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Volume IX | Issue VI | Jan 2019

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Sh. Jagat Prakash Nadda Minister of Health & Family Welfare Government of India

Sh. Ashwini Kumar Choubey Minister of State for Health & Family Welfare, Government of India

Gaurav Malhotra Managing Director, Medicover Healthcare

Dr. Raza Siddiqui Group CEO, Arabian Healthcare Group (UAE)

Dr. Naveen Nishchal Co-Founder, Cygnus Group of Hospitals, Meddo & Chairman - VOH

Indu Bhushan CEO Ayushman Bharat, CEO National Health Agency

Dr. GSK Velu Chairman & MD, Trivitron Healthcare Group of Companies

Suresh Vazirani Chairman & Managing Director Transasia Bio-Medicals Ltd

Dr. Minnie Bodhanwala CEO, WADIA HOSPITALS (Mumbai)

Bomi Bhote CEO, Ruby Hall Clinic

Vivek Tiwari CEO, Medikabazaar

Mr Chander Shekhar Sibal Senior Vice President, Fujifilm India

Mr Rajiv Nath Forum Coordinator, (AiMeD) & JT. M D, HMD Healthcare Ltd

Anjan Bose Founding-Secretary General, NATHEALTH

Dr. Preetha Reddy Vice Chairperson, Apollo Hospital Enterprise Limited

Dr. Jitendar Sharma Managing Director and CEO, AMTZ

Joy Chakraborty Chief Operating Officer at PD Hinduja Hospital

Dr. B K Rana Founding CEO, Quality & Accreditation Institute (QAI)

Naveen Sharma G.M. Operation & Business Development Head, PSRI Hospital

Dr Raajiv Singhal Managing Director, The Evercare Group (UAE)

makers TOP News 2018

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EDITOR SPEAK

TOP News makers 2018 Moment for Medgate Today to Launch Newsmakers 2018 on it's

10 Year th

his is another 'First' in Indian healthcare media. Newsmakers are relevant to any industry or society as they sensitize the people around through their deeds. Healthcare is privileged to have many thought leaders who keep on following their conviction despite many odds. Many of them have proved conventional thoughts or wisdom wrong, and turned out to be a news themselves. As we do have space constraints in this current issue, we are able to feature only a few of them. A common trait that runs through all of the Newsmakers of 2018, is their continued passion to keep on improvising their methods as well as business models despite having achieved phenomenal success in their respective spheres. Another common trait is all of them command considerable admiration in global healthcare community. Overall all of them have showcased Indian healthcare's prowess in Patient Centerity, Clinical Excellence & Management, MedTech Revolution, Start ups Evolution etc. They have made Indian healthcare proud.

As New year 2019 is in progress, it would be interesting to note the surprises sprung up by Newsmakers2018 in coming months. We Wish them all the very best for 2019 and look forward to many more Newsmakers in 2019... Medgate Today is always on the job.

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Contents

TOP News makers 2018

In less than 3 months, 6 lakh people avail treatment under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana

n less than 90 days since the launch, more than 6 lakh people have received treatment under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (PM-JAY). Launched on 23rd September by the Hon’ble Prime Minister from Ranchi, the scheme has provided secondary and tertiary care benefits worth over INR 800 crores to beneficiaries across the country. PM-JAY aims to provide a health cover of Rs 5 lakh per family annually to more than 10.74 crore poor families or 50 crore people for secondary and tertiary care hospitalisation through a network of empaneled health care providers. In addition, around 30 lakh beneficiary e-cards have been generated facilitating access to quality healthcare under the scheme to 3 million poor. Currently more than 16,000 hospitals have been empaneled or are in the process of empanelment under PM-JAY. Out of these, 8,807 or 55 per cent are private hospitals. Shri Jagat Prakash Nadda, Hon’ble Union Minister of Health and Family Welfare, said, “Dedicated to providing the best in class inpatient care for serious illnesses, PM-JAY has performing well so far, two-thirds of the total hospital admission amount of more than Rs. 800 crores has been utilized towards tertiary care procedures or treatment for serious illnesses.” “Cardiology and cardio-thoracic and vascular procedures

Restored Vision of Healthcare ending decade old Policy Paralysis and enabling last mile healthcare

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such as Angioplasty, Coronary Artery Bypass graft and Valve replacement are the top three packages of PM-JAY worth more than Rs. 297 crores and account for 37 per cent of the total admission amount,” he added. Nearly 3,500 Common Service Centres (CSCs), a network of single-window service providers, run by village level entrepreneurs (VLEs), that are a part of the government's rural outreach programme for delivery of digital services, have been engaged for verification of Ayushman Bharat beneficiaries through generation of PM-JAY e-cards across 13 states.

COVER STORY

The health of the people is our real national wealth Shri Choubey: Integrating healthcare for inclusive healthcare 'Health is wealth', is a popular adage. The Mahabharata

composed centuries ago, speaks of 'lavanaam shreyaam arogyam', that is 'of all the pleasures, health is paramount'. But it's an irony that 62.58 percent of our fellow citizens, the children of Mother India, have to pay out of their own pockets for their health and hospitalisation in the dire absence of any health protection scheme. The results are appalling as 4.6 percent of the population are pushed into the vicious cycle of poverty and face untold miseries, mental affliction and indignities. Taking note of the sufferings of the vulnerable sections of the people, visualising its spillover effect over the gross national wealth and having regard to our avowed philosophy - sabka Saath, sabha Vikas-, an article of faith with us, our Government, under the visionary and charismatic leadership of the honourable prime minister, Shri Narendra Bhai Modi, embarked on the path of national transformation, and make India, free from abject poverty, ubiquitous corruption and all pervading despondency-and to make India self- confident, healthy and prosperous, and securing its prestige, glory and legitimate pride of place in the comity of nations. Apart from great many radical policy initiatives by our government, the health sector has witnessed most transformative policy prescriptions and programmatic interventions. We formulated the National Health Policy, 2017 to address the prevailing as well as the emerging challenges aiming to put in place an integrated but robust, affordable, effective, preventive and promotive health care system. All established health care 16 Jan 2019â&#x20AC;&#x201A; w w w. m e d g a t eto d a y.co m

Sh. Ashwini Kumar Choubey

Minister of State for Health & Family Welfare Government of India systems- Allopathy, Ayurveda, Unani, Homoeopathy, Sidha, Prakritik Chikitsa- are part of our health care basket. Instead of the health care systems working in silos, the focus, for the first time, is on integrated health care systems. To widen the Heath care basket, the government is contemplating recognition of 'Acupressure' a part of the ancient Indian system of treatment so that the people may choose the system of treatment which is more accessible, affordable and qualitative and effective. The budget of 2018-19, represented a tectonic shift in the healthcare when the honourable finance minister reiterated our ancient philosophy 'sarve bhawantu sukhinah' and announced the launching of Ayushman Bharat, a significant restructuring of the entire health care system and its efficacious delivery with a view to securing Health for All and Universal Health Coverage. The segmented, sectoral, episodic and fragmented health care model has transformed into a comprehensive, holistic and need based health care system covering in its wide ambit prevention, promotion, ambulatory and palliative health care at primary,secondary and tertiary level. Ayushman Bharat rests on two secure pillars, that is Comprehensive Primary Healthcare (CPHC) through Health and Wellness Centres (HWCs) and financial protection for secondary and tertiary hospitalisation through Pradhan Manri Jan Arogya Yojana (PMJAY). The most ambitious scheme has kick

TOP News makers 2018

COVER STORY

started with a great gusto and unsurpassed optimism as there is tremendous and constant surge in the number of E-Cards being issued. The scheme launched on 23rd Sept. 2018 by the honourable prime minister, is emerging a beacon of hope to the vulnerable sections of the people who had no financial cover and their out of pocket expenses on healthcare was pushing them in the abyss of poverty. It is so enthusing that as on 24th December, 2018, under PMJAY, 32,73,570 E-Cards had been issued, 6,24,880 beneficiaries admitted in hospitals across the country, claims amount of Rs.615.1 crore submitted for reimbursement, out of which the claim amount of Rs.486.0 crore had been approved and rest were under process. The applications for empanelment are rising and so far, out of 58,939 applications, 16,038 hospitals, mostly private, have been empanelled ensuring that the applicant hospitals have the requisite infrastructure and meet the stringent benchmarks so as to assure quality healthcare. It is also quite interesting to note that the average expenditure or claim size is Rs.12,900/. Viewed in this perspective, the annual ceiling of Rs.5 lakh per family per year is quite realistic and adequate. Conscientious of the empirical studies that comprehensive primary health care reduces mortality and morbidity at much lower costs and significantly reduces burden on secondary and tertiary care, and having regard to the fact that epidemiological transition accounts for over 62 percent of premature mortality on account of NCDCs, the focus of the HWCs would be on preventive, promotive, rehabilitative and curative care for Regenerative Mother, New born child and Adolescence healthcare, communicable diseases, non communicable diseases (NCDCs), Ophthalmology, ENT, Dental, Mental, Geriatric care, Palliative care, and emergent emergency situations and trauma services. The HWCs are well equipped with physicians, practitioners of Ayurveda and Yoga, Nursing staff, ASHAs, trained mid level service providers equipped with primary care and public health competencies, besides necessary diagnostics, infrastructure and IT Systems. Our health care is multi pronged but integrated and in adherence to the National Health Policy, 2017. The Mental Healthcare Act, 2017 adopts a right-based statutory framework for mental health care and services. This includes a special clause for women and children related to admission, treatment, sanitation and personal hygiene, restriction on the use of Electro-Convulsive Therapy and Psychosurgery. Moreover and notably, it decriminalises suicides by laying stress on foresight and precursor management. In the area of HIV and AIDS management, we enacted a law in 2017 in

consonance with the the SDG goals to annihilate the epidemic by 2030. India is emulated world wide for the work that we have done and removing the dread that was associated with the disease. TB will be eradicated by 2025 and the current steps derive assurance that the goal will be fully achieved. Through definitive interventions, the prices of essential drugs and implants have come down. Adulteration and spurious drugs are under constant vigil. For control of vector borne diseases, we have an exceedingly alert and responsive institutional mechanism in place, and we have succeeded to curb, control, confine and eliminate the spread of vector borne diseases. I salute our medical scientists, researchers, doctors and paramedics and the administrators who invariably rise to the occasion and display exemplary spirit of service and patriotism and respond to every call of distress. In order to remove regional imbalances in healthcare services and education, we continue to implement the vision of Atal Bihari Vajpayee jee by setting up new AIIMS in different parts of the country as eight more AIIMS have been approved by the Government and vigorous efforts are on to set them up as soon as the State governments offer suitable land. New Medical Colleges are being set up, districts hospitals are being upgraded and the number of MBBS and MD seats are being increased spectacularly to meet the national demand. Prevention is better than cure and therefore, we are laying far greater stress on Immunisation w w w.medgatetoday.com â&#x20AC;&#x201A; Jan 2019

COVER STORY

TOP News makers 2018

under the Intensified Mission Indradhanush especially in the 195 identified districts across the country. Following the strategy of blitzkrieg, we have identified 115 aspirational districts which will give added thrust to boost their health care and infrastructure in general. India has emerged as a global model in many fronts. I had the occasion to inaugurate the BRICS Nurses conference recently. The BRICS Nurses Association has signed a MoU to enhance mutual learning and cooperation. I made it known that the Government of India recognizes that skilled nurses and midwives are critical to healthcare system and health care delivery and the potential role they can play in streamlining the health care services in the country. Recently, I inaugurated (13 December,2018), a three day International Conference at Vishakhapattnam on diagnostic devices and equipments. I made it clear to international investors and suppliers that the Government of India is determined to bring down the prices of diagnostic equipments and procedure and to assure quality diagnostic services while encouraging the Make in India drive. With the setting up of the statutory Food Safety and Standards Authority of India, the science based standards for articles of food and regulating manufacturing,processing and distribution, sale and import are being laid down to ensure safe and wholesome food for human consumption. We conducted a nation wide cyclothon for building health awareness, emphasizing on 'eat right, eat fortified and eat safe' in accord with the Upnishadic wisdom, 'eat what is beneficial, eat according to the season and eat in moderation'. The Government in the Ministry of Health and Family Welfare, under the inspiring and kindred leadership of Shri JP Nadda is also laying focus on health intelligence through the Central Bureau of Health Intelligence (CBHI) under the aegis of Directorate General of Health Services. THe CBHI has launched a National Health Resource Repository project to create an authentic, standardised and update geospatial database of health infrastructure, both medical and para medical workforce including auxiliary services like blood banks, diagnostic labs, pharmacies and many more. Such a periodically updated data repository, fully computerized and web based, capable of being integrated with various other data bases, will help in advance analytics, forecasting, using Artificial Intelligence. For long, there has been a strongly felt need to remove opacity and to streamline and strengthen medical education system. WE have, after holding marathon and extensive discussions with the stakeholders, introduced the Medical Commission Bill in Lok Sabha and, hopefully, the Bill will be passed during the current session itself as we have addressed all major irritants which were responsible for stalemate in Parliament. Another historic initiative that we have taken is to draft a comprehensive new legislation for the first time, namely, the Allied and Healthcare Professions Bill, 2018 The Bill seeks 18 Jan 2019 w w w. m e d g a t eto d a y.co m

to regulate and standardise education, training and services of healthcare professionals, (over 50 Professions), such as physiotherapists, therapists ,nutritionists and lab technologists. I am quite optimistic that the Bill will also have smooth passage in the Parliament. Both the laws, once enacted, will provide a robust and overarching legal framework and go a long way to further strengthen the medical education and medical care in our country. Further, the Surrogacy Bill has been passed by the Lok Sabha during the current session and the Bill is before the Rajya Sabha. With its enactment, commercial surrogacy will be controlled and surrogacy better regulated addressing the allied issues involved. I am quite sanguine and confident that these holistic, integrated and bold-futuristic initiatives will transform the healthcare services and India will emerge globally an emulative model of health care, and we will make India a genuinely prosperous and inclusive nation where there is 'sabka saath, sabka vikas'. *The author is Union Minister of State for Health and Welfare. Views expressed are individual.

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COVER STORY

TOP News makers 2018

The Rising Star Mr. Gaurav Malhotra is the Managing Director of Medicover Healthcare in India of a leading European healthcare group. He has twenty-four years of rich experience in healthcare domain, in leading business and change management across MNCs, start-ups, joint ventures and re-engineering organisations. He has been recognised as 100 Most Impactful Healthcare Leaders by eminent jury at World Health and Wellness Congress. He has been recognised as Top MedTech Leader of India. He has been awarded IMA Medachiever Leadership Award for achieving excellence in Healthcare and has received Leadership Excellence Award from IIM Lucknow. He has recently been awarded Healthcare CEO of the year, Leadership Excellence and Best CEO of the year-Single Speciality. He is a member of prestigious Independent Director's Club, Charter Member of TiE-Delhi, Keiretsu Forum and Mumbai Angels. He is also a Healthcare Council Member of Gerson Lehman Group and a member of Think Tank forum of Society of Human Resource Management. He has served as Managing Director and Chief Executive Officer of Bourn Hall International, Managing Director and Chief Executive Officer of Patni Healthcare Ltd, Founder and Chief Executive Officer of Medfort Hospitals, Business Head-South Asia for Bausch and Lomb and Business Director for Johnson and Johnson Medical. He has done Advanced Management Programme from Wharton Business School University of Pennsylvania. He is an M.B.A. from Xavier Institute of Management and a guest speaker at various reputed forums. He is also a mentor and strategic advisor to many healthcare Start-ups, Private Equity

20 Jan 2019 w w w. m e d g a t eto d a y.co m

investors as well as established healthcare companies.He has won prestigious "Med Achievers Icon of Healthcare 2018" Award for invaluable contribution and iconic work in Healthcare.He is actively involved in supporting various social initiatives.

Medicover is an international healthcare company that helps millions of patients in Central and Eastern Europe, to improve and sustain their health. With over 100 clinics, 4 hospitals and more than 90 diagnostics laboratories across the world, Medicover also partners with more than 3,000 medical centres in 14 countries. The company is one of the largest private sector employers of medical professionals in Europe, providing and coordinating all primary and specialty care, diagnostic testing, hospital services and follow-up care. The clinical and commercial success of Medicover in India is largely attributed to the visionary leadership of Mr. Malhotra, who insisted on providing the highest levels of scientific technology, expertise and patient care to consumers at an affordable cost. One of the reason for his outstanding success was his ability to define the CREDO which is “Why” or “Soul” of the organisation and purpose of existence. “We are committed to achieving superior pregnancy results and consistently delivering patient centric fertility treatment. We will passionately serve childless couples in their journey of parenthood. They are the reason of our existence and we won't

forget that no matter what. We will treat them as we would treat our own loved ones. Mutual Trust and Respect will be our pillar in our relationships with employees. We will create a merit-based organisation and will give our employees equal exciting opportunities to unleash their potential. We will actively engage in social initiatives to make a positive difference in our community. We will ensure we create maximum value for our shareholders and deliver sustainable profitable growth to enable us to further invest in talent development and clinical excellence.”

COVER STORY

TOP News makers 2018

The Healthcare Crusader Dr. Raza Siddiqui

One of the Most Awarded International CEOs Dr Raza has facilitated several collaborations, converging a world-class team of doctors across various specialties, and bringing to the UAE doorstep expertise that has been instrumental in promoting medical tourism in the country. Dr. Raza Siddiqui

Group CEO, Arabian Healthcare Group & Executive Director, RAK Hospital (UAE)

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ith a rich and extensive experience in the healthcare industry spanning over three decades working with leading healthcare institutions both in India and the UAE, Dr Raza Siddiqui â&#x20AC;&#x201C; Group CEO of the Arabian Healthcare Group and Executive Director of RAK Hospital - has become a force to reckon with in the healthcare sector. His astute and unconventional foresight helped give birth to one of the most prominent medical institutions in the northern emirates of the UAE, and since its inception RAK Hospital has progressed by leaps and bounds.

