-18,000 patients for the entire catchment. Johar is confident of taking the clinics to 35 in the next year and half. Along with looking at various ways of community engagement at the unit level, the effort is to make the clinics self-sustainable, recover the cost of running the centres and scaling the model. If theycan demonstrate that, it is a systemic model that they can propagate, asserts Johar.

Expand reach, create value Engagement with community workers to increase the reach of chronic care and disgnostic services is essential for rural geographies along with strategies to integrate primary care with secondary and tertiary care, to help bridge the gap and build trust, says Johar.

Financial barrier also remains a challenge. She stresses that there is a need to establish a market proposition and bringing meaningful value to the service which is acknowledged by the customers. The biggest learning though has been creating a business model in a market with no form of organised care including systemic problems of human resouces and technology.

Scaling up standardised care The model scores points on delivering standardised care and enforcing preventive care at the basic level. Streamlining supply chain and using technology to record data in the form of bar coded enrolment IDs is a plus. Many would be closely watching the scalability of the model and any changes in the evolving business model, if so.

-Shalini Gupta shalini.g@gmail.com

www.expresshealthcare.in

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DR CJ VETRIEVEL

Managing Director, Be Well Hospitals

'BASE OF PYRAMID' ENTREPRENEUR

H e saw the opportunity at the bottom of the pyramid and decided to explore. He found that the Indian healthcare landscape was lacking secondary care centres which provide acute healthcare, especially in small town and cities, and decided to invest in it. Thus, Be Well hospitals took shape in June 2011 with an investment of about one crore rupees. It is a chain of secondary care hospitals targetted at Tier II and III cities. These hospitals typically have 30-60 beds with high quality infrastructure providing comprehensive secondary healthcare services to underserved towns and localities.

These services can either be elective care or emergency care.

Elective care includes the gamut of planned specialist medical care or surgery, usually following referral from a primary or community health professional such as a GP. Dr Vetrievel explains that the developed countries have a clear orderly system of primary to secondary to tertiary well networked and seamlessly functioning healthcare system which in effect keeps the healthcare expenditure of the country well spent.

He further states that Be Well hospitals began to fill the vacuum of an organised secondary care player in India.

learn walking and slowly gets on to running. He plans to open six more Be Well hospitals in the year ahead. They have been funded by the Song Investment Company (By: George Soros, Omidyar Network and Google).

He claims that it’s exciting to create your value ethos and build a strong foundation for the larger vision in the coming years.

What makes it different Be Well intends to change the customer behaviour. What they are offering has been available in the market in terms of nursing homes but with time these had lost the customers’ trust. Be Well intends to bring back that trust in these secondary hospitals by providing an atmosphere at par with the large corporate hospitals but at a fraction of the cost. Dr Vetrievel plans to position Be Well as a quality, ethical multispeciality hospital with focus on 24/7 emergency and critical care services. He says that he intends to change the behaviour of consumers seeking healthcare and see to it that Be Well secondary care hospital will be the first choice for any healthcare need.

Through Be Well Dr Vetrievel not only wants to establish a service provider but also a brand that people will come to trust. He explains that the comfort created will instil

the trust that Be Well will take care of primary to secondary healthcare needs and will only send you up the ladder when a tertiary care intervention is required. Being in the geography, the post tertiary care follow up will also be taken care by Be Well. The other value propositions that he intends to add to each of the hospitals are dialysis, telemedicine etc which would not be available with any other provider in the same geography.

Business model Be Well Hospitals have adapted a relatively low-cost business model. This is an extremely well established business model, where the aim is to drive significant volumes of customers (at a low customer acquisition cost) and by charging a very low price. “The model is to establish a network of Secondary Care hospital (50 to 75 beds) in semi urban, Tier II and Tier III towns of Tamil Nadu in the next one year and then build a pan-India presence. Be Well hospitals will evolve the best primary care system and tertiary referral system which would be integrated to its secondary care hospitals to become a holistic healthcare provider is, promises Dr Vetrievel.

Major challenges In a country already suffering

In the coming year The first few years in the life of a company are very exciting and Dr Vetrievel wants to enjoy this time. He says that 2013 is important as they have started taking the first step and it’s always exciting when one begins to

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QUOTE UNQUOTE

“Our passion for creating an accessible, affordable health network with quality as mantra has been our biggest motivation.”

from non-availability of doctors and other medical / non medical professionals the biggest challenge Dr Vetrievel faced was finding the right people to take his vision forward. He had a tough time building teams, reveals Dr Vetrievel. Along with this, he faced many hurdles in terms of statutory procedures. However, he believes that by virtue of being and doing good things fall into place. He believes in the maxim that 'Be Good, Do Good, Hear Good and Good things will happen to you'. He says that during difficult times they have been given support from all quarters to prove the above quote right and it is evident in the fact that they managed to get the right individuals to join them, the team with the 'same frequency' followed by the right investment partner and so on.

Marching ahead Optimistically, he wishes to see the day when one Be Well hospital will be instituted at all district headquarters of India which is networked, is managed efficiently and professionally and has a primary care link and tertiary tie ups. He dreams of creating access for our population combined with quality healthcare.

Dr Vetrievel plans to add 10 more hospitals by 2014 and become a 16 hospital strong network. He feels that it is an achievable goal as the company has received a sizeable funding from Song Investment Company. Dr Vetrievel now wishes for the best team to march together with utmost clarity and purpose, knowing the job on hand and access to the right capital at the right time.

-Neelam M Kachhap mneelam.kachhap@expressindia.com

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NIHAL AND SHYAMA KAVIRATNE Founders, St Jude Childcare Centre

PHILANTHROPY IN A CORPORATE GARB

E veryday thousands of poor families from various corners of India come to Mumbai, anxiously seeking a miracle for their children diagnosed with cancer. Whilst they are fortunate enough to get the needed treatment with the help of various hospitals and charitable healthcare institutes, they often have no place to stay and have to sleep rough on the streets, leaving these kids, who are recovering from chemo or radiotherapy, open to a wide range of infections. Here, St Jude India Childcare Centres come to their rescue, bridging this gap to help these children recover faster.

The pet project of Nihal and Shyama Kaviratne, St Jude Childcare Centres (St Jude’s) is a model that focuses on providing accommodation and care to children undergoing cancer treatment. What makes this model interesting is that the venture operates as a corporate and has managed to sustain this model, inspite of being a not-for-profit venture.

St Judes works in collaborations with hospitals, cancer aid association and provides an environment that ensures the treatment is effective and allows children to convalesce.

The genesis The story of St Jude Centre began in the year 2005 when the Kaviratnes returned to India after spending 22 years abroad. Shyama grew up seeing her mother caring for children in an orphanage called Bal Anand. Her good work has always inspired Shyama to JANUARY 2013

take on her philanthropy; so when they returned back to India the couple had this vision in mind.

While doing their ground work the Kaviratnes uncovered a huge unmet social need to provide a safe and clean environment for children to recuperate following serious chronic diseases like cancer.

Meanwhile, Nihal had visited the Tata Memorial Hospital and was shocked to see cancer patients sleeping on the pavements; some with tubes in their noses, other with bags and bottles attached while some others patients lay listless on cardboard sheets. He saw this as a opportunity to provide recuperating patients a place to recover. A chance visit to the Cancer Aid organisation in Mumbai was the ‘a-ha’ moment for the duo. They decided to establish a centre that would fill this gap and do something that no one else had done before.

Joining-the-dots In November 2005, they began their quest to find an appropriate place to set up their first centre. Recalling their initial days of struggle, Nihal admits that they had a tough time finding a place which was close to Tata Hospital. During those days Ana Saldanha an interior designer, invited them to visit the Chetana-run cancer ward at the Mhaskar hospital in the Bombay Women and Children’s Welfare Society premises in Parel. Her father, Julio Ribeiro, the then Police Commissioner of Mumbai helped them set up their first centre there.

Initially the Kaviratnes invested Rs 60 lakhs to establish this centre and since then they never turned back.

During this course of time, the Kaviratnes and their proj-

ect team stumbled upon many obstacles- finding an appropriate property, raising funds, operational challenges, convincing people and hospitals to extend their support and educating families on how to cope with cancer were some of the obvious ones. However, even during these rough patch, the Kaviratnes did not loose hope. They were very clear that they would be no cutting corners, nor compromises excepted and continued their journey with sheer determination.

To make themselves heard, they adopted branding techniques such as out door media, and also conducted medical camps to make themselves own. Apart from this, they also got into barter deals wherein people would provide them the land or premise and St Jude would set up and operate the centre. All these effort have worked in their favour. Since the opening of its first prototype model centre in April 2006, the group expanded to have eight centres across India and accommodates over 2300 children and their parents (including returnees) . They have a very strong team consisting of around 40 members and other volunteers. Even more, they have managed to

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‘Think big but start small, get all your action rights and then move fat. But always place quality before quantity’

have around 98 per cent occupancy rate in each of their centres. Every year, the Kaviratnes shell out Rs seven lakhs and rest is funded by various individuals, corporate donors as well as barter agreements. In Mumbai, they have tie-up with Tata Memorial Hospital, Wadia Hospital, Lokmanya Tilak Municipal General Hospital , KEM Hospital, Cama hospital and PD Hinduja hospital.

The vision for tomorrow Moving forward with the same determination, St Judes’ will soon launch their three new centres in Jaipur, two in Delhi and one in Kolkata after which they will venture into Vellore and Ahmedabad. In 2014 St Judes’ will establish three more centres in Mumbai. The Kaviratnes have target in mind that by 2020 St Judes' should have 100 centres spread across different parts of India serving at least 1200 families and really making a difference.

In good times and in bad All in all, St Judes’ model is worth replicating as the venture operates in an exceptionally systematic manner, doing the right moves at the right time and bridging the gap of affordability and accessibility in a small, yet a strong way. A model example like St Judes’ gives a new perspective to the healthcare delivery system.

However, it is also important to note that running a corporate venture needs a lot of money. The only thing that can deter this venture is the lack of funds and volunteers to come forward and work for this cause. We only hope that St Judes’ will never fall short of funds and people in order to continue their good work.

Raelene Kambli raelene.kambli@expressindia.com

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RAJAT GOEL

Co-Founder & CEO, Eye-Q Hospitals

EYE(ING) GROWTH

A pproximately 24 million people are inflicted with blindness in India and another 52 million visually impaired.

While most of it falls in the category of 'preventable' or 'avoidable' blindness, there need to be targeted efforts to counteract the same. Early detection and management along with increasing awareness about eye problems in Tier II towns could help nip the problem in the bud before it reaches epic proportions. A chain of eye clinics is spurring a change that is already underway.

ised care. No wonder then that the punchline for their maiden centre was "Dilli ki ticket kyun katani, aankhon ki suvidha yahin paani".

A hub and spoke model The company has adopted a hub and spoke model that forms the foundation on which the current 20 centres spread across UP, Uttarakhand, Haryana, Delhi NCR and Gujarat operate.

Services range from basic eye examination, vision correction, refractive error correction, oculoplasty, retina disorders to cataract surgeries.

Diabetic retinopathy and glaucoma services are also on the list. A patient has to pay onefifth of the cost for consultation as compared to a private OPD. 50,000 patients have been treated so far, the impact and outreach can be gauged

by the fact that 40 per cent of EyeQ patients come from households with income less than Rs 10,000 per annum and 30 per cent of the total surgeries performed are done for less than Rs 5000. 50 per cent of our business comes from cataract surgeries, says Goel. Each centre is manned by two or three opthalmologists, followed by 20 supporting staff, while corrective surgeries are done at the spokes, those with a lasik surgery are directed to the hub. Helion Advisors and Nexus Partners made investment in this promising venture last year.

Widening the network Goel hopes to have 24 centres by the end of the next financial year and has set up an ambitious target of 100 centres by 2015 for which an

Bridging the urban-rural divide Rajat Goel was at the helm of bringing in cutting edge products in eye care during his stint at Bausch and Lomb, but one visit to Rewari in 2007, a few kilometres away from the city of Delhi, changed the course of his life and of those he would touch. He was appalled to see a glaring difference in the quality of eye care or rather the lack of it and alongwith his colleague Dr Ajay Sharma took up the mantle of taking up this challenge to build a socially impactful business.

The vision was to take quality eye care to those in Tier II and Tier III towns, who in the absence of the same, spend time travelling to cities.

Affordable healthcare was the second priority, providing surgeries for a lesser cost as compared to the norm and also using the power of technology to deliver better and organ-

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SUCCESS

MANTRA

We are competing with organised players in this space, but even then we are confident that patients will come to us because they see a facility that addresses all their needs. Catering to a large volume of patients and a need that is grossly unmet helps us make healthcare affordable as well

investment of Rs 160 crores is in order. Towns such as Meerut, Kanpur, Unnao, Jhansi, Dehradun and Sonepat.in Northern and Western India will be targetted. He strongly feels that there is a huge demand for organised eye care and it needs to be adressed. While secondary care is getting organised, the quality of care needs to improve drastically, he adds.

