Download State-of-the-art Automation is Here - eHEALTH

asia’s first monthly magazine on The Enterprise of Healthcare
volume 10 / issue 3 / March 2015 / ` 75 / US $10 / ISSN 0973-8959
Haematology Analysers & Reagents
eHealth Magazine
State-of-the-art
Automation is
Here
Mri Systems
Maternal &
Infant Care Equipment
Blood Filters
asia’s first monthly magazine on The Enterprise of Healthcare
volume
10
issue
3
March 2015
President:Dr M P Narayanan
Partner publications
Editor-in-Chief: Dr Ravi Gupta
Editorial Team
Health
Sr Correspondent: Anshuman Ojha
education
Sr Editor: Shitanshu Shekhar Shukla
Project Manager: Seema Gupta
governance
Sr Assistant Editor: Nirmal Anshu Ranjan
Sr Correspondent: Kartik Sharma,
Nayana Singh, Souvik Goswami, Gautam Debroy
SALES & MARKETING TEAM: Health
North: Sapna Choudhary, Mobile: +91-9910998066
West: Douglas Digo Menezes, Mobile: +91-9821580403
South: Vishukumar Hichkad, Mobile: +91-9886404680
Subscription & Circulation Team
Manager Subscriptions: +91-8860635832; [email protected]
Design Team
Creative Head: Pramod Gupta
Deputy Art Director: Priyankar Bhargava
Sr Graphic Designer: Om Prakash Thakur
Sr Web Designer: Shyam Kishore
WEB DEVELOPMENT & IT INFRASTRUCTURE
Team Lead – Web Development: Ishvinder Singh
Sr Executive – IT Infrastructure: Zuber Ahmed
Executive – Information Management: Khabirul Islam
event team
Manager: Nagender Lal
Assistant Manager: Vishesh Jaiswal
administration
Head Administration: Archana Jaiswal
Editorial & Marketing Correspondence
eHEALTH - Elets Technomedia Pvt Ltd, Stellar IT Park
Office No: 7A/7B, 5th Floor, Annexe Building,
C-25, Sector 62, Noida, Uttar Pradesh 201301, INDIA.
Phone: +91-120-4812600 Fax: +91-120-4812660
Email: [email protected]
ehealth does not neccesarily subscribe to the views expressed in this
publication. All views expressed in the magazine are those of the contributors.
The magazine is not responsible or accountable for any loss incurred, directly
or indirectly as a result of the information provided.
ehealth is published by Elets Technomedia Pvt. Ltd in technical collaboration
with Centre for Science, Development and Media Studies (CSDMS)
Owner, Publisher, Printer - Dr Ravi Gupta, Printed at Vinayak Print Media
D - 249, Sec-63, Noida 201 309, UP, INDIA & published from 710 Vasto Mahagun
Manor, F-30, Sector - 50, Noida, UP.
Editor: Dr Ravi Gupta
© All rights reserved. No part of this publication may be reproduced or
transmitted in any form or by any means, electronic and mechanical, including
photocopy, or any information storage or retrieval system, without publisher’s
permission.
ehealth.eletsonline.com | egov.eletsonline.com | digitallearning.eletsonline.com | events.eletsonline.com
Send us your feedback for any of our Health news, interviews, features and articles. You can either comment on the individual webpage of a story, or drop us a mail: [email protected]
4
March / 2015
ehealth.eletsonline.com
Contents
14
Haematology
Analysers & Reagents
28- Clinical Logistics are Saving
State-of-the-art
Automation is Here
23
Blood
Transfusion:
A Doubleedge Sword
Transfusion of blood products is a
double-edged sword, which should be used
judiciously. Though blood transfusion can
be life-saving, it can also lead to certain
adverse reactions
Buyers Speak
19-EMR: Need of the Hour
Dr. B.K. Murali, MD, Hope Hospital &
DrMHope Softwares Private Limited
He future appears limitless as researchers
and medical technology manufactures
continue to strive toward increased
image quality, physicians work towards
better diagnoses, and patients anticipate
speedier, more comfortable, and less costly
MRI exams
Mother-Child Care
Equipment Market Smiles
Ahead
Prenatal, fetal and neonatal care is gaining
importance every year with increasing
awareness, demand and affordability for
the latest, improved and technologically
advanced equipment that are available
worldwide
guest column
12-Do We Wait 138 Years for the
Outcomes of Draft National Health
Policy 2015?
Dr. Nomal Chandra Borah, CMD,
GNRC Hospitals
6
March / 2015
ehealth.eletsonline.com
36- ‘Make in India’ Key to
Growth
46-Trends in Cardiology
Dr. Vishal Rastogi, Senior Consultant
Interventional Cardiologist, Fortis Escorts
Heart Institute (FEHI)
41- Direct Radiology Systems are
47-Affordable Hi-end Technology
Kiran Phuri, Director Marketing, Medx
Technologies
Dr. Shubham Sogani, CEO,
House of Diagnostics
56-Technology and Healthcare
Delivery
Dr. Dharminder Nagar, MD,
Paras Healthcare
57-Technological Advancements
and Emerging Trends
Dr. Rakesh Gupta, Chairman and Medical
Director, Sarvodaya Hospital and Research
Centre
here to Stay
53- Technological
Advancements and Emerging
Trends
Shashank ND, Founder & CEO, Practo
62- Health Information Exchange
is for 360 Degree Patient Care
Dinesh Samudra, CEO, Palash Healthcare
Systems
Case Study
30-Developing and Deploying
Software for the Social Sector
60-ASHA Soft – The Online
exclusive interview
Payment and Monitoring System for
ASHAs
10-Government Reaches Out To
NEWS
Communities
50
Manoj Kumar, Executive Vice President
and Chief Executive Officer, Ricoh India
Limited
James Mazarello, CEO, Rosalina
Instruments
Dr. Rajeev Boudhankar, VP,
Kohinoor Hospital
MRI Future – Faster
Workflow, Shorter
Exam Time, More Patient
Comfort
34- IT Infrastructure – The
Backbone of Indian Hospitals
54-NICU Offers Quality HealthCare
38
Patients’ Lives
Bhavesh Y Bhatt, GM, Maquet Medical
India Private Limited
Dr. Jagdish Prasad, Director General,
Health Services, MoHFW, Govt. of India
18-Pharmaceutical Industry -
Technological Advancements and
Emerging Trends
Nakul Pasricha, VP, Authentication
Solution Providers Association and COO,
PharmaSecure
20-Focusing On the Universal
22-Company News
49-Government Desk
58-International News
59-National News
Product Launch
64 - Laura M – Next Generation
Urine Analyser
Healthcare Needs
65 - Carestream Unveils its
26- Blood Transfusion and
Product Showcase
Dr. Stephen Oesterle, Senior Vice
President – Medicine and Technology,
Medtronic plc
Leucoreduction: Need of the Hour
Chetan Makan, VP and GM, Haemonetics
Innovative Radiology Solutions at
IRIA 2015
66-Staying Fit or Staying Healthy
editorial
Remedy Short of Malady?
Finance Minister Arun Jaitley’s maiden Union Budget does talk about sops to
the healthcare sector, but going by the reaction from the Industry, they probably
expected more off the rather ‘reformist budget’.
The Budget proposes an allocation of `33,150 crore for the healthcare sector,
apart from rolling out Atal Innovation Mission, an innovation promotion platform
involving academics, entrepreneurs and researchers, at an estimated cost of `150
crore. The government has also proposed to raise the limit of deduction in the
health insurance premium from `15,000 to `25,000 and from `20,000 to `30,000
for senior citizens. The increase in health insurance premium will enable people to
go for quality healthcare, which is a huge concern in the country.
Some of the other key announcements include a proposal to set up AIIMS in five
states — Jammu & Kashmir, Punjab, Tamil Nadu, Himachal Pradesh and Assam.
Bihar will also have a second institute modelled on AIIMS. Besides, three new
National Institute of Pharmaceuticals Education and Research in Maharashtra,
Rajasthan and Chhattisgarh, and one Institute of Science and Education Research
to be set up in Nagaland and Orissa each. The move will go a long way in
addressing the issue of shortage of doctors and skilled professionals.
While the increase in allocation for healthcare is a welcome move, Mr Jaitley
could have done more. Even after the proposed hike in the government spends, it
remains lowest amongst the BRIC nations. The funds may also fall short to achieve
the ‘Healthcare for All’ goal by the end of the next five-year plan.
Also, the budget leaves the import-dependent MedTech industry, which could
have given impetus to the ‘Make in India’ campaign, completely untouched.
The healthcare sector was expecting announcement of tax holiday for medical
technology companies desirous to set up new manufacturing facilities, and
announcement to set up medical technology manufacturing hubs with singlewindow clearance to provide ease of manufacturing.
Similar is the story of the pharmaceutical industry, which looks disappointed with
no major announcements coming its way. There is also a lack of announcement of
initiatives to boost the bulk drugs industry, which is facing stiff competition from
China.
As if that was not all, the increase in Service Tax rate to 14 percent from
the 12.36 percent is also sure to have an adverse impact on patients and
hospitals.
But as they say, reforms and stimulus don’t go together. Let’s accept the fact.
Dr Ravi Gupta
[email protected]
8
March / 2015
ehealth.eletsonline.com
Introducing the new
Carestream Vita Flex CR System
Smaller footprint. Bigger impact. And more room for care.
First of it's kind innovation in CR
� Offers ability to self-install and self-repair
� Can be positioned in horizontal or vertical position
� 3 Replaceable parts allows for quick and easy repair
� Small, compact, light weight design
2015.
NOW INSTALLING
AND SERVICING
YOUR CR IS
AS EASY AS
CHANGING
A LIGHT BULB!
Face to Face
Government
Reaches Out To
Communities
Around nine lakh ASHA workers have been trained to provide healthcare
facilities to every 1000 population, says Dr Jagdish Prasad, Director
General, Health Services Ministry of Health & Family Welfare, Government
of India in conversation with Nayana Singh of Elets News Network (ENN)
Please brief us on the latest
healthcare initiatives in the rural and
semi urban space in India.
The Government of India is running its
National Rural Health Mission (NRHM)
since 2005, the purpose of which is to
encourage health coverage in the rural
areas and make available health services
till the community level. ASHA workers
have been appointed for this purpose.
Around nine lakh ASHA workers have been
trained to provide healthcare facilities to
every 1000 population. We have also taken
measures to train the sub centres,
PSC, CSC and district hospitals.
These initiatives have achieved
significant results. Infant mortality has
been successfully brought down to 40 per
1000 population, maternal mortality rate
a n d total fertility rate have also
Dr Jagdish Prasad
Director General, Health
Services Ministry of Health &
Family Welfare, Government
of India in conversation
10
March / 2015
ehealth.eletsonline.com
Face to Face
been successfully controlled. States
such as Kerala, Tamil Nadu, Goa and
Maharashtra have made significant
progress and their health standards
are far better as compared to many
European countries.
However, there is a lot to achieve
as far as the rural health standards
of people are concerned.
The availability of doctors at the
village level or the sub centre
level is still a concern. What
are the steps you are taking to
address this problem?
In order to fill up the vacancy of
having adequate number of doctors in
the rural areas, we have introduced
telemedicine to reach out healthcare
services. The ANMs present at the
sub centres have basic knowledge
of medicines and they can help
the patience to communicate with
doctors sitting at tertiary care in
hospitals. We are planning to attach a
medical college in every district and
we want the medical colleges to make
a complete development plan of the
district, sub district, CSC, PSC and
sub centers. We are also planning to
give hands on training to the doctors
working in the district hospitals.
Thus, by the use of Information
Technology, we will be able to cater
to all the healthcare needs in the
rural apace.
The Bill and Millinda Gates
foundation has covered 800 villages
in Bihar. Through the system of
telemedicine, people from these
villages can reach out to the doctors.
Kits have also been made available
so that the body temperature, blood
pressure, ECG, auscultation (sound
of the heart and lungs) can be sent to
the doctors through telemedicine and
thus the patents can be treated.
We are also running health
programmes in schools of the
districts in which health cards of
the students will be made. If any
student has any disease or defect, it
will be detected and treated. We have
provided a fund for this and this fund
will help doctors treat patients free of
cost. Some states have already done
this. The introduction of health cards
for students will ensure that we have
healthy children in the society.
We have launched National
Rheumatic Heart Programme in the
country in which we are trying to
teach children, parents and teachers
that symptoms such as sore throats,
joint pain can be the indications of
rheumatic heart diseases. Similarly,
we have identified 35 diseases and
provided doctors who will visit the
schools and make health cards of
students and treat them in case they
are suffering from any disease.
How are you developing
awareness regarding
healthcare in these areas?
We are introducing health
education in schools in which health
education will be imparted to students
studying in between standard
three to 12. In this curriculum,
students will learn everything
about non communicable diseases,
communicable diseases, prevention
of these diseases, trauma prevention,
right dietary plans, how to detect
diseases in their early stage etc. This
will be a compulsory subject so that
all the students can learn this and also
teach their parents. The Government
of India has already prepared the
syllabus for this and the book is also
ready. We hope to introduce this book
in the coming session. Thus, we hope
that this initiative will help us cure
the non-communicable diseases
such as diabetes, hypertension,
cardiovascular diseases, cancer etc,
which are causing almost 57 percent
of deaths in the country.
We have also launched a screening
programme for cervical cancer,
breast cancer and for mouth cancer.
These can be cured if they can be
treated early. We have decided to help
the 50 medical colleges where there is
a nucleus of cancer treatment. We will
provide them a fund of `45 crore so
that they can upgrade the institutes.
Besides, GoT will provide funds for
developing state cancer institutes.
Are there particular challenges
that you are facing?
Uneven distribution of human
resource is a big challenge for us. We
have more than eight lakh doctors
available to us in the AYUSH system.
They should be allowed to work so
that the gap which is felt at the lower
levels can be filled up.
How are you planning to adopt
IT to develop the health sector?
Besides telemedicine, we are planning
to introduce tele education, which
will help medical students to learn
from the best professors who deliver
lectures in the best institutes. This
will also address the problem of lack
of professors. The Medical Council of
India has to give its permission for
the same.
What is your opinion on making
healthcare more affordable for
everyone?
In order to make healthcare services
affordable, the public healthcare
system has to improve. We have
formed an act under which we
are trying to regulate the prices
charged by private hospitals so that
they cannot charge exorbitant from
patients. If this gets implemented in
all the states, healthcare expenses
will be so high.
What is your vision for a healthy
India?
Prevention of diseases should be
our priority as most of the diseases
can be prevented. Regular health
checkups are also very important.
Our traditional ways such as Yoga,
meditation should be adopted in
our daily routine to keep us healthy.
Taking care of our diet and regular
exercises is equally important to
prevent the lifestyle diseases.
March / 2015
ehealth.eletsonline.com
11
Guest Column
Do We Wait 138 Years
for the Outcomes of Draft
National Health Policy 2015?
Dr. Nomal Chandra Borah, CMD, GNRC Hospitals, Guwahati
F
ederal approach missing, regional imbalances remain unaddressed in National Health
Policy 2015
An evidence-based prescription
from the North-East – relevant to
North, East, West and South – to rectify
the inadequacies of centrally-formulated, nationally-imposed and regionallyirrelevant policy formulation and implementation process.
Let us first consider pieces of evidence that illuminates aspects of the
state of health of the nation and its
care that the Draft Policy attempts to
address. Life expectancy in India has
risen by five years in the past decade,
according to the Union ministry of
health and family welfare. This is due
to better immunization and nutrition,
coupled with prevention and treatment
of infectious diseases. Though India
will remain a young country overall,
the population of the elderly will touch
12-13 percent by 2025 and 17 percent
by 2050, according to the World Health
Organization (WHO).
The longer lives of our people today, however, are often being led under the debilitating shadow of health
conditions resulting from our present
lifestyles and longer life-spans. The
causes of fatality, and often, disability,
today are lifestyle-triggered conditions
such as hypertension which leads to
coronary artery disease and stroke.
12
March / 2015
ehealth.eletsonline.com
Our lives are longer, but not healthier.
A prosperous nation cannot be built
by unfit, unproductive people. Apart
from primary, preventive and promotive healthcare, India must cater well
for secondary and tertiary healthcare,
if we have to pursue a brighter destiny
for this country and her population.
Given this situation, one would have
expected the draft policy to be farsighted and pay significant attention to
the emerging burden of healthcare due
to demographic and lifestyle changes,
and the consequential importance of
secondary and tertiary care – all the
more so as Section 2.7 explicitly acknowledges that non-communicable
diseases and injuries now account
for 50.9 percent of the nation’s burden of disease and that National
Health Programmes offer very
limited coverage and scope of
treatment for non-communicable
diseases.
To address this emerging burden, the nation must be prepared to
provide affordable, accessible specialist care to our population. Let us allow
statistics to further illuminate how inadequately prepared we are to provide
care in the present situation, leave
alone the future – due to lack of skilled
manpower – the foremost requirement
for healthcare. The statistical construct below also highlights how acute
the regional imbalance is.
Guest Column
Let us take a condition, say, epilepsy and the specialists who treat
it – neurologists. If diagnosed early
and treated, 80 percent epilepsy patients can lead a productive life. Lack
of treatment, however, results in arrested intellectual growth, rendering
individuals incapable of contributing
significantly to society for the rest of
their lives. The population of approximately 55 million people in North-East
India carries a burden of prevalence
of epilepsy greater than 300,000 individuals and annual new incidences
numbering over 27,500. Now, nearly 99
percent of these individuals do not receive proper medical attention. This is
not surprising, considering that there
are just 12 (yes, twelve) neurologists
catering to the entire population of 55
million in North-East India – a ratio of
1:45,83,333. In developed nations, this
ratio is around 1:18,000 – more than
255 times higher. Similar is the situation in specialisation after specialisation – cardiology, oncology, nephrology,
hepatology, pulmonology, and the like.
Considering that our population-todoctor ratio or patients-to-bed ratio is
typically one-fourth those found in the
developed world, the situation in specializations is literally more than 60
times worse!
Even if we accept a ratio far lower
than the developed countries, the gap
remains formidable, though surmountable if we innovate. Even if we wish to
have, say, three specialists for 25-odd
key specialisations for every one-million of population, this would mean a
requirement of around 3,750 specialists, of whom 150-odd would be neurologists. Given that we have 12 neurologists at present in the North-East,
this means a required increase of 138
neurologists – almost twelve times over
what is available at present. But here
is the catch: the entire country today is
producing just 50 neurologists, approximately, annually – of which only two are
produced in the North-East. Typically,
at least one of them is from outside the
North-East and will not be available to
serve the people of the region once he
or she qualifies. This means that at this
rate of addition of skilled manpower –
one specialist per year – it will take 138
years to bridge the gap (on the basis
of the entirely unrealistic assumption
that there is no further growth of the
population!). Do note that neurologists
are required to not only treat epilepsy
but several other conditions in people
of all age groups. Ominously, the prevalence of such conditions in the population is multiplying rapidly on account to
present-day lifestyles; and, the above
situation repeats itself in specialty after specialty. Policy to deliver healthcare to the country must address this
ironic, tragic situation.
The situation has manifested itself
in such an acute form due to lack of
region-focused, innovative, visionary,
locally-relevant health policies for creation of skilled manpower pools in the
regions. This is hindering the process
of creation of a resource pool comprising adequately trained manpower –
without which availability, accessibility
and affordability of necessary healthcare for the people will forever remain
a mirage and never become a reality.