COVER STORY

Spearheaded by Dr Raza and his talented team, the institution has successfully fused premium healthcare with finest hospitality, providing the quality service of international standards to the UAE residents. At the same time, RAK Hospital is increasingly attracting medical tourists, courtesy affordable treatment at par with the West and the expert team of specialty doctors. Dr Raza Siddiqui brings to the table a brilliant combination of innovative technology and clinical expertise from across the world. Starting his career as a management trainee at Lupin Laboratories Ltd, a pharmaceutical company in India and later moving to Ranbaxy Laboratories, he joined Indraprastha Apollo Hospital as Marketing Manager in 1995. His result-driven attitude and successful implementation of many innovative ideas quickly led him to the post of Director Operations. During his tenure, he choreographed the successful launch of the largest corporate hospital in India and was also instrumental in making the hospital financially viable in the first year of operations – recognized as a world record of sorts. As the Executive Director of ETA for luxury real-estate and healthcare, Dr Raza was involved in setting up RAK Hospital, which has fast gained reputation for medical tourism and advanced primary and tertiary healthcare. Additionally, he conceptualized and managed a Dh2.5 billion premium unique lifestyle project located in Dubai in collaboration with international partners such as JW Marriott, IMG Sports Academies, Microsoft and Cisco to facilitate the emergence of a multi-cultural community. Dr Raza’s passion for the medical sector and unconventional approach over the past 10 years at RAK Hospital, has put him at the helm of several novel projects and turned them around into success stories. His contribution has not only reaped rich dividends for the group but for the Emirate of Ras Al Khaimah as well. Since the Hospital’s inception, Dr Raza has facilitated several collaborations, converging a world-class team of doctors across various specialties, and bringing to the UAE doorstep expertise that have been instrumental in promoting medical tourism in the country. Dr Raza’s endeavors include collaboration with renowned orthopedic surgeon from US, Dr William Hodge to launch the revolutionary stem cell therapy for joint issues in UAE; tie up with the Fortis Escorts Heart Institute (FEHI) to bring the best Interventional Cardiology and Cardiac Surgery; opening of representative offices for RAK Hospital in the Middle East and African

countries for medical tourist facilitation; the launch of the RAK Diabetes Centre in Dubai that offers complete management of diabetes; and the specially designed CSR Initiative “NAZAR AYENI”- a mobile eye-screening programme for UAE residents. With a greater vision of preventing blindness Dr. Raza launched this community health program for the Prevention of Preventable Blindness that aims to screen 100 % residents of Ras Al Khaimah over time making it a Preventable Blindness free emirate by 2020. Dr Raza’s mission to bring quality healthcare to the UAE, and for his contribution in shaping UAE’s modern healthcare sector with particular focus on medical tourism has won him respect, acclaim and several awards across the decade. Notably, he was nominated by HH Sheikh Saud Bin Saqr Al Qassimi for the prestigious Board of Directors of Ras Al Khaimah Chamber of Commerce and Industry making him the first Indian to hold such a prominent position. In 2018 alone, both Dr Raza on an individual level and RAK Hospital on organisational level were lauded many times for their achievements and won several awards. Among these, the notable few include Dr Raza’s CEO of the year title by the CEO Club International and Healthcare Excellence, CEO of the year from Indo UAE business forum and Icons in Healthcare, Singapore – 2018. For RAK Hospital, recognition came in the shape of JCI accreditation which it won for the 5th time since 2011, Super Brand Award five years in a row and Health Magazine UAE’s Best Hospital Build and Infrastructure Award and many others. The way forward for RAK Hospital will focus on bringing more emerging technologies and international human resource to the UAE. Moreover, capitalising on the strong trust that the institution has won over the decade among the UAE residents and medical tourists alike, the hospital will be further expanding its base in GCC and African countries through active measures. For example, the hospital plans to cater to more patients looking for bone and joint health, particularly from the GCC countries which will be have access to world-class surgical expertise so close at hand. Similar approach will be applied for eye care, neurology, maternal health and other specialities. Given the scenic and rustic beauty surrounding RAK Hospital, making it an ideal spot to de-stress, the hospital will also focus on promoting its rehabilitation programme for both UAE residents and patients living abroad  w w w.medgatetoday.com Jan 2019

COVER STORY

TOP News makers 2018

VOH ACADEMY Committed to Transform Healthcare Delivery VOICE OF HEALTHCARE: A voice of reason, inspiration & leadership

As a voice representing the demands, rights and aspirations of a diverse crosssection of stakeholders, VOH (Voice of Healthcare) has been tirelessly working for the past 3 years to make healthcare delivery smooth - by addressing the dual challenges of accessibility and affordability in innovative and powerful ways. By blending innovative leadership ideas, the involvement of leading professionals and cutting-edge training experiences, VOH ACADEMY will be taking forward its mission of ushering the rise of healthcare into a top national priority, and evolving into a one-stop hub for concepts, solutions and transformation in the space.

VOH ACADEMY: Serving, healing and growing - together. The Voice of Healthcare Academy – a unique initiative geared at generating rewarding career and employment horizons-is systematically and sustainably bridging the Skill Gap in the sector by empowering a new generation of aspiring healthcare professionals. By bringing a panel of Indian and international healthcare specialists, top notch learning resources and an innovative curriculum (where close interaction with the industry is an integral part of the evolution curve) under one roof, it is engineering a targeted, timely and unprecedented revolution in the space. Areas where VOH Academy will be creating professionals, achievers and leaders by imparting skill and training are quality, leadership, management, business development, marketing, clinical excellence, analytics, IT and automation, operational excellence, outcome based benchmarking, fund raising, Customer Relationship Management, innovation, strategy, digital disruptions, supply chain and healthcare financing. 24 Jan 2019 w w w. m e d g a t eto d a y.co m

industry is changing to improved organisational performance to nurturing innovation to fostering teamwork to networking with international peer groups to forecasting and preparing for new market challenges, VOH Academy is a multi-faceted gateway to growth.

Ready to take a giant leap forward?

Dr Naveen Nishchal

Co-Founder, Cygnus Group of Hospitals, Meddo (Arctern Healthcare) & Chairman - VOH

Get in shape for new careers and opportunities in healthcare industry. Whether you are a student exploring lucrative career avenues, an executive weighing rewarding new routes of advancement or a decision-leader looking to level your organization up globally, VOH Academy offers a launchpad to a new phase of prospects and possibilities. From a rich repository of experiences (courtesy industry veterans) to a firsthand, insider-peek into the way the

VOH Academy is set to launch a suite of hi-impact programs that are custom designed for mid and upper level leaders. Interested individuals and organizations looking to claim ‘First Mover Advantage’ are invited to get in touch in advance. We at VOH academy have adopted a pragmatic approach and leaders from across the industry shall be invited to impart first-hand information and share their experiences to mitigate the challenges. Present leaders will be benefitted as they will have better options among trained aspirants for their business. Our institutional partners will be sharing best practices with our participants and telling them the real stories of challenges and success. India is a growing market for Healthcare Delivery and which keeps on growing till we have alternative arrangements of treatment where hospitalisation is not by required. This vision is still far from reality at least 50 years. We are also collaborating with many national and international universities so that contemporary training can be provided. VOH ACADEMY will help organizations increase management capability by combining the science of business and performance management into specialized programs that enable executives to develop new knowledge, skills and attitudes.

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COVER

TOP News makers 2018 Mission Ayushman Bharat for Health & Economic Security of Indians

STORY

A 24x7 call centre has been set up with toll free helpline no. 14555 to answer a range of queries around PM-JAY from queries on eligibility, nearby empanelled hospitals, benefits under the scheme, to hospital empanelment process among others. the launch of the scheme and has received more than 11 lakh (1.1 million) calls.

Indu Bhushan

CEO, Ayushman Bharat National Health Protection Mission (Government of India) 2019â&#x20AC;&#x201A;wwwww. w.m meeddeggaat eto te toddaay.co y.comm 26 Jan 2019

How has been transition from Director General, Strategy & Policy, ADB to CEO of World's largest healthcare programme? The transition has been quite smooth. With my civil service background and networks, I was able to hit the ground running. Experience of working in other Asian developing countries also helped as I had seen the process of how health insurance/assurance schemes were developed in these countries.

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Technocrat, Economist, Masters in  M ore than 6.34 lakh beneficiaries Healthcare, Civil Servant and long have been admitted in hospitals and availed treatment worth total experience in India and Philippines, How authorized amount of more than Rs. challenging was it to work out blueprint 844 crores under PM-JAY. and launch AB-PMJAY within pressing timeframe of 6 months after mapping Indian  A verage claim size is around Rs. healthcare economics and dynamics? 13,000 Planning a scheme of such ambition and  T otal hospitals empaneled + in scale within a short timeframe was never process is more than 16,000 going to be easy. On top of that, we had Am I Eligible webpage (www.mera. a relatively small team to work with. pmjay.gov.in ) is up and running to help However, I was fortunate to have a team people know their eligibility status. So that was highly motivated, skilled and far more than 39 lakh unique hits have dedicated to the mission, and worked day been registered on this portal. and night to deliver the mandate. Healthcare business is complicated, Is AB-PMJAY an economic phenomenon as technologies do have price cost has taken over quality, I mean NABH tag, economy of scale of these accreditation is incentivised for hospital technologies are very difficult instead of a mandatory requirement? to achieve in the age of frequent No, cost has not taken over quality. In disruptions, would there be margin fact, providing quality in-patient care is cushion to empanelled hospitals one of the main objectives of Ayushman delivering advanced healthcare? Bharat PM-JAY scheme. PM-JAY will Ensuring the supply of services encourage healthcare providers to improve through a wide empaneled healthcare the quality of care and services through provider network is very crucial. standard treatment protocols and incentives States are working to continuously structure. Payment through the private grow their network. sector and beneficiary feedback mechanism  A performance-linked payment will further propel healthcare providers to system has been designed to improve the quality of their services. incentivize hospitals to continuously improve quality and patient safety, What are the latest figures in Ayusman based on successive milestones. Baharat scheme? ospitals qualifying for NABH  Till now 33 States/ UTs have signed the  H entry-level accreditation will receive MoU with NHA to implement PM-JAY. an additional 10%; additional 15%  MoU has been signed with Common for full accreditation. Service Centre (CSC) for beneficiary o promote equity in access, identification and will utilize the over  T hospitals providing services in 3 lakh village level entrepreneurs for aspirational districts will receive an identifying beneficiaries. So far, more additional 10%. than 33 lakh beneficiary e—cards have lso teaching hospitals running been generated through the CSCs, and  A PG/ DNB courses would receive an by Pradhan Mantri Arogya Mitras at additional 10 % rate. empaneled providers  S tates have the flexibility to increase  Personalized beneficiary identification rates up to 10% or reduce them as letters signed by the Hon’ble Prime much as needed to suit local market Minister with family card are in the conditions. process of being sent to all the identified families in the villages and towns across  F urther States could retain their the country. So far more than 7 crore existing package rates, even if they letters have been printed and are on their are higher than the prescribed 10% flexibility slab. way to the beneficiaries’ doorsteps.

This scheme will also change the incentive structure from where services are provided to those who can afford it. More than 50% of our private sector facilities are concentrated in the top 20 cities because that is where people have the paying capacity. That will change. This scheme is trying to break that vicious circle by providing incentives to the private sector to expand their services to in tier-2 and tier-3 cities that do not have paying capacity. This was not being done earlier because of the lack of business opportunities. Even for the public sector it changes the incentive structure. For public sector facilities, patients covered under the Ayushman Bharat scheme will be VIPs. They will bring money with them, which in turn can be used as incentives for doctors and other para-medical workers. It will also provide resources for upgrading infrastructure of public sector hospitals. AB-PMJAY has given a new lease of life to struggling small and medium hospitals across all the tiers, however, to ensure best quality care at these hospitals, what other measures Govt. is planning? A performance-linked payment system has been designed to incentivize hospitals to continuously improve quality and patient safety, based on successive milestones. Hospitals qualifying for NABH entry-level accreditation will receive an additional 10%; additional 15% for full accreditation. Large hospitals are still reluctant to Join AB-PMJAY, citing low rates of procedures, don't you think economy of scale is also factor of infrastructural cost? Large hospitals are not reluctant to join the scheme. Yes, some of them do have a concern around the package rates and we’re working on relooking them and may revise them given the particular economy and context of the state in which they operate. w w w.medgatetoday.com Jan 2019

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TOP News makers 2018 Dr. GSK Velu: Indian healthcare needs more "Velu-addition" Bridging " Medical Technologies & Device" devide between Urban and Rural healthcare.

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What is the breakup in market size for Trivitron between tier 1 and tier 2/3? With the increase in urbanization and the problems related to modern world society, there has been a hike in demand for special care and new age technology infrastructure. This need for the advancement is attracting all the medical manufacturers. Tier 2/3 has a great potential to become a business destination and certainly of high focus for manufacturers like us. The most significant edge Tier 2/3 has over Tier 1 is their cost factor that means economical infrastructure, low service cost, etc. Trivitron manages to maintain the balance between tier 1 and tier 2/3 with prime vision to provide accessible and affordable healthcare products. Have you consciously gone after rural India since you began, instead of focusing solely on tier 1? Why or why not? As a leading manufacturer of medical equipment, it’s our responsibility to extend our services in Tier 2/ 3 cities. In the west, innovation in medical device technology means things to get more expensive but in India innovation has to mean greater access and affordability. Given the dynamic nature of the Indian healthcare market, access to these areas is important. The Indian healthcare delivery environment, especially in the Tier 2 and 3 market segments, requires proper infrastructure and availability of Medical Technology products for Healthcare providers. Access to affordable healthcare is very important in order to bring continuity in patient care through understanding customer needs. The opportunities in these markets require a well-thought-out strategy for market success. Thus we took conscious decision to reach out to rural markets. Others, from Phillips to GE, have tried to go after tier 2/3. They have had limited success. Would you say you've been more successful? With so much diversity in products range and the cut throat competition prevailing into the market, this is quite difficult to mention whose better or who is best. The success of our organization is completely relying on our reach to the customer. Gladly, Trivitron caters a huge volume of business from tier 2/3 cities through direct selling and our channel partners spread all across the country. Regardless, the size of demographic region, tier 2/3 areas has always been a priority market for the organization. Being a domestic manufacturer headquartered in India, we always have the advantage to provide affordable products, quick delivery and active installation services to the healthcare institutions, hospitals, laboratories located in tier 2/3 28 Jan 2019 w w w. m e d g a t eto d a y.co m

regions of the country.The strong Indian brands have strong brand equity, consumer demand-pull and efficient and dedicated channel network which have been created over a period of time.

If you have, then what strategy have you employed to reach rural India? Promoting brands in rural markets require the special dealings. Due to the different social & economic conditions, the personal selling efforts become a crucial factor to play. It is important to clearly define, in the early stages, what you want your rural marketing efforts to achieve. Generally, the rural initiatives of corporate can be classified into:  Tactical efforts to achieve increased sales in specific areas, targeting specific audiences.  Building a strong equity for a brand in rural India. Looking at the ground challenges and the opportunities to the marketers and the manufacturers, it can be said that the future is very promising for those who can understand the dynamics of rural markets and make use of them to their best advantage. Are you bullish on the space now due to Ayushman Bharat? Ayushman Bharat is a game changer, but the way it is going to get implemented we have to wait and watch because the biggest problem which we are facing in the health care industry is lack of proper infrastructure. We lack manpower, particularly doctors, nurses, and paramedical in order to multiply. We are well advanced in cities and towns of the country, but if you go to the village or PHC level we are actually lacking infrastructure of people, equipment's, processes and operate at level trainings. For making Ayushman Bharat successful, the need of the hour is to build proper infrastructure. Thus in my opinion, public-private partnership will play an important role in this segment. Ayushman Bharat is good initiative as its intent is to cover the entire country through an insurance program, but the real impact would take some time and particularly domestic medical device the industry has to play very, very integral part for success of this.

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We have innovative product offerings, a powerful vision and a deep commitment to make clinical diagnosis affordable and accessible to more people

The year gone by has been memorable for the Indian healthcare industry with a lot of new initiatives being planned by the Government of India. With the objective of promoting a more comprehensive healthcare delivery system, numerous measures are being implemented through the Ayushman Bharat scheme. Further, to ensure delivery of quality healthcare at all levels and optimum utilization of healthcare human resources, Indian Council of Medical Research (ICMR) has devised the first list of Essential Diagnostic tests based on WHO’s guidelines. Other notable announcements include introduction of Indian Certification for Medical Devices (ICMED) - India’s own Quality certification, Make in India 2.0 and standardization of the public procurement process through the Government e-marketplace (GeM). A lot for the industry to look forward to in 2019!

Reaching out to the masses with essential diagnostics

Suresh Vazirani

Chairman & Managing Director Transasia Bio-Medicals Ltd.

In 2018, Transasia Bio-Medicals Ltd. expanded our reach, in an endeavor to cater to the healthcare needs of 1.3 bn Indians. This enabled us to offer innovative products and solutions to primary health centres across 5000 tier I - IV cities, towns and villages, including the farthest north-eastern regions of Nagaland and Sikkim. One of the most notable installations has been Transasia’s ‘Made in India’ automated clinical chemistry analyzer, in Pangi Valley - a remote and rugged area of Himachal Pradesh. Limited infrastructural development, a treacherous mountain pass and hostile climatic conditions have made this area inaccessible to many! Further, our team of 300+ technical service experts and 400+ after-sales professionals, the largest in the industry, leave no stone unturned to ensure equitable access to quality diagnostics. Transasia’s instruments were also preferred by the Rajasthan Government while inaugurating its mobile van offering ‘basic diagnostic testing on wheels’ to people in the moffusil areas. Moving down south, close to 50 pathology laboratories across Kerala are now equipped with Transasia’s advanced, stateof-the art instruments. Run by Consumer Federations’ Apex, ConsumerFed, these labs offer economically priced, basic as well as advanced testing to its people.

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TOP News makers 2018 On one hand, while Transasia is aiding access to basic diagnostic tests in remote areas, its high-end instruments are being trusted by reputed lab chains and hospitals in urban areas having a high workload. XL-1000, the fully automated, random access clinical chemistry analyzer has recently found its place in four civic hospitals in Chandigarh. Besides this, we also actively partnered with the Government of Tamil Nadu to equip the CEmONC (Comprehensive Emergency Obstetric and Newborn Care) centres with 2600 superior quality TSH kits. TSH is an important parameter evaluated pre and post conception and in new-borns. More than 2.26 lakh patients in around 15 remote towns and villages of Tamil Nadu are set to benefit from these kits. In just last year, Transasia has installed over 10,000 analyzers across the country! That takes our total installed base in India to over 55,000 analyzers on which over 150 crore blood tests get done every year.

Bringing in the latest technologies

Year on year, Transasia continues its pursuit to offer total solutions in lab automation. We recently introduced Laura XL, the latest technological advancement for affordable urinalysis. The system incorporates artificial intelligence for fast and accurate diagnosis. 2018 also witnessed the launch of CUBE 30touch, a touchscreen analyzer designed to determine the Erythrocyte Sedimentation Rate (ESR) on high volume whole blood samples. Transconnect is another step in offering seamless after-sales service. A cloud based system it allows our team to respond to customer queries through remote access in the shortest time possible.

‘Making in India’ for the World

As India’s leading IVD Industry with a legacy of almost four decades, Transasia has been at the forefront in terms of offering total solutions in clinical diagnosis, with a unified focus on achieving ‘Health for All’. To start with, we have always believed in the power of Make in India, something that is evident from the fact that Transasia has been manufacturing diagnostic products in India since the early 1990s! With a vision of creating a ‘Healthier and Happier World’, Transasia has been successfully combining world-class technologies from our global subsidiaries with efficient, low cost manufacturing in India to meet the diagnostic needs of India and the other emerging markets. In 2018, we were conferred the ‘India Medical Devices Export Company of the Year’ award by the Ministry of Chemicals & Fertilizers, Government of India. I am proud that Transasia is contributing to the growth of the economy through its exports to over 100 countries. Further, we were adjudged the ‘Brand of the Decade’ by ERTC Media Pvt. Ltd. in the category of Medical Devices.

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Boosting production and empowering youth

Our greenfield manufacturing plant at Sikkim became fully operational in 2018. The first in this region by an IVD company, this facility is already boosting our manufacturing capabilities and empowering us to reach the remotest regions. This has also created a huge employment base for several youth in Sikkim, who would otherwise have had to move far away from home. Yet another notable achievement for Transasia was the accreditation of our manufacturing facilities with Indian Certification for Medical Devices (ICMED), the first home developed international certification! While manufacturers invest a considerable amount of time and finances in pursuing an USFDA or CE validation, ICMED is set to reduce costs and lead time, further incentivizing ‘Make in India’.