Competent staff Finding the right talent, ready to work in far flung areas has been a tough ride.

There is a huge demand supply gap as far as opthalmologists are concerned with statistics pointing out that for every 6000 people there is one opthalmologist. Not only has a training centre been opened in Rohtak last year to train the staff in soft skills and other skills, fresh Master of hospital administration (MHA) students are recruited as a part of the future leader programme which hopes to expand to 30 people by next year.

Addressing the need EyeQ has taken off to a roaring start, there is a high demand for better eye care services in rural areas and towns and this has been addressed well so far. The ingenious use of technology alongwith utilisation of frontline healthcare professionals to compensate for the lack of an opthalmologist helps build an efficient management system. With the Indian eye care market pegged at $2-3 billion and only a few players reaching out to the population, the future looks bright.

Shalini Gupta shalini.g@expressindia.com

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KRISHNA MAHESH CEO, Sundaram Medical Devices

MINDFUL & MODEST ENTREPRENEUR

T his fourth-generation scion of the erstwhile TVS Group of Chennai wants to inspire the TVS group to invest meaningfully in healthcare and help it become the positive and dynamic force in medical equipment as it is in the automotive industry.

Krishna Mahesh, CEO of the three-year-old company Sundaram Medical Devices (SMD) makes medical beds that meet the highest global quality, safety and usability standards for both the patient and the caregiver at a price that is affordable for the Indian institution. The company started product design and prototyping in late 2009early 2010. The major investment has been in the factory land, building and spending on design. He continued to invest and prototype along with their partnering healthcare institutions both hospitals and medical/dialysis clinics.

Vision for the new year 2013 is a critical year as the first SDM beds will be handed over to the customers. The company has fully prototyped beds that have been tested for many months with a number of their partners and they will be delivering their first sets of orders in 2013. The company needs to ensure that they are not just innovative in their design and delivering a fantastic business proposition but also that they establish and enhance TVS's quality reputation in the healthcare space.

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In the year ahead SDM plans to deploy their dialysis and short term stay (outpatient) bed-chairs across the country.

Also they will deploy inpatient beds (comprehensive recovery units) to high quality hospitals in India. Along with this, SDM plans to continue to work with the top engineering schools to deliver high quality, clinically tested, affordable medical devices that fit within their beds and expand the services that a hospital can provide.

Why SDM? SDM beds are unique as they are designed and manufactured in India and allow 30 per cent space saving.

Mahesh claims that no other bed manufacturer's design allows the space savings that this company has demonstrated. Secondly, all SDM beds are modular and upgradable which means that an institution can buy a mix of electronic and manual beds at start-up and the company will upgrade the beds to full electronic control at any time the hospital chooses. In addition, the company has focussed on incorporating the latest safety thinking: encumbrance-free chair position, low fall height, emergency cardiac release levers in all beds, which is also novel in the industry.

How the busniess operates?

ing the patient bed surface at all. Hospitals/clinics can use that space to treat more patients in the same space or build a smaller hospital with the same capacity.

The model is robust because land and building costs are the dominant costs that a medical institution faces. The cost of healthcare is driven by the capital costs and the pay-back period. Today, it takes about five years for a hospital to break even and only then can they think about redeploying capital.

By saving the space, SMD’s beds increases the hospital’s ROE by 25 per cent and also allows them to achieve break even an entire year earlier, grow faster, as well as provide healthcare to more people.

Obstacles in the path Sowing the seeds of quality consciousness in the healthcare industry, SDM faces a major challenge in changing the customer mindset. SDM urges hospitals to start thinking about what they need, not what is being pushed on them. This is novel for many of them- and there is initial resistance to being asked to think deeply about what's important and making a choices based on the big picture rather than just taking what's always been status quo.

However, Mahesh

The business model revolves around cost saving and optimum utilisation of space.

Their preposition to the medical institution is simple: install SDM beds in your facility and you will save 30 per cent of the floor space, enhance ease-of-use for your caregivers, and improve the safety and comfort of your patients.

The company achieved this without reduc-

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No other bed manufacturer’s design allows the space savings we have demonstrated

believes in creating multiple prototypes to tailor their beds according to the needs of patients and the healthcare providers and has convinced them that SDM is truly and uniquely positioned to serve them,” he adds.

Equipped with a BS and MS in mechanical engineering from Stanford and an MBA from Harvard and with combined experience of working at McKinsey & Co and Toyota, Mahesh feels more than adequate to handle challenges thrown up by the healthcare industry. His obstinate and stubborn self-belief and the significant amount of pre-work he did to validate the idea helped but most of all. He sees how much India needs high quality healthcare and the opportunity to help so many people in need is all the motivation he needs. He wants no one else's loved one to have to face any challenges because of the medical equipment in their hospital, he confesses.

In future Mahesh believes in organic growth and would want to win clients than push his products on them. He is extremely patient with growth. Mahesh initially wants to serve only those institutions that value quality, and are able to understand the business case they are development. They need to value the safety of their patient and care-givers to truly appreciate the value of our bed, he reveals. Mahesh sees healthcare as a industry that will only grow in the coming years and decades. He says that he will try to be the best and if they succeed, the customers will make them the biggest.

- Neelam M Kachhap mneelamkachhap@expressindia.com

www.expresshealthcare.in

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MYSHKIN INGAWALE Co-Founder, Biosense Technologies

TAMERLANE'S ANT

I t took Myshkin Ingawale and team 32 failed attempts to get it right. In the end, like Tamerlane's Ant, he succeeded in developing ToucHb, a lowcost, needle-free portable device that is used to diagnose anaemia in patients. It actually measures blood haemoglobin, oxygen saturation, temperatureand pulse rate. Total blood haemoglobin is used for anaemia diagnosis.

The ToucHb works by shining light of different wavelengths through the tissue of the patient’s finger. Haemoglobin has a characteristic absorbance.

Understanding the spectrum, and understanding what signals to filter out, ToucHb is able to determine the concentration of haemoglobin present in tissue.

The technique is similar to the one used in pulse oximeters, for the estimation of oxygen saturation. But, while a pulse oximeter isn’t able to measure total hemoglobin, the ToucHb does.

Ingawale started Biosense Technologies in 2009, with five friends — three doctors and two engineers — to create ToucHb, just trying to fix a problem they saw in the field. Till date, they have put $300, 000 in the company.

Gearing for 2013 2013 is important for ToucHb as it will move forward in the product testing stage and will go in for regulatory approval. The company has released the devices to a few clinics in India.

Ingawale says that they are planning to scale the production from 30 to 40 per batch to more than 1,000 per batch, but this

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involves putting in place quality management systems which they need to get going.

Apart from the production side, one of the biggest steps for them will be to partner with different international and national health agencies to properly understand the best way to create impact with ToucHb. The healthcare ecosystem is a complex thing, says Ingawale and adds that protocols are designed for good reasons, and they need to work jointly with experienced public health experts to modify the existing system, make small incremental tweaks in the way point of care community health works.

The differentiator ToucHb is a novel, non-invasive testing device that runs on battery and is an inexpensive technology to estimate haemoglobin (Hb) levels in blood. The device gives instant results, is portable and convenient even for a semi skilled health worker to take it to the doorsteps of the affected community.

ToucHb, addresses a social need and will help eliminate maternal and infant deaths caused by anaemia. Talking about the gravity of the problem, Ingawale says that every minute a woman dies as a result of pregnancy or childbirth.

Nearly 40 per cent of maternal deaths are attributed to anaemia. Anaemia has serious economic and social consequences. Overall, it affects the productivity of a geographical enclosure. The WHO estimates the anaemic population to be two billion and there are around one million deaths due to anaemia every year. Current anaemia screening technologies are not very accurate, require laboratory facilities, have high recurrent costs, and necessitate a blood draw that many are unwilling to because of the

existing socio-cultural stigmas.

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Business model Describing their business model Ingwale says that it is based on screening and monitoring of the population for anaemia for better diagnosis and treatment. The business model is like a Xerox machine company he says. Cost per test is Rs 10, the lowest cost per test in the world, Ingawale informs. ToucHb can be used by governments and organisations in the present healthcare scenario. Their business strategy is three- pronged. At the top level they have the public health infrastructure which includes the PHC's and sub centres. They intend to reach here through the government and organisations like WHO and other NGO's. .At the second level is the health clinics, general practitioners, hospitals etc. where they plan to reach by tying up with pharmaceutical companies and their distribution network. Finally, it is the home market where internet, advertisements and campaigns would play a vital role.

Learning from failure Talking about their 32 unsuccessful attempts, Ingawale says that the 'optical method' stuff for a bunch of relatively inexperienced doctors and engineers meant that they were walking in the dark. They learned that every small thing has its own

There are hundreds of fixable problems all around us, and that’s what we are working on

complexities. As the saying goes, you can see the world in a grain of sand. They learned as they went along — how to identify signs of error, filters and how to make the hardware reliable. In other words, they learned the hard way — by being wrong!

The way forward Ingawale truly believes that there is a revolution underway in medical technologies.

Similarly, he is sure that noninvasive, point-of-care diagnostics will increase in power exponentially, become all-pervasive — and, specifically, enable preventive healthcare in a meaningful way for a large proportion of humankind. They have started some interesting new projects, looking for other molecules in the direction that ToucHb has taken with haemoglobin. Ingawale says that there are hundreds of fixable problems all around us, and that’s what they are working on. They have learned quite a bit of what NOT to do in product development, thanks to ToucHb. They hope to use some of these lessons for developing more innovative, high-impact products.

ToucHb has successfully finished pre-clinical trials and the device is currently in clinical studies at Nair Hospital ,Mumbai. So far, ToucHb has achieved excellent results which fall in par with the WHO colour scale standards. The previous two years of development had seen phases of failures, but the passion towards this social cause coupled with the undying zest in the team never lost its shine. As a result of this spirit of collectiveness, Biosense Technologies is getting ready towards the launch of their product, ToucHb. M Neelam Kachhap mneelam.kachhap@expressindia.com

www.expresshealthcare.in

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ARUNACHALAM MURUGANANTHAM Founder, Jayashree Industries

A TRUE TORCH BEARER

S ome might be surprised to see runachalam Muruganantham on our list of healthcare entrepreneurs but he has earned his place by defining preventive healthcare in the right sense with the help of his venture, Jayashree Industries.

And, to add to his credit, he has managed to deliver his service to the segment and areas that need it the most.

So, what makes his venture exceptional? He has ensured that countless women in the hinterlands of India lead hygienic and dignified lives, thanks to his indigenous enterprise that provides sanitary napkins to women in the rural areas of India at very low cost i.e. just a rupee or two for each napkin.

Lighting a spark Muruganantham, living in Coimbatore, Tamil Nadu, woke up to the plight of poor women in India when he came to know that his wife relied on rags and discarded pieces of cloth during her monthly courses, simply because sanitary napkins were unaffordable and would cut into her monthly budget.

He began to learn more about sanitary napkins available and then tried his hand at making one. His initial attempts were abysmal failures. Undeterred he took to researching more about them and enlisted the help of medical college girls in his endeavour. Finally, he managed to create a machine which enabled him to produce good, useable sanitary JANUARY 2013

napkins which did not match the gloss and style of the other sanitary napkins available in the market but definitely served the purpose well. In 1998, he finally managed to create a machine which helped him to manufacture these napkins in large quantities while keeping the production costs low.

But, his travails did not end there. Though he had a good product in hand, his actual challenge was to make his target segment accept the product. No easy task, since his audience were poor, under-privileged and often illiterate women who needed to be first taught about hygiene and the benefits of using sanitary napkins. A task that would have daunted lesser men but not Muruganantham who was committed to his path. With the help of his wife he slowly began to convince other women to buy his product. A painstaking endeavour but not only did he overcome the obstacles but conquered them and moved on to spread the benefits of his invention to other parts of the country as well.

Triggering a revolution Resourcefulness is the key to Muruganantham’s Jayaashree Industries’ success. He recognised a need, understood his target group well and created an original and straight forward solution to fulfil the need since he had realised that the segment he intended to target was immune to gloss and packaging simply because they couldn’t afford it. His business which began with an investment of less than Rs one lakh and comprised a machine designed for mass-production of napkins, a place to produce them and

cheap labour managed to reach out to a large number of people and make their life nominally better than what it was. He not only sells the sanitary napkins but also the machines to produce them.

An example of true grassroot enterprise and innovation.

So far so good, but how has his endeavour made an impact on healthcare? Lack of hygiene and sanitation are the root causes for many infections and by helping women to maintain personal hygiene he is in effect nipping several health problems in the bud itself. Preventive healthcare in the true sense. Today, his efforts have paid off and he is empowering women across the country.

