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Volume IX | Issue V | Dec 2018

Effective Planning & Designing of Hospital Hospital commissioning strategies in 21st century IOT, Machine learning and other latest technology to improve the health scenario of India

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India among the fastest growing global destinations for Medical Value Tourism

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EDITOR SPEAK

India among the fastest growing global destinations for Medical Value Tourism

India is a growing destination for medical tourism, and people from all over the globe are rushing to visit India for their medical needs.

Global Medical Tourism Market Poised to Grow @ of 1.65% CAGR 2018 - 2023

I

ndia among the fastest growing global destinations for Medical Value Tourism. India has been witnessing CAGR@ of 30% over last few years. Reasons for phenomenal growth rate are Quality & Affordable healthcare , Ease of Communication, Hospitality as integral part of Indian culture & heritage, last but not the least excellent entrepreneurial capability and confidence of healthcare providers.

According to Azoth Analytics research report "Global Medical Tourism Market: Analysis by Type (Cardiology, Cosmetic, Dental, Ophthalmology, Orthopedics),According to reports, the medical tourism in India is expected to gain annual growth rate of 30% as a sector. By Country (U.S., Mexico, Costa Rica, Germany, UK, Czech Republic, Brazil, Turkey, UAE, South Korea, Thailand, Malaysia, Singapore, India)" global market is projected to display a robust growth represented by a CAGR of 1.65 % during 2018 - 2023.

The segment of Cardiology witnessed growth at a noteworthy rate over the past few years backed by increased prevalence of cardiovascular disorders, rise in adoption of medical tourism for the treatment of cardiovascular disorders etc. Amongst the regions, North America accounts for the largest regional share in the global medical tourism market in 2018. Key factors driving the robust growth rate of North America region include well developed healthcare infrastructure, surging number of well-trained medical professionals as well as wide number of hospitals under insurance coverage.

Magazine

Volume - IX Issue - V Dec 2018 Editor-in-Chief

Mohd. Afzal Kamal

Feature Editor

Razi Ahsan, Neeraj Vats

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NEWS Update

First of its kind in India, Fortis Hospitals in collaboration with Philips India launches an exclusive echocardiography training centre Fortis Hospital, Bengaluruin collaboration with Philips India today launched an echocardiography training centre, focused to help doctors learn more about echocardiography.

After ECG, ultrasound based echocardiography is the second most widely used test for investigating heart diseases. With increasing incidents of heart diseases in India, echocardiography as an easily available and affordable test needs to be better utilized in various patient scenarios. Physicians are in need of such trainings to better manage their patients and to also upgrade their skills in the latest methods of TBC. Fortis Hospitals through F.A.M.E (Fortis Academy of Medical Education) has always been at the forefront when it comes to academics and education. The echocardiography training centre, which focuses on cardiology and diagnostics is a demonstration of Fortis and Philips’ commitment to up skill the healthcare professionals.

This specialized learning and training centre co-supported by Philips India, is the first of its kind in India as a hospitalindustry partnership. The collaborative venture has a training programme in echocardiography which is related

to non-invasive cardiology, an area predominantly focusing on the various investigations done for patients who have suspected or known cardiac diseases.

Dr. Satish Govind, Chief of Non-Invasive Cardiology, Fortis hospitals, Bengaluru said, “This unique training centre at Fortis hospitals, Bengaluruis fully equipped with facilities that will cater to doctors, both, nationally and internationally. The centre named as ELITE (echo learning and training education centre) will focus on basic echo for the beginners or the not so-skilled practitioners and advanced echo for professionals who may want to upgrade their skills with the latest technology and learn additional echocardiography related specialized procedures. Reputed and experienced faculty who will personally supervise the training, will further enhance the experience of the attendees. Training in small groups with actual equipment, as

also simulators and laptop aids will be done year-round, with plans to incorporate live video teaching from overseas international faculty later in the year. The well-designed interactive training modules will be short and intense with emphasis on practical aspects, which ultimately should lead to better patient care.”

Commenting on the partnership, a Philips India’s spokesperson commented,“Philips has been revolutionizing pathways to address health issues through innovative products and solutions. The launch of echocardiography training centre in partnership with Fortis Hospitals, will be a milestone in imparting clinical education in diagnoses of cardiovascular diseases in India. This state-of-the art centre further drives us to work towards our mission of delivering on personalized and accessible cardiovascular care.”

KIMS Doctors Perform a Rare Open-Kidney Surgery to Save a Patient's kidney Removed potato size very large stone from a farmer from Karimnagar In a rare feat, doctors at KIMS Hospitals have saved life of a 39 year-old-man by conducting an open kidney surgery to remove a very large stone measuring eight centimeters. Size of the stone was of potato and occupied almost entire left kidney resulting in its reduced functioning at only 18 percent. Considering its very large size, doctors had to go for open surgery on the patient.

A 39-year-old male farmer from Karimnagar came to KIMS Hospitals Secunderabad with complaints of pain in the left flank for 15 days. Upon investigation, Dr. Neil N Trivedi, Consultant Urologist and his team found that the patient has a very large stone in 6

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the left kidney due to which his kidney was poorly functioning.

“Usually with such a large size stone, the kidney function would have been damaged. But to our surprise this patient had partially preserved renal function and therefore we planned to remove the stone. We planned for Anatrophic Nephrolithotomy - a surgery in which the kidney is completely split to remove the stone as a whole and then kidney was resutured. The patient recovered well and has been discharged with normal renal parameters.” said Dr. Neil N Trivedi, Consultant Urologist, KIMS Hospitals.

This is a case of silent kidney Stones.

Thus, It is important to be KIDNEY

AWARE. Unlike regular pain and other symptoms involved in regular kidney stones, silent stones never show any sign or symptoms until the kidney function is typically affected. Yearly checkup helps to detect stones early and treat early to prevent any damage in kidney function.

NEWS Update

Gastro ICU inaugurated at Aware Gleneagles Global Hospital Aware Gleneagles Global Hospitals, a Parkway Pantai Enterprise inaugurated the Gastro Intensive Care Unit (Gastro ICU) which offers the high level of intensive care forGI emergencies. The ICU is well equipped with the continuous support from a team of Gastroenterologist to serve patients suffering with GI bleeds, Liver related complications / emergencies, Acute cholangitis, Sever ulcerative cholangitis and will also treat those who have undergone complex surgeries. Dr.Sasmita Dash, M.D. – General Manager, CMO NTPC, inaugurated the facility.

Speaking on the occasion Mr Girish Babu, Chief Executive Officer, Aware Gleneagles Global Hospital, L. B. Nagar, said “The Gastro ICU is launched to provide the best services to patients with critical Gastro diseases. Our team offers round-the-clock care by super specialists to ensure that the patients have the best possible care available to them.”

Dr. N Ravisankar Reddy Consultant Gastroenterologist & Hepatologist, Aware Gleneagles Global hospital, said “The Gastro ICU addresses the needs of ailments specific ICU forGI as the conditions has to be dealt with differently.There are increased incidences of gastro and liver disease due to faulty life styles and habits.

Gleneagles Global hospital is known for its expertise in gastro & liver disease management. So adding this facility of GI ICU is the natural progression towards the patient’s needs. “ “In this area around LB Nagar we are the only hospital with team of gastroenterologists covering emergencies 24X7. Our team also has good expertise in dealing with foreign body ingestion as an emergency”, Dr. N Ravisankar Reddy further added.

The objective of a ICU is to maintain the functioning of the organ system and

improve the patient’s condition, with advanced technologies and modern equipment so that the patients’ primary injury or illness is treated.

Sarcoma awareness: sachin sarcoma society hosts support group meeting at core diagnostics Over 50 survivors share their courageous journeys With its vision to remove the fear of Sarcoma, Sachin Sarcoma Society organized their quarterly support group meeting to create awareness about a rare type of cancer called Sarcoma. The event took place in collaboration with CORE Diagnostics, a next-generation laboratory with advanced diagnostics capabilities.

“The goal of the meeting was to motivate, inspire and boost the morale of other Sarcoma patients undergoing treatment and also to understand the challenges faced by them”, said the President of the Sachin Sarcoma Society, Mrs. Rashi Kapoor. The event was also attended by pathologists, scientists and others from CORE Diagnostics that are often the bearers of a sarcoma diagnosis for such patients.

Sarcoma usually develops from certain soft tissues, like bone or muscle and can be found in any part of the body. Lakshay Nagpal, a Parosteal Osteosarcoma survivor, was diagnosed with a tumor 8

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in his right thigh in November 2016.

Narrating his story of survival, Lakshay said, “Cancer symptoms showed up six months after the pain started. He immediately took the biopsy tests that confirmed the disease. Fortunately, a timely correct diagnosis saved him from chemotherapy and radiation. After the surgery, he resumed his normal life and can walk freely without support.

The Sachin Sarcoma Society hosts a number of sessions for Sarcoma patients of all age groups and their families.

Through the event there were many brave souls aged between 15-80 years— patients as well as caregivers—that shared their stories with brutal honesty.

Speaking on this occasion, Ms. Zoya Brar, Founder & CEO, CORE Diagnostics said, "Both the Sachin Sarcoma Society and CORE share a common mission.

Our organizations are focused on things others don’t – helping bringing awareness

and diagnosis to hitherto lesser known types of diseases. With this mission, we are taking one step further to sensitize the masses about Sarcoma, a rare type of cancer. Most often misdiagnosed, or diagnosed too late, Sarcoma patients are often subjected to a reality much worse than most other cancer patients.

Therefore it is an urgent need to spread awareness on sarcoma. We are touched that the Sachin Sarcoma Society agreed to make us part of their mission. Most importantly, meeting such brave fighters has strengthened our resolve to continue our work on brining the most advance testing to Indian patients.”

NEWS Update

Narayana Health City conducts multi-organ transplant in one day Partners with JIPMER, Pondicherry to facilitate the first dual hand transplantation

Narayana Health City collaborated with JIPMER, Pondicherry to harvest hands for Karnataka’s first hand donation. The patient, a 22 year old male from Anekal, was working at a retail store. He met with an accident while driving a two wheeler.

The patient was brought to Narayana Health City on 15th November and was declared brain dead on 18 November 2018. Father of the patient consented to donate his Heart / Heart Valves, Lungs, Kidneys, Liver, Eyes / Cornea and hand.

The heart is being donated to 18 year old girl, a student from Madhya Pradesh who was suffering from dilated cardiomyopathy and the only treatment that could have saved her life was heart transplant. She has been listed with Jeevasarthakathe since June 2018.

The liver is being given to a 67 year old male, a retired central government employee, hailing from Bangalore. He

was diagnosed with Hepatocellular Carcinoma and the only treatment to save his life was liver transplant. He has been listed with Jeevasarthakathe since August 2018.

Hands (upper limbs) are being donated to 31 year old male from Tamil Nadu and the transplant will be conducted at JIPMER, Pondicherry. The patient lost his hands due to crush injury.

One of the kidney is being donated at Narayana Health City and the second kidney is being sent to Apollo, Mysore.

Kidney patient at Narayana Health City is a 42 year old male, hailing from Bangalore and has been suffering from end stage renal disease since 2014. He has been listed with Jeevasarthakathe since 2015.

Team of doctors conducting the multi organ transplant include Dr. Sanjay Kumar Goja – Director and Clinical

Lead, Senior Consultant and Head of Liver Transplant & HPB Surgery, Dr. Bagirath Raghuraman, MD, DM (Cardiology), Dr. Julius Punnen, Heart & Lung Transplant Surgeon, Dr. Ashely D’Cruz & Dr Sanjay Rao in Kidney Transplant team.

Amrita Vishwa Vidyapeetham and Tata Institute for Genetics and Society to conduct joint research against antibiotic resistance Amrita Vishwa Vidyapeetham’s School of Biotechnology has tied up with Tata Institute of Genetics and Society (TIGS) under the aegis of University of California San Diego (UCSD) to conduct cuttingedge research in antimicrobial resistance (AMR), a rapidly-spreading phenomenon which threatens to make once-treatable bacterial infections deadly again and jeopardize the delivery of modern medicine.

Both are institutions of repute. While Amrita Vishwa Vidyapeetham was ranked the eight best university in India in the 2018 NIRF Ranking, TIGS is a partnership between the University of California San Diego, Tata Trusts and the Institute for Stem Cell Biology and Regenerative Medicine.

Antimicrobial resistance is increasingly globally at an alarming rate, making it difficult to treat even the most common and community onset infections.

However, despite the dangerous increase in multidrug resistance, there are very 10 Dec 2018 w w w. m e d e g a te to d a y.co m

limited options and strategies available to address this crisis.

Talking about the collaboration, Dr. Bipin Nair, Professor of Biotechnology, and Dean, Faculty of Sciences, Amrita Vishwa Vidyapeetham, said: “Recent studies have led to the identification of many genes in pathogenic microorganisms that are responsible for resistance to antibiotics.

WHO has classified multi-drug resistant bacteria Pseudomonas aeruginosa as a ‘Critical Priority’ pathogen with a global unmet need for alternative measures of elimination and treatment in hospital environments. The present collaboration between Amrita School of Biotechnology (ASBT) and the Tata Institute for Genetics and Society (TIGS) will focus on developing new tools to reverse antibiotic resistance. It holds the potential to develop novel sustainable strategies to counter the global menace of multi-drug resistant (MDR) organisms.”

The tie-up between the two institutions derives inspiration from earlier work

Prof. Bipin Nair, Dean, Amrita Vishwa Vidyapeetham and Prof. Suresh Subramani, Global Director, TIGS signing the MoU for antimicrobial resistance research

done between ASBT and the University of California San Diego (UCSD) in establishing the mechanism of action of natural products like clove bud oil to inhibit quorum sensing in Pseudomonas aeruginosa and attenuate virulence. In addition, funding from the Bill & Melinda Gates Foundation and the Department of Biotechnology, Govt. of India as well as Biotechnology Industry Research Assistance Council (BIRAC) to Amrita School of Biotechnology has also resulted in new strategies deploying bacteriophages to counter the virulence of MDR bacterial pathogens.

NEWS Update

P.D. Hinduja Hospital & MRC celebrates International Quality and Safety Week 2018 P.D. Hinduja Hospital & MRC celebrated International Quality and Safety week from November 19th to November 23th, 2018.

Globally, organizations have gained an understanding that success is not theirs alone but also the collective efforts and continuous dedication of their employees towards maintaining quality and safety at the hospital. With a similar thought process, P.D. Hinduja Hospital & MRC organized lectures, activities and panel discussions that involved a new integrated approach towards employee engagement and development with a determined focus on enhancing Quality and Safety at the hospital.

P. D. Hinduja Hospital has always focused on delivering quality healthcare – a practice that has been followed since inception.

Quality & Safe patient care is a continuous process for the hospital and is achieved through sincere efforts and skillful execution by the staff. Quality & Safety Week was conducted to provide a platform to each and every member of the organization to share their ideas & initiatives which play an important role in enhancing the quality of services for patients. The hospital has been organizing the event for the last three years.

Mr. Joy Chakraborty, COO, P. D. Hinduja Hospital & MRC said, “The initiative to start the quality and safety week was taken to bring awareness among more people and also get everybody under one umbrella and work towards accomplishing the mission of the hospital. Our main aim was to sensitize every member of the hospital towards the significance of quality and safety and inculcate a spirit of team work in order to provide better patient experience and care”.

Throughout this week of celebration, P.D. Hinduja Hospital with an aim to enhance employee knowledge and growth also organized multiple informative lectures for their employees.

