Vol 7

No 5

MO

DER

N M

ED

ICA

RE

Ap

ril 2

011

Editorial

4 I April 2011

A fi rst glance may be deceptive, and the Union Budget 2011-12 proves the adage. It may seem to be a ‘no bold moves’ or ‘no big surprises’ Budget, but the government’s objectives are clearly highlighted with

priorities on controlling infl ation, achieving fi scal consolidation and maintaining growth.

Some positives of this Budget on the macro level include higher allocation on infrastructure, no change in excise duty, promoting research, increasing local manufacturing and aiding inclusive growth while targeting 25 per cent Gross Domestic Product (GDP) contribution from manufacturing by 2020. Further, commitment on raising governance standards and making Goods & Service Tax (GST) a reality gives hope.

The Budget has proved healthy for the healthcare sector with an increase in allocation by 20 per cent to ` 26,700 crore. However, looking at the vast unmet needs as well as international practices, the government’s spending on healthcare as a percentage of our GDP still remains minuscule. Though the rollback of intially proposed levy of 5 per cent service tax has brought some relief, a lot was desired in terms of providing affordable and accessible healthcare services in the country.

Other sectoral positives are the rationalisation of customs duty to reduce its impact on certain medical equipment and the ` 500 crore outlay towards the National Skill Development

Council. The latter, in particular, has strategic signifi cance to enhance the much sought-after skilled manpower in the healthcare space.

On the fl ip side, the introduction of Minimum Alternate Tax (MAT) on Special Economic Zones (SEZs) and the phasing out of Export-oriented Units (EoUs) will impact the growth of pharma and medical devices units located there. Also, the increase in MAT from 18 to 18.5 per cent of book profi ts will affect the corporate houses, especially those in the healthcare sector, which do not have profi t after tax.

Besides, some of the expectations that remained unaddressed in this Budget include ease in availability of cheaper fi nance for setting up new hospitals, according infrastructure status to healthcare, bringing in land reforms to provide adequate land for setting up new hospitals, etc. For some experts’ perspectives on Budget 2011-12, turn to the ‘Roundtable’.

Keen to decipher the current scenario of health insurance in India and the recent trends in ophthalmic treatments? Take a look at the ‘Sector Watch’ and ‘Specialty Scope’, respectively.

Manas R BastiaEditormanas@infomedia18.in

A balanced Budget?

Printed by Mohan Gajria and published by Lakshmi Narasimhan on behalf of Infomedia 18 Limited and printed at Infomedia 18 Ltd, Plot no.3, Sector 7, off Sion-Panvel Road, Nerul, Navi Mumbai 400 706, and published at Infomedia 18 Ltd, Ruby House, ‘A’ Wing, J K Sawant Marg, Dadar (W), Mumbai 400 028.

Views and opinions expressed in this publication are not necessarily those of Infomedia 18 Limited. Infomedia 18 Limited reserves the right to use the information published herein in any manner whatsoever. While every effort has been made to ensure accuracy of the information published in this edition, neither Infomedia 18 Ltd and its employees nor its information vendors accept any responsibility for any errors or omission. Further, Infomedia 18 Ltd and its information vendors do not take any responsibility for loss or damage incurred or suffered by any subscriber of this magazine as a result of his/her accepting any invitation/offer published in this edition. No part of this publication may be reproduced in any form without the written permission of the publisher. All rights reserved.

Published by

Editor Manas R Bastia

Editorial Advisor Dr Yash Paul Bhatia, MD-Astron Hospital & Health Consultants Pvt. (India) Ltd. and Member, Editorial Advisory Board, Joint Commission Journal of Quality and Patient Safety, USA

Features Editor Arshia Khan

Sr Features Writer Dr Asma Mohd. Yousuf

Features Writer Chandreyee Bhaumik, Meghna Mukherjee

Correspondent Anwesh Koley (Delhi)

Copy Desk Parita Dholakia

Products Desk Abha Mishra

Assistant Art Director Varuna Naik

Chief Photographer Mexy Xavier

Photographer Neha Mithbawkar, Joshua Navalkar

Sr Designer Sachin Bhogate

Production Pravin Koyande, Dnyaneshwar Goythale, Vikas Bobhate, Ravikumar Potdar, Ravi Salian, Sanjay Shelar, Lovey Fernandes, Pukha Dhawan, Varsha Nawathe, Abhay Borkar, Akshata Rane

Marketing & Branding Jagruti Shah, Ganesh Mahale

CEO-Publishing Sandeep Khosla

Associate Vice President Sudhanva Jategaonkar

Circulation/Subscription Sunil Nair, Distribution Head, Email: sunil.nair@network18online.com; customercare@infomedia18.in

Editorial & Head Offi ceInfomedia 18 Ltd, Special Interest Publications Division, ‘A’ Wing, Ruby House, J K Sawant Marg, Dadar (W), Mumbai 400 028 • Tel: 91-22-3003 4671, Fax: 91-22-3003 4499 Email: mmedit@infomedia18.in

Business Offi ces

Ahmedabad (Shashin)Tel: 079-39826432 Fax: 079-39826464Email: sipdahmedabad@infomedia18.in

Bangalore (Mahadev B)Tel: 080-30010900 Fax: 080-30010999Email: sipd.bang@infomedia18.in

Chennai (Hari)Tel: 044-39864200 Fax: 044-39864250Email: sipd.chennai@infomedia18.in

Cochin (Robin)Tel: 0484-4054380/390 Fax: 0484-4054370Email: kochi@infomedia18.in

Coimbatore (Prakash)Tel: 0422-3092600 Fax: 0422-3092666 Email: coimbatore@infomedia18.in

Hyderabad (Kalyan)Tel: 040-30647600 Fax: 040-30647676Email: sipd.hyderabad@infomedia18.in

Indore (Ameya)Tel: 0731-3074876 Fax: 0731-3074882Email: sipd.indore@infomedia18.in

Jaipur (Durgesh)Tel: 0141-3007414; 3007411 Fax: 0141-2213728Email: sipd.rajasthan@infomedia18.in

Kolkata (Deb Ranjan)Tel: 033 2265 8637/8638 Fax: 033 2265 2964Email: sipd.kol@infomedia18.in

Ludhiana (Jasmeet)Tel: 3026198, 3026199, 3026200, 3026201 Fax: 3026198Email: ludhiana@infomedia18.in

Mumbai (Rahul)Tel: 022-30034640 Fax: 91-22-3003 4499Email: spmktg@infomedia18.in

New Delhi (Surendra/Mukesh)Tel: +91 11 66303278 Fax: +91 11 23327884 Email: sipd.delhi@infomedia18.in

Pune (Rohit)Tel: 020-33223309 Fax: (020) 33223322Email: sipd.pune@infomedia18.in

Surat (Sunil)Tel: 0261-2630181 Fax: 0261-2630974Email: surat@infomedia18.in

Vadodara (Samarth)Tel: 0265-3926500/01 Fax: 0265-2356013Email: vadodara@infomedia18.in

Monthly Issue Price: ` 100

Contents

6 I April 2011

4 Editorial8 National News

14 World News

30 Hospital Monitor Beams Hospital, Mumbai: Conceptualising boutique care

46 In Dialogue Rakesh Joshi Business Development Manager – Medical Business,

Texas Instruments India

48 Personalised Healthcare Differentiated medicare: Say no to ‘one size fi ts all’

Dr Bhuwnesh Agrawal, Chairman & Managing Director,

Roche Diagnostics India

58 Facility Visit Metropolis Healthcare Ltd: Benchmarking against the best

63 Events Calendar

Report

65 CII’s conference on Public Private Partnership Policy Framework: Way forward for delivering quality healthcare

66 MEDICAL FAIR INDIA 2011: A showcase of talent and technology

67 Product Update 74 Rx 80 Product Index84 Advertisers’ List

Note: ` stands for Indian rupee, $ stands for US dollar and £ stands for UK pound, unless mentioned otherwise

Highlights of Next EditionSector Watch: IT in healthcare

Specialty Scope: Dentistry

Sector WatchHealth insurance in India: Need for a wider coverage

Experts Speak Dr A Velumani CEO, Thyrocare Technologies Ltd

REGULAR SECTIONS

20

Specialty ScopeTrends in ophthalmic treatments: An eye for the future

42

36

RoundtableBudget reforms:

Hit or miss?

24

Marketing MantraAchieving patient satisfaction:

It’s time to think out of the box!Vivek Shukla, Principal – Healthcare Business Consulting,

Vivek Shukla and Associates

56

IT @ HealthcareClinical decision support systems:

Promoting evidence-based medicine Dr Aloke C Mullick, Director & CEO,

Seed Healthcare Solutions Pvt Ltd

52

National News

In Brief

8 I April 2011

IFC, Gates Foundation work with Bihar Government to improve health payments systemInternational Finance Corporation (IFC), a member of the World Bank Group, and the Bill and Melinda Gates Foundation are working with the Government of Bihar to fi nd avenues to make government payments to health workers and health benefi ciaries more effi cient, transparent and timely.

Government offi cials, health practitioners, banks and service providers discussed the fi ndings of a state-wide study of the payment processes associated with state health programmes. The study recommends that health records be maintained in a centralised system called the Health Operations Payment Engine (HOPE). Such a system would provide a variety of benefi ts—not only to health workers and benefi ciaries but also to the state.

The HOPE system would also provide an integrated platform that would allow payment service providers and banks to credit incentive payments directly into the accounts of benefi ciaries, health workers and private healthcare providers.

“Effi cient, transparent and accountable payment mechanisms are needed to enforce programme guidelines, specifi cally ones relating to phased payments for benefi ciaries,” said P K Pradhan, Special Secretary and Mission Director, National Rural Health Mission. “IFC’s proposed solution, HOPE, should be taken beyond Bihar to other Indian states.”

Jennifer Isern, Head, Financial Sector Advisory, South Asia, IFC said, “With this proposed solution that will ensure timely, accurate payments, IFC hopes to bring much-needed health support closer to those who need it most. Our diagnostic in Bihar identifi ed key opportunities to improve health payments that could be expanded across India.”

GE Healthcare completes acquisition of Orbotech Medical Solutions

GE Healthcare, a unit of General Electric Company, has announced that it has completed the acquisition of the assets of Orbotech Medical Solutions Ltd (OMS), a subsidiary of Orbotech Ltd (Orbotech), and a manufacturer of Cadmium Zinc Telluride (CZT) detectors used in GE Healthcare’s innovative Alcyone nuclear

medicine technology. “Through the acquisition of OMS we have passed an important

milestone in the growth of GE Healthcare’s Nuclear Medicine business. Our ability to manufacture CZT, a key component of GE Healthcare’s Alcyone technology, will help clinicians around the world provide patients with faster and more comfortable examinations at lower dose while maintaining the image quality. We have entered a new frontier of possibilities in nuclear medicine as we use CZT technology not only in cardiac exams, but apply it to other critical areas such the early detection of breast cancer,” said Nathan Hermony, General Manager, Nuclear Medicine, GE Healthcare.

GE Healthcare recently announced Food and Drug Administration (FDA) clearance of the use of CZT technology in assessment and early detection of breast cancer in women who are at high risk for the disease.

Abbott’s toolkit to identify fussy eating habits among children Abbott recently announced the launch of ‘IMFeD™’ (Identifi cation and Management of Feeding Diffi culties) in India, a new, easy-to-use diagnostic tool to help doctors accurately identify and manage children with feeding diffi culties. Some studies show as many as 80 per cent of parents report some kind of feeding diffi culty in their children. The IMFeD tool addresses this often overlooked condition in young children by applying proven approaches for doctors to properly diagnose children ages two and older. IMFeD has been effectively used in eleven other countries. Until recently, no diagnosis framework was available to help doctors assess and treat their paediatric patients with feeding problems.

In India, an observational study is currently being conducted to determine the perceived effectiveness of the IMFeD tool. “The interim data collected helped us classify children into different feeding diffi culties and suggests the IMFeD tool will help us effectively manage the conditions,” said Dr Mukesh Sanklecha, Consultant Paediatrician, Bombay Hospital and one of the investigators of the study.

Manipal Cure and Care launches its third clinic in BengaluruManipal Cure and Care (MCC) Clinic, a part of Manipal Health Enterprises (MHE), has launched its third multispecialty polyclinic in Bengaluru. The clinic offers a range of world-class healthcare curative, preventive, wellness & aesthetic services, all under one roof. This polyclinic in Banashankari II stage (BSK) is amongst the premium healthcare destinations along with the existing MCC Clinics in Koramangala and J P Nagar. Announcing this initiative, Rajen Padukone, CEO, Manipal Health Enterprises, stated, “MHE is optimistic that these clinics will accelerate its market penetration and reach. This will result in decreased hospital visits for minor ailments.”

Speaking on the occasion, Raman Bhaskar, Head, MCC, said, “It is a convenient solution for patients who need not travel to hospitals for basic and routine medical procedures. Our clinics are also seamlessly integrated with our secondary and tertiary care hospitals.”

National News

In Brief

10 I April 2011

Fortis collaborates with TotipotentRX to set up stem cell therapy centresFortis Healthcare (India) Ltd and TotipotentRX Cell Therapy Pvt Ltd, a leading provider of cutting-edge technologies in the stem cell and regenerative medicine market, announced a collaboration to set up centres of excellence offering cellular therapies and stem cell clinical trials, across select Fortis Hospitals. These centres will undertake stem cell clinical research procedures relating to diabetes, cancer, cardiovascular disease and neurological ischemia. TotipotentRX will also set up state-of-the-art cGMP laboratories in select hospitals. As part of the alliance, a Stem Cell Medical Board will be created to oversee the medical research programme, ensure execution and monitor the progress following International and Indian ethical guidelines. Speaking about the partnership, Shivinder Mohan Singh, Managing Director, Fortis Healthcare (India) Ltd, said, “This tie-up is in continuation with our effort to bring the latest in medicine to our customers, in a caring environment and at affordable prices. ”

Kenneth Harris, CEO, TotipotentRX (MK Alliance Inc), added, “This collaboration allows us to carry out advanced clinical research, aimed at addressing quality of life improvements for several healthcare challenges in India.”

Nova Medical Centers forays into MumbaiNova Medical Centers, (NMC) India’s leading stand alone Day Surgery Centre Group, has forayed into Mumbai by launching its fi rst day surgery center in Chembur. The Chembur centre would be Nova’s fi fth center in the country.

Thirty leading surgeons from diverse specialties will offer their services in a

comprehensive ultra-modern facility. This latest addition from Nova is equipped with state-of- the- art facilities. Built over 13,000 sq ft, the new center has 4 ultra-modern operating rooms, 16 beds with 3 deluxe rooms, 7 OPD consulting rooms including separate ENT and ophthalmology chambers, comprehensive pathology and radiology services, a retail pharmacy and a health check up unit.

“The Center is the ideal environment for both doctors and patients,” explained Dr Mahesh Reddy, Co-Founder and Executive Director, NMC. “Everything top doctors need is readily available in an upscale, collegial setting, and all our patients go home at night to rest,” he added.

Suresh Soni, Chairman and CEO, NMC described the company’s roll-out strategy, “We plan to be in 10 cities by the end of this year. We provide physicians everything they need to get started and succeed. We know how to control costs while maintaining superior quality and effi ciency, and we continuously work to improve each center’s performance. We empower doctor-entrepreneurs to start their own practices, and offer shared support services that deliver economies of scale to each center in our network.”

Nova has aggressive plans to expand in the Mumbai market. Next in line is the Tardeo clinic which would be coming up soon in the historic Famous Cine Labs complex and other centers would be spread across Mumbai in the coming months.

Ovarian cyst weighing 15 kilos removed In a path breaking surgery, a tumour (ovarian cyst) weighing about 15 kilos from a 71-year-old woman was successfully removed.

Dr Kishore C Kumtakar, Consultant, OBG, Malathi Manipal Hospital, who performed the surgery said “Preliminary investigations revealed that a huge mass (cyst) in her ovaries. The tumour would have been dangerous to the patient if left untreated. Hence, the patient had to be operated immediately to remove the huge ovarian mass.”

Informing about this case, Dr Kumtakar adds, “A complex ovarian cyst can cause serious health issues. Often these types of cysts keep growing and become too large, and they have both liquid and solid components within them. Hence, it is important to have routine check-ups, ultrasound and Pap smear for women after 40 years of age.”

WHO brings together partners for health in South-East AsiaGhulam Nabi Azad, Minister of Health & Family Welfare, India, recently inaugurated the conference of ‘Partners for Health in South-East Asia’ organised by the World Health Organization (WHO). Ministers from 11 member states along with high-level representatives from donor countries attended this conference.

The conference was aimed at strengthening collaboration for health and encouraging effective and sustainable partnerships. WHO and partners will now deliberate on priority health issues in the WHO South-East Asia Region. The UN Millennium Development Goals, non-communicable diseases and universal access to health services were some of the issues discussed at the conference.

A huge disadvantage for South-East Asia is the staggering and disproportionately high proportion (40 per cent) of the world’s disease burden with about a quarter of the world’s population. Speaking on the issue of social inequalities, Dr Samlee Plianbangchang, WHO Regional Director for South-East Asia, said, “Perhaps the starkest statistic in public health is the difference in maternal and child mortality in rich countries compared with that of less developed countries.”

National News

In Brief

12 I April 2011

Fortune Magazine’s Global 500 list ranks 3M as the most admired company 3M, the company with a 100-year-old innovation legacy, has proved its strength again with Fortune Magazine ranking it as the Most Admired company in the medical & other precision equipment industry. The ranking is based on the top Global 500 list of Most Admired and Innovative companies, released by the magazine this year.

3M has been the global leader offering innovative products and solutions for medical, oral care, health information management, drug delivery and food safety. The company’s medical specialties employs a wide range of 3M technologies to meet the worldwide needs of the medical device, bioanalytical, diagnostic, cosmetic and consumer health care business-to-business markets. 3M is also the leading global supplier of single-use medical supplies. With expertise in infection prevention and skin and wound care, 3M provides medical products, services and solutions for professionals in hospitals and community settings.

In India, 3M Healthcare is an active player in the Operation Theatre (OT) and Intensive Care Unit (ICU) consumables and is largely into infection prevention, skin and woundcare, dental and orthodontics and food safety.

Fortis in a PPP with the Government of Uttarakhand Fortis Healthcare Ltd has recently announced its plans to set up a Cardiac Centre at Deen Dayal Upadhyaya (Coronation) Hospital at Dehradun under a Public Private Partnership (PPP) with the Government of Uttarakhand. The state-of-the-art facility would be the fi rst comprehensive cardiac care facility in Dehradun. The move is in line with Fortis’ strategy of penetrating into India’s tier II cities to provide high levels of clinical quality and compassionate patient care.

