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Volume III || Issue IV || Nov - Dec 2012

News Update | Expert Views | Dental Hygiene | Health & Fitness | Product Line

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HEALTHCARE Architecture

WORLDDIABETES

DAY

2 Nov – Dec 2012

July–Aug 2012 3

4 July–Aug 2012

EditorDr. m.A. KAmAlChief Editorial AdviserDr. Pradeep Bhardwaj

National HeadAfzal Kamal

Sr. ManagerI.A Khurshid

Cheif CorrespondentSA Rizvi l Dr HN Sharma

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Subscribtion & CirrculationPallavi GuptaAll right Reserved by all everts are made to

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rect, Medgate today holds no responsibility

any unlikely errors that might occur.

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Volume-III Issue-III Nov-Dec 2012

Editor speak

Have an insightful reading.Your suggestions are most welcome!E-mail: editor@medgatetoday.com

WORLD DIABETES DAY

World Diabetes Day raises global awareness of diabetes-its escalating rates around the world and how to prevent the illness in most cases. Started by the International

Diabetes Federation (IDF) and WHO, the Day is celebrated on 14 November to mark the birthday of Frederick Banting who, along with Charles Best, was instrumental in the discovery of insulin in 1922, a life-saving treatment for diabetes patients.

WHO estimates that more than 346 million people world-wide have diabetes. This number is likely to more than double by 2030 without intervention. Almost 80% of diabetes deaths occur in low- and middle-income countries.

IT Solutions & Consulting

Healthcare extends beyond one person, in one department, in one building. It is an active process that requires communication, collaboration, and decision-making-across care providers and care settings. Siemens solutions help you eliminate silos, so patient information flows to the authorized care team-enabling better collaboration, and more informed and efficient decision-making. We offer solutions that break down barriers to help you solve business problems, improve patient safety, strengthen the revenue cycle, and enable technology to improve patient care. Learn how Siemens helps you achieve better patient outcomes with innovative information technology (IT) solutions today.

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Volume-III Issue-IV Nov-Dec 2012

DENGUE FEVER.................... 6

MEDTRONIC RESOLUTE INTEGRITY........ 8

INDIa HEaLTHCaRE INDUSTRY 1H12....... 10

DR. REDDY’S aNNOUNCES........ 12

GE HEaLTHCaRE IT SHOwCaSES ...... 14

MUSkOTIa RETREaT NaINITaL.......... 32

HEaLTHCaRE CONSULTaNCY........ 34

NaBHaCCREDITaTION aN............. 38

M-HEaLTH THE ROaD aHEaD...... 40

SCIENTECH 14B, MULTI-PaRa......... 44

EXCLUSIVE INTERVIEw wITH........ 46

HOSPITaL FURNITURE TENDERS....... 48

THE 3RD INTERNaTIONaL........ 52

Ms. Ameera ShahChanging trends in Diagnostics Industry

16 Expert Views

Dr. M. WaliARCHITECTURAL Challengesfor DESIGNING HOSPITALSOF TOMORROW

24 Cover Story

Dr. M. WaliDIABETES A SILENT KILLER

22 Doctor Speak

Dr. Rajiva KumarDiabetes Toddlers in INFaNTS & PRESCHOOLERS

18 Doctor Speak

CONTENT

[Delivered]

COVIDIEN, COVIDIEN with logo and covidien logo are U.S. and/or internationally registertrademarks of Covidien AG. All other brands are trademarks of a Covidien company

© 2009 Covidien. All rights reserved.

Dengue fever , also known as breakbone fever, is an infectious tropical dis-

ease caused by the dengue virus. Symptoms include fever, headache, muscle and joint pains, and a char-acteristic skin rash that is similar to measles. In a small proportion of cases the disease develops into the life-threatening dengue hem-orrhagic fever, resulting in bleed-ing, low levels of blood platelets and blood plasma leakage, or into dengue shock syndrome, where dangerously low blood pressure occurs.

Signs and symptoms

Dengue is transmitted by sev-eral species of mosquito within the genus Aedes, principally A. aegypti. The virus has four differ-ent types; infection with one type usually gives lifelong immunity to that type, but only short-term

immunity to the others. Subse-quent infection with a different type increases the risk of severe complications.

As there is no vaccine, pre-vention is sought by reducing the habitat and the number of mos-quitoes and limiting exposure to bites. Platelets in blood will be less than 1,00000

Mode of Transmission

Dengue viruses are transmitted to humans through the bites of infective female Aedes mosqui-toes. The disease is not directly transmitted from person to person.

Prevention and Control

l Vector control is implemented using environmental management and chemical methods. Proper solid waste disposal, elimination

of stagnant water in domestic en-vironment and improved water storage practices.

l Aerosol and liquid spray has to be applied directly to the adult mosquito for effective killing, e.g. household pesticides.

l Mosquito coil and electric mos-quito mat/ liquid has to be placed near possible entrance, such as window, for mosquito.

l Wear long-sleeved clothes and long trousers when going outdoors. Bodies could be protected from mosquito bite by applying insect repellent (containing DEET) on the clothes and exposed part of the body especially when you travel to Dengue Fever endemic areas.

l Mosquito bednet could be used when the room is not air-condi-tioned.

DengueFever

8 nov – Dec 2012

UPDATENEWS

Speaking to the Media, India Medtronic’s Managing Direc-tor & Vice President-South

Asia - Milind Shah said “The de-vice combines deliverability, ef-ficacy and safety, not to mention that it is the first DES approved for patients with diabetes. With India having the second highest Diabetic population in the world, the Resolute Integrity coronary stent is set to gain wide acceptance in the country. Medtronic looks forward to providing the benefits to the patients here.”

Its approval by the FDA is based on the impressive performance of the Resolute DES in a wide variety of patients. The global RESOLUTE clinical program consisted of a large randomized controlled trial and a series of confirmatory sin-gle-arm studies involving nearly 250 sites in 32 countries.

In total, the program enrolled more than 5,100 patients who

received a Resolute DES; about a third (1,535) of these patients had diabetes. With the device’s compelling combination of de-liverability, efficacy and safety, not to mention that it is the first DES approved for patients with diabetes, the Resolute Integrity DES promises to gain rapid ac-ceptance nationwide.

The Resolute Integrity DES builds on the success of the mar-ket-leading Integrity bare metal stent. The Integrity platform’s rapid adoption is the result of a proprietary engineering advance called continuous sinusoid tech-nology (CST).CST encompasses one continuous, single strand of wire that is molded into a sinu-soidal wave and then wrapped in a helical pattern and laser-fused at certain points, making each stent comparable to a flexible spring.

With the Resolute Integrity DES, patients with both CAD and

diabetes now have access in India for the first time to a medical de-vice that has been approved by the FDA as a treatment option specifi-cally studied and clinically validat-ed for their particularly complex and potentially life-threatening health conditions. Historically pa-tients with diabetes who undergo PCI have been a difficult-to-treat patient population. They tend to have smaller and often tortuous arteries, longer lesions, diffuse dis-ease and a higher rate of treatment failures including relatively high rates of repeat procedures and stent thrombosis.

Medtronic offers a broad range of innovative medical technology for the interventional and surgi-cal treatment of cardiovascular disease and cardiac arrhythmias. The company strives to offer prod-ucts and services that deliver clinical and economic value to healthcare consumers and pro-viders worldwide.

meDtronic resolute integrity™ Drug-Eluting Stent now available in India

10 nov – Dec 2012

UPDATENEWS

Healthcare covers the sec-tor overview, sector size, competitive landscape

and enviromental scanning for India. It also covers the market trends and outlook, health status indicators, infrastructure, human resources, medical equipments, medical tourism & health insur-ance, foreign investments and in-dustry forecast, plus the profile, comparative matrix and SWOT analysis of the industry leading players:

l Apollo Hospitals Enterprise Limited

l Fortis Healthcare Limited

l Opto Circuits India Limited

l Executive Summary

Indian economy saw a period of slowdown in fiscal year 2012. The country recorded a GDP growth of 5.3% in the fourth quarter which was its worst performance in last nine years.

However, Indian healthcare industry continued to show re-silience in the face of slowdown with leading healthcare players recording a double digit growth, both in revenues and net profits. The industry is growing at a CAGR

of 15% and is expected to cross USD 75 bn by the end of calendar year 2012.

The country was ranked amongst the lowest in terms of government spend on infrastruc-

ture which was around 1.2% of GDP in 2010. Fiscal year 2012 saw a 13% increase in government budget allocation to the flagship programme named National Rural Health Mission (NRHM). The pro-gramme has been quite successful in raising the standards of people’s health, healthcare infrastructure and healthcare delivery across the country within a short span of seven years. However, the country is likely to miss the healthcare targets for 2015 under Millennium Development Goals.

Huge demand supply gap exists in the healthcare sector of India. The country was lagging behind

in terms of average number of hospitals, hospital beds, doctors, nurses and other paramedical staff. The huge population accompanied with large prevalence of commu-nicable and non-communicable diseases demands large scale

development and growth in this sector. Private sector is playing a big role in this regard accounting for more than 70% of country’s health expenditure.

The outlook for Indian health-care is positive owing to double digit growth rate in almost all of its segments, whether its primary healthcare, secondary and tertiary healthcare, medical equipments, disgonotics, health insurance or medical tourism. The ever growing population, increasing govern-ment expenditure on health and growing per capita income will increase the size of this industry in the years to come.

India Healthcare Industry 1H12

12 nov – Dec 2012

UPDATENEWS

The Indian probiotic industry is develop-ing at a steady rate with the environment

set for huge growth in near future. Although the market in India is still in a comparatively nascent stage, it is expected that it will grow at a CAGR of 11 per cent by 2016. The key driver will be the awareness campaigns endorsing its benefits. In a country like India, it is of paramount importance that the advantages of consuming probiotic-fortified foods are explicitly communicated to consumers.