These sessions were given by both internal and external specialized teams and involved topics like Disaster Management – by Bomb Squad of Mumbai Police, lectures by the Nursing, Support Services and Pharmacy Faculty etc. A one day workshop was held by National Safety Council on Safety at Workplace and which was followed by Management Development workshop on Quality Improvements by Mr. Joy Chakraborty. Apart from these sessions, employee engagement activities like Poster competition followed by various interactive games like Room of clues, Spin the Wheel quiz, Snake and Ladder etc. were organized that saw participation of staff in huge numbers. Over the week more than 200 hospital staff took the pledge to comply to maintain quality and safety at the hospital.

On November 23, 2018, the final day of International Quality & Safety Week, P.D. Hinduja Hospital organized talks by eminent speakers from the healthcare industry and also panel discussions. The topics discussed were ‘Delivering quality 12 Dec 2018 w w w. m e d e g a te to d a y.co m

healthcare through skilled manpower and teamwork”. The panel was moderated by M S Venkatesh, Senior Director – HR at P. D Hinduja Hospital and consisted of eminent personalities from the Healthcare, Quality and Consultancy services like Dr. Pikale, Consultant Obstetricians Raheja Fortis, Dr. Anupam Karmarkar, Chief Executive Officer at D Y Hospital, Navi Mumbai, Dr. Lelita Delima, Director Medical Services, Jaslok Hospital and Belinda Sawant, Head of Nursing Services at Saifee Hospital.

The panel discussion was followed by a session on “Creating Patient Safety Culture in an Organization” which was moderated

by Mr. Joy Chakraborty, COO of P.D. Hinduja Hospital & MRC, and had several other speakers like Dr. Rajendra Patankar, Chief Operating Officer at Nanavati Hospital, Dr. S Narayani, Zonal Director at Fortis Hospital and Dr. Surendra Mathur, President ZTCC, Consultant GI Surgeon at Zen Hospital.

NEWS Update

Narayana Health City successfully treats a young patient who suffered heart attack using Optical Coherence Tomography

N

arayana Health City successfully treated a Bangalorean youthwho suffered heart attackwhile at work. The patient, Mr. Mohammed Rafeek, 27year old, was suffering from a coronary artery disease (CAD) with Acute Coronary Syndrome (ACS) and Triple Vessel Disease.

27 year old software professional, Mr. Rafeekwas leading a normal life until recently. One day suddenly he developed chest pain and was rushed to a nearby hospital. It was found that Mr. R a f e e k s u ff e r e d heart attack for which he was given adequate treatment. However, the search for an advanced treatment facility led him to Narayana Health City. The expert team of doctors under the aegis of Dr. Sanjay Mehrotra, Senior Consultant - Cardiology, Narayana Health City did a complete evaluation of the patient’s condition and found that he was suffering from coronary artery disease (CAD) with Acute Coronary Syndrome(ACS). He underwent a coronary angiogram which showed a blockage (stenosis) of 80% in one of the main arteries of the heart called Left Anterior Descending(LAD)and was planned for an angioplasty and stenting.

Optical Coherence Tomography (OCT) is new technology which is used Near Infrared Light (NIR) to visualise the inside of the heart arteries.Optical Coherence Tomographyallows ten times bettervisualization than Intravascular Ultrasound(IVUS) which has been a method used to see the inside of heart arteries for a long time. OCT givesa much better resolution and exact information about the nature of the plaque, extent of narrowing of the coronary artery and helps to choose the size and length of the stent better.

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Speaking about the case, Dr. Sanjay Mehrotra, Senior Consultant Cardiology, Narayana Health City said, “India today is experiencing a rapid transition in the disease burden and is gradually moving towards a scenario where majority of the deaths are caused by lifestyle diseases. In order to combat the rising incidence, we need to strengthen preventive measures by adopting healthy habits. However, there are times when disease is already there and one needs to effectively treat the disease which needs proficient diagnosis and precise treatment.

Technologies like optical coherence tomography help in treating such conditions with more precision.”

“In case of Mr. Rafeek,with the help of OCT we were able to evaluate the diseased portion of the artery clearly as in his case there was Ruptured plaque which precipitates a heart attack was present in an area which cannot be seen on conventional angiography and failure to do so would have resulted in incomplete coverage which in turn would have lead to complication of stent occlusion and repeat myocardial Infarction (heart attack).” added Dr. Sanjay.

Sharing his joy, Mr. Rafeeksaid, “While I suffered heart attack, my wife was nearing her delivery date and it felt like everything around me is coming to an end. I never imagined that I would be back with my wife celebrating the birth of our child. Today, I am not only getting better but leading a normal life again, thanks to the Narayana Health City.

I am so grateful to Dr.Sanjay and his team for giving me a new life specially using this new technology in my case.

One thing that I have learned from my own personal experience is that there is a reason why our ancestors lived a healthy life, it simply because of the discipline they followed” Cardiovascular diseases (CVDs) are posing huge social and economic concerns in India, and the steady upswing in the mortality attributed to CVDs is challenging. To prevent India from becoming the heart disease capital of the world, there is a need to bring a necessary shift in social behaviour and instil ‘healthy living’ as a norm. The responsibility also lies with the medical fraternity to leverage newer techniques which can effectively manage the disease and improve clinical and patient outcomes, eventually reducing the burden.

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NEWS Update

Secretary General Anjan Bose bids adieu to NATHEALTH

Apex healthcare body, Healthcare Federation of India (NATHEALTH) announced that Mr. Anjan Bose, Secretary General bids adieu to the organization after completing a stellar innings of 6.5 years.

Mr Bose was instrumental in making NATHEALTH a credible voice of the sector with its collaborative and inclusive platform of engagement – a unified voice of the Healthcare sector. Today NATHEALTH stands tall as an apex institution in Indian Healthcare known for its unique, inclusive and collaborative approach due to which it

has earned the esteem and respect of many national and international stakeholders, including the Government.

Expressing gratitude and appreciation for the efforts made by the secretary general, NATHEALTH President Mr Daljit Singh said, “The Governing Council is thankful for Mr. Bose’s years of service and stewardship of the organization. We are grateful to him for his contributions to the organization and wish him much success in the next phase of his career; he will always be remembered as the “founder” Secretary General of NATHEALTH.” Commenting on his move, Mr. Bose said, “It has been a very satisfying period for me to have led the creation of a truly representative body comprising the vast ecosystem of Indian Healthcare, Today, Indian Healthcare is at its most serious crossroads ever and in the coming period, there will be many challenges to overcome and many issues to be addressed. It will be a big and challenging transition for

NATHEALTH and its members and I will always be accessible for any possible support in the times to come. NATHEALTH is and will always be in a deep corner of my heart and remain as part of my soul forever.

I wish NATHEALTH much success as it moves into the future” Mr. Bose brought immense credibility to his role by virtue of his deep knowledge of the sector, built upon a foundation of three decades plus of leadership positions that he held with Philips and HP, both national and international, as well as leadership positions of healthcare committees/ subcommittees at FICCI and CII; with his passion and commitment, he brought many organizations, comprising the heterogeneous healthcare ecosystem of the country, into the fold of NATHEALTH; he catalyzed cooperation and trust amongst its members, and created collaborative platforms, on healthcare issues of National importance, with other industry bodies like CII, FICCI, IMA and NASSCOM.

Siddhartha Bhattacharya joins Healthcare Federation of India (NATHEALTH) as Secretary General NATHEALTH announced the appointment of Siddhartha Bhattacharya as Secretary General, effective In his new role, Siddhartha will lead the organization and work with key partners in realizing NATHEALTH’s vision/ mission to spearhead the goal of high quality, affordable health for all.

“Siddhartha Bhattacharya is very well respected and one of the most seasoned and dedicated healthcare leaders of India,” said Mr. Daljit Singh, President NATHEALTH. “His decades of experience in launching successful partnerships in the public and private healthcare sectors and extensive background in healthcare systems and technology will be a tremendous asset to NATHEALTH. We are delighted to welcome him on board.”

“NATHEALTH, as a thought leader of the healthcare sector of our country, is uniquely positioned to shape the dialogue and catalyse the evolution of a high quality, affordable health systems across India, that match up to the best in the world. In pursuit of 16 Dec 2018 w w w. m e d e g a te to d a y.co m

universal health coverage, it is important that all industry partners align with the vision of better health outcomes at better value,” said Mr. Bhattacharya. “I am excited to be part of this transformation and look forward to working with key partners in making an impact” Siddhartha brings over twenty years of leadership experience in health, technology and technology enabled services sector across India and USA. Siddhartha has leadership experience in both Public and Private Sectors in India where he has been responsible for strategic advisory services, operational delivery and technology leadership in the health sector.

Mr. Bhattacharya joins NATHEALTH from ACCESS Health International, a leading health think tank and advisory group with a mission to improve access to high quality, affordable healthcare for people everywhere.

As Country Director in India, Siddhartha was responsible for organizational leadership and worked extensively in areas that drovescalable innovation in healthcare

delivery, financing, and technology.

Siddhartha led the think tank, advisory services, implementation support and innovation transfer programs of ACCESS Health India office and drove the functional integration with global offices.

Prior to ACCESS Health, Siddhartha worked with Emergency Management and Research Institute (GVK EMRI), where he served as Chief Operating Officer and Technology Head for four years. He oversaw the design, development, and delivery of health outreach services, which resulted in improved delivery of emergency health services across multiple states and union territories in India. Mr. Bhattacharya has also held prior leadership positions at Dell, Inc. (USA), Dell International Services (India), Philips (India), and the Government of Kerala, where he was Chief Executive Officer of Information Technology parks across the state.

NEWS Update

Netmeds Announces First Retail Store Opening

Netmeds Pharmacy marks the launch of the company’s franchise model, which will improve access to affordable healthcare for customers Chennai, November 27, 2018: Netmeds. com announces the opening of Netmeds Pharmacy, a brick-andmortar store in Nanded, Maharashtra, as the first Netmedsfranchisee. The NetmedsFranchise programmewill see the launch of a number of branded stores across the country, in locations ranging from metros like Chennai, Bangalore, Mumbai and Delhi to Tier 2,3 cities like Surat, Ahmedabad, Pali, Rajasthan and Balurghat, West Bengal.

About the strategy to franchise, Netmeds. com Founder & CEO PradeepDadha said, “We believe that the neighborhood chemist shop and the local pharmacist will continue to play an important role in the overall healthcare landscape, especially when it comes to serving acute needs. With an eye to fill a void in the

market, especially in Tier 3 and 4towns where there is a dearth of chemist shops, licensed Netmeds stores will combine the company’s impeccable reputation in the pharmaceutical sector with the pillars of e-commerce – availability, affordability and convenience.”

Netmeds Pharmacies will ensure customers have better access, assured quality, and convenience, while the entire franchisee model will help create jobs in local communities and boost the retail economy.

“Currently about 65% of our online business is coming from non-metros.

While we fully intend to continue to serve them through Netmeds.com website and app, we believe we can enhance the customer experience and improve access with NetmedsPharmacies. The stores will offer access to medicines that may not be in stock locally, via our well-established supply chain, at lower prices,” said Dadha.

Going ahead, Netmeds plans to offer more in-store benefits and lower prices for customers over time as the two models integrate logistics and point-ofsale and merchandising systems.The company will maintain operations under the Netmeds brand, preserve its high standards and commitment to providing the highest standards in healthcare, and continue to source from trusted vendors and partners.

Mr. Pradeep Dadha

Founder and CEO, Netmeds.com

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Jaslok Hospital one of the First IVF Centres in India has installed Radiofrequency Safety net

In yet another first, Jaslok Hospital and Research Centre’s International IVF Centre has inaugurated and installed Asia’s first Cryogatt System in the city of Mumbai. The tertiary care took a step further to give specialised services known as the Radio Frequency Safety Net which will help detect Embryos, Sperm and egg.

Agenda: Cryogatt System uses noninvasive Radio Frequency Safety Net track each patient's eggs, sperm, and embryos throughout the duration of treatment. By introducing a system that verifies established safety protocols, Cryogatt System gives our lab technicians, our embryologists, and most importantly—our patients—peace of mind. The new FertilTree-Jaslok system will ensure that this human error does not occur. The centre currently has more than 20,000 samples in storage, Some of which are 20 years in cold storage. With the new system, each container of up to 100 vials or straws can be read in seconds.

Image result for IVF Speciality+ Jaslok Talk Points: ◆ Asia’s first Cryogatt System in the city of Mumbai ◆ Importance of the new technological system in solving the problem ◆ The change in IVF with the help of installation

Worried about SSI, Air Quality and Airborn Infection in MOT ???

Al-Med Introduced Innovative Solution to give you 100% Infection Control for Airborn Infection

Solution To Get Hygenic and Best Air Quality For 100% Infection Free Operation Theatre For Airborne Infection Control Minimise Biological Burden Bacteria, Fungus, Virus, Molds and Spores With 03 GEN

To Minimize Particle Count Class-I (1-10 per sq.ft.)

With LAF & AHU without duct.

Features of 03 GEN - The Magical Air Disinfectant Without Any Chemicals  03 GEN kills all types of bacteria, fungus, virus molds and reduces the biological burden upto 93% with 2.5 ppm concentration within 30 minutes.  Ozone having half life just 10 minutes and its biproduct is Oxygen so very safe to use in unoccupied operation theatres (Rooms).

Features of Infection Control Live Monitoring System (ICLMS)  Actual Temperature Display with control  Actual Humidity (Rh) Display with control  Air Flow From HEPA Filter  Air Cycle Per Hour (ACH)  Air Particle Quality  HEPA Filter working status ‘  Positive Pressure (Pascal) inside the OT  Multiple Gas Sensor detecting CO2, i-butane, Propane, Methane, Alcohol, Hydrogen, Smoke  OT ready for operation indication will get on mobile with display of all parameter with every hour sms alert.  USB to PC (485) connection for recording of Data for Air Quality Parameter for Infection Control medico-legal issue.  SMS Notification & Alert for any type of fault in system and sms will be sent to company and doctors.

Class-II (10-100 per sq.ft.)

With AHU without duct.

Features of AHU Without Duct Patented Innovative Solution for Air Condition of OT  Ductless Air Handling System needs to start just one hour before the operation starts to get Class ll Air Quality in entire Operation Theatre.  Ducted Air Conditioning System for OT has to keep on round the clock may be with temperature control (with VFD) but our Ductless AHU has to keep on just 1 hour before to get desired air quality (Class ll) in entire OT.  HEPA Filter needs to be replaced once in a 2 year as compared to ducted system required replacement of HEPA thrice in a year so saves maintenance cost.  Ducted laminar air flow system (LAF) required Robotic duct cleaning before changing HEPA Filter and duct insulation and maintenance required periodically and costly.  AHU without duct maintain all NABH requirement by giving 20air cycles / hour, positive pressure2.5 Pascal CLASS II Air Quality and With Laminar Air Flow Class I (0-10) Air Quality Get on of table & Routine Cleaning can be done from Inside OT by any non technical OT staff.

Nerul, Navi Mumbai, Maharashtra, India.

Mob: +91-9322510636 / 9332510636 Email: almedequip@gmail.com

www.almedequipment.com

COVER STORY

Medical Tourism

in India set to expand exponentially by 2020 Dr. Ruchi Gupta Founder and CEO, 3hcare.in

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ith the availability of medical technologies and cost-effective world-class treatment, India is becoming a center for medical treatment in the medical sector. The treatment provided is equal to any developed country in the world with recognized facilities, which is at a very affordable cost, Medical Value Tourism is making competitive advantage on others.

With several big investments being made in this sector, the functioning of the industry has become more professional, organized and efficient. Besides the urgent need for quality treatment services, people across the world are making India, the Focal point for cost effective facilities available.

With the integration of surplus talent, technology, tourist attraction, trade and tradition, India is a potential place to promote itself as a Premier Global Healthcare destination and enable streamlined medical services.