Marching ahead with renewed vigour He has 706 installations in the country across 18 states so far. Several women self help groups (SHG), State Governments, NGOs etc., have used his invention to help women overcome societal barriers and move towards progress. He has mammoth plans for the New Year and intends to scale up the number of installations to 7,000 units. The first step towards achieving this objective has

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“Don’t worry about failure. You may fail 999 times but success would be yours the thousandth time”

already been taken.

Muruganantham informs that his venture has signed a MoU with the Gujarat government and it would provide employment to 27,000 women in Gujarat alone in 2013. He intends to invest Rs 80,000 crores in this year to achieve his ultimate goal of creating a million employment industry.

Thus 2013 could prove to be quite pivotal to him in his entrepreneurial journey.

Learning lessons This grassroot entrepreneur’s success story has several learning lessons that can be emulated by the rest of the players in the healthcare sector. His endeavour has actually proved that the goals set by the healthcare sector i.e. quality, accessibility, affordability and sustainability are actually achievable. He delivers a quality product at affordable rates thereby making it very accessible and since the business model can be replicated easily at the grassroot level, it is very sustainable as well. He has also proved that resourcefulness, for which we are famed for, should not be taken lightly.

But, let’s not forget the limitations as well. While the model is replaceable when it is a specific product or service, doing the same at a macro level would not be so easy. Moreover, all endeavours cannot be run with such small investments or with the help of unskilled labour. But, the final word is definitely that Muruganantham, a school drop out turned businessman, has achieved what the rest of healthcare industry is still striving to accomplish.

Lakshmipriya Nair lakshmipriya.nair@expressindia.com

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Healthcare in 2013- looking into the crystal ball Amit Mookim and Jagruti Bhatia from KPMG share their forecasts for healthcare in the year ahead and elaborate on five key themes that would be pivotal for healthcare in the near future hile the Indian healthcare system continues to score low on metrics of penetration, affordability, doctor and nurse density, number of hospital beds, and double disease burden, it would be fair to say that the country’s health sector has made significant strides in many areas over the past decade. ● Healthcare is the fifthlargest employer among all sectors today, and the Government of India (GoI) is now considering a skills programme across levels and vocations. ● India is home to one of the largest telemedicine networks in the world. ● Healthcare in the country witnessed over a billion in private venture and equity capital across more than 40 deals last year. Since 2005, PE funds have invested $2.53 billion in 216 healthcare deals, clearly reflecting the sector’s high growth potential. ● Entrepreneurs have created many new formats to address skill and real estate shortage. India is home to one of the largest eye-care chains in the world; dialysis centres; day care, primary care, and diabetes clinics; and low-cost hospitals — indicating clear innovation across business and delivery models. ● Foreign players have sought opportunities in India, while Indian healthcare majors have gone global. ● The government has taken several measures like tax holiday upto five years for more than 100 bed hospitals in rural areas, lowering of land norms for medical and nursing colleges, to name a few.

Thus, the stage is set for

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Director - Healthcare Advisory, KPMG India

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rapid growth in the next few years. This article is an attempt at ‘crystal gazing’ into 2013 to discuss five key themes that could define the healthcare scenario in the near future.

Theme 1: Affordable care — more for less?

As healthcare struggles through the dimensions of cost, quality and access across the globe — and as developed health systems increasingly look to the state exchequer to save costs while managing social expectations — India looks to build out affordable care models of delivery and services.

Innovation is being achieved through models such as Vatsalya and Glocal, aimed at low-cost, affordable healthcare facilities in semi-urban areas (where penetration is abysmally low); Nayarana Hrudayalaya, which offers cardiac procedures at a fraction of the cost of its competitors; or by Thyrocare, which aims to install more than 100 PET scans across the country and make expensive diagnostics accessible for the middle class. In any case, creating affordable and effective healthcare solutions is one theme that will likely continue in India for times to come.

However, enterprises may want to consider deliberating carefully on creating scalable, low-cost yet effective processes and leveraging technology to create models that are economically viable for patients. Only then can businesses build sustainable foundations on which to scale up and survive in the long term.

Theme 2: Professional management across healthcare providers, stand-alone clinics and small chains While businesses in other industries are built on strong www.expresshealthcare.in

service delivery, innovation, distribution networks, or scaled up manufacturing assets, healthcare is a mix of all of these. This makes the business relatively complicated to operate and manage and eventually scale up. The standardisation of processes, the centralisation of procurement, the leveraging of systems and technology to drive clinical intelligence and protocols, and training are some of the measures that organised players are adopting to differentiate themselves from competition and make their ventures potentially profitable. At the same time, like any other growing sector, there exists a long tail of unorganised, stand-alone players, clinics,proprietors/ partnerships and single establishments. In this context, 2013 is likely to see increased activity from both entrepreneurial talent and established players toward building management models, focused on the increased ownership of existing assets to streamline and consolidate them under unified brands.

Stand-alone nursing homes, community hospitals and secondary care centres have already begun to witness such alliances and acquisitions. Continued activity in different formats on this front can be, thus, expected. This may not be an easy ride, considering the distinct characteristic of each opportunity and deal, as well as the difficulties that are likely to emerge in seeing such opportunities through; the need for improved operations, branding, and standardisation can be expected to drive this change.

Theme 3: Health at home and on the phone!

As India reels under the title of the world’s diabetes and cardiac capital, increased incidence of oncology,

heightened focus on chronic care, pain management and home care in 2013 and beyond will be the need of the hour. By 2050, the country’s population of those aged 60 and above is expected to total 323 million, a number far greater than the entire US population in 2012.

This reflects the need for care models focussed on remote monitoring technology, home care professionals and extended step-down care following discharge, delivered by existing and emerging players. A recent study by the National Health Service (NHS) in the UK states that effective home care could save the NHS £300–390 million by reducing avoidable hospital re-admissions. As we struggle with overcrowded hospitals and a growing healthcare bill, home care will be critical for easing our burden.

Theme 4: Enter the GP and health check-ups Our health system is distinctive in more ways than one. The private sector accounts for 70 per cent of our total spend - one of the categorical outcomes of this is the slow build out of primary and secondary healthcare models. Our insurance system is largely untapped, and the GoI is devising various programmes to make universal healthcare a reality.

The need of the hour is to construct a value chain that gives the underprivileged access to affordable care and simultaneously helps payers scale up their influence to increasingly provide for universal coverage. This can be achieved by front-end family clinics and GPs, who play a key role in preventive care; they have, across the world, demonstrated that they are integral to the ecosystem.

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of GP clinics and family medicine, and 2013 is likely to witness the emergence of such models on an even larger scale. Large players such as Fortis and Apollo are also thinking about how to build out more ’retail–centric’ models of care that feed into their overall ecosystem. On the other hand, corporate players, global healthcare institutions forging alliances with India-based chains, and returning GPs are attempting to build out this part of the value chain.

The market for health check-ups stood at approximately Rs 1, 200 crores as of 2011 and is expected to grow at a CAGR of 20 per cent in the next five years. Primarily driven by the need for, and awareness around preventive check-ups, the space provides opportunities for not only providers such as Max but also for facilitators such as Indus. Activity in this segment is likely to increase by at least 20 per cent in 2013.

Theme 5: Technology and tablets Various other sub-seg-

ments within the healthcare space are expected to emerge as major opportunity areas in 2013 and beyond. ● Telemedicine: While telemedicine as a technology has not reached its due potential in India, it is witnessing remarkable growth. Poised to grow at a CAGR of 20 per cent in the next five years, telemedicine as a segment is estimated to have potential worth $500 million by 2015. ● Teleradiology: Driven primarily by innovation, evolving technology, increased healthcare penetration and the interest of investors in remote healthcare delivery – the teleradiology sector is witnessing consistent traction. The market in India has been estimated at $43 million in 2012 and is forecast to grow at a CAGR of about 15 per cent. ● Hospital management information systems: This is a relatively untapped area in India, but it holds with signifi-

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cant growth potential.

Rising healthcare costs, coupled with evolving demographics and technological enhancements, are expected to drive this space.

Screening devices: As the government rolls out screening for the masses for diabetes, blood pressure, COPD, and various types of cancer, companies may be expected to devise innovative solutions and technologies to facilitate such pilots and projects. In this context, tablets are likely to play an integral role in capturing and analysing sample data; further, with the advent of low-cost gadgets, activity on this front across 2013 and beyond is probable.

Can 2013 drive the change?

All eyes are on India as it prepares to revamp its health system. We cannot afford to create an expensive set-up, which is essential.

Innovation in technology, hardware and delivery models will, thus, be key. Private

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capital can be expected to continue evaluating and supporting economically viable and scalable business models, as well as different formats to meet the dynamic needs of different classes and geographies. The government must continue pushing the agenda toward creating an increasingly robust platform for delivery and working with private payers and providers to develop a costeffective model of healthcare.

Therefore, 2013 will likely move the needle in the right direction; it is hoped that some of the themes discussed in this paper can effectively address the three-pronged challenge of cost, quality and access to health for all.

About the authors: Amit Mookim is a Partner with KPMG in India’s strategy practice and also heads the Healthcare vertical for India.

Jagruti Bhatia is a Director with the Healthcare Advisory vertical for KPMG in India.

Moving towards Universal Health Coverage in India Dr Nata Menabde,WHO Representative to India and Dr Arunachalam Gunasekar,Technical Officer,WHO India Country Office for India elucidate on the steps needed to taken in the coming year for achieving Universal Health Coverage in India and stress that access for all would come with financial protection ncouraged by the country’s unprecedented economic progress, the Prime Minister-led call for achieving universal health coverage in India is gathering further momentum.

Described by the WHO Director General, Margaret Chan as “the single most powerful concept that public health has to offer”, universal health coverage seeks to ensure that all people have access to the needed comprehensive health services of sufficient quality and effectiveness, at the same time ensuring that

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DR NATA MENABDE

WHO Representative to India

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people do not suffer financial hardship while accessing health services.

Universal health coverage is expected to allow everyone the rich and poor, men and women, ethnic or religious majorities and minorities to enjoy full and equal access to the services concerned.

International experience shows that universal health coverage is not only a matter of rich countries. Even lower-middle income countries, for example Ghana and Indonesia, have made substantial progress, providwww.expresshealthcare.in

ed that the idea receives sufficient political support.

Though India's total health expenditure at 4.2 per cent of GDP is not too small a figure in comparison to many countries, the country’s public expenditure on health (1.04 per cent of GDP in 2011-12) is too small to make sufficient progress towards universal health coverage. The government expenditure on drugs, for example, in 201011, was only Rs. 5,034 crores (4.9 per cent of total government expenditure on health), a

much lower figure than most countries.

The persistent low levels of public health expenditure has possibly been also one main reason for service quality and infrastructure deficiencies in public sector health facilities resulting in steady increase of population preference for private sector providers since 199596 (National Sample Surveys). In fact, the main reasons given by the population for private sector preference are non-availability of services in public facilities, lack of satisfaction with EXPRESS HEALTHCARE

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DR ARUNACHALAM GUNASEKAR

Technical Officer WHO India Country Office

provided services, distance and long waiting time.

The high costs of health care has also led to large numbers of ailments going untreated, and increasing numbers being pushed into poverty due to out-of-pocket expenditure (from 26 million in 1993-94 to 39 million in 2004-05). Out-of-pocket health expenditure in India is 60.2 per cent of total health expenditure. This is far above out-of-pocket expenditures in, for example, other BRICS nations China (37.5 per cent), Brazil (32.3 per cent), Russia (17.2 per cent) and South Africa (16.6 per cent).

Significantly, 74 per cent of out-of-pocket expenditure in India is on drugs.

More is needed, please!

A major step the Government of India took in this direction was the launch in 2005 of the National Rural Health Mission (NRHM), with the main focus on improving primary health care. The NRHM has led to an increase in public spending and brought some flexibility into the financing mechanism. On the minus side, it has failed to adequately offset the fiscal limitations of the poorer states, leaving some states having poor health indicators with large unmet expenditure needs.

Shortfalls of health facilities remain at 20 per cent for Sub-Centres, 24 per cent for PHCs and 37 per cent for CHCs, with the worst situation in Bihar, Jharkhand, Madhya Pradesh and Uttar Pradesh. Despite some improvements in human resources for health in the public sector, serious shortages in staffing remain - 52 per cent for ANMs and nurses, 76 per cent for doctors, 88 per cent for specialists and 58 per cent for pharmacists.

Also maternal mortality ratio at national level remains unchanged (5.5 per cent in 2001-03 to 2004-06 and 5.8 per cent during 2004-06 to 2007-09) despite the efforts, with suboptimal performance in the very Empowered Action Group (EAG) states focussed for attention by NRHM. The likely explanations are gaps

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in ante-natal care, skilled birth attendance and emergency obstetrical care.

Part of the difficulty comes from the diversity of the country. The decline in infant mortality rates, for example, has accelerated in recent years but is still about four to five fold higher in the large states of Madhya Pradesh (59), Uttar Pradesh and Orissa (57), Assam (55), Rajasthan (52) when compared to more successfully performing states such as Goa and Manipur (11) and Kerala (12).