While the National Health Policy has
expressed the intent to address the issue of creation of qualified manpower
pool, it fails to acknowledge the scale
of the gap, the consequent dimensions
of the challenge and the urgency to
respond. Regional realities, requirements and methods to cater to these
requirements can best be understood
and addressed by regional drivers of
innovation in public interest. In the
absence of such platforms and mechanisms, a centrally-driven agenda will
only perpetuate the scarcity of skilled
manpower, continuing the economic
benefits enjoyed by some vested interests today, from the shortage of skilled
manpower.
Considering the scale of the challenge as demonstrated by the statistical formulation above, the speed with
which the challenge must be addressed
is significantly higher than possible
through the methods outlined in the
draft national health policy – which
ascribes no role to the states in the
creation of pool of skilled manpower.
The challenge can only be addressed
by adopting what may be termed as
the federal method of formulation of
policy to create skilled manpower pool,
implementation and regulation of such
policy. The federal method of policy
formulation and implementation would
entail providing adequate role for state
governments, state universities, statespecific social entrepreneurs and public-private partnerships. State representatives – public and private – should
be given their seats and their say at the
policy-making table – specifically regarding creation of the pool of trained
manpower, and provided the freedom
and authority to formulate state-specific policies in pursuit of locally-relevant
objectives – in accordance with the
federal mode of transforming India
espoused by our Prime Minister Narendra Modi.
The state governments, universities and other stakeholders should be
empowered to design and develop curriculum and the mechanism to monitor its quality – to create the required
number of specialist clinicians who can
take care of the conditions that are responsible for 50.9 percent of the healthcare burden – as identified by the draft
policy itself.
In the absence of the above, we Indians from the North-East, and perhaps
many others from the North, East, West
and South, will need several lifetimes
before we can benefit from the outcomes that the policy proposes to deliver. Meanwhile, the region will continue
to lag behind in health and Human Development Index parameters, remain
economically backward, a hotbed for
militancy and a burden on the nation,
which is attempting to soar towards its
destiny. Is that the overall outcome national policymakers are seeking from
the Draft National Health Policy 2015,
and other such policies being centrallyformulated and nationally-imposed?.
March / 2015
ehealth.eletsonline.com
13
Haematology Analysers & Reagents
State-of-the-art
Automation is Here
In the near term, information technology will play a growing role as an
adjunct to technological developments in haematology analysers.
C
linical haematology analyser analysis is one of
the oldest and most important sectors of clinical
laboratory analysis. Haematology analysers are
indispensable diagnostic tools and continue to sustain
a strong position in the global healthcare industry.
They include analysers, flow cytometers, coagulation
analysers, and slide strainers. Haematology analysers
are computerized and highly specialized machines that
determine the presence, count, and types of cellular
elements in a blood sample for disease detection and
monitoring. They are also used to determine non-cellular
parameters of the blood such as haemoglobin and
hematocrit. Samples of blood can be processed alone, in
batches, or continuously in a haematology analyser.
In haematology analysers and reagents market,
leading players are adopting the strategies of new product
development, geographic expansions, agreements,
acquisitions, and joint ventures. Market players adopted
these strategies to access new technologies, expand their
product portfolio, enter into growing markets, and to
increase their market share.
Market Dynamics
The global haematology analysers and reagents
market is expected to reach US$ 3.13 billion by 2019, at
CAGR of 5.2 percent from 2014 to 2019. Technological
developments in high throughput haematology analysers,
integration of basic flow cytometry techniques in modern
haematology analysers, increasing adoption of automated
haematology instruments by diagnostic laboratories,
technological advancements, and developments in the
high sensitivity point-of-care (POC) haematology testing
are some of the key factors that are fuelling the growth
of the haematology market. However, slow adoption of
the advanced haematology instruments in the emerging
economies, haematology product recalls, and high cost
of haematology analysers are some of the key factors
hampering the growth of this market.
14
March / 2015
ehealth.eletsonline.com
As of 2014, North America holds the largest share
of 44 percent of the global haematology analysers and
reagents market, followed by Europe. However, the AsiaPacific market is expected to grow at highest CAGR
of 9.4 percent from 2014 to 2019. A number of factors
including developing healthcare infrastructure, large
patient population, increasing funding/investment toward
the development of haematology products, and growing
focus of both international and domestic players on the
We know your time is precious so
we thought we’d make this easy…
The RX series of clinical chemistry analysers has been
developed by Randox laboratories to meet the needs
of clinical laboratory testing. Robust hardware combined
with intuitive software guarantees real cost savings and
consolidation in various laboratory settings.
We offer astonishing flexibility through our world leading,
extensive dedicated test menu ensuring routine chemistries,
specific proteins, lipids, therapeutic drugs, drugs of abuse,
antioxidants and diabetes testing can be run on a single
platform,
Guaranteeing performance like no other, the RX series
provides unrivalled precision, reliability and accuracy for results
you can trust.
Randox Laboratories India Pvt Ltd. Plot 191 – 195, Bommasandra, Jigni Link Road Industrial Area, Bangalore
T +91 80 2802 5000 F +91 80 2802 5012 E [email protected]
Learn more at
therxseries.com
Haematology Analysers & Reagents
Growth Factors
A number of factors such as development of the high
throughput haematology analysers, integration of basic
flow-cytometry techniques in modern haematology
analysers, increasing adoption of automated haematology
instruments by diagnostics laboratories, technological
advancements, and developments in high sensitivity
point-of-care (POC) haematology testing are propelling
the growth of the global haematology analysers and
reagents market. On the other hand, slow adoption of
the advanced haematology instruments in the emerging
economies, haematology product recalls, and high cost of
haematology analysers are restricting the growth of the
global haematology analysers and reagents market.
Technology Advancements
Asia-Pacific countries are stimulating the growth of the
haematology analysers and reagents market in the AsiaPacific region.
The Indian haematology analysers and reagents market
in 2014 is estimated at `671 crore. Reagents constitute 60
percent of the market.
Major Players
Sysmex Corporation (Japan), Beckman Coulter, Inc.
(U.S.), Abbott Laboratories (U.S.), HORIBA, Ltd. (Japan),
Siemens AG (Germany), Bio-Rad Laboratories, Inc. (U.S.),
Mindray Medical International Limited (China), Nihon
Kohden Corporation (Japan), and Roche Diagnostics
(Switzerland) are the key players operating in the global
haematology analysers and reagents market.
Sysmex Corporation
Beckman Coulter, Inc.
Abbott Laboratories
HORIBA, Ltd.
Siemens AG
Mindray Medical International Limited
Nihon Kohden Corporation
Roche Diagnostics
16
March / 2015
ehealth.eletsonline.com
Haematology analysers utilize various technological
solutions in order to recognize cell types in a blood sample
and to count them individually to generate a complete
blood count (CBC) with differential. Manufacturers
have developed finely tuned haematology analysers that
achieve good levels of precision and accuracy in cell
counting through the examination and identification
of thousands, not hundreds, of cells in each sample
analyzed. The challenge of reporting precise results for
immature cells using manual methods is exemplified with
manual reticulocyte counts, which routinely have a CV
of approximately 25 percent. Manual methods, even for
immature cell counts, are being replaced with precise,
reliable automated haematology systems that provide
faster reportable results within the first aspiration.
At the highest level of haematology laboratory
automation are scalable, configurable automation
systems dedicated to shepherding lavender (EDTA) top
tubes through the following analytic determinations: CBC,
6-part white blood count (WBC) differential, nucleated red
blood cell (NRBC), reticulocyte count (RET) and immature
retic fraction (IRF), automated immature platelet fraction
(IPF), and automated smear preparation and staining.
These on-demand tests are standardized assays that
meet performance goals, decrease technologist handson time, eliminate batch testing, and provide results
faster to physicians. When this testing is supported by
a haematology-specific middleware product, clinical
laboratories are automatically reporting up to 85 percent
of their test volume without any operator intervention.
Nowadays, haematology automation platforms offer
more than CBC testing from a single EDTA sample.
Laboratories that have incorporated HbA1c testing on high
speed haematology lines are performing >90 percent of
assays from lavender top tubes with minimal technologist
intervention. Auto validation of HbA1c results can run as
high as 90 percent. Further process improvements are
Haematology Analysers & Reagents
coming to the forefront of haematology, such as pre- and
post-analytical sample sorting/archiving and automation
of digital smear review. Now, these newly formed EDTA
work areas can manage traditional haematology testing
as well as the HbA1c traditionally tested in the chemistry
department.
• Automation: pre-analytical
One area of haematology testing that was late to become
automated was reagent preparation. Haematology
technologists frequently have been frustrated about the
time and effort required to change 20L cubes of diluent.
Recent additions to automated haematology lines address
this concern by including units that utilize concentrated
reagent which is diluted using an in-lab water supply.
This approach minimizes the time and effort required
to prep the analysers prior to the highest volume run of
the day and enables laboratorians to avoid interruptions
in testing due to the need to frequently change diluent in
high-volume testing settings.
• Automation: clinical decision making
The latest haematology technologies automatically provide
results to the physician on immature cell population
characteristics that can reflect the state of leukopoiesis,
erythropoesis, and thrombopoiesis in the bone marrow
through analysis of peripheral blood.
• Automation: standardization
Today, both small and large integrated networks and other
entities having multiple haematology testing sites can
achieve standardization of sample and data management.
Haematology testing systems for these multi-lab
operations provide the following for standardization,
thereby eliminating discrepancies that may occur when
a patient is tested at different laboratories: identical
technology platforms; quality control procedures;
calibrators and controls; and reagents.
• Automation: post-analytical
Sample processing after analysis also flows differently
with complete automation of haematology testing. The
presence of immature granulocytes in the peripheral blood
typically triggers a sample for manual smear review. New
haematology analysers now report these automatically
in the WBC differential as immature granulocytes,
reflecting the presence of metamyelocytes, myelocytes,
and promyelocytes in the sample.
• Automation: staff shortages
Automation in the haematology lab may play a significant
role in addressing anticipated staff shortages in a number
of locations.
Rising popularity of automated haematology
analyzers: Automated instruments enable faster
processing of samples and generate results much
faster than manually operated ones. Automated
haematology analyzers are also more efficient and
cost-effective.
Increase in aging population is a key driver of this
market: The number of older adults is increasing
at a fast pace worldwide. As older people are
susceptible to many age-related diseases, they
require access to medical therapies that depend
on accurate diagnostic test results. Haematology
analyzers play an important role in the early
detection of diseases.
High cost of instrument: The report identifies the
high cost of the instrument as a major challenge
in the market. Modern automated haematology
analyzers come are portable with advanced
features, making it difficult for small vendors to
gain from investing in them.
The latest haematology
technologies automatically
provide results to the physician
on immature cell population
characteristics that can reflect
the state of leukopoiesis,
erythropoesis, and thrombopoiesis
In the near term, information technology will play a
growing role as an adjunct to technological developments
in haematology analysers. There is a tendency for new
haematology analysers to employ increasingly more
detectors than the older models, for improved specificity
in cell classification and for more accurate flagging of
abnormal blood cells. In other words, blood-cell analysis
will become more multi-dimensional, and this multitude
of cellular information will rapidly expand. Moreover, a
more detailed look into the characteristics of a certain cell
can possibly yield more information than just WBC, such
as data associated with cellular activation pathways and
apoptosis or other cellular processes. It is even conceivable
that information that is connected to certain disease states
will be available. Thus, advanced information technology
could be useful for unveiling information that is “hidden”
in signals that register, but currently are used only for cell
counting and classification.
March / 2015
ehealth.eletsonline.com
17
Exclusive Interview
Pharmaceutical Industry- Technological
Advancements and Emerging Trends
Every brand owner requires authentication technologies for different needs,
says Nakul Pasricha, Vice-President, Authentication Solution Providers’
Association and COO, PharmaSecure
C
ounterfeiting is increasingly
becoming a global phenomenon and the pharmaceutical
industry is not spared from the clutches of this peril. It has become a major
issue and an increasing focus of attention by various organisations such as
the US Food and Drug Administration
(FDA) and various Government authorities across the globe. In fact, the
European Parliament has made the
battle against falsified medicines one
of its top goals.
Governments across continents are
formulating and implementing stricter
laws to counter this menace. As the
old adage, prevention is better than
cure, holds true even today, the pharmaceutical companies and the brand
owners need to educate themselves
on the latest advanced authentication technologies and solutions. The
advanced technologies and solutions
should be put in practice in order to
empower the consumers to identify an
original medicine from a fake one.
Every brand owner requires authentication technologies for different
needs. It is his sole responsibility to
identify the amount of risk and then
shortlist the correct technologies to
alleviate it. At various instances, a single technology may not be useful. So,
the Authentication Solution Provider may suggest using more than one
technology to counter the threat.
Advancement in anti-counterfeiting
technologies: Advancement in nanotechnology has enhanced the security
of various authentication technologies. We are developing and adding
18
March / 2015
ehealth.eletsonline.com
nanostructured components like gratings and fluorescent nanopatterns to
make holograms impossible to reproduce, making counterfeit goods easier
to recognise.
Advancement in digital (serialisation) authentication technologies:
With close to one billion mobile subscribers in India, but only about 30
percent of them using smartphones,
it is important to have a solution that
is easily accessible for consumers
across the country, in both rural and
urban areas. Serialisation is one such
solution. Using this solution, unique
alphanumeric or numeric codes are
generated and applied via direct printing or labels on to medicine packages,
with a consumer being able to SMS
this code to a gateway and verify its
authenticity. As each code on each
package is never repeated and almost
impossible to guess randomly, this becomes a low-cost, scalable effective
solution to deter counterfeiting. In addition, this solution can also be used
to connect with patients with chronic
illnesses and help them better understand and manage their ailments.
PharmaSecure has been providing
this solution in India for several years
already, having protected more than
1.2 billion packages, or one for every
Indian citizen.
Integration of anti-counterfeiting
technologies: Schreiner, another
German company, has devised a new
Pharma-Comb label that aggregates
overt features, such as holograms,
color-shifting security inks, guilloche
patterns with more covert elements,
including certain voiding effects, and
LaserSecure – a sophisticated method incorporating special pigments
that only become visible via a dedicated hand-held reading device. The
combination can be customised to
specific manufacturer requirements,
resulting in personalised authenticity
protection for pharmaceuticals. The
Pharma-Comb label has another builtin security feature: detachable label
parts. When detached from the substrate, the message “peel-off part has
been removed” becomes visible on the
bottom label. Other security features
embedded in the detachable label part
make authentication checks possible
even after the label has been appended to a patient’s medical records.
Solutions such as security holograms can complement other technologies like serialisation and track and
trace, delivering a powerful combined
offering for brand protection. Such integration enables brand owners to select the right mix of various technologies to keep the counterfeiters at bay.
Buyers Speak
EMR: Need of the Hour
Please comment on
healthcare market in India visa-vis the global market.
India does not have Electronic Medical
Record (EMR) concept. The EMR
concept can be seen in sumptuous
clinics or hospitals with dozens of
doctors, and not with general hospitals
or primary healthcare centres or small
private practices. However, in bigger
private practices where computers
are used at least for billing, there is
a motivation to use EMRs for patient
care. Though, there are some hurdles
in their adoption.
The patient identifier is something
given to a patient as a card which the
patient has to remember, otherwise
it is difficult to locate the history.
Given many Indians do not always
use their last names, demographic
look ups overwhelm administrators.
Also, providing an ID is not required
for getting healthcare.
To improve the usage of EMR or
Electronic Health Record (EHR) in
India the push needs to come from
one class of sources - the payers.
Individuals do not have enough sway
in this matter that leaves out the
government and insurers. Insurance
is not good and has very little usage
in India. If the government mandates
an ID and managing patient history,
usage could improve a lot.
Please tell us about your
current operations in India and
your expansion plans.
Our current operations are to provide
an ERP using latest technology with
a detailed EMR to hospitals globally.
What are your views on the
price sensitivity of the Indian
Dr B.K.Murali
Managing Director, Hope Hospital & DrMHope Softwares Private Limited, Nagpur
market and how does your
hospital counter this problem?
Please comment on emerging
trends and new technologies.
Indian healthcare IT Industry in
general happens to be price sensitive.
Hence, the key requirement is
that the solution should be cost
competitive. Other than that it is also
necessary that the solution should
have interface with third party
applications. It should offer ease to
use for end users and it must conform
to global standards of healthcare.
SaaS based cloud applications and
accreditation ready ERP are the
trends in the market.
Today’s healthcare market is more
than ever influenced by a number of
external factors that are reshaping
the way in which care providers
deliver medical services. Driven by
the current economic climate and
increasing stress on the sector to be
more efficient, cost savings are only
some of the pressures faced by the
sector as a whole. More informed
and opinionated, today’s patient is
seeking better healthcare delivery,
driven by consumer demand for
more comfort and faster and more
efficient services.
What are your views on
government regulation or any
other challenges faced while
operating the Indian market?
Government regulation to make
EMR
compulsory
and
HL7
compliant
software
will
help
standardise various software in the
market. It must conform to global
standards of healthcare.
For more information visit:
www.hopehospital.com
March / 2015
ehealth.eletsonline.com
19
Exclusive Interview
Focusing on Universal
Healthcare Needs
In India, there is a need for favourable policy environment, bringing in
regulatory clarity and providing incentives to increase competitiveness
of medical devices companies in a transparent and healthy manner, says
Dr. Stephen Oesterle, Senior Vice President - Medicine and Technology,
Medtronic plc
Please comment on medical
technology market in India visa-vis the global market
The medical equipment and devices
industry, valued at US$ 2.5 billion
contributes only six percent of
India’s US$ 40 billion healthcare
sector. Moreover, it is growing at
a faster annual rate of 15 percent
than 10-12 percent growth seen in
the healthcare sector in its entirety.
A rise in the number of hospitals
and the increased requirement
for healthcare facilities creates
a need for sophisticated devices
and equipment, which can provide
accurate treatment to individuals.
The key drivers for growth of
medical technology sector in India
are economic growth leading to
higher disposable incomes, increased
public spending and focus of
government on healthcare, increased
private investment in healthcare,
and increased penetration of health
insurance.
On current operations in India
and your expansion plans
Established in 1979, Medtronic has
been directly represented in India
for over 35 years. Its business region
extends to South Asia that includes
India, Bangladesh, Sri Lanka and
Nepal. The company has more than
1000 employees covering the length
20
March / 2015
ehealth.eletsonline.com
and breadth of the region. The focus
in this region remains on increasing
awareness and accessibility to
therapies and for this, we have Indiacentric programs like Healthy Heart
for All and Shruti.
What percentage of your
company’s global annual
revenue comes from the
Asia Pacific market? Please
elaborate.
Asia Pacific is a very prominent
market for us. In the last fiscal year
its contribution was close to about 16
percent of the total revenue – which
includes South Asia, China, ASEAN
region, Australia and Japan.
It includes some of the largest
emerging markets like China and
India and some developed markets
like Japan and Australia.
What are your views on the
price sensitivity of the Indian
market, and how does
your company counter this
problem?
Our strategy is to focus on addressing
what we call, the universal
healthcare needs. We address these
needs through three core strategies:
therapy innovation, globalization and
economic value.