Even though Asian countries like Thailand, Malaysia and Singapore has started moving ahead of India, the distinct health care features and the initiatives taken by PM of India, exponential growth is confirmed in the upcoming years. Where the overall healthcare market is expected to boom three times from $ 100 Billion to $ 300 billion by 2020, the Indian Medical tourism will reach $ 10 – 15 billion with 4 times the growth in the IT market.

The government is all set to participate and boost the morale of the industry apart from providing great opportunities to list the challenges, priorities and prescription for its betterment. Growth in the medical

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tourism and healthcare delivery industry will enhance employment opportunities besides the congregation of pharma and medical equipment industries.

With perspective of the opportunities lying ahead, investment and support both from the government and private players will prepare a solid base for future MVT in India and the actions have already overtaken the anticipation.

Why is India the best attraction for medical tourism?

With availability of the latest technologies and the growing observance on international quality standards, treatment at reduced cost are the assets that has made India the most desirable medical tourism destinations across the world. It costs only a tenth in India for similar treatment procedures and outcomes as compared to US and UK. It was seen that the maximum number of medical visas were availed by medical travelers from Bangladesh, Maldives, Afghanistan, Nigeria and Korea, due to the fact that visa-on-arrival scheme was an ease for such patients to get treatment and stay in India for 30 days. Earlier a visa would be issued after 2 months of the previous visit and removing such restrictions has also allowed and attracted many medical tourists from the Gulf countries.

Improvements being planned by the Government of India With the advent of online and e-commerce healthcare industry the legal formalities for the patients travelling will be made easy. A

checklist along with relevant information will be available on the embassy website that includes the following – requirement of multiple visas for comfort of multiple entries during follow up treatment, a column for high end treatment cases involving multiple legalities as in case of kidney and liver transplant to avoid clearance problems on arrival.

Transportation of critically ill patients from airport to the hospital is one of the smallest though complicated issue. The checklist can also include the private hospital’s ambulance pick up from the landing strip directly to the hospital to avoid transferring inconvenience to critically ill patients.

These issues if addressed properly can take medical tourism and travellers to India a long way in boosting their confidence.

International travellers focus more on Government accreditations. JCI has more global visibility than NABH (National Accreditation Board for Hospitals & Healthcare Providers) in India. This can sometime become an obstruction for attracting medical travelers to India.

Even though NABH being the highest accreditation followed in India, it still needs to be promoted and recognized on a global platform to achieve global acceptability.

Problems in Fund Transaction - There are strict laws for international fund transfer in many countries. It takes a lot of time for patients to get permission and acts as a barrier for timely treatment. Countries like Iraq and Uzbekistan have such laws, which are included in the fifth part of medical travelers of India.

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COVER STORY

MODULAR OPERATION THEATER All you need to know

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he Modular Operating Theater came into existence with the emergence of new concept that reduces the risk of Surgical Site Infections (SSIs). SSI is often referred as the second most common site of Healthcare Associated Infections (HAIs), which causes considerable morbidity. It can also raise the mortality to as high as 77% if occurs deep at the site.

SSI is generally the initial introduction of microbial pathogens that occurs by different surgical activities performed in the operation theater. The necessity optimizing the infection control developed a new sphere high quality finished, joint less internal steel structure, coated with sterile antibacterial paint, called Modular Operation Theater with reduced risk of SSI, which is influenced by characteristics of the patient, operation, personnel and health care/ facility.

Following are some of the identified advantages of adopting concept of Modular Operation Theater: ✓ Health & Safety is ensured for all the human being involved in surgery. ✓ Almost no disruption and noise is produced as compared with traditional Operation Theaters ✓ Smooth interiors, Tidy environment with no dust bouncy floors, cavities, sharp edged corners. ✓ Effective temperature and humidity control.

Basic Components: Construction: ✓ The standard size of OT is 20’X20’ with a minimum finished height 10’ in order to have a free moment of the operating team and equipment. ✓ Generally, Galvanized Iron PUF panel or Stainless Steel of Grade 304, are used to erect the walls and ceiling of OT. ✓ The Floor is finished with self leveling material for smooth surface.

An earthed copper strip mashing is installed before laying the antistatic, homogeneous, PVC Flooring.

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✓S liding doors are installed, which are hermetically sealed when closed.

Generally automatic doors are preferred, but manual doors can also be installed. Single main sliding Door of minimum size 1540 mm X 2100 mm is recommended, however a small door of size 1200 mm X 2100 mm is installed inter connecting two OTs earmarked for organ transplant. ✓ I t is preferred to provide the natural day light in OT as far as possible, using a Double glass Units with built in automatic or manual horizontal blinds.

Illumination: ✓R ectangular ceiling mounted dimmable LED concealed lights are installed whose intensity can be controlled by the surgeon through the control panel. ✓M ain OT light of single or double dome, is installed at the centre in such a way that it can be rotated 3600 freely.

HVAC System: ✓ An effective HVAC system is paramount for any modular OT in order to achieve effective infection control. ✓T he supply & return air ducts must be of non-corrosive material without any internal insulation or acoustic lining. ✓T he AHU should be away from DG Exhaust, Lab exhaust and Parking area. ✓E very OT must have an exclusive AHU which is designed to deliver HEPA filtered air faces velocity of 25-35 Feet per Minute from non-aspirating unidirectional laminar flow from ceiling diffuser/ array. ✓T he air must be supplied to OT through HEPA (High-efficiency particulate arrestance) filters in the ceiling .The HEPA can be at AHU level if it not feasible at terminal level inside OT. The minimum size of the filtration area should extend one foot (i.e. 304.8 millimeters) on each side of the OT table to cover the entire OT table and surgical team. ✓M inimum total air changes should be 20/hour. It is strongly recommended

PREM PRAKASH SINGH SEHGAL Chief Engineer At Jaipur Golden Hospital, Rohini, Delhi.

DGM projects at QRG Medicare Ltd., Faridabad.

GM Projects at Shree Aggargain International Hospital, Rohini, Delhi.

HOD Engineering at Maharaja Agrasen Hospital, Punjabi Bagh, Delhi.

that minimum 4 air changes out of total minimum 20 air changes should be of fresh uncontaminated air. ✓ A Positive pressure of 2.5 Pascal must be maintained in OT during operational & non-operational hours in order to prevent external air entry. ✓ Return air diffuser should exist 75-150 mm above floor level at all four corners of OT. ✓ An automatic pressure release damper is to be installed in order to release the extra internal pressure, when doors are closed during operation.

Medical Gases: All essential medical gases, such as, oxygen, suction, nitrous oxide, Air 4, Air 7, and CO2 should be made available through pure copper pipeline of appropriate size and connected to the surgeon and anesthesia Pendants.

Pendents: The ceiling mounted Surgeon and anesthesia Pendants consist all medical gases outlets, Electrical switches/Sockets, selves for equipment, surgical tools etc.

They should move freely and stay firmly wherever required.

Controls and Indications: The control and indicator Panel consists of the Peripheral lighting control, temperature and humidity, intercom, medical gases low pressure warning.

Electrical System: An uninterrupted stabilized AC power supply is fed through isolation transformer Panel in order to have protection against harmonic distortion.

Biomedical waste management: A hatch box is provided in order to dispose off the generated biomedical waste.

COVER STORY

Medical Value Travel in India Hair care is among most sought after Treatments

Dr Vinod Sonawane: Managing Director at Bloom Hair Transplant

G

one are the days when Indians would travel the world in search of advanced remedies for their ailments. In fact, it is the other way around these days. The world is coming to India. India has become the hottest stop on the medical tourism landscape.

And why is it so, you rightfully ask?

Well, not only to make use of the affordable, world-class healthcare facilities available in the country, but also to benefit greatly from aspects such as yoga and Ayurveda, two disciplines native to India. India is no longer a cost saving destination, but a destination of choice for those seeking treatment.

The exotic nature of India is an additional draw for many of these tourists. Many travellers club their medical journey with the spiritual experience that is synonymous with India. They are enriched not merely by visiting landmarks and landscapes that they have only heard descriptions of, but also because India is making quick strides when it comes to healthcare.

Today, it is estimated that more than half a million visitors come to India every year for treatment. From cardiology to eye care to hip replacements, patients can avail world class healthcare across different medical disciplines. One of these sectors is hair transplant and treatment. Hair transplant is quickly becoming a sought after reason to visit India.

To Dr.Sonawane, MD- Hair Transplant Surgeon, PG Diploma in Trichology & Managing Director at Bloom Hair Transplant, the future is one filled with promise and much potential.“More and more residents living in Europe and North America are discovering the benefits of healthcare in India,” he said.

“The hair transplant sector has picked up as well. The number of patients I treat in this branch is growing exponentially every year.”

Indeed, this medical tourism boom, and, in particular, the heightened interest in hair transplants, is based on the fact that India now offers specialised healthcare, leading edge treatment and also fabulous post-operative care, at par with any other part of the world. There has been a conscious effort in making India a tourism destination of choice, by enhancing the facilities and amenities that constitute its healthcare and also, by training professionals involved in the same.

As promising as this sector is, here’s a word of warning for patients seeking hair treatment in India. “Choosing a cheaper hair-care alternative by compromising on the quality is never a beneficial option,” Dr. Sonawane said. “It is unfair for both the industry and the patient who may not get the treatment he/she rightfully needs!”

Travellers must remember to carry out comprehensive research and analysis before they decide to undergo any treatment in India. It’s always ideal to find out the track record of the medical practitioners before travelling half way across the world. As with any industry around the world, not every institution may be as adept in hair transplant as others.

Medical tourism is not only here to stay, but thriving in the long haul. It is believed that by 2020, Medical Tourism may become a $9 million industry overall. In India’s case, it will be a great source of revenue in the months and years that follow. Opportunity abounds and a world of treatment awaits every single international patient.

Dr.Sonawane sums it up perfectly- “If its expert hair transplant facilities you seek, India is where you need to be. Come, enjoy the spirituality of India and leave with a luscious head of hair at a value you won’t believe!”

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COVER STORY

Effective Planning & Designing of Hospital Well-designed, hospital can not only prevent harm and injury but also provide psychological support, restore resources and aid the healing process.

Dr Parvez Ahmad

E

ffective planning and designing of hospital approach is “smarter� planning that eliminates waste and errors.

Effective design facilitate to reduce and control environmental hazards and risks, Prevent accident and injuries, Maintain safe, secure and comfort conditions for patients, visitors and staff and minimizes unnecessary environmental stress for patients, visitors and staff working in the hospital.

Feasibility Report:

It is very important to do the feasibility study of the project that comprises to gather the health statistics and find out demographic details, socio-economic details of the community, geographical details and obtaining climatologic profile of that area. It is also important to decide the type and size of hospital and how much cost to be incurred in the project and what will be the source of funding. SWOT analysis to be done to evaluate the Strengths, Weaknesses, Opportunities and Threats of the hospital project.

Site selection

Site of the hospital to be carefully selected and all parameters to be kept in mind that it should be geographically in safe zone, environmental pollution free, should have accessibility to local transportation and availability of community services area and have a general sanitation including public utility services and hospital site will have a scope for future expansion and can be completed in a timely and economical manner.

Viability of Project

Dr PARVEZ AHMAD

International Surveyor - ISQua Principal Assessor - NABH Planning & Designing Expert of Hospital 24 Dec 2018 w w w. m e d e g a te to d a y.co m

Viability of the project should be checked on the aspects of financials, what services is going to be offered, it should meet the need of the patients and meet quality patient care and safety of the patients, visitors, staff and the environment. Hospital infrastructure should also meet the requirement of accreditation bodies like NABH, JCI etc.Â

COVER STORY

✓ Approval building drawing from the corporation / Development authority. ✓ Water connection (At the time of starting construction) & Bore well water connection permission / NOC ✓ Electricity connection (At the time of starting construction) ✓ Land conversion if it’s agriculture /other land ✓ Aviation clearance if Building is in aviation zone ✓ Provisional fire NOC ✓ Layout approval for X-ray, CT, mammography, Radiation oncology etc by AERB.

Infrastructure Requirements

Full filling the norm of NBC and state authorities to meet the infrastructure requirement, Construction of Radiology services like X-ray, CT, Mammography etc to be done as per AERB guideline and consideration to be given to patients flow of IP/OP/Diagnostic/Emergency patients and standard infection control practices while designing the hospital.

Independent routes to be planned for movement of people & for the movement of the hospital stores & supplies. It’s better if staff entry is separate through Time Office only. Provision of smooth entry / exit of ambulance to be given while ambulance is coming to the Emergency department.

Environmental friendly & Green Building (Solar, Biogas, water conservation, energy efficiency, usage of recycled products & renewable energy) can be planned since beginning and hospital can go for Green Building certification programme by Indian Green Building Council.

At most care and attention to be given to the important & critical departments while designing the hospital to meet the zoning concept like Operation Theatre, CSSD, Kitchen department and laundry services.

As per my experience generally focused is given to the clinical services but Engineering and utility services like CSSD, Laundry, Dietary services, MRD, Store – Pharmacy/ General, Mortuary, BME, Maintenance & Engineering (Gas manifold, AC plant, Power& LT panels, STP/ETP, Lifts, DG set, Fire pump room, Solar, water softener etc) to be planned efficiently to get the maximum outcome for the holistic and better outcome of patient care. Proper area for staff like changing rooms with locker facility, staff washrooms, duty rooms, library and seminar room for academic activities etc to be planned while designing the hospital to get a maximum output from the staff through their work.

Legal Requirement to start the hospital

For starting the hospital the following licences/NOC/clearance to be obtained, although it may vary state to state : ✓ Clear title of land ✓ Approval / NOC from the local health authority ✓ NOC from pollution control board called C.F.E (Consent for Establishment)

Detailed Project Report (DPR)

Detailed project report to be prepared in advance for the investment decision-making approval and execution of the project and also preparation of the plan. Detailed project report is a complete document for investment decision-making, approval, planning. Detailed project report act as a base document for planning the project and implementing the project.

Safety Aspects

Patient, visitors and staff safety to be given utmost attention while designing the hospital to maintain the safe and secure environment in the hospital premises like meeting legal requirement; AERB, NBC, Fire Exit signage’s, Fire Exit Plans and directional signage’s, installation of safety devices like hand grab bars in all patients toilet, wheel chair accessibility in toilets, Bed-rails on all beds, Alarms – both visual and auditory, nurse call bell system,Warning signs – radiation or biohazard to be installed on appropriate places and provision of special toilet for physically challenged people to be given.

Infection Control

The design should support concept of zoning and ventilation.

Air changes including fresh air allowance should be ensured as per recommended norms. Proper zoning of OT, CSSD, Kitchen and laundry to be planned to control the infection. Critical areas such as OT, ICU should be separated from the general traffic. Proper Isolation rooms to be planned to prevent spread of infection. Adequate hand washing stations to be provided in IP and outpatients departments with Elbow/long handle tap. Air curtains can be installed at entry of patient care areas such as ICU, OT sterile area and delivery suites. Utility Rooms for clean & Dirty utility / centralize sluice room. Proper place for BMW bins & Temporary BMW storage area to be planned as per the standard / CEA guidelines.