The Janani Suraksha Yojana (JSY) scheme has increased institutional deliveries in rural (39.7 to 68 per cent) and urban areas (79 per cent to 85 per cent) over the 2005–09 period, but low levels of full ante-natal care (22.8 in rural, and 26.1 in urban in 2009) and quality of care continue to be areas of concern. Also, a recent study in Jharkhand on 500 new mothers showed that bad roads, poor connectivity and unavailability of transport at night continue to force more than one-third of pregnant women to deliver at home. Full immunisation in children has only improved coverage from 54.5 per cent in 2005 to 61 per cent in 2009 during the Eleventh Plan.

A few years after the NRHM, the Rashtriya Swasthya Bima Yojna (RSBY) scheme run by the Ministry of Labour & Employment aims to provide financial risk protection for in-patient care (mainly) to the population living below poverty line. It uses an insurance mechanism and currently covers 80 million beneficiaries (in contrast, the NRHM is taxbased). Along with the comprehensive union-funded insurance schemes (Employee State Insurance Scheme, with 60 million beneficiaries and the Central Government Health Scheme covering three million), some 143 million people are now covered in India.

In recent years health insurance schemes funded by some states have emerged, already covering about 110 million people mainly for tertiary care www.expresshealthcare.in

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(Andhra Pradesh – 70 million; Karnataka ? 5 million and Tamil Nadu – 35 million).

All the above routes need to be developed by pooling their financial resources, also reaping the benefit from extra efforts and even the strengths of individual schemes.

The Twelfth Plan strategy towards universal health coverage envisages a rise in public funding by the Centre and States to 1.87 per cent of GDP by the end of the Plan. At the time of writing this article, the Minister for Health & Family Welfare Shri Ghulam Nabi Azad stated in a reply to a question in the Parliament on 11 December 2012 that the tentative allocation for the 12th Five Year Plan for Ministry of Health and Family Welfare is Rs 300,018 crores as compared to the actual allocation of Rs. 99,491 crores during 11th Plan period. The 202 per cent increase in health budget in the 12th Plan over the 11th Plan allocation compares well with the 123 per cent and 109 per cent increase under the “social services budget” and “total budget” respectively.

The Twelfth Five-Year Plan (2012-17) intends to address India’s key financial and service provision challenges and realise the goal of universal health coverage in two parallel steps: ● Clinical services at different levels, defined in a government financed, public health systemprovided Essential Health Package, supplemented whenever required to fill in critical gaps by contracted-in private providers; and ● Provision of high impact, preventive and public health interventions which the government would ensure universally.

The plan for widening the umbrella of NRHM into a National Health Mission for providing primary health care to the urban poor, estimated to be 9.3 million in size, is a further step in the right direction.

International experience shows that India's march towards UHC would not

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only require health financing and financial protection reforms but also sustained efforts to promote, organise and speed up development of systems for better access to quality medicines, vaccines and new and appropriate technologies; strengthening of human resources; participation of communities and private health sector; and institutional and management reforms.

There are other issues on regulation in India which include governance, human resources, corruption, public private partnerships, contracting-in services etc. that also deserve attention.

The problem lies in not having a single, unified system to establish standards (for structures, processes about quality, rationality and costs of care, treatment protocols and ethical behaviour) applicable to both the public and the private sector. Such a unified system would be essential for ensuring accountability of these institutions and organisations.

It is also vital that States are taken on board not only through their financial strength but also their endorsement/ratification of necessary service provision regulation (e.g. Clinical Establishments Act), without which service quality just cannot become a reality.

Conclusion: cautious optimism Sustained political action is one of the foremost requirements for giving momentum for India’s march towards universal health coverage, reflecting the new opportunities for providing the essential health services that the economic growth is creating and meet the fast growing expectations of Indian citizens.

WHO’s 2012-2017 Country Cooperation Strategy with the Government of India, launched jointly by WHOIndia Country Office and the Ministry of Health and Family Welfare after an intense policy dialogue and consultative process, supports the progress of the country towards universal coverage and hails with moderate optimism the prospects in this regard.

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Emerging trends in healthcare Charu Sehgal, Senior Director, Consulting – Strategy & Operations, Deloitte Touche Tohmatsu India, gives a rundown on what to expect in the sphere of healthcare in India, and elaborates on the trends that would reign in 2013 he healthcare sector in India is currently at a cusp – while, the industry is poised to grow at an estimated annual rate of 19 per cent to reach $280 billion by 2020 with India being recognised as a destination for world class healthcare, it is also facing an unprecedented pressure due to the poor reach of quality healthcare to millions of India’s citizens caused by issues of access and affordability. However, adversity is often also an opportunity. This predicament has caught the imagination of committed individuals and institutions in both the private sector as well as the government to look for solutions which ensure that the benefits of world class capabilities reach more than just the top 10 per cent of the population. The government is tackling this issue through several policies and tactical initiatives including increasing its budgetary spend on healthcare from the current around one per cent of GDP, designing and implementing models of healthcare financing including social insurance (like the Rashtriya Swasthya BimaYojna), and partnering with the private sector to best leverage its strengths to achieve its objective of ‘health for all’.

In parallel, an ecosystem of innovations for world-class healthcare delivery, driven by private providers, is developing. India is establishing new global standards for cost, quality and delivery, through its breakthrough innovations in healthcare. The last couple of years have seen a rapid increase of private equity and venture capital funds available for entrepreneurs in healthcare, which has enabled scale-up of some new interesting models for providing healthcare.

There are countless new developments cropping up

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CHARU SEHGAL

Senior Director, Consulting Strategy & Operations Deloitte Touche Tohmatsu India

JANUARY 2013

regularly, but certain strategies, systems and trends are set to reach a tipping point of adoption and popularity in the coming years. Some of the emerging trends in this sector will have widespread effects and the potential to change the landscape significantly.

Use of technology in healthcare Technology is rapidly changing the way healthcare is delivered across the country. It is making healthcare more pervasive and has integrated it more seamlessly into our everyday life.

Technology, for instance in diagnostics, genomics and invasive procedures, has revolutionised clinical practice. While product innovations have been exponential in the last decade, and are only going to grow, process innovations through technologies in healthcare are a recent emerging trend – making management of healthcare more efficient, cost effective and accessible. Innovations in delivering what services are available, and delivering them better is going to be the defining shift in the coming years.

Increasing access to reach the unreached, while controlling costs, is made possible through the induction of technology in healthcare. Telemedicine is being used to connect remote rural populations to medical advice from specialists, which were until now, unavailable to them.

Besides this, telemedicine technology also allows physicians easier access to their colleagues in multiple locations across health facilities, thus offering the possibility of creating a network of health service providers.

Another area where technology will be used increasingly is in healthcare and hospital management to improve efficiency. www.expresshealthcare.in

Technology is offering comprehensive clinical and financial solutions that enable better decisions and outcomes for both businesses and patients, improve revenue cycle, drive quality outcomes and accelerate image management and workflow.

Increasing use of technology is also resulting in evolution of interactive patient care by educating and empowering patients to be active participants in their care management.

Models such as interactive technology platform, online patient self-help groups, increased involvement of patients in care pathways – right from before admission to post discharge, mobile health, social media platforms and patient remote monitoring, among others will be used increasingly in the future. These models play a dual role – provide patients with a multitude of benefits including convenience and choosing a healthcare delivery model/ provider based on informed access; and help healthcare providers increase service levels, at the same time reduce costs owing to higher efficiencies.

Innovative healthcare delivery models Given the increasing competitive intensity, rising real estate costs and a tough operating environment, a large number of healthcare providers are exploring new and innovative business models to tap larger number of patient segments, lesser penetrated geographies, and enhance service offering levels. Various unconventional formats are being tried out by some of the new entrants which have also increased the willingness of existing players to experiment with new models.

The need for efficiency in healthcare delivery has led to the emergence of organised and professionally

managed primary care setups. A large number of providers are setting up chains of multispeciality outpatient clinics across India. Investments in primary care not only contribute to prevention of complications in chronic diseases, but also reduce secondary and tertiary overcrowding by managing simpler health problems at the primary level, thereby allowing them to focus on high-end treatments and in turn improve processes and cost efficiencies. This focus on primary care will continue to attract players in the coming years.

To increase their profitability and consumer-base, healthcare providers are moving beyond the saturated metropolitan centres by expanding geographical reach and tapping lesser penetrated population segments. This trend will continue. Additionally, healthcare providers are increasingly exploring asset light models by entering into hospital operations and management (O&M) contracts or by setting up ‘no-frills’ facilities with basic infrastructure making the setup less capital intensive. These models help providers widen healthcare access while leveraging their operational expertise and focussing on cost efficiency.

Shifting disease burden focus on prevention and wellness The coming decade is going to mark rising demands on costs of healthcare provision, changing demographics with an increasing aging population, and an epidemiological transition towards non-communicable diseases. By 2020, an estimated 97 million Indians will be aged 60 or older, up from about 64 million in 2010. This will pose significant demands on the healthcare system for EXPRESS HEALTHCARE

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geriatric services and associated chronic disease management. India is now faced with a huge challenge of non communicable diseases (NCDs). According to the International Diabetes Federation (IDF), India is expected to be the diabetes capital of the world, with the number of diabetes cases expected to increase from nearly 60 million in 2011 to 100 million by 2030.

India’s share of NCDs is expected to increase to 76 per cent by 2030 and 50 per cent of total healthcare expenditure is expected to be contributed by NCDs. Given these transitions, there is an emerging focus on wellness and prevention of illness rather than only cure. For the government; it has the potential of significantly reducing healthcare costs and having a healthier, more productive population.

Investment in preventive

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care by insurers is cost-effective and yields high returns by preventing critical illness episodes among the insured population, and thereby, reducing payouts. With greater awareness among consumers and patients, health seeking behaviour has increased and there is willingness and acceptance of healthcare directed towards preventing illness and promoting good health.

The coming years will see a shift from focussed curative care to preventive care, encompassing awareness creation of risk factors and disease symptoms, benefits of healthy living, adoption of preventive regular health check-ups, and better nutrition.

Moving beyond clinical expertise Rising costs, expanding demand, and increasing customer expectations charac-

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terise healthcare today and are redefining the roles of patients, providers and payers. This is especially true as health facilities across the chain (primary, secondary, tertiary) are increasingly being run by corporates and funded through private equity – which demands better management practices and accountability mechanisms. The need for efficiently managed health systems, while containing costs and increasing access and profitability, has brought about a shift in focus from just medical expertise to principles of business and management.

Apart from clinical specialisation, corporate hospitals are focusing on internal business functions such as inventory, asset, financial and human resource management, as well sales and marketing and customer relationship management

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(CRM). This trend will continue and create a demand for a specialised resource base.

The striking feature of the healthcare sector is its potential to grow at an exponential rate in the foreseeable future and present new opportunities within related industries, which will emerge as growth drivers. There is immense potential for each stakeholder (e.g. government, entrepreneurs, healthcare service providers, pharmaceutical companies, medical equipment manufacturers) to invest in and grow with the sector. However, given the complex and interdependent nature of the sector there is a need for a cohesive and collaborative approach, where all stakeholders effectively work synergistically and leverage the opportunities to create a lasting impact.

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Suitable for use with children and adults suffering from acute or chronic airway clearance problems, The Vest® Airway Clearance System is now available in India.

www.thevest.com www.hill-rom.com References: 1. Smith MC, Ellis ER. Is retained mucus a risk factor for the development of postoperative atelectasis and pneumonia? – Implications for the physiotherapist. Physiother Theor Prac 2000;16:69-80.

2. Arens R, Gozal D, Omlin K, Vega J, Boyd K, Keens T, Woo M. Comparison of high frequency chest compression and conventional chest physiotherapy in hospitalized patients with cystic fibrosis. Am J Respir Crit Care Med 1994; 150: 1154-1157.

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Ask for free trial sample Lonza is one of the world’s leading suppliers to the pharmaceutical, healthcare and life science industries. Its products and services span its customers’ needs from research to final product manufacture.

As a leader in preservative technology, Lonza offers a variety of products for the personal care industry. Anchored by dimethyl, dimethyl hydantoin (DMDM Hydantoin) and Iodopropynyl Butylcarbammate (IPBC) chemistries, the Lonza line includes patented, unique blends as well as globally accepted versions. These potent preservatives offer excellent protection against spoilage from microbial degradation.

