FUTURE OF HEALTHCAREFUTURE OF HEALTHCARE

RMA CONFERENCERMA CONFERENCEMAHADMAHAD

88THTH JAN 2006JAN 2006

DR DEV TANEJADR DEV TANEJAMBBS , M.S.(GEN.SURGERY)MBBS , M.S.(GEN.SURGERY)

DIP. IN BUSINESS MANAGEMENTDIP. IN BUSINESS MANAGEMENT

TANEJA CLINICTANEJA CLINICUNION BLDG., KOTNAKAUNION BLDG., KOTNAKA

URAN. NAVI MUMBAIURAN. NAVI MUMBAI..drttanejahospital@yahoo.comdrttanejahospital@yahoo.com

FUTURE OF HEALTHCAREFUTURE OF HEALTHCARE

HOW YOU PRACTICE TODAY ?HOW YOU PRACTICE TODAY ?

HEALTHCARE DELIVERY SYSTEMHEALTHCARE DELIVERY SYSTEM

ADVANCES IN MEDICINEADVANCES IN MEDICINEADVANCES IN MEDICINEADVANCES IN MEDICINE

BUSINESS OPPURTUNITIES IN HEALTHCAREBUSINESS OPPURTUNITIES IN HEALTHCARE

ARE YOU AWARE ?ARE YOU AWARE ?

THINK OVERTHINK OVER

HOW YOU PRACTICE ?HOW YOU PRACTICE ?

BEFORE 1980 BEFORE 1980 -- Dr’s KNEW THE PATIENTSDr’s KNEW THE PATIENTS

19801980--2005 2005 -- NETWORK PRACTICENETWORK PRACTICE

FUTURE ?FUTURE ?

FUTURE OF PRACTICEFUTURE OF PRACTICE

DENSITY OF Dr’s INCREASINGDENSITY OF Dr’s INCREASING

PAYING CAPACITY IS INCREASINGPAYING CAPACITY IS INCREASING

Pt. WELL INFORMED / EDUCATED / HEALTH CONSCIOUSPt. WELL INFORMED / EDUCATED / HEALTH CONSCIOUS

Pt. WILL DEMAND QUALITY TIMEPt. WILL DEMAND QUALITY TIME

Pt. WILL NOT HESITATE TO USE CPAPt. WILL NOT HESITATE TO USE CPA

Pt. WILL NOT BE LOYALTO A DOCTOR / CHOOSYPt. WILL NOT BE LOYALTO A DOCTOR / CHOOSY

Pt. WILL BECOME MORE DEMANDINGPt. WILL BECOME MORE DEMANDING

PATIENTPATIENT

PATIENT PATIENT –– IN LATIN IT MEANSIN LATIN IT MEANS

“SUFFEROR” OR “PASSIVE VICTIM”“SUFFEROR” OR “PASSIVE VICTIM”

PATIENT DEFINATION OF DOCTORPATIENT DEFINATION OF DOCTOR

OLD DOCTOR GODOLD DOCTOR GOD

NEW DOCTOR PROFESSIONALNEW DOCTOR PROFESSIONALSERVICE PROVIDERSERVICE PROVIDER

PATIENT PATIENT CONSUMERCONSUMER

AWARENESS AWARENESS –– LIT. / T.V. / EDU. / INTERNETLIT. / T.V. / EDU. / INTERNET

AESTHETICS OF CLINICAESTHETICS OF CLINIC

BEHAVIOUR OF SUPPORT STAFFBEHAVIOUR OF SUPPORT STAFF

HEALTH INSURANCE COVERHEALTH INSURANCE COVER

WILL LIKE TO DISCUSS WILL LIKE TO DISCUSS -- THAN SIMPLY GET DIAGNOSEDTHAN SIMPLY GET DIAGNOSED

PATIENT EDUCATION WILL BECOME IMPORTANTPATIENT EDUCATION WILL BECOME IMPORTANT

DISEASE PATTERN DISEASE PATTERN -- FROM INFECTIOUS DIS. TO LIFE STYLEFROM INFECTIOUS DIS. TO LIFE STYLE

DELIVERY SYSTEMDELIVERY SYSTEM

ØØ GENERAL PRACTITIONERGENERAL PRACTITIONER

ØØ HOSPITAL PRACTICEHOSPITAL PRACTICE

HEALTHCARE DELIVERYHEALTHCARE DELIVERY

1) EMERGENCY CARE 1) EMERGENCY CARE –– ACCIDENT, HEART ATTACK ETC.ACCIDENT, HEART ATTACK ETC.