We have set up R&D centers here
to find solutions and devices that will
help increase economic value to the
patients and clinicians and therefore
make healthcare more accessible for
the people.
We understand kidney disease
is a problem of many in India and
so we are concentrating on the
development of a new dialysis system
that will benefit this large population
who are underserved for treatment.
Less than 10 percent of the kidney
failure patients today are able to
get any treatment due to scarcity of
resources and the capital intensive
hemodialysis centers required.
I would also like to stress here
that our goals for therapy adoption
and access are consistent with
the government’s goals – to make
affordable,
quality
therapies
accessible to more and more people.
So we are focused on partnering
and collaborating with the Indian
government to make this happen here
in India.
What are your views on
government regulation or any
other challenges faced while
entering or operating the Indian
market?
The government’s focus is on
regulating the industry to promote
transparency. At the same time, it
has allowed foreign investment in the
industry to encourage growth and
Exclusive Interview
now also automatic route for FDI.
Medical devices form an integral part
of healthcare and the treatment of
these chronic and non-communicable
conditions that afflict the larger part
of the population.
In India, there is a need for
favourable
policy
environment,
bringing in regulatory clarity and
providing incentives to increase
competitiveness of medical devices
companies in a transparent and
healthy manner. It is important to
have clear and strong regulations
and this requires strong government/
private sector partnership to strike
this balance. The Indian government
has shown very positive signs on their
willingness to partner in these ways
and we are very hopeful of positive
outcomes here.
On emerging trends and new
technologies
Some of the innovations in the
pipeline are products such as
Resolute Integrity, Onyx, DFSin
the area of stents, new balloons
and IVUS/FFR collaborations in
other geographies, Corevalve and
EvolutR (heart valves), new surgical
innovation (fusion, surgical valves).
We also have products like Performa,
ACRT, MRI, Tyrx, Micra, Linq, arctic
front and phased RF, across our
cardiac rhythm and heart failure.
Another product, which we have
developed keeping India in mind is
the Seeq patch, which runs using
cellular technology. Patients with
cardiac arrhythmia are unlikely to
be diagnosed by the conventional
holter monitoring, or an ECG since
the likelihood of symptom-ECG
correlation is very low. This device
monitors a patient for a long duration,
and hence has a higher chance of
providing a diagnosis to patients with
cardiac arrythmia.
What are your company’s
offerings?
Medtronic’s
businesses
are
structured under four key business
groups: Cardiac and Vascular
Group (CVG), Covidien Group,
Restorative Therapies Group
(RTG) and Diabetes Group.
The Cardiac and Vascular
Group offer therapies for
cardiac rhythm disease
management
(CRDM),
coronary
and
vascular
diseases
and
structural
heart diseases along with
endovascular and peripheral
therapies. The primary
offerings under this
group
include
pacemakers,
implantable
defibrillators,
heart valves,
aortic
stent
graft systems
and coronary
angioplasty
technologies.
T
h
e
Covidien
Group that
includes
early
technologies,
advanced
surgical technologies and general
surgical products, medical supplies,
respiratory and monitoring solutions,
and venous solutions.
The Restorative Therapies Group
comprises of therapies for spine
conditions, neuromodulation, and
ENT and surgical technologies.
The primary products sold include
those for spinal conditions and
musculoskeletal trauma, neurological
disorders, urological and digestive
disorders, and ear, nose, and throat
conditions.
The Diabetes Group
is one of the leaders
in advanced diabetes
management solutions,
including
integrated
diabetes management
system, insulin pump
therapy and continuous
glucose
monitoring
systems.
A rise in the number
of hospitals and the
increased requirement
for healthcare facilities
creates a need for sophisticated
devices and equipment
March / 2015
ehealth.eletsonline.com
21
Company News
Practo Invests US$ 30 Million
to Expand into 35 Indian Cities
Hindustan Syringes to Partner
with WHO
H
H
ealthcare startup Practo Technologies has big plans to expand
into 35 Indian cities, and more than six international locations
by March 2016. The firm already has its presence in India, Singapore
and Philippines, and also has registered growth in these markets.
The US$ 30 million investment plan of the company to realise
this expansion dream is one of the largest investments by any
Indian healthcare technology company into Digital health, globally.
Existing investor Sequoia Capital led the round with participation
from Matrix Partners. Avnish Bajaj, MD at Matrix India will join
Practo’s Board of
Directors.
“We are on a
mission to improve
human longevity by
simplifying healthcare.
Over the next 12 months, we will expand to 35 cities in India and
several more international locations to help hundreds of millions of
consumers around the world find the best doctors and make better
healthcare decisions,” told Shashank ND, Founder and CEO, Practo.
According to Shailendra Singh, MD at Sequaio Capital, since their
very first investments in Practo in 2011, the company has come a
very long way with a hard working and committed entrepreneurial
team. The company has raised it to a level of being a market
leader in online healthcare in India. He expressed his company’s
commitment to Practo’s goals and aspirations to transform access
to healthcare in India, leaving a positive impact on society.
industan Syringes and Medical Device (HMD) will
partner the World Health Organisation (WHO) in a
campaign to prevent deaths and serious infections caused
due to re-usable syringes and unsafe injection practices.
The WHO campaign aims to completely eliminate the
practice of using re-usable syringes and replace it with
auto-disable (AD) syringes.
As per WHO, the use of auto disable (AD) syringes could
deliver a net savings to US$ 850 million worldwide from
reduced treatment cost of HIV, hepatitis B and C.
The campaign would benefit Hindustan Syringes and
Medical Devices Ltd (HMD) as it is the world’s largest
manufacturer of AD syringes.
“Syringes should be a life giver, not life taker. It is a very
fulfilling moment for my company and an emotional one at
personal level, as thousands of people unnecessarily lose
life in our country due to unsafe injection practices,” said
HMD Joint Managing Director, Rajiv Nath.
HelioScreen to Enter Indian Market, Announces Partnership
with C.L.A.I.M.S Private Limited
H
elioScreen, has announced their
partnership with C.L.A.I.M.S Private
Limited to enter the Indian market. The two
companies will be attending the Home and
Personal Care Ingredients (HPCI) exhibition
and conference in Mumbai from 4th-5th
March, 2015. Partnering with C.L.A.I.M.S
Private Limited, a clinical research
organisation which provides specialised
clinical research and sensory evaluation
in the area of skin care, hair care, and
body care, the French company will explore the Indian market for
offering their solutions during their visit to India.
Dr. Dominique Lutz, CEO, HelioScreen, said, “As we did shortly
in South-Eastern Asia, we decided to be present in India as
we consider the country a very strategic market. As increasing
disposable incomes continue to change the spending habits of the
22
March / 2015
ehealth.eletsonline.com
sizeable population, and awareness for
new formulations grows, India has the
potential to become one of the major
consumption markets for personal care
products.”
Helioscreen is a laboratory providing
services for testing any products
(cosmetics, textile, clothes etc.) in
regard of their properties for UV /sun
protection by means of In Vitro testing.
With their profound involvement in
R&D, the expert laboratory formed 15 years ago by Dominique
Lutz has conceptualised a very particular kind of ‘robot’ which
is considered as a performer in UV protection as it ensures
consistency during In Vitro testing. All over the world, there is
a great debate about the evaluation of the sun protection for
cosmetic products.
Blood Filters
Blood
Transfusion: A
Double-edge Sword
Transfusion of blood products is a double-edged sword, which
should be used judiciously. Though blood transfusion can be
life-saving, it can also lead to certain adverse reactions
T
he past fifty years has seen a significant,
paradigm shift in the provision of
allogenic blood products. Half a century
ago, most of the blood transfused was whole
blood. However, since the 1960s, whole blood
has been separated into its various components
such as RBCs, platelets, and plasma. The
latter has been further subjected to various
manufacturing processes so that individual
plasma proteins can be purified and made
available to specific patients with specific
plasma protein deficiencies.
Until recently, little attention had been paid
to the leukocytes present in various blood
components. However, it has been shown that
the removal of leukocytes from various blood
products can minimize the risks associated
with these contaminating leukocytes; the
most common among which are: Nonhemolytic febrile transfusion reactions, human
leukocyte antigen (HLA) alloimmunization
and platelet refractoriness observed in
March / 2015
ehealth.eletsonline.com
23
Blood Filters
multi-transfused
patients,
and
transmission of leukotropic viruses.
Although the terms, leukoreduction
and
leukodepletion
are
used
interchangeably
in
literature,
leukoreduction
technically
implies removal of leukocytes by
gross removal method, whereas,
leukodepletion connotes removal of
leukocytes with the help of certain
specific filters or devices.
Market Dynamics
The global blood industry has
experienced strong growth in recent
years and growth will remain solid
though 2018. The key driving forces
impacting the blood industry include
the cost of collection and processing,
technological advances, an aging
population, demand for plasmaderived therapeutics, and changes in
the incidence of diseases and surgical
procedures
and
catastrophes
requiring blood transfusions. The
global blood market consists of more
than blood collection. It includes
blood typing and testing for diseases,
blood storage and processing, blood
transfusions, blood management
and safety issues, synthetic blood
products,
the
blood
products
market, the blood testing and typing
products market, the plasma and
blood collection equipment market
and the synthetic blood products
market. The blood products market is
a good example of the larger market
in microcosm. In 2012, worldwide
demand for non-infected blood
exceeded 200 million pints. Of this,
red blood cells (RBCs) comprised 105
million units. Through 2018, global
demand for RBCs is expected to
reach 140 million units.
The market for blood and blood
components continues to expand
as a result of ongoing technology
advancements/new
product
introductions
and
indications,
expansion of health coverage in
the US via healthcare reform and
continued strong promotion of blood
24
March / 2015
ehealth.eletsonline.com
donation by collection agencies.
The United States is the single
largest global market for blood
products. While some countries such
as India and the Philippines set prices
for blood and blood components,
in many of the developed nations,
including the US, there is no uniform,
fixed price for blood. Rather, the cost
varies from country to country and
region to region, with even nearby
centers often charging different prices
and fluctuations often occurring.
The effective management of blood
supplies is a critical issue for the
blood industry, which continues to be
challenged with a growth in demand
that exceeds any increases in supply.
The US may be the single largest
consumer, but demand is high and
continues to grow in other developed
countries such as India, China, Japan,
and Germany as well.
India has a population of one
billion and has a huge burden of
patient population requiring multiple
transfusions. As per the National
AIDS Control Organization, there is
a requirement of 8.5-9 million units
of blood in our country annually,
India has a population
of one billion and
has a huge burden
of patient population
requiring multiple
transfusions.
and this includes the existing
Thalassemic population requiring
regular transfusions and the rapidly
growing size of the hemato-oncology
patients requiring different types of
blood component support. A majority
of them become alloimmune to
various red blood cell, platelet, and
HLA antigens during the course of
their transfusion therapy. This leads
to various immunohematological
problems in managing the blood
component
support
to
these
patients, especially the platelet
transfusion support in refractory
patients. Therefore, transfusion of
leukoreduced blood components
assumes a lot of significance in
these patients.
Recommended Leukoreduction
Strategies for Developing
Countries
Blood Filters
The effective
management of
blood supplies is
a critical issue for
the blood industry,
which continues to
be challenged with
a growth in demand
that exceeds any
increases in supply.
of this technique is that it cannot
prevent
HLA-alloimmunization
and CMV-transmission.
Modification of the component
preparation technique
Selective pre-storage
leukofiltration for patients on
regular transfusions
• According
to
an
article
Leukoreduced Blood Components,
adopting a buffy coat method of
component preparation generally
gives a log 1 leukoreduction and
to a great extent can minimize the
febrile non-hemolytic transfusion
reactions. A thorough quality
practice can be achieved if
leukodepletion is done in the top
and bottom bags, with the help
of certain dedicated equipments
such as automatic component
extractors. The blood components
prepared with this method can give
the desired therapeutic benefits
to a majority of patients, even
on regular transfusion therapy,
where
transfusions
become
troublesome due to repeated
FNHTRs. However, the limitation
• The packed red cell selective prestorage leukofiltration policy can
be adopted for patients on regular
transfusion therapy such as,
thalassemia major patients, with
skillful inventory management
and active coordination between
the transfusion therapy clinic and
the blood bank.
Platelet concentrates can be
pooled and leukofiltered for a
select group of hemato-oncology
patients in the blood centers, prior
to the storage. This strategy can
achieve 3-4 log leukoreduction,
however, it requires dedicated
technical manpower for stringent
quality control and skillful
inventory management, along
with active coordination with the
treating units.
Harvesting blood components
through aphersis technology
• Blood components harvested,
through Apheresis technology, are
generally 3-4 log leukoreduced,
and provide better therapeutic
benefits than the random donor
products. This can be of great
help to the patients’ refractory
to platelet transfusion with HLA
alloimmunization, as the desired
component can be harvested in
sufficient quantity from an HLAmatched donor. However, the
cost of the consumables act as a
limiting factor for its utility at large,
but it is the best option for those
who can afford it. Mobilization of
resources through philanthropic
organizations for the benefit of poor
patients should also be pursued.
Since the advent of transfusion
medicine,
many
technological
advances have made the collection
of blood products safer and more
efficient.
Ongoing
research,
however, is underway to improve
several aspects of blood component
collection
and
administration.
Advances in DNA technology are
changing the understanding of blood
group antigens and HLA serotypes
and allowing blood centers to solve
compatibility
problems
among
alloimmunized/refractory patients.
Within this rapidly evolving
ecosystem, those who choose to
commit to understanding current
opportunities and threats will be
positioned for a strategic advantage.
While industry conditions vary
somewhat by market, there is
an advantage to having a global
understanding of the industry.
Emerging
trends
are
rapidly
expanding to new regions and
impacting
business
elsewhere.
In addition, research advances,
clinical trial findings, and technology
advances do not know international
boundaries. They are shared nearly
instantly from region-to-region.
March / 2015
ehealth.eletsonline.com
25
Exclusive Interview
Blood Transfusion and
Leucoreduction: Need of the Hour
“We filter the water we drink, but why not the blood
we transfuse” is the common refrain one hears from
practitioners in India, as they continuously endeavour to
improve the safety of the blood components transfused
says, Chetan Makam, Vice President and General
Manager, Haemonetics
What is Leucoreduction?
The terms leucoreduction and leucodepletion as used interchangeably,
depending on the standard followed
is a US or EU standard of permissible
amounts of WBC’s in the final blood
component. US Standard < 5x106
WBCs/unit; EU Standard < 1x106
WBCs/unit.
A common misconception is that
when the whole blood is spun down
into its components and some of the
WBC’s are segregated into the buffy
coat, that this is a leuco depleted product. In reality, this process provided a
1-log reduction in the WBC’s, whereas
the standards call for a 5-log reduction.
Why should we Leucoreduce?
Leukocytes are unnecessary contaminants in unfiltered blood products
and have been reported to be responsible for a variety of adverse reactions,
including alloimmunization, febrile
non-hemolytic transfusion reactions,
immunosuppression and transmission
or reactivation of intracellular virus,
i.e., cytomegalovirus. Leukocyte reduction has been demonstrated to be clinically effective in reducing the incidence
of these transfusion-related complications which can significantly decrease
the cost of medical care producing considerable cost reduction for hospitals.
What patient groups are indicated for providing Leucoreduced
blood components?
26
March / 2015
ehealth.eletsonline.com
Leucocyte reduced blood components
are often provided for specific patient
groups, however, a growing number of
hospitals are now providing all blood
components leucoreduced.
The reasons for this are - growing
evidence supporting the benefits of leucocyte reduction for surgery and ICU
patients, recommendations of governing bodies, and adoption of Universal
Leucoredution in many countries.
Are there countries with 100 per
cent Leucoreduction?
In India, only about six percent of
the approximately 8.5 million units of
blood collected is leucoreduced, compared to 100 percent in many countries such as UK, France, Germany,
Switzerland, Austria, Scandinavia,
Spain, Portugal, Netherlands, Belgium, many other countries are targeting 100 percent leucoreduction or
Universal Leucoreduction (ULR). In
US around 80-90 percent of the blood
is leucoreduced.
Transplant patients, cardiac surgery patients in the ICU, patients in
NICU, oncology patients and thalassemia patients who require multiple
transfusion as the primary recipients
of leuco reduced blood in India today.
While some progressive centers and
hospitals that cater to a sizable medical tourism population have adopted
near 100 percent leucoreduction, most
centers either leuco reduce blood on
the clinicians demand or not all.
Filtration of blood can happen at
different points along the blood supply
chain namely, at the patient bedside,
just prior to transfusion, in the lab on
demand or as a practice of keeping a
small inventory for the patients in critical care or at the time of processing
the blood into components, usually at
centers that have adopted 100 percent
leucoreduction (ULR). Decisions about
when and where to leukoreduce are
based on cost considerations, convenience and patient benefits.
The timing of when to filter the blood
components is also important.
Filtering platelets
Laboratory and bedside filtration both
have advantages. Laboratory filtration
at the time of collection prevents the
accumulation of bioreactive substances
released by stored leukocytes that have
been associated with patient reactions.
An advantage of bedside filtration
is that specific leukocyte reduction
filters consistently will reduce the level
of the anaphylatoxin C3a, which is
associated with proinflammatory and
immunomodulatory effects.
Filtering red blood cells
When RBC units are leukocytereduced prior to storage, a decrease
occurs in the concentration of
substances (e.g., serotonin, histamine,
acid phosphatase and elastase)
that are released by leukocytes and
platelets during storage.
Exclusive Interview
Clinical Logistics are
Saving Patients’ Lives
This remarkable statement is a quote from a newspaper post by
Ole Thomsen, CEO of Healthcare in Central Denmark Region
I
n the post, Ole Thomsen cites a
study revealing that mortality is
9 percent higher in overcrowded
hospital wards compared to wards with
a normal state of occupancy. According
to Ole Thomsen, this problem can be
solved with a clinical logistics solution.
Regional Hospital Horsens has
substantial and positive experiences
from using INSIGHT clinical logistics
for more than five years.
“Clinical logistics enables hospitals
to optimize the staff capacity to the
current patient situation and avoid
that single wards are put under too
much strain”, Thomsen says.
In his experience, clinical logistics
used to involve telephone calls and
handwritten notes that became
quickly outdated in a busy hospital
environment. “With clinical logistics,
we immediately find the answer in the
system which always conveys a real
time overview of the occupancy of the
different departments. This way we
avoid patients waiting unnecessarily”,
Thomsen says.
Clinical logistics is a key to an
efficient hospital
Hospitals are always looking for ways
to improve workflows and operational
efficiency so that throughput increases
without compromising quality or
safety in treatment.
Jørgen Schøler Kristensen is a
medical doctor, holds a doctorate
in haematology and is working as
Chief Medical Officer at the Regional
Hospital Horsens in the Central
Denmark Region. He strongly agrees
with the views of Ole Thomsen on
28
March / 2015
ehealth.eletsonline.com
INSIGHT clinical logistics. In an article
in the Journal for Danish Health Care,
he points out that: “The efficient
hospital” is characterized by stringent
logistics and coordination”. As Jørgen
Schøler Kristensen puts it “this is one
– if not the - essential key to securing
fast and efficient high quality patient
flows. Add to this that the working
environment of the staff is improved at
the same time.”