Value Added services can be added like Prayer room, Coffee shop, ATM facilities, Valet parking etc. Provision of proper Communication system like Telephone lines, EPBX system, intercom facility, Public Address System & CC TV camera to be given while designing the hospital. Hospital should plan effective use of Information Technology like Pneumatic tube system, PACS, Automatic Sensor Doors & Water taps, Wi-Fi zones, Ambulance tracking system, RFID bands etc based on their available budget and resources. w w w.medegatetoday.com Dec 2018

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COVER STORY

Onco-Med Tourism in India

Offering Economics of Care along with Dynamics of Clinical Advancement

Dr. Anshuman Kumar

T

Director (S.O) and Clinical Lead (Academics), Dharamshila Narayana Superspeciality Hospital, New Delhi

he definition of medical tourism broadly elucidates patients who travel abroad to access medical treatment. Medical tourism for cancer care is the most under-estimated and unexplored yet vastly growing domain. Cancer is the leading cause of death due to diseases worldwide. India and China account for approximately 29% of these new cases every year while Europe and America contribute to 45% and Sub-Shaharan Africa, the Middle East, North Africa, East and central Asia together contribute to another 25% of the new cases worldwide.

Generally patients travel to less developed or developing countries for better and affordable cancer care. Medical tourism in India has always focused on Cardiac, orthopaedics, neurosurgery, general surgery and transplants apart from traditional healthcare for wellbeing such as Ayurveda, yoga and Unani.

However, due to government sponsored medical care in resource-rich countries, medical tourism is undergoing a paradigm shift. The most speculated reasons in the field of Onco-Med Tourism are either patients seeking for second opinion, research potentials or specialised care that is unapproachable in the patient’s mother country.

Why do patient from foreign countries choose India for cancer treatment?

Many countries are offering medical tourism servicebut as compared to them India has become preferable choice for cancer patients overother foreign countries.India has always been known for its warm hospitality and rich cultural values. Besides, with its paced progress in field of healthcare, patients get access to complete yet cost effective healthcare solutions with abundance of both high tech patient care equipments and quality 26 Dec 2018 w w w. m e d e g a te to d a y.co m

care treatment under one roof. Besides, India is also becoming front runner in terms of latest Cancer drugs and advanced clinical research methodologies along with comprehensive diagnostics.

treatment planning has ensured less scope for clinical errors with fest recovery.

Moreover, many Onco-Surgeons of India have attained their fellowships from western developed countries like UK and US along with their hands on experience of handling tremendous volume of surgical cases in India. Relaxed visa policy for foreign patients in India, has decreased the inconvenience and patients can get the treatment easily and early.

Future potential for Onco-Med Tourism in India

Treating International Patient from Kabul for Carotid body Tumor Shamblin Type III

International patient Indonesia

Technologically advance machines, quality medical services, low prices, globally recognised doctors, and absence of linguistic barrier give a new lease of life to thousands of cancer patients across the globe. All these health services are provided to them at about 10% of what it would cost in USA and other developed countries with equal clinical outcome. Although, India’s share in Oncology related medical tourism is increasing every year, there is still a huge potential of growth by targeting a large set of untouched countries where the medical facilities are either not available or are expensive. Also, the country has started offering better cancer survival statistics with transparent patient-centric policies. The use of ever evolving Information technology, contemporary surgical techniques, modern radiation therapy equipments and protocol based

Indian metropolitan cities like Delhi, Mumbai, Kolkata, Chennai, Hyderabad and Bangalore are already catering to the maximum number of Cancer tourists from neighbouring countries like Bangladesh, Bhutan, Nepal, Sri Lanka, with potential patient inflow from Kuwait, Qatar, Kenya, Egypt, Afghanistan, Turkey, Iran and Iraq.

While there are considerable number of institutes offering Cancer treatment, India needs more number of comprehensive as well as exclusive oncology centres with quality & advanced level of cancer specialities like Surgical Oncology, Medical & Radiation Oncology, Bone Marrow Transplant and HaematoOncology. Apart from this domains, India needs to progress more in Paediatric Oncology, Bone marrow transplant and contemporary therapies like immunotherapy, to accelerate the inundation of Cancer patients in India.

Also, collaborations with developed institutions can add credibility to Indian organisations providing Cancer Care at all levels of healthcare delivery.

Also, by increasing the patient to quality doctor ratio, India can improve international patient footfall in the sector of Oncology related Medical Tourism.

Most importantly generosity of Indian doctor towards their patient, both pre and post treatment, helps in dealing with life threatening illness of cancer. ▪️

COVER STORY

A Case Study on Refurbishing 300 bedded Yashoda Hospital, Ghaziabad

D

emolishing existing facilities and constructing new is not always an economically viable solution to provide modern healthcare services. There is a need for specific design sensibilities in the healthcare facilities to resonate with the current times. An ideal approach towards hospital design must cater to the needs of not only the patients & staff, but the attendants as well. It is really important to design spaces which inspire the staff and keep their energy levels afloat. With these considerations in mind, here’s a list of certain factors that we’ve considered to re-invent an old facility into making an aesthetically pleasing & functionally efficient Healthcare Centre.

Refurbishing The Brand Identity Through Architecture

The prominent healthcare establishment of Ghaziabad, 300+ bedded Yashoda hospital had aged gracefully through the 25 years of its existence. However, now there was a dire need to reinstate their brand value in order to empower trust across the community. To strengthen their identity our design concept was to bring in a majestic façade along the face of the access road. This façade now acts as the threshold between the hospital and the world outside, while establishing a renewed identity of strength, trust and

BEFORE

care. A lot of louvered panels and jali were used in repetitive modules to create this floating façade. Effort was also made to bring in this secondary skin onto all the faces of this hospital. Modular nature of this skin will lead to easy and affordable maintenance in the future. Green, being the brand colour was added at various intervals to create an overall impression of a special charisma and exceptional aesthetics, serving as a warm and friendly welcome to the hospital.

Strengthening The Backbone: Efficient Space Planning

Another key parameter required for the refurbishment process is an integrated & effective use of existing spaces with consideration to circulation, interaction,

#ABOUT US

➥ Among Top 50 Young Architects of India conferred by the prestigious iGEN Forum 2014, ➥ Silver Winner in Healthcare Category at FOAID Finale 2017 Mumbai etc.

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Studio An-V-Thot Architects Pvt. Ltd. New Delhi-110017

AFTER

flexibility, daylight and ventilation.

Healthcare must not only cater to patients and staff, but also the attendants thus provision of good open public spaces such as waiting areas is another significant factor. Reinventing nonexistent lobbies, while creating better waiting areas without hampering the circulation was taken care of. Very few possibilities of civil alterations in existing layout can sometimes be a challenge in healthcare refurbishment projects. Here at Yashoda, there were ill-illuminated corridors leading to Y-shaped patient rooms; which further led to disorganised furniture placement.

Through efficient lighting, furniture refurbishment, artwork installations & incorporating common material palette which eventually ran across the hospital,

COVER STORY

we successfully managed to bring in the positive vibes which were lost with time.

Soothing shades of beige, whites & greys were chosen & a pinch of lime green was added to develop a style statement.

BEFORE

Arteries & Veins: Segregating Circulation / Movements

Segregation of the patient and service circulation is one of the significant aspects to be considered, not only to avoid chaos but in order to increase efficiency for smooth functioning of a hospital. Hence the traffic flow needs to be differentiated at a point or integrated at other, to avoid creating a congested environment.

However minute it may look but an effective way-finding signage system is crucial to keeping a hospital environment systematic, productive, and free from interruptions. Its even more crucially significant to patients and attendants since they’re already in a heightened state of anxiety. As designers it was very important for us to understand the patient and staff psychology and bring them comfort and hope through architectural interventions.

THE HEALING FACTOR

The fact that built environment has the ability to affect patients’ health and psychological well-being, has been ignored in several existing healthcare buildings in the past. Taking in account the ideologies of “patient oriented care” the monotonous clinical environments can be transformed into warm, appealing and positive healing spaces.

By using a subtle yet inviting material palette running through the wards, corridors and every space possible, we intended to rejuvenate the internal areas.

Child psychology was the reason we chose a spectrum of bright and welcoming colours, which is a pleasing sight for the children in the PICU. Unlike other ICUs, this space exhibits a wider dash of colours.

An interesting feature here is the comic wall that has an interactive character to itself with the display of cartoons with playful dialogues.

Artwork has the capability to heal patients; hence a lot of artwork has been installed at various intervals. Thus we managed to exploit every opportunity to create healing architecture.

BEFORE AFTER

AFTER

NURTURING WITH NATURE

Incorporating greeneries at different corners and focal points in a refurbishment project is a must. It is another integral aspect that helps in healing the patients while bringing them closer to nature.

Proper daylight solution should be planned around these corners which results in better air quality. With proper placements at focal points, a courtyard is always a cherry on the cake to enrich the aesthetics of a healthcare facility.

COST & TIME OPTIMISATION

Renovation of a running hospital requires a lot of strategic time management, construction noise management, and workforce distribution strategy. Since the hospital was running, thus in order to avoid functional errors, we designed a concept which ran across the Hospital. Effective measures were taken to help reduce the overall cost. Furniture were re-furbished rather than changed, Vinyl Flooring were added on top of existing Marble flooring & a variety of measures were taken to save both time and money.

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COVER STORY

International Medical Tourism in India

Prof. Dr. Sanjeev Bagai

Padma Shree Presidential Awardee.

Dr B. C. Roy Presidential Awardee.

Sr. Consultant Paediatrician and Neonatologist and Pead. Nephrologist.

Since the last two decades or more, India has become the fulcrum & international hub for Medical Tourism.

Patients from more than 60 countries flock the doors of Indian hospitals as the clinical results given in India are better than most western countries.

Patients with cardiac diseases, cardiac surgery, oncology, plastic surgery, urology, renal & liver transplant, aesthetics & cosmetic illnesses, joint Replacements & spine surgery, neurological diseases & endoscopic neuroscience procedure, IVF, Pediatric conditions, etc come at regular frequency.

Centers in Delhi, Bombay, Calcutta, Chennai, Bangalore etc are the favorite sites combined with recreational tourism too.

The business is dominated by numerous facilitating companies, individual facilitators and direct international tie ups.

In 2015, the sector was estimated to be worth US $ 3 billion & is projected to reach 8 billion by 2020. In the last year more than 17 lac patients visited India for treatment.

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The drivers of this tread are lower cost of procedures, better clinical outcomes, no waiting list, no language barrier, great air connectivity, best quality of care, ease of foreign exchange transfer and superb list operative follow up care.

It’s a win - win situation for all with the hospitals getting revenue & international patients prompt care.

The early destinations of south east Asia and indeed USA has totally changed now.

There are some concerns though, largely not substantive in nature of hospital acquired infection etc, though most hospitals are accredited and of international standards in India. Many of our surgeons & doctors even do clinics abroad and outreach programs to identify the patients accurately for specific procedures.

Post treatment recovery is facilitated with economically located accommodations near the hospitals. The e- connectivity had also linked the international cases to the Indian doctors for Skype/ teleconference consultations. Thus helps the patients to have on going discussions with the treating doctors.

The standard of care here is as per WHO standards the level of technology & digital health available in India at an economical

cost is unparalleled. The advancements in laparoscopic & robotic surgeries, endoscopic procedures is the best in the world in major centers in India.

The local rules and regulatory guidelines must be adhered to. This is especially relevant in organ transplantation and ivf cases.

Most of the costing is now as a package pricing with no hidden costs. It’s an all inclusive cost which gives transparency to the travelers.

Sine combine the treatment with holistic care including yoga, Ayurveda care, rejuvenating treatment, wellness resort care etc.

There are certain precautions advised to international travelers too, including malaria prophylaxis, certain vaccines to be taken, counseling & interpretation professionals.

Most top hospitals have a great promotional strategy with international desks, facilities to render all assists to patients like transportation pick & drop, visa assist, etc.

India is the long term preferential destination for treatment with the best outcomes in medicine. It’s a fulfilling journey which show cases medical talent pool in India as the worlds best.

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Hospital commissioning st strategies in 21 century

COVER STORY

Shrini Shukla Commissioning Consultant and Administrator, DKS Super speciality Hospitals, PGI and Research Center, Raipur, Chhattishgarh

“Commissioning” is a process intended to assure that all building systems in a facility in accordance with the design intent, that the design intent is consistent with the owner’s project requirements, and that operations and maintenance staff are adequately prepared to operate and maintain the completed facility.

In 21st century, a new dimension of sustainability and green building is also added to the above for increased efficiency and decreased operational expenditure. Despite advocacy for commissioning, the process is not always followed and many buildings designed for high performance fail to achieve high-performance results.

The LEED (Leadership in Energy and Environmental Design)-New Construction (NC) reference guide states that “conventional commissioning has limited the focus to HVAC systems but that coordinating other building sustainable design systems in the commissioning process results in higher performance, sustainable buildings.”

This matrix below has listed steps of commissioning and its essentialness as per the facility type, some of the steps mentioned in it are further elaborated for giving insight to what all exactly it means.

Feasibility Report: This is essential

to know what all facilities are most desirable in near by area and which has least competitors and even if competitors are there SWOT anaylsis can help to find a strategy to capture major share in the community.

Selection of facilities:

Deciding for facilities to be provided is the criteria that determines time and cost of inception and regular operation. Accordingly planning of equipment procurement, electricity and allied works like Medical 32 Dec 2018 w w w. m e d e g a te to d a y.co m

gas pipeline is laid and staff recruitment can be computed which adds to regular cost. One essential criterion of deciding this should be strong revenue generation sources of particular facility to make the strongest of all.

Design:

It should not be limited to providing an aesthetically functional building or patient centric care or centralized services like its being done in many metro cities, it should be an energy efficient building. It is a wellknown fact that although the component of expenditure on design of a hospital is meagre compared to the expenditure on operation and maintenance of the building and the impact of an efficient design may help in reducing these costs substantially. Considerations like Segregation and Zoning of building components/departments as per their energy need and controlled medical environment. Many energy efficiency codes like ECBC, BEE, Teri-Griha, LEED etc. have formulated guidelines and parameters for all compliance approaches. These include the building systems envelope, HVAC, Max natural light utilization, maximum LED usage, electrical power, solar hot water and pumping etc. The rooms with large volumes, long corridors, big size of the building, loss of heat through long pipelines, loss of air conditioning through long ducting systems, steam networks with very long pipes, power loss due to harmonic currents, etc. add up to a large amount of energy consumption in the hospital building.

Bed side arrangements like adequate plugs, side locker, Nurse calling system and sitting facility for attendant must be included too!

Outsides of hospital must be well litted especially emergency gate and it should be covered area where ambulance may be parked for shifting patient to stretcher Ramp and stairs is an essential parameter, Fire exit must be planned separately.

ETP and STP are mandate for any hospital above the level of polyclinic, accordingly space should be allotted for it near main chamber.

Commissioning recruitment: This

team

smoothens the journey of top management towards hospital operationalization since structural modifications as given by experts at this level can be easily incorporated. Remember doctors are end users of the facility but they may still miss out on something important from management or statutory aspect like 14mm thick wall requirement in radiation zone

Equipment procurement:

The best way to do this is a committee approach discussing all specs of equipment before negotiation and taking down the user end infrastructure requirements before hand from supplier, some need UPS supply and AC mandatorily while some others need negative earthing. Also the consumables and attachments the company is providing must be known and what all is covered under guarantee.

Buy back clause, conduction of some trainings and AMC facility can also be bagged if negotiation is strongly done. A strong suggestion would be to keep even these small discussions minuted to avoid hassles at the time of installation and this also makes process independent of a particular person.

For hospitals more than 200 beds ambulance procurement should have at-least 1-2 ACLS and rest BLS with adequate communication and patient tracking system.

Surgical hand instruments may be ordered later too.

Medical Gas systems: For the plant, what all services and how many points of each services are needed of medical gas are required need to be given to company person, accordingly he may work out the plant space requirements. 4 jumbo cylinders of Oxygen are required on a ventilated bed in 24hrs, nitrous gas usage depends on number of surgeries planned to be conducted in a day. For a hospital more than 200 it is advisable to have in house oxygenator and air compressor plant to save operational cost, it is costly but is cost efficient. Oxygen and air compressor Plant should always be locked!