A New Generation of Disinfectants (US EPA Registered) Lonza is also a global market-leading supplier of antimicrobials, preservatives and public health related chemical technologies. Lonza offers one of the broadest portfolio of biocidal quaternary ammonium based disinfectant and sanitizer formulations for use in the environmental service, healthcare, food service, food processing and institutional-commercial markets. For more information, visit our website www.biocidl.com/biocidl/en.html Lonzagard™ – NAHS (Non-Alcoholic Hand Sanitizer) – HD-2 (Alcohol-40% with 4th generation quats, hand disinfectant)

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INTERVIEW

'Thermo Fisher looks at organic as well as inorganic routes to growth’ Marc Casper PRESIDENT & CEO, THERMO FISHER SCIENTIFIC

D

uring a regularly scheduled trip to India to connect with employees and customers, Marc Casper, President & CEO, Thermo Fisher Scientific spoke to Viveka Roychowdhury on the company's focus to bring high tech speciality diagnostics applications like immunodiagnostics, clinical assays, microbiology and anatomical pathology to customers in India

Thermo Fisher Scientific clocked strong revenue and earnings growth for the second quarter ended June 30, 2012. What is the contribution of the various regions (North America, Europe, APAC, ROW)?

As of the end of our second quarter this year, (trailing 12 months through Q2’12) approximately 20 per cent of our revenues came from APAC and ROW. Europe accounted for 26 per cent, whereas North America comprised the remaining for 54 per cent.

Of the company's three business segments, i.e.

Analytical Technologies, Speciality Diagnostics and the Laboratory Products and Services, which is the fastest growing product/ service segment?

We have a track record of growth and innovation in each of these segments. Our Lab Products and Services segment represents just under half of our revenues and is expected to grow steadily. This segment has an addressable market of about $29 billion, growing at two to four per cent annually. Our annual (trailing 12 months through Q1’12) revenues of around $ 6 billion came from a balanced mix of everyday lab equipment, consumables and services. Our Analytical Technologies segment is a third of our revenues and is where the bulk of our product innovation JANUARY 2013

Our recent acquisitions of Dionex, Phadia and One Lambda give us added capabilities in growing markets within the analytical and speciality diagnostics segments occurs. This segment addresses a market of approximately $31 billion, growing between four and six per cent. Our annual (trailing 12 months through Q1’12) revenues of $4.1 billion came from our range of Chromatography and Mass Spectrometry Equipment and Consumables, Chemical Analysis Instruments, Environmental and Process Instruments and Biosciences portfolios.

The Speciality Diagnostics segment is just over 20 per cent of our revenue, and covers a broad spectrum of products such as Clinical Assays, Immunodiagnostics, Microbiology, Anatomical Pathology and our healthcare channel – all adding to annual (trailing 12 months through Q1’12) revenues of about $2.8 billion. The addressable market for us is about $19 billion, growing at between four and six per cent annually.

Our recent acquisitions of Dionex, Phadia and One Lambda give us added capabilities in growing markets within the analytical and speciality diagnostics segments, adding to the unique value proposition we can bring to our customers.

What are the region-wise trends in these segments?

In Analytical Technologies, APAC and ROW contributed almost 32 per cent of our revenues, with North America representing 39 per cent and Europe 29 per cent. (trailing www.expresshealthcare.in

12 months through Q1’12) In Speciality Diagnostics, a high majority of revenue (trailing 12 months through Q1’12) (about 59 per cent) comes from North America. Europe represents 29 per cent of our revenue in this segment, whereas APAC and ROW total about 12 per cent.

In Laboratory Products & Services, North America contributes 66 per cent of revenues, followed by Europe (21 per cent) and APAC & ROW (13 per cent) (trailing 12 months through Q1’12)

Analysts predict that since around two-thirds of revenue is generated from the sale of consumables and services, the company is insulated to some degree from the cyclic nature of the manufacturing industry. Is this observation bearing out?

Yes –it is correct that from a product mix perspective, about two-thirds of our revenue is from the sales of consumables and services. This ensures that many of our 13,000-strong customerfacing team interact with our customers every day. This puts us in a position to have a unique mind-share in this industry.

What are the other strategies put in place by Thermo Fisher Scientific to maintain strong growth?

Looking

at

the

end

markets, we are indeed very balanced as nearly a quarter of our revenues come from each of our major market segments – Pharmaceuticals & Biotechnology, Healthcare & Diagnostics, Industrial & Applied and Academic & Government. This, combined with our unique product mix spanning instruments, equipment, consumables, reagents and chemicals, software and services gives us an industryleading position in most markets that we serve.

An important part of our growth strategy is to increase our presence in Asia Pacific and Emerging Markets. At the time of our merger in 2006 that created Thermo Fisher Scientific, only 10 per cent of our revenue came from Asia Pacific and emerging markets.

Today it is 20 per cent and in five years we expect it to be at least 25 per cent. Our tremendous success in China, India and other parts of these exciting markets has shown that we have a proven strategy.

Is the company mulling further acquisitions? In which areas?

Thermo Fisher looks at organic as well as inorganic routes to growth. We have been investing in acquisitions that help us to enhance our offering to our customers and increase our access to growing markets worldwide.

What are the consumer trends driving the healthcare and diagnostics markets (in terms of evolving paradigms of patient care, constraints facing healthcare providers, role of the government, etc.)?

All across the world, doctors and patients are clearly demanding early and accurate diagnosis – whether for a serious illnesses such as sepsis through our novel biomarker, early detection of EXPRESS HEALTHCARE

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cancer, or characterisation of allergies that are otherwise difficult to diagnose using our first and only fully automated allergy panel.

Today, infections and epidemics are no longer confined to a territory; they quickly become a global concern. In fact, we are proud that in India, Thermo Fisher has been supporting highthroughput screening of H1N1 samples through our protein purification technology and has been a consistent and preferred technology provider to the National AIDS Control Program for the past decade.

The programme aims to ensure safe and quality-checked blood components for transfusion to check the spread of infections such as HBV, HCV and HIV. Our robust equipment, including blood bank centrifuges, ELISA readers, refrigerators and plasma freezers have been running and protecting samples for more than a decade.

In India, we also see an emerging market for In-Vitro Fertilization and Bio-Banking,

of which cord blood processing and stem cell banking are fast growing sectors. We provide a good technology platform in all these areas, such as our CO2 incubators, cell culture consumables, centrifuges, ultra low temperature and cryogenic storage—all of which are vital for the therapies.

For the healthcare and diagnostics end markets, what is the focus of the company in the APAC region and India specifically, in terms of product focus areas, etc?

Asia Pacific and India in particular have a tremendous opportunity for growth for our speciality diagnostics applications.

With a large percentage of the global population being located in this region, as well as China’s and India’s investments in healthcare facilities, we are optimistic of this business here.

Our focus is on bringing immunodiagnostics, clinical assays, microbiology and anatomical pathology to our

customers in India. Globally, we are leaders in novel biomarker development and share great partnerships with leading in vitro diagnostic companies. We look forward to creating similar such longlasting relationships in India.

Another potential area of growth is mass spectrometry in routine clinical use.

Thermo Fisher Scientific announced in July that it would acquire One Lambda, the leader in transplant diagnostics. How does this fit into the company's existing healthcare and diagnostics portfolio?

We are pleased that we have recently completed the acquisition of One Lambda Inc. With approximately 320 employees and revenues of $ 182 million (2011), this will now become part of our Speciality Diagnostics Business. This acquisition significantly increases our access to the attractive transplant diagnostics market. One Lambda’s tests for tissue typing and antibody detection

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complement our existing immunosuppressant assays, allowing us to offer a broad menu of tests across the transplant-testing work-flow. We are excited about this combination and the opportunities it presents to ultimately improve the lives of transplant patients.

What are the channels used to service this clientèle?

In India, for our speciality diagnostics products, we have a network of channel partners.

We also have excellent relationships with our key customers such as major hospitals, corporate healthcare providers and large diagnostic chains.

What is the guidance for FY2012 for the healthcare & diagnostics segment?

We do not give formal guidance by end market but we do expect the healthcare and diagnostics market, worldwide, to remain relatively stable for us. viveka.r@expressindia.com

Zane lights from Kohinoor Surgicals Surgical operation theater LED s lights

Multifaceted mirror polished multi reflector ideology

●

●

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● New generation LEDs with high illumination field, fixed in the centre of the reflector with perfect aluminium heat transfer technology. ● Thanks to highest overlapping of light rays to produce shadowless light beam to illuminate the surgery sight inside of cavity and walls.

Perfectly angled and balanced of multi-faceted mirror polished multi-reflectors fitted with LEDs to produce homogenous light field requires just 30 watts of electricity.

The ultra cool light source with 3 nos. of wings minimises turbulence on and around the surgery sight, thus the light head’s wings are perfectly laminar air flow compatible.

Highest energy efficient and correct heat dissipation through well designed aluminium heat sinks to cool the light source.

Contact Kohinoor Surgicals 215, Allied Ind. Est, Ram Panjwani Marg, Mahim (West), Mumbai - 400 016 Telefax: 91-22-6666 9381 Website:www.kohinoorsurgicals.com Email: kohinoorsurgicals@hotmail.com

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Specifications of Zane 1. Dome head

three wings

2. Lux

90,000 Lux ± 10%

3. Colour temperature

5,500°K

4. Colour of the light

Cool white

5. Adjustment of light

0 TO 99

6. Dimmer

Digital

7. In put voltage

150V A.C. TO 280 V A.C.

8. Out put voltage

20 VOLTS D.C.

9. Out put current

1.5 Amp.

10. Lamp head power consumption

30 WATTS

11. P.F.C.

0.94 TO 1 @ 230 VOLTS A.C.

12. LED driver

SMPS WITH PFC

13. Power saving

85 per cent of conventional, halogen

14. Efficiency

? 80%>

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Transasia Bio-Medicals launches Sysmex 6 part differential haematology analyser Launch held at 53rd Hematcon 2012, organised by Indian Society of Haematology and Blood Transfusion

JANUARY 2013

ransasia Bio-Medicals, India’s largest IVD company, has launched Sysmex XN Series – the first haematology analyser to use fluorescent flow cytometry and cell counting to detect abnormal samples. The launch took place at 53rd

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vant information and showcases the abnormalities in the scatter grams. This helps in early detection of bone marrow abnormalities and aids haematologists in their clinical investigations and further channelising the future course of treatment.

cater to small to large workloads.

Supported with innovative software technology, it allows laboratories to access on-line external quality control (QC) comparison with peer-group laboratories. The software also has the capaci-

any time with the addition of functions or ‘apps’, RET (reticulocytes), PLT-F (fluorescent platelets) and BF (body fluids). The analyser measures NRBC with every CBC. The new advanced XNSeries is designed for a long

Hematcon 2012, organised by Indian Society of Hematology and Blood Transfusion (ISHBT).

Sysmex XN series, manufactured in Japan by Sysmex Corporation, is a next generation instrument which is designed to enhance clinical values. Transasia and Sysmex have been business partners since 1993. Sysmex XN series plays an initial role in evaluation of haematological conditions and diseases, providing data in screening of anemia and infections. The analyser on identifying abnormal samples flags rele-

The modular integrated transportation system comprises automated Haematology analyser along with SP-10 slides preparation unit, thus enumerating clinically relevant parameters enhancing complete flexibility during comprehensive diagnosis. The Sysmex XN series from XN 1000 to XN 9000, embraces the modular concept and scalable system lab with 50 or >500 CBC samples a day and allows combination of multiple analysers, transport system, slides preparation system and other instruments to

ty to monitor instrument performance and external quality control from a technical (engineering) perspective.

Predictive failure detection and maintenance monitoring are built into the XN analysers, and can be monitored remotely as required.

Another benefit of the XN series is the increased laboratory efficiency by reducing the number of false positive flags at higher sensitivity and specificity. It provides automated reflex/re-run testing based on the results enumerated. In addition, each XN module can be extended at

product life and with a consistent user interface in all models. By leveraging on its strengths to deliver additional value, Transasia Bio – Medicals with the launch of Sysmex XN, 6 part haematology analyzer aim to secure its position as the undisputed leader in haematology.

www.expresshealthcare.in

Contact Transasia House, 8, Chandivali Studio Road, Andheri East, Chandivali Studio Road Mumbai, MH 400093 Phone: 022 4030 9000 EXPRESS HEALTHCARE

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Specialised patient care using electronic medical record EMR adoption rate in developed countries is very high as compared with under developed countries

n the modern medical scenario healthcare practices has been evolving and always looking for better avenues to improve the overall well being of the patients.

These days Information Technology (IT) has been helping healthcare stakeholders by offering ways and

I

means to take their facilities to the next level.

In today’s world, physicians are looking for better options to improve their productivity, efficiency and improve the overall patient care. Physicians are also looking forward to attend to more patients without compromis-

Configurable Workflow

the same successfully.

■ Record availability with

patient – Most of the time patient needs the critical clinical records to refer to other physicians or to share with their family members; however, with the current manual system it is not possible to make these records available with the patients.

Elements of Electronics Medical Records

■ Patient appointment –

With the current manual system it is hard to change / reschedule or cancel the appointment and use the

Practice management features

Note: These are few examples of patient medical records; however, more records can be included to digitise the healthcare practice.

Manage patient records electronically

Certified EMR by recognised certified body

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ing on the quality.