The facility is expected to become operational by November 2011. Further, Dr Asha Mathur, Director General, Health Services, Government of Uttarakhand, added, “We are pleased to join hands with Fortis Healthcare. With this partnership, we are confi dent that the people of Dehradun will benefi t immensely and the high quality services from Fortis will help save precious lives and improve the healthcare eco-system in the city.”

Global Hospitals ready to perform nearly 100 liver transplantationsGlobal Hospitals Group, with the largest multi organ transplantation centre, recently updated that it has achieved the distinction of becoming the foremost hospital in the world for performing the widest variety of liver transplantations apart from treating all types of liver diseases.

Speaking on the occasion, Dr K Ravindranath, Chairman & Managing Director, Global Hospitals Group, said, “In a country like India, it is estimated that more than a lakh of patients are in serious need of liver transplantation, while less than few hundred are receiving transplantation. By rapidly expanding our footprint across the country, we are keen to reach out to over a billion population of India with our services. We will also reach the other billion plus population in other continents like Africa & Europe.”

Advanced technology for breast cancer treatment now at Hinduja HospitalHinduja Hospital, one of the leaders in healthcare delivery, has introduced a state-of-the-art digital technology for breast cancer treatment. It is the fi rst private hospital in India and the only hospital in the Western Region of India to have introduced the US FDA-approved digital technology with 3D imaging for early detection of the breast cancer. The introduction of this digital technology will help in the screening for breast cancer in women for early signs of cancer.

Announcing the launch of the Digital mammography, Dr Raju Wadhwani, Consultant Radiologist, Hinduja Hospital, said, “Digital Mammography is a very safe procedure that uses low doses of radiation to produce high-quality X-rays to detect breast lesions or abnormalities that are too small or subtle to be felt. The unique features of this technology has made digital technology a reality and invaluable in breast cancer management.”

Minimally invasive procedure saves brain haemorrhage patient at Yashoda A 56-year-old patient from Warangal district was brought to Yashoda Hospital following sudden severe headache and vomiting. Computed Tomography (CT) scan of the brain revealed bleeding inside the brain (sub arachnoid haemorrhage) and a brain angiography, which revealed a large size brain aneurysm on the right side of the internal carotid artery. The patient was referred for an urgent balloon assisted coil embolisation of aneurysm procedure, a unique non-surgical procedure. Dr Randhir Kumar, Yashoda Hospital performed the surgery. In this case, the doctor opted for the endovascular route, which is a less invasive non-surgical treatment of cerebral aneurysm without opening the skull or touching the brain.

“We were successful by using a balloon and seven platinum coils of different sizes the aneurysm was completely obliterated. The procedure took 2 hours and the patient was safely shifted to another ward on the second day and was discharged on the third day. The patient is able to perform her routine chores without diffi culty,” commented Dr Kumar.

World News

In Brief

14 I April 2011

Rising patient numbers and novel products set to drive the Chinese anti-diabetics marketDriven by the growing diabetic population and the improved healthcare insurance coverage implemented as part of the country’s 2009 healthcare reform, the value of the overall diabetes drugs market in China will triple from $0.7 billion in 2009 to $2.1 billion by 2019, according to a new report from independent market analyst, Datamonitor.

One of the key drivers for anti-diabetic drug sales in China is the country’s large diabetic population. According to the 2010 Chinese National Diabetes and Metabolic Disorders Study, the prevalence rate of diabetes in China has reached 9.7 per cent, making China the country with the largest diabetic population in the world.

Yifu Liu, a Datamonitor healthcare analyst and author of the report, said, “A number of interlinked factors, including the aging population, urbanisation, dietary changes and decreasing levels of physical activity, will contribute to making this already large population grow further.”

Incubators by IKS give maximum security with minimum gas usage The IVS-9000GC & IVS-9160GC triple gas incubators from IKS have been praised by IVF users not only for their performance but also for their very low CO2 and N2 consumption. IKS International is a highly skilled and experienced organisation based in Rosmalen, near Hertogenbosch in the Netherlands. IKS supplies a comprehensive range of advanced products and services to clinical, biotechnology, pharma and microbiology laboratories worldwide.

Due to the novel design of these incubators, the minimum quantity of nitrogen – less than 10 litres - is required to restore the internal environment when the door is opened. CO2 usage is minimised as well. Recovery to a stable condition takes less than fi ve minutes, reducing the impact on sensitive samples.

AirStrip, GE Healthcare collaborate on cardiology technology AirStrip and GE Healthcare have recently announced a collaboration on cardiology technology. The collaboration between AirStrip Technologies and GE Healthcare aims to benefi t the physicians. The physicians will now be able to have access to real-time electrocardiograph data on their heart patients via their iPhone and iPads. GE Healthcare manufactures and develops medical imaging, medical diagnostic and patient monitoring systems. AirStrip is a mobile medical-software application developer.

Through this partnership, cardiologists are hopeful that they will be able to access data from the GE Healthcare MUSE Cardiology Information System on their smartphones using San Antonio-based Airstrip’s Airstrip Cardiology software. Further, hospitals will be able to purchase the AirStrip programme via GE Healthcare.

The goal of the alliance is to give cardiologists the ability to access patient data even when they are working off-site.

Democratic Republic of Congo (DRC) introduces a life-saving vaccine Pneumonia is one of the biggest killers of children worldwide and is responsible for a quarter of all child deaths under fi ve years of age in the DRC. To bring about a change in this incidence, DRC stepped up its immunisation process by including vaccines to combat pneumonia.

As per the programme, the vaccine will fi rst be introduced in two of the 11 provinces. The country’s First Lady Olive Lembe Kabila and Minister of Health Victor Makwenge Kaput are joining parents and health workers in Kinshasa to witness the fi rst child being immunised as a part of the offi cial introduction of pneumococcal vaccine into the national immunisation programme.“The introduction of the pneumococcal vaccine and the systematic immunisation could save the life of many children dying from acute respiratory infectious diseases in this country,” said Dr Léodégal Bazira, acting WHO Representative in DRC.

Boston Scientific launches Stent Systems in IndiaBoston Scientifi c Corporation recently declared its launch of the PROMUS® Element™ Everolimus-Eluting Coronary Stent System and TAXUS® Element™ Paclitaxel-Eluting Coronary Stent System in India. Both Element Systems incorporate the same novel platinum chromium (PtCr) alloy, innovative stent design and advanced catheter delivery system, and represent the Company’s third-generation drug-eluting stent technology.

“The new platinum chromium alloy and stent design of the PtCr Element Stent series represent signifi cant innovations in DES technology,” said Ashok Seth, MD, Fortis Escort Heart Institute, New Delhi. “The PROMUS and TAXUS Element Stent Systems give physicians in India a choice of two proven drug and polymer combinations – used in millions of patients worldwide – on an entirely new platform,” said Hank Kucheman, Executive Vice President and Group President, Cardiology, Rhythm and Vascular, Boston Scientifi c.

World News

In Brief

16 I April 2011

Integration of Maquet’s operation room (OR) table with Siemens angiography systemsMaquet, a publicly-listed Swedish Getinge Group company with around

2.3 billion n revenues (2010 fi scal year), recently announced that Siemens Healthcare will integrate Maquet’s operating table ‘Magnus’ in its ‘Artis zeego’ and ‘Artis zee’ ceiling interventional systems. With this integration, we will observe customer benefi tting the most with the multidisciplinary use of the hybrid OR – which means it will be usable both for angiographic imaging and for open procedures where extremely fl exible patient positioning may be required.

The Magnus OR table system is fi tted with exchangeable table tops – a fully radiolucent carbon top as well as a highly fl exible, segmented table top. The latter allows surgeons the most appropriate positioning of the patient for a wide variety of surgical procedures, including complicated positions, which are particularly occurring in orthopaedics and neurosurgery. Siemen’s Artis zeego is the only robotic C-arm-system on the market, which can adapt to the complete height adjustment of the table for standing or sitting working positions of the surgeon. The integrated solution, which is equipped with an additional fl oating carbon table top, offers full cathlab functionality especially useful for cardiac and vascular interventions. The table top would also provide 360° radiotranslucency, thereby giving optimum X-ray images.

New endovascular therapeutic hypothermia system launched by Philips

Philips recently announced the launch of the InnerCool RTx Endovascular System for

cooling as well as warming, and the system provides advanced whole body temperature modulation therapy in a closed-loop system from the inside out. It is a high-performance system, which can rapidly raise and lower the body temperature of certain non-paralysed, awake patients of all sizes in the intensive care setting.

This system cools and warms patients with its unique integrated temperature sensor catheter that is placed below the heart through the femoral vein. Once in place, the closed-loop system modulates whole body temperature without fl uid introduction or exchange by circulating cool or warm saline. This system also includes a programmable console with an intuitive touch screen interface. It also allows for cooling of awake patients, which helps to avoid the risks inherent with paralytic agents such as masking seizures or inadequate levels of sedation.

In addition to the new InnerCool RTx Endovascular System, Philips also offers the InnerCool STx Surface Pad System for cooling and warming, which provides a cost-effective and easy-to-use solution with an advanced design for non-invasive temperature modulation therapy.

“The Philips InnerCool RTx Endovascular System brings signifi cant advancements in temperature modulation therapy and makes this technology even easier to use,” said Mike Miller, Senior Vice President and General Manager, Cardiac Care, Philips Healthcare.

GE Healthcare names Jan De Witte as President and CEO of Healthcare ITGE Healthcare declared steps to more effectively bring its world-class technology and domain expertise to bear while strengthening its ability to help its customers solve some of the healthcare industry’s toughest problems - lowering costs while improving access to quality patient care.

Jan De Witte, President and CEO of GE Healthcare’s Performance Solutions division, has also been named President and CEO of its Healthcare IT business. De Witte, who reports to John Dineen, President and CEO, GE Healthcare, succeeds Vishal Wanchoo who was recently named Senior Vice President of Growth Initiatives for GE India. Under De Witte’s leadership these two GE Healthcare businesses will use the knowledge the company has gained over the past 100 years serving the healthcare industry to deliver the right technologies to their respective customers.

John Dineen, President and CEO of GE Healthcare said, “Having a single leader like Jan De Witte lead both businesses sends a visible signal to our customers that GE Healthcare is dedicated to growing its IT and solutions offerings, providing them with a unique partner that can deliver the strategic advice they need with outstanding technology.”

Bayer HealthCare selects New Jersey for consolidation planBayer HealthCare has fi nally chosen New Jersey over New York for a consolidation plan of its East Coast business. Though a specifi c location is yet to be selected in this regard, scouts are sizing up locations near existing New Jersey operations.

According to a press release, Bayer HealthCare declared that a site decision will be confi rmed within a few months time.

“We are very excited about the prospect of having a new site and facility that can house East Coast-based Bayer HealthCare employees from every division and function under one roof,” said Mark Trudeau, President and CEO, Bayer HealthCare Pharmaceuticals Inc., Bayer HealthCare LLC USA and chair of the company’s US East Coast site search committee.

World News

In Brief

18 I April 2011

Healthcare organisations collaborate for patient data exchangeFive of the nation’s leading healthcare organisations and pioneering users of e-health records—Kaiser Permanente, Mayo Clinic, Geisinger Health System, Intermountain Health, and Group Health Collaborative—have collaborated in order to create a new consortium through which there would be secured exchange of their patients’ real-time, digitised medical information on-demand, and to serve as a national model for low-cost, data interoperability among clinicians.

The new collaborative called Care Connectivity Consortium was declared recently at a press conference in Washington DC, US, by its fi ve members. “Paper is a horrible way to share information,” said George Halvorson, Chairman and CEO, Kaiser Permanente. “However, as the nation’s healthcare providers move forward with the adoption of e-medical record systems, electronic silos replacing paper silos is not progress. You need connectivity!”

Thus, it is the goal of the consortium to tap the collective experience of data sharing and thereby use national health IT and interoperability standards for creating a replicable, affordable model for timely, secure, on-demand, exchange of patient data with the permission of the patient that can be replicated by others.

Healthcare deduction for public school employees ruled unconstitutional

A Michigan law that requires public school employees to pay 3 per cent of their pay for retiree healthcare has been ruled unconstitutional. James Giddings, retired circuit court judge has recently released this decision.

Giddings commented that the deduction takes money without due process of law. Earlier this year, another Ingham Circuit Court judge had also ruled a similar deduction for state employees unconstitutional. However, the Michigan Court of Appeals said that the state could continue deducting the money, but must put it in escrow. Both cases are likely to go to higher courts.

Children facing obesity menaceAccording to a recent research by the Universities of Bristol, Stirling and Strathclyde, children between the ages of seven and 11 years are at the highest risk of becoming overweight or obese. 19 per cent of the 5,000 children monitored by the universities became overweight or obese between these ages. That is, just 10 per cent put on too much weight between three and seven years, while 7 per cent became overweight or obese between the ages of 11 and 15. Debbie Lawlor, Professor, University of Bristol, suggested that the statistics could be used to determine the best ages to instigate childhood obesity prevention strategies.

Meanwhile, John Reilly, Professor, University of Strathclyde, commented, “This research gives us an important insight into the stages of childhood and adolescence when the environment is most obesity promoting.”

ACO rule: Healthcare industry reacts with cautious enthusiasmThe Centers for Medicare and Medicaid Services recently released its long-awaited proposed rules on Accountable Care Organisations. Donald M Berwick, CMS Administrator, said, “American Cornhole Organization (ACOs) are not just a new way to pay for care but a new model for the organisation and delivery of care.”

The Medical Group Management Association (MGMA), one of the primary lobbies for physician groups, also commented on this. William F Jessee, CEO, MGMA, said, “The formation of ACOs has the potential to greatly improve the coordination of care received by Medicare benefi ciaries, and thus offers the promise of safer, more effi cient and effective care,” Karen Ignani, CEO, America’s Health Insurance Plans, said that ACOs presented an opportunity for Medicare and Medicaid in order to build on the successes of the innovative payment systems that exist in the private marketplace for improving the quality and safety of patient care and help put the health care system on a sustainable path.

HP accelerates the transformation of healthcare HP, one of the largest technology companies, recently declared that a new solution portfolio will aim to deliver fl exibility and effi ciency to health organisations.

This new HP Digital Health solutions are based on HP’s extensive portfolio of products, solutions and partnerships. Again, it also enables health organisations to accelerate change and innovation, advance operational effi ciencies and further orchestrate care across the ecosystem. In short, it helps healthcare organisations become Instant-On Enterprises. Commenting in this regard, Scott Lundstrom, group vice president, IDC Health Insights, said, “HP’s approach is to ‘instant-on healthcare’ should help to address and simplify the transition healthcare organisations will need to achieve this level of effi ciency.”

Sandeep Johri, Vice president, Strategy and Solutions, HP Enterprise Business, “HP’s new end-to-end Digital Health solutions portfolio enables clients to effi ciently coordinate care across the extended healthcare community.”

Experts Speak

20 I April 2011

‘Our defi ciency is that only 1 per cent of the laboratories deliver quality, compared to 50 per cent of the West’

Arshia Khan

The story of Dr A Velumani, Chief Executive Offi cer, Thyrocare Technologies Ltd, has truly been an inspiring tale of determination and dedication. Born in 1958 in Appanaickenpatti Pudur (District - Coimbatore), Tamil Nadu, in a farmer’s family, Dr Velumani completed his BSc Chemistry from Madras University followed by MSc in Biochemistry from Bombay University. After being awarded a PhD for his research on Thyroid, 14 years of teaching and a long career as a Scientifi c Offi cer in Bhabha Atomic Research Centre (BARC) specialising in Radio Immuno Assay (RIA), he was ready to take the fi rst step towards entrepreneurship. He decided to quit his government job at BARC and start his own business.

At that time his only assets were his simplicity - driven by truth, his knowledge and seed capital of ` 1 lakh that he received as his Provident Fund (PF) settlement and a dream – a dream of providing the cheapest thyroid-testing facility in the country, and pass on the benefi ts of low cost to his customers - patients, pathologists, doctors, hospitals and nursing homes. Moreover, his aim was to provide this cost-effective service at uniform rates throughout the length and breadth of India.

Experts Speak

20 I April 2011

...says Dr A Velumani, CEO, Thyrocare Technologies Ltd. He worked as a Scientifi c Offi cer in Bhabha Atomic Research Centre (BARC), Mumbai for more than 12 years. He takes us through the busiest thyroid clinics in the country that he pioneered and talks about the need of the hour in the Indian healthcare industry.

Experts Speak

21April 2011 I

The birth of ThyrocareKeeping this in mind, Thyrocare Technologies Ltd was incepted in 1996, in a 150 sq feet area, with an investment of ` 1 lakh. The only instrument for doing thyroid test was ‘gamma counter,’ which costed ` 50,000. He was lucky to fi nd a pathologist who had the machine but was not using it because of few samples to test (5 samples/day). An agreement to keep the machine was made where Dr Velumani agreed to do free thyroid testing for the pathologist for three years. Says, Dr Velumani, “Like that there were 10 pathologists in the city and I had 10 gamma counters and 500 samples a day.”

Today, Thyrocare stands at a 50,000 sq feet offi ce in Navi Mumbai with a capacity of 50,000 investigations per day and a franchise network of 600 collection centres across the country. He affi rms, “Thyrocare is seen as the world’s largest thyroid testing laboratory, accredited with ISO 9001-2000 certifi cate, and rated by CAP, NABL & CRISIL as Grade ‘A’, consistent with the highest standards in the Indian healthcare industry.” This nationwide networked, bar-coded and bi-directionally interfaced diagnostic laboratory is valued by the investors at around ` 800 crore. Dr Velumani adds, “Thyrocare grew well when growth was not monitored (200 per cent Compound Annual Growth Rate (CAGR)) from 1996 to 2005) and it has come down to 30 to 50 per cent CAGR in this last 5 years. He continues, “We monitor growth on a monthly basis and I am confi dent that it would grow atleast 30 per cent year-over-year for the next 10 years.”

Fulfi lling dreams Dr Velumani started Thryocare with a dream of providing affordable care to people. But he still feels that the dream has not been fulfi lled. As he remarks, “Patients still pay more than what they should. 33 per cent of my services go to an end user at costs that are appreciated. Another 33 per cent reaches them at acceptable costs. However, 34 per cent are overpaying due to the greedy middle men. But may be that is plausible, given the kind of need and greed driving people in the medical industry. Even if I can take 10 per cent from the last category to the fi rst category in next 10 years, I will be very happy.”