COVER STORY

Please note, liquid oxygen plant requires Excise license, since it is an explosive agent!

Manifold should be manned on 24*7 basis and cylinders in manifold should be three times of the total no. of points for backup by the maintenance team.

Gas points are required in OT, ICU, pre and post operative block, radiology block near each radiology machine, most essentially near CT-scan and MRI, vacuum is also needed in CSSD. All bed side accessories for gas points near beds must be bought from a single company to minimize compatibility issues. While negotiation all high pressure and low pressure silicon tubes also should be incorporated in order with AMC and hand holding as pre requisite.

Design modification in discussion with doctors: This should be done at regular intervals just in case some important criteria might have been missed earlier as per the requirement of equipment being ordered, this minimizes the cost and facilitate creation of the most convenient and efficient structure.

Plumbing systems: Water need of

the hospital can be calculated bed wise, per bed, per day 80 litres of water is needed. At-least 2 lines of water supply from Municipal corporation and bore wells as per the water need should be there considering the break down time management. A separate over head tank must be planned for critical areas like ICU, OT and CSSD to maintain adequate water pressure in rest areas.

If dialysis facility is in house then a separate tank must be made for utilizing RO’s waste water in washrooms and garden irrigation. Some CSSD machines may also require RO water.

Electrical systems:

First and foremost at least 2 electricity lines from electricity board are desirable for hospitals more than 200 beds for back up management. In addition considering the nature of services being provided in hospital uninterrupted supply is most essential hence UPS and generator also should be installed for critical care areas to manage at least 4 hrs of power cut.

Earthing is most essential in all areas.

Equipment specific earthing should be paid attention to for avoiding machine break down in certain areas.

Power sockets must be adequately given in ICU area and all bed side! Intercom and LAN cabling for operating software is another focus area too!

In addition in electrical control unit must have rubber mats

Hospital safety systems: Fire exit route, smoke detectors, extinguishers, sprinklers and alarm system are 5 important criteria for safety from fire.

Hospital emergency codes should be decided at least for Medical emergency by forming a team of anaesthetist, duty doctor nearest Nurse in charge, Quality team, Housekeeping supervisor. They all need to be trained about their work in such emergency. Other disaster codes are essential too as stated in NABH norms.

These require central announcement system as well.

Recruitment:

This must be started from the stage of equipment installation and before applying licenses since many licenses require dept. staff name e.g. AERB needs X-ray technician and Radiologist details, similarly Narcotic license needs Anaesthetist or General Medicine doctor and a registered Pharmacist.

Equipment installation:

This should be done in due presence of BioMedical Engineer, Nurses or technician (As per equipment user) and doctors in a team. All warranty guarantee, service related papers must be filed separately and centrally. Also service no. should be labelled in each machine so that staff may report any break down immediately.

HMIS:

For HMIS procurement needs should be given and in accordance to no. of systems on which HMIS will be used server must be purchased with uninterrupted supply.

Server license must not be ignored.

Software testing is most essential before the inception.

Inventory management: All assets including furniture, machines should be uniquely labelled and noted in central store and also make an issue register for tracking which all departments are they placed in.

Engineering

drawings: All electrical, Medical gas, plumbing, sewer line chamber drawings must be there

Statutory licenses:

Mandatorily required ones for all hospitals- Clinical establishment act registration, Building permit, Fire NOC, BMW agreement and NOC from PCB, lift license, excise permit for spirit, Narcotic drug license, vehicle registration of Ambulances and GST.(building permit and clinical establishment are not mandatory for Govt. setups) ✓F or USG: PC PNDT ✓F OR any type of X-ray and CT scan: AERB, lead aprons and TLD badges (Lead wall barrier is needed in room which it is placed in) ✓F or blood bank: FDA license ✓F or pharmacy: Retail and bulk drug license and Gomusta

Form format printing: A committee with doctors, Matron, Administration and MRD staff should be made for its due acceptance by users (doctors and nurses) avoids discrepancy later on.

Operations manual and hierarchy: This is mandate in NABH but if it is in place it makes hospital operations smooth and hassle-free. Deciding pricing of various facilities also becomes inevitable part of this stage.

Test run of all facilities, equipments and medical gas lines: Before admission of patients all machine and medical gas plant’s functioning must be tested, sometimes color coding of gases may get exchanged and it can be life threatening for patient.

Retrocomissioning: This is a final check with hospital design and plan before patient admission for all system check.

After this commissioning team’s role is over and regular staff may take over all operations. Hand holding for stock entry and inventory may be done. w w w.medegatetoday.com Dec 2018

33

COVER STORY

M

How mobile Technology and Smartphone’s are impacting the healthcare sector

obile phones have dramatically changed the lives of billions of people. Millions of Indians in urban centers today in India have a Smartphone that they use for entertainment, for office work, to keep in touch with friends, and a number of other things too numerous to list.

Excitingly the healthcare industry has kept in lockstep with the revolution brought on by mobile technology. Many people today in India use mobile technology that allows a doctor to monitor their vital signs continuously and in real time. By continuously monitoring a person’s vital signs a doctor or qualified medical technician can gather information and act in a timely manner when the patient’s vital signs deviate from a healthy norm. Mobile technology has also disrupted the healthcare sector in the following ways.

Better Monitoring of Patients Monitoring Patients with Asthma

Doctors can monitor the symptoms of patients who are suffering from Asthma by using mobile technology including Smartphones. By continuously monitoring a patient’s symptoms, doctors and medics can accurately predict when or if a patient will suffer from a bout of asthma and treat the patient accordingly.

Monitoring and Treating Diabetics

A mobile device can be used with a Smartphone to monitor the blood sugar levels of patients suffering from diabetes. Patients suffering from Type 2 diabetics are especially helped by such continuous monitoring.

General Fitness Training

A number of fitness apps available on the app store and play store allow users to keep track of their daily calorie intake and help them eat a nutritious diet. Such apps can also be calibrated to allow users to lose weight or to eat protein in the right quantity to increase muscle mass. Users can also use such apps to monitor how many calories they burn while they exercise or go for a run.

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Taking Advantage of Medical Infrastructure

Smartphones can also be used to easily book an appointment with a doctor or to schedule a lab test and to access the results of lab tests online. Nearly all hospitals and clinics in large Indian urban centers make available the results of medical examinations and tests online. Not only does this save patient’s time, but it also allows them to keep their medical history safe for future use.

Other ways in which Smartphone’s enhance healthcare are elaborated below

Better Monitor of Patient Compliance

When a patient is discharged from a hospital and is asked to use prescription medication at home, there is little opportunity for a doctor to ensure that the patient complies with the doctor’s advice. However, thanks to Smartphone’s a doctor can monitor how well a patient is doing while at home and check whether the patient is having the medication as prescribed.

Furthermore, Smartphone's allow hospital staff to ensure that a patient has understood the advice given to him or her. Put succulently Smartphone’s facilitate better communication between a doctor and his or her patients by informing doctors if a patient has not understood the instructions given by the doctor. Such care is leading to higher recovery rates among patients and is lowering the rate of readmission to hospitals.

Seamless Data Flow

Medical data must flow fluidly between doctors, lab technicians, nurses, patients, and other caregivers. Such a free flow of information is possible only through the use of mobile technology and Smartphones. An advantage of such a free flow of data is that it makes medical records available at the push of a button on a handheld device and obviates the need for physical documents.

Regular Monitoring

Before Smartphone’s and wearable devices, doctors could only check their patient's vitals while the patient was physically present. However, because of the ease and affordability of data flows, doctors can monitor the health of their patients even when

COVER STORY

the patient is not physically present. Such monitoring allows a doctor to keep an eye on a patient’s vital signs when the patient is performing specific tasks such as exercising, working in an office, or even when the patient is sleeping.

Wearable mobile devices along with smartphones also allow doctors to evaluate the effect of medication on a patient and to simultaneously prescribe different medication if needed. While earlier such monitoring could only be done at a prearranged time when the doctor met the patient, today such monitoring can be done throughout the day. Such continuous monitoring allows doctors to serve their patients better than was possible before.

Eliminating Routine and Time Consuming Tasks

The use of mobile technology has made it possible for doctors to dedicate themselves solely to serve their patients.

Whilst before many doctors had to perform routine and timeconsuming tasks such as data entry, digital technology and mobile devices have largely done away with the need to perform such tasks. It was estimated that before the widespread use of digital technologies which allow information to be stored online automatically, doctors spent nearly as much time performing routine data entry work as they did examining their patients. The elimination of routine tasks allows a doctor to examine more patients than he or she could earlier. Clearly, Smartphone's and mobile devices lead to a better allocation of human resources allowing doctors to concentrate on their role while routine tasks are automated.

A More Accurate Diagnosis

In addition to the advantages listed above, mobile devices including Smartphone’s often allow doctors to reach a more accurate diagnosis when examining their patients. This means that not only are doctors able to see more patients than they could before, but they are also able to more accurately diagnose such patients.

A more accurate diagnosis is made possible because medical records are neatly stored online and handwritten prescriptions are easier to read and understand. Also, there are mobile apps available today that can automatically check whether a prescription is valid and suitable, reducing instances of prescription error. Finally, because smartphones are carried by so many people throughout the day they make it possible to identify the causes of numerous illnesses.

Making Education Easier

Across many medical colleges in India, mobile devices including Smartphone’s are transforming how the next generation of doctors learn. Bulky textbooks which students had to read cover to cover are being replaced by digital books that are saved on mobile devices. An advantage of these digitally stored medical books is that they allow students to search for specific information very quickly. Whereas a medical textbook may have demanded that students search across the book looking for specific information, digital books require only that a phrase or word be entered in the query bar and all the information relevant to the query is made available in the blink of an eye.

The next generation of doctors who're studying in universities today doesn't need to carry heavy textbooks or go back and forth from a college library while carrying heavy books. Today high-quality medical textbooks are available online which allows medical students to find all the information they need to become great doctors. Also a medical student today need not be confined to reading only books that are found in the library or books that are part of the course structure. Medical students today can get easy access to the latest information published in leading journals by using their Smartphone’s. The easy availability of quality information has the potential to create doctors who are of a higher caliber than those created in any prior generation.

Smartphones Allow Virtual Examinations

In a country as vast as India not everyone can have easy access to the best doctors. Millions of Indians living in thousands of small towns and villages across India have little or no opportunity to be examined by a specialist practicing in a large city like Mumbai or New Delhi. However, thanks to Smartphone's and ultra-fast data speeds, patients living in a small Indian town or village can schedule an appointment with a leading specialist. Such interaction not only saves costs but also allows people who live in small towns to receive the same quality medical care that wealthier urban dwellers are accustomed to. The need for such virtual examinations in India is crucial and smartphones are the centerpiece of the technology that makes such examinations possible.

Global Collaboration and Individualized Plans

Because doctors regularly see dozens of patients it can become difficult for them to give as much attention to each patient as is necessary. Smartphones allow doctors to categorize a number of patients who have similar symptoms together and allow them to treat such individuals better than they could have been treated individually. By being able to categorize patients doctors are able to better serve them because many patients in the same category likely require similar remedies and treatments.

Finally, Smartphone's allow doctors across the globe to treat patients together. This means that a number of doctors working in different parts of the country or across the globe can have a video conference in real time to discuss the latest findings as well as solutions to treating patients. The final beneficiaries of such great global collaboration are the patients because they gain from the combined medical expertise of the world’s best doctors.

No one can argue that smartphones have not drastically changed the way most of us live, they have. However, they have changed not only the routine tasks we perform during the day they also offer us easier access to quality services from professionals such as doctors. By placing the most valued information in the palm of our hands and by allowing doctors to work more efficiently smartphones allow people to live healthier lives. w w w.medegatetoday.com Dec 2018

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COVER STORY

Dr. Ashutosh Tiwari

(Chairman and Managing Director - VBRI Group)

Digital Health enabling good health for the rural areas Dr. Ashutosh Tiwari is the Chairman and Managing Director of VBRI innovation and technology group headquartered in Sweden. Under his excellent leadership, the company that began with small publishing activity in 2002 has become a multi-national company expanding its outreach into the research segments of education, health, energy, technology, agriculture, and environment. He is responsible for the functioning of the organization in India and on the International frontier. Dr. Tiwari has adroitly framed VBRI to facilitate social welfare and rural upliftment across the world, especially India.

Dr. Tiwari, a Non-Resident Indian Technocrat, and Entrepreneur is also Director at Institute of Advanced Materials, VBRI AB; Secretary General; International Association of Advanced Materials, Chairman and Managing Director of AAA InnotechPvt. Ltd. One of the youngest world leaders in the field of Nanotechnology, Dr. Tiwari has published more than 500 articles and has edited/authored around 50 books on the advanced materials and nanotechnology. With VBRI innovation and technology group as the parent organization, the multitalented aficionado has been guiding the organization to attain excellence, including communication and engagement with world scholars, research forums, development organizations,research institutes, industries and universities across the globe. Dr. Tiwari adroitly monitors the services provided by VBRI group across various segments including Innovation and Technology, IT Services, Education, VBRI Press, and Events.

Dr. Tiwari, with his prowess and expertise in the subject field, has several honorary professorship affiliations since 2009.

He has also innovated a range of nanotechnology advances in Technology developments for Healthcare, Programmable medicine, Intelligent- security, and environmental tools. Dr. 36 Dec 2018 w w w. m e d e g a te to d a y.co m

Tiwari has been awarded ‘The Nano Award', 'Innovation in Materials Science Award' and 'Advanced Materials Medal' for his extraordinary contributions to smart materials and medical nanotechnology. He is a founder member and Co-Chair of Advanced Materials Congress and World Technology Summit.

He also holds the Executive Chair in the Advanced Materials Congress, World Technology Conclave, Baltic Conference Series, Global Graphene Forum and Energy Technology Congress held in Europe, Asia, and the US. Prior to the establishment of VBRI innovation and technology group, Dr. Tiwari served as Universitetslektor at Linköping University. After completing his doctorate degree from Allahabad University, Dr. Tiwari joined the National Physical Laboratory, India as a young scientist and later moved to the University of Wisconsin, the USA for postdoctoral research.

He has also achieved significant fellowship awards across the world including the Marie Curie fellowship by the European Commission, JSPS regular and bridge fellowship, NIMS postdoctoral fellow from Japan, SI fellowship from Sweden and various grants from INSA, CSIR, DBT, ICMR, MOES and DST in India.

Dr. Tiwari is passionate about building a new social arena and creating incredible development tools for the mankind with New Age Technology, Artificial Intelligence, and Transformational Research. He strongly believes in the ideology of “Commitment to Excellence” and building the business through cooperation, exchanges of working methods, infrastructures, multidisciplinary researches, and progressing ahead as a united global team. Dr. Tiwari is also a dedicated social activist, working for the social upliftment, especially for the welfare of rural India for over two decades.

EXPERT VIEWS

THE Healers Smile providing comprehensive clinical care it also offers rehabilitation and family focused methods of promoting a healthy environment for the child, thus striving to prevent childhood diseases.

BJWHC also has the largest Neonatal Intensive Care Unit (NICU) in the West Zone. In its effort to provide universal healthcare, BJWHC also acts as a tertiary level referral center, is a nodal centre for Clubfoot in Maharashtra and is the only centre for Neonatal/Paediatric Dialysis in Western India.

Dr. Minnie Bodhanwala CEO, WADIA HOSPITALS (Mumbai)

Located in the heart of Mumbai, The Bai Jerbai Wadia Hospital for Children pledges to extend its services to people, regardless of their socio-economic status. Believing strongly in the fact that quality healthcare should not be restricted to only certain sections of society, the BJWHC offers state of the art services for neonatal and paediatric care at affordable costs.