2) ROUTINE CARE 2) ROUTINE CARE -- URI, LOOSE MOTION, HT, DM ETC.URI, LOOSE MOTION, HT, DM ETC.

3) ELECTIVE TREATMENT 3) ELECTIVE TREATMENT

(A) LIFE STAGE (A) LIFE STAGE –– DELIVERY,CATARACT,DENTURESDELIVERY,CATARACT,DENTURESFAMILLY PLANNING OP. ETC.FAMILLY PLANNING OP. ETC.

(B) LIFE STYLE (B) LIFE STYLE -- COSMETIC SURGERY, COSMETIC SURGERY, LASER EYE SURGERYLASER EYE SURGERYTKR / THRTKR / THR

MAJOR IMPACT ON MAJOR IMPACT ON HOSPITAL PRACTICEHOSPITAL PRACTICE

vv MEDICAL INSURANCEMEDICAL INSURANCE

vv HOSPITAL ACCREDIATION HOSPITAL ACCREDIATION –– NABH , JCINABH , JCI

vv TELEMEDICINETELEMEDICINEvv TELEMEDICINETELEMEDICINE

vv HEALTH MANAGEMENT ORGANISATION (HMO)HEALTH MANAGEMENT ORGANISATION (HMO)

vv THIRD PARTY ADMINISTRATOR (TPA)THIRD PARTY ADMINISTRATOR (TPA)