India at present accounts for little more than 1 per cent of the total global market revenue in the probiotic sector and it is an enormous shortfall taking into consideration the fact that India has the maximum cattle population and is the world’s largest milk producer.

Dr. Reddy’s Laboratories (NYSE: RDY) announced today that it has launched

Montelukast Sodium Oral Granules, a bioequiv-alent generic version of Singulair® (montelukast sodium) oral granules in the US market on September, 26, 2012, following the approval by the United States Food & Drug Admin-istration (USFDA) of Dr.Reddy’s ANDA for Montelukast Sodium Oral Granules.

The Singulair® Oral Granules brand had U.S. sales of approximately $61 million for the most recent twelve months ending July 2012 according to IMS Health*.

Dr. Reddy’s Montelukast Sodium Oral Granules in 4 mg are available in unit dosage package of 30.

Dr. Reddy’s Announces the Launch of Montelukast Sodium Oral Granules

Assessment of the Indian Probiotics Market

A prototype has already been built at the Univer-sity Medical Center Utrecht in the Netherlands

that combines a 1.5-Tesla MRI scanner with a linear accelerator.

Now that the prototype has been developed, the two companies will create a limited number of pilot systems that can be used by a consortium of radiation oncologists and doctors that will help develop the technology. The consortium so far includes University Medical Center Utrecht, Philips said.

Elekta, best known for its Gamma Knife radiosurgery equipment, and the Dutch conglomerate recently signed a multi-year joint development agreement, a spokesman for Philips said in an e-mail.

Elekta president and CEO Tomas Puusepp said the technology has the potential to “revolutionize cancer care” by using MRI’s soft-tissue imaging to make treat-ments more precise.

“The need to maximize therapeutic radiation on the target, while minimizing the exposure of healthy tissue is entirely driven by the best interests of the patient — they deserve the best chance for a cure and an improved quality of life,” he said in a statement.

However, when this system comes to market, it won’t be the first MRI-guided radiation therapy unit to be released. In May, Cleveland-based View Ray Inc. re-ceived Food and Drug Administration clearance for its MRI-guided Cobalt system.

Also, this isn’t Philips’ only MRI-guided cancer treat-ment endeavor. The company is also working on the MR-guided High Intensity Focused Ultrasound system, which uses MRI to guide focused blasts of ultrasound to heat up and destroy tumors.

Philips and Elekta announced that they were working on an MRI-guided radiation therapy unit they say could help make can-

cer treatments more accurate.

14 nov – Dec 2012

UPDATENEWS

Introducing the Covidien EEA™ Hemorrhoid and ProlapseStapler Set with DST Series™ Technology

THE NEXT GENERATION OF HEMORRHOIDOPEXY

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• Anoscope design enhances pursestring ease, consistency, and placement

• Instrument innovations create new levels of tissue access and visibility

• DST Series™ Technology provides optimal staple formation and consistency

Access. Visibility. Consistency. Delivered.

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GE Healthcare IT, a division of General Electric Com-

pany, will be exhibiting regional firsts among its latest range of IT solutions at this year’s HIMSS AsiaPac12 Conference and Ex-hibition, from 17-19 September at the Marina Bay Sands, Singapore, on stand #527. Additionally, a full slate of Company experts will be featured as part of the AsiaPac12 conference speaker series.

At the expo, GE Healthcare IT will demonstrate how its broad portfolio is helping to fulfill the needs of its customers, in particu-lar supporting the aim of providing patients with access to high quality healthcare in a cost effective and efficient way.

“The face of healthcare is changing and we are entering a time of ‘collaborative care’ which is a patient-driven, outcomes-driven method of delivering healthcare,” said Mitchell Silong, General Man-ager, GE Healthcare IT, Asia Pa-cific. “IT helps make this possible by linking together information from across the healthcare delivery system (inpatient, ambulatory, and home-based) to generate new in-sights that contribute to improved patient outcomes.”

A key theme running through GE Healthcare IT’s latest innova-tions is accessibility. Clinicians want to access all types of patient data at the touch of a button from anywhere at any time. In particu-

lar, they want to improve work flow and be able to share information and collaborate with other spe-cialists to make clinical decisions more quickly.

“Our IT solutions connect data from across departments, the hospital enterprise and the region to provide a comprehen-sive view of the patient, and have been developed to give clinicians access to the right, quality infor-mation precisely when they need it,” continued Mr. Silong.

“This is particularly significant in ASEAN where we are address-ing the need for care in remote areas through teleradiology. We believe moving data, rather than moving the patent is the most ef-ficient way to allow access to the best care available, specifically for rural areas.”

Highlights of the company’s broad portfolio of technologies on display on the GE Healthcare IT stand include:

Radiology

l The GE Centricity* Radiology Information System (RIS), offer-ing the latest generation of com-munity-wide radiology workflow sharing capabilities

l A Web based PACS viewer for global reading across enterprises which is deeply integrated with RIS through a single user interface

l A four-level Vendor Neutral Ar-chive which allows patient records from across different hospitals, to be consolidated and stored using industry standards2

l A Clinical Patient Information Viewer which provides access and viewing of patient histo-ries to multi-disciplinary teams throughout the patient’s health community

l Centricity Radiology Mobile Access (CRMA) allows clinicians and radiologists to quickly find images and reports through the AccessNow app, on their mobile device - iPhone, iPod,Touch, an-droid Touch.

High Acuity Care

l The Centricity Perioperative software is highly adaptable man-agement software to streamline workflow and help enhance pa-tient care before, during and after surgery

Cardiology

l Launching for the first time in Asia, Centricity Cardiology En-terprise is a tightly interfaced-cardiovascular IT solution that includes both CVIS (Cardiovas-cular Information System) and-CVPACS (Cardiovascular Picture Archiving and Communications System) functionality,providing clinicians full access to a single comprehensive, web-based patient record.

GE Healthcare IT Showcases its Latest Innovations at HIMSS, Singapore

16 nov – Dec 2012

UPDATENEWS

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Healthcare is one of the key parameters in which a country’s development

and key stature is measured. Being one of the largest sectors in terms of revenue & employment gener-ation, the healthcare industry is growing rapidly with expectations to become a US$280 billion indus-try by 2020. Healthcare industry comprises of pharmaceuticals, hospitals & diagnostics. How-ever, diagnostics in India forms an integral part of the healthcare industry which comprises of hos-pitals and allied sectors such as; pathology, medical equipments & supplies, medical tourism and private medical insurance.

The industry is comprised of more than 100,000 labs across the country and only 10% of the

market is consolidated by few major players. The current mar-ket exhibits strong demand and huge investments and therefore the organized sector is expected to command close to 50 % market share by end of this decade.

Key dimensions that shape the market growth are –

l Resource information available to the patients

l Compliance programmes / rewards

l Clinical diagnosis & Direct Drug marketing

l Disease management pro-gramme

l Wellness Movement

l Competitive environment by the healthcare providers

Major segments which need services of diagnostic players are Doctors who prescribe tests to patients, corporate clients for wellness programmes and clinical trial lab support as well as rou-tine laboratories and hospitals who need a referral center for specialized tests. With the rising awareness for healthcare, demand for good quality diagnostics has grown as well, and customers prefer to partner with laborato-ries demonstrating high levels of accuracy and services. The other major change has come through advances in technology and au-

Changing trends in Diagnostics Industry

Ms. Ameera ShahManaging Director and CEO, Metropolis Healthcare Ltd.

There are numerous opportunities for the Pathology sector, as India has emerged as a preferred healthcare destination.

18 noV – Dec 2012

VIEWSEXPERT

tomation of equipment, resulting in reducing the turnaround time for reports and providing quicker diagnosis. Molecular diagnostics and Diagnostic Medical Imaging are the rapidly growing fields in the Indian diagnostic market.

The core focus is to provide convenience to customers, be it through all varieties of tests pro-cessed in India, home health ser-vices, using technology for result communication or providing a network of collection centres for easier access. All these changes have contributed to the consoli-dation of the lab industry.

Although the entire scenario re-mains highly fragmented, the mar-ket is witnessing rapid expansion with organized diagnostic cen-ters adopting innovative business models. Moreover, the mounting number of diagnostic centers and tests are proving lucrative for both foreign and domestic players.

Industry growth however comes along with some challenges -

l Vast geography poses logistical issues

l Affordability of new tests and accessibility of new centres

l Uniqueness of each market in terms of culture, language and custom differences

l Competition from regional players

l Lack of awareness among healthcare professionals for the

range and utility of tests

l Lack of proper coverage under healthcare insurance

l Accreditation of healthcare facilities

l Dearth of skilled personnel

l Resistance from Government policy makers

India is soon becoming a hub for alternative medicine. Even at a very basic level, there are emerging pressures in demand-ing insurance and health plans for national healthcare. Suddenly we are witnessing a robust penetra-tion of Insurance in the Health-care Industry and reformation of health insurance schemes has taken precedence.

Exploring the Opportunities:

There are numerous opportu-nities for the Pathology sector, as India has emerged as a preferred healthcare destination. Consoli-dation of organized players and the health insurance industry is opening for privatization. Diag-nostic centers are now harboring advanced laboratory techniques like Molecular diagnostics, Nan-otechnology and Multiplex assays using Micro arrays to provide bet-ter diagnosis. There is complete automation covering various labo-ratory segments from pre-analytics to final reporting.