A teaching hospital of world-wide repute, this 450 bed hospital is propelled by a highly accomplished team of over 60 paediatrics specialists devoting themselves to the care of over 2,00,000 children on an outpatient basis, and approximately 18,000 children as inpatients, annually.

In brightly painted wards, surrounded with their favorite Disney characters, children are treated for a wide spectrum of rare and complex conditions, in an environment that does its best to keep their spirits high. With tender care by the staff and each doctor taking a personal interest in every child’s health and well-being, the hospital sees its responsibility as much more than just medical treatment. Besides 38 Dec 2018 w w w. m e d e g a te to d a y.co m

Congenital and acquired heart illnesses are prevalent amongst under privileged who lack knowledge and access to the appropriate treatment. One in a hundred children suffers from a heart ailment.

Wadia Hospital alone sees more than 3,500 children with heart ailments annually, out of which almost 600 to 700 need surgical intervention. To beat these numbers and to ensure that every kid in need gets access to the expensive

cardiac treatments, the Bai Jerbai Wadia Hospital for Children’s Cardiac Centre was born in December 2016. We also act as a tertiary level referral center.

The annual Little Hearts Marathon not only engages the community to participate in the healthy and fun event, but also spreads awareness and raises the funds essential to set up and maintain the state of art cardiac facility.

BJWHC is the first public hospital to set up a dedicated pediatric cardiac surgery centre and boasts of 100% success rate, till date. Since the inception we have performed more than 800 cardiac surgeries within less than two years’ time frame. This centre has been in operation since the last twenty months and the first open heart surgery was successfully performed on 6th February 2017.

In association with UNICEF we have come up with Nutritional Rehabilitation Center to treat malnourished patients.

Extending new horizons, We have also

EXPERT VIEWS

launched the bone marrow transplant unit which will enable us to complete the Onco Care gamut at our hospital.

Mission

Our mission is to carry forward the philanthropic legacy of the Wadia family and deliver world-class treatments in Paediatrics care at affordable costs.

Vision

Our vision is to provide top of the line affordable healthcare services at par with international standards through preventive, curative, intensive and rehabilitative methods as well as spreading awareness about the same through imparting quality health education. It is also our endeavour, as a teaching institute, to provide quality education to aspiring doctors.

Core Values

We believe our team can make a huge impact on the lives of our patients and caregivers by adopting a compassionate and positive attitude. We are committed to working together to embed a culture and an environment that encourages the following values:

Patients First Our patients are the centre of everything we do. Our foremost priority is to ensure that our trained professionals meet the needs and expectations of every patient by adopting a ‘Patients First’ approach. It is our duty to ensure patient safety and quality treatment for every patient

Integrity We pride ourselves in being ethical and responsible in our thoughts and actions. We appreciate and encourage openness, honesty and accountability in every interaction with our patients, caregivers as well as co-workers.

Excellence Together as a team we strive to provide the best quality healthcare for our patients and are devoted to continuously improve our methods and embrace best practices.

Teamwork We encourage and highly value teamwork across the organization to ensure that each member contributes and adds value to the environment and services provided by the hospital.

Caring At the Wadia Hospital, we treat those we serve as well as each other with love, compassion and kindness thus creating an atmosphere within the organization that promotes and instils these values.

w w w.medegatetoday.com Dec 2018

39

EXPERT VIEWS

A Leading Chain of Women & Children Hospitals

Neeraj Lal Cluster Head & Vice President Bangalore Operations

40 Dec 2018 w w w. m e d e g a te to d a y.co m

Rainbow Children’s Hospital has strived to achieve excellence in the services provided to children requiring super specialty care in a child-family-friendly environment without compromising on quality.

Today, with integrity, excellence, innovation and teamwork, Rainbow has evolved as the nation’s leading and largest group of children’s hospitals. Today the Rainbow Group has 1100+ beds offering pediatric super specialty services, with eleven branches spread over Hyderabad, Vijayawada, Bengaluru, Delhi and Chennai Rainbow Children’s Hospital has varied landmark achievements in the field of tertiary child care✓ Outpatient clinics schedule more than 6L+ visits annually. ✓ Largest series of pediatric patients receiving High Frequency Oscillatory ventilation in India ✓ More than 5000 surgical procedures are carried out every year in our centres ✓ 30,000 inpatient admissions each year and around 1800 neonates are treated annually ✓ Critical care supported by our Level 3, state of the art Neonatal Intensive Care Units (NICU) and Pediatric Intensive Care Units (PICU). ✓ Vaccination and immunization programs ✓ 24*7 Pharmacy, Emergency & Transport Services. ✓ Hospitals clinical staff includes 250+ consultants, 800+ nurses and 150+ paramedical personnel. ✓ NICU with Family Centric rooms • Most advanced ventilators & monitoring system • Human Milk Bank • Pediatric Intensive Care • Specialized isolated rooms for managing children with burns

EXPERT VIEWS

Perinatal Coverage Birthright by Rainbow Group of Hospitals is a unique initiative, born with the aim of providing high standards of care for the pregnant woman, fetus, newborn child and the new mother.

So that none of them is deprived of a tertiary care facility. We do 8500+ Deliveries across the three cities with a very high percentage of normal deliveries annually.

Birth Right Fact file: ✓ 300+ Beds dedicated for Obstetrics & Gynecology with experienced medical professionals dedicated 24/7 to the hospital. ✓ 4000+ Gynecology procedures annually ✓ Over 1000+ IVF procedures done successfully ✓ Outpatient clinics schedule more than 1.5L visits annually with care and counselling for the expectant as well as new mothers. ✓ Beside our natural inclination for normal deliveries, we are equally known for our expertise in handling "high-risk cases".

Bengaluru: The nation’s leading pediatric healthcare chain, entered into Bengaluru with a 200 bed exclusively designed multi-specialty children’s hospital.

Today, Rainbow has two units & 300 beds in the city 2 units strategically located & accessible covering at entire city Both the units are built to Suit the needs of mother & child Overall 300 dedicated beds for OBG & Pediatric tertiary care full Spectrum of Obstetrics & Pediatric Super Specialties Largest NICU set up in the city with 60 beds 24 x7 Senior Consultant led Emergency services Round the clock availability of In-house doctors Well trained, specialized nursing & paramedical staff In-house Emergency transport services Empanelled with all leading TPA & Insurance companies Dedicated corporate health care plans with Privilege Health Card Complete pregnancy care with onsite antenatal classes support fertility team with inhouse lab.

Rainbow Bangalore have some of the rare services such as Advanced

organ support : CRRT, SLED, IHD, Plasmapheresis, MARS, Advanced centre for hearing and cochlearimplants ,centre for comprehensive care of cerebral Palsy including first 3Dgait lab and Orthotics Lab in India .

Unique Centre of Excellence in Bangalore

COCHLEAR IMPLANT CENTRE: Rainbow Children’s Hospital, Marathahalli is one of the very few hospitals in the country to have a comprehensive cochlear implant unit comprising of surgeon, dedicated audiologist, speech therapist and rehabilitation specialist. Services offered include cochlear implant surgeries, Postoperative rehabilitation and speech therapy & diagnostic procedures which include BERA, pure tone audiometry, new born hearing screening, hearing aids & Tympanometry.

KIDNEY TRANSPLANT CENTRE: The Rainbow Children’s Hospital, Marathahalli is a Government of Karnataka approved hospital for Pediatric Kidney Transplant. The center has comprehensive pediatric and neonatal kidney care with state-of-the-art facilities and world class kidney transplant team which comprises of transplant surgeon and pediatric nephrologist, with intensive care and other pediatric subspecialty support under the same roof. Services provided include:✓ Neonatal & Pediatric CRRT ✓ Neonatal & Pediatric Hemodialysis ✓ Kidney Biopsy ✓ Management of Pediatric Renal Calculi ✓ Complex Congenital Anomalies of Kidney, Urinary Bladder and Genital Tract

CHILD DEVELOPMENT CENTRE: Rainbow believes in helping the little ones achieve the best of their potential through our multidisciplinary team approach that would maximize their development. The team includes child psychiatrists, psychologists, dedicated speech therapists, occupational therapists and trained Pediatric Physiotherapists.

Rainbow Children’s Hospital is well equipped for evaluating and treating children with psychological disturbances.

Diagnostic and therapeutic services like Comprehensive developmental assessment, IQ Assessment, Behavioural assessment and intervention, Attention enhancement training, Management of ADHD etc.

CENTRE FOR CEREBRAL PALSY CARE: Rainbow Children’s Hospital, Marathahalli is home to India’s first center for comprehensive Cerebral Palsy care,”Pragati”. The center brings together state of the art facilities and expertise under one roof. For the 1st time in India, a children’s hospital has an advanced 3D gait analysis lab, pediatric orthopedics, orthotic center (for making splints & braces) and all ancillary services needed for world class management of children with cerebral palsy and special needs. In addition, the center also has advanced rehabilitation facilities for sports injuries and gait analysis for runners. w w w.medegatetoday.com Dec 2018

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EXPERT VIEWS

How can Medikabazaar help

hospitals achieve NABH standards I

Dr. Akash Rajpal

Executive Vice President & Product Management Medikabazaar

One of the primary reasons is that there is a lack of understanding and awareness about the standards.

Even if the hospital management team know about NABH standards, lack of in-depth knowledge in terms of interpretation of each objective element, its application in various scenarios and type of medical establishment and even its understanding at basic conceptual level adds to the woes of percolating it down to the last housekeeping staff essential for appropriate patient care. Not everyone can hire an expensive NABH consultant.

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ndia’s present population stands at 1.3 billion. By the sheer capacity of that number, one can imagine the pressure faced by the country’s hospitals regarding catering to thousands of patients on a daily basis. According to reports, the waiting time for patients to be admitted in a general bed for medical procedures is one year. World Health Statistics convey that India is one of the lowest ranked nations in the number of hospital beds per 1000 population with 0.9. With a change in lifestyle, India sees a rise in deaths caused by non-communicable diseases. A WHO report said that non-communicable diseases, such as cancer cause 61% of deaths in India. Nowadays, diseases are more complex which requires intricate diagnostic and medical procedures.

Due to the above, it is all the more important for medical establishments to uphold and maintain certain healthcare standards and guidelines aimed at providing quality medical care. More so, medical establishments need to achieve the same cost-effectively especially considering the low reimbursement rates of Ayushman Bharat, GIPSA, etc.

The National Accreditation Board for Hospitals & Healthcare Providers (NABH) is one such institution which provides healthcare facilities in India, a set of carefully formulated standards made to assure that hospitals operate under standard protocols for cost-effective monitoring of resources and timely intervention. NABH standards cover almost all the crucial aspects of medical establishments.

The guidelines range from how hospitals should uphold patient rights to effective management of facilities to ensure safety for both staff and patients. Though NABH standards are not mandatory, its significance has been the subject of a huge discussion as the government has made it compulsory to have at least, entry-level NABH standards, to allow cashless insurance facilities to patients, including incentive-based payments to hospitals for a volume-driven Ayushman Bharat scheme. A November 2017 news report

by The Pioneer stated that only 1% of Indian hospitals had taken sufficient measures for NABH accreditation. The report added that although NABH was in place for more than 10 years, only about 1000 medical establishments (both in public and private sectors were in the process of working towards NABH standards.

Why are the numbers so low? One of the primary reasons is that there is a lack of understanding and awareness about

EXPERT VIEWS

the standards. Even if the hospital management team know about NABH standards, lack of in-depth knowledge in terms of interpretation of each objective element, its application in various scenarios and type of medical establishment and even its understanding at basic conceptual level adds to the woes of percolating it down to the last housekeeping staff essential for appropriate patient care. Not everyone can hire an expensive NABH consultant.

How can MedikaBazaar help in achieving NABH standards?

Procurement is essential to the success of an organization and achieving NABH accreditation as without timely and right inventory in place; patient care cannot be effectively achieved.

Organizations like Medikabazaar are trying to enable hospitals to achieve operational efficiency by helping them to adopt an online procurement system, harness the shifting culture of offline to online search for knowledge seeking behavior for nurses, doctors, and purchase managers before purchasing any items for hospitals. With its Artifical Intelligence and Machine Learning softwares, Medikabazaar helps its partner hospitals in not only incurring savings on their Total Cost of Operations (TCO) but also purchase quality supplies, unsurpassed negotiations and provide quality patient care. As mentioned above, patient care takes center stage for the NABH, Medikabazaar through their technology-based supply chain solutions can help hospitals achieve certain NABH standards. Let’s go through some of these standards.

Management of Medication (MOM) Standard 13: Documented policies and procedures guide the use of medical supplies Objective Element A: There is a defined process for acquisition of medical supplies and consumables NABH’s interpretation of the above explains as to how hospitals should review and select their vendors for medical supplies. Vendor selection is a vital part of operations as supplies procurement constitutes about 1/3rd of their OPEX (the second largest expenditure after staff salaries).

Therefore, if hospitals select the wrong vendors, they might procure above benchmark rates, mediocre supplies & even miss out on innovations in items which may improve care, and a lack of all these can hurt patient care and also lead to significant revenue loss.

Hospitals have an established and conventional procedure to procure their medical supplies. The purchase manager searches and reviews potential vendors. This depends on a lot of factors such as the location of the vendor, certifications and their goodwill in the market. After the vendor is selected, hospitals contact them to inquire about their required supplies, negotiate prices, and then procure them. Such an offline procurement process can be complicated and costly.

Typically, vendors approach hospitals themselves. In such

cases, at times purchase managers don’t review the vendors thoroughly and select any manufacturer who contacts them.

This again results in the problems mentioned above.

Ideally, the objective of medical establishments should be to make the procurement process qualitative, costeffective which can allow them to save on their Total Cost of Operations (TCO) and indirectly result in affordable medical bills for the patients.

It can be clearly understood that to fulfill just one NABH standard, hospitals have to endure a complex and rather time-consuming process, especially if they have to maintain quality patient care and curb revenue loss. Such procurement processes require a lot of time, space, and human resource.

Healthcare centers can eliminate all of the above-mentioned procurement issues if they adopt an online system as serviced by organizations such as Medikabazaar who are India’s largest online B2B platform for medical supplies.

With services such as product comparison, quality check of supplies, Medikabazaar enables hospitals to make informed purchase decisions and save up to 30% in their OPEX.

Access Assessment and Continuity of Care (AAC) Standard 1: The organisation defines and displays the healthcare services it provides Objective Element B: Each defined service should have appropriate diagnostic and treatment facilities with suitably qualified personnel who provide out-patient, in-patient and emergency cover Before establishing any medical establishment, an extensive market research should be conducted which can help the owners of the facility, understand what category of establishment is needed. Such studies can also help the owners understand the type of facility required based on the needs of the people in the region. For example, if research shows that the majority of people in a particular area have cardiac diseases, then a doctor planning to open a medical facility can choose to establish a center dedicated to heart diseases. When this is decided, the doctor will need the relevant equipment for the same. This is where Medikabazaar can help the facility by supplying them with the appropriate equipment and consumables required to establish the medical center.

NABH standards are quite exhaustive as they aim to make hospitals patient-friendly and protocol driven. Therefore, at times, these standards can seem quite intimidating for medical establishments to follow. Hence, Medikabazaar is making an earnest attempt to elaborate and describe NABH standards in a way which can be easily understood by purchase managers and hospitals. This will, in turn, help them to implement processes as per NABH standards ❏ w w w.medegatetoday.com Dec 2018

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EXPERT VIEWS

What about the brain?

Anil K Srivastava

Director – Sales and Marketing Medical Equipment, Nihon Kohden India

Up to now understanding continuous EEG in ICU was associated with resource demanding electrode placement. Nihon Kohden is proud to launch and present to the world AE120A EEG Headset – fast, easy, wireless, continuous EEG for critical care.