vv CPA / REGULATORY CHANGESCPA / REGULATORY CHANGES

HOSPITAL PRACTICEHOSPITAL PRACTICE

PRESENT SCENARIOPRESENT SCENARIO

MOSTLY SMALL NURSING HOMES MOSTLY SMALL NURSING HOMES –– MOSTLY DOCTOR COUPLE MOSTLY DOCTOR COUPLE

THEY LACKTHEY LACK

1) QUALIFIED SUPPORT STAFF1) QUALIFIED SUPPORT STAFF1) QUALIFIED SUPPORT STAFF1) QUALIFIED SUPPORT STAFF

2) GOOD LIFE SUPPORT SYSTEMS2) GOOD LIFE SUPPORT SYSTEMS

3) ADVANCED INVESTIGATION FACILITY BACK UP3) ADVANCED INVESTIGATION FACILITY BACK UP

4) QUALITY FOR MEDICAL INSURANCE STANDARDS4) QUALITY FOR MEDICAL INSURANCE STANDARDS

5) POOR RECORD KEEPING5) POOR RECORD KEEPING

6) 6) POOR HYGIENEPOOR HYGIENE

FUTURE OF HOSPITAL PRACTICEFUTURE OF HOSPITAL PRACTICE

üü MOSTLY GROUP PRACTICEMOSTLY GROUP PRACTICE

üü PROFESSIONALLY MANAGEDPROFESSIONALLY MANAGED

üü MOSTLY TIED TO HMO / TPA / HOSPITAL CHAINSMOSTLY TIED TO HMO / TPA / HOSPITAL CHAINS

üü HUB & SPOKE MODELHUB & SPOKE MODEL-- CORPORATESCORPORATES

üü MARKETING OF SERVICESMARKETING OF SERVICES

üü NOT ONLY CURE BUT CARE ALSO NOT ONLY CURE BUT CARE ALSO –– HOSPIPOTELSHOSPIPOTELS

üü TELEMEDICINETELEMEDICINE CONNECTIVITYCONNECTIVITY

HOSPITAL PRACTICE HOSPITAL PRACTICE

IMPACT OF MEDICAL INSURANCEIMPACT OF MEDICAL INSURANCE

HAVE TO MAINTAIN MEDICAL RECORDSHAVE TO MAINTAIN MEDICAL RECORDS

PROPER BILLING SYSTEMSPROPER BILLING SYSTEMS

FOLLOW PROTOCOLS OF TREATMENT / MEDICINES FOLLOW PROTOCOLS OF TREATMENT / MEDICINES PRESCRIBEDPRESCRIBED

COMPUTERISATIONCOMPUTERISATION

HEALTH INFORMATION SYSTEMSHEALTH INFORMATION SYSTEMS

TPA TPA –– THIRD PARTY ADMINISTRATORTHIRD PARTY ADMINISTRATOR

HOSPITAL PRACTICEHOSPITAL PRACTICE

IMPACT OF HOSPITAL ACCREDIATIONIMPACT OF HOSPITAL ACCREDIATIONDIAGNOSTIC DIAGNOSTIC SERVICES SERVICES -- NABLNABL

INTENSIVE CARE FACILITIES / OPER. THEATRE STANDARDSINTENSIVE CARE FACILITIES / OPER. THEATRE STANDARDS

SPACE ALLOCATIONSPACE ALLOCATIONSPACE ALLOCATIONSPACE ALLOCATION

QUALIFIED MEDICOS / NURSING / PARA MED STAFFQUALIFIED MEDICOS / NURSING / PARA MED STAFF

MEDICAL RECORDS / BILLING SYSTEMMEDICAL RECORDS / BILLING SYSTEM

SUPPORT FACILITIES SUPPORT FACILITIES -- KITCHEN / HOUSE KEEPINGKITCHEN / HOUSE KEEPING

ADVANCES IN MEDICINEADVANCES IN MEDICINENANOTECHNOLOGYNANOTECHNOLOGY

STEM CELL THERAPYSTEM CELL THERAPY

GENETIC MAPPING / GENOMEGENETIC MAPPING / GENOME

ROBOTIC / VIRTUAL SURGERYROBOTIC / VIRTUAL SURGERY

BIOBIO--TECHNOLOGYTECHNOLOGY

NEWNEW--DRUGS / VACCINES / MACHINESDRUGS / VACCINES / MACHINES

TELEMEDICINETELEMEDICINE

APPLIANCES WORN BY PATIENTAPPLIANCES WORN BY PATIENT--REHABILATATION / MONITORING CHR. DIS.REHABILATATION / MONITORING CHR. DIS.

SURGERY SURGERY àààààààà INTERVENTIONAL MED INTERVENTIONAL MED àààààààà NONNON-- INTERVENTIONAL MEDINTERVENTIONAL MED

ALTERNATIVE THERAPIESALTERNATIVE THERAPIES

NANOTECHNOLOGYNANOTECHNOLOGY1 MICRON = 0.001mm 1 NANOMETER = 0.000001 mm ( 0.1 MICRON )1 MICRON = 0.001mm 1 NANOMETER = 0.000001 mm ( 0.1 MICRON )

NANOTECH IS DEVELOPMENT OF ENGG DEVICES SO SMALL THAT THEY ARE NANOTECH IS DEVELOPMENT OF ENGG DEVICES SO SMALL THAT THEY ARE MEASURED ON MOLECULAR SCALEMEASURED ON MOLECULAR SCALE

NANOTECH DEVICES 100NANOTECH DEVICES 100--1000 TIMES SMALLER THAN HUMAN CELLS1000 TIMES SMALLER THAN HUMAN CELLS

NANOSCALE DEVICES SMALLER THAN 50 NM CAN ENTER CELLSNANOSCALE DEVICES SMALLER THAN 50 NM CAN ENTER CELLS

NANOSCALE DEVICES MORE THAN 20 NM CAN MOVE OUT OF BLOOD VESSELNANOSCALE DEVICES MORE THAN 20 NM CAN MOVE OUT OF BLOOD VESSEL

NANOSCALE DEVICES CAN INTERACT WITH MOLECULES ON BOTH SURFACE NANOSCALE DEVICES CAN INTERACT WITH MOLECULES ON BOTH SURFACE & INSIDE THE CELL& INSIDE THE CELL