Bridging the skill gap

The Make in India initiative has the capacity to turn tables for the Indian medtech industry, with medical devices and diagnostic services being considered as a value enabler of the Ayushman Bharat scheme. Though a lot needs to be done by policymakers in terms of changing certain regulations, and deterring imports, the onus is also on the industry to contribute to this initiative, in ways more than one. For instance, enhancing and utilizing the skillsets of healthcare professionals collectively lies with the medical institutions, government agencies and health technology suppliers. So, we at Transasia have been focusing on continual infrastructure development, innovations in technology as well as development of our employee capacities. An effort in this direction is the setting up of the Erba Institute of Medical Lab Technology in Panchgani, Maharashtra. Affiliated with Bharat Sevak Samaj Vocational Education, Chennai, the institute offers certified diploma courses at concessional rates, in order to empower the marginalized youth with a rewarding career pathway.

Fostering technological expertise

Besides this, through 2018, Transasia has continued to support industry-academia collaboration by means of scientific seminars and CMEs, especially in the Tier II, III and IV cities. As 2019 dawns on us, we look forward to yet another year of fostering technological expertise to develop simple yet sustainable, futuristic products, dedicated to offering uncompromised services to doctors and in turn their patients for accurate and timely treatment. Founded in 1979, Transasia offers solutions and products in Biochemistry, Hematology, Coagulation, ESR, Immunology, Urinalysis, Critical Care, Diabetes Management, Microbiology and Molecular Diagnostics. Transasia's main focus remains on the emerging countries in Asia, Africa, the Middle East, Latin America and Eastern Europe. In Asia, besides India, it caters to the diagnostic needs of countries such as Thailand, Indonesia, Philippines and Vietnam. Through 14 overseas acquisitions in countries as varied as the Czech Republic, Germany, U.K, France, Italy, Russia, Turkey and the USA, Transasia serves millions globally. w w w.medgatetoday.com Jan 2019

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TOP News makers 2018

The Iron Lady of Healthcare with Soft Heart for have nots Dr Minnie has over the years has dedicated herself to and perfected the charitable healthcare though industry is still struggling to decode affordable healthcare Presently working as CEO of Nowrosjee Wadia & Bai Jerbai Wadia Hospitals, Parel, Mumbai Received more than 70Awards in her career for various categories for the Healthcare organizations she has worked with. Dr. Minnie has played an instrumental role in bringing a positive transformation at Wadia Hospitals and shown compassion towards the underprivileged Women and Children of our Nation. . With her dedication, excellence, innovation and sustainable vision Wadia Hospitals being charitable semigovernment organizations are providing quality, safe and affordable healthcare at par with top corporate hospitals to the underprivileged Women and Children of our nation. Dr. Minnie Bodhanwala is presently managing two hospitals with 830 beds, with the staff capacity of almost 1800 including medical, paramedical and administrative manpower.Dr Minnie is also the advisor to the Chairman of Wadia Group for CSR activities, advisor to Impact India foundation, advisor to the Modern Education society which operates 7 colleges in Mumbai and Pune, Advisor for Britannia Nutrition foundation &Sir Ness Wadia Foundation. Holding Directorship at Bombay Dyeing Mfg & Co. Ltd, National Peroxide Ltd and the Bombay Burmah Trading Corporation, Ltd. With her help the state have been able to achieve high standards of healthcare in our region and cater to the underprivileged people from all over the country and abroad. Due to her efforts our region proudly hosts the largest NICU in the country with 155 beds, the Paediatric hospital caters to more than 30 sub specialities, thus providing comprehensive treatment to children under one roof, also she has looked minutely into the health needs 32 Jan 2019 w w w. m e d g a t eto d a y.co m

European Medical Association awarded Dr. Minnie Bodhanwala as the best “Healthcare Expert” at the Europe Business Assembly event in Dubai.

Black Swan Award for Women Empowerment by Maneka Gandhi– Asia One Awards 2018

"Care Health" must be promoted over "healthcare" in larger context of India's health security

Dr Minnie Bodhanwala for achieving the Prestigious Brand Impact Award - 2018 at Dubai for Providing World Class Socially Responsible Health Care Solution

Dr Minnie Bodhanwala for winning the "Social Impact Award" 2018-2019 for providing Affordable Healthcare Services to all Sections of the Society.

of the community by catering to people with rare health conditions which are often ignored by other health players as these health conditions do not earn much revenue for them or these patients are extremely poor and cannot afford expensive treatments. With her efforts Wadia Hospitals have a dedicated nodal center for Clubfoot treatment in Maharashtra, a dedicated clinic for Cancer, Malnutrition, HIV, TB, Epilepsy,

Dr. Minnie Bodhanwala CEO, WADIA HOSPITALS (Mumbai)

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“Power of Women Award" Always Helping Hand" of Maharashtra Awarded by Eknath Shinde “The Mother of Orphans”

The Conjoined Twins separated in 2013 celebrating 5th Birthday at Wadia Hospitals with Dr. Minnie Bodhanwala

At Little Hearts Marathon 5th Edition

Felicitating the Parents whose children fought from Cancer by Actor Kunalkapoor at Wadia Gold Cup

FREE CARDIAC SCREENING CAMP from 13th to 18th August 2018.

Occupational therapy etc. Recently the Hospital has also started with a clinic for children suffering with MDVI which is one of a kind initiative in this region. She has also set up IVF center for the poor patients who cannot afford expensive treatment. The hospital caters to more than 3,00,000 patients every year.

Celebrating GO BLUE Theme at World Children’s Day at Wadia Hospitals in association with UNICEF subject to eradicating malnutrition from the society

expensive surgeries by collecting funds for them. With the success of the 5 editions of LHM, the hospital started with a dedicated cardiac surgery center for disadvantaged children. Further to that Bone Marrow Transplant Set up is also establishedbenefitting the underprivileged of the Society.

Dr. Minnie Bodhanwala has contributed in a strong way for development of Public Over the years she has arranged Health in Maharashtra and beyond. several medical & malnutrition camps in the rural areas and She has initiated education programmes projects which have Equal distribution of the underprivileged been approved by health services is as for of our nation for Government of India important as equal empowering them. Dr. under 35AC scheme. Minnie has played a The project dedicated distribution of wealth key role in establishing towards mobile health a strong foundation for in rural areas and towards women and child healthcare in community projects in dental health rural, semi urban and urban areas are of for Impact India foundation by UNDP, UNICEF and WHO for their“Hospitalgreat service to the community. Every year thanks to her vision the entire on-Wheels” project. community comes together to participate in the Little Hearts Marathon(LHM) which is a social event and initiative of Dr. Minnie to engage the community and help spread awareness for prevention of cardiac diseases in children and also help the children who suffer from Cardiac diseases and cannot afford

Dr. Minnie is also a Principal Assessor with National Accreditation Board for Hospital & Healthcare Providers (NABH), Internal Auditor Joint Commission International (JCI), Internationally recognized auditor for ISO 9001 & 14001 and additionally she has a Master Black Belt in Six Sigma.

IVF Centre of Wadia hospital, Mumbai becomes the first ART centre accredited under QAI's ART accreditationprogram. Presenting the accreditation certificate. Quality & Accreditation Institute w w w.medgatetoday.com Jan 2019

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TOP News makers 2018

STORY

Effective Leaders

get their team members to dream big and provide the resources and impetus to get them to fulfill their dreams

ailing from Pune itself, I completed my degree in Mechanical Engineering and Management. I was later awarded a scholarship by the World Trade Organisation (WTO) for studying International Trade in Rotterdam, Holland in 1985. I have been in the service industry for close to four decades and worked at General Electric, U.S.A. and Tata Motors before joining Ruby Hall Clinic. I soon realised that innovation is my first love and using innovation to change the lives of the people around is a mission I was ready to accomplish. Management is at the intersection of things, people and money. In other words, your technical skills will help you handle a future

management role, but you'll need to develop key soft skills to deal with the people and a big-picture organisational perspective. And this was a challenge I was ready to undertake at this institute. I believe my previous experience helped me break out of the minute details that I was used to working with and helped me see things from a higher perspective. I have tried my best to place Ruby Hall Clinic on the path to holistic development. Be it educating nurses and doctors with acclaimed academic programs to teaching all ranks of the staff the use of technology and prize-winning flexible HR policies. After all, you don't build a hospital, you build people. And then people build the organisation.

What encouraged you to start your Business/ Profession?

What type of struggles/problems did you face in your life?

It was in the year 1997 when I left as Vice President at General Electric. U.S.A. on the insistence of Late Dr. K. B. Grant who advised me to return to my roots. With close to three decades in the service industry including a fifteen-year stint at 'TELCO, I sought a new beginning, venturing into the fast-paced world of healthcare would be a new challenge. While earlier, most hospitals appointed doctors at the management level, it was our founder - Late Dr. K.B. Grant's exemplary vision to use international management skills to transform Ruby Hall Clinic into one of the most sought-after institutes in the medical fraternity. In fact, at that time I was the only professional CEO to have joined a hospital. For a number of years, hospitals were run by doctors using the same time-worn strategies and protocols. But things have now changed for the better. CEOs are now professional and master a series of new skills. They are expected to understand the continuum of care, from inpatient to physician offices to ancillary services to technological advancements, pharmacy and educational initiatives and are capable of bundling it all around providing excellent service at reduced cost.

The need to upgrade in terms of technology has always been a problem we have tackled head on. Competition in this sector has been driven very much by cost and by being the lowestcost provider. But low costs don't necessarily equate with great outcomes or great quality. The rising demands for healthcare, as a result of ageing populations and soaring demand from a newly enriched emerging economy such as ours, means that considerable strain is being placed on us as a hospital. From new life-saving medication to the latest revolutionary medical equipment, we are doing everything in our stride to maintain our 'patient comes first' policy. Over the last few years, healthcare costs are rising making it vital that something is done to ensure that everyone is able to have access to the best medical services. Fortunately for us, the technological revolutions that are occurring within the industry have in turn helped us turn our obstacles into pinnacles of success - be it the da Vinci Robot, High resolution digital PET Scanner, the Digital Spect CT machine, or True Beam Linear Accelerator or even Virtual Clinics. This has further strengthened our commitment to provide the highest standards in patient care along with world class equipment to the common man.

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What are the biggest risks you have taken to achieve your goal? It was Dr. K. B. Grant who laid the foundation of a strong legacy, and I gave it my all to carry his legacy forward. Thus began a period of regeneration and new beginnings for the institute. From a two-bedded nursing home in the heart of Pune, we have grown into a 750-bedded multi-specialty medical centre including a 130-bedded unit at Wanowarie, a 100-bedded unit at Hinjawadi with over 3000 working employees. This is besides the 24 peripheral centres across the state of Maharashtra. One of the biggest risks we took was the foundation of a branch at Pune's southern-most area in 2013. Keeping in mind that medical tourism is a key development area and Ruby Hall Clinic has been receiving over a thousand patients per year from across the globe, we launched the Wanowarie unit in 2013. Dr. Grant's vision to establish a unique boutique hospital for high-net worth individuals (HINIs) and foreigners

How did you identify the opportunity in the market? For us, an opportunity to expand meant more than just adding doctors to our line of credit. Hospitals' traditional approach to expand market share was centred around the notion of "heads in beds," or how many patients were present in the physical hospital facility or on the hospital property. This included hospital discharge volume, emergency room visits per year, newborn deliveries and bed occupancy rates. Our modern principle of population health – providing healthcare instead of sickcare – is quickly antiquating this type of approach. By identifying submarkets – be it in Wanowarie (an area focusing on all-round health), Hinjawadi (an area where IT ailments took control) or even Kenya (where providing medical treatments to one and all is important) we tailored our services and delivery models to match the population's distinct healthcare needs. Depending on an array of demographic variables, we kept our eyes and ears open at all times becoming the preferred destination for medical conditions not just in India, but also internationally.

Awards & Acknowledgment. brought about the concept of 'comfort with care. We are credited to be one of India's first Gold rated LEED certified, green medical facilities boasting of satisfaction factor of ninety-percent of our patients, which is rare in the current medical scenario. Following this, we pushed ourselves to soar higher in 2016. Years of planning, construction and designing every minute detail came in to fruition in the form of Ruby Hall Clinic Hinjawadi. Located in the IT hub of suburban Pune, the satellite medical institute became the first holistic healthcare provider in this area. In alignment with the gleam of technology exuding from the IT giants it is surrounded by, the hospital's charcoal grey structure reflects the perfect amalgamation of healthcare and technology. In the same year, we further strengthened our presence in international waters placing Ruby Hall Clinic on the global map. Despite its breathtaking natural beauty, we realised Kenya faces a number of serious problems - one mainly being poor healthcare. For most Kenyans, medical care is a life-and-death struggle. Keeping this in mind, we decided to save the lives of a number of medically-starved patients with the launch of a new 400-bedded facility. This multi-speciality centre is known as Ruby Hall Clinic - Nairobi is under construction.

O utstanding Zoroastrian of the Year by World Zoroastrian Chamber of Commerce  8 NABH Quality Certificates awarded to Ruby Hall Clinic B est Companies to Work For 2009 &. 2012 - Ranked 1st amongst Hospitals T he Best Medical Tourism facility in India 2012, by President of India, Smt. Pratibhatai Patil.  " International Centre of Excellence for Bariatric Surgery" by the Surgical Review Corporation, USA G lobal Centre of Excellence in Cardiology by the American College of Cardiology in 2014 A warded First Prize for Energy Saving by MEDA in whole of Maharashtra - Commercial Building category in 2008-2009 & 2011-2012 A warded Best Hospital to work for in India by The Economics Times in 2012 A warded Best Hospital to work for by AHPI in 2016 T he Best Energy Conservation & Management Award 2012, 2013 & 2015 by CIl

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Mission

Healthcare Ecosystem’s Integration with Affordable & Accessible Healthcare

Mr. Vivek Tiwari Founder, and CEO, Medikabazaar

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Vivek Tiwari, the affable CEO of Medikabazaar has revolutionized the way medical establishments procure medical supplies. By integrating technology with procurement, Medikabazaar has made the supply chain of hospitals’ more transparent and streamlined, something which conventional purchase models failed to achieve. With a digital catalog of more than 100,000 products, the company is enabling hospitals to purchase efficiently, thus making healthcare more accessible and affordable.

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TOP News makers 2018

edikabazaar set out from a one room office in 2015 with a missionary zeal and dynamic leadership of Vivek Tiwari who had successful leadership stints in leading MNCs earlier wherein he realized the acute necessity for an organized and fast procurement system in a highly unorganized and fragmented Indian healthcare industry. He also meticulously mapped approximately 20-30% inflated medical supplies cost due to the presence of intermediaries in supply chain thus further compounding the unaffordability of healthcare services. There was no earlier relevant precedent or reference to follow. It was a journey fraught with huge risk that could have cost a lot to this IIM graduate in his mid-30s. Unfazed, he decided to chart out his own path and destiny with his conviction and belief in this endeavor having far reaching implications for Indian healthcare. Vivek, while preparing for his healthcare entrepreneurial journey, was guided by his earlier and rich experiences across various industries comprising of global organizations in healthcare, FMCG sectors and other Indian conglomerates. Insights gained from working in multiple industries contributed to the significant success of his healthcare startup. Vivek’s efficient execution of growth strategies, coupled with effective man-management, made Medikabazaar into one of the fastest growing, trusted and admired brands in the healthcare industry in 2018. The idea of Medikabazaar in Indian healthcare is so powerful that it made some industry observers coin a new term, “Mid-level integration,” a management thought disruption. This integration helps Medikabazaar customers to shore up their middle line largely based on procurement, supply chain and inventory management, therefore, extracting the best and timely value of their financial resources by enabling better micro-management. The jury is out and reflects in strong integration of affordable procurement, rather acquirement with affordable medical delivery by healthcare providers. Medikabazaar has also emerged as the biggest integrating factor across the flora & fauna of the healthcare ecosystem. The company’s target customers are small, medium, and large hospitals, clinics, medical research institutions, and diagnostic centers. It has 100,000+ medical devices and consumables from more than 5000 manufacturers. Medikabazaar also furthers the objectives of Ayushman Bharat of affordable and available healthcare as the company aims to empower all healthcare providers, access to affordable medical supplies as per their requirements. Vivek, a true visionary, decided to introduce the best medical technologies across the globe to the Indian market to enable the country’s healthcare establishments provide appropriate diagnostic and treatment solutions to emerging complex medical problems. A vision comes with its own set of challenges and possibilities. Vivek has been working throughout the year on his pet project of AI & ML driven healthcare procurement, probably the

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first of its kind in the world. The challenges of predictive procurement analysis are huge as healthcare services are compulsion and not consumption based, hence they don’t follow any linear patterns. However, initial pilots have been quite revealing and successful and would be nothing short of a tectonic shift in global healthcare procurement. As a strong votary of advanced Medtech systems, Vivek has aligned Medikabazaar with Andhra Pradesh Medtech Zone Limited (AMTZ), an emerging global leader in medical technologies, to promote Indian MedTech across the globe. He considers global exchange of medical technologies as an integral part of Affordable Universal Healthcare Coverage. His action plan for 2019 is:  Enhancing the coverage of pin code destinations from 20,000 to 35,000 for better healthcare accessibility  Connect with 50,000 hospitals  Enrolling more domestic and international vendors with Medikabazaar with a twin objective of promoting vendors of quality medical products irrespective of their sizes thus giving them a level playing field as well as enriching buying experience of domestic and international customers  Sharpen focus on international customers to cater to growing supplies requirements from global buyers  Launching AI &ML driven procurement tool to help buyers have better control on their purchase and inventory  Design and implement a vendor education and engagement program to help them in achieving cost-efficiencies and reducing wastages  Seek more VC funding to expand domestic and global footprints  To scale up MedikaRecycle, and help its customers liquidate their locked, non-performing medical devices and surplus inventories and realize better value thereof Last but not the least, launching more customer interaction and engagement programs to ensure Medikabazaar stays just a click away for their various medical needs 

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TOP News makers 2018

Fujifilm One of the Leader in Rediology & Imaging Device Sector Fujifilm’s renowned digital image processing expertise, including Dynamic Visualization, optimizes image display

Fujifilm is one of the leaders in diagnostic imaging and information systems. How would you summarise your contributions in Radiology and Imaging field? Our products are best in terms of image quality. Major difference is quality and reliability of our products. We have CR (computed radiography), DR (digital radiography) and digital mammography and Synapse PACS (Picture Archiving and communication system). We have over 1,20,000 CR (computed radiography) systems installed worldwide. In India alone, we have 30,000 CR & Imagers installed.