To get more insights of the brain the European Society of Intensive Care Medicine (ESICM) strongly recommends the use of EEG monitoring in critically ill patients. Also, the European Resuscitation Council (ERC) advises the use of cEEG for detection and monitoring in ICU patients following cardiac arrest, as 1/3 of patients who remain comatose suffer from seizures.

We are hopeful that Nihon Kohden AE-120A EEG Headset will help ER and ICU clinicians to diagnosethe most demanding organ, the Brain 44 Dec 2018 w w w. m e d e g a te to d a y.co m

Clinicians monitor many vital parameters which reflect the status of the heart and respiration to ensure a good perfusion. But what about the most demanding organ,the brain? Why does the patient not clearly wake up? Why is the patient unconscious?

The importance of EEG parameter in Critical Care has been acknowledged globally. Nihon Kohden presents brand new technology for Emergency room /ICU to start quick & simple EEG monitoring.

The AE-120A EEG Headset developed for quick and easy continuous EEG monitoring. One of the difficulties of performing EEG monitoring in ER/ ICU is that very few physicians can apply 10-20 EEG electrodes to the correct positions on a patient’s head and it’s associated with resource demanding electrode placement. The AE-120A EEG Headset could be a solution for these problems. Anyone can apply EEG Headset with simple steps in ER/ICU without the knowledge of EEG electrode placements technic.

The headset’s flexible design allows electrodes to be positioned correctly simply by placing the pad on the patient’s forehead.

Disposable electrodes enable quick application without needing to prepare attachment sites first, as needed in conventional EEG.

EEG head set AE-120A is equipped with 'Active amplifier'. 'Active amplifier' makes artifact from environment and body movement less.

Since artifact on EEG waveforms is a big headache in ICU. EEG measurement data can be transmitted wirelessly using Bluetooth, which enables EEG to be measured in an ER/ICU without adding to the number of medical devices surrounding the patient.

Nihon Kohden is proud to announce that the AE-120A EEG Headset (CerebAir) – a telemetry EEG amplifier designed at its Advanced Technology Center in Tokorozawa, Japan – received the Red Dot Product Design Award in the category “Life sciences and medicine”.

EXPERT VIEWS

Emerging Challenges for General Surgery Ashim Dutta Head of Marketing AB Hospitals

G

eneral surgery procedures include a vast selection of common surgical procedures from gallbladder removal (cholecystectomy)to removal of the Uterus (hysterectomy) that are frequently performed with minimally invasive methods compared to complicated open surgeries of the liver, pancreas, and oesophagus.

Demand For General Surgeries

In 2017, the number of generals surgeries performed worldwide totaled approximately 59 million. Forecast for these procedures is to grow in a 3.6% compound annual rate exceeding 70.5 million surgeries by 2022.Though general surgeries overall is a relatively mature segment, some procedures, specially those using minimally invasive methods, are exhibiting substantial growth due to their acceptability among wider section of patients.

Major Challenges

Declining interest in General Surgeries There are various reasons for the waning interest in general surgeries among medical students. Reasons for this decline are diverse and lots of factors have been identified through numerous studies and retrospective studies. Particularly, lifestyle problems, probability of litigation, absence of role models, insufficient undergraduate education exposure and gender issues are specifically prominent.

Multiple sub-specialization options The knowledge explosion in medicine is a principal source of development of the specialization seen throughout the last two decades.

The fast and the deep successes in medical technology have increased the sophistication of surgical, interventional and intensive care thereby fueled further specialization and sub specialization. There are various reasons for surgeons to specialize.

To be completely competent in the face of knowledge base that's growing in all areas, many surgeons choose to restrict the number and kinds of surgical procedures they perform. In addition, it might be simpler to develop expertise in certain subspecialties, and also more tasteful experience frequently leads to economic benefits.

As a phenomenon of progressive specialization carries on to evolve, the effect on hospitals and healthcare delivery will be substantial. In case the trend carries on, a larger workforce of surgeons will probably be needed to supply the plethora of services encompassed by the principal components of general surgery.

Demand for diverse skill sets required by general surgeons Continued expansion in the availability of health resources in developing regions is driving increased utilization of general

surgeries, leading to growth in procedures at a rate in excess of the international population growth of about 1% each year. General Surgery is a specialty that needs familiarity with and knowledge of a wide range of conditions that might require surgical treatment.

The length and depth of the knowledge will change by disease category. In most areas, the surgeon will probably be expected to be effective in diagnosing and treating the entire spectrum of diseases. While wisdom and good technical abilities are crucial, they alone don't ensure success as a general surgeon.

Confidence, endurance, perseverance, and patience are imperative.

Fantastic leadership, motivational, and decision-making skills are also essential requirements. Lastly, the importance of commitment to patient care can't be overstated.

Even though general surgery remains probably the most admired residencies for medical students today, it's facing horrible pressure, including less attraction to surgery as a profession, a growing interest in surgical sub specialty, and higher attrition rates.

For general surgeries to survive there's need to introduce changes to make new priorities in clinical practice, education and research, and to increase the morale and prestige of general surgeons ❏

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EXPERT

Dr. Raju Vaishya

President of Arthritis Care Foundation (AFC) & Senior Orthopaedic Surgeon at Indraprastha Apollo Hospitals, New Delhi

VIEWS

Women are at higher risk of osteoporosis Avoidance of sunlight exposure due to sociocultural reasons, poor intakes of dietary calcium and increasing environmental pollution lead to low bone density among indian women. According to experts, habitual low intakes of calcium have been reported in toddlers, adolescents, pregnant and lactating mothers, and postmenopausal Indian women.

With the increase in life expectancy of Indians, an alarming rise has been noted in the number of women being diagnosed with clinical osteoporosis. low calcium intakes with extensive prevalence of vitamin D deficiency, poor knowledge about osteoporosis, and difficulties in the diagnosis of osteoporosis in Indian conditions are some of the reasons that have resulted in osteoporosis becoming a major public health problem in India, especially among the Indian women Marked by thinning of bones, osteoporosis is also referred to as a silent disease for being asymptomatic and remains undetected until the patient faces a fracture (a silent disease). The disease makes the bones brittle to the extent that a minor slip, jerk or fall can lead to a major fracture. Although the condition develops with age, increasingly, osteoporosis is being diagnosed in relatively younger people as well.

“If we are receiving 100 patients of the older age group, at least 30% of them are osteoporotic. In our camps, organised

by Arthritis Care Foundation (AFC), we now find young people around the age of 35-40 years too with low bone mineral density, which means they are at a higher risk of developing osteoporosis. Younger people have become more vulnerable to this disease. It due to the modern lifestyle, sedentary habit, consumption of alcohol and tobacco, smoking, urban dietary habits of consuming more of high calorific and junk food, adulteration in food, and developing cardiac diseases and diabetes mellitus at a young age.”

46 Dec 2018 w w w. m e d e g a te to d a y.co m

Red meat and caffeine should also be avoided.

Additionally, calcium supplements should be taken as prescribed by your doctor.

Traditionally, Osteoporosis is more prevalent in women, after they reach menopause. Reportedly about 80 percent of women in India, which is more than three in every four women, have osteoporosis and menopausal women above the age of 50 are more at risk.

Although exercising does not increase bone density, it improves health in more ways than one and also contributes to preventing osteoporosis.

Explaining why women are more affected, Dr. Raju Vaishya said “Women have lower bone density than men, and they lose bone mass more quickly, as they age which leads to osteoporosis. It is because of the lack of estrogen which is a hormone that helps to regulate a woman’s reproductive cycle, and at the same time, plays a key role in keeping bones strong and healthy in both men and women. While premenopausal women have more estrogen than men, they experience a dramatic drop in estrogen production after menopause and therefore are more likely to face faster bone loss leading to osteoporosis.”

Increase physical activity and include exercising in daily routine. Weightbearing exercises and physical activities like running, jumping, walking, and so on help the body maintain good balance and posture.

Adequate and healthy diet plays a crucial role in the strengthening of bone and human skeletal system.

Osteoporosis can be avoided or at least its onset can be delayed by following a healthy diet and an active lifestyle.

Diet management: Especially, for osteoporosis, a diet rich in calcium, protein, magnesium and vitamin D is vital. The following healthy dietary practices should be followed: Include calcium-rich food in the diet: Calcium strengthens bone. Non-fat milk, yogurt, broccoli, cauliflower, certain types of fish like salmon, almonds, and green leafy vegetables are all excellent sources of calcium.

Protein-rich foods like lentils, kidney beans, grains, nuts, and seeds help the body to keep the muscles healthy.

Healthy muscles support the bones.

Consumption of tobacco and alcohol should be reduced as much as possible.

Don’t exercise body parts which have a history of fracture. It may cause unnecessary injuries.

Do practice Yoga, as it is known to increase flexibility and strength in the body.

INTERVIEW

Medical Fair India Committing Great Service to Indian Medical Industry for 25 Years...

Mr. Thomas Schlitt Managing Director, Messe Duesseldorf, India Mr. Schlitt, Congratulations for Successful events during your tenure. How has been your journey in India so far and what is the future road map?

My journey in India has so far been a truly wonderful learning experience.

There is much that I have learnt during my time and which has allowed me the opportunity to create a meaningful impact on the exhibition portfolio for Messe Duesseldorf India.

In a world of profound changes, with the acceleration of innovation and a growing competitive landscape in the exhibition market, it is necessary for the Messe Duesseldorf Group in India to assert its identity through the creation of powerful brands catering to the wide array of markets.

This for us is the right time, when we are riding the momentum of our recent successes in exhibition portfolios,strengthening our existing exhibitions by adding new target segments and creating new entities by mergers and acquisitions.

We cater to some important industry sectors in India and would like to take advantage of this increased level of visibility to further grow our profile.

Our vision 2030 is a natural step for 48 Dec 2018 w w w. m e d e g a te to d a y.co m

further growth aimed at supporting our ambitions to scale up the existing exhibitions, bring new topics, raise our standards and bring credibility to an important international market like India.

Medical fair the oldest exhibition brand in India, has been doing a great service to Indian medical fraternity for more than a decade, do you have any plans to maximize more shows every year?

I believe that organizing a trade fair is a strategic venture; therefore, the starting point is the exhibitor. The purpose is, and it generally is, to promote the medical industry and attract investments as a means for sector development. Therefore, we are evaluating all options to further develop the market and be a catalyst.

Yes, additionally, we are assessing the feasibility for organizing more shows, focusing on its objective, theme and market scope. Besides market conditions, we as an international trade show organizer, must also keep in view other critical aspects for the sustainability of the trade fair.

An analysis with respect to the abovementioned factors and the identification of ways to ensure that the essential requirements are met, should be the initial assessment for the feasibility of any addition to our existing shows.

Our vision 2030 is a natural step for further growth aimed at supporting our ambitions to scale up the existing exhibitions, bring new topics, raise our standards and bring credibility to an important international market like India.

INTERVIEW Don't you think within exhibition segment, there is plenty of scope for many sub-segments like AI, Medical Equipment, Hospital Architecture, HMS etc.?

With more than 4 decades of experience as the leading healthcare business platform in Germany, MEDICA is a hub of knowledge. In India, Medical Fair India with 25 years of existence has gained key insights into the country’s healthcare market.

MEDICAL FAIR INDIA is well known for its ability to detect trends and respond to new Innovations. Therefore, each edition is unique as it explores new sub-segments and opportunities for diversification. The successful segments which have been added to MEDICAL FAIR INDIA are CLINLAB India - Conference &Exhibition on IVD and Clinical Laboratory and FTR4H (Future for Health lounge and pavilion) which explore show Mobile, Internet of Things, Data & Artificial Intelligence and Roboticstrans form the Healthcare Industry. The 2019 edition will see the launch of Reha India, powered by REHACARE to be featured for the first time in India,alongside Medical Fair India. This segment will focus on the rehabilitation sector in India bringing together all categories of stakeholders in this segment.

In addition, medgate today, our esteem partner will drive the conference on vital issues,development and innovation in healthcare industry. Together with industry stakeholders and partners, MFI is constantly exploring new topics which should the right fitment for business and technical education at the show.

Could you Please get us a glimpse into comparative medical products buying behavior in India, Europe and Africa markets?

Global medical device production value will witness strong growth. However, gaining a market share in the traditional markets (Western Europe, and the US) will remain difficult due to growing regulatory scrutiny and pricing pressures.

The US will remain the largest producer and consumer of medical devices, accounting for majority of the global market. Operating in and exporting to

emerging markets of Latin America and Eastern Europe will be challenging due to decelerating growth of these regions’ healthcare industries.

Although it has been hard to penetrate the Asia Pacific medical device market, this region may present unique opportunities for medical device producers to grow and gain new markets.

The region was the fastest growing medical device market, rising at a CAGR of 10%. For instance, China’s and India’s healthcare service revenues are expected to advance, resulting in a large number of new hospital construction projects and thus soaring demand for medical and surgical equipment.

As online buying is future of procurement; how do you align your exhibitions with this emerging buying platform?

The big bang of Informationcommunication technologies and media facilities in the last decade have bridged distances and made an astonishing mass of information available, facilitating its transfer both in qualitative and quantitative terms. Without any doubt, habits and behavior have drastically changed the way of doing business, through Internet-based services. Online marketplaces and business databases, companies’ websites and industry portals are facilitating B2B andB2C linkages, and actual business transactions are possible though e-commerce.

Following the Indian government’s push for digital transactions, the purchase of medical equipment and machinery online will bring more transparency and efficiency into the procurement process. Exhibitions like Medical Fair India provide a platform to populate this information to the larger audience and amplify the platforms available.

Medical Fair's success has inspired local competition having local advantage, how have you been successfully staying ahead of your competition?

Medical Fair India is segmented into multiple areas of specialization, with a global presence and expertise. Our exhibitors achieve their objective both

ways - by catering to the domestic market (MFI) and international market with MEDIC Alliance, which is the partner for medical trade fairs worldwide from our global network of Messe Düsseldorf in Bangkok, Bogotá, Moscow, São Paulo, Suzhou and Singapore!

India is a very sensitive market when it comes to Medical exhibition and conference. However, we have been consistent in our pricing, delivery and standards. This has really helped us to stay ahead of other available options in this industry. Medical Fair India acts as a platform where connections are made and business relationships are nurtured. With global engagements and participation from over 20 countries, MEDICAL FAIR INDIA is now synonymous to the Medical industry in India and working furtherto increase the level of visibility and act as a catalyst for defining the healthcare industry in India.

What does India as a market mean to you, Please share your vision for Indian healthcare industry, Medical tourism etc?

Healthcare has become one of India’s largest sectors - both in terms of revenue and employment. Healthcare comprises hospitals, medical devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance and medical equipment. The Indian healthcare sector is growing at a brisk pace due to its strengthening coverage, services and increasing expenditure by public as well private players.

I believe that India's competitive advantage lies in its large pool of welltrained medical professionals. India is also cost competitive compared to its peers in Asia and Western countries in terms of manufacturing of medical devices. The cost of surgery in India is about one-tenth of that in the US or Western Europe.

The country has also become one of the leading destinations for high-end diagnostic services with tremendous capital investment for advanced diagnostic facilities, thus catering to a greater proportion of population.

Besides, Indian medical service consumers have become more conscious towards their healthcare upkeep ❏ w w w.medegatetoday.com Dec 2018

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PRODUCT LINE

SNG India: Leading Healthcare Solution Provider of India & South Asia Our vision is, as a part of the healthcare industry, we want to continue to help by introducing latest technologies, assist to cope up with the latest innovations in the world, while adapting them to the Indian scenario.