Pathology industry has central-ized its focus on “brands” and its

convergence with the radiology services will enable culmination into service of Prognosis Moni-toring based on Radiology / Lab Results.

Way Forward -

l Penetration of health insurance

l Further consolidation amongst organized players and entry into smaller towns

l New advances in Home ( non-invasive glucose monitoring) and Point of Care Testing

l Pathology and Radiology get-ting recognized as specialized areas of medicine rather than “support areas”

l Convergence of pathology and radiology services to reach a final diagnosis- Prognosis Monitoring based on Radiology / Lab Results)

l Support a paradigm shift to-wards integrated, preventive health care

l Promote financing systems and policies that support prevention in health care

l Equip patients with needed in-formation, motivation, and skills in prevention and self-management

l Make prevention an element of every health care interaction

l The healthcare system requires to be upgraded and in some cases completely re-imagined

VIEWSEXPERT

nov – Dec 2012 19noV – Dec 2012

The target range for these young children is to achieve pre-meal sugars of 6 to 12 mmol/L (110 to 220 mg/dL). This range allows good blood glucose control while reducing the risk of severe hypoglycemia.

Dr. Rajiva KumarChild Specialist, Muzaffarpur

Diabetes Toddlers in InFAnTS & PRESCHOOlERS

Type 1 diabetes is less com-mon in preschoolers than in older children and ado-

lescents. Less than 1% of diabetes is diagnosed in the first year of life. Less than 10% is diagnosed before the age of 5. The diagnosis is often missed in younger chil-dren for 2 reasons. The first is be-cause diabetes is less common in younger children. The second is that the symptoms are often con-fused with other minor illnesses. A baby might be in severe diabetic ketoacidosis before a diagnosis is made. Once the disease has been diagnosed, however, the situation can be corrected quickly and long-term management can begin.

When it comes to managing diabetes in young children, It’s helpful to first consider how nor-

20 nov – Dec 2012

SPEAKDOCTOR

World Diabetes Day14 November

mal infants and toddlers behave.

Diabetes care in young children:

Diabetes care in children under 5 involves a balance between what might be considered ideal–close to normal blood sugar readings–and what is safe and practical. The target range for these young children is to achieve pre-meal sugars of 6 to 12 mmol/L (110 to 220 mg/dL). This range allows good blood glucose control while reducing the risk of severe hy-poglycemia. Too tight control in infants and toddlers is especially risky as they cannot yet recognize the symptoms of low blood sug-ar. Repeated episodes of severe hypoglycemia in these children may lead to mild intellectual or learning impairment later in life.

Very young children often have changing appetites. They don’t al-ways eat the same amount of food from day to day. It’s important that the diabetes care routine reflects that. If blood sugar levels before meals are allowed to go slightly higher than for older children, the infant or toddler is more likely to remain safe even during periods of food refusal or picky eating. Parents will be less worried and frustrated, and mealtime will be more pleasant. For safety’s sake, young children should eat at reg-ular meal and snack times, having at least 3 meals and 3 snacks a day. But beyond that, imposing a rigid meal plan on an infant or toddler may only increase the stress in the family.

As children grow they become more predictable in their eating. They can also start to recognize and describe their low blood sugar reactions. At that time blood sugar targets also change. More structure in meal planning becomes both possible and necessary.

Signs of a healthy infant or tod-dler with diabetes:

How do parents and others who care for your children know that everything is going well? Look for:

l Normal growth and weight gain

l Developmental milestones, such as rolling over, sitting up, crawling, standing, walking, and talking at about the expected age

l No signs of high blood sugar levels, no overly wet diapers, no unusual thirst

l Good energy

l Few mild low blood sugar re-actions, and no severe reactions

l No ketones in the urine

l Blood sugar readings that are not often less than 6 mmol/L (110 mg/dL)

l Blood sugar readings that are not over 12 mmol/L (220 mg/dL) for long periods of time

l A happy and secure attitude in the child

Impact of diabetes on an infant & toddler:

Young children with type 1 di-abetes go through the same stages of development as their friends without diabetes. However, the routines and tasks needed for good diabetes care may influence and sometimes interfere with this de-velopment. All parents of young children with diabetes worry about the effects of diabetes on their growth as individuals, and how they will cope with the condition as they grow older.

Parents are often concerned about:

l The fact that their young child

22 nov – Dec 2012

SPEAKDOCTOR

World Diabetes Day14 November

cannot talk about symptoms of hypoglycemia (for example, is the toddler having a hypoglycemic spell or a temper tantrum?)

l Dealing with their own and their child’s anxiety about the pricks and injections

l Developing a treatment plan that does not interfere with the child’s normal daily activ-ities, including naps

l Giving meals and snacks on time and in the same amounts (toddlers with picky appetites can really cause stress at mealtimes)

Try to balance your child’s need for support against the risk of overpro-tection and being excluded from activities they would normally do at that age.

Coping strategies

Some helpful hints in coping with diabetes in a young child include:

• Trytoadoptamatter-of-fact approach to insulin injections, finger pricks, and mealtimes. Young children quickly pick up on parents’ anxieties and use them to control their environment. Try to be quick, calm, and reassuring when carrying out routines. Re-duce your child’s fears by prepar-ing the insulin or blood testing equipment in another room before involving your child. When it’s over, give her a big hug and kiss.

l Share responsibility for the rou-tines wherever possible. In sin-gle-parent families, have a friend

or family member help with the diabetes routines on a regular ba-sis. This prevents the toddler from playing one caregiver off against the other. The parent, the toddler, and the support person can remain confident that the child will be safe in the parent’s absence.

l Acknowledge your child’s feel-

ings and provide reassurance, but don’t delay needles or finger pricks until he is “ready.” Consider using distractions such as toys, songs, or television.

l Try to allow your child to have some control over the routine if she wishes. For example, she can choose the finger for the next prick.

l For the really picky eater, set limits on time allowed for meals and snacks. Don’t sit for hours fighting over each piece of food. The child always wins.

Making injection time go smoothly

It’s not unusual for children of all ages to go through periods when they cry, squirm, and try to

avoid insulin injections and fin-ger pricks. Sometimes it’s because the needle hurts. More often they are angry about being held still or having their play interrupted. Remember how hard it is just to wipe a toddler’s nose! They may also be reacting to the fear and anxiety they sense in you. Here are

some helpful hints for making injection time go more smoothly:

l Try to take a mat-ter-of-fact approach to the insulin injections and finger pricks.

l Be quick, calm, and reassuring when you carry out these routines.

l Reduce your child’s anxious time by getting the dose and/or equip-

ment ready before you involve your child.

l If possible, go where your child is playing to cause less disruption.

l Crying, protests, and other delaying tactics are normal. Re-member that each time you give insulin or do a finger prick you are helping your child stay healthy.

l Gently hold or restrain your child if she struggles.

l Get the needle or finger prick over with quickly. Delaying it only prolongs the agony for everyone.

l Give your child a big hug and kiss after you give the needle, even if she didn’t cooperate.

l Praise your child for any sign of cooperation.

nov – Dec 2012 23

SPEAKDOCTOR

World Diabetes Day14 November

Diabetes a Lifestyle disorder:

Diabetics have to maintain a healthy lifestyle that includes lifestyle modification and healthy eating.

l 347 million people worldwide have diabetes

l In 2004, an estimated 3.4 mil-lion people died from consequenc-es of high blood sugar.

l More than 80% of diabetes deaths occur in low- and mid-dle-income countries.

l WHO projects that diabetes deaths will increase by two thirds between 2008 and 2030.

Most of the people do not know when they have become diabet-

ic, so it is very important to get checks for diabetes. Once at the age of 6months in the infancy then at 2 years and then 5 years and later on at college going age and thereafter at the age of 35, 50 and 70 years respectively.

Women an become diabetic during pregnancy who are oth-erwise normal as per the sugar parameters. It becomes very im-portant to look for diabetesduring ante- natal care so the Gynecolo-gist and obstetricians have a very responsible job in the future years not to miss any diabetic patients. Diabetes involves the body from head to toe. It causes complica-tion in Heart, Eyes, kidney, Brain, Blood vessels and almost all of the organs of the body. Diabe-tes can be treated once a person knows that he is diabetic. So it

is very important to detect di-abetes and to diagnose it early because if the diabetes is caught early, the outcome of treatment is much better especially in the target organs mentioned above are protected and the complication are minimized. Sudden death ,stroke, Kidney failure, blindness and fetal deaths are common complication which can be avoided with proper medication and lifestyle changes.

Monitoring of diabetes is also very important and school going children should be encouraged to come forward for early detection of diabetes. The cutoff sugar level as per W.H.O definition is 126 mg/dl in fasting state and glycosylated hemoglobin values of more than 6 are suggestive. One should be very careful if one has three car-dinal symptoms of diabetes such

DIABETES A SILENT kILLERDiabetes Mellitus is going to be one of the greatest killer in next

twenty years and India is going to be capital of Diabetes by 2050

Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use can prevent or delay the onset of type 2 diabetes.

24 nov – Dec 2012

World Diabetes Day14 November

Dr. M. WaliPhysician to

the President of India

SPEAKDOCTOR

as Poly-urea (Frequent passing of Urine) Polyphagia (Increased Appetite) and Polydypsia (Dis-proportionate excessive thirst) .Should the above symptoms persists one should immediately consult the doctors.

How can the burden of dia-betes be reduced?

Prevention:

Simple lifestyle measures have been shown to be effective in pre-venting or delaying the onset of type 2 diabetes. To help prevent type 2 diabetes and its complica-tions, people should:

l Achieve and maintain healthy body weight;

l Be physically active – at least 30 minutes of regular, moder-ate-intensity activity on most days. More activity is required for weight control;

l Eat a healthy diet of between

three and five servings of fruit and vegetables a day and reduce sugar and saturated fats intake;

l Avoid tobacco use – smoking increases the risk of cardiovascular diseases.