In this journey, he has observed and learnt a lot from the people and surroundings. He inherits this entrepreneurial spirit not from a single place or person. As Dr Velumani avers, “In life, few of those who failed educated me on what should not be done. In business too, I have seen many failures and studied why they fail and made sure that I do not do repeat certain mistakes. I am a good entrepreneur too.” He continues, “Resistance to change from all levels like by my mind, body, family, employees, vendors and clients, was a big hurdle to cross. But it was necessary to bring and accept change, and hence I changed quite a lot of things. It was, is and will be the biggest challenge any entrepreneur will face. Other issues like insuffi cient funds, resources, too much of competition – all of them I consider as routine or minor.”

Indian scenarioHighlighting the incidence of thyroid cases in India, Dr Velumani elaborates, the incidence of thyroid in the country as a whole is not consistent, just as the rest of the world. Different regions highlight different incidence ratios. As he remarks, “Even in India, the incidence may not be the same in Ganges belt and Krishna Belt or Kerala.” However, the difference in numbers could also be due to lack of studies conducted throughout the country. He informs, “There has not been any organised study in this last two decades, though Dr Kochu Pillai of AIIMS proved that Ganges belt has endemic goitres more than the rest of the country. Worst of the country or globe will have 2 per cent, while best could have 1 per cent incidence. Further, average incidence in the country and worldwide is around 1.5 per cent. In this, 4 out of 5 are women and worst affected age is between15 and 40 years.”

Diagnosing and improvisingAs far as treatment standards are concerned, thyroid is well standardised globally now for more than 30 years. Nothing much has changed except the knowledge of the disease or disorder, exclaims, Dr Velumani. With regards to diagnostics in general and clinical chemistry in particular, 600 laboratories (out of the 60,000 laboratories) deliver a better laboratory quality than the globally best can deliver since all of them use the best of the global brands for instruments and reagents, and similar quality check programmes. He states, “Our defi ciency, if at all we call

Interesting moments at BARCGreat institute for those who want to grow and go. I did exactly the same. Enough politics if you wish to get into it. I had great and affectionate superiors, loving and caring colleagues and also quality projects in hand. I did my MSc and PhD there. When I entered BARC I was a boy and came out as a matured man in 15 years. Except that it was too big an organisation to care for people who deserve it the best, it is a place where I enjoyed working, learning as well as growing.

What interests you more teaching or research?I have lost respect for the word research since I have observed that often the word is misused – by those who wish to do it or have been doing it or having done it or having failed in it. My research pursuits are not for molecules or gadgets or technologies. But my pursuit lies in improving quality, enhancing speed and reducing the cost of healthcare that can be delivered in diagnostics in general and from a laboratory in particular. I enjoy teaching a lot.

Dr Velumani’s diary

Experts Speak

23April 2011 I

it as defi ciency, is only 1 per cent of the laboratories deliver quality as compared to 50 per cent in the West.”

However, he feels certain things are necessary for the growth and correct progression of the diagnostic industry. Explains Dr Velumani, “Consolidation of industry, education on what is possible and available to end users, an eye for and consciousness about ‘quality’ improvements in deliverables. Improved interaction and communications among various professional bodies and government departments or peers – without barriers of ego is also a must.”

Moving ahead The industry is slowly but certainly becoming organised. Branded laboratories and reputed pathologists get better attention now. Vendors of reagents and instruments are becoming more aggressive with volume players and hence costs are not going up with infl ation (in some cases, they come

down too). Size matters, and major players are adopting an inorganic growth route, but the major problem they face are ‘integration challenges’ due to multicultural nature of member labs. It is certainly encouraging to be in this space in this decade.

As far as predicting the healthcare scaenario, Dr Velumani feels volume, quality, cost and speed will play a role in shaping up the industry and every player has to be disciplined to deliver more than what a customer can dream. The race as such is on now for more than 10 years and it has produced results too. By the year 2015, there would be at least ‘ten companies with a valuation of more than 1000 crore (right now hardly any)’ and ‘50 companies with more than 500 crore (right now 5 labs claim so)’ would lead the space with quality that can attract global business to India.

As per Dr Velumani, factors aiding the development of the industry in the right direction include appropriate demographic shift, good purchasing

power, priorites for wellness, availability of technologies at door steps, cost of services reducing due to innovations in Information Technology (IT) and competition and indeed precipitation by sedentary life styles.

(arshia.khan@infomedia18.in)

Thyrocare received investments from Bennet Coleman (The Times of India) Group for ` 25 crore in 2006

CX Partners have invested ` 188 crore in the company

First laboratory in India to have signed for total laboratory automation

Dr Velumani owns and edits ‘Health Screen’ a monthly magazine focusing on Prepatient care

Has written and printed ‘Wellness Book,’ which provides complete details of preventive care and has already sold more than 1,00,000 copies in just one year.

Did you know this?

Roundtable

24 I April 2011

Union Budget 2011 created a roar in the healthcare industry. It received a lot of criticism and faced many protests. However, with the reversal of service tax, the healthcare sector heaved a sigh of relief. Here are some comments on what this year’s Budget offers to the Indian healthcare sector.

With lot of expectations, the healthcare sector was anxiously waiting to see what effect the Union

Budget 2011 will have on the Indian medical world. And the announcement resulted in many frowns and few smiles. The levy of 5 per cent service tax that the Budget 2011-12 proposed initially on treatment and health check-ups at air-conditioned private hospitals with over 25 beds and diagnostic labs was a major cause of grievance, such that it was very soon labelled as the misery tax. However, the strong disapproval from the medical fraternity resulted in the rolling back of the service tax. This brought a relief; however, there is still anxiety among the industry people regarding many issues that were not considered in this year’s Budget, and it will take yet another year to address the obstacles in the way of affordability and accessibility of healthcare services.

Dr Asma Mohd Yousuf

Budget 2011 is good news for healthcare sector as the 5 per cent service tax or so called misery tax, which was earlier imposed on all healthcare services, has been withdrawn by the Finance Minister.

This year’s Budget is better compared to the last year’s Budget because the agony for

healthcare sector started then as the service tax was levied on all preventive health check-up services.

This year the expectation was government will increase the expenditure on healthcare sector. Our country is the second fastest growing economy

in the world. However, the healthcare expenditure is only 1 per cent of the Gross Domestic Product (GDP), and thus, it does not meet the expectations at all.

For better results, the healthcare sector should be included in the infrastructure sector. There should be an increase in the GDP expenditure in this sector by at least 3 to 5 per cent. Besides, there should also be an increase in the Public Private Partnership (PPP) in the healthcare sector. The number of doctors and nurses should also increase. And the number of beds should double the present number.

Dr Ajay SharmaSenior Consultant Dental Surgeon, Prosthodontist and Oral Implantologist, Max Healthcare, New Delhi

Budget reforms

Hit or miss?

510/

Roundtable

26 I April 2011

Healthcare has gained a lot of importance in the recent years. Our healthcare budgets need to be suited and structured to meet this global demand. Though the allocation of budget to this sector is getting better with every passing year, still more funds could have been allocated this year in order to

meet the heavy demands. The challenges for the future are improvisation of infrastructure, adoption of technology, standardisation of healthcare,

computerisation and bringing accountability and developing human resources.

In addition, the focus must be on indigenous technology and quality products to make the system self-suffi cient. Also, there should be restriction on the taxations so that healthcare costs do not mount. Further, the insurance sector also needs to play a bigger and better role to utilise the budget effectively.

And of course, the government’s decision on the reversal of the misery tax is indeed good news.

Dr N K VenkataramanaVice Chairman and Chief Neurosurgeon, BGS Global Hospitals, Bengaluru

With great relief, we appreciate the consideration given to the roll back of service tax on healthcare services.

Healthcare access to all, and that of the highest standards, has been the driving force for the healthcare sector inIndia and imposition of this service tax

would have been a huge deterrent to this vision. With this roll back, the government has taken

a progressive step that will go a long way in ensuring a healthy nation. The health provider network is encouraged to take the health challenges of the nation with continuous support fromthe government.

We, at Apollo Hospitals, would like to assure that we will continue to play our part in taking healthcare sector ahead through all the means and resources that are at our disposal.

Dr Prathap C Reddy Founder & Chairman, Apollo Hospitals Group, India

610/

7/10

The Finance Minister should be congratulated for his bold initiative in announcing the roll back of 5 per cent service tax on services provided by hospitals and diagnostic centres. This will provide much needed relief to patients who are already reeling from the effects of high infl ation. This positive gesture

by the government coupled with a responsible behaviour of private healthcare players in reducing the cost of treatment and diagnosis will greatly boost

preventive care and early diagnosis, thereby helping in the control of the mounting burden of chronic diseases in India.

Budget 2011 addresses ‘inclusiveness’ as priority, but does not address other priorities like ‘growth’, ‘accessibility’ and ‘affordability’. However, increased spending at macro level through higher allocation on healthcare and increased coverage under the Rashtriya Swasthya Bima Yojna (RSBY) will benefi t poor sections of the society.

Pradip Kanakia Partner - Assurance, PricewaterhouseCoopers, Bengaluru

510/

Despite overall allocation increasing by 17 per cent over last year, this Budget seems to lack the punch for accelerating inclusive development agenda. The proposal for widening of service tax net to cover diagnostics and hospitalisation in air-conditioned hospitals would have created a larger hole in

the pockets of patients. This is likely to be brought back at a later date with Goods and Services Tax (GST) but for now it has been rolled back after the strong criticism it received.

No major initiative has been announced in the Budget for improving the quantity and quality of human resources in health sector, which is one of the major bottlenecks faced by the healthcare sector. On the whole, Union Budget 2011-2012 is a progressive healthcare Budget, mainly for the economically challenged masses and has the potential to improve the health index of the country. However, the transformation expected by the healthcare industry continues to remain unfulfi lled in this Budget, as the healthcare industry has again failed to gain the priority infrastructure status.

Dr Rajeev Boudhankar Vice President - Kohinoor Hospital, Kohinoor City, Mumbai

610/

Roundtable

28 I April 2011

Dr S ManivannanJoint Managing Director, Kavery Medical Centre and Hospital, Trichy

The Budget allocation of ` 26,700 crore to the healthcare sector represents an increase of 20 per cent over last year’s allocation, which is still inadequate. However, the rationalisation of customs duty, which will reduce the customs duty on certain medical equipment is a welcome change.

After considering the withdrawal of service tax levy on healthcare, there is nothing signifi cant compared to last year’s Budget. However, Finance Minister’s announcement that healthcare services will be within the purview of GST may adversely impact the cost of healthcare delivery to the patient, which needs to be seriously debated and discussed with all the stakeholders before introduction. Given the fact that the public/government investment in healthcare is

inadequate, private sector has been investing heavily in the healthcare sector to bridge the substantial gap in the healthcare delivery. However, expectations like the availability of cheaper fi nance from banking/fi nancial sector for setting up new hospitals, treating healthcare as an infrastructure with concessional rate of interest, longer repayment period due to long gestation period for achieving cash break even and land reforms to make available adequate land for setting up new hospitals have not been addressed.

Clear-cut guidelines in this regard would have helped in encouraging the fl ow of the much needed investments in this sector. However, the clarifi cation that losses from new hospitals will be allowed to offset against profi ts of existing hospitals being operated by a taxpayer is an acceptable change.

Budget 2011-12 has been proactive and better than the last Budget with the rollback of the service tax. Further, reduction in customs duty and countervailing duty on raw materials for syringes and needles to 5 and 4 per cent, respectively, is an incentive for domestic manufacturers. Reduction in import duty on

lactose used in homoeopathic medicines from 25 to 10 per cent will bring down the cost of homoeopathic medicines. Reducing the corporate tax from 7.5 per cent to 5 per cent will have positive impact on all corporates including those in healthcare.

With increase of minimum excise duty from 4 to 5 per cent, pharma companies that had their products in the

4 per cent rate, will be affected and may raise the cost of medicines. Increase of Minimum Alternate Tax (MAT) from 18 to 18.5 per cent of book profi ts will affect all organisations especially those in the healthcare sector, which do not have profi t after tax. Inclusion of units operating in Special Economic Zones (SEZs) under the scope of MAT may affect pharma and medical devices units set up in SEZs.

Health insurance market has emerged as a new and lucrative growth avenue for both the existing users as well as the new users. Further, Indian medical tourism is bringing forex into the country and thus should be given further recognition, exemption and leverage.

Dr Shivani Sachdeva GourInfertility Expert & Gynaecologist, Phoenix Hospital, and Founder - Surrogacy Centre India, New Delhi

The increased outlay towards healthcare in the Union Budget will boost National Rural Health Mission’s (NRHM) efforts in ensuring the reach of quality healthcare to rural parts of the country. These efforts have been further strengthened by increasing the remuneration to aanganwadi teachers, helpers and workers.

The ` 500 crore outlay towards the National Skill Development Council presents an enormous scope to enhance skilled manpower in the healthcare arena such as nurses, laboratory technicians, radiographers, dialysis technicians, cath lab technicians, etc. Also, inclusion of unorganised sector workers in hazardous mining and associated industries like slate and slate pencil, dolomite

mica and asbestos under the umbrella of health insurance will surely ensure more accessibility of basic healthcare facilities. Alternative medicine and disciplines has also got a considerable boost from the Budget.

With an increased allocation of 20 per cent as compared to last year’s Budget, we are looking at a total outlay of ̀ 267 billion for the health sector. This will immensely help the country’s efforts in providing healthcare to all. In the post-Budget deliberations, the Finance Minister has indicated that healthcare would be given ‘infrastructure’ status – this will boost the sector, increase private participation and ease a steady fl ow of funds into healthcare projects. The healthcare sector emerged as one of the benefi ciaries of the Union Budget 2011-12.

Dr Vivek DesaiManaging Director, Hosmac India

5.510/

510/

710/

Hospital Monitor

30 I April 2011

Founded in 1994 by Dr Rakesh and Manju Sinha, with a dream to form the neighbourhood’s fi rst ‘Boutique hospital’, Beams Hospital

has come a long way. With every milestone added to the plethora of achievements, the ambition to reach even higher and serve

better has become all the more prominent. The path has not been smooth, but that has never hindered the pace in which the hospital decided to grow.

Beams, a foremost chain of surgery centres dedicated to MAS is backed by expertise of more than 15 years. Spread

over an area of 9,000 sq ft, the hospital now plans to extend its services to other major cities as well. Manpower comprises about 11 part- and full-time doctors and 18 nursing staff. Focussing on creating a niche in laparoscopic surgery in gynaecology, urology and general surgery, S Krishnamurthy, CEO, Beams Hospital, says, “Gynaecology

Beams Hospital, Mumbai

Conceptualising boutique care

Meghna Mukherjee

With a specialised team of doctors, administrators and qualifi ed nursing staff in Minimal Access Surgery (MAS), the hospital plans to expand its services to other cities as well. While doing so the mission of ‘patient care at all times’ will be the main focus. A glimpse of the strategies, investments and services in place.

Hospital Monitor

32 I April 2011

& obstetrics holds a marketshare of about 13 per cent of the total healthcare industry in India. Within laparoscopic surgeries, we focus more on performing surgeries for fi broid removal, hysterectomies and deliveries. In 2002, 2003 and 2007, we had won the Limca Book of Records and the Guinness Book of World Records for removing the largest fi broid weighing 3.4 kg and the largest uterus weighing 4.1 kg through laparoscopic surgery.”

Investments and expansion plans Functioning expertise was brought into Beams Hospital by Ambit Pragma Ventures, a Private Equity (PE) fund. Now, the hospital plans to expand its services from being a single entity to a 10-centre unit spanning across major cities like Amritsar, Chennai, Hyderabad, Bangalore, Pune, Ahmedabad, New Delhi, Kolkata and Indore.

Krishnamurthy explains, “We have been running a successful MAS model for the past 15 years in Mumbai. The cost of setting up a MAS centre is about ` 6-8 crore. Now we plan to widen our horizon and introduce eight more centres across the country that will not only focus on gynaecology but also on urology, general surgery and arthroscopy. The centre at Amritsar has been operational since 2008 and now the centres at Hyderabad,

Bangalore and Indore have also started functioning. We will follow a similar investment pattern for setting up other centres as well. We plan to start the other centres in the next 12-18 months.”

The hospital is also constantly working on enhancing its technological and expert services in the fi eld of laparoscopic surgery. It has received the ISO 9000 accreditation and is now working on achieving the ISO 18000 accreditation, which is for maintaining environmental safety, and is also looking at receiving a process certifi cation for healthcare.

Services and technological advancements The hospital is a 32-bed MAS centre. About 40 per cent of the patients here opt for short stay service. The hospital’s administration department has issued a policy that all centres across the country will have at least 25 beds. In addition, the hospital is equipped with two operation theatres, one labour delivery room, one ultrasound system, one

high-intensity focused ultrasound, one no touch breast scan and is backed by other high-end facilities.

Beams has constantly been working on increasing and exploring new technologies for its services. As Krishnamurthy avers, “We have always ensured that we use the latest technology at our centres. The laparoscopic and anaesthetic equipment are imported from Germany & the US. Upgradation of technologies is done yearly at our fully functional centres. MAS is a technology-based surgery, and hence we need to ensure that all technologies are up to the mark.”

Emphasising on the scenario of the current healthcare industry, Krishnamurthy says, “Even today, healthcare is not largely technology based. But we realise its importance in laparoscopy, and hence technological advancement is a must for us.” Explaining the emergency services provided at the hospital, Krishnamurthy explains, “Although occurrence of emergency cases is less in a specialised MAS centre such as ours, however if need be, we are well equipped to handle it due to our association with effi cient ambulance services, blood banks in the area that cater to us and also with private and public hospitals in the city in case a patient needs to be shifted to an Intensive Care Unit (ICU).”

Academic lens With a belief to produce the best gynaecologists in the city and the country, Beams Hospital trains students throughout the year under the guidance of doctors in the hospital. Emphasising on the need to train young minds,

We plan to widen our horizon and introduce eight more centres across the country that will not only focus on gynaecology but also on urology, general surgery and arthroscopy.

S KrishnamurthyCEO, Beams Hospital

Quick Bytes

The fact that a patient can return to his normal life and perform daily activities in a two to three days time is high with MAS.

Quick Picks

Patient care at Beams

Hospital Monitor

34 I April 2011

Krishnamurthy says, “We conduct bi-annual training programmes on laparoscopic surgery for gynaecologists. Till date, we have trained more than 100 surgeons. We have plans of getting the accreditation from the National Accreditation Board for Hospitals (NABH) and also to offer DNB course in gynaecology at our centre.”

Besides, the hospital organises a number of activities in the academic arena, wherein specifi c cases are documented and showcased to the students. “We are also planning to affi liate with some university or institute in the US, based on the Ambulatory Surgical Care (ASC) model,” informs Krishnamurthy.