T

he velocity at which modern technology is reshaping our everyday lives is progressing at lightning speeds. The impact of technological innovation advances to grow, changing all industries as it evolves. Out of all the industries that technology is responsible for accelerating innovation in, healthcare is one of the most important. Healthcare labs are now outfitted with modern types of equipment, and diagnostics techniques and devices like smartphones and tablets are commencing to replace traditional monitoring and recording systems. Technological advancements in healthcare have contributed to services being taken out of the confines of hospital walls and blending them with user-friendly, accessible devices.

Sun Narula Group (SNG) India is one of the largest independent healthcare solution providers, with world class technology products and services. The company is providing high-tech Healthcare Automation in the space of Healthcare Logistics, Hospital Pharmacy Automation, Hospital Warehousing and Stores Automation. SNG has emerged as a pioneer in India and South Asia with an abiding clientele, historically over 2000 hospitals and more recently spanning over 450 leading hospitals and healthcare providers.

Person behind the Facades of Success

Pankaj Narula, Managing Director & Head Marketing & Business Development with SNG India a.k.a Sun Narula Group, have taken forward the family legacy of 63 years and have sculpted overall strategic direction and effective operations of the company, ensuring that SNG remains a frontliner in providing automation to healthcare logistics in India.

“We are not a mere medical equipment or a medical supplier organization. We are solutions provider, and that is what we focus on. We provide customized solutions and technologies which are continuously innovated and improved, enabling the introduction of renovated solutions to our customers’ time to time. We are in a very niche product line and products are for enhancing hospital facilities and help them reduce healthcare delivery cost,” says Pankaj.

Comprehensive Spectrum of Services with Stupendous Team

Over the years SNG has evolved as an infrastructure organization, providing solutions for enhancing hospital infrastructure regarding logistics, automation, regarding 52 Dec 2018 w w w. m e d e g a te to d a y.co m

patient handling & healthcare delivery. So the most important verticals that the company has today is Hospital Healthcare Logistics, which is an automation of materials transport within the hospital, efficient Trunkey ICUs, ERs, OTs, and Patient Handling Solutions right from design to execution. The latest vertical SNG has the Pharmacy Automation Solutions & Storage Solutions.

Reaching New Heights by tackling Obstacles

While discussing the challenges SNG has faced, Pankaj disclosed, “One of the biggest problems the company faced was that the Indian hospitals were not ready to spend even a single dime on logistics automation or pharmacy automation.

They were only interested in spending money on radiology and diagnostics. That was a challenge, so it took us few years to educate our customers and to make them aware why they need automation and better technologies in other areas as well. Thankfully, they have listened to us, and everything has evolved since then.”

Successful Clientele

SNG is one of the only companies in India or rather South Asia, who has developed a centralized customer care department for their clients. Apart from that, the company has over 60 engineers, spread over the country so that SNG can provide quick response to their customer’s concerns. The company has strong in-house Project Management Teams & Customer Support Teams to ensure unmatched support to the clients, right from design to commissioning and service support with a dedicated SNG Customer Care Department.

SNG’s Outlook on the Future Aspects

On company’s future plans, Pankaj revealed that; “We haven’t made SNG large yet, but we are trying to do it. Our focus has to be in doing what we like the most not just making it large. We like doing this, and we like creating solutions for our customers. We have to be focused on customer needs, the gaps; the voids and we can fill these shortcomings and provide clients with the right solution at the right cost.”

SNG under the leadership of Mr. Pankaj Narula has been rated to be top 500 leading healthcare brands in India by MBI & has been recently awarded as: ✓ The Most Emerging Brand of the year 2015 by Medgate. ✓ Top 100 SME in India 2016 by India SME Forum. ✓ Top 10 fastest growing healthcare group 2016 by Silicon Review. ✓ Top 10 Most Valuable Healthcare Solutions provider Company by Insight Success, 2016 ✓ Best Emerging Brand of the Year by National Awards for Excellence in Healthcare, 2016

POST EVENT

Taiwan Responds to Global Surgery Initiative, and Leads Internationally by “Training the trainers” in highly-specialized surgical field Taiwan’s leadership in reconstructive microsurgery. and in cultivating renowned reconstructive surgeons globally is an asset of Taiwan, and invaluable domestically and internationally. This consolidates Taiwan’s leadership in medical sciences. spreads Taiwan’s ideal values of humanitarianism. helps Taiwan’s government to foster diplomatic ties with other nations. promotes overseas Taiwanese descents in medical professions. and advocates Taiwan’s higher education (PhD & MSc.).

Reconstructive microsurgery is a highly specialized subspecialty that utilizes autologous or allo tissue to restore human dignity after cancer, trauma, and congenital deformities.

It requires compet ent surgical training, and sophisticated tools such as operating microscope. and broad scientific knowledge.

Reconstructive microsurgery is life saving and enhancing. and resources conserving.

Taiwan’s international fellowship programs in reconstructive microsurgery are deeply rooted in the medical system since 1990s, internationally-renowned in teaching surgical competency, critical thinking, leadership, mentorship. and philanthropy, and constantly evolving as now combine master

Mohd Afzal Kamal, Editor-in-Chief, Medgate Today, (India) with Prfo. (Dr.) Fu -Chan Wei, Chang Gung University, Taiwan

TOP Micro Reconstruction Surgery Professors -Taiwan

54 Dec 2018 w w w. m e d e g a te to d a y.co m

degree in science with clinical fellowship.

Taiwan’s innovative and pioneering surgeons, supportive national institutes and affordable high-quality national insurance, team collaboration, and strong humanitarians drive and a culture of giving back have made Taiwan “mecca’ of training the trainer.

Two training pathways exist, the most important of them is to train surgeons to become trainers themselves by becoming surgically competent and capable of provide good surgical care to their people, and then desiring and qualified to TRAIN other surgical colleagues, and spread the giving back philosophy learned in Taiwan.

Since 1985, hundreds have been trained from advanced countries, underdeveloped countries, and those ravaged by war. The majority of Taiwan’s graduates now hold leading positions in their home countries or internationally, and all of them act as indirect ambassadors to Taiwan, spreading love, giving back, and cherishing freedom.

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POST EVENT

MR. A. P. SIDDIQUI REGISTRAR, JMI

PROF. HINA ZIA, DEAN, FOAE, JMI

PROF. S.M. AKHTAR, HOD, FOAE, JMI

DR. ANSHUMAN KUMAR, DIRECTOR, DNSH

AR. RANG EMEI, PRINCIPAL ARCHITECT, HELIX

LET’S WISH OUR BHARAT AYUSHMAAN BHAVAH! 1ST HEALTHCARE ARCHITECTURE NATIONAL SYMPOSIUM & EXPO: CONFLUENCE 18

H

ealth is our most precious asset and the right of every human being. It is not only the responsibility of an individual but also, of the whole community, to make it a habitable space. No matter where the people live and work, they all require an access to the healthcare facilities throughout their lifetime. Apart from just the stakeholders and policy makers, the role to provide a user friendly and affordable healthcare, is played by the clinical professionals, healthcare architects, MEP consultants, biomedical engineers and equipment planners. The design of any healthcare facility can increase or reduce the cost-effective & schematic utilisation of resources. It can elevate the manpower requirement, increase the Average Length of Stay of Patients in the hospital, and can even spread infection if defectively planned.

For the same, Faculty of Architecture & Ekistics (FoAE), Jamia Millia Islamia University (JMI) in collaboration with Dharamshila Narayana Superspeciality Hospital (DNSH) welcomed students,professionals and academicians from allover the nation to their first Healthcare Architecture Symposium: ‘Confluence 18’ on October 13, 2018.

The Plenary Session was inaugurated by Prof.

Hina Zia, Dean, FoAE, JMI, where she welcomed everyone and discussed about the gaps & challenges in the transforming healthcare sector at global level along with the environmental manifestations that influences the hospital facility planning and design. “Given the multidisciplinary nature and changing requirements of the healthcare industry, 'Confluence 18' attempts to bring on board architecture and healthcare experts to deliberate on some of the pressing challenges and possible implementable solutions, specifically to Indian context which demands solutions for diversity and affordability”, says Prof. Hina Zia. Prof. S.M. Akhtar, Head, Department of Architecture, FoAE, JMI gave keynotes of the symposium by emphasising on the need of this specialised amalgamation. He had envisioned, more than a decade ago, the need of interaction

56 Dec 2018 w w w. m e d e g a te to d a y.co m

between architects and doctors to understand and supplement requirements of each other and how this unique concept can help improve the medical architecture, design and planning.

“Architecture based Healthcare planning has become the gold standard. Comfort, Compliance, Consistency, Cure, Control, Consensus & Concordance matters in its design”, voicedDr. Anshuman Kumar, Director and Clinical Lead-Academics, Dharamshila Narayana Superspeciality Hospital, New Delhi who wasalso the ‘Guest of Honour’ at the national conclave. He talked about the role of healthcare facility planner as soon as the idea of medical infrastructure is conceived to be followed by evidence based inputs from healthcare professionals and users.

Dr. Kumar has been internationally active as a planning consultant and spreading awareness about efficient hospital design and cancer awareness apart from his hectic patient treatment schedules.

The dais also welcomedAr. Rang Emei, Principal Architect, Helix Healthcare Architecture as their ‘Chief Guest’, who threw light upon how the healthcare architecture has evolved with the technology and introduction of specialised medical equipments during the past few years.

The conclave was presided over by Mr. A.P. Siddiqui, honourable Registrar, Jamia Millia Islamia who stated the need of amalgamation of Healthcare and architecture in today’s changing scenario where we need a climate responsive yet every efficient healthcare infrastructure.

The Confluence EXPO 18 showcased the work of architecture students and clearly exhibited their dedication and hard work. Besides, it exhibited the analysis of planning, building integrated services, flow networks, equipments and administrative flow of various departments of Oncology facility under educational collaboration of FoAE, JMI with DNSH lead by Ar. Shruti Gupta, Assistant Professor, FoAE, JMI and Resource Co-ordinator between both institutions.

POST EVENT

The Session 1, chaired & moderated by Prof. Anil Dewan (School of Planning & Architecture, New Delhi) who himself is an enthusiastic international hospital planner, spectated eminent transdisciplinary speakers like Dr. Sudhakar Manav (CEO, Apollo Hospitals, Assam) who deliberated about the role of Architecture in seamless Healthcare delivery while senior facility design consultant Dr. K.B. Sood (MD, NOUS Consultants (P) Ltd.) threw light upon how healthcare facility design and planning has emerged and revamped within past few decades with respect to design standards, policies and technology.

On the other hand, Ar. Nandini Bazaz (GM, HOSMAC India (P) Ltd.) discussed about specialised architectural needs of Cancer Hospitals. The same was followed by a panel discussion themed on ‘Intersection of Healthcare & Architecture’ with Ms. Urvashi Prasad (PHP, Niti Aayog) who share her perspective about role of national healthcare policies like Ayushman Bharat and primary care Health & Wellness centres, whereas Ar. Mala Mohan (ADG, MES, Ministry of Defence) talked about various alternate materials and overall block planning of hospital buildings along with the importance of ambulatory care departments while Mr. Vishal Indurkhya (GM, North Zone, HOSMAC (P) Ltd) motivated the students about the importance of specialised need of practical exposure for hospital planners at grassroots level in the field of architecture & healthcare.

Furthermore, the session hosted Dr. Sonal

Atreya (Assistant Professor, D, /o Architecture & Planning, IIT Roorkee) wherein she talked about importance of well-being & lifestyle along with controlling health-hazards & Nosocomial infections via architectural design, and Dr. Neeraj Dipak (Dr. L.K. Hiranandani Hospital), who conversed amicably about the infrastructural planning of NICUs. The Session II, moderated by Dr. Pranay K. Sinha (EHS/DOTS, AIIMS, New Delhi) was themed on ‘The Paradigms of User Oriented Health facilities’, in which, Dr. Ashish Gupta (CEO, BOC) presented on Hospital associated infections and HCO structures with their importance in architectural design. He also stated the advantages of equipment oriented juristic planning. Besides, the need and advantages of sustainable and energy-efficient hospital design were highlighted

by Mr. A.C. Verma (Executive Director, HTFE Pvt Ltd, New Delhi). The podium was shared for further panel discussion by renown personalities like Dr. Saranjit Bhasin (Head Prosthodontics, F/o Dentistry, JMI), Dr. Ashish Roy (Principal Planner, DDF Consultants P Ltd., India), Mr. V.S. Kukreja (Director, VS Kukreja & Asso.), Prof.

Khalid Moin (Professor, D/o Civil, JMI) and Ar. Shikha Sharma (Principal Architect, Green By Design).

Various challenges were identified during the deliberation with possible loopholes and solutions in health facility policy making, planning, facility engineering and financial viability to make our society safe & healthy in the presence of more

AR. SHRUTI GUPTA, ASST. PROF., FOAE, JMI

PROF. ANIL DEWAN, SPA, NEW DELHI

DR. SUDHAKAR MANAV, COO, APOLLO, ASSAM

AR. NANDINI BAZAZ, GM, HOSMAC, INDIA

MS. URVASHI PRASAD, PHP, NITI AAYOG, INDIA w w w.medegatetoday.com Dec 2018

57

POST EVENT

AR. MALA MOHAN, ADG, MES, M/O DÉFENSE

MR. VISHAL INDURKHYA, GM, NORTH ZONE, HOSMAC

than 250professional and academic luminaries such asMr. B.K. Rana (CEO, QAI), Ar. Pradeep Aggarwal (Health Finance & Policy Making, Jaipur), Prof. Lamba (Professor, Royal University of Bhutan),Dr.(Col) H.S. Ratti (Director, r-health), Mr. Vinod Vijayumar (Director, CAAD, Chennai), Ar. Shamit Manchanda (Manchanda & Asso.), Dr. Srikant Mishra (Fortis, Gurugram), Ar. K.K. Mitra (Former Director, MES, Ministry of Defence) and many more.

“This Sangam was the first attempt in it’s kind, targeting the indispensable key issues of affordability and feasibility of healthcare infrastructure for a common man. We are in an era where we need to join hands together to make healthcare affordable at all levelsof healthcare delivery. And what can be a better way to achieve than architecture, design and planning. The main objective of this Symposium was to bridge that gap between the architecture, healthcare and engineering world.”, said Ar. Shruti Gupta, Organising Secretary, HAS Confluence 18, who envisioned this unique need and has dedicated her soul to the cause since past eight years. She bid adieu with a vote of thanks on behalf of both the organisations to all the speakers, panelists, delegates, guests and students for making this event a tremendous success along with all associated partners, LS Power Controls, Kinlong, IP Infotech, Arancia Kuchens, Water Miracle, XAL Tools, C&S Electrics, Prince Piping Systems, Supreme, Dirtt (Modular Hospitals), Calyx (Interior Designers) and Media Partners MedGate Today.

This event provided a forum for stakeholders from all over the nation, who, otherwise, are unable to come together to discuss these issues in depth and at length.

DR. ASHISH K. GUPTA, COO, BOC, INDIA

ER. A.C. VERMA, EXE. DIRECTOR, HTFE P LTD.

DR. (AR.) SONAL ATREYA, ASST. PROF., IIT ROORKEE

DR. SARANJIT BHASIN, HEAD, F/O DENTISTRY, JMI

DR. NEERAJ K. DIPAK, NICU, L.K.HIRANANDANI HOS.

PROF. KHALID MOIN, D/O CIVIL ENGG., JMI

DR. PRANAY K. SINHA, EHS/DOTS, AIIMS

AR. SHIKHA SHARMA, PRINCIPAL AR., GBD, INDIA

58 Dec 2018 w w w. m e d e g a te to d a y.co m

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