In 2004, an esti-mated 3.4 million people died from consequences of

high blood sugar. 347 million people

worldwide have diabetes

WHO projects that diabetes deaths will

increase by two thirds between 2008

and 2030

More than 80% of diabetes deaths

occur in low- and middle-income

countries.

nov – Dec 2012 25

World Diabetes Day14 November

SPEAKDOCTOR

ARCHITECTuRAL Challenges

DESIgnIng HOSPITAlS OF TOMORROWfor

Dr. R. CHANDRASHEKHARB. Arch. HFP Phd.FIIA FIHE MAHA

Chief Architect (Govt. of India)

26 nov – Dec 2012

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Hospitals are the most com-plex of building types that we often come across in

our lives. Each hospital comprises of a wide range of services and diverse types functional units. A functional design can promote skill, economy, conveniences, and comforts that we often seek in a hospital.

However, keeping in mind the

complexities of Hospital Design-ing, we must understand that there are two types of hospital projects that we often accomplish to serve the varied types of healthcare needs of the mankind. We can broadly categorize them into two types: The Green Field Project and the Brownfield Project.

A Green Field Project is the commencement of a new hospital

project whereas a Brownfield Proj-ect focuses on the modernization, remodeling and expansion of an existing hospital.

Brownfield Hospitals

A Brownfield Project is often considered as a popular model where the existing structures are utilized to build something which has more functional advantages.

nov – Dec 2012 27

STORYCOVER

Since the loss of function-

ality poses a major economic burden, such projects are gaining more acceptance today where the objective broadly revolves around the reduction of the direct eco-nomic losses of non-functional hospital units by bringing in mod-ern and advanced facilities ful-filling the varied heathcare needs

“A business model which uti-lizes existing infrastructure, local resources, trains local manpower, corrects deficiencies and overrides constraints by constantly innovat-ing ,Referred as “Light Asset Mod-el” of expansion which can be rep-licated fast and has low gestation. “A retrofit model of expansion which optimizes on all available resources in the vicinity & yet man-ages to create its own brand iden-

tity”.

E v e n in the Metros,

when local body clearances from different

departments involving various formalities delay the project, the utilization of the existing envelope of the building saves you from taking any municipal sanctions. Hence, remodeling of an existing hospital can be a viable option.

The purpose of Brownfield hos-pital is to achieve optimization of an existing infrastructure which leads to functional excellence re-quired for the healthcare needs of the public and staff. The project may aim at the improvement in elevations and interiors to suit the modern-day needs and also achieve green architecture/ healing environment. The various facili-ties mixed to suit the latest needs and these can be augmented by the engineering services such as medical gases, DG sets, HVAC with required air changes and electrical needs suiting the latest technolo-gies and equipment. And in total-

ity, the review of the existing

technology to meet the cur-

rent standards. The increased ef-

ficiency becomes a key element.

For optimization of the Brownfield projects, some of

the key issues are:

l Budget: Financial analysis, work of the Financial Team.

l Execution: for infrastructure developments, the Project Man-agement Team.

l Technology: Engineering and Bio-Medical Team to understand and use resources.

l Resources: HR Team

l Operations & Commissioning: A dedicated team to fine tune and monitor the execution and com-missioning of the Project as per schedule.

These Teams can be In-House Teams or Outsourced from pro-fessional healthcare consultancy firms or institutions.

The success of a Brownfield project lies in Accurate Analysis of Existing Infrastructure, utilisa-tion of Existing Technology and Manpower, meticulous planning ,viability analysis and due diligence practices, precise project planning and a budget planning , up gra-dation needs and commissioning process, & HR activities.

28 nov – Dec 2012

STORYCOVER

Implementation of the project with proper monitoring system can result in timely completion of a project with optimization of Resources, which may attributes to Financial gains in terms of reduced cost of project, increased return on investment, fast replicability.

With these upgrade, the ex-isting infrastructure can be suc-cessfully utilized to augment the level of care. The expansion possibility and the architectur-al facelift can turn the built up area to look more pleasing and functional. However, it also has to address important elements like cordoning the site, providing timely logistic services, material handling, operating essential de-partments and ensuring adequate supply of electricity, water supply etc., utilizing and upgrading the technology of available existing equipment and introducing new technology. Additionally from a manpower point of view, it should look at re-appropriating the skills of the operating staff, absorption of staff in requisite manner and train-ing of the available manpower. One may also have to follow a robust organizational process for speedy com-missioning and quality management system, IT technology, and finally accredita-tion rules to be followed for motivation.

G r e e n field hos-pitals

In green field projects, which are generally done on a virgin or a new site, the process begins with the selection of the site. While selecting the site, one has to be careful of the location with respect to the geological phenomenon of that area, i.e assessing whether the area is prone to earthquakes, volca-nic eruptions, landslides, Tsunami, hurricane or flooding, because these factors do have bearing in the working out of the right kind of structure, plinth level of the building etc. Then follows Master planning strategies in which you always work out a complete mas-ter plan, and every design should have a planned zone for the future growth and these can appear as dotted lines on the site plan. Or, these may be developed as con-structed unoccupied shell space or as structural capacity to allow for future ver-tical addition to a building.

Hence, any master plan layout will have an Institutional zone consists of Hospital zone, an Ac-ademic zone, Services zone, these will deal with bulk services like electric room, generators, Air con-ditioning plant, overhead tanks, underground tanks etc and the hostel facility will be housed in a Residential zone and a green buffer is planned to segregate residential and institutional zones.

From the Macro-zoning, the planning is carried on to Mi-cro-zoning in which various con-figurations in terms of blocking are done based on the facilities to be accommodated in a particular floor plate e.g. floor consists of cardiology, car-diac

nov – Dec 2012 29

STORYCOVER

surgery with their respective OPD, IPD etc. And if it’s a teaching in-stitution, a faculty area should be located in the same level and various such groupings on the basis of their specialization are stacked one upon another on different floors with a common floor where extensively service oriented facilities like OT, ICU, Endoscopy, dialysis etc. can be accommodated.

Importance is also given to the functional circulation by segre-gating different types of traffic that include the movements of the patients, doctors and sup-port services. Each department is planned after identifying activities and activity sequences to achieve smoother functional relationship.

Every design should have a strategy to deal with the issues surrounding flexibility, convertibil-ity robust utility and expandability. These are achieved in modern days by working out with a pre-engi-neered structure, nicknamed as ‘Plug & Play’ infrastructures. These light weight structures can be used independently as a loose-fit design. The concept of loose fit design is more appropriate f o r

larger spaces that can be used for more than the minimum functions originally proposed. And to ar-range in departments or regroup-ing that allow for future expansion. While incorporating the flexibility in design, spaces can be designed to adapt to multiple designs . An example is a patient room that can be adapted for the purpose of simple procedures such as a line insertion. The different function can be accommodated by simply adapting the space because it has been planned to serve a range of possibilities

We also need to understand that in the healthcare infrastructure, we need to address convertible flexibility which is a type of flex-ibility with relatively low effort, time, and/or cost, a space can be converted to another use. Example : a patient room with plumbing, gasses, and electrical systems in the wall for future conversion to critical care.

In order to offer flexibility in design, the utility and communica-tion infrastructure of a healthcare facility should be capable of expan-sion and upgrade. The availability

of utility and network capacity

simplifies and dramatically reduces the cost of the future project.

Both project types have their own set of complexities and have desired goals to achieve that we need to keep in mind while work-ing on any hospital projects. There are, however, key elements that can be commonly applied while work-ing on any of the above hospital projects. Some of these elements have been discussed here for your benefits:

Indoor Air Quality (IAQ)

The importance of indoor air quality (IAQ) is very critical in hospitals and healthcare facili-ties. Hospital air conditioning plays a more important role in help maintaining the total hygiene and prevention of Hospital Ac-quired Infection (HAI) within the hospital environment than merely being a source of comfort. In many cases, proper air conditioning and improved indoor air quality can be an important aspect in patient therapy while in several cases it could be a part of the treatment itself. Thus properly designed air conditioning systems are imper-ative in a hospital with specific requirements for ventilation, fil-

tration and cross-con-

30 nov – Dec 2012

STORYCOVER

tamination.

Use of Environmental controls to prevent the spread and reduce the concentration of infectious droplet nuclei in ambient air.

Primary environmental controls consist of controlling the source of infection by using local exhaust ventilation (e.g., hoods, tents, or booths) and diluting and removing contaminated air by using general ventilation

Secondary environmental con-trols consist of controlling the air-flow to prevent contamination of air in areas adjacent to the source (AII rooms) and cleaning the air by using high efficiency particulate air (HEPA), filtration, or UVGI (Ultra Voilet Germicidal Irradiation).

Improperly maintained HVAC systems may cause symptoms as-sociated with Sick Building Syn-drome (SBS). SBS symptoms that may be attributed to moisture with the HVAC systems .”Humidifica-tion systems with poor condition/maintenance are associated with significantly increased upper respi-ratory symptoms, eye symptoms, fatigue/difficulty concentrating, and skin symptoms. Less frequent cleaning of cooling coils and drain pans are associated with signifi-cantly increased eye symptoms and headache. Symptoms may be due to microbial exposures from poorly maintained ventilation sys-

tems and to greater levels of vehicular pollutants at air intakes nearer the ground level.