In advanced countries, most of the physicians seek technological support to improve their patient care. In recent time, Electronic Medical Records (EMR) has proven as the revolutionary IT product for physicians to improve their overall patient experience and improve their healthcare practices. EMR adoption rate in developed countries is very high as compared with under developed countries as there are certain challenges that the doctors face.

Physician’s challenges in current scenario

tices. Following are few of them : ● Searching for the records is a time consuming process ● Records are merely on papers therefore physicians are unable to use the data out of it ● Records are non-transferable to other physicians ● No clear process to track patient history ● No use of effective note/ patient records ● Records are difficult to digitise

■ Handwritten prescription – There are chances that handwritten notes might be incorrectly deciphered and pharmacy takes the call on what the medicine should be. A few NGO’s have also suggested ways to improve handwritten prescriptions by writing in capital letters.

Following are the typical challenges that physicians face in their healthcare practices: ■ Patient records - Most of the records are maintained using papers, hence there are inherent road blocks in improving healthcare prac-

■ Patient education – To improve patient care one of the important steps needed is to improve patient’s awareness and educate the patient as much as possible. However, with the present arrangements, it is not possible to do

■ Practice management – With the manual system in place, physicians spent most of the time in managing the practice and hence very little time to spent on strategising on how to improve the patient care.

www.expresshealthcare.in

available slot for other patients. It is achievable to certain extent but surely challenging for the staffs to manage the patient appointment list.

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ePrescription Facility

Secured Access to all stakeholders

Compliance Reporting

Patient Records availability on online portal

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Selecting right EMR software for healthcare practice The right EMR software must have the following features: ● Certified as per Government norms ● Electronic patient appointment features ● ePrescription ● Practice management ● Critical notes for patient ● Workflow as per physician need ● Compliance reporting ● Store/retrieve patient records

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Patient education Online patient portal Laboratory/Pathology records Health Information Exchange (HIE)

Conclusion For advanced patient care physicians can take help of IT and adopt reliable, efficient and best software which will improve the productivity and quality of their practice. This will also benefit the patients and make their visit to the doctor pleasurable.

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Look at a growing practice differently Balasubramanian G, Director, BigSun Technologies talks about time management and other steps that can be taken to optimise a venture

BALASUBRAMANIAN G

Director BigSun Technologies

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ery few people understand the pains of a growing practice and those involved in setting up one. Simply put, people hardly realise the pains of a doctor or a medical professional. How do we tackle this problem objectively?

The answer lies in time management. This is a very difficult proposition for most doctors to manage and they honestly don’t have an answer to this. If you try finding out more, you will only hear “There are too many variables to manage”

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will take up solving the puzzle of better time management for doctors and health professionals using technology. Is this relevant? Is it possible? What are you talking about? I have done it all and it does not work. Trust me, people with these answers have never managed a good technology adoption in their career span. Talk about this to a technology savvy doctor and he or she will show you one sophisticated gadget and talk as if he/she is very comfortable with this and

is how do we put all these things together. So we went back to the drawing board and got some analysis going. The outcome of this analysis is what we will share in this series that we have named 'Good Quality Practices Always Grow' Our objective here is to reach out to the minds of the medical professional and explain through a simple set of articles a way or a method to follow to achieve growth with higher customer satisfaction. Let us begin here by writing the details of your

equally important. Any practice is bound to grow if a doctor is more informed about his patients. All patients prefer doctors who care for them and understand their problems well beyond prescription of drugs. So what is new about all that we just told you? If this is what you feel about what you just read, you need consultation help from a technology consultant, who will put together a personalised electronic health record for your OPD practice. The interesting point to focus here would be

or “ I don’t know”.

What does this mean to the future of doctors and what are the educated patients telling them? I would rather go to someone who respects my time as much as his or her time.

Does this affect us today? It does, because it is here that we start to realise what better management of our time will do for our customers and us. Most discussions end up with doctors managing “extremely busy practice” situations. This should not be made a part of our current discussion. There is a good solution, which exists for the busy doctors as well, which we will take up in one of our future articles.

In today’s discussion, we

has been using it for ages.

Go one step further and you will almost get convinced that he or she has got it right. If you spend time and dig deep, you will get your answer.

Adopting and understanding technology are different things all together.

Implementing good technology is not just about buying it. It should start with a buying event definitely. It should then be pursued and continued. Simply put, there must be a definite implementation and adoption plan that involves change.

We have spoken so far about better time management, technology, implementation and change. The first question that one would ask now

practice on a piece of paper.

This should bring out your strengths, your growth drivers, your needs and aspirations. Apart from many other points written there, growth in income, reduction in costs, better risk mitigation, inventory tracking and fund management are some elements which come up.

Surprisingly, we saw many of these elements leading to an electronic medical record (EMR) or an electronic health record (EHR). You will be unwilling to accept this, so we decided to break it down into simple steps for you to understand.

Growth in income is a mix of new and old customers always. Both are

to get yourself a EHR designed to grow your practice. This is also not what another doctor has; this is what is relevant and customised to your practice.

We will continue with this series to understand more about how this can be achieved.

www.expresshealthcare.in

Contact Balasubramanian G, Director, BigSun Technologies M: + 91 9820298089 E: gs@bigsunworld.com www.bigsuntoday.com www.bigsunworld.com B-406| Technocity, Plot No.X-4/1,4/2,MIDC, TTC, Mahape, Navi Mumbai–400710 India JANUARY 2013

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Just healthcare 24x7 Himanshi Seydain, VP-Corporate Relations, Pioneer Futuretech (Healthcare IT) elaborates on the benefits offered by eMedicard – a health card that promises Just HealthCare 24x7 ublic health in India exhibits a peculiar trend. In spite of a compound annual growth rate of 15 per cent in the healthcare industry, public health in India is full of paradoxes and challenges. Life expectancy at birth, for example, has increased from 48.8 years in 1970 to 64.8 years in 2009.

However, there is an increasing incidence of deaths from chronic non-communicable diseases, or lifestyle diseases as they are popularly known, among people aged 35 to 60.

Simultaneously, a report by P r i c ewa t e r h o u s e C o o p e rs (PWC) suggests that 18.9 crore Indians will be at least 60 years of age by 2025, the implication being an enormous burden on the healthcare infrastructure of India as a result of the growing elderly population. In addition to that there has been a serious rise in lifestyle ailments like heart diseases, cancer or diabetes. In 2008, more than 35 per cent Indians who died of a heart attack, cancer or diabetes were in their productive years (age 35-60).

Given the issues and challenges public health in India is facing presently, there will always be a gap in terms of healthcare resources vis a vis people who are sick in the near future. Hence, as an alternative to consolidating resources for curative services is preventive healthcare. WHO indicates that at least 80 per cent of premature deaths from CVDs and type 2 diabetes, and 40 per cent of cancers are preventable if a healthy lifestyle is maintained and/or the conditions leading to the disease is detected early!

Deteriorating health also has serious implications on the economics of our country. WHO says, 3.2 per cent Indians will fall below the poverty line because of high medical bills, i.e., more than 61 Indians go below the poverty-line every minute by spending on healthcare. It is also suggested that about 70

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JANUARY 2013

per cent of Indians spend their entire income on healthcare and purchasing drugs.

Save your health, save your life, save your money!!

A preventive health check-up simply keeps you up-to-date with your health status! Also it is an investment that not only helps you save money today; it saves you from future catastrophic expenditures.

Pioneer Futuretech (Healthcare IT) pioneers in creating a health card called the eMedicard – Just HealthCare 24x7 that brings healthcare to your door steps with no added costs rather with a battery of benefits and discounts.

The services that eMedicard brings for you: ● 24*7 Free teleconsultation with doctors for medical advice and second opinions ● 24*7 Doctors on call in times when you can’t go out to the clinics and hospitals ● 24*7 Diagnostic facility at your door steps ● 24*7 Instant first line of treatment during emergencies ● 24*7 Ambulance services equipped with doctors within 10 minutes Apart from all these great benefits to bring you the best healthcare, it also keeps electronic medical records (EMR) for you. EMR is not something that we as Indians hear very frequently but it holds utmost importance in times of emergencies. EMR pull together all of a patient's information, from the results of the last routine check-up with her primary care doctor to CT scans from her emergency hospital admission because of a fall, in one place that is secure but remotely accessible not only to physicians but to the patient herself.

A study concluded that heart attack patients who have EMR, when brought to the emergency departments www.expresshealthcare.in

of hospitals are less likely to develop complications or die as compared to patients who have no such records to help the doctors treating in emergency. This is so because in times of emergencies the patients or their families cannot carry health records to the hospitals. This is also one of the reasons why we are able to bring to you the best healthcare advice as well as service as we know your medical and family histories. eMedicard is a service

that helps manage your health needs for best results, provides rapid medical attention during times of emergencies and helps you save on medical expenses. It has a unique multifaceted approach towards healthcare and is thoroughly equipped to handle and manage its clients’ preventive and emergency healthcare needs. It is emerging as a facility that is here to bridge the gap between the healthcare needs and delivery.

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Machine extraordinaire from Periclave Periclave's gauze cutting machine promises to make gauze processing easier and simpler with its advanced features ounded by Zoru Bhathena, Periclave is backed by 65 years of family experience in manufacturing steriliser, autoclave, CSSD, TSSU, laundry and kitchen equipment for hospitals.

Gauze is a dressing for wounds made of loosely woven material such as cotton. Gauze cutting and making is very important for working of the hospital and for infection control.

Traditionally, it was a painstaking work as the cutting was done with a handle held scissor. This needed huge manpower who would get exhausted due to heavy manual work. Hence the work was mostly outsourced and as a result quality monitoring was very difficult.

Looking at the this issue, Periclave has launched mechanical gauze cutting machine which does not require holding of heavy cutting tool because of which processing of huge

The system meets all modern requirements for effective cutting of gauze with low power consumption. The company claims that its new 200 mm blade design gives large cutting space and reduces time, thereby saving energy.

This versatile system is known for its ruggedness and yet silent with vibration less operation. The cutter completes cutting in a very short process time thereby making gauze cutting simple and fast.

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load with little manpower is possible.

Periclave gauze cutting machine is a professional heavy duty machine. It has been developed for hospitals, CSSD and other places where gauze might be processed.

The design allows for top performance at lowest possible operation cost and investment. The mechanical control centre ensures that maximum productivity is obtained.

Main features 1) The unit is fitted on the table of 900mm (L) x 600mm (W) x 900mm (H) formed out of SS304 qualitymaterial 2) The low profile base plate drastically reduces the fabric distortion and drag 3) The close fitting of the wing of the base plate easily slips under the bottom ply without catching or snagging the gauze

4) The motor cooling fan dissipates heat build-up and directs the hot air-flow away from the operator 5) Operating handle and lever are positioned for maximum convenience 6) Blade can be sharpened by the automatic sharpening unit only when lever is pressed down, ensuring safety 7) Blade size – 200mm, 8” 8) Cutting height – 165mm 9) Power – 230V Ac 50Hz, 0.75HP 10) Total Weight – 16kg 11) Mounting – table top Contact : Zoru Bhathena Periclave House, 63-A, Kandivali Co-op Industrial Estate, Charkop, Kandivali (West), Mumbai – 400067 Tel: 022-2867 3130 , fax: 022-28673140 , e-mail: info@periclave.com Website: www.periclave.com

Ziqitza@HBII 2012 Ziqitza Health Care, one of the exhibitors at HBII 2012 found it to be a very worth attending event and is very happy about the interest they recived from the visitors about their venture iqitza Health Care operates the Emergency Medical Response (Ambulance) Services under two models: Dial '1298' for Ambulance and Dial '108' in Emergency (popularly called 108 model). Currently Ziquitza is operating 860 ambulances across the state of Bihar, Rajasthan, Punjab, Mumbai, Kerala and Odisha. It was one of the companies who participated in the recently held HBII 2012.

The company says that HBII 2012 was a great platform for people from healthcare fraternities to meet and showcase their products/

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services to delegates/attendees to drive the growth.

“HBII 2012 for Ziqitza Health Care has proved to be good as it gave us a platform to connect on large spectrum with like minded people. It made us aware on t h e trends in the healthcare sector,” says Ruchika Beri, Assistant Manager , Marketing and BD, Ziqitza Health Care.

She says, “We received an overwhelming response from the the visitors as they appreciated the work which we do in emergency medical Sector. It also received lot of inquiries regarding theirser-

vices and how visitors/delegate could support them in their initiative.”

In HBII 2012, the visitors showed lot of interest to associate with the company and its work. The company hopes to cater to them post understanding their needs.

Contact Ziqitza Health Care AAA CSSC, M.N. Roy Human Development Campus, 2nd Floor, C Wing, Plot No 6, F Block, Bandra Kurla Complex, Mumbai:400 051 Ph:+91-22-26578800 JANUARY 2013

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Magnificent solutions from Maple Maple Digital Technology International offers very cost effective PACS and DICOM solutions to its users aple Digital Te c h n o l o g y International is a pioneer in providing Indian customers with efficient, reliable and, robust end-to-end solutions using Apple’s pioneering technology. They assure that they provide impeccable service and attention to customers.