FIRST PREDICTED BY NOBEL LAURETE DR RICHARD FREYMEN IN 1959FIRST PREDICTED BY NOBEL LAURETE DR RICHARD FREYMEN IN 1959

NANOTECHNOLOGYNANOTECHNOLOGY

NANOSHELLS NANOSHELLS –– 2020 TIMES SMALLER THAN RBCTIMES SMALLER THAN RBC

NANOPROBES NANOPROBES –– ATTACHED TO ANTIBODIES. EMIT MAGNETIC ATTACHED TO ANTIBODIES. EMIT MAGNETIC FIELDFIELD

QUANTUM DOTS QUANTUM DOTS –– EMIT LIHGT OF DIFF. WAVELENGTH EMIT LIHGT OF DIFF. WAVELENGTH DEPENDING ON SIZE . SUPERIOR TO DYESDEPENDING ON SIZE . SUPERIOR TO DYES

NANO COMPLEX NANO COMPLEX –– HORMONE / PEPTIDES / LIPOSOMESHORMONE / PEPTIDES / LIPOSOMES

ORGANIC DENDRIMERSORGANIC DENDRIMERS

HOLLOW POLYMER CAPSULESHOLLOW POLYMER CAPSULES

USES OF NANOTECH’YUSES OF NANOTECH’Y

1) CANCER THERAPY 1) CANCER THERAPY -- NANO SHELL BOMBS / SMART BOMBSNANO SHELL BOMBS / SMART BOMBS–– INTERRUPT CELL DIVISION PROCESSINTERRUPT CELL DIVISION PROCESS-- CHEMO TH DRUG + CELL KILLING PEPTIDECHEMO TH DRUG + CELL KILLING PEPTIDE

2) PROVIDING OXYGEN 2) PROVIDING OXYGEN –– ARTIFICIAL RBC 0.1 MicronARTIFICIAL RBC 0.1 Micron

3) ARTIFICIAL MITOCHONDRIA 3) ARTIFICIAL MITOCHONDRIA –– FUNCTION FOR DAMAGED MITOCH. FUNCTION FOR DAMAGED MITOCH. EXCHANGE OF COMPLEX METABOLITESEXCHANGE OF COMPLEX METABOLITES

4) AUTONOMUS MOLECULAR MACHINES 4) AUTONOMUS MOLECULAR MACHINES –– MONITOR LEVEL OF DIFF. MONITOR LEVEL OF DIFF. COMPOUNDSCOMPOUNDS

5) BIOSENSORS 5) BIOSENSORS –– TAKING SNAPSHOT AT MOLECULAR LEVELTAKING SNAPSHOT AT MOLECULAR LEVEL

6) CONTRAST IMAGING 6) CONTRAST IMAGING –– NANO PARTICLESNANO PARTICLES

FIRST MOLECULAR PRODUCT FIRST MOLECULAR PRODUCT BY 2010BY 2010--20202020

STEM CELLSTEM CELL

PRIMAL UNDIFFRENCIATED CELLS PRIMAL UNDIFFRENCIATED CELLS

WHICH RETAIN THE ABILITY TO DIFFRENCIATE INTO OTHER CELL TYPESWHICH RETAIN THE ABILITY TO DIFFRENCIATE INTO OTHER CELL TYPES

THAT ALLOW THEIR USE IN REPAIR & REPLENISHMENTTHAT ALLOW THEIR USE IN REPAIR & REPLENISHMENT

SOURCESSOURCES

1) ADULT STEM CELLS 1) ADULT STEM CELLS -- BONE MARROWBONE MARROW

2) FOETUS STEM CELLS 2) FOETUS STEM CELLS -- (ABORTED)(ABORTED)

3) EMBYONIC STEM CELLS3) EMBYONIC STEM CELLS

4) UMBLICAL CORD BLOOD STEM CELLS ( UCSC )4) UMBLICAL CORD BLOOD STEM CELLS ( UCSC )

ADVANTAGES OFADVANTAGES OF

UMBILICAL CORD STEM CELLSUMBILICAL CORD STEM CELLSDERIVED FROM WHARTON’S JELLY DERIVED FROM WHARTON’S JELLY

NO ETHICAL ISSUENO ETHICAL ISSUE

UNDEVELOPED ABO & HLA ANTIGENS UNDEVELOPED ABO & HLA ANTIGENS -- LESS CHANCES OF LESS CHANCES OF HOST/GRAFT REACTIONHOST/GRAFT REACTION

BLOOD FROM UMB.VEIN BLOOD FROM UMB.VEIN -- STEM CELLS HARVESTED STEM CELLS HARVESTED -- STORED IN STORED IN CRYO VIALS AT MINUS 196 DEGREESCRYO VIALS AT MINUS 196 DEGREES

SC THERAPY SC THERAPY -- LEUKEMIA , STROKE , SPINAL CORD DAMAGE , LEUKEMIA , STROKE , SPINAL CORD DAMAGE ,

DAMAGED RETINA , DIABETES , CIRRHOSIS , DAMAGED RETINA , DIABETES , CIRRHOSIS ,

OSTEOPOROSIS , BERGER’S DIS .,HEART ATTACK OSTEOPOROSIS , BERGER’S DIS .,HEART ATTACK

..