The Indoor air quality is gener-ally maintained by use of filters in HVAC which generally prevents particulates gasses and microbial . However the trapped pathogens are in the filter bank and never killed. Thus forming colony of pathogens. Hence judicious uti-lization of ‘UVGI’ (Ultra Violet Germicidal Irradiation) is recom-mended in HVAC. Or using the Photo-Hydro-Ionisation,(PHI) in the AC system where-in Hydrogen based oxidizers are created by ex-posing activated oxygen molecules to a hydrated catalyst containing four unique metals and 300 nm UV light (Photon Energy).

These Friendly Oxidizers are…Hydro-peroxides, Hydroxides, Super Oxide Ions, Ozonide Ions.

Friendly Oxidizers are blown into the conditioned space, Mi-crobes and gases are destroyed on contact.

Oxidizers break down into ox-ygen and water vapor. this system kills airborne and surface pol-lutants.

Hospital acquired infections

Most in-fections that become

clinically evident after 48 hours of hospitalization are considered hospital-acquired. It was also es-tablished that 80% of HAI are thru Touch surface.

“The Direct Cost of Healthcare Associated infections in the UK alone is 1 billion GBP each year”

Antimicrobial Copper is the most effective touch surface ma-terial, killing greater than 99% of bacteria within two hours of ex-posure. No other material, such as silver-containing coatings, comes close !

Copper and copper alloys have intrinsic antimicrobial properties with well documented efficacy against a wide range of patho-gens. The Copper Development Association (CDA) has conducted a series of laboratory tests under Environmental Protection Agency (EPA) Good Laboratory Practices (GLP) protocols that have provided evidence that copper surfaces kill microbes in a matter of hours. Antimicrobial Copper isn’t just pure copper,

It’s shorthand for a host of cop-per alloys that can be formed into

nov – Dec 2012 31

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32 nov – Dec 2012

STORYCOVER

DURABlE

WEAR RESISTAnT

CAn STAnD UP TO HARSH EnVIROnMEnTS

CAN RETAIN DETAILS AND FINISH OVER TIME -Affordable touch surfaces can be available in a variety of colours and finish options.

green Architecture

Many of the amenities that new-er hospitals are becoming known for consume lots of energy. Thus, it’s has become important for the design architects to blend green architecture elements with health care design so that consumption of energy can be minimized to a certain extent. One of the benefits of incorporating green architecture

elements is to make the hospital en-vironment more patient-friendly.

The Healing architecture or the Evidence based health care architecture creates safe and ther-apeutic environment for patient care and encourages family in-volvement. It promotes efficient staff performance and is restorative for workers under stress. It allows facilities professionals to use sci-entific research to Plan, Design, Construct and Operate health care facilities that are geared towards promoting not only treatment but more conducive healing and work-ing environment.

Evidence-based Design is transforming the healthcare en-vironment by providing proven architecture methodology to im-prove patient outcomes, safety, and satisfaction, as well as service

efficiency of the staff. Such evi-dence will also allow facility design and construction to be flexible, adaptable and future ready.

Building Information Management

It expands benefits to hospi-tal design and operations and in-cludes a better design coordina-tion between different disciplines. It also systematically assembles structured information about the health facility for project manager from planning, commissioning and maintenance point of view. It saves time and helps avoid errors in project implementation. Con-sidering the green building pa-rameters, the design should come with a compact plan, increased efficiency with a better control of the useable area and ease of future expansion. Efforts should be made

nov – Dec 2012 33

STORYCOVER

to reduce the travel distances of people and services.

Hospital Design safety mea-sures

Hospitals should also make sure that clinical parameters with re-gards to the patient safety must be adhered to, in order to make a hospital safe in terms of structur-al and non-structural members. Hence every hospital should strict-ly follow codes of structural safety and safety from non-structural members such as False ceiling, A/C ducts etc...

Hospital represents an enor-mous investment, the value of non-structural elements can be higher than the structure itself, and the required safety measures need to be incorporated to maintain the structure as a safe place for

patients, doctors and other staff.

Emergency Exit

The evacuation plan with blend-ing of open spaces and built spaces with a proper fire escape, staircases and routes, proper refuge areas for easier evacuation are important for a multistoried structure. The appropriate signage (way finding) and display of evacuation routes in different parts of building need to be included. These important safety measures will build confidence among patients and give them a sense of security in the hospital.

Successful completion of a proj-ect is the mission that we always strive to make with meticulous attention to all aspects of construc-tion quality and time and cost. The objective is always to complete the project in time with affordable

cost, whether it’s a Green Field Project or a Brownfield Project. By integrating healthcare support services, systems and equipment commissioning along with func-tional construction, we can make the hospital commissioning perfect and user-friendly. Project man-agement is, however, the key to timeliness and cost control of any project that we need to always keep in mind while working out a hos-pital designing project.

Muskotia Retreatnainital-an exclusive residential community for the discerning few!!

Vacation homes is an up-coming concept in In-dia. Owning of Vacation

homes is being adopted by people with higher disposable income and it is generally considered for investment post the basic hous-ing and real estate investment needs are met. In India Goa has been one of the most preferred destination for owning Vacation homes amongst high net worth individuals, professionals and Rich and famous. Holidaying in Vacation homes are a great break for the family for rejuvenation and healthy living. Mostly in US, Europe, Canada and also Goa va-cation home owner prefer to give their property on rental to ensure best upkeep of the property and get revenue income. Vacation rentals usually occur in private-ly owned vacation properties (holiday homes), so the variety of accommodation is broad and inconsistent. The property is a fully furnished property, such as

Muskotia Retreat at Nainital is a dream of long years of creating Vacation homes for the discerning few. Plan is to provide Rent-A-Villa proposition to the people who own homes at Muskotia Retreat.

34 nov – Dec 2012

PROPERTYHEALTH

a holiday villa, apartment, cottage, condominium, townhome or single-family-style home.Vacation rentals can range from budget studio apartments to lavish, expensive private villas in the world’s most desirable locations.

Muskotia Retreat at Nainital is a dream of long years of creating Vacation homes for the discerning few. Plan is to provide Rent-A-Villa proposition to the people who own homes at Muskotia Retreat.These homes are coming up in surroundings of Kilbury forest adjoining Nainital which is an international birding destination and within the touching vi-cinity of Corbett National Park. Muskotia Retreat homeswould be constructed using unique com-posite material with standard RCC structure,fully furnished, heated homes,set in a wildscape , whilst using various sustainable methods of living.

The attempt at Muskotia retreat is to create a small community of likeminded people who would help build this unique living complex in an integrated

manner, thereby creating a unique asset for their family and friends. The community will have their own homes within Muskotia Retreat. Sustainability is the core to the concept at Muskotia Retreat.

The team working on the design is attempting number of initiatives like use of Solar power in passive heating of homes, rain water harvesting and purification, recycling of water, LED lightning, local area plants and flora that has strong survival instincts and consumes less water and some more. Endeavour is to get right balance between environ-ment and those who live, learn, and play here to make sure it lasts long in future.

At Muskotia retreat there will be great emphasis for good health. There are planned paved and un-paved trails that will encourage residents to get out and enjoy nature in its most beautiful untouched forest setting. Visit www.muskotiaretreat.com to experience the concept.

nov – Dec 2012 35

PROPERTYHEALTH

Hosconnn.com–online healthcare Consultancy Portal aims to use Internet

Tech-know-logy

l To simplify the Inherent com-plications

l To provide value based decision making, and

l To provide expert advice avail-able and accessible…..to the medical fraternity throughout the nation

Hosconnn.com has experi-

enced healthcare industry pro-fessionals having rich experience, strong commitment, high focus on customization, with an empa-thy to client’s needs that makes it completely focused and involved in any project that it undertakes.

We provide consultancy ser-vices on specific issues through Case Study based approach (con-sultants of the projects would be cross examined to enhance the Quality of Recommendations/ Solutions).

HEALTHCARE CONSuLTANCYgoES oNlINE

Through online route we offer advisory consultancy and solutions to the clients, and provide guid-ance to the team Implementing and executing the project on behalf of the client. On implementation issue, we wish Clients to have more Comfort Levels, Ease & Leverages vis a vis their Resource Mix. Our key responsibility would be to ad-vise client to manage/optimize project cost.

Perceptual Balancing:

Over the years knee-jerk /adhoc responses (to the issues, challeng-es and even opportunities) have been quite common across various strata of healthcare.

Through Expert & Experienced knowledge pool of Hosconnn.com, we would strive to “Analyze & Grade” the Operational & Op-portunity issues and “Calibrate” the responses.

Speed is the need:

Our Online Status would enable

KRISHnEnDU gHOSHIndustry Expert

www.hosconnn.com

36 nov – Dec 2012

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us to have more time & sharper focus resulting into Quality Deliverables in 2-4 weeks irrespective of issues/locations

Also On-line “Case Studies Driven” Healthcare Consultancy is “relevant” in changed Perspectives (Competitiveness, Quality, Commercials, Cost, and Technology etc). because

l It would bring in fresh perspectives to the issues to be undertaken and prevent Intellectual and Creative Inertia.

l It would also keep CCP (Cut, Copy & Paste) Syndrome in check

l Lack of Experienced Consultancy professionals across nation

l On-line consultancy is beyond Infrastructural Limitations

l On-line Case Studies allow thinking out of box and healthy debate & cross Examination among the experienced Professionals

Consultancy Service Portfolio

We provide comprehensive consultancy services for:

l Hospital Design/Architectural Services

l Hospital Construction/Project Consultancy (Sans PMC)

l Hospital Administration

l Hospital Operations

l Hospital Environmental ,Regulatory & Statu-tory compliances

l Hospital Quality Benchmarks like ISO, NABH etc,

l Hospital IT Infrastructure

l Hospital HR solutions

l Value System

l Market is Eternal so no Short cuts

l Market is primarily driven by Professional Values & Character

Innovation:

Preparatory Consultancy

We wish to introduce this InnovatioN “Prepara-tory Consultancy” with the Following

Key & Urgent objectives:

l To ensure Smooth & Early Transition from “Project Mindset” to “Functional/Operational Mindset”

l To remove/minimize all sorts of Teething Trou-bles/Excuses/ Complacency (early Negligence/Nuisance Management is an urgent need). This would decide the Break-even Time & subsequent Revenue Projections/Generation.