Mr Chander Shekhar Sibal Senior Vice President, Fujifilm India

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We have done digitalization of X-Ray rooms across nooks and corners of India through PPP with KRSNA in Assam and Himachal Pradesh and these sites are connected through teleradiology for immediate reporting.. List out your innovative products and solutions on Radiology and Imaging front. Tell us some significant features of some of them. Fujifilm India Pvt Ltd, a pioneer in the development and application of imaging and information innovations to healthcare technologies, had partnered with different institutes all over India for the installation of its 50 Micron 3D Mammography machine - a highly advanced breast cancer diagnostic machine that has made early detection of breast cancer a reality for women. Fujifilm’s ‘FDR Smart F’ which is a highquality Digital Radiography system that delivers a user-friendly, smart workflow for busy imaging centers. This flexible DR solution saves space and simplifies installation costs by eliminating ceiling height requirements and construction costs associated with overhead / ceiling-mount x-ray systems. The ‘Fujifilm FDR Smart F’ features an ergonomically designed floor mounted tube stand to provide lighter and smoother movement for faster, more efficient workflow. It offers a choice of a four-way floating tabletop and a six-way elevating table, making it flexible for patients of all shapes and sizes. A wide variety of exams can be performed using the optional tilting wall stand. Nonambulatory patients can be easily imaged in the seated position. The unique rotation bucky design helps avoid the risk of Flat Panel Detector dropoff and the rotating bucky also helps to image the patient horizontally or vertically (in chest bucky) and longitudinally or tranverse manner in the table, with a 14 x17 detector itself without the need for 17 x17 detector. The Grids also can be

easily removed to meet different exposure requirements. The system offers host of advanced features like Automatic Exposure Control (AEC), DAP, Image Stitching, Cassette tracking, tilting wall bucky etc., so that customers can choose the features based on their requirement. The High Frequency Generator (40 / 52 / 68 / 82KW Variants) offers accurate power output. Depending on the customer budget, they can choose single or dual detector configuration with options of CSI / GoS Detectors. The Detector size (like 14 x 17 or 17x17) and wired / wireless configurations can be customized flexibly as per the user requirement. Fujifilm’s renowned digital image processing expertise, including Dynamic Visualization, optimizes image display based on recognition of contrast levels throughout the entire exposure field. Overall, Fujiflm’s FDR Smart F is a great DR solution that offers efficient workflow and throughput with excellent Image Quality without any compromise and can suit different budgets and requirements of customers. Shed some light over Synapse Enterprise PACS. What latest innovations have been made on this front? FUJIFILM Synapse is our one-stop shop. With an integrated mammography, RIS and PACS solution, high end FDA approved 3D post processing applications cater to entire hospital departments right from Radiology, Cardiology, Surgery , Orthopaedics, Neurology, Urology, Dental and Maxillofacial , Podiatry , Forensic Science for Virtual autopsies . We have fully trained clinical and dedicated IT professional’s support team. Fujifilm offers a comprehensive approach to PACS customers. Synapse product range have very unique feature which enables Multi Site

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hospitals and diagnostic centres to use the interconnected workflows and imaging needs. Tele radiology comes as a default component in our Synapse PACS RIS offering. Fujifilm provides obsolesce protection for software under CME which is one of the best attributes of our approach. Brief us about the recently launched product, ELUXEO 7000 Series for early detection of gastrointestinal (GI) cancer. Early detection is the key to success in any kind of cancers. If it is detected early at first or second stage then patient can be treated cost-effectively. Early detection increases life span of the patient. If cancer is detected at third or fourth stage then the cost of treatment goes very high and it becomes fatal at Times. In India major problem is late detection of cancer. More than 50 per cent of the patients die within one year of detection of cancer in India. It is Because of late detection. Here we have new technology for targeted biopsy and early alarm, then up to a certain level Treatment also possible if cancer invaded up to submucosa (second layer of gut wall). We recently launched a red dot awarded design Endoscopy system (ELUXEO – 7000 series), which is the first its own kind of system in area of flexible endoscopy loaded with 4 different color LED lights (Blu, Blue violet, green & red), to get white light all lights are channelized in single path (Technology called as multi light), Lights play vital role here, we takes short/narrow wave length light to get micro surface pattern, BLI & LCI are unmatchable feature allows clinician to detect the growth early, which helps to save the life. We are into the very highend systems with very high resolution scope with (Blue Light Imaging - BLI) and linked color imaging (LCI). These systems go inside the body and give high resolution images to detect cancers at very early stage. This is useful for all types of Gastro cancers including stomach cancer and colon cancers. Then we have CR system. We have range of systems to detect cancers at early stage. Not only that, after screening, advance detection, staging comes, we have

Endoscopic ultrasound system developed by FUJIFILM in-house with the best EUS scopes with shorter rigid portion reduce patient Trauma, allow doctor ease of working and maneuverability. Fujifilm has installed Amulet Innovality at several healthcare centers across the country. Why is it touted as future of mammography? Fujifilm India Pvt Ltd, a pioneer in the development and application of imaging and information innovations to healthcare technologies, had partnered with different institutes all over India for the installation of its 50 Micron 3D Mammography machine - a highly advanced breast cancer diagnostic machine that has made early detection of breast cancer a reality for women. Fujifilm’s advanced tomosynthesis technology reveals the internal structure of the breast thus simplifying the detection of lesions that gets overlooked in a routine mammography.

Fujifilm is focusing on the Full Field Digital Mammography market and taking proactive steps to improve the early detection rate by conducting symposiums and spreading awareness. FFIN conducted a symposium in Delhi withBatra Hospital, Mumbai with NM Medical Center, Chennai with SRMC, Kolkata with Peerless Hospital, Vishakhapatnam with Vijaya Medical Center, Shimla with Indra Gandhi Medical College and Aurangabad with Government Medical College followed by press conference to generate the awareness about the cause. In our continues effort to generate awareness about this noble cause, we have tied up with PINKATHON (women Marathon) as a “Wellness Partner” and educate the women of the country that how early detection saves life. We are installing mammography units in mobile vans to generate the awareness to the masses and screening women with potential risk of breast related diseases, one such example is Indian Cancer Institute at Delhi.

To generate the awareness we also conduct patient awareness programs in association with hospitals like Tata Memorial Centre ACTREC , NM medical Mumbai, Action Balaji cancer hospital Delhi, SRMC Chennai, Shankra Cancer Hospital Bangalore. We also launched the clinical case study book on digital mammography titled “Identifying Breast Cancer with 3D Tomosynthesis” written by Dr. Shilpa Lad from NM Medical Mumbai. How do you analyse market of Radiology and Imaging in India in terms of huge opportunity and challenges? The Indian device industry is growing at fast pace. We don’t have much equipment infrastructure in our hospitals especially at the Government hospitals. Less number of Doctor, Nurses, Technician and paramedical staff. We need to see how best we can utilize the existing facilities to nurture the talent. Increase of efficiency and quality of healthcare institutes. The Government is tying up with private companies through PPP to provide equipment, services to people. There are huge requirements due to range of factors. We have very less number of radiologists or doctors currently. Only 10,000 radiologists are catering to huge population of India. Fujifilm is committed to provide quality system and digitalization and PACS for teleradiology to be partner in Ayushmanbharat. There is immense requirement of quality solutions which can provide healthcare to 125 cr population. We have the problem of less infrastructure in rural area, 70% of people are getting only 30% of skilled infrastructure. We require tele-radiology, digital solutions so that patients don’t need to travel to radiologists. Rather through images patients can be monitored and treated. The Government has also come up withAyushman Bharat Yojna under which Rs five lakh insurance will be given to underprivileged people (10 crore families) who are below poverty line. This will increase the paying power of the patient. With this new system in place, the poor people can avail tertiary care. ‘Modicare’ will improve healthcare delivery by empowering poor to get tertiary healthcare facilities. w w w.medgatetoday.com Jan 2019

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TOP News makers 2018

STORY

Mr Rajivnath:

The Mountain Man "

of Medical Device Industry

Mr Rajiv Nath

Forum Coordinator, Association of Indian Medical Device Industry (AiMeD) & JT Managing Director, HMD Healthcare Ltd.

Contribution to the Industry and Society We have partnered with Govt. of Andhra Pradesh and helped them establish Andhra Med Tech Zone (AMTZ) Medical Device Park at Visakhapatnam,Kalam Institute of Healthcare Technology for accelerating indigenous development of Medical Devices & IBSC – Indian Biomedical Skill Consortium for Certification of Biomedical & Clinical Engineers. We are delighted and in highspirits to be a part of the newly established National Medical Devices Promotion Council which will provide an impetus and boost Indian medical devices manufacturing industry and support 40 Jan 2019 w w w. m e d g a t eto d a y.co m

the Make in India impetus for medical devices in India. AIMED had been seeking a council for thedevelopment of Indian medical devices for quite some time. We look forward to new opportunities to contribute in Nation building bybuilding a strong Indian medical device industry which is of utmostimportance to address our National Healthcare Security Concerns &Economy. “We have requested to initially table six items on the agenda related to the medical device regulatory framework. They will include trade margin rationalisation to protect consumers from exorbitant pricing and restrictions on import of second-hand medical equipment till we have robust regulations to ensure calibration and patient safety.

Change Agent and Management. AiMeD has been seeking regulations for medical devices for many years to address Patients Safety Quality related concerns and also Consumer protection to address pricing concerns of access to affordable Medical Devices. We have been seeking a separate medical device law and a separate medical device rulebook and a separate regulatory framework, separate from medicines and drugs for many years now. This year the government did introduce a separate medical device rulebook but it is still under the existing Drug Act which is a misfit. Two years back we were promised that a separate Act will be coming out but we have not seen any consultation with stakeholders

on the draft that was created by the Ministry of Health. India needs to regulate all medical devices and not item by item as is the constraint under DCA. In the absence of sector-specific technical regulations for medical devices, the BIS (Bureau of Indian Standards) Act can be used to regulate all devices at one go, for starters. The National Accreditation Board of Certification Bodies is already accrediting certification bodies for Voluntary Quality Assurance Indian Certification for Medical Devices (ICMED) certification under a QCI-AiMeD Scheme. Incentivising ICMED certification by MOH&FW will help manufacturers in capacity building for voluntary compliance to quality, thereby ensuring global competitiveness to enable the smooth transition to mandatory compliances under a Patient Safety Medical Devices Law. A strong and fair regulatory environment will help the Make in India campaign by encouraging the growth of this industry.

Out of Box Solutions India is 70 per cent import-dependent in medical devices, and 90 per cent in medical electronic There is an urgent need for an integrated and calibrated development policy to put ‘Make In India’ initiative in medical devices sector in top gear and reduce high import dependency on foreign made devices in order to promote indigenous manufacturing of drugs and devices which would go a long way in making healthcare affordable.

TOP News makers 2018 The government should provide a level playing field to Indian medical device manufacturers We are asking Govt to put a cap on Trade Markups over the overseas manufacturing landed price and the Indian manufacturers ex factory price - the trade margin should not exceed 75% . This request is pending with DoP, NitiAayog, NPPA and PMO and we are following up on the same as not will this protect consumers and ethical manufacturers but aid Make in India . India’s Medical Device market at Retail & Institutional level is currently estimated to be over11$ billion (80000 CroreRs.) – the fourth largest in Asia. According to the recent estimates of the National Pharmaceutical Pricing Authority (NPPA), patients across the country have saved around Rs 15,000 crore under the government’s initiative of ensuring affordable, quality medicines for all. Much more can be saved by patients if Niti Aayog and PMO act on AIMED’s recommendations on price controls. The question Parliamentarians should be asking the government is what’s the opportunity cost of higher costs borne by patients for not acting on AIMED’s recommendations to cap trade margins to 75% over the import landed price and Indian manufacturers ex-factory price. Indian manufacturers seek Preferential Market Access by preferential pricing as is permissible under WTO, reasonable Tariff Protection, Price Controls and strong deterrents like punishment to errant companies engaged in unethical marketing practices to boost domestic manufacturing.

Price controls can be done in a calibrated manner through:  1% GST Cess on MRP as a Tax based disincentive;  Capping Trade Markups to a Rational Level; & Price Caps on few Priority Devices To be effective and industry-friendly, we need a regulatory framework with a clear demarcation of roles of the regulator, of the supervising accreditation body that assists the regulator, and that of certification bodies who audit the manufacturer. And

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to be able to effectively check and control the industry and yet be able to unleash its true potential, the underlining principle of any regulatory framework should be “Minimum Government – Maximum Governance”.

Alignment of Vision, Mission and Action. AIMED’s vision for India is to be among the Top 5 Medical Devices manufacturing hubs worldwide, to spearhead the policy needs to accelerate the manufacturing of medical devices in India and end the 70-90% import dependence forced upon Indian Medical Device industry and an import bill of over Rs 31, 000 crore. The Indian market at retail and institutional level is estimated to be at over Rs. 80000 Cr (11 Billion $) AIMED’s mission is to strengthen the Indian medical devices sector by facilitating domesticmanufacturers to rise to international level and discouraging unfair trade practices in import and lead India to an export driven market in the sector. Make India a global robust hub for medical devices manufacturing and fulfilling Govt’s ambitious mission of making quality healthcare affordable for common masses. Along with KIHT, AiMED is also advocating for the development of more medical devices manufacturing supporting infrastructure in other zones and regions of India . Our first focus is to create the required ecosystem and enabling policies to support medical devices manufacturing in India. Right now Govt. even does not know who makes what and how many manufacturers are there in India. Ayushman Bharat will take care of the needy 1/3 of Indian population with nil or near nil income What about the middle class ? For them to afford healthcare at reasonable costs we need regulations of Healthcare & Medical Devices and caps on Trade Markups and a strong ethical marketing watchdog. As an Association that encourages responsible manufactures we have consistently lobbied and requested GoI Dept for above w w w.medgatetoday.com Jan 2019

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TOP News makers 2018

Harmonisation of Human interest with technological advancement.

Dr. G D Agarwal, Managing Director, G Surgiwear& Jt. Coordinator, R&D (HWG) & Implants, AiMeD

India is a Country with limited resources. We have suggested to MOH, DOP, WHO & Kalam Institute a Priority List of Medical Devices to be mapped to a list of Priority Communicable & Non Communicable Diseases. Then list Products being imported so that these can be incentivized to focussed upon to produce locally to ensure affordable home grown access and stable pricing. In the Healthcare Delivery System, Medical Devices play a pivotal role in identifying / diagnosing the disease which facilitate the medical fraternity to provide comprehensive solution to the patient to overcome the disease. Apart from the individual getting treated from the disease, it also plays a crucial role in reducing the disease burden of a community, state or the country. In summary, the medical devices are used for the following purposes across the spectrum of healthcare delivery  Diagnosis, prevention, monitoring, treatment, or alleviation of disease;  Investigation, replacement, or modification of the anatomy or of a physiological process;  Control of conception; on the human body by pharmacological, immunological, or metabolic means Unfortunately, Medical Devices in India are still dominated by the Multi National overseas Players and we are hugely import dependent.

Mr. Sanjeev K Marjara, Director (Technical), Allengers Medical & Jt. Coordinator, R&D (HWG), AiMeD

Thought leadership and track record of creating future leaders. AiMeD is run as a non-bureaucratic, flat organization with Jt. Coordinators who heard various Product Verticals of Consumables & Disposables, Electronics & Equipment, Implant & Instrument & IVD Reagents. Additionally there are Horizontal Domain specific Jt. Coordinators for leading Horizontal groups of Regulation, R&D etc and then Regional / Zonal Jt. Coordinators for West Zone, South Zone etc to take care of regional issues. Mr. Abhinav Thakur, Managing Director, Accurex& Jt. Coordinator – IVD & West Zone, AiMeD Mr. A Manickam– Director, Trivitron& Jt. Coordinator, Govt. & Public Affairs, AiMeD Mrs. Mala Vazirani, Director, Transasia& Jt. Coordinator – (HWG – Legal), AiMeD Mr. G S Bhuvaneshwar, Consultant Medical Devices Design, Development, Testing & QMS, Former Head, Biomedical Technology Wing, SCTIMST & Jt. Coordinator, Regulations, AiMeD Mr. Ashok Saraf, Consultant, Robonik India & Jt. Coordinator, R&D (HWG), AiMeD 42 Jan 2019 w w w. m e d g a t eto d a y.co m

Mr. Chandra Ganjoo, GM – HR & Admin, Trivitron& Jt. Coordinator, HRD (HWG), AiMeD Mr. SubhashPunja, Managing Director, Robonik& Jt. Coordinator – EVG, AiMeD Mr. Nitin Mahajan, Managing Director, Mitra & Jt. Coordinator – EVG, AiMeD& MSME (HWG), AiMeD Shri Balamurugan, AVP, HCL Technologies Ltd. & Jt. Coordinator, EVG, AiMeD Dr. G Velu, Managing Director, Trivitron& Jt. Coordinator, EVG, AiMeD Ms. Rama venugopal, Executive Director, Value Added Corporate Services & Jt. Coordinator South Zone, AiMeD Mr. Suresh Vazirani, Managing Director, Transasia& Jt. Coordinator, IVD & West Zone, AiMeD Mr. Jatin Mahajan, Managing Director, J Mitra & Jt. Coordinator – IVD, AiMeD Mr. Gurmit Chugh, Managing Director, Translumina& Jt. Coordinator – Implants, AiMeD Mr. Kishore Khanna, Managing Director, Romsons& Jt. Coordinator – Consumables, AiMeD Mr. Rajeev Chhabra, Managing Director & Jt. Coordinator – Ortho Vertical Group, AiMeD Mr. Vivek Mangalwedhkar, Managing Director, S H PitkarOrthotools& Jt. Coordinator, Ortho Vertical Group, AiMeD

Achievemnts during 2018 QCI, AMTZ and AiMeD launched Indian Bio-Medical Skill Consortium : The development of biomedical skill sector in India received a major boost with the formation of the Indian Bio-medical Skill Consortium in partnership with Association of Indian Manufacturers of Medical Devices (AIMED), Andhra Pradesh MedTech Zone (AMTZ) and Quality Council of India (QCI). DOP issued Public Procurement Order Guidelines for Medical Devices in consultation with AiMeD AIMED & BUSAN TECHNOPARK Ink MoU to Promote & Boost Indian and Korean Medical Devices Sector AMTZ inaugurated Common Manufacturing Facility Centre & factories on December, 13th, 2018 and a MOU was signed to kick start the second phase of the Project. AIMED appointed as the Member of National Medical Devices Promotion Council by DIPP

TOP News makers 2018

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Founding Secretary General Anjan Bose bids adieu to NATHEALTH after a stellar innings from 2012...a true STATESMAN in Indian Healthcare The year 2018 has been full of news from the healthcare sector but one of the most impactful came in November... Anjan Bose's unanticipated departure from NATHEALTH.