According to Jørgen Schøler
Kristensen, logistics is an important
lever in the development of future
healthcare because we need to treat
ever more patients in a shorter time
span. At the same time more patient
flows are growing ever more complex
and the organizations handling the
patient flows are getting larger. This
demands efficient and well coordinated
workflows alongside maintaining –
preferably improving patient safety
and overall quality.
IT for better logistics
Jørgen Schøler Kristensen is of the view
that “The efficient hospital” demands
tools and processes, which both
support and contributes to the further
development of good communication,
coordination and overview during the
execution of daily clinical work. In his
experience, INSIGHT clinical logistics
is that kind of tool.
The system has two main user
interfaces:
• Firstly the large interactive
screens places strategically in the
departments
• Secondly the browser based
interface ”Anywhere” which is
accessible on all PC’s, laptops
and so on. The Anywhere is also
available for mobile devices.
On the interactive large screens,
the clinical staff is at any given time
presented with a full overview of
patients, staff, treatment activities,
surgeries, test results and so on - in real
time. The staff is at any given time able
to edit informations and changes are
instantly (in under one second) visible
Exclusive Interview
to all staff on both interactive large
screens and Anywere. Jørgen Schøler
Kristensen points out that this is key
to enhancing cooperation among staff
as well as between departments and
the systems’ incorporated webcams
and chat functionality supports
communications. Finally tracking is
used making it possible to know where
ones colleagues are at present.
And Ole Thomsen wants clinical
logistics to go further. He explains:
“The vision is that the overview that
Clinical Logistics provides today on
large touch screens will ultimately
be in the pockets of the healthcare
professionals, where it is constantly
within reach”.
Logistics is of great value
One of the departments where INSIGHT
clinical logistics has had a tremendous
impact on the execution of the daily
operations is the surgical ward.
Jørgen Schøler Kristensen explains
that the work flow in the surgical ward
consists of a vast number of serial
actions involving staff from a number
of different departments. The serial
nature of the workflow has the distinct
consequence, that delays and errors
propagates on to the subsequent
actions of the surgical flow.
And Ole Thomsen adds: “Whenever
a patient is in surgery, the doctors
are easily and efficiently able to
communicate with the staff outside
the operating theatre by updating
an electronic touchscreen. This is
relevant in many cases, for instance
if a member of the surgical team is
running late or an additional specialist
is needed for surgical assistance. The
staffs outside the operating theatre
stays updated and able to effectively
plan the next activities via the status
changes conveyed to them from the
operating theatre. “This makes sure
that the patient has a good and safe
course of treatment all the way from
layering to anaesthesia, surgery
and recovery”.
Ole Thomsen explains how clinical
over the hospital.”
The results in short
Bhavesh Y Bhatt
General Manager - Maquet Medical
India Private Limited
logistics is also of high value in the
emergency departments where there
is a large flow of patients. “We get
an overview of the incoming patients
and are able to prioritize the patients
who are in the greatest need of acute
care. At the same time we are able
to see which doctors and nurses are
attending to each patient and make
sure that the right staffs are assigned
to the particular patient,” Thomsen
says. “Furthermore the system
provides us with a detailed overview
of the individual patients’ flow. This
makes us able to stay ahead and be
prepared for the next step”.
Jørgen Schøler Kristensen points
out the differences from before to
after implementation of an IT-system
for clinical logistics: “Before the
implementation of an IT-system for
clinical logistics, the overview of the
surgery programme for the day only
existed on a large piece of paper,
which was manually updated with
acute surgeries and other changes
during the day. Changes and other new
information had to be communicated
by phone and only the staff in the OR
theatre had knowledge on how far
along the ongoing surgery was.
Today the complete real time
overview of the programme for the
day is available on the interactive
large screens and staff are able to
edit infomation during the day which
is instantly available in all screens all
Jørgen Schøler Kristensen points out,
that several actions have been taken
to describe and measure the gains
from implementing a joint IT-system
for clinical logistics in the Central
Denmark Region. “Both qualitative and
quantitative studies show that clinical
logistics provides better overview,
improves communication and supports
efficient coordination and in effect
optimizes the collective workflows.
At the same time all users of the
system say that the system has resulted
in a higher quality of treatment and
has improved patient safety”, he says.
The same conclusions were
reached in a Medical Technology
Assessment carried out by the Centre
for Public Health. Finally the one
evaluation done of the system in an
Emergency Department was carried
out by Regional Hospital Horsens.
The evaluation showed an increase
of production of 19 percent in the
course of 18 months from the system
implementation.
Ole Thomsen sums up the reason for
Central Denmark Region to implement
a joint IT-system for clinical logistics:
“This way the healthcare regions
are constantly working on improving
work flows in hospitals and making
them more flexible. Because we do not
believe that time heals all wounds”.
INSIGHT
INSIGHT Clinical Logistics supports
workflows throughout the hospital. The
unique and user-friendly design makes
the system preferred by healthcare
professionals. The integration of
multiple platforms, including mobility,
and the adherence to integration
standards (HL7) makes the system the
preference among IT professionals.
The author is Bhavesh Y Bhatt, General
Manager - Maquet Medical India Private
Limited
For Further information, please contact on
[email protected]
March / 2015
ehealth.eletsonline.com
29
Case Study
Developing
and Deploying
Software for the
Social Sector
Client: Jan Swasthya Sahyog (JSS) Hospital
Project: Hospital Management and
Information System (HMIS)
Testimonial: Dr Yogesh Jain,
Co-Founder, JSS Hospital
Vendor: ThoughtWorks
Industry: Healthcare IT
30
MArch / 2015
ehealth.eletsonline.com
Case Study
“When we started to work with clients in
the social sector, our strategy was that
we are a global technology company, and
this is the value we bring to the sector.
Today, after a few years of working with
clients in this space, even how we approach
the problem is different. Although technology is
still the largest part of what we do, we also look
at the other aspects that need to be in place to
make that technology successful.”
Pradipta Kundu, Client Principal, ThoughtWorks
Supporting a truly ambitious mission
Jan Swasthya Sahyog (JSS) is a voluntary,
non-profit, registered society of health professionals running a low-cost health program in the rural areas of Bilaspur, Chhattisgarh. For 14 plus years, they have been
providing healthcare services through a
community health programme in a rural
health centre, which includes a 55-bed hospital. They operate village outreach centres
in three other villages that are not easily accessible. The team at JSS researches ways
to minimise the cost of healthcare and influence policy makers. They also advocate for
the poor in various areas of public health.
Patients at JSS typically wait one full
week to see a doctor – in spite of the outpatient department accommodating 300
patient visits per day, including emergency
cases. Many of these patients live on site
during this time. They sleep in corridors
and cook on makeshift wood-burning stoves,
while waiting patiently in 47°C temperature.
The cost of transportation and the opportunity cost of lost wages for patients and their
families are not insignificant. And yet, they
choose to make the long journey to JSS because they have the utmost faith that they
will be cured there.
The staffs at JSS feel the burden of these
expectations. They wanted a Hospital Management and Information System (HMIS)
that would make their processes more efficient. Apart from benefits like improved
documentation and effective decision and
advocacy support, an Electronic Medical
Record (EMR) coupled with an HMIS could
help save time - their most constrained resource. Patients themselves would benefit
the most, as they would be able to receive
treatment hours or even days sooner, allowing them to return to their homes and jobs
that much quicker.
Developing an integrated, flexible
and infrastructure-appropriate
solution
Jan Swasthya Sahyog had tried to put a system like this in place a few times in the past,
with little success. They deployed a number
of siloed applications in registration, billing, and laboratory, but nothing came close
to what they had in mind. As a result, their
staffs were skeptical about new companies
offering solutions and products.
JSS started working with ThoughtWorks
in December 2012. Since then, an open
source, integrated HMIS and EMR has been
developed that aims to meet the needs of
hospitals like JSS in low-resource settings
- one that can manage information across
different departments, allow for the hospital’s unique workflows and processes, and
be hosted and operated at the hospital site
(requiring no Internet dependency). Several
software releases have been deployed till
date - the final features and modules should
be released by mid-year. Registration, billing, laboratory, radiology, pharmacy, the outpatient department, and the inpatient department are already using the new system.
MArch / 2015
ehealth.eletsonline.com
31
Case Study
“There are many
criticisms of
technology, indicating
that it can take away
the human element of health
care. ThoughtWorks has
shown us how technology
can help, and still remain
very human”.
Dr Yogesh Jain, Co-Founder,
JSS Hospital
Harnessing the benefits of an
intuitive and adaptable system
There are a number of visible outcomes
from these early releases, almost all relating to the improved efficiency of care
delivery. The system can be used on a
variety of devices at the point-of-care,
including mobiles, tablets, and laptops,
with minimal staff training required
due to the system’s intuitive design.
Earlier, individual laboratory report generation went on until past 6
p.m. on a daily basis. The lab technicians and assistants now complete
their daily workload by 4:30 p.m., no
matter how many patients there are,
even as their daily patient caseload
has increased from 120–150 to 180–200
patients per day. In the past, the team
could only run their electrophoresis
machine once a week, in an area of the
country where the incidence of sickle
cell anemia is high. After the laboratory system came online, they are able
to run the machine three times per
week, thanks to the extra time available to lab staff. Time savings have also
been deployed to bring previously outsourced tests in-house, saving patients
both waiting time and money.
Time spent searching for existing patients’ files or redoing previous
tests like x-rays has drastically reduced. Staff can go through their patients’ history, pull up past prescriptions, and more, within five minutes.
The same task used to take them up
32
MArch / 2015
ehealth.eletsonline.com
to a few hours, especially when patients had forgotten to bring their
JSS registration card with them or if
the quality of their physical reports
had deteriorated. Similarly, time
previously invested in hand-counting
and reporting patient visit numbers,
disease incidence, etc., is now redeployed into direct patient care activities like patient counselling because
of automated report generation.
Ensuring adoption success
through better development
and deployment
There is something very rich happening at the intersection of developers
and end-users at JSS, something core to
Agile software development philosophy.
Through a combination of constraint
and desire, developers are working sideby-side with the end-users of the software, and as a consequence, the software is much richer for it. For example,
doctors requested a “my patients” tab
so that they could review their cases for
the day. The development team has been
very Agile in what they plan for – securing wins where this new digital system
can provide functionality that the previous paper-based one could not, thereby
increasing physician buy-in.
Moreover, working with JSS inspired ThoughtWorks to go beyond being just a software solution provider.
Apart from traditional solution delivery and train-the-trainer training, the
team got involved in other areas like:
• owning and handling the solution completely, including thinking
through future design (e.g., integrating with a community health
worker system)
• setting up servers, upgrading operating systems, procuring hardware,
and training the local IT staff
• working with the staff directly to
help them overcome their fear of using new devices and a new system
• facilitating business process reengineering, helping establish new
processes and managing the transition from one to the other
If the software development team
had not taken on this ownership – the
responsibility to make the software
work – the deployment would not be at
the stage where it is today.
There are many tried and tested
models out there for technology deployment in a traditional corporate
environment. Software in the social
sector space is at a juncture where one
is trying many new things. For this to
work, both parties need to realize that
something is being ventured for the
first time and have the mind-set that
this experimentation is part of the process. To introduce something so substantial into a hospital while not disrupting the actual flow of operations
in spite of low computer literacy has
been a challenge but also wonderful.
Exclusive Interview
IT Infrastructure The Backbone of
Indian Hospitals
The healthcare sector has been a bit conservative from the perspective of
IT usage, but realised that IT can really add value to the business, says
Manoj Kumar, Executive Vice President and Chief Executive Officer,
Ricoh India Ltd
India stands for promises and
opportunities, and has leapfrogged
to become a formidable power
in the global economic scenario.
Transforming healthcare dynamics
of the country will support the
advancement of the economy which
has already grown to one of the
fastest growing economies in the
world.
Yet today, India finds itself
lagging
behind
peers
on
healthcare
infrastructure
and
healthcare outcomes. The Indian
healthcare sector faces shortage
of infrastructure, with 0.7 beds per
1,000 persons as compared to other
large developing economies (Brazil
with 2.6 beds, and China with 2.2 beds
per 1,000 persons). There is dearth
of human resources for healthcare,
with 0.6 doctors and 1.3 nurses
per 1,000 persons. India’s overall
healthcare expenditure is only 4.2
percent of its GDP compared to an
average of 8.5 percent globally, and
lower than other emerging countries
such as Brazil (9.0%), China (4.6%)
and Russia (5.4%). Further, the
government investment is even
lower at 1.3 percent of the GDP, and
most of it is either on manpower
cost, running health programs
34
March / 2015
ehealth.eletsonline.com
or building infrastructure.
IT has become a business
enabler for multiple industries
such as banking, manufacturing,
telecom, logistics, and aviation.
The healthcare sector has so far
been bit conservative from the
perspective of IT usage, but has
started realising that IT can really
add value to the business. According
to IDC report, only two percent of
India’s IT spend is focused towards
healthcare. However, healthcare is
expected to be one of the fastestgrowing verticals in IT spending.
As the healthcare industry starts to
enter this phase of transformation,
technology providers will need to
Hospitals
currently
manage large
volumes of data,
and technology will
help manage this
data, turning it into
intelligence in order to
improve efficiencies of
businesses
provide a consultative approach to
deliver business solutions and not
focus on selling their technologies.
The technology solution needs to be
simple and user friendly with focus
on patient-centric care.
IT and hospital management
IT has the potential to transform the
current healthcare scenario in India
and improve the quality of life of its
citizens. Some of the areas where
applications of technology solutions
for Indian healthcare industry
can play a vital role are creating
health awareness and influencing
behaviour, overcoming infrastructure
gaps, building skill-sets, focusing
on patient-centric services, and
improving decision-making powered
by big data analytics. With growing
need for personalised medicine,
healthcare delivery is combining
sciences of diagnostics, medicine
and behavioural economics. IT
can be put to use in increased
awareness
and
promoting
a
behavioural transformation- mass
dissemination of healthy practices,
running ICT programmes on digital
media (diet plans, exercising,
reducing use of tobacco, etc.), apps
for healthcare monitoring, auto
Exclusive Interview
reminders for medicine, healthcare
call centers. Healthcare providers
can also leverage IT in improving
healthcare access and overcoming
infrastructure gaps – hospital
information system (HIS), mobile
medical
units.
Telemedicine,
teleradiology,
telediagnosis
are
still at very nascent stage in India.
Nevertheless, a lot of development is
being stimulated.
IT has also been playing a key
role in building skill-sets and
continuing
knowledge
update
through online training courses for
medical staff (including clinicians,
nurses, paramedics, radiologists,
pathologists and general duty
staff). Sharing content digitally,
such as tutorials, journals, videos,
presentations, whitepapers, online
CMEs has been made easy by IT
applications.
IT has been an enabler
of
patient-centric
services,
such
as
Electronic
Health Record
(EHR)
for
g e t t i n g
treatment
at
any
center
across India,
surveillance,
controlled
instrumentation,
improved 4As –
access, awareness,
attitude
and
affordability.
Hospitals currently manage large
volumes of data, and technology will
help manage this data, turning it
into intelligence in order to improve
efficiencies of businesses. Whether
it is connecting patient care history
through simple data mining tools, or
facilitating phases of research in the
life sciences space, technology will
play a big role.
Even for diagnosis, IT serves
as the backbone and is involved
at every step from tracking the
samples via barcode, which ensures
that specimens are tied to patients
correctly through the entire process,
to performing statistical quality
control on results and deliver
reports securely and swiftly to our
customers. Without sophisticated
IT applications, preserving patient
privacy and delivering accurate
results can be challenging.
One of the most important
aspects of IT infrastructure
application is also the
database
technology
in health care to
maintain
patients’
records.
These
medical
records
exist in a wide
range of health
care
settings,
and effectiveness
of databases for
their
management
depends greatly on
the environment. In addition to
databases, management also needs
automated machines which can
deliver efficient and related data in
order to draw proper conclusions.
These automated machines have the
capability of generating conclusion
based results for the management.
These systems are not only for the
evaluation of the patient, but can also
be used to provide data related to
administration at regular intervals.
Powering hospitals for a
successful transformation
IT deployment can transform the
functioning of key areas of hospital
operations. One of the key barriers
for IT adoption in various hospitals
is the perceived challenge in
integration of multiple platforms that
are running in the hospital. Other
reasons include unavailability of
appropriate hardware and software,
financial assistance and support in
implementation.
Ricoh
globally
recognises
healthcare as a focus area and
has a strong history of delivering
technology solutions. The firm
comes up with a unique solution
for hospitals named “Hospital in a
Box”. The objective is to set up an
IT system that adds real value by
being quick to deploy, and easy to
adopt. The benefits of this solution
includes reduced administrative
cost, increased profitability and
enhanced customer satisfaction,
with
streamlined
workflow,
improved
productivity,
better
inventory management, and
better decision making. The
solution offers a perfect
mix of hardware, software
and services based on the
hospital’s requirements.
Additionally, it provides
manpower
training,
24x7
helpdesk,
customer relationship
management (CRM) and
digital marketing.
March / 2015
ehealth.eletsonline.com
35
Exclusive Interview
‘Make in India’
Key to Growth
We can reduce the cost of imports and India can save crores in taxes and private
hospital money, says James Mazarello, CEO, Rosalina Instruments
Tell us more about the
company.
We started as a company catering to
pharmaceuticals to repair services
and maintenance sophisticated analytical and biomedical equipment in
1988. We had experience on quality assurance equipment for cancer
treatment and concentrated on dosimetry. We slowly took up to servicing of larger equipment till we were
capable handling independent portfolios from foreign companies. We have
now branch into three division analytical equipment, medical equipment
and industrial and defense equipment
our concentration has been on cancer treatment equipment since last
25 years.
Please share your views on the
“Make in India” campaign
There’s never been a better time to
“Make in India” than now as it is high
time to self motivate and not wait for
the government to take the first step.
It completely changes the thought process to a higher level and high quality
of products that need to be delivered.
Foreign companies have cooperated
with local entrepreneurs for faster
development of both the companies
and proper utilisation of resources.
Government should identify and encourage micro development programs
for such purposes; Grameen bank is
one such example.
On hazards of radiation in
hospitals
36
March / 2015
ehealth.eletsonline.com
Core Linac’s has not changed
much in treatments, though they have
adapted to the latest technologies
that have evolved, but this has benefited the patient to a lesser extent.
Quality treatment also means keeping
the hazards away.
On new products
The two most important points in delivering accurate and precision treatment is the amount of dose and the
point to which one imparting the dose.
There are two major aspects in radiation monitoring.
Firstly, radiation to personal
working in the environment, radiation
to common people who are prone to
such environment where radiation exist and radiation to the patient themselves who are being treated (this
falls in both categories).
The second aspect is the radiation
treatment itself. Delivering quality radiation treatment is the sole responsibility of the hospital where the patient
is being treated. In radiation treatment consulting the radiation oncologist and a proper advise is of utmost
importance and it is here that safety
of the patient comes into picture, delivering the correct amount of dose to
the diseased tissue and protecting the
healthy tissue has been a great dilemma to all both in India and the world.
We have produced the 0.65 cc Ion
chamber, which is the heart of the
quality assurance system. The product has to be imported and costs
about `1.2 lakh to 1.5 lakh.