Serving the society The hospital constantly participates in various healthcare camps and events organised in the city. Commenting on the Corporate Social Responsibility (CSR) activities, Krishnamurthy explains, “We annually organise conferences and camps in our hospital where patients who cannot afford a laparoscopic surgery, undergo the surgery free of cost. About 10 patients in the category of undergoing a ‘free surgery’ are operated every year. Further, we are trying to come up with various such programmes where we can provide quality services and also help those who cannot afford such a surgery. Our aim is to serve mankind through our expertise.”

The winning mantra With upcoming hospitals focussed on providing solution through MAS, the level of competition is on a rise for Beams. Nonetheless, with experienced staff and administration in place, the hospital has managed to overcome them. Krishnamurthy opines, “With more and more centres coming up based on the theme of boutique hospital and MAS, the level of competition is high. There is a compelling case for patients to move to the chain of boutique hospitals, which offer technologically advanced MAS in a personalised and caring ambience. Considering the competitive environment and looking

at the trend in which more and more specialised boutique hospitals are coming up, I think format such as ours could be a strong competition to larger hospitals in the near future because of the specialised services that we offer alongwith a well qualifi ed, experienced team of surgeons and use of highly advanced, upgraded technology providing complete safety as well as cost effectiveness. Looking at all the factors, the customers will soon know where they need to get treated.”

Further, explaining the challenges that Beams faces, Krishnamurthy says, “The single biggest challenge for Beams is to attract the right kind of surgeon to perform surgeries. We have maintained the aesthetic value with which we serve our patients and ensure that they are treated with utmost care and attention. The second challenge is to create awareness about MAS. There is minimal awareness among the population at large about the benefi t of MAS. The fact that a patient can return to his normal life and perform daily activities in a two to three days time is high with MAS. Hence, we constantly try to educate our patients on the success level and the advantages of MAS.”

The concept of medical tourism is highly recognised at Beams. Providing insights into the related fi eld, Krishnamurthy avers, “We believe in medical tourism. Also, we are in the process of structuring it further. About 2-3 per cent of the patients visiting our hospital are from abroad. We have treated patients from various countries like the US, UK, UAE, Singapore, Kenya and others. We also have a specialised team of doctors who provide online counselling to the patients fi rst and then they are advised to visit the hospital for treatment. For maintaining transparency in our working module, we record the surgeries performed on our patients. We provide the patients with one copy of the record and one is stored at the hospital for further assistance and documentation purposes.”

Tapping the future Beams is far sighted when it comes to providing quality services and better treatment for its patients. Krishnamurthy says, “We are open to tie-ups with individual or group practitioners. We would like to associate local surgeons from bigger hospitals with our centre so that they can provide excellent treatment to our patients. Also, our aim is to create the fi nest MAS centres in the country fi ve years down the line. With a single-centre concept that is doing well, we hope that the multi-location centres will help us in building a smaller chain of hospitals, which will cater to serving patients through MAS.”

The ability to deliver consistently is a big challenge for most healthcare service providers. Krishnamurthy opines, “With disposable income, a typical consumer’s expectation for healthcare has raised. At present, more and more corporatisation is taking place in the healthcare industry that helps in the formation of more chain of hospitals, which can cater to the ‘secondary level of surgeries’ and will create a niche in the secondary care sector. There are no sure shot models presently where the debate whether government should handle healthcare or the private players can settle. But both these models have their own challenges. In comparison to the healthcare model adopted in the US, India is still trying to reach up to that status. Healthcare in India was previously public based, but now with about 85 per cent of privatisation in the healthcare industry, we can predict that this sector will excel in the near future.”

(mmedit@infomedia18.in)

Sector Watch

36 I April 2011

With the rise in lifestyle diseases, especially in urban India, the need for an effective health insurance plan cannot be ignored. In the absence of an appropriate health insurance, being sick or meeting with an accident can cause considerable fi nancial trouble. Hospitals providing latest medical facilities and state-of-the-art infrastructure charge duly to the patient. Heath insurance is the tool that can help at large in such circumstances. It may seem like an expense today, but it helps in protecting against a future expenditure that may be considerably higher and unbudgeted for. Unfortunately, in India, this is an underpenetrated market. A detailed analysis.

Dr Asma Mohd Yousuf

Sector Watch Sector Watch

36 I April 2011

Sector Watch

37April 2011 I

Healthcare has emerged as one of the fastest growing sectors in India, yet there are people who are still unaware

of what benefi ts health insurance policies can provide them. “The healthcare spend in the country is expected to double and touch ` 2,250 billion by 2014. And with just three per cent health insurance penetration in the country, a large part of the sum is poised to be paid out of one’s pocket. India’s insurance market still lags behind other countries in terms of penetration. With the penetration level at three per cent in India it is far behind UK (12.5 per cent), Japan (10.5 per cent) Korea (10.3 per cent) and US (9.2 per cent). In terms of insurance coverage per capita, India stands at $ 1.1 as compared to $ 2313.6 in the US and $ 31.1 in the UK,” informs Antony Jacob, Chief Executive Offi cer, Apollo Munich Health Insurance, India. In agreement, Dr Pervez Ahmed, CEO & Managing Director, Max Healthcare, New Delhi, says, “It is estimated that only about 12 to 13 per cent of Indians are covered under any form of health insurance (private insurance coverage is approximately three to four per cent only). The Indian health insurance scenario is a mix of mandatory Social Health Insurance (SHI), voluntary private health insurance and Community-Based Health Insurance (CBHI). Health insurance is, thus a minor player in the health ecosystem.”

Growth driversResearch has shown that Indians across all segments and age groups are presently more prone to lifestyle-related ailments and diseases than previous generations. This fact, undoubtedly negative, stands out as the root cause for the potential growth of the health insurance sector.

Jacob informs, “The growing percentage of middle class citizens in the country and the increasing healthcare cost is also adding to the growth of the health insurance segment. Changing demographics, affl uence and work-life balance has brought about a paradigm shift in the attitude of people, who demand for a better quality of healthcare. Health insurance as a mechanism to fi nance this need, is therefore, fi nding greater acceptability. Thus, the market has great

prospects, but the need of the hour is to identify products that will suit customers’ insurance needs and win their confi dence.”

Sanjay Datta, Head-Customer Service, ICICI Lombard General Insurance Company Ltd, India, feels that the biggest target for the insurance companies in the next fi ve years would be to cover 20 per cent of the Indian population. This is expected to be driven by factors like entry of new competitors, increasing consumer awareness, relaxation in income ceiling, low growth in public sector employment and increased efforts of Non-government Organisation (NGO)/self-help groups. He further adds, “Over the past few years, many companies have entered into the market, and the industry is seeing a lot more innovation with product offerings for different segments including senior citizens, corporates, low poverty line and affl uent class. Information Technology (IT) has also been one of the signifi cant enablers of growth in the sector. Given the current health insurance penetration levels in the country, at about three to four per cent, there is a signifi cant potential and a long way to go. However, compared to the Western world, it is still at the tip of the iceberg.”

Inclusion – exclusion criteriaA typical health insurance policy covers the basic costs in case of hospitalisation due to any accidents/diseases, which does not

form a part of the permanent exclusions of the policy under which an individual is covered. The expenses covered include cost of room, boarding expenses as provided by the hospital, nursing expenses, doctors, operation theatre charges, expenses related to surgical appliances, etc. As a part of the standard plan, coverage for pre and post hospitalisation expenses and specifi ed day-care procedures are also offered. However, the coverage may vary from product-to-product and insurer-to-insurer.

Jacob says, “With the development of the sector and increasing awareness of health insurance, some insurers have launched products to cover Outpatient Department (OPD) treatment as well. Apollo Munich has launched Maxima, which covers out-patient treatment expenses like OPD doctor consultations, pharmacy bills, diagnostic tests, dental treatment, optical services and annual health check-up costs along with in-patient treatment. Critical illness riders are available as add-ons to health insurance policies and these cover treatment for diseases, such as cancer, strokes, kidney failure and heart attacks. These riders are subject to each insurer’s policy and underwriting principles.”

Explaining further, he adds, “Maternity expenses are widely excluded when it comes to health insurance plans. But lately there are a few plans that have started to offer coverage against maternity expenses after a certain

The healthcare spend in the country is expected to double and touch ` 2,250 billion by 2014. India’s insurance market still lags behind other countries in terms of penetration.

Antony JacobChief Executive Offi cer (CEO), Apollo Munich Health Insurance, India

Higher affl uence of the Indian middle class Increase in various lifestyle-related diseases Rising healthcare costs growing awareness about the benefi ts of

health insurance Availability of quality healthcare Community-based health plans Increased awareness about healthcare and preventive care in the country Initiatives by government Rise in numbers of patients visiting India for medical treatment

Growth drivers for health insurance market in India

Source: Sanjay Datta

Sector Watch

38 I April 2011

amount of waiting period. Apollo Munich too offers maternity expense coverage after four years of waiting period.”

Highlighting further, Datta says “Health insurance in India is normally a comprehensive health cover, covering nearly all illnesses and injuries requiring minimum 24 hours of hospitalisation, subject to a few exclusions namely AIDS, STDs, mental disorders, congenital defects. A typical health insurance policy does not cover any medical expenses that are routine in nature or for convenience like routine health check-ups, cosmetic surgery, plastic surgery aestheic treatment, etc. There are certain waiting periods with regards to Pre-Existing Diseases (PEDs) or some named illnesses like cataract, hysterectomy, etc, for a defi ned period of two years or four years,”

As per Dr Abhijit Bopardikar, Director, ReeLabs, Mumbai, “Unlike the West, there are numerous critical and non-critical illnesses that are not covered, which adds to the confusion for the common man regarding the purchase of an insurance policy. The only advantage in these cases is the income tax benefi ts that come with the purchase of these policies. Many alternate forms of therapies are only partially covered or left uncovered. For instance, the ubiquitous bone marrow stem cell therapy that is possibly the answer to many life threatening hematological disorders are not covered by these agencies. In such cases, raising funds becomes a herculean task and

generally spells doom for the affl icted person and the policy makers as well.”

Giving more insights on the reason for such exclusions, Dr Ahmed says, “Anything which occurs or is diagnosed post taking a policy is normally covered. The main reason behind the same is to curtail claim costs; when premiums and penetration are low, then it is a loss making proposition for any insurer.”

Micro and rural insuranceMicro-insurance is seen as a boon for the rural Indian population. There are numerous initiatives underway in the country to reduce poverty and it requires not just generation of income for poor, but also protection of these incomes and its resources. Through micro-insurance schemes, the rural poor will not only get access to affordable insurance, but also will be able protect themselves against high-frequency risks, such as serious health conditions, accidents, harvest failures and fi res.

“Micro-insurance offers an innovative way to combat poverty by helping the rural poor systematically manage the fi nancial risks to their livelihoods and lives. With only two per cent of the poor covered through micro-insurance, there exists a huge untapped market. The demand for micro-insurance in India has remained low in a large part because of a mismatch between services offered by the insurers and the needs of the insured. Schemes such as

Rashtriya Swasthya Bima Yojna (RSBY), Arogyashri, etc, which address an important segment, are doing a good job and should be continued and strengthened even further,” explains Jacob.

The rural economy is exposed to fundamental risks and has limited access to appropriate risk mitigating solutions. Penetrating the rural market calls for a paradigm shift and signifi cant investment in building a base for the future. The rural market and rural mass in India are exposed to many risks for livelihood as well as for their assets like home, farm equipment, cattle, crop failure, etc. These risks cause fi nancial strain. Rural insurance acts as a cover for all the above mentioned risks.

Further, Datta adds, “ICICI Lombard realises that future growth will come from expansion of markets, focussing on volumes in smaller towns and rural areas at a tenth of the cost of urban markets as well as leveraging on established distribution networks. Our pioneering efforts in creating awareness about insurance in rural India include focussed verticals for rural and government to service the unique needs of each market as well as the development of customised products.”

Government intiativesHealth insurance is poised to play a critical role by fi nancing medical innovation and technology, and making them readily available within India. This eventually should also leave a strong rub off effect for the government run schemes to enable quality healthcare access utilising the existing healthcare bandwidth.

“Government and the regulator have been playing an important role in developing and facilitating growth for the entire sector. The biggest development in this industry was the opening up of the industry following the 1999 Insurance Regulatory and Development Authority (IRDA) regulation. Also, with the proliferation of bancassurance for life and general insurers, changes are visible in the way insurance products are distributed in India. However, health insurance in our country is still underdeveloped but offers huge potential,” elaborates Jacob.

It is estimated that only about 12 to 13 per cent of Indians are covered under any form of health insurance. Health insurance is, thus a minor player in the health ecosystem.

Dr Pervez AhmedCEO & Managing Director, Max Healthcare, New Delhi

Over the past few years, many companies have entered into the market, and the industry is seeing a lot more innovation with product offerings for different segments.

Sanjay DattaHead Customer Service, ICICI Lombard General Insurance Company Ltd, India

Sector Watch

40 I April 2011

He further adds, “Considering the vast majority of population living below the poverty line across the country, the government’s plan this year to increase health allocation by 20 per cent and widen the scope of RSBY is a positive move and may bring in newer opportunities for increased insurance penetration. However, on the private health insurance front, the State should incubate a favourable business and distribution environment for faster penetration.”

Government and private playersThe liberalisation of the sector along with the entry of stand-alone health insurance companies has triggered a higher level of competitive intensity as well. This has resulted in the industry seeing advanced levels of innovation with various product offerings for different segments including senior citizens, corporates, below poverty line and the affl uent class.

“With only three per cent of the Indian population covered by health insurance, the market surely requires large scale focus from all the stakeholders, including the regulator, to address the logistic challenges so as to create an effi cient distribution network for better accessibility and improved investment opportunities in the insurance sector. For this segment to grow, public and private sector along with the regulator and the government will fi rst need to raise the level of awareness amongst consumers and make people

aware of the importance and benefi ts of health insurance. Each company will also have to do its bit to raise awareness and also increase the penetration in Tier 1 and 2 cities,” informs Jacob.

Insurers also need to work on certain aspects, such as lack of understanding of product features and perceived apprehension in claims procedures and settlement. These factors must be distanced from the consumer’s mind to further fuel growth and uncomplicate health insurance for the consumers.

“Currently, more than 60 per cent of the health insurance business resides with four government companies, ie, United, National, Oriental and New India. However, private insurers like ICICI Lombard and stand alone health insurers like Apollo Munich & Max Bupa have a clear focus and in the near future we see an equal split between government and private players,” says Dr Ahmed.

According to Datta, “Today, there are a wide range of unique, user-friendly and innovative health insurance plans to choose from, that cover much more than basic hospitalisation. From the popular standard family fl oater plan on ‘indemnity’ basis, where the insurer is only reimbursed costs incurred, to the policies covering OPD expenses and specialised cover for critical illness, today there are over 30 companies across the general insurance and life insurance space offering a variety of health insurance plans.”

Ensuring a healthy futurePrevalent lifestyle and work habits have resulted in limited or lack of physical exercise. Enhanced levels of stress and poor food habits have resulted in increase of chronic ailments, such as diabetes, hypertension, obesity, cardiac diseases and gastrointestinal diseases. With health taking a toll, people must ensure that they are ready to face the future securely. That is where health insurance plays a vital role in India.

Discussing future prospects of the health insurance segment in India, Jacob says, Overall, the health insurance industry in India is expected to grow at a Compounded Annual Growth Rate (CAGR) of 25 to 30 percent by 2015 to reach a market size of approximately ` 28,000 crore. Increasing consumers’ knowledge and attention to details will also be crucial to the success of insurance companies.”

Dr Uma Nambiar, CEO, SL Raheja (a Fortis associate) Hospital, Mahim & Zonal Director, Fortis Healthcare, Mumbai, says, “Small premiums can help in saving lives and reducing the fi nancial burden on account of the huge medical expenses incurred. Therefore, besides educating the masses, it should be ensured that all steps are taken to avoid any malpractice. Proper screening methods should be applied before a person purchases a plan to confi rm if the person fulfi ls the criteria for that plan. Agents should provide every detail about the insurance policy to the customers. Also, people should make honest claims about the declaration of medical bills. There is a huge potential in the health insurance sector in India but to make optimum utilisation of this opportunity, hospitals and healthcare providers should work together.”

Health insurance as a mechanism to fi nance is fi nding greater acceptability and presenting greater prospects for the sector. However, the success of this industry and its players hinges on the awareness levels of consumers. With growing support from the government in terms of tax exemption, and increased involvement of the private sector to provide better healthcare facilities and insurance cover, this sector shall witness exciting opportunities in the years to come.

(asma.yousuf@infomedia18.in)

Unlike the West, there are numerous critical and non-critical illnesses that are not covered, which adds to the confusion for the common man regarding the purchase of an insurance policy.

Dr Abhijit BopardikarDirector, ReeLabs, Mumbai

There is a huge potential in the health insurance sector in India but to make optimum utilisation of this opportunity, hospitals and healthcare providers should work together.

Dr Uma NambiarCEO, SL Raheja (a Fortis associate) Hospital, Mahim & Zonal Director, Fortis Healthcare, Mumbai

Specialty Scope

42 I April 2011

‘What we see depends mainly on what we look for’ - John Lubbock

However, to see and look, one needs to have a healthy vision. But according to World Health Organization (WHO) estimates, 75 per cent of blindness and 80 per cent of visual impairment is avoidable. Also, a total of 285 million people are visually impaired, of which, 39 million are blind and 246 million have moderate-to-severe visual impairment. About 90 per cent of people with visual impairments live in developing countries, and with India being a developing country, yes, this is a matter of great concern.

Refractive errors are silent conditions. They can be detected only on a formal vision test but if not taken care on time can lead to many complications, blindness

being one of them. Also, a refractive error in one eye is often missed till a very late age. The only way to ensure effective treatment of refractive errors is to recognise them at an early age.

Vital statsDr Priti Manjunath, Consultant Cataract and Refractive Surgeon, Nethra Eye Hospital, Bengaluru, says, “The prevalence of blindness is 1.84 per cent in urban vs 2.03 per cent in rural population of India. The incidence of moderate visual impairment in Indian population is 8.1 per cent.” She further informs that the incidence of visual impairment is 11.2 per cent higher for those living in rural areas as compared to the urban population.

Discussing the common types of refractive errors, Dr Ashwin Sainani, Paediatric Ophthalmologist and Squint

Specialist, PD Hinduja Hospital, Mumbai, says, “Refractive error is the inability of the eye to focus on near, distance or both near and distant images. The common types of refractive errors are myopia, hypermetropia, astigmatism and presbyopia. Myopia is the commonest among all refractive errors. These are treated with glasses or contact lenses.”