UMBILCAL CORD STEM CELLSUMBILCAL CORD STEM CELLS

1980 1980 -- UMB. CORD BLOOD APPROVED FOR USE BY FDAUMB. CORD BLOOD APPROVED FOR USE BY FDA

1988 1988 -- FIRST UMB. CORD BLOOD TRANSFUSION FOR BLOOD CANCERFIRST UMB. CORD BLOOD TRANSFUSION FOR BLOOD CANCER

1998 1998 -- FIRST UCSC T/T BY DR E GLUCKMEN IN PARIS FOR FANCONI’S FIRST UCSC T/T BY DR E GLUCKMEN IN PARIS FOR FANCONI’S ANAEMIAANAEMIA

IN INDIA IN INDIA -- KOREAN COMPANY HISTOSTEMKOREAN COMPANY HISTOSTEM

TO SET UP BIGGEST UCSC BANK IN WORLDTO SET UP BIGGEST UCSC BANK IN WORLD

DAILY 72,000 BIRTHS IN INDIADAILY 72,000 BIRTHS IN INDIA

HISTOSTEM CELL THERAPY CENTRE WITH APOLLO HOSPITALHISTOSTEM CELL THERAPY CENTRE WITH APOLLO HOSPITAL

UCSC BANK UCSC BANK -- Rs 35,000/Rs 35,000/-- FOR 21 YRSFOR 21 YRS

MOST FAMOUS PT. MOST FAMOUS PT. -- MR AJIT JOGIMR AJIT JOGI

GENETIC MEDICINEGENETIC MEDICINEHUMAN GENOMEHUMAN GENOME PROJECTPROJECT --HUMAN GENETIC HUMAN GENETIC MAPPING COMPLETED TWO YEARS AGOMAPPING COMPLETED TWO YEARS AGO

HOW GENES ARE ARRANGED IN 23 PAIRSHOW GENES ARE ARRANGED IN 23 PAIRSOF CHROMOSOMESOF CHROMOSOMES

PROTEOMEPROTEOME --HOW VARIOUS PROTEINS / NUCLEIC HOW VARIOUS PROTEINS / NUCLEIC ACIDS ARRANGED ON GENES ACIDS ARRANGED ON GENES

HAPMAPHAPMAP –– ANALYTICAL TECHNIQUE CALLED ANALYTICAL TECHNIQUE CALLED PASSIEVLY PARALLEL DNA SEQUENCINGPASSIEVLY PARALLEL DNA SEQUENCING

GENE THERAPYGENE THERAPY

1)1) SCREENING OF GENETIC MARKERSSCREENING OF GENETIC MARKERS2)2) TO IDENTIFY GENES RESPONSIBLE FOR DISEASESTO IDENTIFY GENES RESPONSIBLE FOR DISEASES3)3) GENETIC VACCINES GENETIC VACCINES ––SPECIFIC ANTIGENS THAT WILL SPECIFIC ANTIGENS THAT WILL

CAUSE IMMUNE RESPONSECAUSE IMMUNE RESPONSE4)4) CANCER VACCINESCANCER VACCINES4)4) CANCER VACCINESCANCER VACCINES5)5) GENETIC ENGINEERED CYTOKINESGENETIC ENGINEERED CYTOKINES--IMMUNO IMMUNO

SUPPRESANTSSUPPRESANTS6)6) GENE TRANSFER THERAPYGENE TRANSFER THERAPY7)7) REPAIR OF MUTATED GENESREPAIR OF MUTATED GENES8)8) PREVENTIVE MED PREVENTIVE MED -- PREDICT DIS.PREDICT DIS. BY G MAP’GBY G MAP’G9)9) CUSTOMOSED MEDICINES CUSTOMOSED MEDICINES -- BY GENETIC MAPPINGBY GENETIC MAPPING