We have supplied about a 1000
chambers to various hospitals across
India of various sizes. These were
wholly imported from abroad. The
cost of each chamber averaged about
`1.2 lakh, the basic system of quality assurance for any hospital will
cost about `80 lakh to nearly a crore.
Quality treatment independent of the
LINAC the hospital plans to procure
should be made economical to the
patients. Make it in India, cost will be
low and patients will be benefited.
Blue prints have been laid for
many products in this range and it
will take some time before we can
come out with many products. We are
also trying to collaborate with some
American, German and Swedish companies to join hands with us, if this
collaboration succeeds then it will be
much faster.
We can reduce the cost of imports,
and thus save crores of tax payers’
money and avoidable expenses by private hospitals.
Delta Discover
4
TM
MEASURE THE DOSE TO THE PATIENT AT TREATMENT
Radiation
Dose
Optimization
Made
Easy
Water Phantom
Advanced Technology
Premium Quality
Affordable Price
User Friendly
127, Bussa Udyog Bavan, T.J Road, Sewri, Mumbai - 400015. Tel : 91 22 24173493. Email: [email protected] www.rosalina.in
MRI Systems
MRI Future: Faster Workflow, Shorter
Exam Time, More Patient Comfort
The future appears limitless as researchers and medical technology
manufacturers continue to strive towards increased image quality, physicians
work towards better diagnoses, and patients anticipate speedier, more
comfortable, and less costly MRI exams, writes Anshuman Ojha of Elets
News Network (ENN)
M
agnetic resonance imaging
(MRI)
technology
has
gained impetus from the
keen interest shown by technology
developers and manufacturers who
wish to make it more patient friendly.
It has become one of the preferred
diagnostic imaging methods for
imaging the central nervous system,
particularly for detecting brain
tumors, spine lesions, imaging blood
vessels, and stroke affected areas of
the brain.
The global magnetic resonance
imaging market is a shifting, capital
equipment market that is saturated
with numerous players developing
innovative technologies. Given their
38
March / 2015
ehealth.eletsonline.com
impressive safety and efficacy as well
as non-invasive nature, MRI systems
have seen continued adoption since
they were first introduced to the
healthcare market. Rapid advances
in the field imaging along with the
development of MRI safe technologies
have greatly expanded the potential of
therapeutic applications.
The US market will be driven by
physician adoption of new systems,
especially high-field devices, as a
result of acceptable safety profiles
for high-field strength devices and
the decreasing cost of equipment.
The global MRI systems market
will more than double in value from
approximately US$ 4.1 billion in
2013 to over US$ 9.2 billion by 2020,
representing a Compound Annual
Growth Rate (CAGR) of 11.8 percent,
according to market research firm
Reportstack.
Closed systems with high field
strengths dominate the market due
to their high clinical significance
and
higher
image
resolution.
Technological advancements such as
the introduction of MRI-compatible
pacemakers and digital broadband
scanners drive the growth of the MRI
market. Aging population in developed
countries and increasing cases
of chronic diseases in developing
economies accelerate the market
growth from the demand side.
MRI Systems
The use of MRI technology is
expected to dilate globally owing to
its significance in modern medical
diagnosis for diverse biomedical
applications. MRI systems for
neurology and brain disorders
command the current market, while
cardiac MRI and breast MR systems
are gaining momentum, due to rising
cardiac and breast cancer cases
globally. With its ability to image
anatomically and functionally, MRI
has found its way into surgical
applications as well as in diffusion
and perfusion imaging. It is being
combined with other modalities such
as PET, SPECT and ultrasound to
achieve new heights of image clarity.
The overall MRI markets in Japan
are expected to experience growth
through 2020, including low-field
40
March / 2015
ehealth.eletsonline.com
systems, which are declining in many
other countries globally. China will
experience growth during the forecast
period, although low-field systems will
grow at a small CAGR of one percent.
In India, the low-field strength MRI
market segment will decline slightly
at a negative CAGR of 0.6 percent
through 2020.
In France there is no market for
low-field MRI system sales, although
the market for mid- and high-field
systems is expected to undergo
significant growth in the coming years.
MRI is one of the fastest growing
market segments in the country, and
will be valued at over US$ 181 million
by 2020. Valued at just US$ 30 million
in 2013, the high-field MRI market in
UK is one of the smallest in Europe,
due to poor reimbursement and slow
adoption of advanced systems.
In Brazil, cost and reimbursement
remain the top concerns of practicing
radiologists who must base diagnostic
strategies on cost-effectiveness to a
greater degree than their counterparts
in US or EU. As a result of this slow
market growth, many US and EUbased companies often overlook the
Brazilian market, focusing on greener
pastures in Europe and US where
profitability is easier to achieve and
maintain. This leaves radiologists in
Brazil with limited options in terms of
new technology, which in turn slows
progress in the country and ultimately
hurts patient outcomes.
Indian Market
The market of diagnostic MRI systems
in India will see a growth of 15 percent
CAGR over the next five years. The
increased potential offered by new
diagnostics tools, such as functional
MRI, weight-bearing MRI, and
diffusion of new clinical applications
of this technology among physicians
and patients are fueling the growth.
Improved clinical outcome for patients
has allowed the modality to reach
tier-II and tier-III cities, avoiding the
patients to travel many miles for an
MRI scan.
The Indian MRI systems market
is estimated at `1190 crore in 2014.
About 356 units of diagnostic MRI
systems were sold. On the basis of
technology, Indian diagnostic MRI
systems market may be segmented as
0.2-0.5 T MRI, 1.5T MRI, 3T MRI, and
refurbished MRI.
Though 3T systems have an
edge over 1.5T systems in terms of
image quality, clinical applications,
and certain other aspects of MR
imaging, the versatile good system
with multiple channels and coils
on 1.5T system can equally provide
great imaging. Nowadays, more and
more manufacturers were flouting
higher field MRIs of 3T to upgrade.
However, in India it is not financially
viable to invest in 3T machines as
Exclusive Interview
Direct Radiology Systems
are here to Stay
Indian radiology market for ages has not seen a major transformational change, but
now it is taking place and is evident in technology, products design and features,
says Kiran Phuri, Director Marketing, Medx Technologies
Please share more
about your company
We come to the Indian
radiology market with a
strong team of eminent
engineers that have
more than two decade
of experience with them.
This is our strength
and with their in-depth
understanding of the market and
their expertise in creating innovative
solutions, we at Medx Technologies
have we have designed and developed
latest technology products which are in
line with international specifications.
Currently, we have a complete range
of high frequency general X-ray
systems, mobile X-ray systems and
mobile C-arm imaging systems, which
are way ahead in terms of technology
comparing to the existing products
being marketed by competition.
Kindly share your views of the
latest trends in radiology market
in India?
Indian radiology market for ages has
not seen a major transformational
change, but now it is taking place
and is evident in technology, products
design and features. Specifically
talking about X-ray imaging there
would be over 40,000 low frequency
systems currently in use and many of
them would be over ten years. With
new technology the market potential
and growth is too high as most of the
age old systems and old technology
systems may be replaced with newer
technologies in the next five years. So
with the ongoing changing trend we
see a big opportunity
in the Indian Imaging
radiology market.
What are the key
segments that your
products focus in
radiology?
In the past, the X-Ray
Imaging market in India
did not witness any major changes in
technology and almost things were
stagnant with low frequency systems
being the basis of Imaging. The major
shift came in 2008 when digital Imaging
became affordable, and since then we
have seen a change and this digitation
process has brought about a change
in the basic Imaging technology as
well. With the need of better imaging
quality, high frequency X-ray systems
have been gaining major acceptance
in the new sales.
The latest trend in X-ray Imaging
of-course has been digitisation
using CR but is now changing pace
towards Direct Radiography (DR)
Systems. To be in line with future
market requirements, at Medx we
have a range of DR solutions from
the affordable series to the highest
end technology products to meet a
variety of customer needs. For high
end imaging requirements, Medx
Technologies has collaborated with a
few European and US companies to
get technology from them and produce
affordable systems in India.
What are the unique features
that you have introduced in your
imaging products?
At Medx Technologies, our main
focus has been in developing high
frequency generators, which are
more stable to Indian power supply
conditions and are future ready for
digital radiography solutions (DRS).
We have been quite successful in
doing this as we can boast that our
high frequency generators have been
working past three years without any
voltage stabilizer requirements and
a single day breakdown in the worst
parts of the country where electricity
is not stable. Our dream to provide
affordable technology is the basis
of our product designs. We try to
develop and create new technologies
keeping in mind the vision to make it
affordable. With some of our products
released, we can surely say that we
offer some higher end solutions at
nearly 40 percent lower cost than
similar spec products available from
the international market.
What are your business plans for
this year?
We already have a basket of products
to offer which range from the lowest
end mobile X-ray to 50kW high
frequency systems. This covers 80
percent of the general market demand
in India. For 2015, we have a lineup
of new products which are currently
undergoing necessary certification and
would be commercially released soon.
In the next six months we are releasing
high capacity X-ray systems with 65kW
and 80KW, range of high-end digital
radiography solutions, and higher end
C-arm imaging systems with cardiovascular imaging capabilities.
March / 2015
ehealth.eletsonline.com
41
MRI Systems
the cost is double of a 1.5T system.
The manufacturers have now wisely
developed robust 1.5T systems
capable of everything a 3T could do
and at a marginally higher cost. Using
parallel imaging technology these
systems can produce equally good
images and also take lesser time as
compared to earlier systems.
The future of MR imaging lies in
high-field MR systems but equally in
low field systems, which are patient
friendly and targeted to specific body
parts and diseases. Public-PrivatePartnership (PPP) may also play a
huge role in providing accessibility
to patients residing in remote parts
of the country. There is a constant
increase in the number of hospitals,
day centres and private clinics all
over India and to cater to this growing
need, there will be immense demand
for diagnostics in the country.
Major Players
The MRI market is dominated by GE
Healthcare, Siemens, Philips, Toshiba
and Hitachi — all had something new
to offer. Here is a look at some of the
latest innovations in MRI systems.
42
March / 2015
ehealth.eletsonline.com
most scans nearly completely silent.
Additionally, the SIGNA Pioneer
features Total Digital Imaging, which
enables improved image quality and
increases signal-to-noise ratio by up
to 25 percent.
With MAGiC, Panagiotelis explains,
one can get six different image
contrasts from one composition,
taking a total of approximately
five minutes, one-third of the time
normally required.
“We can actually go back after
the scan and change the contrast,”
Panagiotelis says. “Let’s say you
made a mistake; you can simply move
the contrast of the image you got and
optimise the contrast. We think there
will be a huge interest in MAGiC as
it’s a real answer to the needs of the
customer today.”
Both the SIGNA Pioneer scanner
and the MAGiC technology are
pending FDA approval and have not
yet received the CE mark.
Two other systems GE will
introduce in 2015 are the SIGNA
Explorer and SIGNA Creator, the
latter an entry-level, value-segment
system.
Philips Healthcare
GE Healthcare
At RNSA, GE Healthcare unveiled its
new SIGNA Pioneer 3.0 Tesla MRI
system that comes with a new imaging
technique called MAGiC, which,
according to Ioannis Panagiotelis,
GE’s global CMO, may reduce imaging
times by up to two-thirds.
“Our big thing was the return of
SIGNA, which we first introduced
in 1983, with four new systems,”
Panagiotelis says. “It was always
associated with leadership and
innovation and this is a vision we want
to bring back for MR.”
The scanner features an enhanced
version of GE’s SilentScan technology,
which originally was only available
for neuro scans, but now makes
Philips has introduced Ingenia 1.5T
S, a new addition to the Ingenia and
dStream family specifically designed
for medium- to large-scale hospitals
that serve large patient volumes with
high-performance MR imaging.
It includes mDIXON XD, which
provides fat-free imaging and four
contrasts in one sequence in virtually
all applications and anatomies,
including
subtractionless
MR
Angiography, whole body imaging,
and even combinations of fat-free and
motion-free imaging simultaneously;
and O-MAR, a solution for excellent
image quality, even for patients with
orthopedic metal implants.
“What makes Ingenia 1.5T S unique
is that it addresses the root causes in
a holistic way, delivering ‘first time
right’ imaging for high productivity
MRI Systems
and a superb patient experience,”
says Annemarie Blotwijk, director of
MR marketing for Philips Healthcare.
“mDIXON XD and O-MAR improve
MR speed and robustness to make
MR more accessible to patients and
new applications. It strengthens
Philips’ Premium IQ solution, which
aims at delivering more diagnostic
information in the available time slot.”
Philips has also introduced new
quantitative techniques in body
and cardiac imaging to make MR a
more definitive diagnostic solution,
including MR elastography for the
assessment of liver fibrosis and T2
or T1 mapping for cardiac disease
assessment.
“Today, MR is already crucial and
established imaging modality already
today, but our customers see a huge
potential to increase the impact of MR
even more,” Blotwijk says. “The future
of MRI is in delivering faster, more
definitive diagnosis, shortening the
time to diagnosis with more definitive
outcomes. This will be achieved by
making MR procedures extremely fast
and reliable and by making MR more
patient friendly. It will also require
more quantitative data and provide
intelligent data analysis tools to
provide definitive answers and enable
personalised treatment plans.”
At RSNA, Philips demonstrated
the concept study of an MRI coil
that is not only fully digital, but also
features an integrated power supply.
This allows a data-only connection of
the coil, significantly speeding up the
workflow.
“In the future many MRI
developments will be based in the
software domain, arising from the
coupling of digital data acquisition,
reconstruction and post-processing,”
Blotwijk says. “We believe that
meaningful innovation starts with
collaboration, which is why we
developed a high-end reconstruction
framework with a plug-and-play
environment for new and custom
reconstruction algorithms that also
44
March / 2015
ehealth.eletsonline.com
supports a graphical programming
interface for our clinical research
partners.”
Siemens Healthcare
“Considers MRI a young modality
because its potential is so limitless,
and the company’s latest products
have focused on improving speed and
clinical use”, said Stuart Schmeets,
Senior Director, MR Marketing,
Siemens Healthcare.
“The efficiency of healthcare has
evolved, making the diagnosis faster,
and some of the buzz in the industry
has been, ‘How can we increase speed
for MRI?’” Schmeets added. “It is
about collecting more information
in less time and completing complex
diagnoses.”
At RSNA, it unveiled its 1.5T
Magnetom Amira MRI system, which
was designed to speed up scans to
as little as 10 minutes, while saving
energy when the scanner is not in
use. According to Schmeets, the
system allows for 20 percent shorter
exam slots, accommodates more
patients per day, makes MRI expertise
accessible to every technician,
reduces the number of rescans with
standard procedures, and minimizes
complexity and maximizes efficiency
for each MRI exam in an institution.
Siemens also introduced its new,
FDA-cleared 24-channel version of the
Magnetom Skyra, Siemens’ advanced
wide-bore 3T MRI system.
“The new configuration of the
Skyra joins the previously available
48-channel version and has a lower
cost entry point for customers
looking to perform advanced clinical
applications,” Schmeets says. “We
have a tremendous customer feedback
programme and that helps drive our
R&D and where we are headed.”
Additionally, Siemens has in the
pipeline its new, 510(k)-pending SEE
it solution for prostate MRI exams,
which will enable users to perform
noninvasive prostate MRI without an
endorectal coil. According to Schmeets,
MRI has the highest sensitivity and
specificity for assessing prostate
cancer as it can rule out the presence
of life-threatening cancer with more
than 89 percent certainty.
“Powerful coil technology and
unique applications help to streamline
processes and maximise system
utilisation,” Schmeets added.
Siemens continues to make use
of its Day Optimising Throughput
MRI exam software, which provides
intuitive
protocol
management
designed to produce quality exams in
less time, with the potential to shorten
exam time up to 20 percent.
Toshiba Medical Systems
Toshiba introduced the Vantage
Elan MR system, a 1.5T MR system,
designed to help providers save time,
money, and space. Josh Emperado,
Toshiba’s senior manager for MR
market development, says the Vantage
Elan magnet and couch fit in a footprint
of 23 square meters and it offers the
lowest total cost of ownership.
“The buzz we hear in the industry
is about making the whole exam
much more comfortable and patient
friendly,” Emperado says. “At the
same time, MR technology is complex,
and we need to make it easier for
the customers. Our new system is
quieter, more comfortable, and we’ve
streamlined the process so that
patients spend the least amount of
time possible and customers can
perform them easier.”
Among its features are Toshiba’s
standard Pianissimo noise-reduction
technology that’s designed to help put
patients at ease, a single set of coils
that does’t need to be readjusted for
multiple exam types, and noncontrast
imaging techniques allowing for
safer exams.
“Toshiba puts customers first
with an MR system that delivers
productivity, reliability, and high image
quality, but can fit into the budgets
of small community hospitals,” says
Nancy Gillen, vice president marketing
MRI Systems
and business development at Toshiba
America Medical Systems. “We think
hospitals of all sizes should be able
to offer their patients the very best in
imaging to enhance patient care and
outcomes.”
Toshiba’s MR series also offers
an upgradable solution to its existing
Superb
Micro-Vascular
Imaging
technology, which enables the
visualisation of micro-vascular flow
without the use of contrast.
Hitachi Medical Systems
The mandate around Hitachi’s MRI
systems in 2014 dealt with several
industry trends that shaped the
direction of its newest products.
“MRI continues to move from
qualitative to more quantitative
assessment—such as techniques to
visualise certain biomarkers and then
map those over traditional anatomical
images,” says Shawn Warthman,
MRI marketing director for Hitachi
Medical Systems America. “Our
new MRI platforms needed to meet
diverse market segment needs. Like
all imaging modalities, MRI is focused
a lot on workflow enhancements,
continuing to push exam times closer
to 15 minutes from the norm of 30
minutes.”
At RSNA, Hitachi introduced new
software designed to improve image
quality, workflow and new clinical
applications for its customers. These
include a new k-space parallel
processing scan method, improved
fast spin-echo imaging, new fat
suppression sequences, improved
tuning and prescan set up, noncontrast
tissue perfusion, white matter lesion
detection, breast spectroscopy, and
cardiac wall motion analysis.
Key features in Hithachi’s Echelon
Oval 1.5T system include 74-cm oval
bore, a 63-cm wide mobile patient
table,
and
workflow-integrated
technology with integrated coils and
on-gantry monitor.
Trends
One of the emerging trends in the global
MRI systems market is the intense
competition among the vendors. The
leading vendors provide an extensive
range of advanced instruments
globally and the low-key vendors also
deliver a wide range of products to suit
the needs of their customers.
Growth Drivers
One of the major drivers in the market
is advance in technology, which
results in the availability of efficient
and inexpensive devices. Advances in
technology enhance the quality of the
output by improving field strength,
which results in a better signal and
improved image quality. Technological
innovations in the healthcare industry
have resulted in the development of
customised equipment as per the needs
of the patients.
This impressive growth will
be driven by continual design
developments,
cost
reductions,
reimbursement improvements and the
rapid uptake of less expensive MRI
systems in emerging markets.
Challenges
One of the major challenges in the
market is the growth of the used and
refurbished MRI systems market.
Many local vendors are exporting and
importing used and refurbished MRI
systems. Used and refurbished MRI
systems are available at half the price
of new ones, and the vendors also
provide a warranty period of a couple
of years on them.
However, current economic factors
remain the greatest threat to new
innovation in the next five years,
despite numerous advancements in
MRI system capability.