Vision careUntreated refractive error is a cause of reduced vision until glasses are prescribed. Visual acuity can be reduced permanently in children who have not been treated for refractive errors in time (before 7 years of age) due to amblyopia. Myopic patients can have reduced vision due to a retinal detachment. Therefore, regular eye checks are needed in patients with family history of eye problems like glaucoma, myopia, diabetes, etc. Associate Prof Dr Eric Papas, Executive Director, R&D and Director, Post Graduate Studies, Brien Holden Vision Institute, Australia, affi rms, “Vision, safety and health should always be kept in mind. Eyes should be at least checked annually.”

Spectacles: Then and nowOver the years, the quality of spectacles has improved. Mukesh Arora, Contact Lens Specialist, Segal Optics, Mumbai, says, “Today, light weight frames are available. Plastic is mostly used as lenses because it is safe and can be used in various styles of frames.”

According to Dr Manjunath, “Modern eyeglass lenses are commonly made from plastic like polycarbonate. These materials

Dr Asma Mohd Yousuf

Eye care is a serious concern that is often neglected by people. Healthy eyes and good vision are blessings that are often taken for granted. And for a child it is even more valuable because their learning abilities in early years of life depend highly on visual input. Here is an overview on the effect of refractive errors and solutions to rectify them.

Trends in ophthalmic treatments

An eye for the future

Photo

©D

INO

DIA

Specialty Scope

43April 2011 I

reduce the danger of breakage and weigh less than glass lenses. Some plastics have more advantageous optical properties than glass, such as better transmission of visible light and greater absorption of ultraviolet light. Also, some plastics have a greater index of refraction than most types of glass; this is useful in the making of corrective lenses shaped to correct various vision abnormalities such as myopia, allowing thinner lenses for a given prescription. Newer plastic lenses can also correct the higher order aberrations that naturally occur on a person’s optical system. These lenses create sharper vision for people who have problems with blurry or dull vision, as well as help reduce the halos, starbursts and comet-tails often associated with night time driving.”

Above all, today, there are automated refractors or autorefractors used for examining eyes to provide an objective measurement of a person’s refractive error based on which the prescription for glasses or contact lenses with the appropriate power is made. This is achieved by measuring how light is changed as it enters a person’s eye. However, Arora says, “Autorefractometer is an objective test, and a subjective test is a must in order to confi rm the power of the lenses.”

Power of contact lensesContact lenses have numerous advantages over spectacles. It gives clearer vision as there is no distance between the eye and lenses. They do not fog up with changes in temperature, give more freedom and can be worn by sportsmen during intense physical activities.

Describing the benefi ts of silicone hydrogel contact lenses, Tim Grant, Vice President Professional Affairs, APAC & MENA, Ciba Vision, Australia, says, “Silicone hydrogel contact lenses are good for vision and have better oxygen permeability levels as well. Besides, these contact lenses do not give hazy vision. However, due to the material and manufacturing cost, disposable contact lenses are expensive.”

However, Dr Papas informs, “On repeating lenses more than the prescribed time, its health benefi ts decrease. There

is development of proteins, lipids and bacteria, and thus, its use becomes uncomfortable. The more oxygen permeable lenses are the better will be the eye health. Less oxygen permeability causes corneal swelling. “

All contact lenses are foreign bodies to the eyes and can sometimes give rise to eye problems. The incidence of these complications from lens wearing can be prevented by following stringent lens hygiene. Wearers should view the warning signs and symptoms seriously, and contact an ophthalmologist immediately if red-eye, eye discomfort, reduced vision, sensitivity to light and eye discharge develops.

OrthokeratologyElaborating on what is orthokeratology, Dr Manjunath says, “Orthokeratology is the design and fi tting of special gas permeable contact lenses that gently reshape the clear front surface of the cornea, so that one can see clearly even after the removal of the lenses. Unlike a refractive surgery, however, the corneal reshaping effect may

be temporary. Then you have to wear the ortho-k lenses again to maintain the proper corneal shape.”

Highlighting further, Dr Papas says, “The lenses used in orthokeratology are hard and are not very comfortable to the eyes. Moreover, orthokeratology cannot be used in case of hypermetropia and astigmatism. Besides, moulding of the cornea itself is a debate among ophthalmologists.”

Refractive surgery“Laser surgeries can change the corneal shape, which can lead to correction of refractive error. There are other types of refractive surgeries like conductive keratoplasty, implantable contact lens, lens exchange and keratotomies,” informs Dr Harshavardhan Ghorpade, Consultant Ophthalmic Surgeon, Fortis Hiranandani Hospital, Vashi, Navi Mumbai, while discussing the surgeries used in the correction of the refractive errors of eyes.

He continues to explain, “Today, machines with high laser speed are available. Wavefront-guided lasik, customised

The prevalence of blindness is 1.84 per centin urban vs 2.03 per cent in rural population of India.

Dr Priti ManjunathConsultant Cataract and Refractive Surgeon, Nethra Eye Hospital, Bengaluru

Currently, refractive surgeries are getting more and more advanced and accurate with progress in laser technology.

Dr Ashwin SainaniPaediatric Ophthalmologist and Squint Specialist, PD Hinduja Hospital, Mumbai

Vision, safety and health should always be kept in mind. Eyes should be at least checked annually.

Associate Prof. Dr Eric PapasExecutive Director, R&D and Director, Post Graduate Studies, Brien Holden Vision Institute, Australia

Specialty Scope

44 I April 2011

lasik, excellent quality keratomes as well as protocols for prevention of infection, infl ammation, fl ap complications and future ectasias have been recognised. Stem cells are used for making artifi cial corneas. But refractive surgeries are a great advancement in itself.”

Adds Dr Sainani, “Currently, refractive surgeries are getting more and more advanced and accurate with progress in laser technology. The future includes Laser-Assisted In Situ Keratomileusis (LASIK) in children, LASIK for presbyopia and advances in femtosecond laser. One must realise that a decision to go for contact lenses or refractive surgeries is entirely the patient’s prerogative. It is fi nally a cosmetic decision and neither options improve vision beyond that they have with glasses on.”

Market reportAs per a GlobalData report, the global market for vision care devices was valued at $ 20 billion in 2009, and is forecasted to grow at a Compounded Annual Growth

Rate (CAGR) of 3 per cent to reach $ 24 billion by 2016. The market is expected to be driven by the increasing patient population suffering from refractive errors, their increased awareness and the cost effectiveness of vision care devices over refractive surgery.

The vision care devices market in India and China was valued at $ 320 million and $ 1,592 million, respectively, in 2009 and is forecasted to grow at a CAGR of 4 per cent to reach $ 420 million and $ 2,034 million, respectively by 2016. Whereas, the global market for contact lenses was valued at $ 7.6 billion in 2009, and is forecasted to grow at a CAGR of 4 per cent to reach $ 10 billion by 2016. In the near future, silicone hydrogel lenses and daily disposables are going to be the key trends in the vision care devices market.

The visible futureAccording to the report by GlobalData, currently in China and India, about 41 per cent of the adult population is myopic, which forms a huge wearer

base for vision care devices. The potential contact lens market in these two countries alone will include at least 800 million myopic and 500 million presbyopic people.

The advent of modern refractive surgeries have revolutionised the treatment of refractive errors. However, it must be remembered that refractive surgeries does not suit all patients. It is a cosmetic decision just like contact lenses. Orthokeratology has also shown promising results, although infection is a major risk. Even today, spectacles are the safest treatment for refractive errors. Besides using visual aids, timely detection and treatment of refractive errors in children is very important. Awareness should be created on various visual impairments. At the same time, it is also crucial to introduce diet improvement and supplementation programmes.

Dr Ghorpade concludes optimistically by stating, “Presently, the overall visual impairment is 0.8 to 0.9 per cent. However, VISION 2020 and National Programme for Control of Blindness (NPCB) aim to reduce it to 0.3 per cent by the year 2020.”

VISION 2020 is the global initiative for the elimination of avoidable blindness, a joint programme of WHO and the International Agency for the Prevention of Blindness (IAPB) with an international membership of Non Government Organisations (NGOs), professional associations, eye care institutions and corporations. With the goal ‘A world in which no one is needlessly blind and where those with unavoidable vision loss can achieve their full potential,’ VISION 2020 aims to eliminate the main causes of avoidable blindness and to prevent the projected doubling of avoidable vision impairment between 1990 and 2020. The VISION 2020 initiative is intended to strengthen national healthcare systems and facilitate national capacity building, and with almost a decade to go, let us hope that this aim is successfully achieved.

(asma.yousuf@infomedia18.in)

Silicone hydrogel contact lenses are good for vision and have better oxygen permeability levels as well. Besides, these contact lenses do not give hazy vision.

Tim GrantVice President Professional Affairs, APAC & MENA, Ciba Vision, Australia

Stem cells are used for making artifi cial corneas. But refractive surgeries are a great advancement in itself.

Dr Harshavardhan GhorpadeConsultant Ophthalmic Surgeon, Fortis Hiranandani Hospital, Vashi, Navi Mumbai

Today, light weight frames are available. Plastic is mostly used as lenses because it is safe and can be used in various styles of frames.

Mukesh AroraContact Lens Specialist, Segal Optics, Mumbai

In Dialogue

46 I April 2011

Which areas/equipment according to you are likely to fuel growth in the medical devices segment?Growing hospital infrastructure and healthcare spending is fostering the need for high-end devices to enable accurate and faster treatment. The key drivers fuelling growth in medical devices industry are as follows:

Increasing population & affordability: Improving Indian economy and increasing disposable income has led to a signifi cant change in the manner an average Indian views healthcare. Visiting a hospital only in case of severe illness is passé; the new Indian now undergoes regular health check-ups at periodic intervals

Increased prevalence of lifestyle diseases: With the shift towards urban lifestyles growing at a rapid pace, the incidence rate of diseases like diabetes, chronic heart diseases, cancer and hypertension has increased

signifi cantly in India. Increased diabetic population in India has led to more and more people taking their health more seriously than ever

Improved hospital infrastructure: The past decade has witnessed a signifi cant growth in the number of high-end hospitals in urban India. Healthcare has become more

accessible in these areas. In tier II & III cities, which are yet to witness this growth, the demand for high-end medical equipment and quality healthcare is increasing.

What are the trends you foresee in the Indian life sciences segment and how will you customise your offerings to meet the demand of your clients?The Indian healthcare sector has evolved rapidly in the past decade. With changing lifestyles and the advent of high-end technology, healthcare in India is now more organised than ever. From a

medical perspective, TI’s focus in Indian healthcare sector has been specifi cally in the area of medical electronics. Following are some of the key trends and enabling technologies in this segment:

Imaging techniquesa. Ultrasound: This has undergone

miniaturisation, and become portable. Fusion imaging [merging of two different modalities like Computed Tomography/Magnetic Resonance Imaging (CT/MRI) with ultrasound images]. This has also shown rapid advancement in electronic processing and data acquisition technology

b. MRI: Increasing patient comfort and enhancing the diagnostic information highlight the trend in modern MRI equipment. Techniques such as parallel imaging technology are implemented to speed up MRI scanning, thereby enabling shorter breath-hold times, higher resolution and shorter stay time for the patient lying in the scanner for any examination

c. CT: A key trend in the CT segment is the shift towards combination scanners, which are primarily hybrid scanners comprising Positron Emission Tomography (PET) and CT imaging capabilities. Real-time imaging will drive applications in this segment.

Devices and implantsa. Total demand for cardiac implants

will continue to rise, largely due

‘Telemedicine and e-healthcare haveimmense potential for growth in India’

Arshia Khan

Rapidly increasing lifestyle diseases in India, hospital infrastructure & healthcare spend are fuelling the growth of high-end electronic medical equipment industry, feels Rakesh Joshi, Business Development Manager–Medical, Texas Instruments India (TI). He underlines the key growth trends in this segment over the next few years.

In Dialogue

46 I April 2011

The increasing awareness of healthcare has created a rapidly growing need for innovative medical solutions like portable & affordable ultrasound applications for use in doctors’ equipment, ambulances, mobile triage solutions and remote regions. Semiconductors are set to play a pivotal role in designing and developing portable and affordable medical devices.

In Dialogue

47April 2011 I

to the widening use of Cardiac Resynchronisation Therapy (CRT) devices in the treatment of Congestive Heart Failure (CHF). CRT devices are more effective than alternative drug therapies in restoring the blood pumping capabilities of CHF patients along with reducing their risk of disease complications, such as atrial fi brillation. Ultra-low power electronics fi nd applications in this area

b. Use of Radio Frequency (RF) technology to control electrical stimulation for neurological stimulators is another trend observed in this segment.

Patient monitoring and management systems

a. Certain segments like Electrocardiography (ECG) and neurophysiological monitoring systems have developed rapidly and continue to advance due to higher adoption rates

b. Wireless lower-acuity monitors that are the size of a cell phone can be used with Wireless Local Area Network (WLAN) for transmitting the vital signs of emergency room patients who might be ambulatory or moved to other areas of a hospital

c. Higher acuity can also be wireless but due to limitations in the size, memory and processing power of wireless technology, these monitors typically transmit fewer measurements than standard, non-wireless monitors.

TelemedicineTelemedicine and e-healthcare have immense potential for growth in India, where a major portion of population resides in rural areas, with little or no access to quality healthcare advice/treatment. Additionally, with increasing lifestyle-related diseases like diabetes, cardiac, etc, it becomes obvious that we need easily accessible technology and a common platform that connects millions of patients, spread across the

country, to medical experts in the time of need.

Defi brillatorsUse of devices with biphasic technology and low-energy defi brillation is another emerging trend. Multi-directional current in biphasic defi brillators lowers the threshold for successful defi brillation, thus saving more lives. Biphasic defi brillators adjust the waveform according to patient’s needs for delivering the best possible waveform at any given time.

Embedded technologies and softwareThe function for embedded systems in medical technology is never-ending. For example, new embedded systems are developed wherein pills containing ‘smart’ processors are taken by patients to repair organs for cell formation or irregularities in cell function. Currently,

this is a small industry, but it is possible that embedded systems will be able to perform any medical process in the future, eg, surgeries or X-ray analysis. Multi-core processors for real-time processing are the trends in medical imaging. Software beam formed with the help of Digital Signal Processors (DSP) for ultrasound imaging provides fl exibility and reduces hardware cost on high-end equipment.

What is the growth potential for medical electronics in emerging markets like India and China? In an emerging market like India, there is a lot of potential for growth and

demand for medical electronics (of which semiconductors are an essential part). The increasing awareness of healthcare has created a rapidly growing need for innovative medical solutions like portable & affordable ultrasound applications for use in doctors’ equipment, ambulances, mobile triage solutions and remote regions. Semiconductors are set to play a pivotal role in designing and developing portable and affordable medical devices. The connectivity enabled by semiconductor technology (wired or wireless) will drive applications such as telemedicine that will facilitate access to the required level of healthcare. Indian electronics Original Equipment Manufacturers (OEMs) are developing a number of portable devices like digital thermometers, blood pressure monitors, insulin pumps, heart rate monitors, digital hearing aids, etc. in addition to hospital equipment like CT and MRI scanners, X-ray machines, ultrasound scanners, etc.

How has healthcare evolved with technology?The move towards greater adoption of semiconductor technology in the fi eld of medicine has resulted in an improvement in the quality of life and higher productivity. Areas like preventive healthcare, technology solutions for disability and high-quality healthcare for diseases are also being addressed. Medical practice is gradually moving out of the doctors’ chamber and entering into other spaces like the Internet and homes. Modern technologies such as telemedicine, e-healthcare and digitisation are enabling more people to remotely monitor ailments without physically visiting a medical facility. Patient data storage and access has become safer and easier, with patient consultation & diagnosis moving to the Internet. Healthcare facilities have started using data servers to monitor and access complete patient information over a common network.

(arshia.khan@infomedia18.in)

Quick Bytes

The function for embedded systems in medical technology is never-ending. For example, new embedded systems are developed wherein pills containing ‘smart’ processors are taken by patients to repair organs for cell formation or irregularities in cell function.

Quick Picks

Personalised Healthcare

48 I April 2011

Personalised Healthcare (PHC) is about providing treatment as per patients’ needs for obtaining better clinical outcomes. It is

based on the concept that the treatment will be selected based on patient characteristics that are identifi ed through molecular diagnostic tests.

PHC recognises that all individuals are different and that the ‘one size fi ts all’ approach is not effective. While a drug can be highly effective for one patient, the same might not show the desired results when given to another patient with the same diagnosis.

Experts today are able to tailor treatments according to the needs of specifi c patient populations based on the knowledge of biology, diseases, mechanisms of action of drugs and the biological

differences between patients as well as the characteristics of their disease. This has helped in making healthcare better, safer and more cost-effective.

PHC is a key enabler for further improvements in medicine. This will enhance the safety and effi cacy of medicines as well as improve patients’ lives, their health, quality of life and survival. Therefore, the prime objective here is to provide PHC solutions, which deliver superior options for diagnosis and treatment to clinicians and patients.

Pioneering PHCPHC is not a new concept. There are a number of excellent examples of successful implementation of PHC in medical practice, and numerous PHC solutions are also available today. However, in recent years, the considerably increasing knowledge of the human body and disease mechanisms has helped in concluding that PHC approach will soon become important. The goal is to provide healthcare professionals with more powerful diagnostic tools and with targeted treatments based on new

insights, at the molecular level, about how diseases arise. PHC is a win-win situation for everybody involved, ie, regulators and policy makers, industry, payers and reimbursers, physicians and providers and, most importantly, patients.

For patients, it means better treatment outcomes with safer and more cost-effective treatmentsFor regulators and policy makers, it means increased effi cacy and safety as well as reduced healthcare costsFor industry, it means differentiated medicines and new diagnostic testsFor payers and reimbursers, it leads to an effi cient use of healthcare budgets and increased cost benefi t per patientFor physicians and providers, it means obtaining maximum benefi t with least toxicity.

Today, one in three medicine fails to produce the desired effect, and only about two-thirds of all patients actually benefi t from their drug treatment. In fact, one in seven or eight patients actually feel worse after treatment than before. This situation is not particularly satisfactory.It is unsatisfactory for patients or doctors because neither the desired effects nor side effects can be clearly defi ned or reliably calculated. Also, it is unsatisfactory for health insurers because they have to pay for treatments, the quality of which leaves a lot to be desired in several cases.

This gave rise to the concept of PHC, where the treatment is tailored to specifi c needs of individual patient groups. This new approach to healthcare is facilitated by progress in the fi eld of molecular diagnostics tools, which has been fuelled by identifi cation of new biomarkers, and thereby increasingly favoured by the stakeholders in the healthcare system. This could perhaps be described as a quantum

People are different and no single treatment suits two different patients despite the presence of same symptoms. This has prompted clinicians and drug manufacturers to move towards providing medication specifi c to particular patient populations, that is personalised healthcare.