After enjoying success in the consumer and professional film and video industry, Maple ventured into the medical vertical more than three years ago. Since then, it has successfully deployed Osrixbased solutions in over 60

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hospitals and diagnostic centres across India.

Osirix is an image processing software dedicated to DICOM images (.dcm/.DCM extension) produced by imaging equipment such as MRI, CT, PET, PET-CT, and confocal microscopy (LSM and BioRAD-PIC format). It can also read many other file formats like TIFF, JPEG, PDF, AVI, MPEG and Quicktime. It is fully compliant with the DICOM standards for image communication and image file formats. Osirix is able to receive images transferred by DICOM communication protocol from any PACS or imaging modality like STORE SCPService Class Provider, STORE SCU – Service Class User and Query/Retrieve.

Osirix has been specifically designed for navigation and visualisation of multimodality and multidimensional images such as 2D Viewer, 3D Viewer, 4D Viewer and 3D Series with temporal dimension.

Maple also offers ‘qDRAS’ - an eco-system meant for: ● Creating database ● Viewing DICOM images ● Editing ● Tagging ● Fast retrievable low-cost archival solution

GDRAS for Collaboration Quick Database Remote Access System (qDRAS) is a complete intra-office communication tool created by Maple to facilitate seamless information sharing in every possible way. You can share data in real time with others, even if they are in a different continent. SPIDER can be used effectively by medical professionals for teleradiology, remote consultancy or multi-location centre connectivity.

They claim that their solution is perfect for doctors/medical professionals on the move as they can view complete information with DICOM images on portable devices like iPads, iPhones, androids etc from anywhere and at any time.

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They also claim that their skilled technicians understand criticalities of the medical industry and are always available to provide support and solutions catering to unique requirements of each facility and personnel.

Current features of the programme ●

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Dicom and non Dicom file support on multi platforms 3D MPR, MIP, Curve MPR All types of tools for Viewer and 3D Virtual endoscopy Dicom servers preference for Query, Retrieve and Send Web Server: - Administer users from the Web Web Server: - Internet and Intranet Ultrafast performance Intuitive interactive user interface Exclusive innovative technique for 3D/4D/5D navigation Distributed under open source licensing - LGPL Open platform for development of processing tools The most widely used DICOM viewer in the world More than 50,000 users Centre-to-Centre connectivity

Teleradiology Teleradiology has improved patient care by allowing radiologists to advise and treat without being near the patient’s location. This is possible by transmitting the patient’s images from one location to another.

Using qDRAS, Maple’s teleradiology solution enables teleradiology without any additional tool. It helps medical professionals to collaborate with other professionals by easily sharing images or work from outside their clinic or hospital, or advise a patient remotely. All this happens over a secure network to eliminate chances of unauthorised access.

Radiology workstations Maple claims that its workstation is built with the best-of-the-breed hardware and software components.

Osirix on the powerful Mac Pros brings best of both worlds together to bring the users an efficient, reliable and easy-to-use solution.

PACS Maple provides the users with an easy way to store, quickly retrieve and access images acquired with multiple modalities through its picture archiving and communication system (PACS) solution. Osirix is a robust and extensible PACS server that provides unique features like Web-based administration, unlimited number of clients and fully compatible with the DICOM protocol.

Web server Web server is a multipurpose web-based viewer with a highly modular architecture. It has been designed to meet several expectations of clinical information systems and their future evolution regarding medical imaging: providing a web-based access to radiological images, as well as offering multimedia capabilities.

Web server can be easily interfaced to any PACS supporting WADO via a web portal or as an XDS-I consumer in an IHE (Integrating the Healthcare Enterprise) environment.

Web server can be accessed on Intranet and Internet.

For customised PAN-India PACS & DICOM Solutions contact: 250, Powai Plaza, Opposite Pizza Hut, Hiranandani Gardens, Powai, Mumbai – 400 076.

Branch Office : Saldhana Providence, Balmatta Road, Mangalore - 575 001 Tel: +91 90047 45674 / +91 77383 69799 Email: osirix@mapledti.com.

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WEGACHECK - A holistic approach to diagnosis 3 CUBE Biomed Services introduces WEGACHECK in Indian healthcare and medical devices market as a frontline diagnostic tool revention creates safety and quickly leads to well-being! Today, the buzz in the healthcare market is all about 'Prevention is better than cure'!

Growing awareness about preventive and personal healthcare in urban as well as rural Indian population has created lots of business opportunities for medical service providers (diagnostic centres, pathology labs, hospitals, medical care centres, doctors, dispensaries, nursing homes etc) and healthcare entrepreneurs in India. If one can detect or diagnose patient’s clinical/medical conditions at an early stage of disease, one can prevent years of prolonged medication and agony.

3 CUBE Biomed Services introduces WEGACHECK in Indian healthcare and medical devices market as a

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frontline diagnostic tool for doctors. WEGACHECK is a clever and helpful device that provides important diagnostic information and decisive tips for doctors in arriving at diagnosis and deciding on the best therapies. WEGACHECK is an additional diagnostic tool about health issues that not always can be detected by traditional examinations such as X-ray, ultrasound, computed tomography or blood tests: Inflammatory foci, chronic and hidden disease as well as allergies and functional disturbances can be traced by WEGACHECK – Check Medical Device.

WEGACHECK is the ideal frontline diagnostic tool for evaluating a patients overall health and fitness.

WEGACHECK is CE0494 certified as a diagnostic device for complimentary medicine and ISO 13485:2003 certified

diagnostic medical device manufactured by Wegamed, Germany.

WEGACHECK Recording Method The two fundamental concepts supporting the WEGACHECK technique are Functional Medicine and Pischinger’s basal System.

WEGACHECK utilises bioimpedance mechanism during the measurement. It applies an electrical stimulus with pulsed measurement organs. In a measurement, WEGACHECK points out all the reaction organs that have something to do with the disease. The WEGACHECK recording is thus a snapshot, directing one’s attention to the organs that currently need attention.

Advantages of WEGACHECK There are lot of cases which go undiagnosed with traditional devices as most of devices are not based on or do not look at patient holistically. This device could be well utilised as a diagnostic tool to correlate patient’s actual clinical/medical condition with his/her physical, mental symptoms.

Skin is the organism’s interface to outside world.

The way that the skin and the matrix with which it is connected, react to external stimuli reflects the organism’s condition.

WEGACHECK measures skin resistance e.g. fungal hat in regulatory behaviour graph – it can easily diagnose mycotic burden at an early stage with following type of graph and physicians or individuals can take necessary step to prevent it from being developed into fungal infection.

Introduction to WEGACHECK Pilot Study 3CUBE decided to conduct pilot research study in Kolhapur, Maharashtra dur-

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ing the period November 26, 2012 to December 20, 2012 at two clinics of Dr Subhash Kumbhar and Dr Sandip Nejdar.

Purpose of pilot research study 1. To check the utilisation of WEGACHECK medical device in medical practice for diagnoses.

2. How useful is this device in detecting disease in its early stages?

Here are some classic cases which 3 CUBE found during their research study on patients – A 30-year old male patient named Pravin Patil (name changed for confidentiality purposes), took a WEGACHECK test on November 28, 2012 at Dr Subhash Kumbhar’s clinic.

Before conducting the test, patient had not given history regarding his complaint about occasional joint pains as he thought it’s not a major issue. But Patil is known to have a case of Psoriasis and is undergoing treatment for the same.

After conducting test, his graphs are as follows:

Report interpretations Type of graph is hormonal – neural and rheumatic.

This clearly indicates signs of joint pains and arthritic changes in patient which is not diagnosed yet.

Also the patient had nervous stress which is a result of fluctuations in the hormonal system and this is indicated by hormonal-neural graph.

Patient’s acid-base balance showed chronic acidity at around 50 per cent which is a cause of concern in rheumatic conditions. It could lead to acidosis.

Now from this particular test report, Dr Subhash Kumbhar could easily diagnose the changes in patient at physical as well as mental level. E.g. Case under consideration suggests undiagnosed arthritic changes and JANUARY 2013

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CASE STUDY 1 – Undiagnosed case of Psoriatic Arthritis

patient is suffering from psoriasis. That means Dr Subhash Kumbhar could conclude that the patients medical condition was tending towards psoriatic arthritis changes which is one type of arthritis. Now, Dr Subhash Kumbhar could start treatment at an early stage for psoriatic arthritis.

Also he could work on patient’s chronic hyper-acidity to regulate it which may be the cause for leading the patient’s condition to psoriatic arthritis. Also if necessary, Dr Subhash Kumbhar can suggest the patient to do RA factor test for rheumatoid arthritis.

A 38-year old female patient named Kirti Mohite (name changed for confidentiality purposes), had taken a WEGACHECK test on November 28, 2012 at Dr Subhash Kumbhar’s clinic.

Patient was complaining of hysterical symptoms with nervous mental state. After conducting a test, her graphs were as follows:

Report interpretations Type of graph is Hormonal – Neural and Rheumatic CASE STUDY 2 – Detecting Hormonal-Neural & Rheumatic type patient

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Patient had nervous stress which is the result of fluctuations in the hormonal system, and this is indicated by hormonal-neural graph This clearly indicates signs of joint pain and arthritic changes in patient which is not diagnosed yet Patient’s acid base balance is showing chronic acidity around 54 per cent which is a cause of concern in rheumatic conditions. It could lead to acidosis Patient had not given history of one odd occurrence of convulsive attack in recent past as it was the first time she had convulsion complaints Now, from this particular test report and patients actual condition, Dr Subhash Kumbhar could easily diagnose the changes in patient at the psychosomatic level which were causing physical problems to patient. After taking the history of the patient, Dr Subhash Kumbhar came to know that she had a convulsion attack in the recent past and graphs confirmed it. There was too low energy in the head region. So, Dr

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Subhash Kumbhar suggested the patient to do a CT scan for further confirmation before starting the treatment. The patient’s graph showed rheumatic changes in the gonads region with left kidney in the pre-clinical condition.

That means Dr Subhash Kumbhar was in a position to suggest the patient to do RA factor test for rheumatoid arthritis to confirm the above findings thereby having a more targetted approach to specialised tests and treatments.

Testimonials Dr Subhash Kumbhar says that WEGACHECK measurement supplements orthodox examination methods and procedures – especially if one takes a holistic view of the patient that transcends the somatic level. In the recent future, it could prove itself as a frontline diagnostic tool which will help medical service providers to take a look at a patient with a holistic view in mind.

Conclusion The purpose for which this pilot research study has been conducted was successful. Medical practitioners can utilise WEGACHECK in early detection of diseases and also patient could get more benefits as always prevention is better than cure.

Summing up, one can say that WEGACHECK believes in a holistic approach towards individuals clinical/medical problems by focusing on researching the causes of any illnesses.

Wegacheck adds a new dimension to diagnostic references and acts as a guide to doctors. It can open the door to a more targeted and personalised approach to treating patients. The device is manufactured in Germany and distributed in India by 3 Cube Bio-Med Services.

Contact 3 Cube Bio Med Services 305 Maker Chamber V Nariman Point Mumbai – 400021 Phone: +91 22 66576031 Mobile: +91 9820655730 E-Mail: jsheth@3cubeservices.com Web: www.3cubeservices.com EXPRESS HEALTHCARE

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T-Ring: A new age tourniquet The T-Ring provides a bloodless operating field for emergent and elective medical procedures involving the digits and lower extremities

tion. The T-Ring is the only digital tourniquet that automatically adjusts to the size of the digit, resulting in a safe, reliable pressure with each use. In fact, the T-Ring has been shown to effectively provide haemostasis while applying less pressure than any other tourniquet method! This makes the “TRing” the safest, most efficient and effective digital tourniquet in use today.

It instantly exsanguinates as it is slid onto the digit, providing immediate haemostasis and ideal wound visualisation. The device comprises a brightlycoloured outer plastic ring within which is a flexible disc which itself contains a hole. This is supplied in a sterile packet and can be pushed over the lacerated digit to exsanguinate it and provide haemostasis. The ring has two “cutaway” sections on it, which allow its two halves to be separated, pulled apart and gently moved over a larger laceration if appropriate.

Similarly, the device can either be gently slid off the finger or the plastic outer ring can be broken and the inner flexible portion cut.

-Ring is designed to give health care providers a safer and more effective option to current digital tourniquet methods. While current digital tourniquet methods are effective, they all have the risk of complications associated with their use such as excess pressure and necrosis due to prolonged applica-

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Indications

The T-RING Advantage!