“Simplifying Health Care”

38 nov – Dec 2012

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New / upgrading Hospital Projects

Quality & Performance Improvement

Highest Technically Rated Consultancy in India by NHRC 2010 2011

Total Hospital Solutions from ACME Consulting

• Market Research• Techno-Commercial Feasibility Studies• Project Reports• Design, Planning & Architecture• Facilities & Equipment Planning• HR & Staffing Services

• NABH Accreditation• NABL Accreditation• ISO Certification• Hospital Quality Improvement• Third Party Patient Satisfaction Surveys• IT Solutions- HMIS – NABH Compliant

Head OfficeF 159, 5th Street, Anna Nagar (East)Chennai – 600 102Tel Nos: 91-44-26267 6703, 04, 05Suresh Shenoy , General ManagerMobile: 97104 01761

Regional Offices

Kerala:Haridas Menon, Marketing MangerMob: +91 96332 76757,

Karnataka & Andhra PradeshB.H. Balaji, Regional HeadMob: +91 94488 84514

Western RegionDevasri Chatterjee, Regional HeadMob: +91 98202 64749

www.acmeconsulting.in

India is today acknowledged as a rapidly growing global healthcare major. The fame

of our Doctors and Nurses is leg-endary and they can claim to be the first skilled manpower export from our country, much before the software professionals started going abroad.

Today Indian Doctors and Nurses are at work in almost all countries of the world, both in the highly developed countries like the US, UK, Australia and Europe and in the interiors of Africa and across the Middle East countries.

India’s claim to global health-care major status has also been reinforced by our Hospitals here, being touted as the new low cost healthcare destination of the world. This has led to the coining of the term, ‘Medical Tourism’, Medical Treatment and Tourism in the cost of one. We have today a number of the leading Health-care Groups setting up Hospitals exclusively to cater to patients

from abroad.

We also have the fairly recent phenomenon of leading Indi-an Healthcare Groups setting up Hospitals abroad, currently, mainly in the Middle East and SAARC countries and some com-ing up in African countries like Nigeria, Uganda and Kenya. All these developments point clearly in the direction of India becoming recognised as a global healthcare provider, definitely a good foun-dation for us to now build on and become a healthcare super power. But what do we lack for reach-ing that highest level or are we doomed to remain just a low cost destination, popular only because our charges are much much lower than those in developed countries? when will we see international chartered flights coming in droves to our country, when will we see Western Insurers supporting treat-ment in our Hospitals.

We will see that day happen when our Hospitals become cen-

ters of excellence, comparable with the best in the world, when we gain that ‘touch of class’ in our services.

l When all patients to the Hos-pital – not just the foreign ones, get greeted at the front desk with smiling and courteous staff, who have the answers to all their que-ries, who ensure that appoint-ments are given and adhered to, who inform you in advance if the doctor is getting delayed.

l When the signage at the Hos-pital is sufficient, multilingual and unambiguous and really helps you get to where you want to go, with-out asking anyone.

l When the Doctors keep to their timings and clearly explain the diagnosis and line of treatment.

l When Nurses smile, show they care, speak the language of their patients and follow standard prac-tices, when the Nurse is trained at handling difficult patients, stressed

NABHAccreditation an essential requirement for Global recognition of our Quality.

B.g. MEnOnManaging Director, ACME Consulting

Taken from his talk given at NEXUS HOSPICA’ 12

National Conference held on 5th October 2012

40 nov – Dec 2012

VIEWSEXPERT

out and impatient ones.

l When the Waiting Areas are comfortable, with enough seats, temperature and air quality well maintained, enough toilets and all kept always spotlessly clean

l When tests are carried out in well equipped labs and radiolo-gy centers, with equipment duly calibrated and operated by qual-ified persons. When the results can be absolutely relied upon by the Doctor.

l When the food from the Can-teen is safe, hygienic and delivered by clean servers promptly, on time.

The challenge for our Hospi-tals is huge, if we have to become globally recognised as a healthcare super power. All these and more are aspects that we all from the healthcare sector know that we lack. Then what is it that prevents us from taking that determined step forward and lift ourselves to the next level.

This was the dilemma faced by Indian IT Companies about 7-10 years back. All of them were at that time pure ‘body shops’, arbitraging on the difference in salaries paid in the US and here. We used to ship, in those days, hundreds of IIT and REC engineers, the best brains in our country to work at the prem-ises of the American Companies on an hourly or daily rate, doing basic coding and data entry which till then was being done by 12th Standard American kids and even school dropouts. We charged for

a day what the Americans would charge for an hour of work. Lat-er, we woke up to this situation and began acquiring skills and a reputation for good quality work. The Infosys and TCS and Wipros’ went in for higher value added work. Most important they went in for the most stringent quality management standards like the CMM and the ISMS 27001 which brought them on par with the US and Europe’s best IT Companies.

Today these Indian majors have been joined by another 10-15 Com-panies from India to compete on par with the US IT Majors like the IBMs and Accentures for huge global IT contracts. We are now no more known as low cost IT Service providers, but as a high value provider who delivers best quality and at very competitive prices.

For this transformation to take place in the Indian Healthcare Sector, we need to strive for that perfection and passion for excel-lence. Our Hospitals should be accepted as the best in the world. Our Orthopeadic Hospitals should be re-known for doing the best hip replacements, our Nephrol-

ogy Centers for the safest kidney transplants and our Cardiac Units for most successful rate of by-pass surgeries conducted in the world. To achieve this global level of ex-cellence, the NABH is today the only way forward.

The NABH, National Accred-itation Board for Hospitals and Healthcare providers is acknowl-edged to be on par with the world’s best healthcare accreditations like

the JCAHO or JCI of the US, the ACHS of Australia. It is a truly independent body coming un-der the Quality Council of India. As NABH approved Consultants for over 5 years, incidentally the only accredited consultants by NABH in the whole of South India, we can vouch for the ab-solutely credible and unbiased nature of their assessments, seen by the fact that from 2007, from

the time the Accreditation was introduced till now, less than 150 hospitals have got the NABH, out of the over 5,000 medium to large Hospitals we have in this country. The assessment by NABH covers every single area and aspect of the Hospital and in a most detailed manner. For the final audit at a large hospital 4-5 senior Assessors come and spend nearly 4 days at the Hospital, thereby ensuring that no practice, process, system or practice is left un-examined. Such a stringent accreditation requires the most rigorous development and implementation of the system and it is this that lays the right path for the Hospital to later go on striving and maintaining global standards.

nov – Dec 2012 41

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42 Nov – Dec 2012

Over the past few years, sev-eral agencies in develop-ing and developed coun-

tries have undertaken m-Health projects with mixed outcomes and formulated strategies to actively pursue the deployment of these projects at a larger scale for univer-sal delivery of quality healthcare. Many of these projects have been successful in enhancing efficiency and reaching the last mile; while there have been few projects that also warranted amendments in the processes and raised few questions. With over eight billion mobile subscribers worldwide 850 million in India, mobile networks and devices are ubiquitous. Lever-aging their power can accelerate achieving the MDGs, especially for health.

The emerging technologies:

The governments and private telecom companies of develop-ing and developed countries now have rich experiences and busi-ness models which can be shared

m-HealthThe Road Ahead

Dr. Sanjeev SoodHospital administrator

air Force Station, Chandigarh

VIEWSEXPERT

Nov – Dec 2012 43

regionally and globally to further enhance the success of m-Health projects. At the same time, the advent of new technologies, sensor networks, mobile applications, and home-based services for health-care, and the sheer level of penetra-tion of mobile devices at the rural level, raised the expectations of the masses and created a certain hype around m-Health. This requires a shift in the way government and private agencies have been strat-egizing their m-Health projects to live up to these expectations.

m Health –Managing the hype

Hardly a week passes when there is not a seminar or a con-ference on “m-Health” in some part of the world. These brochures project high-gloss images of mobile phones and heart signals, celebra-tory claims about how all of this will “revolutionize” healthcare, and liberal use of the words “in-novation” and “transformation” in almost every keynote title. However, this well-intentioned but premature celebration of all things “m-Health” may come back to bite us, if we’re not extremely careful. Here are some of the con-cerns that need to be addressed:

Defining m-Health

There is a lack of consensus among the experts when talking about say “m-Health.”There is a difference of opinion how they de-fine the term--what’s in and what’s out of the definition. Then, some experts feel that it is all about “well-ness” applications for the masses

to drive prevention. Others define it as mobile applications, usually on smart phones, that leverage some of the government’s pub-lic health data so consumers can know things from their pollution exposure to flu migrations.

Managing expectations

As m-Health reaches a fevered pitch, there is a fear that no tech-nology solution could ever achieve the enormous claims and utopian breakthroughs so many are prom-ising. Experts are doing a terrible job with expectations management because consumers and clinicians are all likely to believe that these

solutions and services are widely proven, affordable, and available. This is just not the case yet. The potential is there, but not yet the products and price points.

So, too, there is much risk in trumpeting the power of m-Health prematurely. It’s easy and quick to put up a slick demo. It’s hard and time-consuming to do a clin-ical trial, or a complete redesign of a care model that integrates m-Health data into meaningful medical practice, or a longitudinal ROI or behavior change study. At the same time, not every m-Health application or service requires a randomized, clinical trial to prove

VIEWSEXPERT

its worth, but some kind of evi-dence is warranted.