Mr. Anjan Bose, fondly and respectfully called Anjan-da by all and sundry in the industry, took this surprising call to bid adieu to the unique collaborative inclusive multi-sector apex body in Indian Healthcare NATHEALTH, after being the nucleus of it's origin, formation and subsequent amazing progress in this short span of time. He has been a wonderful collaborator par excellence, firmly believing that the only way to break the historically well-known trust deficits in this critical sector was COLLABORATION, COLLABORATION AND MORE COLLABORATION! Under his unique leadership, NATHEALTH started breaking many trust barriers through his personal credibility and untiring and competent efforts and brought many eminent organisations from diverse segments to the NATHEALTH platform "for doing some good work together for the progress of the healthcare sector and good health of the Nation", as he used to

say in various forums... It was amazing to watch him bring players from Providers/Hospitals of various sizes, MedTech(Equipment & Devices), Diagnostics, Health Education, Innovators/Start-ups, Homecare and even Health Insurance and Investors, to name a few, together on one common collaborative platform! Anjan Bose, a thought leader of great stature and orator of highest calibre, demonstrated through honest, sincere, passionate efforts and good initiatives, that " even competitors could collaborate for good causes"! Anjan-da has always described Healthcare Sector as a complex jigsaw puzzle with so much diversity and passionately believed in the power of working together collaboratively as "one solid industry team" cutting across all barriers for the common causes! This has been a major driving force behind NATHEALTH's initiatives on PPP, Digital Health, Make in India, Healthcare Financing, Preventive & wellness and others. Through his perceptive and statesmanship ability, Mr. Anjan Bose brought on board esteemed organisations like International Finance Corporation(World Bank arm), NASSCOM, IMA, CII, FICCI, Duke University, AustradeAustralia , TFHC-Holland into positive collaborative partnerships...A case in point is the unique "Code of Ethics" that NATHEALTH designed for Indian Healthcare, in partnership with IMA. With Anjan-da leading at the centrepoint, NATHEALTH also forged very positive associations with the Government through NITI Aayog, Ministry of Health and others...He reached out to the global leaders in consulting and thought leadership like BCG, Bain & Co., Deloitte, PwC and

with their support, NATHEALTH came out with some outstanding and relevant knowledge papers and benchmark events in Healthcare. On the momentous Ayushman Bharat deliberations with the Government, NATHEALTH with Mr. Anjan Bose at the forefront, played a major role in trying and helping the Government and the eminent private institutions empathise with one another through understanding of the respective challenges, and work together for enhancing accessibility and affordability. In NATHEALTH's annual information document of 2018, Mr Anjan Bose had said..."Indian Healthcare is uniquely placed at this point of time.The positives and negatives are at constant interplay. At one end we have taken long strides to establish ourselves as a highly skilled medical ecosystem with excellent clinical outcomes and strong value proposition; at the other end our country has a massive disease burden that is compounded by significant delivery challenges of talent shortage and inadequate infrastructure. Addressing these challenges is our immediate priority and will require the joint commitment of all stakeholders.We need to come together, working together in collaborative spirit in order to achieve NATHEALTH's vision of "Be the credible and unified voice in improving access and quality of healthcare." When someone appreciated his good work, he would often respond by quoting from Robert Frost's poem..."The woods are lovely, dark and deep. But I have promises to keep, And miles to go before I sleep, And miles to go before I sleep." Anjan-da, we salute you for your visionary, sincere and untiring efforts to make India a healthier place to live... May your good work continue to benefit Indian Healthcare Sector. w w w.medgatetoday.com â&#x20AC;&#x201A; Jan 2019

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TOP News makers 2018

STORY

Dr. Preetha Reddy Who Led Apollo

Landing in Indian healthcare in 1983!!! Creating paradigms of success in terms of touching lives across globe

reetha Reddy is the Vice Chairperson of the Apollo Hospitals Group, Asia's foremost integrated healthcare provider. She is widely recognized for her contributions in making high quality healthcare accessible to millions across the country and also for her support to various entities and industry bodies, working for the betterment of India. Apollo Hospitals is acclaimed as the pioneer of private healthcare in India, and was the country's first corporate hospital. A proponent of integrated healthcare, Apollo Hospitals has a robust presence across the healthcare spectrum. Since its inception, in 1983, the Group has touched the lives of over 50 million individuals from 140 countries. Preetha works closely with the organization's clinicians in introducing contemporary protocols to continuously enhance clinical outcomes. She leads the thrust on continuous quality improvement processes to achieve the highest standards of patient satisfaction. She is the Managing Trustee of the Apollo Hospitals Education Trust; a principal body steering institutions in Nursing, Allied Health Sciences and Management, with a shared objective of building a talent pool of skilled health human resources in India. In addition to her responsibilities at Apollo Hospitals, Preetha Reddy works with industry bodies and the Government of India to advance policy decisions on healthcare. She was a Founding Member of the Quality Council of India and under her guidance, teams from Apollo Hospitals worked with the Government of India in introducing the NABH (National Accreditation Board for Hospitals and Healthcare Providers).

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Preetha Reddy is a member of the IndiaUS CEOs Forum and India-Malaysia CEOs Forum. She is a nominated Member of the Council for Scientific and Industrial Research and is also on the Governing Council of NATHEALTHHealthcare Federation of India. Committed to service, Preetha Reddy provides leadership and direction to several social projects like SACHi (Save a Child's Heart Initiative) which supports diagnostics and treatment of underprivileged children ailing with congenital heart diseases. Across the country, whenever the need arose, she championed facilitation of prompt medical assistance to provide relief and rehabilitation in times of disasters and natural calamities. She has been the recipient of a Lifetime Achievement award for distinguished

Apollo has been incrementally contributing not only to private healthcare, but also to Indian Public healthcare.

service in the field of Social Science from the Loyola Forum for Historical Research. She was also awarded the NHRDN 'People CEO Awards - Women Leadership' by The National HRD Network. Preetha Reddy holds a Bachelor's degree in Science and a Masters in Public Administration. She was conferred the degree of Doctor of Science (Honoris Causa) by the Dr. MGR Medical University, Tamil Nadu in recognition of her outstanding work in the field of healthcare.

Dr. Preetha Reddy

Vice Chairperson, Apollo Hospital Enterprise Limited

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TOP News makers 2018

STORY

AMTZ Launch &4th WHO Global Forum on Medical Devices AMTZ emerges as Global MedTech Leader of 21st Century

Dr. Jitendar Sharma Managing Director and CEO, AMTZ

AMTZ - a crest jewel on the crown of India’s Healthcare Developement brings 100 countries to witness the dedication of world’s first medical devices industrial & research park to the nation

izag enjoyed and fully justified the privilege of hosting 4th WHO Global Forum on Medical Devices. It was the historical event as first time this conference came to India and AP Med Tech Zone was proud to host the event. It took enormous calibre and strategy to apply for this and host this successfully at Andhra Med Tech Zone, AMTZ, India’s first and world’s most comprehensive medical technology park from 13th-15th December. The Indian medical devices’ industry is estimated to be INR 30000 crore industry and touches all our lives and is highly import dependent. By the latest count World Health Organisation had approved registration applications of 1049 delegates from 90 countries. The delegates included, representatives from country governments, Ministries of Health, United Nations and Inter-governmental institutions like the WHO, other UN bodies, bilateral donors like GIZ (of Germany) and US Aid etc, researchers and academia and NGOs with affiliations with the WHO. Medical device industry was well represented in full force.

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A number of Key dignitaries attended the Forum and placed their plenary speech before the audience of 1200 delegates. Among them preliminary Hon’ble CM N Chandra babu Naidu, who did the grand dedication of AMTZ to India and the world. He also invited the WHO and Global Forum organisers to use AMTZ for the forum every year. He shared the critical importance of medical devices and implants and considering India has a 90% import dependency, setting up in-house manufacturing capacity is crucial to make medical devices accessible and affordable. It is an important but under-recognised aspect of global health and universal health access and AP government is committed to address that, not just for AP and India but the entire world, especially citizens of developing Countries. Hon’ble CM Naidu also inaugurated: Bio-Valley Incubation Council (incubation centre for hybrid med tech applications), Medi-Valley Incubation Council (incubation centre for med tech equipment), Indian Bio-Medical Skills Council (Skill building for the biomedical sector to promote employment and manufacturing) and Kalam Institute of Health Technology (does comprehensive mapping and duration of health technologies in India bridging the gap areas, it also helps in transforming successful innovations and technologies for market adaptation). Other key dignitaries who graced the occasion were: Union Minister of Commerce and Civil Aviation, Shri Suresh Prabhu, Union Minister of StateMinistry of Health and Family WelfareShri Ashwini Choubey, Minister of Health Medical and Family Welfare of Andhra Pradesh-Md Farooq Ali and Puducherry Health Minister-Malladi Krishna Rao.

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Shri Suresh Prabhu expressed the need for an enabling ecosystem to help evolve this industry of medical devices in India and he looks forward to achieve this through AMTZ. Hon’ble minister inaugurated National Medical Devices Promotion Council, Centre for Medical Equipment Procurement with Global eMarket and Centre for Patents for Biomedical Equipment. In his keynote address he also spoke about our intrinsic connect with medical devices, as we live longer and need devices to support mobility and quality of life. From amongst the key bureaucracy, the senior officials who attended the forum were: Dr VK Paul- Member NITI Ayog, Ms Preeti Sudan, IAS, SecretaryHealth-Govt of India, Mr RK Vats, IAS, Additional Secretary-Health-Govt of India, Mr Arun Singhal, IAS, Additional Secretary-MoHFW of Govt of India, Dr Mandeep Bhandari-Joint SecretaryMoHFW, Dr Eswara Reddy-Drug Controller of India, Dr VG Somani-Joint Drug Controller, Mr Rajiv Agarwal, IAS, Joint Secretary-Department of Industrial Promotions and key leaders of Department of Biotechnology, Department of Science and Technology and National Pharmaceuticals Pricing Authority including Ms Shubhra Singh, IAS, Chairperson-NPPA. From WHO, Dr TedrosAdhanom- Director General and Dr Soumya SwaminathanDeputy Director General, addressed the forum via audio-visual message. Dr Suzanne Hill- Head of Essential Medicine division and Dr Henk Bekedem- WHO Representative to India attended the forum in person. From manufacturing and industry associations, there was a good representation. PHDCCI was represented by Mr Vivel Seigell, CII South Africa by Mr Jitin Bhatia and AIMED (Association of Indian Medical Device Industry), Mr. Rajiv Nath. Built over a 270-acre land, AMTZ is a World-class facility in Medical technology built with an intent to bring affordable health technology to the masses. AMTZ is the home for medical devices, equipment, testing &

validation labs, prototyping, innovation, manufacturing regulatory along with policy support. All dignitaries applauded this event at Andhra Medtech zone that would get India to global focus on medical technologies. Dr. Poonam Malakondaiah, Special Chief Secretary (Health), Govt. of AP, said that the need of the hour is quality, affordability and accessibility, and with launch of AMTZ, she looks forward to address this need which has remained unaddressed in India for long time. The Managing Director and CEO, Dr Jitendar Sharma shared the insights of making AMTZ, which garnered huge applause. A 270-acre med tech park’s phase-1 got completed in flat 342 days. Dr Jitendar Sharma announced that with the comprehensive infrastructure in place, this park is world’s most equipped park ahead of the western world. Any device requires 18 labs and AMTZ is unique in giving all those 18 labs in the same address. He compared the 342 days of manufacturing journey to the energy and hope of a nation in construction. Considering the health requirements for a country like India, it is instructive what is possible and could be possible with the right leadership, mentoring and support, the 342 days’ construction of AMTZ and the hosting of WHO 4th Global Forum is precisely that.

The key thematic topics with the focus of “Access to Medical Devices” discussed were:

 Free diagnostics, making diagnostics accessible  Oxygen supply options and systems for low and middle income countries

P ricing administration, regulation and policies F it-for-purpose policies and laws for regulation E nabling ecosystem for manufacturing in country E thical issues around device donations N on-communicable diseases and priority devices H ow countries are preparing to adapt to the Essential Diagnostics List recently released by WHO in the 71st World Health Assembly N omenclatures and classifications which are standard across the world and the necessity E mergency medical devices P riority and essential medical devices by facility

Some key proceedings were:

R egulation was a major conversation point. M ore, better and up-to-date legislations were called by many countries across regions and continents  I nnovation and scale-up was a major deliberation topic and scale-up challenges came under sharp focus M arket access for new innovations was also a topic of concern and ways and means for the same O ne of issue that came under focus was that most of the posters and innovations being discussed were curative and not preventive The inauguration of AMTZ and Global Forum Medical Devices concluded with the clear message that AMTZ has scripted history in the world of medical technology and access to medical devices.

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TOP News makers 2018 Perfecting Art of Healthcare Administration & Management

EVENT

The Joy of enriching Indian Healthcare Contribution to the Industry and Society Joy Chakraborty is currently, ChairmanHealthcare Initiatives of CII (Western Region), President – Voice of Healthcare (Western India), Member of National Healthcare Committee of CII; Secretary of Association of Healthcare Providers of India (AHPI - Maharashtra & Goa). He has contributed to the healthcare policy making and has been invited by Govt of Maharashtra the Committee as a member for Developing state’s Clinical Establishment Act (CEA). He is also working on the Trauma Care Policy of Govt. of Maharashtra. Joy is a former Member of the Accreditation Committee of NABH and Health Sector Skill Council (HSSC) ; Advisory Board Member – National Educational Policy, Medical Education, Ministry of HRD, Govt. of India. Change Agent and Management As CII (Western Region) President, Joy hosted a multi stakeholders meeting on Ayushman Bharat. He organised the regional consultation meeting on Non Communicable diseases management in collaboration with NITI Ayog to develop PPP framework and worked with the department of multiple states. He has also worked very closely with Harvard Medical International for the improvement of healthcare outcome. Joy is currently Member of Harvard Business Review Advisory Council. Alignment of Vision, Mission and Action He has been invited on the board of studies and many other positions in various academic institutions across the country. He is a Member of Advisory Board of Healthcare Programs (IIM-Calcutta); Member of Industry Academia Board (XLRI – Jamshedpur). 48 Jan 2019 w w w. m e d g a t eto d a y.co m

Joy is also on the Board of Studies and a visiting faculty for IIHMR, Jaipur. He spearheaded the development of the Allied Health Sciences course at P.D. Hinduja Hospital. Today, there are 10 different courses offered in various areas like Lab, imaging, MRD, CSSD, Endoscopy Technician course, etc. Several of these are certified by the HSSC. Harmonization of Human interest with technological advancement He has been instrumental in initiating several technological advances in P D Hinduja Hospital & MRC. Besides introduction & upgradation of medical technology like Gamma Knife & Robotic surgery, he has also played as an instrumented role in initiating patient engagement programmes through the use of technology. Some of the initiatives are: Online scheduling of appointments for patients along with registration & availability of reports online. The easy to use new Electronic Medical System along with the e-prescription pen; these help the doctors access to patient medical history at the click of a the button and also helps hospital digitize the patient data. Request and Feedback system which can be used via tab, app or phone number was introduced with an in-built escalation matrix so as to ensure all patient requests and complaints and responded to within defined time frame. Introduction of patient friendly wheelchair transport services in the hospital, few of several initiatives. Thought leadership and track record of creating future leaders Joy is working with Cleveland Clinic and with Johns Hopkins to develop patient engagement programmes.

The design of these programmes will have an emphasis on patient centric care, patient safety, clinical governance and quality along with use of latest technology like new electronic medical records, artificial intelligence and predictive analytics to implement and sustain a successful programme. Achievements during 2018 Joy initiated the process of Green and Clean Hospital certification by Bureau Veritas. Hinduja Hospital has become the first hospital to receive the certification. Under his leadership, the hospital has won several awards notable being the IMC Ramakrishna Bajaj Award for Quality and Arogya Healthy Workplace award.

Joy is passionate and currently working closely with Cleveland Clinic to develop Patient Experience Model He has been awarded Rashtriya Sanman Award by National Education & Human Resource Development Organization.

Joy Chakraborty Chief Operating Officer P D Hinduja Hospital

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TOP News makers 2018

The Quality Man of India

STORY

 Medical Laboratory 15189:2012

per

ISO

 Testing and Calibration Laboratory as per ISO/IEC 17025:2017 Certification program for Medical Labs Centre for Education & Training (CET)

Dr. B K Rana

Founding CEO, Quality & Accreditation Institute (QAI)  B.K. Rana is the Founding CEO of Quality & Accreditation Institute (QAI) and former Director and CEO-In-Charge of NABH, Quality Council of India.  Board Member of International Society for Quality in Health Care (ISQua)  Former Chairman- ISQua Accreditation Council.  Board Member of Asian Society for Quality in Healthcare (ASQua)  Appointed ‘ISQua Expert’ & ‘ISQua Lead Surveyor’  Appointed Chief Advisor to the Academy of Medical Laboratory Auditors (AMLA), Advisor to Indian Institute of Healthcare Communication, TR LifeSciences, National Referral Centre for Lead Poisoning in India (NRCLPI) & Senior Advisor, Indian Society for Lead Awareness & Research (InSLAR)  Dr. Rana is an Expert in setting up Accreditation Body and developing standards  He is International Consultant of World Health Organization (WHO), World Bank, Asian Development Bank (ADB) and USAID  International Assessor for Clean Development Mechanism (CDM) of United Nations Framework Convention for Climate Change (UNFCCC). QAI was set up to create an ecosystem of education, training, accreditation and quality improvement. We believe that this organisation would provide a platform to stakeholders including professionals and organisations, associated with quality in any way, to share their wisdom and

knowledge in order to make its Vision realised. This will further provide tremendous opportunities to all concerned to learn and contribute in improving organisations engaged with QAI. We aims to operate globally and working in Nepal, Bangladesh, Nigeria, Ghana, Philippines & Mexico.

Vision: Nurturing the largest global pool of organisations and people through quality improvement and accreditation framework.

Mission: To conceive and deliver education, training, accreditation and related programs in partnership with stakeholders using an approach of co-design and co-creation.

Under CET, different education and training programs related to healthcare quality, patient safety, laboratory quality management system, communication, nursing etc. are being conducted on standard and customised basis. We also engaged in healthcare project management & evaluation. Also participates in national/ international conferences as supporting partner.

Achievements of B.K. Rana in 2018:  Elected Founding Member of the International Academy of Quality & Safety (IAQS)  Appointed Consultant forWorld Health Organization (WHO) for Patient Safety Friendly Hospital Initiative Standards  Appointed Consultant forAsian Development Bank (ADB) on healthcare quality standard & assurance  Led the successful launch of QAI accreditation programs

Announcements:  First Medical Lab accredited as per ISO

QAI is an institutional member of the 15189:2012 (Doctor.e Lab, Delhi) International Society for Quality in  First Testing Lab accredited as per ISO/ Health Care (ISQua). QAI has started following two independent centres which are governed bythe respective Boards:  Centre for Accreditation of Health & Social Care (CAHSC)  Under CAHSC, following accreditation programs are operational:  Home Health Care  Assisted Reproductive Technology (ART)/IVF Centre  Dialysis Centre  Quality & Patient Safety in Hospitals

Centre for Laboratory Accreditation (CLA)

IEC 17025:2017 [Dept. of Life Science (R&D), DattMediproductsPvt. Ltd., Haryana]

 First ART/IVF Centre accredited (Wadia Hospital, Mumbai)  First Home Health Care accreditation assessment completed (Health Care at Home, Noida)  Launch of an indexed peer reviewed international ‘QAI Journal of Healthcare Quality & Patient Safety’  First assessor training course for Dialysis and ART accreditation programs announced

 Under CLA, following accreditation/ certification programs are operational: w w w.medgatetoday.com Jan 2019

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TOP News makers 2018

STORY

Mr Naveen Sharma, GM operations at PSRI , is among few Marketing geniuses of healthcare in India. He believes challenges bring changes resulting in to better understanding of overall business environment. He is perfectionist as well as strategist which has reflected in his meteoric performance at PSRI. He attributes his successful career to the his management and peers , as he strongly believes behind every corporate success there lies a emphtatic team !!!

Naveen Sharma

G.M. Operation & Business Development Head, PSRI Hospital

Mr. Naveen Sharma, GM operations & Head Business Development at PSRI, is among few Marketing geniuses of healthcare in India. He is armed with 25+ years of intensive experience in Marketing & Sales, Business development, Operations & Project development within the healthcare industry. He believes challenges bring changes resulting in to better understanding of overall business environment. He is perfectionist as well as strategist, reflects in his meteoric performance at PSRI. He attributes his successful career to the management and peers, as he strongly believes behind every corporate success there liesaemphaticteam. Having worked with Wockhardt Hospitals Ltd. as Group Head Marketing, International SOS, Indraprastha Apollo Hospitals, GlaxoIndia, Ranbaxy laboratories & Rastogi Surgical Pvt. Ltd, Mr. Sharma also acquires an expertise in devising marketing strategies for a meliorating business. Alongside he has been a proactive planner with a flair for adopting emerging trends and addressing industry requirements to achieve organizational objectives and profitability norms. 50 Jan 2019â&#x20AC;&#x201A; w w w. m e d g a t eto d a y.co m

He has expertise in devising marketing strategies for ameliorating business. A proactive planner with a fair for adopting emerging trends and addressing industry requirements to achieve organizational objectives and profitability norms. Prior to his efficient professional performance Naveen Sharma pursued studies such as Internal Accessor Course from NABH Quality, Council of Health care marketing management course from IIPM, Finance for Non Finance Executives course from IIM Lucknow. He has extensive experience in Strategy making & implementation, foreign alliances with client & expanding repertoire of network partner for quality deliverables in the market. Mr Sharma has been awarded recently for his outstanding contribution in the healthcare sector, to name few, he has been awarded best hospital management & operation (National Award) by 8th MT India Healthcare Award 2018, he was also awarded as Health care personality of the year â&#x20AC;&#x201C; Business Leadership by 7th MT India healthcare award. He was also awards by Voice of healthcare, Walk for life, Elets Healthcare & wellness summit & Physical Education foundation of India for his immense support &contribution in to the healthcare.