GENETIC MAPGENETIC MAP--22

BIOTECHTEHNOLOGYBIOTECHTEHNOLOGYUSE OF BIOLOGY , TECHNOLOGY , COMPUTERS & OTHER USE OF BIOLOGY , TECHNOLOGY , COMPUTERS & OTHER SCIENCESSCIENCES

USES USES –– HUMAN , PLANT , INDUSTRYHUMAN , PLANT , INDUSTRY

““50 % OF ALL MEDICINES IN FUTURE50 % OF ALL MEDICINES IN FUTURE””““50 % OF ALL MEDICINES IN FUTURE50 % OF ALL MEDICINES IN FUTURE””

WORKS ON WORKS ON –– IMMUNE RESPONSEIMMUNE RESPONSE-- METABOLIC PATHWAYSMETABOLIC PATHWAYS-- NEW DRUG DELIVERY SYSTEMSNEW DRUG DELIVERY SYSTEMS-- PRODUCES PROTEINS & PEPTIDES FOR HUMAN TH.PRODUCES PROTEINS & PEPTIDES FOR HUMAN TH.

EXAMPLES EXAMPLES -- HEP B VACCINE , AIDS VACCINE , MALARIA VAC.HEP B VACCINE , AIDS VACCINE , MALARIA VAC.-- INSULIN SPRAY FOR INHALATION INSULIN SPRAY FOR INHALATION -- MEDICINES IN FRUITS / POTATOMEDICINES IN FRUITS / POTATO

2121stst CENTURY CENTURY GOLDEN AGE OF BIOLOGICAL GOLDEN AGE OF BIOLOGICAL

SCIENCESCIENCE

BEFORE 17BEFORE 17thth CENTURY CENTURY

MOSTLY EMPIRICALMOSTLY EMPIRICAL

1818--2020tHtH CENTURY CENTURY

MOSTLY SCIENTIFICMOSTLY SCIENTIFIC

ADVANTAGES OFADVANTAGES OFROBOTIC SURGERYROBOTIC SURGERY

ELIMINATES ELIMINATES

1) HUMAN ERRORS1) HUMAN ERRORS2) HAND TRMORS2) HAND TRMORS2) HAND TRMORS2) HAND TRMORS3) KEY HOLE SURGERY3) KEY HOLE SURGERY4) AVOID HEART LUNG MACHINES4) AVOID HEART LUNG MACHINES5) PRECISION / ACCURACY5) PRECISION / ACCURACY6)CAN MOVE IN EIGHT DIRECTIONS 6)CAN MOVE IN EIGHT DIRECTIONS AGAINST SIX OF HUMANAGAINST SIX OF HUMAN

ROBOTIC / VIRTUAL SURGERYROBOTIC / VIRTUAL SURGERY

(A) (A) DaVINCI ROBOTDaVINCI ROBOT -- FOR PROSTRATE SURGERYFOR PROSTRATE SURGERY(B) (B) AESOP ROBOTAESOP ROBOT -- FOR CARDIAC SURGERYFOR CARDIAC SURGERY(C) HUMANOID ROBOTS(C) HUMANOID ROBOTS

LINDBERG OPERATIONLINDBERG OPERATIONFIRST TRANSATLANTIC SURGERY FROM NEW FIRST TRANSATLANTIC SURGERY FROM NEW FIRST TRANSATLANTIC SURGERY FROM NEW FIRST TRANSATLANTIC SURGERY FROM NEW YORK, USA TO STRASBOROUGH IN FRANCEYORK, USA TO STRASBOROUGH IN FRANCE

APPLICATIONSAPPLICATIONS

1)1) ANY PART OF WORLD CONNECTED BY INTERNETANY PART OF WORLD CONNECTED BY INTERNET2)2) WAR / DISASTERS WAR / DISASTERS –– TELEMENTORING HELMETSTELEMENTORING HELMETS3)3) IN SPACE MEDICINEIN SPACE MEDICINE

ROBOTIC SURGERY ROBOTIC SURGERY INSTRUMENTSINSTRUMENTS

The surgical robot has 2The surgical robot has 2--3 working arms and a single arm 3 working arms and a single arm

for assembly to the laparoscope (telescopic lens)for assembly to the laparoscope (telescopic lens)