Differentiated medicare

Say no to ‘one size fi ts all’

Dr Bhuwnesh AgrawalChairman & Managing Director, Roche Diagnostics India

Personalised Healthcare

49April 2011 I

leap in drug therapy. The relationships between drug response and individual genetic variations called pharmacogenetics provide information that when considered with other factors, helps physicians to better assess the right medication dosage for a patient.

People are different, but drugs are not differentiated enough. There is a great need for more effective and safer medicines. PHC should not be (mis)interpreted as that every person receives medicines made just for them. Rather, it expresses the idea that groups of individuals with shared features – eg, genetic characteristics – can be ‘bundled together’ such that treatments can be optimally tailored to their needs.

On an average, 20-80 per cent of patients actually profi t from the medicines they take. This is because today’s medicines are generally standardised products meant for general patient population – PHC, however, strives to differentiate.

Any course of treatment starts with a diagnosis, ie, identifying the patient’s illness as accurately as possible. The more accurate the diagnosis, the more successful drug therapy is likely to be. Here, Roche is in an excellent position since it is the only healthcare company in the world to possess top-class-in-house expertise in both areas. As such, we are extremely well placed to provide ‘custom-made treatments’ that are perfectly suited to patients. With the pillars of diagnostics and pharmaceuticals, the Roche Group is perfectly positioned to pursue the goal of PHC, and over the last few years, has shown examples of how interweaving diagnostic and pharmaceutical expertise pave the way to achieve this goal. Roche’s portfolio encompasses the fi elds of oncology, virology, metabolism, transplantation and many more, as explained hereafter.

OncologyBreast cancer: One of the greatest advancements in the treatment of breast cancer is the drug, Herceptin, which targets Human Epidermal growth factor Receptor 2 (HER2)-positive breast cancer, a type of more aggressive breast cancer. However, not every patient responds to this treatment in the same way. Approximately

25 per cent of breast cancer patients have HER2 gene over-expression. By measuring the presence of the growth factor, HER2, in breast cancer through a specifi c HER2 test supplied by Roche Tissue Diagnostics (Ventana), it is possible to determine HER2-positive beast cancer patients who will respond to Herceptin.

Colorectal cancer: An excellent example of PHC at work is the KRAS mutation test, which will be made available in India in 2009. This test helps in direct treatment of patients affl icted with metastatic colorectal cancer. Recently, scientists have developed more targeted therapies for colorectal cancer that look at limiting the growth of cancerous cells. One such therapyis the Epidermal Growth Factor Receptor (EGFR) inhibitor (or anti-EGFR therapy), which prevents growth signals from entering the cells, thus stunting the growth of the tumour. The KRAS gene is a defi ning factor in looking at whether a patient with colorectal cancer can benefi t from EGFR inhibitors. Patients with a mutated KRAS gene (35-45 per cent of metastatic colorectal cancer patients) are unlikely to respond to EGFR inhibitors. With the TheraScreen® K-RAS mutation test, doctors as well as patients will have a better understanding of treatment options to employ for achieving greater effectiveness.

Lung cancer: The TheraScreen® EGFR 29 test is designed for detecting 29 of the most common somatic mutations in the EGFR gene and also detects mutations not visible by sequencing. Recent studies in Non-Small Cell Lung Cancer (NSCLC) have shown that some patients carry somatic mutations in the EGFR gene. These mutations may correlate with responsiveness to the EGFR tyrosine kinase inhibitors, a targeted therapy for NSCLC.

CardiacN-terminal proBNP (NT-proBNP) is an ideal example of all aspects of PHC. It can be used to screen people at risk for Cardiovascular (CV) disease, and also in otherwise healthy people for early detection. For example, after a heart attack or after chemotherapy, it can diagnose Congestive Heart Failure (CHF) and help differentiate heart versus non-cardiac causes of shortness of breath. High levels of NT-proBNP also show a worse outcome, indicating that these patients must be treated more aggressively. It can also be used to monitor and guide treatment – the reduction in NT-proBNP is useful to optimise treatment in selected patients.

VirologyHuman Immunodefi ciency Virus (HIV): The way HIV patients regularly test their viral load is an example of PHC. Patients

Continnum of care- NT-proBNP utility across the spectrum of heart failure

CarvedilolDiureticsACE-InhDigoxin

Prevention Early diagnosis

Differential diagnosis, further DX

Management Strategy

Differential Treatement

Treatemtn Adjustement/Optimisation

Community based screening

after AMI chemotherapy

Patients with dyspnea

Patients with LVD

Treatment Optimisation

NT-proBNP NT-proBNP NT-proBNP NT-proBNP NT-proBNP NT-proBNP

PredispositionScreening

Targeted Screening

Diagnosis Prognisis Treatment Stratifi cation

Treatment recurrence monitoring

Personalised Healthcare

51April 2011 I

can get their viral load tested (along with a CD4 cell count) when fi rst diagnosed with HIV – this acts as baseline. They are then tested again 2-6 weeks after the treatment is initiated to evaluate the effi cacy of the therapy. Subsequent tests are carried out every three to four months to monitor long-term therapy to ensure that the patient has not developed resistance to the drug.

Hepatitis C Virus (HCV): Hepatitis is a viral infection that can go undetected in the body for years. If left untreated, it can lead to cirrhosis, liver failure and cancer. Tests that diagnose and monitor the virus in blood and treatment with Roche’s drug – Pegasys – have helped many people infected with it. However, not all patients respond equally to this treatment. A Roche Hepatitis C viral load test measures early response to therapy with drugs such as Pegasys, while another test that identifi es the HCV subtype provides information to help determine the correct duration of treatment with such medicines.

A shorter treatment duration with Pegasys/Copegus will provide patients with the full benefi ts of therapy while

reducing unnecessary drug exposure. The four-month treatment course will be for patients who are infected with particular strains of chronic hepatitis C (genotype 2 or 3), have low virus levels before starting treatment and who show a rapid virological response by clearing the virus from the blood within the fi rst 4 weeks of treatment. This is a new treatment concept in hepatitis C, which seeks to customise regimens for patients based on how well they respond to treatment. It is enabled by using Roche’s highly sensitive, real-time Polymerase Chain Reaction (PCR) diagnostic tests (the automated COBAS AmpliPrep/COBAS TaqMan HCV Test), which accurately measure the levels of virus in the patient’s blood.

MetabolismDiabetes: Roche Diagnostics provides blood glucose tests, insulin pumps and a whole series of services to tailor insulin treatment to patients’ needs.

Osteoporosis: A broad range of tests are made available by Roche Diagnostics

to assess bone integrity and monitor the effects of anti-resorptive therapy with drugs such as Bonviva.

Drug metabolismThe AmpliChip CYP450 Test analyses variations in two genes that play a major role in the metabolism of many widely prescribed drugs. This is the world’s fi rst commercial pharmacogenetic product for predicting individual drug response that implements gene chip technology.

TransplantationCellCept is an immunosuppressant manufactured by Roche to prevent the body from rejecting a kidney, liver or heart transplant. The key metabolite in CellCept is Mycophenolic Acid (MPA). An immunochemistry-based test measuring MPA guides optimal patient dosing. This enables doctors to accurately tailor CellCept dosages and safely lower the dosages of more toxic agents, thus further improving the outcome for patients.

(Bhuwnesh.agrawal.ba1@roche.com)

IT@Healthcare

52 I April 2011

Clinical decision support systems (CDSS) provide clinicians and other care givers with information that

is intelligently fi ltered and presented to enable improvement of treatment outcomes. The Institute of Medicine has long recognised problems with healthcare quality, and for more than a decade has advocated using electronic CDSS to improve quality. However, one must not forget that these

health Information Technology (IT) applications are a means to improve healthcare quality, not an end in themselves. Electronic medical records (EMRs) with Computerised Provider Order Entry (CPOE) digitise clinical information. But there can be no major improvements in the quality of care from the use of health IT without proper implementation and use of CDSS.

Every year, more than a lakh death are reported in US due to medical errors, including drug interactions. For India, these numbers would be in several multiples of the US fi gures. Any of the several types of CDSS tools can prevent most of these mishaps. Examples include a pop up alert to potential drug interaction; clinical prediction

rules to assess the risks of particular medication for a patient subset; clinical guidelines for treatment of diseases; or reminders for timely follow-up. EMRs lay the foundation for patient safety and healthcare quality improvement but CDSS is the tool that delivers these goals.

DesignEarly CDSS systems were derived from expert systems research. Engineers strived to create programs with rules that would allow it to ‘think’ like an expert clinician when confronted with a patient subset. Thereafter, these systems evolved so that they could be used to assist clinicians in decision across routine tasks, warning clinicians of potential problems and providing suggestions as per programmed rule sets.

Common features of CDSS systems that are the knowledge base (e.g., compiled clinical information related to diagnoses, various types of drug interactions, allergies and evidence-based guidelines), a smart program linking that knowledge with patient-specifi c information and a data bus for porting such information into the CDSS engine and convey relevant information outputs (e.g., lists of possible diagnoses, drug interaction alerts or preventive care reminders) back to the clinician.

CDSS can be built into the EMR or hosted as a standalone application available on the network, or on a mobile device, like a smart phone-based dosage calculator. Its knowledge base may be available centrally for local use as needed, or locally with constant

Clinical Decision Support System (CDSS) assists clinicians at the point of care. This unique support system forms a signifi cant part of the knowledge management technology via its capacity to support clinical processes from diagnosis and investigation through treatment and long-term care.

Clinical decision support systems

Promoting evidence-based medicine

Dr Aloke C Mullick(MS Surgery), Chief EvangelistEMR Mavens

Photo

by:

Josh

ua

Nav

alkar

IT@Healthcare

53April 2011 I

upgrades. Practically, a deployed CDSS could utilise any of these computational architectures, methods of access or devices. The way these elements are constructed and deployed will depend on the type of clinical automation systems in place, local vendor solution availability, clinical workfl ow, security issues and funding constraints.

SettingsCDSS has the ability today to support physicians and clinical care givers at all key stages in the care delivery pathway, including preventive care, diagnosis, treatment, monitoring and follow-up. They can include order sets created for particular diseases or patient subsets, based on evidence-based guidelines and/or customised as per individual clinicians’ preferences, provide access to guidelines and other external clinical content that provides information relevant to particular patients/diseases, clinical

reminders for preventive care and alerts that fl ag potentially dangerous clinical situations needing attention. Commonly, CDSS is used for addressing needs, such as assisting accurate diagnoses, screening for preventable diseases or averting adverse drug events.

ControlsA key feature of CDSS is the level of control the user has over the decision to use CDSS recommendations. Others include whether the CDSS recommendations are set up to be displayed on demand so that users have full choice to access it as also to accept it. These two control aspects are related and connect closely with how the CDSS advice matches a clinician’s intention. CDSS are designed to: Remind clinicians of things they need to

do, but should not have to remember Provide information whenever care

givers are unsure about the next course of action

Assist to correct errors clinicians may make and

Recommend that the clinicians change their plans.

The users’ reactions to CDSS may differ with these diverse intents. An analogy can be seen when a user employs the calendar functions on the PC, an alarm automatically pops up a reminder of something the user intends to do. This automatic notifi cation is the most helpful feature of the calendar application. The spell checker in MS Word provides advice as well as corrects errors, doing so ‘automatically’ while one writes, or ‘on demand’ after one fi nishes and then accesses the function. Similar Word features make suggestions about changing what has been done. The grammar checker is often accessed on demand to correct grammatical errors. It can also suggest sentence revision, which may be ignored. Many users access the help function in MS Word. However, for most people the automatic appearance of the help wizard (like an automated decision support alert) creates ‘reminder fatigue,’ which leads to it being disabled. Automated alerts therefore should be few and relevant. Users are more amenable to on demand information.

ChallengesCDSS challenges depend largely on how closely the system is tied to what the clinician already intends to do. Clinicians may initially want a set of clinical reminders, and after review

assessments agree that they need some more. The timing of reminders is the key issue after the user has agreed to be reminded. Questions like ‘should reminders for preventive care pop up in advance of the patient visit or during the patient’s visit’? are debated. Other key user issues are speed and ease of access. Even though most clinical users recognise the need for information, they are willing to access it only if

Segments where CDSS helps

Care Segment CDSS Examples

Prevention Immunisation alerts, screening alerts, disease management alerts (e.g., Hb1Ac levels to be checked every 3 months)

Diagnosis Diagnostic suggestions for a set of symptoms and signs(e.g., The Isabelle ® CDSS system)

Therapy Diagnostic and drug order sets as per guidelines, dosage calculators, drug-to-drug interaction alerts, drug-to-disease interaction alerts, drug-to-allergy alerts, treatment guidelines (e.g., NCCN guidelines for oncology)

Follow-up Clinical reminders, drug adverse drug reaction (ADR) monitoring, clinical guidelines-based surveillance alerts

Uses of CDSS

CDSS intention Match with users’ intention required

Clinical examples Issues that need to be addressed

Automatic reminders for actions that clinical user does not want to remember

High Drug-to-drug interactions; dosage calculators

Timing of the reminders and alerts

On demand information in areas where clinical user is unsure on how to proceed

High Treatment guidelines; latest evidence base

Information validation; who will update the knowledge base; speed and ease of access

Correct clinical users’ errors and/or recommend new plan

Low Critical drug-to-drug interactions

Timing; manner of presentation; clinicians’ level of control over response

IT@Healthcare

55April 2011 I

it can be accessed without wasting time or effort. Diffi cult or time-consuming access drives away potential users from CDSS.

The key issue in pointing out errors or suggesting that physicians change what they had planned to do for the patients is balancing the clinicians’ desire for autonomy with improving patient safety. A related issue revolves around how much control users have over the manner they respond to CDSS suggestions. This relates to whether clinicians are forced to accept the CDSS suggestion, the ease with which they can ignore it and the amount of effort needed to override the advice.

BenefitsAs EMRs join the mainstream, the base for truly achieving the advantages of electronically managed and recorded clinical workfl ow is put in place. There is really no meaning in creating electronic records without using the vast storehouse of digitally available clinical content to guide and enable truly evidence-based care. An oft quoted example in the West is the importance of prescribing Aspirin in the fi rst 24 hours following acute myocardial infarction (AMI). Hospitals switching from paper-based systems to EMRs with CDSS (in this particular instance with a drug order set for AMI) saw their Aspirin prescribing rates go up from 30 per cent to more than 90 per cent. The system, by suggesting what is clearly established in the evidence base, was just preventing physician oversight, an all too common phenomenon in a busy emergency room.

It is, however, relevant to note that for CDSS to achieve its stated purpose of improving patient outcomes, the system needs to be properly designed, carefully implemented and judiciously used. Systematic evaluations of processes of implementation, user satisfaction, and other factors that may affect the outcome of the intervention should be done by experts in the fi eld. There is a need for qualitative evaluations of the physician-CDSS interaction and its impact on the clinician, the workfl ow, and other organisational processes and outcomes, in order to continuously refi ne the system and maximise its benefi ts. Several institutions in the West have treated CDSS as an out of the box system to deploy and use as-it-is and suffered from poor usage and negligible benefi ts in the long run. Others who created a system of constant feedbacks and reviews guiding system redesign and iterations, created a strong culture of CDSS usage leading to improved safety and clinical outcomes. Last but not the least, hospitals must beware of sketchy systems, which depend on non-validated content and poorly designed logic and interaction engines. These systems can actually cause clinical harm, and already have entered the realm of accepted causes of iatrogenic injuries.

(acmullick@gmail.com)

Marketing Mantra

56 I April 2011

Let me give you a secret for marketing of services. It is more about the experience and emotion than it is about

the product and its features. Contrary to what I just said, many hospitals and doctors in India believe the reverse to be true. I constantly run into hospital promoters and doctors who brag about the latest equipment they have acquired and its features. They want to ‘differentiate’ their offering based on the tangible assets that they have. Seldom does anyone talk about the excellence in customer experience.

The irony is refl ected in a recent survey conducted in the US. The survey suggests that people choose one hospital or doctor over another based on how they are treated as human beings than any other parameters. In other words, the most important consideration for a patient to visit a hospital is the experience that he will get as a ‘person’.

He is now turning into a customer who has expectations from the service provider. He is evaluating the hospital in his head all the time. He now has options. If his expectations are not met, he may go elsewhere and never come back again.

Most hospitals have a feedback collection mechanism. I reckon that getting a feedback form fi lled is not enough. Here are some drawbacks of feedback forms:

The forms are not always fi lled by the patients. Sometimes the relatives who have come to pick them up at discharge time fi ll the forms.

The forms are generally fi lled in a hurry as the person is looking forward to go home.

The last few experiences that are a key to satisfaction to the patient are not captured in the feedback form. For example, which form captures the behaviour of the ambulance driver if the patient is dropped back in the hospital ambulance?

Too often the staff of the hospital infl uences the patient and his family to get the form fi lled.

The person who gets the form fi lled is not the same for every patient. Hence, the collection mechanism is not consistent. In large hospitals, some wings have more active feedback seekers than others. Hence, the feedback collection is skewed towards one part of the building.

Another myth is that a satisfi ed customer is equal to a delighted customer. A satisfi ed customer is the one who has no complaints. But that does not mean that he is delighted with the services. A satisfi ed customer defi nitely does not mean that he is a loyal customer.

Hence, mere compliance to standard operating procedures is necessary but insuffi cient in any hospital. There has to be an experience that customers can rave about. You need to give them a story to take home and talk about.

When we talk of delight, we talk of going a step ahead of customer’s

If hospitals and healthcare providers are assuming that new diagnostic techniques and state-of-the- art infrastructure can bring in the best quality of care and patient satisfaction, they might need to think again. In today’s world, a patient, as a customer, has several choices with regard to healthcare providers, and he may prefer those who provide him a delightful experience rather than a satisfactory and normal experience.

Achieving patient satisfaction

Its time to think out of the box!

Vivek ShuklaPrincipal - Healthcare Business Consulting, Vivek Shukla and Associates

Marketing Mantra

57April 2011 I

expectations. For example, the customer may expect the receptionist to be soft-spoken, effi cient and well-informed. This is satisfactory and to create customer delight, you will not only have to meet all the expectations, but also will have to provide at least something more.

ComplexitiesProviding delight is a complex issue. Here are some intricacies you can master: Delight has to be created and experienced at the same time. The management cannot be present with the staff at all

times. The staff has to be inspired enough to do it on their own as no single person or department is exclusively accountable for providing a great overall experience to the customer.

Customer delight is hard to measure. Delight for one person may be just satisfaction for another.