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TOP News makers 2018

Global Indian Healthcare Maestero: Setting markable benchmarks in the global Healthcare sector

fter several years of being a practicing surgeon and an administrator of several reputed hospitals, I quit my last job as the CEO of a Bangalore based hospital and joined a Private Equity Firm in May 2015. I was excited that my role in the Private Equity Firm will allow me to gain wider exposure in the emerging markets healthcare systems which would create Value propositions like creating Clinical Corridor through sharing of knowledge,clinical expertise and best practices amongst various stakeholders and across various geographies. In November 2017, I had to unexpectedly step into managing the CEO office of a Key operating asset with 2000+ beds across multiple locations. I transitioned into the role amidst harsh realities of difficult financial circumstances and severe external and internal pressures. 18 months into its investment, the Company’s margins spiraled down to half and it faced severe cash flow crisis and the expectation was to “TURNAROUND”

Dr Raajiv Singhal is a Graduate and Post Graduate of the prestigious Armed Forces Medical College (AFMC), Pune and an alumnus of IIM, Ahmedabad having extensive experience of over 22 years in the healthcare industry. He carries the credit of setting-up the first e-ICU concept in India and establishing Hub and spoke model for several successful Heart Command Centers In India and abroad including UAE, Nepal, Bangladesh and Afghanistan. He has been felicitated by Governor of Karnataka for outstanding contribution for ‘Innovation in Healthcare’ As part of the Evercare Operations team he is instrumental in setting up the Clinical Corridor between India and Africa and serves on the Board of Hospital group in South Africa in addition to Bangladesh and India I didn’t know what would be waiting for me but still said yes, and entered one of the most challenging time’s thinking“you’re starting from a position of weakness and not all turnarounds succeed especially in Healthcare”. The journey towards turnaround in last 12 months has been anything but smooth and it is exciting to evidence the fruits of labor in a short span of time. In this digital era where there are tons of stories on turnaround available everywhere, I thought this story deserves to be shared for the simple reason that “Healthcare Delivery” is construed to be complex influenced by multiple stakeholders and it is a common belief that turnaround stories are difficult. Casual conversations over a cup of coffee prompted questions on what enabled this turnaround and I often keep repeating that sticking to the basics is the key mantra. There were no “novel ideas “or “disruptive strategies” used.

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COVER STORY

It was persistence with which the two basic objectives of turnaround where pursued is what I believe have clicked. Like in every situation of turnaround the two basic objectives were to cut the costs as fast as possible and find the path for successful growth. As simple as these may sound these are the trickiest and the most difficult aspects. Finding the right balance was the key challenge. I embarked on the journey which passed through three key phases and I hope my experiences would be useful insights which can be applied to any real life management situation and not just a turnaround

Getting to know the company and choosing an agenda The first thing I did was to partner with the CFO in understanding key financial aspects of the Company. I believe this was the starting point that stimulated discussion and led to choosing an agenda and a road map to achieve the turnaround objectives. Understanding the financial aspects helped in identifying unprofitable service lines, and cost savings. Several initiatives were built around these opportunities which were targeted to be achieved in short term and long term The information also helped in communicating to the Board , operating teams, key stakeholders including Doctors, regarding the performance of the business and the issues it is facing, getting across key information and concepts and have them accept the harsh financial realities of the Company.

Building relationships and team

Having aligned with the key objectives for a turnaround the next big task was to work with teams for implementation. Internal communication was critical for alignment. I had to re-organize and show my team I was going to do something different, and show my internal customers we were going to do something different. Turnaround initiatives required to be rolled out in a time bound manner and it included cost cutting measures and downsizing the jobs. Downsizing was not just distressing for those who had to leave but also for those who stuck around.

Having the right team was critical to success. I was fortunate to retain and hire a trusted team which was like minded and had a thorough understanding of the prevailing situation on ground. Determination and cohesiveness of the teams ensured that every initiative got implemented without impacting the service and quality

In addition to the team , building relationship with a group of trusted insiders, key influencers inside the company who were not necessarily from management , but are well respected proved to be instrumental in managing the right communication in various corridors and in successful implementation of initiatives.

Making a difference

In this section I would like to touch upon the leadership attributes that help the CEO in making a difference. CEO Job is critical in the situation of turnaround. The uncertainty, lack of confidence, diverse expectations of stakeholders can be very taxing. Staying persuasive, agile, transparent and brave are very important attributes to sail through the difficult times. Being brave was important for me to retain the management team and keep it motivated. The journey was an emotional roller coaster at a personal level and required me to mask the sinking feeling to ensure that teams did not come under pressure. This is the most taxing part of the job but this very attribute makes a significant difference as the teams draw their strength from their leader to deliver. Implementation of plan is key to success. However change often encounters resistance. Cynicism, apathy, insecurities, fear of failure are the common reasons to resist change management. It was no different for me or my team. Without exception every initiative under consideration faced challenges in implementation. In order to make the plan meaningful and successful, we had to stay persistent and persuasive with the key stakeholders. What helped was being transparent in our communication with all the stakeholders backed by facts and data. Transparency also helped us build key relationships and breaking barriers. As a team we made sure we were approachable, patient in addressing concerns and persistent in implementation. Success is achieved only through failures. What is important is to take quick action when falling behind. Agility helps in altering plans and decisions to ensure objectives are met. Time is Money .While the goal is to assess the impact of initiatives it is also very important to analyze what is the implication of failure. This helped us build mitigation plans that bought us back to track whenever faced with challenge. In conclusion, although CEO remains in the focus for a turnaround the basic success factors are 3 Pâ&#x20AC;&#x2122;s â&#x20AC;&#x201C; People, Planning and Persistence. I would like to draw reference to a Cricket team where the Captain may lift the trophy but every individual contributes to the success.

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COVER STORY

Mr. Arindam Haldar CEO- SRL Diagnostics

When it comes to the year ahead the healthcare fraternity’s expectations encompass new technology, investment, health programmes and public private partnership. For diagnostic laboratories the main drivers will be the continued focus on preventive healthcare, shorter turnaround time through automation, next gen logistics network, value added services like application of AI for personalising test packages and qualifying lab reports, home collection of samples and establishing connect with customers through hand held devices. There is no doubt that the nation needs to shift its focus from curative to preventive healthcare. Accordingly, since diagnostics pave the way to determine choice of management, the diagnostics industry could be the focal point for driving preventive healthcare in India.

Dr Rana Mehta

 Ayushman Bharat will catalyse the growth of a new healthcare ecosystem for the Partner and Leader Healthcare, PwC India country. Besides the delivery of care, Fraud, Data Analytics and a Primary care  Investor interest in the sector is now model in the private sector are likely to be tepid due to regulatory uncertainty and areas of growth. a continuous pressure on margins.  Focus on Brown field projects for the  Continued interest for long term large players with minimum creation of investors given the skewed supply additional greenfield capacity. demand dynamics which is likely to continue in the coming decade.  Given the pressure on the margins hospitals will focus on operational  A renewed focus of technological efficiencies to reduce costs. access to care will catalyze the growth of the digital healthcare sector both for  Single specialty will see consolidation startups and established players. given that growth has slowed down.

Mr. Akshat Seth

CEO of CK Birla Hospital Of Women Healthcare is one of the fastest growing sectors in India with the government aggressively planning to make quality healthcare available to all. However, as far as healthcare for women is concerned, we still have a long way to go. A recent report by the World Economic Forum highlighted that India ranks third from the bottom in parameters of women's health & survival. We hope that the government and the industry will build on the momentum of recent policy initiatives, such as Ayushman Bharat, to substantially improve women’s health in the country. At the CK Birla Hospital for Women, since our inception, our endeavor has been to provide clinical care of international standards with warmth, responsiveness and sensitivity. We are focused on addressing healthcare needs of women across all life stages – we have built strong clinical programs across a wide range of specialities. These include Obstetrics & Gynaecology, Neonatogy, Fetal Medicine, Orthopaedics, Breast health, Aesthetics & Plastics and Advanced Surgeries. Equally, we believe, it is important to build awareness around preventive health for women from a young age. 54 Jan 2019 w w w. m e d g a t eto d a y.co m

COVER STORY

Mr. Manish Sachet CFO, Ziqitza Heathcare Ltd

The launch of the Ayushman Bharat Yojana at the beginning of this financial year has been a welcome move which will increase access to secondary and tertiary healthcare for the masses. While this increases access to quality hospital care, there is yet a lack of awareness among people on the importance of pre-hospital care. Citizens should be educated about the importance of emergency healthcare which if administered within the Golden Hour can increase the chances of survival significantly. With the increase in use of healthcare facilities, there will be a spur in the use of ambulances to access hospitals as well. The Government should consider including ambulance services in the scheme to ensure timely treatment. This would require adding fleet of ambulances to the 108 service to widen reach. Due to the Governmentâ&#x20AC;&#x2122;s consistent efforts, the patient to ambulance ratio has reduced from 1:1,00,000 to 1:60,000. In the coming year, we expect that the ratio to be further reduced to meet global standards. While the Ayushman Bharat Scheme is a great scheme on paper, to implement the yojana effectively, we expect the right allocation of budgets and resources. 2019 is a year where a lot has to be implemented on ground in the healthcare segment and private-public partnerships can go a long way to help achieve this

Ashish Zutshi

Director Sales Rossmax International Swiss GMBH

ROSSMAX - YOUR TOTAL HEALTHSTYLE PROVIDER Mr. Ashish is working closely with various stake holders for a Healthy India with mission and passion for perfection, has been creating comprehensive and inclusive framework for affordable medical device industry. Rossmax, A leader in the global healthcare market, is committed to developing and supplying premium products and solutions with supreme technologies on a top quality level. The business fields are PREVENTION, MONITORING, THERAPY. The product and service portfolio consists of healthcare products in the field of Fitness, Obesity, Hypertension, Respiratory Care, Fever Management, Hot & Pain Therapy, Wound Healing as well as Sleep Disorder. All products are distributed in more than 80 countries and are clinically validated and approved based on latest quality standards. With the only fully integrated factory in the industry, Rossmax is very proud on their world class manufacturing capabilities and end-to-end process controls. From pioneering research and product development to highly efficient manufacturing, shipping and logistics, the operational excellence is a crucial key to the success.

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DOCTOR Developments in the field of Medical Technology SPEAK

rtificial Intelligence is the big buzz word in Radiology today. In the recently concluded annual meeting of the Radiological Society of North America (RSNA) at Chicago, there was a 3 fold increase in the number of exhibitors from AI companies and numerous research papers in the academic presentations. Such activity in the field of Radiology has been seen after many years, and the reason for that has been that there has been no disruptive innovation in medical devices since the invention of CTs & MRs in the 1970s & 80s; and the introduction of cardiac CT in the early 2000s. The key question being asked today hits the core of Radiology - will AI take over the job of the Radiologist? Max Healthcare has been aligned with the changes in the ecosystem and is collaborating with multiple deep learning companies with research projects that try and understand the meaningful impact of AI. The two major areas of impact in AI in Radiology are in workflow enhancement & in disease detection & diagnosis. The latter is currently the lower hanging fruit and (at a macro level) similar to the facial recognition software readily available on all mobile phones. The early evaluation of AI in disease recognition and characterisation is promising. Having the AI tools shall enable a pre-read for radiologists, similar to the process in teaching institutions, where the resident doctor in training reads the scans which are then looked at and finalised by the senior radiologists. This builds efficiency and more importantly, enhances the quality by reducing medical errors. The major causes of medical errors in Radiology are missed findings and incorrect interpretations. The former is usually driven by multiple "human factors" including overwork, work fatigue and even state of mind at the

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work place. Once the AI tool helps detect all (more than the fatigued radiologist) abnormalities, the errors related to missed findings will automatically reduce. Since we are at the early phase of the curve the current downside while the "machines learn", is a higher rate of false positives. The increased specificity (making the correct diagnosis) of AI tools, will take significantly longer, since this involves providing validated radiological data and a greater focus on labelling by radiologists for "teaching" the AI tools. The various solutions being worked on by the AI companies involve plain x-rays, where different companies are focussing on providing suites for chest x-rays and musculoskeletal x-rays. The chest x-ray solutions are being used at screening for tuberculosis, detection of pneumothorax and a more comprehensive evaluation where multiple abnormalities are picked up including nodules (which is impactful in oncology follow up for metastatic disease). The above examples are global issues where timely and accurate treatment has a larger impact on the healthcare of the individual and the society at large. There is also a proportionate reduction in cost of treatment when the timely diagnosis reduces cost of treatment due to improved outcomes. A similar impact is faced in musculoskeletal trauma, where AI tools are not only helping make a more accurate diagnosis, but with the addition of generating alerts; help bring the report on top of the pile - when a radiologist is reporting multiple x-rays, there is sequential evaluation of the x-rays and an x-raywith a critical diagnosis will be reported based on its location in the pile (or list in workstations). Once the AI tool has picked up a fracture, or a pneumothorax, the tools shall push the x-ray to the radiologist to report first and aromatically

Dr Bharat Aggarwal

Director - Radiology Services, Max Super Speciality Hospital, Saket

help generate the report before all the normal or less critical x-rays. There is also significant work being done in CT and MR technology, helping diagnosis of various conditions such as stroke, intracranial haemorrhage, lung nodules & masses, liver volumes; and also, specific high impact diseases like multiple sclerosis and dementia. The absence of a perfect financial healthcare model anywhere in the world is also creating an opportunity for AI companies to build tools that bring in efficiency in system. By monitoring workflow patterns and creating efficient models in patient movement workflows and communication tools, AI will drive greater efficiency in bringing efficiency in the speed of treatment and effective utilisation of manpower and equipment resources. This has a large impact in Radiology where the cost of capital for equipment is large and capacity utilisation a huge issue. A more futuristic impact of deep learning and Ai in radiology will be the ability of predictive analysis of radiology data to determine outcomes before the human eye can detect abnormalities. An area where this shall have significant role shall be in temporal evaluation of patients in ICUs undergoing serial x-rays: the AI tools should be able to help give guidance to the treating doctors before all the signs (radiology and pathology) become apparent in the current processes. While we have seen a brief glimpse of the virtualisation of our reality, the core question regarding the radiologists' future? We are here to stay, and our roles will evolve in effectively utilising all tools that modern science offers us to improve patient outcomes and actively participate in clinical decision making

DOCTOR SPEAK

Artificial Intelligence is leading the revolution in Radiology

I is the hot topic everywhere with many AI start and most of the incumbent modality and imaging IT vendors marketing it. The technology is hard to ignore. The vendors are making progress with bringing AI solutions into the daily workflows of radiologists and other imaging specialists.Even amongst radiologists the sentiment for AI has progressed from the initial fear and scepticism, to actively engaging with vendors to explore how AI can maximise productivity and lead to better clinical outcomes. Most of the AI solutions till date are essentially detection and/or quantification tools for specific use-cases, e.g. lung nodule detection. Over time, AI will evolve and the solutions will have broader capabilities. For example, algorithms that provide automatic feature detection will also provide quantification and characterisation of abnormalities detected on imaging outputs. AI based image analysis provides solutions for a wide range of radiology specialities,

from neurology through to musculoskeletal, with a particularly high concentration for lung and breast applications. However, health care budgets are under pressure globally and care providers will need to prioritise their AI investments by initially selecting a shortlist of vendors and algorithms to evaluate. In the short-term, simple AI tools that help radiologists manage their work more efficiently thus increasing their productivity will be the low-hanging fruit, but in the longer run, the move to quantitative imaging and the use of imaging biomarkers to predict a patientâ&#x20AC;&#x2122;s response to treatment will become an attractive market. AI-based medical image analysis tools is firmly in the early stages of development and the transition to it becoming a mainstream market is likely a few years away. With focus on AI at an all-time high, AI solution providers need to undertake large-scale clinical validation studies to demonstrate the performance of their solutions in realworld clinical settings and to ascertain if the promise of a) workflow efficiency and b) output quality lives up to expectations, and by how much. This will boost trust and confidenceof radiologists in AI technologies and strengthen the business case for investing in AI solutions.