Healthcare providers are calling on
manufacturers to develop both cheaper
and better technology, meaning suppliers’
success will depend on the development
of MRI solutions offering improvements
in cost, efficiency and workflow, while
also enhancing clinical diagnostics.
Despite the need for replacements,
hospitals do not always decommission
MRI systems at the end of the products’
manufacturer
recommended
lifecycles, which negatively affects
sales in developed markets as new
system purchases are delayed or
abandoned.
The Indian MRI market will be fueled
by the rapid uptake of less-expensive
MRI systems that will allow access
to healthcare in more remote areas
of these price-sensitive economies.
With increase in average income,
growing demand for healthcare, and
higher standards for care, emerging
markets are expected to see a rise in
MRI diagnostic procedures, as the
technology offers safe and valuable
insight into patient conditions and is
a powerful, irreplaceable decisionmaking tool for physicians.
In a time of rapidly changing
environments due to regulations,
financials, competition and technology,
medical imaging will be a focal point of
successful providers. The difference
between successful providers and those
that struggle will come down to the
people who make up the organization
and can utilize the resources and
create an organization that is informed
and flexible.
March / 2015
ehealth.eletsonline.com
45
Buyers Speak
Trends in Cardiology
T
his is the Golden Era of
Cardiology. No other field in
medicine has seen so many
advances as in this field and it’s
just the beginning. The death rate
of acute heart attacks has halved in
past two decades. The focus is now
shifting to prevention, early detection
and minimally invasive treatment of
the disease.
Trends in cardiac imaging
There is already a discernable shift
from diagnosing disease at a later
stage, after symptoms occur, in
asymptomatic diagnosis. Patients at
high risk can now be selected on the
basis of risk profiles and screened
in the doctor’s office. An important
recent development is the realisation
that the vast majority of heart
attacks are not due to progressive
atherosclerosis, but to sudden
rupture of non-occlusive, vulnerable
plaque. CT angiography is now
widely being used in the emergency
department to distinguish noncardiac chest pain from those acute
heart attack patients in whom the
initial ECG is non-diagnostic. Cardiac
MR is also very helpful in diagnosing
structural diseases of the heart with
greater accuracy.
46
Dr. Vishal Rastogi
Senior Consultant Interventional
Cardiologist, In charge - Heart Failure
Clinic, Fortis Escorts Heart Institute
(FEHI), Gurgoan
anti-platelet agents, which are being
used in the treatment of acute heart
attack patients and in patients who
undergo angioplasty. Their usage
has reduced cardiovascular death,
stent thrombosis and urgent target
vessel revascularization. Dabigatran,
apixaban and rivaroxaban are very
exciting addition for stroke (paralytic
attack) prevention in patients
suffering from atrial fibrillation, a
form of irregular heartbeat.
Trends in drug treatment of
disease
Trends in interventional
cardiology
After the publication of courage
trial, which showed that in patients
with stable angina, drug treatment
is equally effective as angioplasty
or bypass surgery, more and more
patients with stable coronary artery
disease (CAD) are being managed
medically. Newer drugs such as
ivabradine and ranolazine are very
effective in control of symptoms.
Ticagrelor and prasugrel are novel
Today, most type of diseases can be
treated by less invasive catheter based
interventions obviating the need for
more complex surgery. Transcatheter
Aortic Valve Replacement (TAVI) has
made life very comfortable for high
surgical risk patients with aortic
stenosis. Moreover, till now, mitral
valve leakage repair was strictly
a domain of surgeons. Recently, a
percutaneously applied clip called
March / 2015
ehealth.eletsonline.com
MitraClip has allowed lots of patients
avoid high-risk surgery. Multiple
long blockages are now increasingly
being treated by angioplasty because
newer medicated stents have shown
excellent long-term safety and efficacy.
Another milestone in the treatment
of coronary artery disease is the
advent of Biodegradable Scaffold,
also known as vanishing stent - a
device that keeps the artery open till
it heals and then gradually dissolves
to leave behind a normal, natural
artery. One of the most important
innovations for management of CAD
patients is cath table assessment of
significance of blockage by fractional
flow reserve (FFR). It is a simple and
accurate guide to tell us whether a
blockage needs fixing or can be left
on medications.
Trends in heart failure
As the survival in patients with CAD
is improving, the number of patients
suffering from heart failure or weak
heart is also increasing. Management
of these sick patients is very difficult
and these patients require frequent
hospital admission. However today,
along with medicines, various
devices like implantable cardioverter
defibrillator (ICD) and cardiac
resynchronization therapy (CRT)
have allowed these patients to live
longer with good quality of life. Now
definitive treatment such as cardiac
transplant and artificial heart is also
widely available.
Now the distinction between
a cardiologist, a surgeon and an
imaging expert is blurring and a
new approach called the heart team
approach is necessary to properly
evaluate and treat the patient.
For more information visit:
www.fortisescorts.in
Buyers Speak
Affordable Hi-end
Technology
Please comment on MRI
machines market in India visa-vis the global market.
India is the second most populous
country in the world with over 1.2
billion population. As expected, it
also has a very high disease burden.
This in turn represents the huge
market and the large prospect for
the healthcare industry.
The Indian MRI market has
witnessed strong growth over the
last few years and will continue to do
so over the next five years. Southern
India tops the list in terms of
installations whereas in future bulk
of the demand will come from West
followed by North. Buying behaviour
of MRI depends on the budget and
the type of population catered by the
institution. Therefore, the latest and
advanced 3T MRI is not afforded.
An increase in healthcare
infrastructure boosts the demand
for MRI equipment installation,
also increasing the demand from
hospitals and imaging centres.
Increased
health
insurance
coverage and disposable income
fuels the affordability among the
patients, leading to increase in
health insurances and per capita
disposable income. Medical tourism
is opening up new avenues for
growth for this market. Greater
budgetary allocation towards health
sector will see better infrastructure
in state run hospitals. The duty
structure should be decreased for
such equipment. Both doctors and
patients are increasingly becoming
more aware of the benefits of MRI
test. Higher currency fluctuation
squeezes the profit margin of the
players. Currency fluctuation affects
this market as this market sees
heavy imports (for both first-hand
and refurbished equipment). Highly
capital intensive MRI equipment
demand high service charges, which
in turn is passed on to the patients
resulting in lack of affordability
amongst patients. Lack of regulation
in the medical community on MRI
referral fees further hampers the
affordability of patients for this
modality.
Looking
into
the
rapid
developments in technology such
as faster scan times and higher
imaging quality, higher and more
sophisticated machinery makes it
possible to even detect small lesions
<5mm. The advancements in MRI
Physics are decreasing the use of
contrast administration for MRI.
The latest advancement of PETMRI makes it a highly sensitive
tool to detect any cancer anywhere
in the body at very early stages,
without giving any radiation from
the machine unlike the PET-CT
Scan. This makes this innovation of
PET-MRI the safest way and most
comprehensive way to study and
deal with cancers. It has helped
in decreasing the time for cancer
imaging and diagnostics, further
decreasing the time gap between
Dr Shubham Sogani
CEO, House of Diagnostics
March / 2015
ehealth.eletsonline.com
47
Buyers Speak
diagnostics and treatment, helping
patients fight cancer and time, as
cancer is a fight against time. Right
treatment at the right time may cure
cancer. It gives the doctor the correct
extent of cancer and helps him make
the right decision. Lesions which
are missed on a regular positron
emission tomography (PET) scan
are picked up using the MRI Scan,
thus complementing the findings
of a regular PET. It is safe as no
radiation exposure from the MRI
(unlike CT scan) completely removes
the untoward side effects and harms
from CT scan during a PET-CT.
This technology is now being used
for cancer screening and also can
detect cancer anywhere in the body
in just one examination which lasts
for about 45 minutes only.
The Indian market is becoming
increasingly more susceptible to
refurbish MRI equipment because of
cost advantage - about half the cost
of new equipment. MRI equipment
are penetrating more because of the
various tie ups between government
and private companies. As per latest
trend MRI equipment is installed
through PPP model. Teleradiology is
emerging as a tool for reporting MRI
images to counteract the lack of good
radiologists especially in remote and
rural India.
Please tell us about your
current operations in India and
your expansion plans.
We are mainly concentrated in the
Delhi - NCR Region with the largest
number of MRI scanners installed
under one brand. We have the highest
end PET-MRI (a high end 3T MRI
with PET Scanner) at Indraprastha
Apollo Hospital, a 3T super-magnet
MRI installed at Hargovind Enclave
in East Delhi, 1.5T super-magnets
installed at Hargovind Enclave,
Saket, Faridabad centers, Open cum
standing and weight bearing MRI
installed at Hargovind Enclave in
Faridabad and Apollo New Delhi.
48
March / 2015
ehealth.eletsonline.com
We have 8 MRI’s installed in Delhi/
NCR Region itself and six diagnostic
centers being run and managed
by us. With Delhi market maturing
and the demand for MRI’s rising
we expect to further expand our
portfolio in Delhi -NCR and also are
targeting other nearby markets with
such fully equipped centers. Today
we do diagnostic tests at rates which
are lower than those being charged
by government hospital also as we
cater to large volumes.
On the price sensitivity of the
Indian market, and how does
your hospital counter this
problem?
The Indian market is very price
sensitive and patient’s affordability
is a major challenge in diagnostics
and treatment. We are now offering
50 percent discount on the prevailing
market rates on all tests done at
our centres in Hargovind Enclave,
Saket and Faridabad. An MRI test
prescribed by a doctor on a 3T MRI
for instance, which costs Rs 18,000 at
any private hospital, costs between
Rs 7,000 to 9,000 at our centres. This
has resulted in a large patient flow to
our centres and we are now handling
a good volume of patients.
On government regulation or
any other challenges faced
while operating the Indian
market?
The main challenge faced by the
healthcare industry is the huge costs
of infrastructure. Government should
look into subsidising the costs by
removing VAT, service tax and excise
applicable on all goods and services
which are directly supportive to
healthcare industry such as on
equipment and consumables. This
in turn will greatly decrease the
burden of costs on patients making
it more affordable to them. Lack of
regulation in the medical community
on medical referral fees further
hampers the affordability of patients
for diagnostics and treatment.
On emerging trends and new
technologies.
The new technologies in the space
of MRI are PET – MRI, which is a
ground breaking innovation that
has changed the way doctors are
approaching and treating cancers.
Also its use in cancer screening
for people who wish to rule out any
and all types of cancers by just one
test makes this advancement truly
a medical marvel. The 3Tesla MRI
with high power of a 3Tesla magnet
gives better quality images and
resolution are far better, making
even the minute lesions visible. Silent
MRI decreases the noise inside a
MRI machine. While open MRI is
recommended on claustrophobic
patients. Standing weight-bearing
MRI has given a new dimension to
spinal and joint problems, which get
exaggerated in standing and weight
bearing positions.
What are your Hospital’s
offerings?
We are one of the healthcare
institutions that offers discounts
on all diagnostic tests, including 3T
MRI, 1.5T MRI, open cum standing
weight-bearing MRI, CT Scans, PETCT scans (at Rs.9,999), laboratory
investigations besides all general
tests such as X-Rays, ultrasounds,
bone densitometry, mammography,
OPG, PFT, EEG, EMG, ECG, etc. We
offer a comprehensive whole body
cancer screening check up using
the PET-MRI at Indraprastha Apollo
Hospital in New Delhi using the high
end PET-MRI.
Affordability is the key for all. The
manufacturers have to sell affordable
products without compromising on
quality, Government has to provide
subsidy to the service providers to
make investigations such as those of
MRI affordable for patients.
For more information visit:
www.houseofdiagnostics.com
Government Desk
Centre to Unveil New National Health Policy Soon
A
new health policy will be soon introduced by the Centre
with special emphasis on AYUSH - Ayurveda, Yoga and
Naturopathy, Unani, Siddha, and Homeopathy system. The
new policy will redefine the role of AYUSH, giving adequate
importance.
AYUSH system, with its long history of use at various stages
of civilisation would be made an integral part of the healthcare
arrangements at all levels, right from the primacy health centres
to the top.
According to Union Minister, Shripad
Naik, there can be a revolution in
healthcare if strengths in AYUSH system
of medicine are properly utilised by
prompting, supporting and spreading
awareness about it.
On the other hand, the Central
Government has approved a sum of Rs
54,351.02 lakhs for allocation to all States
and Union Territories for mainstreaming
AYUSH under the National Rural Health
Mission (NRHM) during the current year 2014-15. Under NHM
and NRHM, engagement of AYUSH doctors and paramedics
are being supported, provided they are co-located with existing
District Hospitals, Community Health Centres and Primary Health
Centres with priority given to remote PHCs and CHCs. States
and Union Territories engage the AYUSH doctors as per local
preference.
States and Union Territories utilise funds for appropriate stream
of AYUSH, as per their requirement.
Under the scheme, Manipur recruited
95 AYUSH doctors for co-located health
facilities, 72 AYUSH doctors under Rashtriya
Bal Swsthya Karyakram (RBSK) and 59
paramedics and pharmacists. Co-located
AYUSH health facilities in Manipur are
available at seven district hospitals, 17
community health centres; one, at other than
community health centre above block level
but below the district level, and 72 primary
health centres.
NUHM to be Implemented In Karnataka by March
T
he National Urban Health Mission
(NUHM) will finally be implemented in
the first week of March. As a part of the
initiative, 13 Urban Public Health Centres,
including eight in Bengaluru will be brought
under the scheme.
According to Health Minister, U T Khader,
the objective of the NUHM was to address
the health service needs of slum dwellers,
migrant and vulnerable sections in urban
areas.
Towns and cities having a population of
more than 50,000 would be covered under
the scheme, he added.
Some of the existing healthcare facilities
now identified under the Urban Public
Health Centres would be revamped with
modernisation of infrastructure and
deployment of medical staff, nurses and
paramedics. There would also be the need
to muster for medicines and diagnostic
equipment.
Programmes such as delivery of
healthcare, environmental sanitation and
supply of safe drinking water will be taken
up under the Mission.
March / 2015
ehealth.eletsonline.com
49
Mother-Child Care Equipment Market
Smiles Ahead
Prenatal, fetal and neonatal care is gaining importance every year with
increasing awareness, demand and affordability for the latest, improved and
technologically advanced equipment that are available worldwide
P
remature and congenitally ill infants are born as a
result of advanced maternal age, induced fertility,
labor treatments, poor prenatal care, and lifestyle
preferences such as smoking, drinking, and obesity.
Various disorders such as anemia, bronchopulmonary
dysplasia,
intra-ventricular
hemorrhage,
hyperbilirubinemia, and transient tachypnea are
diagnosed at birth. Thus, proper prenatal care, balanced
nutrition, and appropriate medical care are necessary
for a healthy pregnancy and birth. Maternal and infant
care equipment are used to monitor, evaluate and treat
diseases in the prenatal and postnatal stage of infants.
Prenatal, fetal and neonatal care is gaining importance
every year with increasing awareness, demand and
affordability for the latest, improved and technologically
50
March / 2015
ehealth.eletsonline.com
advanced equipment that are available worldwide.
Premature birth has been one of the leading causes of
neonatal death globally, that kills more than one million
newborns every year. There are approximately 15 million
premature babies born every year across the globe that
require urgent medical attention and intensive care,
which creates the demand for maternal and infant care
equipment. Prenatal, fetal and neonatal care equipment
are also required for numerous other applications, such
as treatment for hypothermia, jaundice management,
fetal and neonatal monitoring, respiratory assistance
and others. Growing awareness, low cost equipment, and
replacement market are some of the factors driving the
growth of neonatal equipment industry.
Maternal & Infant Care Equipment
Global Market
Increasing demand
for improved and
technologically advanced
equipment such as double
walled closed incubators, highly
portable fetal dopplers will add to
the growth of the market.
The global prenatal, fetal and neonatal equipment
market was valued at US$ 6.63 billion in 2014 and
is expected to grow at a CAGR of 6.1 percent from
2014 to 2019, to reach an estimated value of US$ 8.92
billion in 2019. Some of the major prenatal, fetal and
neonatal equipment available in the global market are
ultrasound and ultrasonography, fetal dopplers, infant
warmers and incubators, phototherapy equipment,
and respiratory assistance and monitoring devices.
Among these, respiratory assistance and monitoring
devices are the largest sub-segment with over 40
percent share of the neonatal equipment market.
North America dominates the global prenatal,
fetal and neonatal equipment market, with more
than 28 percent share in 2014 in terms of revenue,
followed by the European market (25%). Major factors
contributing to the leading position of the North
American market are high incidence rate of premature
births, increasing age of maternal population and
high level of awareness, demand and affordability for
various prenatal and neonatal care equipment in the
region. Asia-Pacific is expected to show the highest
CAGR of 7.8 percent during the forecast period from
2014 to 2019 in the global prenatal, fetal and neonatal
equipment market.
The key factor responsible for the growth of the
prenatal, fetal and neonatal equipment market is
increasing incidences of premature births worldwide.
Africa and Asia are the largest contributors towards
the premature newborns, with Africa exhibiting highest
One-Touch Wireless Health Tracker!
March / 2015
ehealth.eletsonline.com
51
Maternal & Infant Care Equipment
incidence rate of premature births.
However, the US exhibits the second
highest incidence rate of premature
births with 10.6 percent of all births
in the region in 2005. Increasing
age of maternal population is also
leading to a number of complications
that require various prenatal, fetal
and neonatal care equipment.
Rising awareness levels along
with increasing affordability of
the population especially in the
emerging economies will help the
growth of this market in future.
Increasing demand for improved
and
technologically
advanced
equipment such as double walled
closed incubators, highly portable
fetal dopplers will further add to the
growth of this market.
Indian Market
Indian neonatal equipment industry
is experiencing spectacular growth
for the past few years as many
new entrants are emerging in this
market providing better healthcare
facilities, thus, leading to increased
competition. The Indian neonatal
equipment market was valued at
`201 crore in 2014. The market
grew at an average rate of 25
percent over the past three years.
New and technologically advanced
equipment in the prenatal, fetal and
neonatal equipment market will
further provide growth opportunities
52
March / 2015
ehealth.eletsonline.com
The Indian
neonatal
equipment
market was
valued at `201 crore
in 2014
to this market in future.
Leading
multinational
companies, medium sized corporate,
importers, and small companies
are operating in this field; however,
the market is dominated by
multinational companies in premium
segments
and
medium
sized
companies in low cost segments.
The neonatal mortality rate in
India is amongst highest in the
world and skewed towards rural
India. Non-availability of trained
manpower along with poor health
infrastructure is one of the major
hurdles in ensuring quality health
and neonatal care. Despite a decline
in Infant Mortality Rate (IMR),
neonatal mortality is more or less
static. It is therefore essential
that neonates are provided utmost
care at the first month of life so
that neonatal deaths on account of
asphyxia, infection, and preterm
births could be prevented. The
neonatal
mortality
constitutes
about 75 percent of infant deaths
in the country. Under the National
Rural Health Mission, several
initiatives have been undertaken to
accelerate the pace of reduction of
child mortality.
Growing
wealth,
increasing
mortality rate (IMR), increasing
demand for private healthcare,
reforms from governments, and
active participation of social
organizations in neonatal healthcare
programs are some of the factors
driving the growth of this industry.