The surgeon is seated at a remote console, where he has The surgeon is seated at a remote console, where he has complete control over camera and robotic instrument complete control over camera and robotic instrument

movement using hand manipulators and foot pedal controlsmovement using hand manipulators and foot pedal controls

Tiny robotic instruments are inserted through keyTiny robotic instruments are inserted through key--hole (0.5hole (0.5--1 cm) 1 cm) incisions made in the abdomen. The magnified threeincisions made in the abdomen. The magnified three--dimensional view dimensional view offered by this robotic system allows the surgeon to appreciate the offered by this robotic system allows the surgeon to appreciate the

anatomic structures and organs being dissected with greater detailanatomic structures and organs being dissected with greater detail

By manipulating master controls using the surgeons’ thumb and index By manipulating master controls using the surgeons’ thumb and index finger, the surgeon is able to control tiny wristed instrumentation with great finger, the surgeon is able to control tiny wristed instrumentation with great precision and accomplish complex surgical tasks such as suturing and precision and accomplish complex surgical tasks such as suturing and

dissection all with the facility of a human wristdissection all with the facility of a human wrist

TELEMEDICINETELEMEDICINE

NASANASA -- REMOTE ACT OF MEDICINE REMOTE ACT OF MEDICINE USING INFORMATION & COMMUNICATION MEANSUSING INFORMATION & COMMUNICATION MEANS

(A) (A) PATIENT CAREPATIENT CARE

1) CONSULTATION1) CONSULTATION2) TRANSMISSION OF PATIENT DATA2) TRANSMISSION OF PATIENT DATA3) VIRTUAL / ROBOTIC SURGERY3) VIRTUAL / ROBOTIC SURGERY4) HEALTHCARD / CHIP4) HEALTHCARD / CHIP

(B) (B) PATIENT EDUCATIONPATIENT EDUCATION

1) MED EDU. LEAFLETS / REFRENCES1) MED EDU. LEAFLETS / REFRENCES2) ONLINE SECOND OPINION2) ONLINE SECOND OPINION

TELEMEDICINETELEMEDICINEFOR DOCTORSFOR DOCTORS

1) CME1) CME

2) SECOND OPINION2) SECOND OPINION

3) ONLINE CONSULTATION / WEBSITE3) ONLINE CONSULTATION / WEBSITE3) ONLINE CONSULTATION / WEBSITE3) ONLINE CONSULTATION / WEBSITE

4) ONLINE OPINION 4) ONLINE OPINION -- RADIOLOGY / LABRADIOLOGY / LAB

5) VIRTUAL / ROBOTIC SURGERY5) VIRTUAL / ROBOTIC SURGERY

6) WEB CONFERENCES6) WEB CONFERENCES

7) MEDICAL REFRENCES7) MEDICAL REFRENCES

APPLIANCES WORN BY PATIENT APPLIANCES WORN BY PATIENT FOR REHABILITATIONFOR REHABILITATION

CYBERHANDCYBERHAND

ALTERNATIVE THERAPYALTERNATIVE THERAPYDEFINITION :DEFINITION :

COMPLIMENTARY & ALTERNATIVE MEDICINE IS COMPLIMENTARY & ALTERNATIVE MEDICINE IS ““A GROUP OF DIVERSE MEDICAL & HEALTHCARE A GROUP OF DIVERSE MEDICAL & HEALTHCARE SYSTEMS”.SYSTEMS”.

COMPLEMENTARY COMPLEMENTARY -- WITH CONVENTIONAL MEDICINEWITH CONVENTIONAL MEDICINECOMPLEMENTARY COMPLEMENTARY -- WITH CONVENTIONAL MEDICINEWITH CONVENTIONAL MEDICINE

ALTERNATIVE ALTERNATIVE -- IN PLACE OF CONVEN. MEDICINEIN PLACE OF CONVEN. MEDICINE

36% OF AMERICAN USED ALT. TH. IN LAST 12 MTHS.36% OF AMERICAN USED ALT. TH. IN LAST 12 MTHS.