For that matter, there are still regulatory issues abounding around software, mobile devices and applications, decision support tools, and online forums that pro-vide medical protocols, care plans, or advice. There is no end to of private players making incredibly un-validated medical claims on keynote stages, and the jury is still out on how, when, and to what degree the regulatory bodies are going to weigh in on these new capabilities. Similarly, there are privacy policies to be negotiated and navigated with this conver-gence of consumer electronics and medical technologies.

So again, it is hoped that the m-Health proponents and prog-nosticators can better manage ex-pectations, ease out these thorny issues, and under-promise while over-delivering what m-Health

has to offer.

Moving Beyond m-Health Bias-es:

There are some biases about m-Health movement that are matter of concern : it’s sup-posed to be about cell phones, with cool gadgets, for young people. There may be many out there who don’t share

these biases, however one need to tackle these biases related to m-Health.

First, do we really understand who the users of these technolo-gies will be and what the specific scenarios and contexts of usage are? In particular, there is concern about some anti-aging bias in this movement.

While there is great promise for m-Health applications to drive a more prevention-oriented par-adigm for younger populations worldwide, the ground reality is that we also have some senior cit-izens--many of whom aren’t com-fortable with or just can’t see smart phone screens--to reckon with for the next 20 years or so. The population with multiple chron-ic conditions is the largest cost challenge one faces in healthcare, and account for almost 3/4th of hospital visits. One needs to make

sure we are designing solutions and systems that fit well into the lifestyles and cohorts who most need them.

Part of the problem may be one of definition, part of it trying to understand the market, its needs, the technology currently available to meet those needs and how does that technology become a part of the workflow of traditional care processes, or augment if not dis-rupt that workflow. Many ques-tions that remain unanswered or poorly answered.

Challenges and Opportunities Ahead:

Quite awhile back, when re-searchers first started looking into the m-Health market, they felt that indeed, there truly is something here and that provided the tools were simple enough, the value big enough that m-Health. It was at that time when the term was coined: Health is Mobile. Health does not happen when one is in-front of laptop or desktop comput-er, it happens when one is on the move, going to an appointment, picking up a sick child from school, etc. Researchers agree with Deloitte that an mPHR like application has incredible potential, however, the lack of personal health information (PHI) in a common, computable digital format, (eg CCD or CCR) is a significant hurdle.

In the West, there is a signif-icant change occurring and the rapid acceleration in adoption of smartphones is staggering. This

44 nov – Dec 2012

VIEWSEXPERT

may truly be key, for as the PWC report points out, most consumers would prefer to get their m-Health solution from their physician. Thus, if physicians get on-board in using something like the iPad, this could become a virtuous cir-cle. First, the doctor will be able to easily create and update a pa-tient’s record, digitally creating the content (PHI) that a consumer/patient could then use to populate their own mPHR. The physician’s familiarity and use of such tech-nology will also drive a higher comfort level with using such in the process of care coordination and engagement with the con-sumer, including reviewing data in the consumer’s mPHR that may not have originated from their practice.

Conclusion: Challenges and next Steps:

There are several key challenges to consider in developing mobile healthcare solutions and delivering the promised m-Health benefits.Whilst mobile healthcare can provide incremental revenue for network operators and vendors, the consumers of healthcare services (namely healthcare professionals, insurers, and patients) are more concerned with its impact on the system itself. Thus, a successful solution will need to overcome the following challenges which can be effectively managed through careful planning and design:

a) m-Health devices and services must be easy to use and provide clear benefits

b) m-Health solutions need to be tightly integrated into existing healthcare professionals work-flow

c) The cost-benefits of the m-Health solutions need to be clear and must have a sus-tainable business model

d) m-Health solutions must com-ply with all necessary privacy obligations

Ultimately, mobile healthcare services and devices are only effec-tive if adopted by healthcare pro-fessionals and patients. Healthcare solution providers must therefore focus on developing products and services that are easy to use, with-out additional layers of complexity.

Healthcare professionals must see clear and immediate benefits from any new device before add-ing it to an already bulging doc-tor’s bag. Devices (such as smart phones that allow mobile access to patient records and contain imaging software) can improve healthcare worker efficiency and also make doctors jobs easier, thereby mitigating chronic man-power shortages and increasing employee retention.

At the same time, highly usable devices still face a major challenge from established vertically inte-grated technologies used in exist-ing systems. Ease of integration with existing systems is a criti-cal selling point for hospitals and healthcare professionals, which emphasises the need to estab-

lish open interoperable systems. It is understandably easier for a hospital, insurer, or heath care professional to launch a modular component of a healthcare sys-tem rather than replace the entire system itself. Yet, even modular components require clearly de-fined policies and work flows to facilitate integration and uptake.

A third challenge to mobile healthcare adoption is cost-effec-tiveness. Mobile healthcare solu-tions must demonstrate an unam-biguous return on investment with visible improvements to efficien-cy and patient care. Vendors and network operators need to work with healthcare professionals and insurers to develop and prove the business case for their solutions. However, a further challenge lies in developing business models that work for all players in the overall healthcare value chain. This can often be a significant obstacle due to the complexity and differences in healthcare ecosystems. Lastly, device manufacturers and net-work operators must ensure that devices and connections are both reliable and resilient for rural In-dian conditions.

Serving the healthcare verti-cal requires additional measures to ensure limited interruption to data transmission and accuracy.

For example, network operators could keep secure backups of data whilst maintaining redundant sys-tems that would function in case of a primary network or device failure.

nov – Dec 2012 45

VIEWSEXPERT

46 nov – Dec 2012

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Q.: Brief About yourself ?Tell us about your projects done and up-coming projects?

Our firm CP Kukreja Associates is a leading architecture and engi-neering firm based in New Delhi. The firm has over 200 professionals across various disciplines ranging from architecture, structure and other services disciplines. The firm has designed prestigious hospital and healthcare projects both in India and abroad.

Q.: How normal architects are dif-ferent from Healthcare architects.

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EXCLuSIVE INTERVIEW WITH DIKSHU C. KUKREJA ARCHITECT

Rise in demand of Hospital , Healthcare Architects &consultants

India presently has a bed deficit of approximately 30 lakh beds as per the WHO recommendation of four beds per 1000 population. Considering even a 250 bedded hospital on an average, the country would need 12000 hospitals in the near future.

INTERVIEW

48 nov – Dec 2012

does green building play into your work?

Our firm is recognized for envi-ronment friendly and sustainable design. Accordingly the entire architectural design approach is to amalgamate architectural and engineering disciplines keeping in mind Green Building principles.

Q.: Many of your fans would say that you design your buildings with a strong focus on both user experience and natural light, is this correct? Can you tell us more about this?

Yes, our architecture lays strong emphasis on the experience of the user and natural elements such as natural light, ventilation, views, etc. We strongly believe that buildings need to be rooted in the context of where they are designed for. This context could be geographical , cultural, climatic or social.

Q.: Who inspires you?

The design philosophies of Mr. CP Kukreja are an in-

spiration not only for me but for our entire firm.

Q.: What is your ultimate goal when it comes to your work? What do you want to be remembered for?

My ultimate goal is to create buildings which can shape the way people live in them and their behavioural patterns. The build-ing should not just look beautiful from outside but have a lasting impression and experience both from outside and within.

Q.: How would you describe your signature style? As we all know, we’re in the era of the ‘iconic build-ing’ and the ‘starchitect’. However facile this might be, the designs of public institutions are often of-fered to the biggest names, and the most ‘iconic’ architects. How do you feel about this trend, and how do you work in a system like this and continue to create thoughtful, meaningful architecture, when so many de-velopers

are looking for ‘the next Bilbao’?

We do not believe in a single architectural style, since styles are only a passing phase while buildings are supposed to last for much longer. Having said that, for us our signature approach is to make each building contextual, purposeful and symbolic.

While I do not believe in the notion of ‘starchitect’, I do feel that as a professional one builds ones reputation based on what you deliver in your practice. Accord-ingly, a well deserving architect is sought out by institutional clients to design their buildings as iconic. Therefore it is first my endeavour to create good architecture and further projects can follow later based on one’s performance and beliefs.