Customer satisfaction and delight are always progressive. Whatever is considered to be delightful by customers today, will be considered a simple norm a few years later. When most of the players start providing a service at a particular level of excellence, it becomes a norm and is expected by the consumer.

Customer experience is culmination of a series of experiences. In the series, the fi rst few and the last few experiences are more important. A series of good experiences can be undone by a long discharge procedure on the last day of the hospital stay.

Identifying the expectations To be a successful customer-oriented organisation, the hospital must look at the expectations that its customers have from the various ‘points of contacts’. A point of contact is the place or the department that a customer is likely to interact with while undergoing the experience of visiting a hospital. A few points of contacts are the security guard, doctor, receptionist, and lift man, while non-human points of contacts are the hospital brochure and air conditioning. The customer’s experience with each of the point of contact would culminate into a bright, dull or neutral experience at the hospital.

Customer delight as a strategyAs said earlier, customer delight goes beyond fi lling up the customer feedback forms. It goes to the extent of calling them up after they have left your hospital. Moreover, it is not easy to replicate the Herculean effort of providing delight at every step of the service experience. You can certainly stand apart from the rest of the crowd if you are able to put the pieces in place before anyone else.

As the Mayo brothers rightly put it ‘Interest of the patient is the only interest to be considered.’ Today, healthcare providers do need to ponder this and customer loyalty or customer delight-centric strategies must be followed.

(vivekshukla2006@gmail.com)

Facility Visit

58 I April 2011

Processing over 12 million tests a year and catering to more than 10,000 laboratories, hospitals, nursing homes and 50,000

consultants, Metropolis Healthcare Ltd has earned the reputation of being one of the very few multinational chains of diagnostic centres. It has branches in the UAE, Sri Lanka, Mauritius, Bangladesh, Nepal and South Africa.

Journey so farSince its inception in 1981 as a

Mumbai-based laboratory, Metropolis has come a long way. Visionary leadership, strategic associations with other leading laboratories across the country, strict ethical policies and a penchant for technology are some of the attributes that contribute in making Metropolis one of the largest laboratory chains in the country. Accreditations such as International Organization for Standardization (ISO), National Accreditation Board for Testing and Calibration Laboratories (NABL),

College of American Pathologists (CAP) reiterate the fact that stringent national and international quality requirements are met. This is indeed imperative in a service sector like healthcare. A wide network with 500 collection centres proves the excellence and the commitment of the organisation. It pledges to deliver accurate and timely results across the 4500 routine, specialised and highly specialised investigations that use technologies including Biochip and DNA sequencing.

With cut throat competition, Metropolis Healthcare Ltd knows how to set itself apart. Setting up one lab in each state of India and becoming a preferred partner to the Government are some of its aims. A look at the journey of the organisation and its growth plans.

Metropolis Healthcare Ltd

Benchmarking against the best

Chandreyee Bhaumik

Facility Visit

61April 2011 I

Further, innovations like Home Health Services help the company to reach out to immobile/weak patients so that going for a check-up or routine or mandatory test is no longer an inconvenience for them. Elaborating on the strength of the company, Ameera Shah, Managing Director and CEO, Metropolis Healthcare Ltd, says, “We provide a completely different experience to our clients as we comply with global standards and not just national. We are in fact the benchmark for several other companies.”

Way it is For any enterprise to survive on the speedy track inhibited with competition, following a business plan is extremely essential. Metropolis located at Worli, Mumbai is the main referral lab. Discussing the business model of the company, Dr Nisha Sana Ahmad, Chief of Lab Services & General Manager Haematology & Haematostatis, Metropolis Group-National, elaborates, “We now have a standalone lab at Churchgate where lab testing is done. This lab caters to South Mumbai. Routine tests are also conducted at the Churchgate laboratory and the specialised ones at the Worli branch. In about one month, we will also be establishing another lab in Thane.”

At Metropolis, upgradation of technology is a continuous process. The lab ensures best practices and works with awareness drives and health check-up camps. As, Dr Ahmad avers, “With time we can see an increasing concern in the arena of diagnostics. Since we live in a developing country, the progress has not reached its apex. In India, there are primarily two types of diagnostics. One type takes care of the prevention side of the process, while the other type encompasses the patients when they are actually suffering.”

The capability of Metropolis to carry out health check-ups and testing across large geographies ensures that companies/corporate customers or individual customers can be assured of consistent results. The company

considers that in the battle against diseases, diagnosis is the fi rst step. The services extended by the company include clinical laboratory medicine, radiology and imaging services, hospital laboratory management, central laboratory services for clinical trials, site management services, home health services, preventive health check-ups and remote pathology testing services.

VisionThe company aims to become the global network of highly automated and sophisticated diagnostic laboratories along with cutting-edge technology, accuracy, effi ciency, unparalleled customer service and above all a stringent ethical code. Dr Ahmad clarifi es, “In this organisation quality is given prime importance. Several accreditations that we have attained help us in maintaining our standards.” Elaborating on this line of thought, she adds, “Another essential requisite in our company is the consultation factor. We do not just receive samples and give reports but also talk to doctors, and arrange consultations

with them.” Discussing the present areas of concentration, Dr Ahmad says, “At present, we are focussing on the way to change mercury thermometers into non-mercury ones.”

Metropolis hopes to become one of the most preferred partners for the Government of India with plans to set up at least one lab in each state. This would help in developing a platform to learn and share knowledge. It is not just the national supremacy that matters but the company also desires to position itself among the top three dominant players in South East Asia, Middle East and South Africa.

Hygiene: A prime concernBeing a pathological laboratory, hygiene is a prime concern. There is an assigned safety offi cer, who has to conduct regular programmes in this regard. If there are any blood spills, needle pricks then immediate action is taken so that hygiene is not compromised. Further, a physiotherapist is appointed who takes care of ergonomics ensuring that correct posture is maintained while an

There is growing awareness in healthcare, and in the next fi ve years we would bethe leading player.

Ameera ShahManaging Director and CEO, Metropolis Healthcare Ltd

Referral lab at Metropolis

Facility Visit

62 I April 2011

employee is working at the computer. Further, the offi cer also sees that in the refrigerators that are only meant to store samples or required solutions food and drinks are not kept. Again, double gloves are worn - one is used for handling the samples and the other is while performing other chores like working on the computer. Further, it is

also ensured that the person wearing gloves is not allergic to gloves because this might cause harm to the samples under consideration. Also, if a person has any contagious disease, care is also taken in that respect. Dr Ahmad reiterates, “We conduct sputum tests every month to see that the staff dealing with the samples is not infected.”

Money mattersCommenting on the investment pattern for the company, Dr Ahmad says, “Investment is not uniform in all the sectors. We primarily have three types of equipment - major equipment, minor equipment and miscellaneous equipment. Most of the major equipment are either bought or rented or on generally it is a ratio of 50:50. Again, minor equipment like centrifuges, incubators are usually bought. The last category, which includes equipments like glasswares, also involve buying.

Elaborating on the Return on Investment (ROI) Shah elaborates, “From the gross income, we reinvest ` 30 - 40 crore to our business.”

What sets them apart?Like every aspect Metropolis also has its own share of problems. Ameera clarifi es, “Today there are several small- and medium-sized companies in this line, and thus there are at times dearth of proper talent and technology.” She continues, “Since there is growing awareness in healthcare, in the next fi ve years we would be the leading player.” It is the positive vibes of the company that sets it apart from the rest on the same track. Dr Ahmad signs off saying, “When somebody gives us negative feedback we take it positively. We do not consider it as complaint. We feel that it is an opportunity to improve. The tests are then given to the neutral body of quality assurance department. Sometimes the complaint is not valid, but in the process lot of things, which are learnt are considered more important.” Thus, learning from mistakes defi nitely marks the difference.

(chandreyee.bhaumik@infomedia18.in)

Lab technicians at work

Events Calendar

63April 2011 I

International Congress on Patient SafetyThe event aims to throw light on patient safety priorities in healthcare. It will discuss best practices in patient safety, role of clinicians in patient safety, insurance perspective in patient safety, role of Information Technology (IT) in patient safety, culture of patient safety, communication for patient safety & medical errors and many others.

Date: April 21-22, 2011Venue: Hyderabad International Convention Center, HyderabadOrganiser: Apollo Hospitals, Johnson & Johnson, PhilipsTel: + 91 40 2360 7777 Fax : +91 40 2360 8050Email: patientsft@gmail.comWebsite: www.patientsafety.co.in

Hospital Management Conference 2011Hospital Management Conference (HMC) is a research based content driven conference programme that aims to bring up-to-date worldwide hospital management thinking and experience to senior hospital and healthcare managers in India. There will be case studies; interactive panel discussions on trends, challenges, solutions and technologies that will help keep the industry in line with current and future progress.

Date: May 27-28, 2011Venue: Hotel The Westin, MumbaiOrganiser: UBM MedicaTel: + 91 9819166942 Email: shalu.chopra@ubm.comWebsite: www.hmcindia.in

Meditec Clinika 2011Meditec Clinika is the third international trade fair for medical equipment and technology showcasing innovative

medical products & systems in India. The event aims to take a step forward in contributing to the quality of healthcare.

Date: July 2-4, 2011Venue: Palace Grounds, BengaluruOrganiser: Orbitz Exhibitions Pvt Ltd Tel: + 91 22 2410 2801/02/03/04Fax: + 91 22 2410 2805Email: info@meditec-clinika.comWebsite: www.meditec-clinika.com

Healthex 2011 Healthex 2011 is an international exhibition on hospital, medical and surgical equipment, materials, supplies and allied services, which aims to showcase the latest innovations in the fi eld of medical technology to the medical experts from all over the country and abroad.

Date: August 5-7, 2011Venue: Bangalore International Exhibition Centre, BengaluruOrganiser: Bangalore International Exhibition Services Pvt LtdTel: + 91 80 65833234Email: suresh@bies.co.inWebsite: www.healthex.co.in

Seventh Medicall The event aims to attract the healthcare industry exhibiting a wide range of products including hospital equipment, surgical equipment, rescue and emergency equipment, facility management and support services.

Date: August 6-8, 2011Venue: Chennai Trade and Exhibition Centre, ChennaiOrganiser: MedExpertTel: + 91 9840326020 Email: medexpert@medicall.inWebsite: www.medicall.in

NATIONAL

India’s premier industrial trade fair on products and technologies related to Machine Tools, Hydraulics & Pneumactics, Process Machinery & Equipment, Automation Instrumentation, Packaging & Auxiliaries, IT Products, Electrical & Electronics, Material Handling and Safety Equipment.

For details

Infomedia 18 Ltd,Ruby House, 1st Floor, J K Sawant Marg, Dadar (W), Mumbai 400 028.

• Tel: 022 3003 4651 • Fax: 022 3003 4499 • Email: engexpo@infomedia18.in

RUDRAPUR: Uttarakhand, Sept 23-26, 2011, Gandhi Park

AHMEDABAD: Gujarat, Nov 14-17, 2011, Gujarat University Exhibition Hall

CHENNAI : Tamil Nadu, Dec 16-19, 2011, Chennai Trade Centre

INDORE: Madhya Pradesh, Jan 6-9, 2012, Poddar Plaza, Nr Gandhi Hall

AURANGABAD: Maharashtra, Feb 17-20, 2012, Garware Stadium

PUNE: Maharastra, Nov 18-21, 2011, Auto Cluster Exhibition Centre

Events Calendar

64 I April 2011

INTERNATIONAL

China International Medical Equipment FairAn international exhibition that will serve the entire value chain for the medical device market. The event aims to exhibit a wide range of medical image devices, medical electronics equipment, surgical devices, ambulence and medical vehicles, outsourcing services, medical optical devices and many others.

Date: April 16-19, 2011Venue: Shenzhen Convention & Exhibition Center, ChinaOrganiser: Reed Sinopharm ExhibitionsTel: +86 10 8455 6695Fax:+86 10 8202 2922Email: jin.liu2@reedsinopharm.comWebsite: www.en.reed-sinopharm.com

World Vaccine Congress Washington 2011An international exhibition of the vaccine products industry to showcase modern vaccine technologies. The exhibitor profi le would include analytical instruments, labware, excipients, equipment, etc. Professionals from the pharma and biotech industry, sales and marketing personnel, technology delivery manufacturers and members of the higher management are expected to attend this event.

Date: April 11-14, 2011Venue: Gaylord National Hotel and Convention Center, Washington DC, USAOrganiser: Terrapinn Pte LtdTel: +61 2 9005 0700Fax: +61 2 9281 3950Email: enquiry.au@terrapinn.comWebsite: www.terrapinn.com

14th ASEAN Paediatric Congress The 14th ASEAN Paediatric Congress and the 3rd ASIAN Paediatric Otolaryngology meeting will concentrate on topics like trends, issues, priorities in paediatrics

and also translate & transmit new knowledge & information to doctors and allied health professionals. The event will also conduct interactive sessions.

Date: April 14-17, 2011Venue: Suntec, SingaporeOrganiser: The Meeting Lab, Congress SecretariatTel: + 65 6346 4402Fax: + 65 6346 4403Email: info@apc2011.com.sgWebsite: www.apc2011.com.sg

REHAMEDEXPO 2011An international specialised exhibition showcasing modern rehabilitation technologies for remedial treatment. An array of diagnostic equipment, medical technology, IT equipment, etc, will be displayed at the exhibition. Professionals and consultants from the healthcare, health insurance, medical sciences, medical software systems, etc, are expected to attend this event.

Date: April 25-28, 2011Venue: EcoCenter Sokolniki, RussiaOrganiser: MVK - International Exhibition Company Tel: +7 495 995 05 95Email: info@mvk.ruWebsite: www.mvk.ru

IHE USA 2011 This event aims to be an ideal platform for companies and associations specialising in healthcare and medical industry and all other related industries to showcase and exhibit their products and expertise all under one roof. The trade show will offer its exhibitors an excellent opportunity to increase their brand awareness and promotion.

Date: May 10-12, 2011Venue: Charlotte Convention Center, Charlotte NC, USA

Organiser: Arosa Exhibitions LtdTel: +1 980 219 8449Fax: +1 980 219 8449Email: gviniconis@arosa-group.comWebsite: www.arosa-exhibitions.com

FIME International Medical ExpoAn international exhibition that aims to showcase allergy products, biopsy needles, cardiology equipment, blood pressure equipment, blood bags and many other things. The event hopes to attract buyers and sellers from all over the world.

Date: August 10-12, 2011Venue:Miami Beach Convention Center, Miami, USAOrganiser: FIME International Medical Exposition, Inc. Tel: +1 941 3662554Fax: +1 941 3669861Website: www.fi meshow.com

BioProcess International China BioProcess International China will be organising its 3rd annual event and will focus on topics like Cell culture, cell line engineering, purifi cation and recovery, process charaterisation, process analytics, formulations and disposables technologies which will be presented by top notch scientists and executives from all around the world. The objective of the event is to provide China and the regional countries with high quality presentations, case studies and strategies that will help the region’s burgeoning bioprocessing and manufacturing industries achieve their potential faster and more effi ciently.

Date: August 22-24, 2011Venue: Grand Hyatt Hotel, Shanghai, China Organiser: IBC Life Sciences Tel: + 816 472 0701Fax: + 65 6508 2407 Email: mlangley@ibcusa.comWebsite: www.ibclifesciences.com/BPIChina/overview.xml

The information published in this section is as per the details furnished by the respective organiser. In any case, it does not represent the views of

Report

65April 2011 I

With healthcare spending expected to rise by 12 per cent per annum and contributing signifi cantly

to service sector growth trajectory for India, MEDICAL FAIR INDIA 2011, was expected to generate a huge response from the medical fraternity. And it did just that. Over 260 exhibitors from 15 countries across the globe participating in the fair, this business-to-business event proved a strong interactive platform for the medical industry.

Industry estimates suggest that by the year 2015, total spending by the Indian healthcare industry could contribute around 8 per cent of Gross Domestic Product (GDP) and would employ around 9 million people. This warrants a steady growth for the medical equipment companies both domestic and international players willing to set base in India. Events like Medical Fair India provide just the opportunity

for medical practitioners and companies to showcase their latest in technology and also to increase their client base.

Opinion bagSpeaking about the event, Sarabjit Singh, Director, ARVS Equipments Pvt Ltd, said, “The response from the event was good and we have been getting queries from prospective clients after the event. The event was well organised but we would have preferred a different time of the year. However, the venue at Pragati Maidan was perfect as it is right at the centre of the city, so it makes our work easier to get clients to visit us,” he added. While there were participants from across the country, international exhibitors came from China, Taiwan, Korea and France to name a few. “The number of international exhibitors was substantial and it was heartening to see new technology and ideas being displayed at the fair. However,

we would have liked to have exhibitors from a broader ambit of the medical fraternity; the overall response to the event was good,” said Vinod Kumar Sekar, Executive Director, Green Sol Synergies Pvt Ltd. “The opportunity was great and being the largest medical fair in the subcontinent region, many domestic as well as international players in the medical domain showcased their products,” he added.

The medical equipment industry in India has witnessed a fl urry of companies from across the globe into India with high-tech products, which has witnessed high demand from hospitals and healthcare institutes. This year’s Medical Fair provided an opportunity for healthcare equipment companies to display their products in the heart of the city. “The fair was a good opportunity for us to fi nd a platform where we can make business,” said Kumar Prashant, Director, Entrack Corporation.

What’s next?While the fair had a lot of positives , there were a few areas which exhibitors felt could have been taken care of. Like, the timing of the event clashed with the annual closing for companies; hence, many of them could not turn up for the fair. “Events such as these should not be held on weekends. I have been attending the Medical Fair for the past fi ve years and can say that a slot during the weekdays would have surely garnered more response,” opined Prashant.

The next edition of MEDICAL FAIR will be held from March 2-4, 2012in Mumbai.

(anwesh.koley@infomedia18.in)

The 17th edition of the Medical Fair India, held at New Delhi, witnessed wide participation from both domestic and international players, but the event this year was a low key profi le.

MEDICAL FAIR INDIA, 2011

A showcase of talent and technology

Anwesh Koley

A glimpse of the exhibition

Report

66 I April 2011

CII held its Western region PPP policy framework conference at Ahmedabad recently.

It was organised with the objective of bringing all stakeholders on a common platform, and learnand observe certain successful PPP case studies and discuss about the various fi nancial, administrative and legal aspects of the policy. PPP is an important avenue through which certain unmet needs can be met for the healthcare industry. Long-term sustainable partnerships are far and few in this sector, and there is a need for clear and controversy-free guidelines to formulate PPP.

The conference had several lead speakers and most of them highlighted the scenario of PPP and Gujarat with regards to healthcare.