20% OF BRITONS USED ALT. TH. IN LAST 12 MTHS20% OF BRITONS USED ALT. TH. IN LAST 12 MTHS

BUSINESS OPPURTUNITIES IN BUSINESS OPPURTUNITIES IN HEALTHCARE HEALTHCARE

CIICII--McKINSEY REPORTMcKINSEY REPORT

1) MEDICAL TOURISM 1) MEDICAL TOURISM -- TIE UPS WITH HOSPITALSTIE UPS WITH HOSPITALS

HOTELS / AIRLINES / NHSHOTELS / AIRLINES / NHS

2 ) HEALTH SPA RESORT 2 ) HEALTH SPA RESORT -- ANANDA / NUSI ANANDA / NUSI

3) HOME FOR AGED3) HOME FOR AGED

4) MEDICAL TRANSCRIPTION / BILLING4) MEDICAL TRANSCRIPTION / BILLING

5) MED PROCESS OUTSOURCING 5) MED PROCESS OUTSOURCING

RADIOLOGY RADIOLOGY -- WIPRO GE WIPRO GE

LABORATORY LABORATORY -- RANBAXY SPECIALITY LABRANBAXY SPECIALITY LAB

BUSINESS OPPURTUNITIES IN BUSINESS OPPURTUNITIES IN HEALTHCAREHEALTHCARE

6) TRAINING 6) TRAINING -- DOCTORS / NURSES / PARA MEDICAL STAFFDOCTORS / NURSES / PARA MEDICAL STAFF

7) LIFESTYLE CLINICS 7) LIFESTYLE CLINICS -- OBESITY OBESITY

-- WELLNESS / ANTI AGEING / CHRONIC DIS.WELLNESS / ANTI AGEING / CHRONIC DIS.-- WELLNESS / ANTI AGEING / CHRONIC DIS.WELLNESS / ANTI AGEING / CHRONIC DIS.

8) REHABILATATION CENTRES8) REHABILATATION CENTRES

9) ALTERNATIVE THERAPY CLINICS9) ALTERNATIVE THERAPY CLINICS

10) DRUG CLINICAL TRIALS10) DRUG CLINICAL TRIALS

11) MEDICINAL PLANTS CULTIVATION11) MEDICINAL PLANTS CULTIVATION

ARE YOU AWARE ?ARE YOU AWARE ?

25% DRUGS SOLD ARE SPURIOUS25% DRUGS SOLD ARE SPURIOUS

ABOUT BANNED DRUGSABOUT BANNED DRUGS

UNETHICAL DRUG COMBINATIONSUNETHICAL DRUG COMBINATIONSUNETHICAL DRUG COMBINATIONSUNETHICAL DRUG COMBINATIONS

PHYTOSANITARY STANDARDSPHYTOSANITARY STANDARDS

WE MOSTLY BLINDLY FOLLOW MEDICAL WE MOSTLY BLINDLY FOLLOW MEDICAL REPRESENTATIVESREPRESENTATIVES

THINK OVERTHINK OVER

PLAN GRACEFUL RETIREMENT FROM PRACTICEPLAN GRACEFUL RETIREMENT FROM PRACTICE

NON MEDICAL CAREERS FOR YOUR CHILDRENNON MEDICAL CAREERS FOR YOUR CHILDREN

DO YOU HAVE DO YOU HAVE –– LIFE / MEDICAL / INDEMNITY INSURANCE COVERLIFE / MEDICAL / INDEMNITY INSURANCE COVER

ARE YOU WORKING ON SELF DEVELOPMENTARE YOU WORKING ON SELF DEVELOPMENTARE YOU WORKING ON SELF DEVELOPMENTARE YOU WORKING ON SELF DEVELOPMENT

DO YOU FOLLOW A HEALTHY LIFESTYLE ?DO YOU FOLLOW A HEALTHY LIFESTYLE ?

ARE YOU UPGRADING ARE YOU UPGRADING ––MEDICAL / NON MEDMEDICAL / NON MED

ARE YOU A BETTER HUMAN BEINGARE YOU A BETTER HUMAN BEING

YOU ARE STILL YOUNGYOU ARE STILL YOUNG TO LEARN COMPUTERSTO LEARN COMPUTERS

GOD BLESS YOUGOD BLESS YOU

THANK YOUTHANK YOU