INTERVIEW

nov – Dec 2012 49

Ref Number: 6627669 Tender Number: 2012_RMSCL_2954_1 Tender Prod. No: 2012_RMSCL_2954_1 Buyer/Seller: Rajasthan Medical Services Corporation Limited Requirement: Supply of furniture & hospitals other supplies section-j (hospital furniture and hospitals other supplies) for the rate contract period 2012-2014.Location: Jaipur - Rajasthan - India Document Fees: INR2,000 EMD: INR100,000 Estimated Cost: INR200,000,000 Closing Date: 9/11/2012 at 13:00 Hrs. Contact Details: MD, RMSC RMSC, D Block, Swasthya Bhawan Tilak Marg, C-Scheme, Jaipur, Rajasthan, India Document Sale To: 8-11-2012 at 18:00 Hrs

Ref Number: 6627654 Tender Number: 2012_RMSCL_2952_1 Tender Prod. No: 2012_RMSCL_2952_1 Buyer/Seller: Rajasthan Medical Services Corporation Limited Requirement: Providing of Hospital Furniture & Hospitals Other Supplies for The Rate Contract Period 2012-2014Location: Jaipur - Rajasthan - India Document Fees: INR2,000 EMD: INR100,000 Estimated Cost: INR80,000,000 Closing Date: 9/11/2012 at 13:00 Hrs. Contact Details: Md, Rmsc Rmsc, D Block, Swasthya Bhawan, Tilak Marg, C-Scheme Jaipur, Rajasthan, India Document Sale To: 8-11-2012 at 18:00 Hrs

Ref Number: 6627635 Tender Number: 2012_RMSCL_2951_1 Tender Prod. No: 2012_RMSCL_2951_1 Buyer/Seller: Rajasthan Medical Services Corporation Limited Requirement: Supply of furniture & hospitals other supplies section-J (hospital furniture & hospitals other supplies) for the rate contract period 2012-2014.Location: Jaipur - Rajasthan - India Document Fees: INR2,000 EMD: INR100,000 Estimated Cost: INR70,000,000 Closing Date: 9/11/2012 at 13:00 Hrs. Contact Details: MD, RMSC, RMSC, D Block, Swasthya Bhawan Tilak Marg, C-Scheme, Jaipur, Rajasthan - India Document Sale To: 8-11-2012 at 18:00 Hrs

HOSPITAL FuRNITuRE TENDERS

nov – Dec 2012

TENDER

50

Ref Number: 6617199 Tender Number: 2012_RMSCL_2931_1 Tender Prod. No: 2012_RMSCL_2931_1 Buyer/Seller: Rajasthan Medical Services Corporation Limited Requirement: Supply of hospital furniture & hospitals other supplies for the rate contract period 2012-14 - Section JLocation: Jaipur - Rajasthan - India Document Fees: INR2,000 EMD: INR100,000 Estimated Cost: INR50,000,000 Closing Date: 9/11/2012 at 13:00 Hrs. Contact Details: MD, RMSC RMSC, D-Block, Swasthya Bhawan C-Scheme, Jaipur – 302005 Rajasthan - India Document Sale To: 8-11-2012 at 18:00 Hrs

Ref Number: 6630422 Buyer/Seller: Metal Handicrafts Service Centre Requirement: Supply, Delivery, Erection, Testing & Commissioning Of ICP-MS. Supply, Delivery, Erection, Testing & Commissioning Of FTIR. Supply, Delivery, Erection, Testing & Commissioning Of Fume HoodLocation: Moradabad - Uttar Pradesh - India Document Fees: Rs.2,500 EMD: Rs.300,000 Estimated Cost: Rs.11,000,000 Closing Date: 31/10/2012 at 15:00 Hrs. Contact Details: Metal Handicrafts Service Centre Peetal Nagri, Rampur Road Moradabad, Gujarat - India Tel # +91-0591-2460131 Fax # +91-0591-2460131 Document Sale To: 29-10-2012

Ref Number: 6559430 Tender Number: PUB-002/12-13 Buyer/Seller: Tata Institute Of Fundamental Research Requirement: Supply, installation & commissioning of laboratory furniture. 2.Supply, installation, erection & commissioning of office furniture. 3.Design (architectural & structural), supply, installation & construction of aluminum partition along with doors. 4.Supply, installation & commissioning of laboratory equipment like fume hood, exhaust blowers & chemical cabinetsLocation: Mumbai - Maharashtra - India Document Fees: Rs.500 EMD: Rs.120,000 Estimated Cost: Rs.6,000,000 Closing Date: 5/11/2012 at 00:00 Hrs. Contact Details: Tata Institute Of Fundamental Research Homi Bhabha Road, Mumbai, Maharashtra - India 400005 Tel # 91-22-2278 2890/2588/2510 Fax # 91-22-2280 4566

TENDER

nov – Dec 2012 51

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54 Nov – Dec 2012

Hospital Build Infrastruc-ture India 2012, the only dedicated B2B trade show

for the Hospital Infrastructure & Healthcare sector is receiving an overwhelming response from the industry for their 3rd edition, which is scheduled for 14th- 16th December 2012 at the Bombay Exhibition Centre.

Godrej Interiors, Allarch Healthcare, Tata Motors, Por-talp International, Draeger India, Tahpi, Alvo, Modular Concepts, Responsive Inds, Hospaccx India systems, Medica Synergie, Zebra Technologies, Bioni Paints India, Sio Vasundhara, CR Medisystems, RR-Eubiq are few of the leading participants who will stamp their presence at this 03 day awe-in-spiring platform.

Going by the response and sup-port the platform is receiving, it is indeed evident that HBII 2012 will again captivate the industry’s attention and offer everyone in the hospital supply chain an un-matched opportunity to network,

upgrade knowledge, source, sell, share ideas and technology and partner, all under one roof. The event promises to showcase the best range of latest trends and tech-nologies in the Healthcare sector.

Participants speak on their offerings at HBII 2012

“Looking into the huge demand for Quality HealthCare Services in the coming years in India and so the need to have World Class Healthcare Infrastructure to sup-port the industry, Godrej Interio has launched new series of Health-care Furniture in recent times. Our Healthcare Furniture range is indigenously designed to match Global Safety Standards and offer distinct competitive advantages to patients, healthcare providers and all other stake holders alike.

Our presence at 3rd Interna-tional Hospital Build & Infrastruc-ture India 2012 will provide an ideal platform to show case our offerings in the most appropriate ambience” - godrej Interio, Gold

Partners at HBII 2012. “Allarch offers solution from Architecture Designs to Medical Grade Mobile Computing under one roof with understanding of Evidence Based Healthcare. Allarch Healthcare Technologies is committed to deliver innovative and enabling technologies to healthcare provider for translating vision of Safer, Op-timized and Healing Environment into Practice. Allarch believes that Hospital Build & Infrastructure India 2012 is the right platform to share vision of complement-ing solutions and introduce more “care” in healthcare” - Allarch Healthcare Technologies, Silver Partners at HBII 2012.

“Tata Motors recognizes the fact that the healthcare industry in India is slated for a paradigm shift in years to come. With increased awareness and better access to healthcare coupled with increas-ing congestion in the cities, the demand for advance life support ambulances has to increase. In order to meet the future needs, Tata Motors has developed a wide

The 3rd International Hospital Build & Infrastructureindia joins hands with leading healthcare companies as their sponsors…

SHOWPRE EVENT

Nov – Dec 2012 55

range of ambulances. We are ex-cited for this opportunity at 3rd International Hospital Build & Infrastructure India 2012 to show-case how Tata Motors is providing a complete transport solution to the Healthcare industry” – Tata Motors, Supporting Partner at HBII 2012. Knauf is one of the world’s leading productions and construction material compa-ny with over 220 facilities and 22,000 employees present in over 60 countries. Knauf recognizes that each part of a new hospital holds unique challenges, such as mixtures of acoustic, fire ratings and impact performances. It has solutions for special requirements, such as X- Ray protection (new technologies), interior and exterior design, and Access Panels options for operation Theaters.

“Looking at the growth in the healthcare sector and their re-quirements Knauf is excited to be a part of Hospital Build India 2012” - Mr. Amer Bin Ahmed, Managing Director Knauf Mid-dle East, Registration Partner at HBII 2012

“Sio Vassundhara International along with Portalp International will launch a range of automatic doors, security devices & builder’s hardware for the Health Industry , with their state of art set up, bring-ing together world class products with the latest technologies for security and safety, thus ensuring true value on investment.

We cater to the Hospital In-frastructure sector in a big way

and we look at Hospital Build & Infrastructure India as the best platform to meet our clients from the Health Sector” – Sio Portalp, Bag Sponsor at HBII 2012.

“Eubiq India recognizes the fact that healthcare industry in India is going to touch the sky in recent coming years. With increased awareness and better facilities Eubiq India is going to stand in the next line of advance-ment of Indian healthcare industry. Eubiq Singapore is the inventor and manufacturer of GSS System - The World’s Most Flexible Pow-er Outlet System. GSS System is the infrastructure platform of the future - all your Power, Data and Communication (Audio, Video and Telephone) needs can be neatly integrated onto a single track.

We are enthusiastic and excited for this wonderful opportunity at 3rd International Hospital Build & Infrastructure India 2012 to showcase how Eubiq India is pro-viding all the power, data & gas management solutions” - Eubiq India Pvt. ltd, Lanyard Sponsor at HBII 2012.

Archetype Group, a leading multi-disciplinary construction consultancy in Asia, and AIA As-socies, a French-based firm spe-cialized in the development of high quality and technical healthcare facilities, will showcase our com-bined skills and competencies at Hospital Build & Infrastructure India 2012. Founded in 1971, and with nearly 600 employees working out of several agencies in France

and China, AIA Associés is one of Europe’s foremost healthcare design firms, offering a full range of combined expertise and out-standing services in architecture, engineering, urban planning and sustainable development.

As the ideal partner to AIA’s activities, Archetype Group brings extensive experience in fast-grow-ing markets in the Asian region, with a particular focus on Project Management expertise gained over several years in India. Together, we aim to bring our recognized leadership in design and project management to the rapidly devel-oping healthcare sector in India. We look forward to learning more about India’s great potential and specific needs and to meet with key leaders in this industry at Hos-pital Build & Infrastructure India 2012. – American Institute of Architects & Archetype group, Exhibitor at HBII 2012. “Bioni India will introduce a modern coat of paint that can do a lot more than simply look good.Bioni India, in collaboration with Bioni Germany & Fraunhofer Institute will launch paints & Coatings based on Silver Nanotechnology that creates new & eco-friendly painting solutions for building interiors and exteriors.

HBII has undertaken a magnif-icent job by acquainting hospital facilitators and hospital expeditors under one roof and thus creat-ing a smaller world and helping the hospital industry grow in a healthier, efficient & resourceful way” – Bioni Paints, Germany- Exhibitor at HBII 2012.

SHOWPRE EVENT

56 nov – Dec 2012

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