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DOCTOR SPEAK

An extraordinarily unwonted journey towards "HEALTHY INDIA"

Dr. Hemant Patel President Elect, (IRIA)

Role of radiologists getting bigger by the day with the integration of advancing technology in clinical practice. How do you see the situation emerging in India? Radiology has come a long way from the era of radiographs & conventional barium procedures to state-of-the-art cross-sectional imaging modalities with increased spatial and temporal resolutions to digitization with ‘filmless’ technology. Over time, diagnosis in radiology has become easier with remarkably improved and advanced imaging modalities and the new generation of radiologists may not know how difficult things once had been. Today we have made remarkable advances in diagnostic radiology with ever improvising cross sectional imaging modalities. New generation CT scanners with higher slice systems (improved image quality, reduced scan times, eliminate stitching artifacts, freeze cardiac and respiratory motion ), new detector technology ( reduces electronic noise and enables sharper images), and iterative reconstruction (provides diagnostic image clarity on low dose scans). The most recent advances in magnetic resonance imaging (MRI) technology 58 Jan 2019 w w w. m e d g a t eto d a y.co m

have been software innovations that have opened new possibilities to expand the use of MRI. Short duration of the exam is especially a comforting factor to the pediatric & geriatric patients. Intra-operative MRI is a reality today as it enables clinically validated brain study in very short time (just 5 min). Neuro-navigation softwares with image processing facilitates surgical mapping and improves efficiency in the OR. Despite the immense advancements in imaging technology, we still have a large population in rural India that doesnot have access to these newer advancements. Progressively, imaging modalities though refurbished machines or old generation scanners are being installed and facilities coming up in these parts of the country. Telemedicine and web based Remote viewing systems are bringing them a step forward, providing access to expert opinions in remote locations, reducing expenses and thus improvising patient care and management. Currently, the most prominent or pressing clinical applications of molecular imaging are in the fields of oncology and cardiovascular disease. In oncology, molecular imaging has already resulted in some breakthroughs in cancer staging and treatment response assessment and it is anticipated to facilitate early disease detection. In cardiovascular disease, molecular imaging is expected to serve a central role in addressing basic questions regarding cell therapy for cardiac repair and vulnerable plaque detection Integration of artificial intelligence (AI) is a big wave in Radiology and imaging. In clinical practice of future it won’t take away our responsibilities as a radiological provider, but they will shift how we handle our workload. “Just like Excel spreadsheets changed the way

accountants work, deep learning AI will prove the same thing is true in radiology,” Algorithms will tee up some of the routine things for us so we’re more efficient with mundane tasks and routine screenings. It will give us more time to focus on the unusual and atypical scans. We radiologists are fortunate to live in such exciting times, and today’s researchers have fascinating scientific breakthroughs awaiting them. Only time will tell if the present exciting era ever will be regarded as ‘golden era of radiology’ Some radiologists say that the decision as to what imaging modality is required for a particular case should be taken by the radiologist and not the referring physician. What is your comment? Unlike other specialities, the field of Radiology entails wide spectrum of imaging modalities like X-rays, Sonography, CT scan, MRI, nuclear medicine etc. It is a task to master even a single modality, let alone all of them. Each of these modalities have their own disctinct advantages and limitations, and there are newer innovations and constant technological improvisations, which are best understood by the radiologists. At the same time, medicine in general is progressing at such a fast pace in all its sub-specialities and the expectations of the referring is also increasing to answer smallest queries, which is possible today with better understanding of these modalities. I believe that referring clinicians and surgeons ask the right questions to which they need answers from the radiologist to help in management of the patient and can rely on the radiologists to correctly use the optimal imaging modality to provide the most satisfying answers, thus benefitting the patient. For example, now it is a routine practice to combine MRI pelvis

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with contrast CT imaging for female pelvis imaging or combining the dynamic evaluation of USG with higher spatial resolution of MRI for MSK pathologies. So only by the continuous liaisoning and communication with our referring colleagues can we keep pace with the progressive understanding of the science, learn and find answers to the ever increasing demands and thus provide better and higher standard of care to our patients. Interventional radiology is coming up as a subspecialty to radiology. What is the current status of IR training in India? Interventional radiology (IR) is a sub specialty which provides minimally invasive image-guided diagnosis and treatment of disease. According to statstics, only one interventional radiology expert is available per every 2.18 lakh populatin in India – so there is a huge lacunae to fill. Nevertheless there has been a steady growth in this field world wide & in India, mostly because of increasing demands from referring physicians, the widespread availability of imaging equipment for guided procedures, IR's potential to serve as a convenient alternative to open surgical procedures and reduce recovery time, and the tremendous advances in IR hardware. Today we have a wide variety of new IR techniques that are successfully incorporated into clinical practice, which involve the use of catheters, guide wires, glide wires, balloons for angioplasty, coils, liquid embolizing agents, stents and stent grafts, radiofrequency ablation devices, thrombectomy devices, etc. IR definitely has a promising future with the continuing advances in this field – namely the clinical gene therapy – which is rapidly developing and promising therapeutic modality. Gene therapy involves ‘transferring recombinant genetic material (DNA/ RNA) into the host cell in order to change the gene expression in the host cell to gain a therapeutic effect.’ Interventional radiologists will ‘play’ an important role in the transmission of genetic materials to the target cells, using percutaneous injection or catheter systems. In the times ahead, interventional radiologists will play an increasingly important role in selecting, guiding, and monitoring clinical gene therapy. Research in gene therapy applications is underway in diverse areas, including infections, malignancies, metabolic disorders, and enzyme deficiencies. It also has a role in the treatment of ischemia of the myocardium and extremities with angiogenetic growth factors to promote collateral artery development as well as in treating stenoses following balloon angioplasty or stenting and in therapeutic angiogenesis. It is therefore important that interventional radiologists be prepared, continuously updating their knowledge to keep abreast of the advances in molecular imaging and clinical gene therapy applications and issues. The interventional radiologist must know it all: from the awareness of gene therapy terminology to concepts in cloning, vectors, and detection of their expression; from a functional knowledge of molecular imaging and immunology, to understanding the different types of catheters used in the practice of gene transfer technology, such as pressure diffusion, passive

diffusion, and mechanical and electrically strengthened catheters. Interventional radiologists should also recognize and be aware of the ongoing advances in the development of novel treatment technologies, commonly used targeted tracers and probes, and of the visualization tools employed to analyze targeted therapy. The time is not far, when catheter-based delivery of tagged stem cells to target lesions becomes an established procedure. As president-elect of IRIA, what are the areas in profession and practice that you think deserve immediate consideration? It is the role of academic and research institutions to gather knowledge and dedicate resources in the new emerging fields. The radiological community needs to invest in this future by education and participation and by creating relevant research facilities. Well,I have taken lead and started with IRIA Research and education Foundation. As on today Medical education research is not as well understood or established in India. Compared with medicine in general, these challenges are multiplied in radiology, where there are relatively fewer extramural research money available and skilled investigators to carry out radiology education research. The reasons for this are many, but most importantly, there is insufficient funding for medical education and a dearth of skilled and experienced medical education researchers.

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Prostate cancer Right Scan at the Right time Dr Harsh Mahajan

MD, Founder and Chief Radiologist, Mahajan Imaging, Padma Shri Awardee Former National President of Indian Radiological and Imaging Association

rostate cancer is the second most common cancer and sixth leading cause of cancer death in men worldwide. It has been thought till recently that prevalence of prostate cancer in India is much lesser than Western countries. But with changing demographics of Indian population enabled by urban migration, increased awareness and improved access to healthcare there is surge in the prevalence. As per the populationbased cancer registries (PBCRs) of India, Prostate cancer is the second most common cancer among males in large Indian cities like Delhi, Kolkatta, Pune and Thiruvananthapuram. There are primarily two common disease conditions that affect prostate in elderly males, benign prostatic hyperplasia and prostate cancer. It is necessary to differentiate Benign prostatic hypertrophy (BPH) from prostate cancer. The symptoms of BPH include urinary frequency, urgency, decreased or intermittent force of stream, or a sensation of incomplete can overlap with those of prostatic cancer. BPH is considered a normal part of the aging process in men and

is hormonally dependent on testosterone production. An estimated 50% of men demonstrate histopathologic BPH by age 60 years. This number increases to 90% by age 85 years. But there is cancerous change in BPH.

Clinical examination

The clinical digital rectal examination can help identify the enlargement of prostate gland. But it has very low accuracy in detecting prostate cancers. Studies have established the sensitivity of per rectal finger test to be 0.51 and specificity of 0.59 implying that it can identify only half of all prostate cancersand overestimate nearly half of them.

PSA test

Prostate-specific antigen (PSA) evaluation is the most commonly performed blood analysis in patients with suspected prostatic diseases. But this is highly nonspecific. Till recently, the upper limit of normal level of PSA was thought to be 4 ng/ ml. But studies have shown that no PSA level guarantees the absence of prostate cancer. As the PSA level increases, so does the risk of this disease. When the PSA is 1 ng/mL, cancer can be detected in about 8% of men if a biopsy is performed. With a PSA level of 4-10 ng/mL, the likelihood of finding prostate cancer is about 25%.

Ultrasound

Ultrasound is a commonly performed imaging study to identify prostatic diseases. Transrectal ultrasonography (TRUS) is better suited for assessment of prostate gland morphology as compared to the transabdominal Ultrasound. But transabdominal ultrasound has the advantage of measuring the post void retained urine to quantify the severity of urinary retention. But ultrasound, although a very good study for follow up of prostate gland size, it is not a sensitive test for identifying prostate cancers. 60 Jan 2019â&#x20AC;&#x201A; w w w. m e d g a t eto d a y.co m

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MRI Use of PSA as a screening tool followed by systematic transrectal ultrasoundguided (TRUS) biopsy has resulted in increased detection of prostate cancer. This has come with the risk of overdiagnosis and overtreatment, as many of these are clinically insignificant low-risk prostate cancer. It is in such scenarios, Magnetic resonance imaging (MRI) is very helpful. Use of MRI in the diagnosis of prostate cancer brings added value to screening and surveillance. For detecting prostate cancer, a special type of MRI study called Multiparametric MRI (mp-MRI) is usually performed. During this study, a dye is injected to assess the blood flow in the prostatic gland and identify small cancerous foci, which usually have a very high blood flow. It may be useful for decreasing the burden of prostate biopsies in men on active surveillance. It is an effective tool to rule out clinically significant and highgrade prostate cancers, and results could identify patients most likely to benefit from biopsy. Screening for prostate cancer is a controversial topic. Screening offers the opportunity to find cancers at a more curable stage. But due to the unpredictable natural course of prostate cancer with many cases being indolent while some progressing rapidly, screening inevitably results in over treatment. In a recent study of 576 men with suspected prostate cancerpublished in the Lancet, MP-MRI had greater sensitivity than TRUS-biopsy for detecting clinically significant cancers (93% vs 48%). If follow-up biopsy were performed only in men with suspicious MP-MRI scores, then 27% would potentially avoid primary biopsy.MRI is

a very objective and reliable modality for follow up of patients diagnosed of having low grade cancers, most of which are not actively treated but closely observed.

MR guided Fusion - Biopsy

Needle biopsy of the prostate is indicated for tissue diagnosis to confirm prostate cancer. Pathologic evaluation of the biopsy specimen permits calculation of the Gleason score, which is used to help determine prognosis.Prostate biopsies are usually performed under transrectal ultrasound guidance using a probe inserted into the patientâ&#x20AC;&#x2122;s anus. Before the MRI Fusion technology was available, all prostate biopsies had been performed in a blind but systemic fashion with the collection of multiple cores from predefined areas within the prostate. However, the MRI/Ultrasound Fusion technology allows now for using the MRI images obtained as described above and targeting abnormal areas that have been identified on those images by the Radiologist. While performing the biopsy the annotated images of the MRI with the suspicious areas marked will be available on the monitor. These images will then be fused with the realtime transrectal ultrasound image of the prostate. This will subsequently allow an MRI-targeted sampling of suspicious areas, under ultrasound-guidance.

Bone scan vs PSMA PET

Many patients diagnosed with early stage prostate cancer get cured with definitive local therapy i.e. Radical prostatectomy or Radiotherapy, however many will develop metastatic disease. Prostate cancer is well known for its spread to bones. Bone metastases are the most frequent site in about 80% of PCs patients and is therefore one of the most important

determinants of treatment and outcome. Once bone metastasis is diagnosed, the intent of treatment become palliative. Bone scintigraphy/scan (BS) with 99mTc-Methylene diphosphonate (MDP) has been the most favoured investigation for detecting these metastases. Recently prostate-specific membrane antigen (PSMA) has been acclaimed as a distinct target in prostate cancer. Its expression is 100-1000 times more in prostate cancer cells and level of expression is directly proportional to tumour grade, metastasis and progression. PSMA PET allows visualisation of both internal organs and bone in a single study. Apart from pre-surgical evaluation, PSMA PET/CT should also be considered a routine part of follow-up of treated prostate cancer patients since metastasis may present with low PSA levels leading to delay in addressing relapses. We recently presented a research study involving 150 patients at the annual meeting of radiological society of North America (RSNA) held in Chicago. We found that suspected PSMA avid metastatic lesions are common and are identified at low post treatment PSA levels and it will help decide appropriate salvage therapies.

Artificial Intelligence in prostate Imaging

The recent advances in computer sciences, especially with the advent of deep learning, artificial intelligence is enabling the radiologists to become more accurate in their diagnosis. At our research division, CARING- Centre for Advanced Research in Imaging, Neuroscience and Genomics,we are exploring ways to employ artificial intelligence in prostate imaging. Our researches along with our collaborators based in Spain already have developed an algorithm to automatically segment the prostate gland on MRI scans and we will be presenting this work at the upcoming European Congress of radiology at Vienna. To conclude, due to the recent advances in imaging technologies, Prostate cancer detection is possible at a very early stage if the right scan is done at the right time.

w w w.medgatetoday.com â&#x20AC;&#x201A; Jan 2019

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Latest intervention technique to treat aneurysm

Flow diverter stents

Dr. Vipul Gupta

Director, Neurointervention, Agrim institute for neuro sciences, Artemis Hospital, Gurgaon Aneurysm is a swelling that occurs in the blood vessels due to the weakening of its walls that causes a bulgy appearance. Aneurysm can form in blood vessels in any part of the body including arteries and veins and can have serious consequences. Usually the most common occurrence of aneurysm has been seen in the aorta, back of the knees, brain or intestines. If the aneurysm gets ruptured, it can even cause internal bleeding and stroke leading to casualty. It is caused by combination of potential risk factors like smoking, advanced age, high cholesterol, hypertension or tissue disorders. The symptoms are only prevalent when it ruptures and intervention is possible depending upon the location size and the condition of aneurysm.

Who is at risk of Aneurysm? Males are more likely to develop aneurysms than females. Age group of more than 60 years is at higher risk. Other factors may include  Fat and Cholesterol diet  A family history of heart disease and heart attack  Obesity  Smoking  Pregnancy can also increase risk of aneurysm of the spleen

Types of Aneurysm Classification of aneurysm is basically done depending on its location in the body. Blood vessels of the brain and the heart are the most common locations to get seriously affected. The 62 Jan 2019 w w w. m e d g a t eto d a y.co m

swelling can be of two types- either the complete blood vessel is swollen or a specific side of the blood vessel can bulge out from sides. The following are the most common types of aneurysm – Aortic Aneurysm- when the swelling is seen in the aorta that is the largest artery starting from the left ventricle to the chest and abdominal cavity. Aortic aneurysm can cause the aorta to swell from its normal diameter of 2.5 cm upto or even beyond 5 cm. Abdominal Aortic Aneurysm (AAA) - is the most common aneurysm that occurs in aorta. This aneurysm bulges in the part of the aorta that runs through the abdomen. Timely intervention can not only prevent casualties but also treat the condition. Thoracic Aortic Aneurysm (TAA) - is a less known aneurysm that can affect aorta running through chest. The percentage of occurrence is only 25 percent in the chest.

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Can it be prevented?

Cerebral Aneurysm - Intracranial Aneurysms occurs in the arteries that supply blood to the brain. They are also called Berry Aneurysms due to their appearance and also can frequently rupture and bleed. The ruptured aneurysm can be fatal within 24 hours. Peripheral Aneurysm - Peripheral Aneurysms develops in arteries other than aorta. It develops in the popliteal artery which runs in the lower part of thigh and knee. It can also develop in the artery located in groin, neck, arms and arteries supplying blood to the kidneys or bowel.

How is it diagnosed? Usually aneurysm remains undetected and screening may be required for the patients needing monitoring or treatment. Women being at lower risk of developing aneurysm, men must undergo ultrasound screening for sure around the age of 55 years and above or a regular smoker. MRI scan are useful for identifying aneurysms that do not rupture but the symptoms are prevalent. In case when the aneurysm gets ruptured and leads to the risk of bleeding in the brain, CT scans are preferred. An Angiogram may be performed in extreme cases with severe rupture and bleeding in the brain to identify the exact area for treatment.

Most of the cases being congenital, it is not always possible to prevent aneurysm. Though certain changes in lifestyle can help prevent the risk – Smoking cessation – smoking is one of the major risk factor for development of aneurysm and its rupture. Immediately stopping smoking can reduce the chances by 80%. Maintaining Blood pressure – high blood pressure tends to weaken the walls of the blood vessels due to its pressure. Hence maintaining healthy blood pressure reduces the risk of aneurysm. Following a balanced diet intake, regular exercise and medication can maintain a healthy blood pressure. Maintain normal BMI – Increased weight puts extra pressure on the heart, hence reducing and maintaining healthy body weight helps in reducing the stress on the walls of the blood vessels. Prevent high cholesterol diet – High cholesterol intake leads to plaque buildup inside the blood vessels that causes reduced space for the blood flow. This puts excess pressure and stress on the walls of the blood vessels leading to weakened vessels. This condition is known as atherosclerosis which has a very high linkage to form aneurysm.

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Surgical intervention - Flow Diversion Stent This device is the new innovative intervention for treatment of aneurysm for the initial stages hen it has not ruptured. Flow diverter stent is a pipeline method technique that includes placing a device inside the sac of the parent blood vessel to divert the blood flow from aneurysm. This intervention is an endovascular technique in which a cylindrical, metallic mesh stent is placed inside the blood vessel containing aneurysm. These stents prevents the coils from exiting the aneurysm and maintain the pressure on the coil to keep aneurysm under control. Over a period of time, blood clots on the coil are naturally healed and the blood is diverted away from the vessels that are already weakened to prevent any rupture. Flow Diversion can be used to treat large-or giant wide necked brain aneurysms and is the most effective and the newest technology available for the treatment.

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Better safe than sorry most hospitals and diagnostics centres do not comply with the safety norms as per a report published by Hindu business line. The study which this report was referring to mentioned that there was very little awareness in the general public as well as the professionals in the field.

What is required?

adiology is essential for both diagnosis and therapeutic disease management and has proved its benefits to the society at large. However not many on the ground are sensitised about the consequences of ionising radiation on healthcare professionals and the public. Hence it is required that proper care is exercised throughout the life cycle of the equipment i.e. from manufacture, supply, use, installation, maintenance, servicing and ultimately decommissioning. TheAtomic Energy (Radiation Protection) Rules, 2004, promulgated under the Atomic Energy Act, 1962, provides the legal framework for the safe handling of radiation generating equipment (in this context - X-ray equipment). As per Rule 3 it is mandatory for all the manufacturers/ Suppliers/Users of x-ray equipment, to obtain requisite ‘Licence’ from Atomic Energy Regulatory Board (AERB) for carrying out any of the above activities. Even then, radiation hazards in using medical devices such as X-Ray machines are grossly neglected in the country and

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AERB compliance could be achieved in health facilities as a three pronged effect; firstly medical equipment type approval should be in place (which is sought by the manufacturer), secondly site layout compliance which is normally the responsibility of the end user unless the equipment is procured with turnkey clauses and thirdly adherence to quality assurance norms like annual calibration, personnel protective equipment (like lead aprons, TLD badges, etc.) and

testing of equipment. Designating a Radiation Safety Officer (RSO) and competent human resource for operating the equipment as per AERB guidelines is mandatory to accomplish this exercise. In order to facilitate online submission of application for various regulatory clearances, AERB has launched e-governance application e-LORA. (E-licensing of Radiation Applications) System. All diagnostic and therapeutic X-ray emitting equipment need to be registered and their respective institutions are required to obtain all the requisite consents from AERB through e-LORA. States are also expected to establish Directorate of Radiation Safety (DRS) under Health & Family Welfare

Department to carry out regulatory inspections of x-ray facilities and support the utilities in obtaining licence/ registration from AERB. As of date DRS are established and functioning in states of Kerala, Mizoram, Chhattisgarh, Tripura, Arunachal Pradesh and Punjab; in the remaining states the process in underway. AERB has also setup regional regulatory centres at Chennai, Kolkata and Delhi for decentralised regulatory control.

What is done so far? The Government of India is supporting states under National Health Mission’s free diagnostics service initiative to provide X-ray diagnosis free of cost. In the public health system, X-ray machines are installed upto the block level hence it is crucial to be wary of unsafe use of x-ray radiation and health risk associated with it. In this context Ministry of Health & Family Welfare in consultation with all the stakeholders has prepared guidelines to ensure compliance, this also confirms Ministry’s commitment to provide financial and technical support to the states in this endeavour. To rapidly strengthen public health facilities safety in terms of diagnostic radiology and equip public health facilities to address concerns related to radiation safety, National Health Mission has emphasised AERB safety guideline. In order to reinforce and support states in complying with AERB norms, model Request for Proposal (RFP) has been developed. A lump sum amount per facility to meet all the regulatory requirements within the AERB framework is also provided to states. The RFP document lays out the requirements for bidders to help facilities obtain “Licence for operation”from AERB. These guidelines and RFP document are expected to serve as a valuable resource to achieve 100% compliance to radiation norms.