The T-Ring is used in elective medical procedures involving the digits of the upper and lower extremities. In the evaluation and management of acute problems, its uses include: ● Wound exploration for foreign bodies, or underlying tendon, bone or joint injuries ● Wound repair of lacerations, avulsions, and tip amputations ● Management of nail and nail bed injuries ● Achievement of complete haemostasis to allow closure of smaller wounds with adhesive strips; eliminating the need for painful injections and costly, time consuming suturing ● Drainage of paronychia, and finger and toe abscesses The T-Ring is also indicated for the management of the following elective procedures: ● Elective tendon, bone or joint surgery ● Excision of tumours, warts and other deformities ● Wound or scar revisions and biopsies

The T-Ring has numerous advantages when compared to current digital tourniquet methods: ● Automatically adjusts to any size digit ● Safe pressure - every time ● Unlike Other Methods, it cannot be Over Tightened ● Immediate haemostasis provides ideal wound visualisation ● Highly visible, will not be forgotten on the digit ● Slides over lacerations, avulsions and traumatic skin flaps ● Faster and easier to use than any other method ● A breakthrough in digital tourniquet safety!

www.expresshealthcare.in

T-Ring is a US FDA approved product manufactured in US, California by Precision Medical Devices LLC For distribution and sales contact us at: info@3cubeservices.com +91-22-66576030/31/32 www.3cubeservices.com

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Indigenous sterilisers from Kaustubh Enterprises Kaustubh Enterprises' indigenously produced ethylene oxide sterilisers and ETO cartridges for various healthcare needs are gaining popularity with time austubh Enterprises are the Indian manufacturers of ethylene oxide steriliser and pure (100 per cent) ETO cartridges. These are indigenous products approved and acclaimed by clients from academic, research, industrial and healthcare segments all over India and even abroad. All the products are marketed under the brand name ‘Rujikon’ (registered trademark) Kaustubh, Rujikon was started by MV Bhagwat in 1980 and the firm was instrumental in development and manufacture of ethylene oxide sterilisers (steriliser) and ETO cartridges. The ETO sterilisers they manufacture are available in manual, semi automatic and fully automatic models to meet the requirements of all private surgeons i.e. general, eye, orthopaedic, cosmetic, neuro, cardiovascular as well as all small nursing homes, medium and big hospitals, medical institutions, in short the entire healthcare sector. The organisation is the brainchild of MV Bhagwat. He was associated with many prestigious R&D institutions renowned worldwide, for more than 42 years.

He handled numerous R&D projects and developed a wide range of appliances and equipments for the PhD students of pure and applied sciences faculties. His knowledge and experience of years paved his path to innovate the ETO Steriliser in 1980 and he became the first person in India to develop and subsequently manufacture the “Rujikon ETO Sterilizer (Steriliser)”Later his son, Kaustubh Bhagwat, the current CEO of the company, with a Masters Degree in pure sciences joined the organization in 1986 and took over the upgradation and marketing of ETO sterilisers. Moving ahead on the foot steps of his father, Kaustubh Bhagwat developed the 100 per cent ethylene oxide cartridges, on his own which is used in ETO sterilisers. He also developed the

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‘unique cartridge puncturing device whereby the cartridges can be punctured in vacuum conditions inside the ETO steriliser.

The i n ve n t i o n / d eve l o p m e n t s made by MV Bhagwat and his son got acclaim and acceptance by many leading surgeons and scientists world o v e r. Ac h i e v e m e n t s T h e y introduced their fully indigenous ethylene oxide gas steriliser for first time in India in the year 1980 and received the prestigious G S Parkhe industrial merit prize and the Dahanukar Entrepreneur Award. Since then nearly 1000 such sterilisers have been manufactured and supplied by the company and are working successfully at various hospitals, medical institutions in India and abroad.They have developed a world class cartridge puncturing system, whereby the cartridges can be punctured inside the chamber under vacuum conditions, thereby eliminating the risk posed by pure ethylene oxide. They have also offered a dual operation model whereby the user has the flexibility to either use refillable cylinders or disposable cartridges. Available chamber capacities are from 1.5 cu.ft. to 8.0 cu.ft.

They have also introduced a semi- automatic model, with almost fully automated functions, having chamber depth of 54” (137 cms), which can conveniently accommodate up to 130 cm long cardiac catheters without bending or coiling, thereby leading to its enhanced life. The company informs that it has become extremely popular with the cath lab fraternity. They have recently introduced an ETO steriliser with inbuilt aeration facility which does not require external compressed air, thereby making the working noiseless and hassle-free.

They have also introduced a fully automatic ETO steriliser with inbuilt printer and aeration facility which is extremely easy to use and maintain. www.expresshealthcare.in

Products offeringsThe different models of ethylene oxide sterilisers and ETO cartridges they manufacture are available under the brand Rujikon. The different types of ETO sterilisers they offer are : ● Rujikon ETHYLENE OXIDE STERILIZER, DUAL MANUAL MODEL “KB Series” ● Rujikon ETHYLENE OXIDE STERILIZER, SEMI AUTOMATIC MODEL “KANC Series” ● Rujikon ETHYLENE OXIDE STERILIZER, SEMI AUTOMATIC MODEL “KANC Series” for CATH LAB ● Rujikon ETHYLENE OXIDE STERILIZER, FULLY AUTOMATIC MODEL “KA – 2 Series” ● Rujikon ETHYLENE OXIDE STERILIZER, FULLY AUTOMATIC MODEL “KA – 2 Series” for CATH LAB ● Rujikon 100 per cent (PURE) ETO CARTRIDGES

(TIFR) Bangalore Large number of eyesurgeons ● Cath labs - in India and abroad ● Private/govt hospitals all across India & abroad ●

Why Kaustubh Enterprises? ●

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Accessories They provide the following accessories along with the sterilisers1) Sealing machine 2) Chemical indicators 3) Packing material (paper and plastic) 4) Gas cylinders filled with EO+CO2 mixture or 100 per cent pure ETO cartridges and as a start up kit

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Catering to healthcare and research segment

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They cater to research centres, speciality laboratories, private surgeons, hospitals, medical institutions, nursing homes, day care centres, eye specialists, ortho specialists, general surgery centres, gynaec care units, cardio thoracic surgeons, interventional cardiologists, plastic / cosmetic surgeons, neuro surgeons, cath labs etc.

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Notable clients ● ●

IIT’s all over India National Centre for Biological Sciences

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ETO sterilisers in various sizes and with different combinations ie., ETO steriliser with aerator, dual manual model, semi–automatic, fully automatic with inbuilt printer - available.

All types and sizes of ethylene oxide sterilisers available to suit your budget First fully indigenous ethylene oxide steriliser was developed by them way back in 1980 acclaimed for its time tested performance World Class ETO cartridge puncturing system They understand the need of various research and healthcare institutions and have designed units which are safe and simple to operate Quality of products is tested using special purpose machines Participated in numerous national level trade fairs/expositions and Medical conferences of eye surgeons, interventional cardiology, general surgeons, orthopaedic etc Extremely good and assured technical backup The same team at your service for continuous 32 years

Contact Kaustubh Enterprises, Rujikon Kaustubh Bhagwat A/6, Nutan Vaishali, Bhagat Lane, Matunga (WR) Mumbai – 400 016, Maharashtra (India) Mob: +(91)-9820422783 Phone: +(91)-(22)-24309190 Fax: +(91)-(22)-24375827 / 24311525 Email: rujikon@gmail.comkaustubh4307@gmail.com EXPRESS HEALTHCARE

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HiTek’s modern day OTs HitTek OTs take up complete turnkey projects and their projects cover installations of modular ICU, IVF labs, medical gas pipeline system and modular OT’s, which also include the HVAC system iTek OTs, formerly known as Hi_Tek Medical Solutions is an ISO 9001-2000 and CE certified company, delivering “Future Oriented Medical Technology in Hospital Construction” pan India. The company is an one stop solutions for hospital, modular OT, OR, modular ICU / Integrated OR construction, starting from MGPS(Medical Gas Pipeline system to complete Modular OT, including HVAC, thus offering complete turnkey solution with single onus of responsibility.

Established in the year 2005., HiTek OTs, is motivated under the guidelines of Board of Directors of the company, the Board of Directors of company consists of professionals who have vast experience, especially in the field of medical, engineering, architectural and each director has a niche in their own respective field in this industry whether it may be, engineering, development, project execution or sales. The company have grown into a leading supplier, by developing processes that minimise customer risk and maximise their success.

In order to provide our clients with a one stop solution for their requirements of modular OT’s, HitTek OTs take up complete turnkey projects and their projects cover installations of modular ICU, IVF labs, medical gas pipeline system and of course modular OT’s, which also include the HVAC system.

Their relationship with the client is from the concept stage itself, which includes the floor layout plans to define the sterile, semi-sterile and the non-sterile areas and also at the same time to define the work flow and the flow of material and patients in order to have maximum efficiency without compromising on sterility issues and at the same time complying with the relevant standards.

The company’s endeavour towards taking advance designing concepts is to min-

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imise infection ratio, carrying approach towards extremely high hygiene norms, clean air, work flexibility with ergonomic design/work efficiency and comply with necessary relevant standards:HTM-03-1; HTM-02-1, HBN26 etc.

Their product range includes: 1) Pre Fabricated Operation Suit Wall Panel, Ceiling Panel, Slopping Panel, Corner Panel with Riser imbibing facility to Electrical – Communication – Mechanical components, Planair Ventilation Ceiling / Plenum / Air and Light Diffuser/Laminar Air Flow System, Antibacterial and Antifungal Coating System, Conductive Flooring System for Operation Suits, Antistatic Flooring System for ICU or OT Corridors, Door and Door Frame(Hermetically Sealed Sliding Door – Automated or Manual Operated), Operation Theatre Control Panel(Membrane Touch or Programmable Touch Screen), Bed Head Panels, ICU Pendant Console, Curtain Track System for ICU, Hinge Mounted Double Leaf Single Side Open able Stainless Steel Door, Hinge Mounted Single Leaf Single Side Open able Stainless Steel Door, LED based X-Ray View Screen, Equipment Storage Unit, Magnetic List Board, Stainless Steel Automated Scrub Sink(Single Bay to Three Bay options), Cascade Pressure Stabilizer(PRD), Hatch Box with UV Light, Clean Room Lights, Various types of LED Based Operation Theatre Light, Operation Theatre Table, Air Conditioning System for Operation theatres(AHU with Air Cooled Package Chiller/Condensing Unit), Surgical Pendants(Single Arm/Double Arm), Anesthesia Pendant(Fixed/Swivel Pendants), ICU Beds, View Window Equipped with Motorized Blinds, Medical Gas Pipeline System.

Few of their satisfied luminary clients are as under: www.expresshealthcare.in

Client name ESI Hospital, Sector 9A Gurgaon, ESI Hospital - Bari Brahmana (Jammu), Chirayu Hospital (Bhopal), Chauhan Multispecialty Hospital & Trauma Centre (Pathankot,PB), ESI Hospital – Basaidarapur (New Delhi), Sri Aurobindo Institute of Medical Sciences (Indore), QRG Central Hospital (Faridabad,HR), Deep Hospital (Ludhiana,PB), Rajshree Hospital & Research Center (Indore), Tirathram Shah Charitable Hospital(new Delhi), St Joseph Hospital (Ghaziabad), IGMC(Indira Gandhi Medical College)Shimla, Subharti Medical College (Meerut, UP), PK Dass (Nehru) Hospital (Kerala), ESI Hospital (Bhubaneshwar), Index Medical College (Indore), Vision Eye Centre (Delhi), ESI Hospital - KK Nagar (Chennai), MGS Hospital (New Delhi), Gama Centauri Hospital (Kolkata), Mediview Nursing Home (Kolkata), Integral Medical University (Lucknow), Nitin

Nursing Home (Patiala, PB), Panacia – New Sunrise Hospital (Gurgaon, HR), Rajiv Gandhi Cancer Hospital & Research Centre (New Delhi), Sir Ganga Ram Hospital (New Delhi), Air Force Command Hospital (Bangalore), Monilek Hospital & Research Centre (Jaipur, Rajasthan), Adhar Hospital (Kolhapur, Maharashtra), Raji Nursing Home (Thrissur), GSL Medical College (Rajahmundry), Bhagwan Mahaveer Hospital & Research Center (Jaipur, Rajasthan), Tanuku Hospital (Karnataka), Kidney Hospital & Lifeline Medical Institutions (Jalandhar, PB), IKDRC Hospital(Ahmedabad, Gujarat).

Contact: HiTek OTs 346, Sultanpur, MG Road New Delhi - 110030, India Phone - 9899821339, 9212488715, 9212388713 email ID: hitekmedical@yahoo.co.in website : www.hitekmedical.co.in JANUARY 2013

REGD. WITH RNI NO.MAHENG/2007/22045. REGD.NO.MH/MR/SOUTH-252/2013-15, PUBLISHED ON 8th EVERY MONTH & POSTED ON 9, 10 & 11 EVERY MONTH, AT IND.EXP.PSO.

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