Exclusive Interview
Technological Advancements and
Emerging Trends in Healthcare
Single health account of the patient linked to their families, storing their
medical information securely and providing helpful information timely,
will help people live a healthier and longer life, says Shashank ND,
Founder & CEO, Practo
H
ealthcare is perhaps one
of the few industries yet
to be completely disrupted
by technology. It bothers me that
millions find it difficult to search for
an efficient doctor than a movie hall.
It is easier to get a joke on your email
than getting your own healthcare
records. We talk of Digital India and
making access to good healthcare
a fundamental right yet millions in
India and billions around the world
struggle for it every day. How are we
going to solve the problem?
Even if you look at people with
access to healthcare, their experience
is not much better. They have no way
of finding the best doctors other than
asking a few of their friends who
may or may not know great doctors.
Their medical history (if they were
diligent enough to actually have one)
is stored in fat files that need to be
lugged around every time they want
to see a doctor and even when they
do; it is so cumbersome for doctors
to go through them. They simply
order more tests which make the
file even fatter and leave your health
not much better. Why cannot your
healthcare information and history
work for your benefit? Surely, in an
era where keyboards can predict
your next word and cars are driving
themselves, your healthcare data
can (and should) do more than just
compile in a file (fat or thin or digital)
and twiddle its thumbs.
There has to be a better and
easier way of doing this. I envision
a world where technology will help
consumers find the best doctors with
a few clicks. Generating, accessing
and storing health records would
be entirely done digitally. Patients
will have a single health account
linked to their families that will store
their health information securely
and providing helpful information
(prescription reminders for instance)
in a timely manner (prescription
reminders to take medicines) to help
people live healthier, longer lives.
Practo Ray software automates
and simplifies clinic management so
that doctors can focus on treating the
patients. With Practo Tab, doctors
can provide a superior patient
experience in the clinic as well as
have offline access to all their digital
records.
The possibilities from here on are
endless. For instance, finding the
best doctor on Practo from thousands
of doctors listed across the various
countries we operate in and securely
sharing your health information with
the doctor with a single click, will
make it extremely easier (and for the
first time practical) for the patient
to consult a doctor irrespective of
geographical distance. This will make
people in every corner of India (and
around the world) getting access
to the best healthcare they can. It
will also make healthcare industry
become a global integrated entity
working to improve patient care.
The good news is that things
are changing rapidly. Doctors and
healthcare providers want to improve
patient healthcare experience but so
far, all the technological change had
been focused on large medical devices
and creation of medicines (which is
obviously important). But the next
phase of innovation will be centered
on improving patient ability to make
more informed healthcare decisions
and making all the magic of modern
medicine accessible to consumers
easily, transparently so that they can
live healthier longer lives.
March / 2015
ehealth.eletsonline.com
53
Buyers Speak
NICU Offers
Quality Healthcare
Preterm births are the underlying cause for the fetal and neonatal care
products and services market across the globe.
Please comment on neonatal
infant care unit market in India
vis-a-vis the global market.
Preterm birth poses a grave challenge to perinatal and maternal care,
and is the major reason for neonatal
mortality. Around 28 percent of the
four million annual neonatal deaths
that occur worldwide are directly
attributed to preterm birth. This percentage of neonatal deaths is different for various countries, depending
on their respective degree of neonatal mortality. The primary reason for
such pronounced differences is the
cause of neonatal death and the stark
measure of healthcare inequities between low and high resource settings.
According to the National Institute of
Health (USA), the increased adoption
of preterm equipment has enhanced
the survival rate of premature babies.
Tell us about your current
operations in India and further
expansion plans.
Kohinoor Hospitals is planning to
have 500 self-sustained beds by 2020.
At present, our hospital project has
envisaged having 210 beds by the end
of this year.
54
quality care for which he is ready to
pay a reasonable price.
At our hospital we have, right
from the project stage, gone in for
a Green Hospital, which cuts our
operational costs in terms of savings costs for electricity, water, etc.
These savings are passed on to the
patients. Additionally, we have different classes of admissions so
that we can take care of all sections of society. For the poor, we
have tied up with some NGOs who
sponsor certain operations at very
low costs- paediatric cardiac interventions. Our experience is that patients are ready to pay reasonable
tariff if you provide them with
quality services and counsel them about the costs
rationally.
What are your
views on government regulation or
any other challenges faced while
operating the
Indian market?
What are your views on the
price sensitivity of the Indian
market, and how does your
hospital counter this problem?
The problems with
regulation are illustrated by India’s medical tourism industry,
which according to
government sources
will be worth `9,500
Indian market is very price sensitive;
however with increasing awareness,
education and disposable incomes,
the Indian consumer is asking for
Dr Rajeev Boudhankar
Vice President,
Kohinoor Hospital, Mumbai
March / 2015
ehealth.eletsonline.com
crore in 2015, and as much as `54,000
crore in 2020. Almost 75 percent
of the medical imaging equipment
(worth `18,000 crore in 2011) that
serves this industry is imported, and
the value of imports themselves grew
at a compounded
rate of 16 percent
in 2010-2014.
A part of
the problem
is corruption
and
inefficiency. There
is no national
Buyers Speak
body to oversee the procurement and
provision of generic medicine, which
currently originates from local manufacturers known to operate their
plants in unsanitary conditions.
What are the various upcoming
trends and new technologies?
Time has come when challenging
conventional constraints in healthcare can change the scenario in India. I agree with the Mckinsey report,
which says that disruptive technologies deployed together have the potential to bring affordable healthcare
to millions in the coming decade. The
healthcare sector needs to be liberated from the institutional and human
shackles that inhibit the transformative power of technology. Despite
facing severe challenges, the Indian
healthcare sector could become one
of the most fertile test beds for technology innovation around the world.
India’s myriad healthcare shortfalls
are well known, and facts are the
most troubling.
Furthermore, poor access to clean
water and sanitation compounds are
other problems, as does a lack of
awareness of preventive measures,
which traps many in a cycle of debilitating malnutrition and disease. Finally, affordability alone will not solve
the problem. Healthcare operates
through a funnel of awareness and
promotion, prevention, diagnosis,
treatment and compliance. Trained
and appropriately incentivised human resources are required across
the entire funnel, but India doesn’t
have enough of them. The ratio of
practising doctors and nurses to the
population has fallen to 1.4 per 1,000
in India, far below the World Health
Organisation (WHO) norm of 2.5.
This means conventional solutions
will not make a dent. Those who are
trained and want to work are not
willing to practise in poor, rural communities. And those who are willing,
they are either not trained or not certified, or both.
Would you like to suggest any
other thing?
Some of the new technologies are
helping smallest infants progress
faster in the Neonatal Intensive Care
Unit using new devices to personalise
the nutritional needs of premature
babies, and help smallest infants with
head shape and sleep cycles. Several
new technologies being used in the
USA are also making it easy for the
smallest babies to gain more weight
and being healthy.
Doctors have begun routinely using a device known as the Pea Pod
to measure the body composition of
the infants. It looks like a mini Magnetic Resonance Imaging (MRI) machine. It is heated, and the baby is
placed inside for approximately three
minutes. Using an air displacement
method, the machine senses change
in pressure and can determine the
percentage of body weight that is fat
and the percentage that is lean body
mass. With this information, health
care workers can then personalise
the baby’s nutritional supplements to
help with appropriate weight gain.
The Pea Pod is important in helping the NICU team facilitate a healthy
weight gain in the smallest infants by
calculating the amount of lean mass
and body fat in the infant on a daily or
weekly basis. At the same time, some
hospitals in the USA conduct ongoing
studies of breast milk composition,
using a device that analyses the percentages of fat, protein and carbohydrates in breast milk. To date, health
care workers have performed hundreds of analyses of breast milk.
The information from both analyses, ultimately leads to weight gain,
better neurological outcomes and
shorter hospital stays for babies in
the Neonatal Intensive Care Unit
(NICU). Cedars-Sinai is currently
the only hospital in the United States
with the new technologically advanced mattresses. Together, these
new technologies are helping reduce
the babies’ stay in the NICU and
sending them home to their families,
where they belong.
For more information visit:
www.kohinoorhospitals.in
March / 2015
ehealth.eletsonline.com
55
Buyers Speak
Technology and
Healthcare Delivery
Please comment on healthcare
market in India vis-a-vis the
global market.
The Indian healthcare industry can be
termed as the sunshine sector, with its
increasing revenues, investments, FDIs
and technology advancements. In comparison to our global counterparts, we
now also have destination and specialised tertiary care hospitals providing
low-cost treatment and care to patients
from all over the world. With the estimate of growing US$ 100 billion by 2016,
one can be certain that with public and
private partnerships the gap of healthcare infrastructure, medical professionals shall be abridged. In my opinion
the important aspects to be learnt and
incorporated from the global market
are – government expenditure and support to healthcare along with structure
in planning the same. Today with production companies being opened in India, and Indian hospitals opening their
units abroad, we see recognition and a
positive future for ourselves.
Please tell us about your current
operations in India and your
expansion plans.
At present, Paras Healthcare has
three commissioned hospitals at Gurgaon, Patna and New Delhi. By the
last quarter of 2015, we shall also be
commencing Paras in Darbhanga. By
2020, Paras Healthcare aims to establish healthcare facilities at tier-II and
tier-III cities. Five years from now, it
will have a bed strength of 1500 and
revenue of `800-1,000 crore.
What are your views on the
price sensitivity of the Indian
market, and how does your hospital counter this problem?
The mission of Paras Healthcare is
56
March / 2015
ehealth.eletsonline.com
to provide affordable specialised tertiary care healthcare facilities to the
common man. To give access and approach to healthcare you have to suit
the pocket of the community at large.
With around 70 percent of the population making expenses out of pocket,
majority still in cash, hospitals have to
streamline their costs. One should not
view price sensitivity as a hurdle. In
fact, it is a challenge, which forces you
to utilise your resources, optimise your
processes and ensure that we deliver
quality healthcare services.
What are your views on government regulation or any other
challenges faced while operating the Indian market?
The government support to the private
sector to establish specialised tertiary
care centres is in adequate, despite
the fact that today 70 percent of the
healthcare facilities are provide by
private players in India. High custom
duties, slow government approvals
and low primary health coverage are
all hurdles. Also, closure of many PPP
projects takes time. The government
policies need to be more defined, timeline oriented and robust to suit the
finances and the ground realities of a
private player. Projects like universal
healthcare coverage and healthcare
for all should be realised into reality.
Please comment on emerging
trends and new technologies.
The two most significant emerging
trends in India are dual disease burden, gaping reality of the gap between
healthcare infrastructure and manpower. The first forces us to understand the changing paradigm of diseases and the second asks for more
policies, government inclusion and
Dr Dharminder Nagar
Managing Director
Paras Healthcare, Gurgoan
Public-Private-Partnership (PPP). In
view of technology and healthcare
delivery, today we are going through
a metamorphosis. We are open to
all types of healthcare models. The
concepts of telemedicine, paperless
healthcare, healthcare at home (from
bench to bedside and online doctor
consultation and second opinions) are
just few examples that make us realise that the Indian Healthcare industry is exceptionally dynamic.
It is time that the Indian healthcare
fraternity accepts its digital transformation and incorporates the same. A
model that saves time, cost, resources
and is more convenient should be selected. A comprehensive inclusion all
over the country shall transform the entire industry and its interface. Doctors
who are hesitant, professionals who are
sceptical should accept evolution. We
need to make sure that we have the resources and the capability to accommodate technology at its introduction and
not at the end of its market life cycle.
For more information visit:
www.parashospitals.com
Buyers Speak
Technological
Advancements and
Emerging Trends
Please comment on
healthcare market in India visa-vis the global market.
Healthcare
has
evolved
tremendously in the last two
decades. India had been lagging
behind in providing medical care to
its population and it had to look upto
western countries for providing
advanced and tertiary healthcare.
But in the last few years, several
operators in the tertiary segment
have come up to provide excellent
quality oriented healthcare to both,
Indian as well as international
patients. Now-a-days in India, we
have a huge inflow of international
patients for medical value tourism.
India’s
primary
competitive
advantage over its peers lies in its
large pool of well-trained medical
professionals. Also, India’s cost
advantage compared to peers in
Asia and Western countries is
significantly low as the cost of
surgery in India is one tenth of that
in the US or Western Europe.
Please tell us about your
current operations in India and
your expansion plans.
Currently, we have our tertiary care
centre in Sector 8, Faridabad and
another secondary care centre at
Sector 19, Faridabad. We also have
two peripheral satellite clinics and
an institute to train nurses and
paramedics. We plan to expand
at peripheral level by putting
What are your views on
government regulation or any
other challenges faced while
operating the Indian market?
Dr Rakesh Gupta
Chairman and Medical Director
Sarvodaya Hospital and Research
Centre, Faridabad
up peripheral centres at Palwal,
Mathura and Hodal.
What are your views on the
price sensitivity of the Indian
market, and how does your
hospital counter this problem?
I believe that the Indian market is
acutely price sensitive i.e. majority
of treatments are carried out in
the value segment and this applies
more to elective procedures. But in
cases of life threatening situations,
or highly advanced procedures
where scarcity of skilled deliveries
is there, price doesn’t matter.
Government is playing a leading
role in transforming the Indian
healthcare industry. With most of
the comprehensive reforms in the
twelfth five year plan, government is
set to play the role of stewardship
for the Industry. If an organisation,
like ours follows all rules and
regulations, there are no challenges
as such.
However,
finding
proper
and
demographically
suitable
manpower seems to be a challenge
at times, leading us to start our own
nursing and paramedics institute
to
develop
skilled
resources
focused on precision and advance
healthcare treatment.
Please comment on emerging
trends and new technologies.
We live in an era of rapid
technological advancement and
great interconnectivity in terms
of communication that enables
professionals
in
the
Indian
healthcare industry to provide
patients with the most advanced
tertiary care treatment possible.
It enables us to achieve greater
efficiency
improved
outcomes
and provide world-class care to
our patients.
For more information visit:
www.sarvodayahospital.com
March / 2015
ehealth.eletsonline.com
57
International News
Medtronic Gets FDA Approval for
VenaSeal Closure System
M
edtronic, an Irish medical
technology firm has received
approval from the US Food and
Drug Administration (FDA) for its
VenaSeal closure system.
The company has developed a
minimally invasive
procedure to close
lower superficial
extremities such as
the great saphenous
vein in patients with
symptomatic venous
reflux.
Medtronic aortic
and peripheral vascular business
endoVenous franchise general
manager, and vice-president,
Sandra Lesenfants, said, “The FDA
approval of the VenaSeal system
strengthens our endoVenous
portfolio, providing physicians
and their patients with a nontumescent treatment option. The
VenaSeal System, together with
our Venefit procedure,
provides physicians
and patients with
leading treatment
options.”
The VenaSeal
procedure is the
only non-tumescent,
non-thermal, and
non-sclerosant procedure approved
in the US, which uses a specially
formulated medical adhesive that
closes the vein.
Siemens Provides Imaging
Technology for Neighbors’
Health System
S
iemens has partnered with
Neighbors Emergency
Center to offer its imaging
technology. Under the deal,
Siemens will provide its
imaging equipment for all new
facilities of the Neighbors Emergency Center, which are
expected to open in new Texas markets and other states.
Bruce McVeigh, CEO, Neighbors Emergency Center,
said, “It is currently a common practice for many ER
facilities to purchase refurbished equipment. This contract
with Siemens creates a standardised, state-of-the-art
package of new radiology and imaging equipment for all
of our Neighbors Emergency Centers, as we strive to be a
leader in the free-standing emergency center market.”
Siemens will supply its new CT, overhead X-ray,
and ultrasound equipment for each new facility of the
Neighbors Emergency Center.
Illumina Introduces New NeoPrep Library Prep System
U
S-based Illumina has introduced a new
NeoPrep Library Prep System, which
claims to simplify the library preparation
and offer quality sequencing-ready libraries
for next-generation sequencing (NGS).
The NeoPrep System has been developed
for use with the Illumina portfolio of library
preparation kits, supporting the commonly
used NGS applications on all Illumina
sequencing systems.
The new system comprises NeoPrep
desktop instrument, disposable library
cards and reagents, and provides an
efficient and complete workflow, together
with Illumina sequencers and the
BaseSpace computing environment.
Illumina life science business general
manager, and senior vice-president, Kirk
Malloy, said, “Illumina is enabling the
broadest-possible adoption of NGS across
research, clinical, and applied markets.
“It makes NGS accessible to any lab by
radically simplifying the library preparation
process, creating a seamless workflow of
Illumina solutions for library preparation,
sequencing, and data analysis.”
The system is said to be the first
commercially available product, which
ResMed Acquires US-based Jaysec
R
esMed has acquired Jaysec, a provider
of Internet-based software solutions
for the home medical equipment (HME)
industry. Headquartered in Knoxville,
Jaysec’s products assist HME providers
resupply their patients and communicate
with referring medical providers.
“Jaysec’s products streamline key
HME business practices such as resupply,
58
March / 2015
ehealth.eletsonline.com
allowing home medical
equipment providers to
focus on delivering quality
care for their patients,”
said Raj Sodhi, President,
ResMed’s Healthcare
Informatics Global Business
Unit.
Jaysec offers an automated resupply
solution - GoJaysec - that uses
performs library
preparation,
quantification
and normalisation in a single and selfcontained instrument.
The system provides quality DNA and
RNA libraries from starting amounts four
to ten times lower than those required for
equivalent manual assays, by precisely
manipulating droplets within the tightly
controlled library card environment. Users
can prepare up to 160 libraries per week,
by creating 16 libraries per run, noted
Illumina.
interactive voice, text and secured email
communications to direct patients to a
self-serve portal for easy
authorisation of HME
resupplies, including
CPAP masks and
accessories. This targeted,
periodic communication
automates the resupply
process. The portal offers
a cost-effective solution while reducing the
administrative burden for the HME.
National News
Healthcare Goes Hi-tech with Patient
Details on Tablet & Smartphones
A
Delhi-based healthcare at home
has asked their nurses to carry
Tablet computers or Smartphones
with proprietary applications.
Over the past three years, a clutch
of professional home healthcare
companies have started in the
country, and in the process they
are not only making nurses more
high-tech, but also opening up more
career paths for them and creating
specialisations in a profession.
The nurses get their visiting
schedules and patients’
addresses on their tablets
a day in advance, says
Charles Walsh, who, along
with Gareth Jones founded
this service in India with
the Burman family, the
promoters of the Dabur
group.
The Walsh-Gareth duo
co-founded Healthcare at
Home Ltd in UK in 1992. The Indian
company, which is unrelated to the
UK one, started operations in April
2013. The nurses also have access
to a patient’s health records, clinical
history, hospital discharge summary,
lab and imaging reports, along with
a detailed care plan that provides
information on the medicines and
equipments required during a home
visit. The tablets are also equipped
with GPS to help track the location of
the nurses.
India Needs Many
Hospital Management
Professionals by 2020:
IIHMR
B
y 2020, India will require lot many
hospital management professionals,
reveals a recent study by Institute of Health
Management Research (IIHMR).
“With the role of private hospitals
expected to go up, we see a huge demand for
healthcare managers. The private healthcare
industry is likely to grow seven-fold from the
present US$40 billion to US$280 billion in
2020. A big part of it would come from the
corporates,” said Biranchi N Jena, director,
IIHMR.