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Recent advances in Radiology In recent times, there are advances in the hardware as well as software in the imaging based equipment’s. These advances are helping the radiologist in decision making. There are few important developments that need mention and are as under: Artificial intelligence (AI) in Radiology: AI is being used in radiology equipment for stream lining workflow, automatic scanning, motion sensors etc. for last few years. However, nowAI isthere to stay in radiology decision making process and is being adopted by the radiologist in image interpretation that is likely to make an impact on healthcare outcome. It is being used in all modalities in Radiology. In radiographic examination, it is being used to automatically classify osteoporosis, emphysema, age related changes in the lung on chest radiograph, in mammography to detect and to classify the lesion as benign or malignant on the basis of pattern recognition. In CT evaluation of the chest, it has been used to detect and evaluate the pulmonary nodules, various patterns of interstitial lung disease just to give few examples. Remote-viewing systems: There is a proliferation of remote viewing systems to call up images on a Web-browser or ability to forward images from a PACS to referring physicians. This is a key radiology requirement to make imaging available to the clinician. Currently, images are generally not accessible unless a physician has access to the hospital or imaging centre’s PACS. If not, a CD is burned and sent by courier or mail, which may not always open. If images are not accessible or CDs do not open, repeat imaging exams are often performed, adding to the cost and unnecessary radiation if X-ray based systems are used for a repeat study.Patients are given to access their images and reports to share their access code to their doctor, who can then access the data. Imaging and software systems are becoming much more intuitive to help speed exam times and workflow. New

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advanced visualization tools that auto segment and quantifies anatomical structures or function. Simplified, automated protocols on the imaging systems themselves are also helping technologists perform studies more quickly and efficiently, especially using CT and MRI systems.

Development of Helium free MRI: First time introduced by Philips, The Netherlands at the RSNA 2018 – the model called Ingenia Ambition 1.5T is a blue sealed magnet that is virtually Helium free and about 800 kg lighter than regular 1.5T MRI but does not compromise on image quality. Such He free magnet opens up possibility to build up true mobile MRI in near future. Advances in Mammography:Key technology advances on the show floor included breast ultrasound and breast density software. Automated breast ultrasound system, for screening women with dense breast tissue is used in combination with mammography is being developed, the system is clinically proven to increase cancer detection rate in women with dense breast tissue. It reduces the inter-operator variability inherent in hand-held ultrasound systems.

to the anatomy of patients over the current stand of hard coils, bringing these close to the area of interest and enables in better image quality. Development of Compressed SENSE technology in MRI:Introduced by Philips for all anatomies and for all 2D, 3D and 4D scans that have helped to reduce the scan time in MRI and has also able accurately perform quantitative MRI with improved resolution and temporality. Development of ultrashort TE technology: has helped to image the bone as efficiently on MRI as CT, thereby eliminating the need for side effects of radiation based techniques and also helps in reducing the gradient sound of MRI which is major reason for non-compliance of some of the patients In summary, we can conclude that continued development in the hardware and software technology has helped to improve clinical decision making and is likely to impact the health care in future.

Wireless Transducer: introduced by Siemens is the world’s first wireless transducer ultrasound system. It eliminates the impediment of cables in ultrasound imaging. The Freestyle is a point-of-care system that will expand ultrasound’s use in interventional and therapeutic applications. The transducer can be used to image up to 10 feet from the console. OLED Displays:New OLED medicalgrade monitor is the latest addition to the image display. The superb color reproduction, especially for dark images, helps radiologistto observe very subtle details such as the faint color difference between various tissues. Flexible MRI Coils: Development of flexible MRI coils by the major vendors in the field of MRI have helped to mould

Dr. Rakesh K Gupta

MD, Director and Head,Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurugram

COVER STORY

Renal Biopsy – The Speciality at Aware Gleneagles Global Hospital Dr Radha Sagar

Consultant Pathologist Aware Gleneagles Global Hospitals

istopathology is the examination of tissues from the body under a microscope to spot the signs and characteristics of disease. Histology is the study of tissues, and pathology is the study of disease. So taken together histopathology literally means the study of tissues as relates to disease. A histopathology report describes the tissue that has been sent for examination and the features of what the cancer looks like under the microscope. A histopathology report is sometimes called a biopsy report or a pathology report. Biopsy is an examination of tissue removed from a living body to discover the presence, cause, or extent of a disease. A renal biopsy is a procedure used to extract kidney tissue for laboratory analysis. The word “renal” describes the kidneys, so a renal biopsy is also called a kidney biopsy. The test helps a doctor to identify the type of kidney disease a patient has, how severe it is, and the best treatment for it.

Precisereason to do a kidney biopsy is”

AGGH is one of the most sought after hospital for the Renal Biopsy for the most advanced technics, most modern equipment like immunoflorescent Microscope and most capable team of doctors and in the most obvious reason that the hospital specialises in the Kidney transplants.

 Severe kidney disease with no clear cause

A kidney biopsy involves taking one or more tiny pieces (samples) of your kidney to look at with special microscopes. The microscopes make it possible to see the samples in greater detail.

 Know a problem that cannot be cured, but can be slowed down by other therapy

The biopsy sample can be taken in two methods:

 Why a transplanted kidney is not working well

 Percutaneous biopsy: a needle placed through the skin that lies over the kidney and guided to the right place in the kidney, usually with the help of ultrasound.  Open biopsy: the kidney sample is taken directly from the kidney during surgery. The kidney sample is then sent to a doctor (pathologist) who looks at it with microscopes and checks for any signs of disease. Why Renal Biospyrequired - Some kidney complications can be detected by blood and urine tests, special tests sonogram and along with symptom of patient .But for certain patients with sometypes of kidney disease, and patients who have to undergone a kidney transplant , with improper functioning of the graft kidney a correct diagnosis can only be made with a Renal biopsy.

 Nephrotic syndrome and glomerular disease which happens when the filtering units of the kidney are damaged  Blood in the urine  Protein in the urine  Uncharacteristic blood test results

A Renal biopsy can help doctor understand:  If a disease is getting better with treatment or if it is getting worse

 How much permanent damage has happened in the kidney,  Helps the doctor to decide on further treatment  Presence of a kidney tumor  If a certain treatment is hurting the kidneys It is essential that the doctor prescribing the Renal Biopsy make the patients understand why the procedure is required and why it is necessary. After the kidney sample is taken, it is sent to specially trained pathologists who will read and interpret your kidney biopsy. It often takes three to five days to get the full biopsy results. In some cases, you may have a partial or full report within 24 hours or less. A report given by the pathologist is important for Nephrologist to decide on thefuture line of treatment.

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Innovation in Diagnostics How it can Transform the Indian Healthcare Industry

Ms. Arunima Patel Managing Director, iGenetic Diagnostics

ealthcare industry in India is currently at a place from where it can grow exponentially, given the right resources. The recent spike in the pace and speed of growth of healthcare can be attributed to strengthening coverage, improved quality of services, and increase in expenditure by public as well as private players. Amid this impressive progress, one industry that has emerged as a prominent game changer in the healthcare sector is diagnostics. In a market where there are no certain governing laws to check quality of services, the private players have taken upon themselves to introduce standardization in their practice and follow protocols set by international medical bodies to ensure consistent and world-class service to all their consumers. The availability of good diagnostics is central to both the treatment and control of infectious diseases. Since parasitic and vector-borne diseases have the highest burden in low-income developing countries like India, the design of diagnostics for such diseases is complicated. In such a setting, the ideal diagnostics facility must have certain innovative characteristics. Innovation in diagnostics can bring significant patient and economic benefit. Technologies that are faster, cheaper, more accurate, more portable, user friendly and easily connected with healthcare systems have the potential to increase productivity and improve care pathways.

Design for India

There is so much talk around Make in India but our focus should be ‘Design for India’. Today ninety percent of development and innovations in diagnostics are done in western markets, which need to be bought and adapted for the Indian consumer. Every technology that we import is meant for the western 68 Jan 2019 w w w. m e d g a t eto d a y.co m

population and solves problems typically faced in their markets. The need of the hour is indigenous solutions created in India for problems faced by healthcare consumers in emerging markets. We need to ‘Design for India’ in the country and actually manufacture anywhere.

User-friendly: Affordable and Simple to Perform

Affordable innovation, that presents ways in which to pioneer, be versatile, and do a lot with less, will facilitate a resource-constrained country like India, address challenges in provision. Such a model will make sure that health care is “available” and “accessible” to each subject of the country on a priority basis. For this, the nation's innovation capability must be increased through the correct implementation of business incentives, policy support, finance mechanisms, human capital and bestin-class infrastructure. The aim ought to be to form a righteous cycle of basic understanding, wherever knowledge is seamlessly translated into sensible solutions to deal with unmet health care needs.

EXPERT VIEWS

Equipment-free

Mobile platforms hold the capacity of revolutionizing the diagnostics industry, creating opportunities for telemedicine. The future of diagnostics could comprise of smart phones, tablets and laptops at health clinics. Connected non-invasive diagnostic devices can capture diagnostic and patient info and phones or tablets could connect securely via 3G/4G data to cloud-based apps. Cloud services could connect to a network of specialists using smart phones, ready to provide quick responses. Eighty-five percent of skin issues can be fully diagnosed by a dermatologist with a photo taken by a smart phone. From the embarrassing STDs and acne to rashes that donâ&#x20AC;&#x2122;t go away and other skin issues, there is a huge efficiency to the consumer and the doctor in managing the interactions through a mobile platform.

Digital Diagnostics

Taking help of the new smart mobile platforms can help in infiltrating the remotest regions of India. India has the cheapest mobile services on the planet. 3G is already available across much of India; there will continue to be a ferocious price war to capitalize on the 3G and 4G spectrum purchased by the mobile carriers. This is all good news for consumers and health care providers. Because, the combo of omnipresent smart phones and 3G data creates a massive low-cost platform for delivering health care servicesâ&#x20AC;&#x201C;the foundation of telemedicine. This device will be integrated through 3G/4G with a group of quality specialists who can deliver opinions on patient diagnostics within minutes. Patients do not have to take time away from work for an appointment. There is also no

travel time or associated expenses, such as paying for commute or child care.

Telemedicine

Telemedicine is referred to the innovation of remote delivery of diagnostic services, such as report assessments or consultations, over the telecommunications infrastructure. It permits medical personnel to judge, diagnose and treat patients while curbing the requirement for an in-person visit. Telemedicine permits diagnostic facilities to share patient info, laboratory results, with an expert at another location. Interactive telemedicine permits physicians and patients to speak in real time. Such sessions may be conducted within the patient's home or in a nearby medical facility, using telephonic conversations or the employment of video conferencing software system. Through telemedicine, patients in rural areas can acquire specialty diagnostic services a lot more simply.

Technological Advancements

Understanding the need of a new diagnostic technology in the medical framework paves way for advancements in testing research and development of new tests that are more accurate, more reliable and more cost effective. This may include replacing an existing test, as a triage test to direct the need for additional tests, or as an add-on test performed after the current diagnostic workup to further stratify patients. Understanding the role of a new test highlights its impact on existing diagnostic test pathways, and resource utilization, and may identify places where disinvestment in existing diagnostics may be possible w w w.medgatetoday.com â&#x20AC;&#x201A; Jan 2019

EXPERT VIEWS

Scenario of Diagnostic Imaging in India

Aanjaney Shahi

Consultant, Healthcare Technology, National Health Systems Resource Centre

Overview

Diagnostic imaging refers to several different technologies that are used to view the human body in order to diagnose, monitor, or treat medical conditions. Each type of technology gives different information about the area of the body being studied or treated, related to possible disease, injury, or the effectiveness of medical treatment. PPP initiatives in health sectors have also increased the demand for diagnostic imaging services in public health facilities. National free diagnostic service initiatives & various statelevel model have been established to deliver the services in public health facilities. The diagnostic imaging services in PPP-mode, the service providers setsup & operates & maintains high-end radiological imaging technologies like Computed Tomography & Magnetic 70 Jan 2019 w w w. m e d g a t eto d a y.co m

Resonance imaging equipment. The shortages of specialists in set up have enabled the use of technological & information technologies pathway for tele-reporting of medical imagining cases. It has remarkably reduced the cost. These initiatives have created huge opportunities in health sectors. The government of India has initiated free skill development under PMKVY through Health Sector Skill council.

Innovations

In today’s scenario, it has been witnessed, that requirement of artificial intelligence is in all sphere. In diagnostic imaging, AI platform uses advance algorithms that are enabling auto detection of 3-Dimensional anatomical structures, etc. These features have enhanced software tools for reporting of cases as well as has made it more quantified.The lack of resources in LMIC have ignited many incubation centres across countries to come with innovative solutions to overcome

these challenges. The innovations range from usage of Artificial intelligence in diagnostic imaging, cloud based secured storages, mobile imaging systems, etc.

Manufacturing & Regulations

Under make in India scheme, Government of India is setting up Special economic zones for medical device manufacturing. It would have the provision of manufacturing units & common scientific facilities for X-ray & CT scan tubes and EMI-EMC testing. The diagnostic imaging devices that works on radiation ionisation platform are being regulated under The Atomic Energy act, 1962 by Atomic Energy regulatory Board. PCPNDT act regulates all clinical applications for Ultrasonography usages. The Ministry of Health & Family Welfare has already come with the Medical device rule,2017 which has been effective from January, 2018 to make it easy for medical device manufacturers to comply drugs and cosmetic acts.

POST EVENT

Government committed to providing quality healthcare within the country and outside through promoting healthcare services sector - Suresh Prabhu Mr Suresh Prabhu, Minister of Commerce and Industry, Government of India, today said that government is committed to providing quality health care within the country and outside through promoting the service sector. Speaking via video conferencing at the ‘Advantage Health Care - India 2018’ (4th International Summit on Medical Value Travel) organised by FICCI jointly with the Department of Commerce, Ministry of Commerce & Industry, Government of India, Mr Prabhu said, “We have set aside almost Rs 5,000 Cr or approximately 700 million dollars for enhancing the overall services sector including healthcare.” Mr Sudhanshu Pandey, Additional Secretary, Ministry of Commerce and Industry, Government of India, said that it is extremely important that the healthcare facilities are affordable as only then more and more people can access quality healthcare. “Our efforts in India have been to reduce the cost of healthcare services, while we take our journey towards universal coverage, we try to offer and share our resources with the global citizens,” he added. He further said that India itself carries a very large disease burden and is trying to come up with programs and policies, latest one being Ayushman Bharat Scheme, where effort have been made to extend a wide insurance coverage to the Indian citizens numbering over 500 million so that they can have access to better health care facilities. Ms Sangita Reddy, Vice President, FICCI & Executive Director Apollo Hospitals Group said, “India is unparalleled in delivering quality medical care at one tenth of the global cost, and aims to transform this sector so that India becomes an epicenter of Medical Value Travel.” She further added that we will continue to work on better facilities, translation, food, and outstanding 72 Jan 2019 w w w. m e d g a t eto d a y.co m

Release of FICCI – EY Knowledge Paper on Medical Tourism in India by Mr. Sudhanshu Pandey, Additional Secretary, Ministry of Commerce and Industry, Government of India, Ms. Sangita Reddy, Vice President - FICCI & Executive Director Apollo Hospitals Group, Dr. Devlina Chakravarty, Co-Chair – FICCI MVT Committee & MD- Artemis Hospitals

medical services for our foreign patients. Our doors are open, our hearts are open, and our facilities are on par with the best. Dr Devlina Chakravarty, Co-ChairFICCI MVT Committee & MD, Artemis Hospitals said that India has more than 1600 NABH accredited facilities, & 32 JCI accredited hospitals. “Cost is not the only differentiator for India when it comes to medical value travel, we’re also known for our talent,” she added. On the occasion ‘FICCI-EY Knowledge Paper on Medical Tourism in India’ was also released by FICCI in association with Ernst and Young. The dignitaries at the two-day conference and exhibition included Mr Dilip Chenoy, Secretary General, FICCI;

Dr Shohani Ramzi, Head International Relation, Health Ministry of Iraq; Mr Suranjan Gupta, Executive Director, EEPC India; Dr Harish Pillai, Co-Chair – FICCI MVT Committee & CEO Aster Hospitals & Clinics, India at Aster DM Healthcare. Advantage Health Care India - 2018 aims to present India as the most preferred healthcare destination for patients from across the globe. The idea behind the summit is to provide an opportunity for India to showcase its immense pool of medical capabilities as well as help develop opportunities for healthcare collaborations between the participating countries. Visitors and delegates from over 71 countries are participating in the Summit.

‘FICCI-EY Knowledge Paper on Medical Tourism in India’: Key takeaways of the report: A sia accounts for the 58% share of total disease burden, while Africa stands at 24%, indicating the disease burden stress to be highly prominent in Asian region  The largest disease burden comes from cardiovascular diseases which accounts for 14-15% of the total. This is followed by cancers, mental and neurological disorders, new born complications and other NCDs. Diarrhea and other infectious disease also account for 10%  MVT is a burgeoning multi-billion dollar industry and likely to grow higher due to many beneﬁts offered to patients  95% of the medical travelers from Africa prefer travelling to Asia for medical treatments. A high-quality treatment at lower healthcare costs coupled with the possibility to travel to exotic places made Asia the preferred region for foreign medical travelers  India, Malaysia, Thailand and Singapore are the most preferred countries for medical treatments globally due to advanced quality healthcare and affordable healthcare costs  Countries like Costa Rica, Mexico, Barbados and Antigua are expanding their services faster thus attracting patients from North America and Europe. The UAE is also developing itself as MVT hub by promoting developments in Dubai. Huge amounts of investment have been made in Dubai by the government, as it envisages itself as the medical hub in coming years  The lowest spending by the government has been observed in countries like Bangladesh and Myanmar indicating inadequate medical infrastructure. Thus, the inadequate infrastructure in source countries and higher prices of healthcare in developed economies like US and Canada, becomes the high potential region where India can focus for the development of MVT.

INTERVIEW

A visionary turned missionary The Man who has transformed vision into obsession in Taiwanese Healthcare.

lobal Medical Technologies and Specialty Training Courses are different verticals in healthcare, so do you have two separate approaches to promote them or relying on single unified approach ? TAITRA has been actively promoting Taiwan’s medical services since 2008 through extensive exhibitions, trade missions, medical seminar and forum to assist Taiwanese medical providers gain international visibility. TAITRA has also been helping to establish Taiwan's medical brand to reinforce Taiwan's status as one of the best medical platforms in the world. We organize overseas promotion activities and bring patients with rare disease to Taiwan for treatments. Is there any comparison exist between medical technologies and Specialty Training Courses, if so, Pl share? We believe that Taiwan’s mature ICT and high-tech industries have the necessary skill sets to take part in medical and healthcare markets, which also encourage the development of medical services, as well as digital medical industry. Training specialty physicians goes hand in hand with the advanced of medical technology. Do you have country or region specific approach to promote two verticals? A: TAITRA focus our effort in promoting Taiwan’s Healthcare in regions such as Southeast Asia, Hong Kong, Macau, and Mainland China, where they share similar cultural background and language with Taiwan. It has been extended to the Middle East region as new opportunity arises. Medical technologies are game changer, and to stay for long, how disruptions friendly these technologies are ? TAITRA has been the best promoter for Taiwan’s fledgling medical technology industry. Smart medical has become a major industry trend. Taiwan’s ICT and manufacturing capabilities play an important role in the world. As responsible media for integrated global healthcare mission, I would like to know whether Taitra would like to go for private healthcare or govt to govt contact or both, kindly share your priority map. TAITRA mainly focuses on facilitating and cultivating cooperation between Taiwan’s Healthcare Industry and foreign companies.

74 Jan 2019 w w w. m e d g a t eto d a y.co m

Walter Yeh

President & CEO, Taiwan External Trade Development (TAITRA)

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