At present Telangana and Andhra Pradesh
seek a demand of around 2000 healthcare
professionals, but it would increase to 10,000
by 2020.
IIHMR has recently tied up with
Netherlands-based Maastricht University’s
Faculty of Health Management and Research
(FHML) to provide global exposure and quality
facilities to its students.
‘Figure-1’: Now in India
A
medical photo sharing application
‘Figure 1’ that enables healthcare
professionals upload images and scans
to aid diagnosis, is now available in
India. The app allows the doctors and
the students to connect, discuss and
share content related to the field of
medicine.
The app launched in 2013, is available
in 48 countries and the images are
viewed more than 1.5 million times a
day. It is the most popular app with the
healthcare professionals in the US and
the UK. ‘Figure 1’ hopes to gain traction
among India’s 2.3 million healthcare
professionals.
“Medicine is a visual field and there’s
so much to be learned from medical
images. ‘Figure 1’ is a privacy-conscious
way for Indian healthcare professionals
to view, share, and talk about a wide
variety of medical findings,” said Dr.
Joshua Landy, a Critical care medicine
specialist who developed the concept
while seeing patients in an Intensive
Care Unit (ICU) in Toronto, Canada.
The company has worked with the
Indian lawyers to ensure the platform
complies with the country’s privacy laws.
The app protects its subjects by autodetecting and blocking faces and also
gives users the option to blur parts of
a photo that might give away patient’s
identity.
The app can be downloaded from the
App Store and Google Play.
March / 2015
ehealth.eletsonline.com
59
Case Study
ASHA Soft - The Online Payment
and Monitoring System for ASHAs
S
Naveen Jain,
Mission Director,
National Health
Mission,
Rajasthan
ince the inception of National Rural Health
Mission (2005), Accredited Social Health
Activist (ASHA) component has played an
important and critical role in the implementation
of NRHM activities. The ASHA programme was
introduced as a key component of the community
process intervention and over the period of
eight years, this programme has emerged as the
largest community health worker programme
in the world and is considered of critical
importance in enabling people’s participation
in health. ASHA is a community, whose role is
to generate awareness on health issues and it
also acts as an interface between community
and health services. In Rajasthan, it is known
as ASHA Sahyogini, as it works jointly between
Department of Medical Health and Department
of Women and Child Development. ASHA is
selected by Gram Panchayats and works with
the help of Anganwadi Centres. Before it starts
functioning, it has to undergo intensive induction
training.
To reduce the Infant Mortality Rate (IMR) and
Maternal Mortality Ratio (MMR), to ensure better
health services and to prevent other diseases, at
present, approximately 47000 ASHA Sahyoginis
are functional in the state. ASHA Sahyoginis are
paid incentives against providing various health
services to pregnant mother and child and also
for providing health services to the community.
The roles and responsibilities of ASHA include
the functions of a healthcare facilitator, a service
provider and a health activist. It coordinates
as a bridge between health and WCD in
delivering key services and message for Child
and Maternal health. Besides, ASHA Sahyogini
also renders important services under National
Disease Control Programme (NCDC) such as
malaria, TB, leprosy, cataract and many more
health provisions.
ASHA are paid incentives against 26 types of
60
MArch / 2015
ehealth.eletsonline.com
activities and that also at different time
period and from various channels. These
complexities in their payment system cause
various problems for ASHA’s payments.
Because of not being paid on time, ASHA’s
were getting de-motivated to render proper
services to the community. Getting payment
for every activity on time is a challenge, which
has been acting as disincentive to them. To
ensure their timely and seamless online
payment, ASHA software popularly known
‘ASHA Soft’ has been conceptualised. It is a
unique initiative by the NHM, Rajasthan. The
software has been developed in a very short
time span because of the keen interest shown
by the authority to solve the major problem of
ASHA’s delayed and partial payment, which
was being faced at grass root level. ASHA Soft
is an online system which facilitates the user
to capture beneficiary wise details of services
given by ASHA to the community, online
payment of ASHA to their bank accounts and
generate various kinds of reports to monitor
the progress of the programme.
Objectives
To ensure their timely and seamless online
payment, ASHA Soft has been conceptualised
with objectives to monitor the performance
of each and every ASHA every month. To
identify the gap area and need assessment
Case Study
for rendering better services at community level.
Assessing the quality of services in remote and
vulnerable areas, it would be easier to assess the
service delivery of ASHA in remote areas and
marginalised community. Further, timely payment
of incentives to ASHAs will maintain their
motivation level. Methodology, the software has
been developed by NIC, Rajasthan state unit and
the NHM core group constituted for this purpose
under the directions of the Mission Director,
NHM, Rajasthan. Master data for each and every
ASHA was created constituting their personal
profile including their educational qualifications,
level of trainings, any other skills etc. All the
concerned functionaries have been oriented and
trained for their responsibilities. Directions and
circulars have been issued to states, districts,
blocks, PHC officials. A detailed manual has been
prepared and circulated to all data entry points
and various stake holders. Training for filling up
the claim form has been done in all the districts
up to PHC and ASHA level. For online payment,
Bank of Baroda has been selected, which provides
services without any additional charges.
ASHA Soft Analysis Report
From the analysis of first month’s payment
disbursement through ASHA Soft, various
patterns related to ASHA’s functioning have
emerged. The pattern of payment draws a
picture of ASHA programme all over the
state. For instance, it was found that in most
of the district in Rajasthan, the majority of
services rendered belong to monthly meeting
and routine activities of ASHAs followed by
maternal health, immunization services and
family planning services. There is a very
negligible proportion of National Health
Programmes such as TB, leprosy, cataract
and malaria (Fig 1).
Implementation Process
This online payment process has been
implemented all over the state from 26th
December 2014. The payment process includes
steps where ASHA would prepare their monthly
claim form (self appraisal forms). ANM will
verify their claim form (self appraisal forms).
Verification and entry of data would be done
by IA or Data entry operator or PHC or ASHA
Supervisor. ASHA wise data entry would be done
of self appraisal form and line listing. Sanction
of payment will be done by MOIC with assistance
of accountant or LHV and release of payment
through digital signature of the CM and HO by
the seventh of every month. The payment will
be transferred to ASHA’s bank account. ASHA
will receive SMS on their mobile regarding the
transfer of payment.
Figure 3 brings out a clear picture of the
ASHA’s functioning in the state. In terms of
rendering services under child health, there
is a clear correlation with the level of training
received under sixth and seventh module and
the amount of services provided.
Similarly, the analysis from the payments
of month January shows improvement over
the December report. The temporal analysis
of these two months shows the impact of
persuasion to all districts after December
performance. As evident from figure 4, the
level of best performing ASHAs have gone up
and there is a sign of healthy competition in
the competent ASHAs of all the districts.
Thus, the knowledge of the ASHAs on the
nature of activities and job responsibility
is the pre-requisite for effective service
delivery. Awareness among ASHs about
their responsibilities is the most crucial
factor, which has been now possible to link
with performance through ASHA Soft. It is
critical that through ASHA Soft Rajasthan is
going to witness a new dawn in the field of its
community health.
MArch / 2015
ehealth.eletsonline.com
61
Exclusive Interview
Health Information
Exchange is for 360 Degree
Patient Care
The health information exchange is a point that connects a healthcare
provider to all information needs with respect to its hospital and patient
records, says Dinesh Samudra, CEO, Palash Healthcare Systems
Please share with us the
latest product that you have
launched for the healthcare
sector?
We have launched an exclusive
service for the healthcare Industry. All
the healthcare institutions currently
maintain the patient records in
their own premises and there is one
information set which is present with
the patients. There is no centralised
location where all the information
is available for a better treatment
programme. So we have created a
portal where we have attempted to get
the healthcare providers, consultants
and patients together to interact
with each other and thus meet the
challenge of carrying and multiplying
the medical records. The Health
Information Exchange is a point that
connects a healthcare provider to all
information needs with respect to
its hospital and patient records. The
elimination of the need of a physical
health record of the patients for
the hospital and consulting doctors
empowers them to get access to
patients’ data anytime anywhere thus
ensuring that the hospital delivers a
24x7 services to its patients. A direct
advantage of this info being readily
available is improvement in speed of
delivery of care, quality and safety
becomes better and brings down the
cost for hospitals to keep themselves
connected to their patients roundthe-clock. The SWARM Health
Information Exchange has three
62
March / 2015
ehealth.eletsonline.com
16. The main impetus of technology
in the healthcare holds immense
promise and will gain more grounds
if the healthcare providers adopt and
implement healthcare information
management systems this will help
them streamline their process,
become quality oriented and will
be able track the flaws in the entire
system and take better care of the
patients by just one simple solution
that weaves hospital, consultants and
patients together.
components that are interconnected
Consulting Connect, Palash Practice
and Palash Fingertips. These will
operate
across
administration,
doctors and patients for simplification
of processes, effective compliance
and improved health outcomes.
What are your reflections on
the Union budget presented for
2015-16 for healthcare sector?
The budget clearly indicates that
the Government of India has a
focus on healthcare and education.
This government and the budget
clearly indicate their intention on
measures to improve the healthcare
infrastructure and delivery in India.
There have been some announcements
to increase the adoption of health
insurance and we hope that many
such measures will follow as we move
forward in the financial year 2015-
Please share with us your
projections of growth and
expansion for 2015-16
financial year?
Last year was a great year for us
and we booked orders worth US$
2 million and 150 percent growth in
profits, so we are looking at becoming
a US$ 100 million company in the
next five years. We are aggressively
working towards our global presence.
Currently we are in 16 countries with
focus on Middle East, Africa and
South East Asia markets. We have
also started our work operations
from London, UK recently and are
looking to foray and expand our
presence across European markets
from our London location. We already
have our presence in the US market
through one of our partners, and we
aim to expand our presence even
across pockets in the US and maybe
go independent in two year or so in
that market.
Company profile
Medicare Gas Pipeline Services
India is developing country and termed as a potential healthcare industry, Indian
healthcare has suddenly started gaining a momentum by experiencing a new wave
of opportunity, says Rajesh Mate, CEO, Medicare Gas Pipeline Services
Please comment on medical technology market
in India vis-a-vis the global market
Please comment on emerging trends and new
technologies.
India is developing country and termed as a potential
healthcare industry, Indian healthcare has suddenly
started gaining a momentum by experiencing a new
wave of opportunity. We now have capability of
offering world class facilities at lesser cost than
developed countries.
We have a sound infrastructural base that is well-equipped
with advanced technology machines and equipment. Build
over a large space, our infrastructural base is divided
into various sections to assure smooth production.
To enhance the production capacity without
compromising with the quality, we continually
upgrade the production machines.
We boast of an experienced team of
engineers, technicians, and other allied
workers that is well-versed with the
production. Their industrious efforts
lead to provide unbeatable products and
services thereby offering utmost level of
satisfaction to the clients. They always
keep themselves abreast with the everchanging market requirements to fulfill the
prevailing market needs.
Please tell us about your current
operations in India and your
expansion plans.
Medicare
Gas
Pipeline
Services
was established in the year 2007
as a designing, planning, supplying,
installation, manufacturing, exporting,
trading, commissioning unit and service
provider of central medical gas pipeline systems
along with basic supply systems, accessories, equipment,
nurse call systems, ICU and operation theatre products. We
have been successfully catering to hospital industries with
oxygen, nitrous oxide, medical / surgical air supply system
and vacuum system etc. Today, we are well-reckoned as
one of the prime service providers for medical gas pipeline
services in India. Currently we are engaged in big hospital
projects at Maharashtra, Gujarat and Rajasthan.
What are your views on the price sensitivity of
the Indian market, and how does your hospital
counter this problem?
Indian market is very price sensitive. Need to provide high
quality state-of-the-art MGPS facilities at affordable cost.
Providing tailored systems and services at very economical
rates is our first priority. Quality is the prime concern of the
organization that is maintained at every level of production.
As, we are a quality cautious company, we conduct
stringent quality tests starting from the procurement of
raw materials to the finished product. Furthermore, our
quality control unit keeps a strict vigil on the production
process to assure the development of flawless products.
What are your company’s offerings?
• Offering a comprehensive range of products and
services
• Backed by a qualified and experienced team
• Timely delivery of the products
• Products are manufactured in conformance with the
highest national / international standards
• Reasonable charges
Your major customers in 2014?
• SMBT Hospital, Nandi Hill, Ghoti Road, Nasik,
Maharashtra
• Medipulse Hospital, Jodhpur, Rajasthan
• MGM Hospital, Aurangabad, Maharashtra
• Patni Health Care, Thane, Mumbai, Maharashtra
• MIT Hospital, Aurangabad, Maharashtra
• LBS Hospital, Bhopal, Madhya Pradesh
• Vedant Hospital, Thane, Maharashtra
• KLS Hospital, Vile Parle, Mumbai, Maharashtra. March / 2015
ehealth.eletsonline.com
63
Product Launch
Laura M - Next
Generation
Urine
Analyser
T
ransasia Bio-Medicals Ltd. has launched Laura
M analyser - the next generation Urine Analyser
with high-throughput that is capable of measuring
all routine parameters in urine along with Microalbumin
and Creatinine. It is produced by ERBA Lachema, the
Czech Republic subsidiary of the ERBA –Transasia group.
Objective evaluation of the urine samples by Laura M
instrument helps to eliminate any subjective interpretation
and operator bias of the color reaction of the diagnostic
pads, contributing to accurate diagnosis.
Urine Analysis is recognised as an integral parameter
for diagnosis. With the advent of latest technology, urine
analysis is now done either through visual detection with
the help of urine strips or automation.
Urine chemistry strips are mainly used for routine
testing, treatment monitoring and preventive medicine.
There are different types of urine chemistry strips available
in the market, providing high diagnostic specificity and
sensitivity.
Majority of labs, hospitals are moving towards
automation in urine analysis to provide quality and costeffective results. Hence, automated analysers providing
objective evaluation of urine samples are gaining
momentum due to their ease of operation and faster
turnaround time. Objective evaluation by using a reader
helps to eliminate any subjective interpretation of the color
reaction and thereby contributes to accurate diagnosis.
The continuous loading analysers offer added advantages
64
March / 2015
ehealth.eletsonline.com
over strip readers such as higher memory, LIS, throughput,
QC, etc. On the other hand, sedimentation analysers are
proving to be more efficient to those laboratories where
the sample load is quite high.
Major features of Laura M include smooth workflow
management that provides continuous loading with very
high throughput of 600 tests per hour and results in 60
seconds. It also gives a provision for LIS interfacing. The
product has an efficient data management system with
internal memory capacity of 2000 measurements.
Laura M carries a large colour user friendly touch
screen, hygienic disposal of used strip by waste container,
an in-built thermal printer that flags all abnormal results.
It also has multiple sensors to detect strip at different
stages preventing any operator error. The Urine Analyser
has the flexibility to interchange between different metric
systems for units of measurement and set the critical
values, as per laboratory practices.
The strips are protected against the common
concentration of Ascorbic Acid (200-800mg/dL), ensuring
no interference with measurement of Glucose, Blood, or
Nitrates on the strip. DekPHAN Laura and MicroAlbuPHAN
Laura are routine 10 and 2 parameters specialised
Microalbumin and Creatinine test strips respectively. All
PHAN range of strips has a uniform incubation period of
60 seconds.
For more information visit:
www.transasia.co.in
Product Launch
Carestream Unveils its
Innovative Radiology
Solutions at IRIA 2015
E
nhanced product features
of four recently launched
systems
ensure
faster
diagnosis and treatment for patients,
improve efficiency for hospitals.
Carestream Health India that
develops new radiology products
and advanced IT systems for the
healthcare industry has unveiled
state-of-the-art radiology systems
and
solutions
at
radiology
conference, IRIA 2015 in Cochin.
It has launched four innovative
products and solutions - Carestream
Vita Flex CR System, DRX Revolution
System, DryView 6950 Laser Imager
and MPS.
Carestream Vita Flex CR is a
complete plug and play CR solution. It
delivers excellent image quality and
can be positioned virtually anywhere
in a healthcare facility. This new
flexible design enables it to operate
vertically as well as horizontally, so
it can process CR cassettes sitting on
the floor, or on tabletop or even from
the back of a van.
Second product, the DRX
Revolution is a digital X-ray machine
on the wheel. It provides wireless
access to high-quality images in as
less as five seconds. It features a
collapsible column that improves
visibility during movement and
positioning and provides the ability
to easily maneuver the system in
tight spaces.
The DryView 6950 is a high
quality, high productivity medical
printer designed to produce rapid
output of high-resolution images
for all imaging modalities including
mammography. In addition to CT,
MR, CR, DR and other modalities,
this new laser imager will also
support output of full-field digital
mammography (FFDM) and CR
mammography images. It can deliver
a maximum film density of 4.0, which
is preferred for mammography.
While MPS - managed print solutions
allows customers to focus on their
core business.
For more information visit:
www.carestream.in
March / 2015
ehealth.eletsonline.com
65
Product Showcase
Staying Fit or Staying Healthy
“Sound mind in a sound body” is a simple yet a powerful statement
that is packed with significant meaning.
T
he first step in staying fit is
to be staying healthy. Without
knowing the status of health
and working to staying fit could
become dangerous. Also, it is equally
dangerous to do those exercises that
could possibly harm your body based
on your disease conditions. To stay
healthy, one should ensure that their
body vitals are in desired range. If
not, immediately seek professional
advice.
Seek professional advice on your
fitness regime, as it is important to
know what works and what does
not. Also, for people with health
conditions, it is important to have
your fitness regime set based on your
health.
AMI B.O.L.T: Creating a new
vision in Indian Healthcare
Ecosystem
AMI B.O.L.T, a wireless healthmonitoring product of American
Megatrends, is one such solution
that can help individuals monitor and
record the key vitals parameters at
place, any time.
AMI B.O.L.T. is one of a kind
portable lifestyle health device that
seamlessly integrates with iOS,
Android and Windows phones to
measure and record vitals at the
comfort of your home. It is a portable
mobile device with dimensions
similar to smartphone and it does
not need AC outlet to operate.
The device can be carried
anywhere and is simple to use.
Everyone can use it and one can
easily measure vitals in the comfort
of their home. Also, clinicians and
paramedics can measure vitals in
rural areas without carrying heavy
medical equipments. Security forces
& soldiers working in remote areas
can measure vitals with ease.
AMI B.O.L.T is a cloud-enabled
solution. With AMI B.O.L.T your
health vitals can be stored in
your personal health cloud. Trend
monitoring and graphical reporting
is built on mobile and cloud platforms
to get a snapshot at any given point
in time.
Healthcare organisations like
Astermed City, Portea and several
others are using B.O.L.T to assist
their customers to manage and
maintain healthy life.
AMI B.O.L.T helps you to keep a
tab on your health. Life is precious
and we have one opportunity to live
it to the fullest. To make the best out
of this life, we need to stay healthy.
To know more about AMI B.O.L.T, please visit :
www.amibolt.com
66
March / 2015
ehealth.eletsonline.com
6th Annual
2015
eINDIA.eletsonline.com
11th
INDIA’S PREMIER ICT EVENT
High Efficiency
Leucocyte Reduction Filter
Protect patients from microaggregate and
leucocyte-related transfusion complications
with bedside high efficiency leucoreduction
filter sets.
www.haemonetics.com
Copyright ©2013 Haemonetics Corporation
COL-AD-000159-AP(AA)