Collaborate to growIn the same vein, speaking on the developments in Gujarat, Jay Narayan Vyas, Minister for Health & Family Welfare, Tourism, Devasthan Pilgrimage Development, said, “Gujarat will lead in the PPP model of healthcare.” He mentioned U N Mehta Cardiology Centre, Institute of Kidney Diseases and the Gujarat Cancer Research Institute as the success stories of the PPP model of Gujarat. The Minister complimented CII in bringing this discussion forum to Gujarat, the most happening state

for PPPs. He also released a white paper on ‘Partnerships in Healthcare: A Public Private Perspective.’ The gap in demand and supply was pointed out by Atul Garg, Chairman CII Gujarat State Council. He mentioned that the major challenge that India is facing is in expanding the demand and supply gap as there is low utilisation of hospital infrastructure and less number of medical professionals.

In his introductory remarks, Dr Vivek Desai, Chairman, CII Western Region Healthcare Sub-Committee, said CII is the fi rst to spot the very silent revolution on PPP that is happening in Gujarat. He categorically mentioned that the success of PPP model depends on the contract, which happens between three parties. Economic and fi nancial sustainability of PPP is vital as most of the PPP projects in the healthcare sector have long gestation periods. The conference also had elite speakers from the academic front. Dr K V Ramani, Professor, Public Systems Group, Center for Management of Health Services, IIM Ahmedabad described how the combination of the expertise of private sector and facilities from the Government can deliver better services to the community as and when they need. He gave details of the Vasna Urban Health Centre in Ahmedabad as a model for the PPP. Overall, the conference received an overwhelming response. It did achieve the set objectives and the speakers showed hope for PPP policy adoption for meeting the unmet needs of the healthcare industry.

(mmedit@infomedia18.in)

Shri Jaynarayan N Vyas, addressing the gathering. (From L to R): Prof (Dr) K V Ramani, Atul Garg, Chairman, CII Gujarat State Council & COO, InteQ IT Services (India) Pvt Ltd; Anju Sharma, Commissioner of Health, Secretary - Public Health & Mission Director, National Rural Health Mission, Government of Gujarat; Dr Vivek Desai, Chairman, CII, WR Healthcare Sub-Committee & MD, Hosmac India Pvt Ltd; Sumita Chakravarty, Deputy Director, CII.

Chanting this mantra the Confederation of Indian Industry (CII) held a conference on Public Private Partnership (PPP) policy framework . The event witnessed a plethora of participants.

CII’s conference on Public Private Partnership Policy Framework

Way forward for delivering quality healthcare

Product Update

67April 2011 I

This section offers an overview of the latest medical/surgical equipment available in the worldwide market. If you wish to have your products featured in this section, send us the details at mmedit@infomedia18.in. Also gain added advantage through our ‘Product index’ and ‘Advertiser’s list’ to facilitate your business.

NATIONAL

Medical refrigeratorSigmatech Scientifi c Products offers Sigmazk medical refrigerator with glass door manufactured by Zhongke Meiling Cryogenics Limited Company, China. The medical refrigerator is specialised refrigerating equipment for cold storage of pharmaceuticals as well as biological products. It is suitable for hospitals, drugstore, pharmaceutical factories, biotech companies, research centres and many more. This medical refrigerator is provided with microprocessor-based temperature

control system; combined with two sensors monitoring the chamber temperature and one sensor monitoring the ambient temperature. A stable and accurate chamber temperature can be maintained at ambient temperature ranging from

Endocervical brushGlobal Surgimed Industries offers Endocervical brush. This is used for cervical papanicolaou (Pap) smear screening. Plastic spatula is also available. Wooden as well as plastic spatula have smooth edges. The pack consists of brush and wooden spatula. Each set is individually packed in medical paper pouch pack and is sterilized by Ethylene oxide (EO) gas. Stainless steel spatula with plastic handle is also available.

Global Surgimed Industries - New DelhiTel: 011-2748 0250Email: gulshan1966@hotmail.com

0°C to 32°C. Forced air circulation system provided with this refrigerator ensures temperature uniformity.

Sigmatech Scientifi c Products - Hyderabad - Andhra PradeshTel: 040 - 6453 4491, 098496 32904, Fax: 040-4003 1896Email: s_tech07@yahoo.com

Product Update

68 I April 2011

LampSaga Enviro offers lamps by DR Fischer. These lamps are used in the medical sector, for medical instruments and products. Operation

Theatre (OT) lamps, lamps for the dental sector and analytical equipment make very high demands on precision and safety. Even the smallest amounts can be precisely tailored to the particular needs of the customer and handmade. The lamps are used in domestic appliances, refrigerator, microwave & ovens. The company also offers Industrial Infrared (IR) lamps for plastic blow moulding machines, textiles coating & laminating, printing, semiconductor & general heating.

Saga Enviro Pvt Ltd - Secunderabad - Andhra PradeshTel: 040 27713 368, Fax: 040 2771 1410Email: drfi scher@vedgroup.net/ vedintl@vedgroup.net

Laser-based tool setting systemBlum Novotest Measuring & Testing Technology offers laser-based tool setting system for CNC machine tools. Blum laser control NT uses their patented NT Technology for the measurement, which provides positive and accurate measurement and breakage detection of tools. The measurement using NT technology does not get infl uenced by the falling coolant & chips. Blum lasers use focused beam instead of parallel beam using additional optics to facilitate precise measurement of even small tools. These are used in die & mould industry for accurate measurement of tool length, radius, controlling the form of the tool, etc.

Blum Novotest Measuring & Testing Technology Pvt Ltd - Bengaluru - KarnatakaPhone +91 93421 06498/ +91 93421 06499Email: info@blum-novotest.com

Baby incubatorV-Care offers model ‘V-150’ baby incubator, which comprises skin and air control system as well as digital display system to set the required temperature, and to measure canopy’s and infant temperature. To indicate the heater output, there is a bar graph LED system and these built-in features assure easy operation. In the model ‘V-180’ baby incubator a digital microprocessor is incorporated, whose function is to control and check all important functions. These incubators are used to measure infant temperature & air temperature and to set the required temperature. It is provided with a digital display system. These micro-computerised systems have large and brighter displays for easy monitoring and viewing from a distance. Fault indications are provided with alarm, for air probe failure, baby probe failure, 1° C temperature low and high, high temperature cut-off, power failure, etc.

V-Care - Bengaluru - KarnatakaTel: 80-2311 0651-52/2350 6047, Fax: 80-2311 0645Email: sales@vcaremed.com

Swab stickGlobal Surgimed Industries offers swab sticks. These are made of balsa wood, sanded and polished with fi nely rolled compacted cotton at one end. It has a smooth surface. It has no smell, no splints and no water lines. This is used daily for cleaning and wakeup in medical fi eld. Swab stick is available in unsterile form in

100 pcs packing. This is also available in individually packed Ethylene oxide (EO) sterilised form.

Global Surgimed Industries - New Delhi Tel: 011-2748 0250Email: gulshan1966@hotmail.com

Electric injection moulding machineNeejtech India offers electrical horizontal injection moulding machines from Niigata in Japan. The machine ranges from 30 to 1000 ton & vertical IMM

ranges from 30 to 150 ton. All electric machines are generally known as green machine because it saves more than 60 per cent power consumption than similar size hydraulic/toggle machine. The machine is absolutely free from oil and does not create pollution. Due to no oil use it reduces maintenance and repair cost of hydraulic system. It ensures enhanced accuracy, reliability, and also provides great cost savings and contributes to environmental preservation. The machine is ideally suitable for medical, automotive, pharmaceutical-healthcare and packaging molding segment of industry. It runs quietly & without vibrations. It is very precise due to no deviation through oil viscosity, compressibility, through drifting hydraulic valve action time. By switching over from hydraulic to electric injection moulding machines one can save greater

cost on power consumption, cooling water consumption, hydraulic oil elimination, even housekeeping and maintenance cost. It will increase up time and decrease material wastage. Total annual saving of 100 ton electric IMM will be around R 6.5 lakh/year over 100 ton hydraulic IMM.

Neejtech India - Ahmedabad - GujaratTel: 079-2656 1312, Mob: 09825040231Email: sales@neejtech.com

Product Update

70 I April 2011

IHC/ISH staining systemBiogenex Life Sciences Pvt Ltd offers ‘Xmatrx Diagnostics’ fully automated IHC/ISH staining system with ready-to-use factory protocols and provision for user protocols. Its key technology includes 40 independently controlled thermo-cyclable slide stations with provision of individual slide loading and unloading. Here, temperature can be controlled from ambient temperature to 105°C in less than two minutes irrespective of laboratory conditions. It is designed to automate all the steps in molecular diagnostic technology and also has provision for any future technologies.

The reaction micro-chambers on slide enable less reagent consumption with volumes as low as 30 µl. Disposable pipette tips used for reagent disposal eliminates cross contamination. Inventory management of the reagent is made easy due to RFID reagent vials and powerful software. Its report generation capability with bi-directional connectivity makes it ready for regulatory requirements like record keeping for number of assays, run log, reagent usage, etc.

Biogenex Life Sciences Pvt Ltd - Hyderabad - Andhra PradeshTel: 040-2718 5500, Fax: 040-27185511Email: sales.support@biogenex.com

Oxygen concentratorModitech offers oxygen concentrator with NASA-derived rapid pressure swing adsorption technology. It comes with oxygen purity indicators and in-built pulse oximeter for SPO2 monitoring. The features of this concentrator include purity of oxygen, which conforms to medical standard, requires only air, low power consumption with uninterrupted fl ow of oxygen, crush-proof tubing, etc. This oxygen concentrator is provided with adjustable fl ow meter with 0.5 lpm variation and has in-built devices for nebulising therapy. The built-in temperature control is provided for working at very low climate. It is used for respiratory diseases such as chronic bronchitis, bronchial asthma, emphysema, pulmonary heart disease and may more. It is also used in cardiocerebral vascular diseases, such as high blood pressure, arteriosclerosis, coronary heart disease, myocardial infarction, heart rate disorder, etc.

Moditech International - ChandigarhTel: 0172-271131, Telefax: 0172-508 5177Email: info@medoxy.net

Product Update

71April 2011 I

AutoclaveNarang Medical offers autoclave pressure steam steriliser. This portable vertical autoclaves are made out of thick high-quality (14 gauge) stainless steel sheet, deep drawn to cylindrical shape, without joints and welding. The seamless construction does not allow bacteria residue and is free from dirt accumulation. It is fi tted with pressure gauge, safety valve (weight type), seam/pressure release cock and lid handle. The lid is similar to

pressure cooker with locking over rubber gasket. The company also offers autoclaves made of 10 gauge aluminium. The drum is deep drawn & the ring on top is riveted. The lid is made by casting. The locking of lid is done by six nuts with rubber gasket seal in between. This autoclave consists of two safety valves, pressure gauge, fl exible metal rubbing, outer stand, inner aluminium container, inner tripod stand, etc.

Narang Medical Ltd - New DelhiTel: 011-4555 4000 (100 Lines), Fax: 011-4555 4001Email: NET@narang.com

Resuscitation unitD4Surgicals India offers resuscitation unit. The double digital display system is provided to measure the infant temperature and to set the required temperature. The large bright displays are easy to monitor and can be viewed from a distance. The bar graph LED system is provided to indicate the heater output. It comes with single element imported CE marked ceramic heater placed in a parabolic refl ector. The large baby tray is made of stainless steel frame with three side acrylic collapsible walls. This resuscitation

unit comes with IV stand, observation lamp, self-test system, trendelenburg/fowler system, feather touch keys and monitor tray. It is available in servo and manual modes.

D4Surgicals (India) Pvt Ltd - Mumbai - MaharashtraTel: 022-6523 5614, Fax: 022-2878 17 83Email: info@d4surgicals.com

Product Update

72 I April 2011

LED photo therapy unitnice Neotech Medical Systems offers the ‘Sapphire 4000’ LED-based photo therapy system. This is designed to meet both the NICU and Well Baby Nursery. This design eliminates a big & gauche box of the fl uorescent and halogen lamp type of photo therapy. This unit is designed specifi cally to overcome the drawbacks including low irradiance levels, temperature rising and scattered, and unfocussed coverage. This photo therapy system follows the international standard. A microprocessor system is provided to control the irradiance of the LED, treatment time and lamp usage hours. The system delivers up to 94 MW of penetrating light directly to the baby’s skin for effective jaundice management. This unit does not emit UV rays, but only blue rays to reduce the potential risk of skin damage. It also does not emit IR rays, but only cold light rays to reduce the potential risk of fl uid loss. The unit is light in weight, easy to handle and suitable for all types of incubators, radiant warmers and cradles. Alphanumeric display is provided to ensure simultaneous monitoring of lamp usage hours, treatment hours, lamp power output and real-time/date.

nice Neotech Medical Systems Pvt Ltd Chennai - Tamil NaduTel: 044-2476 4608, Fax: 044-24762594Email: marketing@niceneotech.com

Anaesthesia machineAshwani Diagnostics offers anaesthesia machine with square tubular electrostatic powder-coated steel sections. The ring top tray is for monitor. The table top is made of stainless steel. It comes with one large storage drawer and gas-specifi c yokes for gauges with claming bars. The machine is provided with large-diameter anti-static castors with brakes for mobility. It contains two pressure gauges for oxygen and nitrous oxide. The non-return cum pressure release valve minimises risk of back fl ow of gases. It is provided with oxygen failure warning device and fl owmeter. Space for three vapourisers is provided as standard. Emergency oxygen fl ush outlet button is provided at table level and a changeover unit is provided for open or close circuit. The standard accessories include one/two built-in oxygen outlets (422 kPa) for driving ventilators, extended rear platform for two 10-ltr water capacity cylinders and facemask for adult & paediatric use.

Ashwani Diagnostics - New DelhiTel: 011-2209 0997, 2027 9390, Fax: 011-2209 4144Mob: 097170 98703Email: ademco@vsnl.com

Product Update

73April 2011 I

The information published in this section is as per the details furnished by the

respective manufacturer/distributor. In any case, it does not represent the views of

CPAP maskBesmed Health Business Corp offers CPAP mask, which is a fl exible, one-piece silicone forehead pad.

It conforms to the contour of the forehead to provide comfort and stability during use. Due to its unique and patented adjust forehead design, it increases the fl exibility and comfort for different patients. Double-layer cushion optimises seal and minimises pressure on the nose. It is provided with quick-release clips, which allow for easy removal of the headgear and eliminate the need of adjustment. The swivel and 360° elbow rotation connector enables easy attachment and disconnection to air tube and provides fl exibility of tubing position.

Besmed Health Business Corp - Taipei - TaiwanTel: +886-2-2290 3959, Fax: +886-2-2299 9076Email: info@besmed.com

Nuclear magnetic resonance spectrometerCole-Parmer offers picoSpin™ Benchtop Nuclear Magnetic Resonance (NMR) spectrometer. This is an innovative and disruptive technology that combines low price and a compact foot print, with true

spectroscopic capability. This device is a complete liquid-phase proton NMR system, including permanent magnet, transmitter, receiver, data acquisition, programmable pulse sequencer, Ethernet interface, and intuitive web-based control software. As a breakthrough technology, it has already garnered the attention of the scientifi c community. NMR is the most powerful analytical tool in chemistry. One can deploy multiple units within a factory to continuously monitor process fl uids and control them all from a web browser anywhere in the world. The students can experience NMR hands-on in chemistry lab courses and in their research projects.

Cole-Parmer - Vernon Hills - USATel: 847-327-5886, Fax: 847-327-2983Email: bdumey@coleparmer.com

Disposable probesKeeler offers single-use disposable probes for its cryomatic cryogenic surgery unit. These disposable probes are used with a disposable adaptor for single surgery use or as a backup for high-performance reusable probes. Important features of these probes include the following: it does not require cleaning or sterilisation, single use eliminates the possibility of cross infection or tip blockages due to dust and debris, saves time and ensures surgical reliability. The company’s cryomatic is engineered to create a simple-to-use system with a reliable freeze. The intuitive console automatically confi gures itself according to the probe’s characteristics, removing the need for manual set up. To simplify the set up pre-surgery procedures, the gas pressure is automatically set by the console for carbon dioxide (CO

2) or

nitrous oxide (N2O). The control console provides clear, digital

readouts of probe activity, temperature, time elapsed and gas pressure. Probe operation is controlled by a footswitch, leaving the user’s hands free at all times. The whole system is quick and easy to set up, a major advantage if experienced staff are not always available.

Keeler Ltd - Windsor - UKTel: +44-1753 857 177, Fax: +44-1753 827 145Email: info@keeler.co.uk

INTERNATIONAL

Cardiac pacemakerAPC Cardiovascular offers ‘Model 4170’ single chamber temporary cardiac pacemaker. It is designed to operate in either demand or asynchronous modes. The Model 4170 includes continuously variable

rate, output & sensing controls and also has the added feature of a separate high-rate control to provide rapid stimulation capability from 60 ppm to 800 ppm. The unit is housed in a durable metal case with a fi xed attachment for bedrail mounting. The company also offers dual-chamber pacing analyser, in which all modes, parameters & test functions are directly accessible by key press and the test results are displayed continuously on the LCD, one channel at a time to avoid confusion.

Its key feature include 12 sets of test results that can be held in memory, identifi ed by patient ID, and may be printed via infrared connection to the optional model 4850 IR Link™ printer.

APC Cardiovascular Ltd - Cheshire - UKTel: +44-0-1270 216 142, Fax: +44-0-1270 216 251Email: info@apc-cardiovascular.co.uk

Rx

74 I April 2011

Rx

75April 2011 I

Rx

76 I April 2011

Product Index

80 I April 2011

To know more about the products in this magazine, refer to our ‘Product Index’ or write to us at mmedit@infomedia18.in or call us at +91-22-3003 4684 or fax us at +91-22-3003 4499

and we will send your enquiries to the advertisers directly to help you source better.

Sl No Product Pg No

1 Adult/paediatric transport ventilator...... 15

2 Alcohol swab ................................................. 75

3 Anaesthesia machine.............................. 72, 76

4 Anaesthesia system ........................Back Cover

5 Analyser ........................................................... 3

6 Aspirator ........................................................ 86

7 Audio/video mounting system ..................... 9

8 Audio-visual auscultation device................ 63

9 Autoclave........................................................ 71

10 Baby incubator ........................................... 68

11 Barcode patient ID band ............................. 62

12 Bed-side phototherapy................................. 74

13 Biodegradable bag ........................................ 75

14 Bipnasic defi brillator.................................... 15

15 Blood glucometer ......................................... 45

16 Blood pressure monitor............................... 45

17 Blood pressure recorder............................... 15

18 Caps non-woven ......................................... 75

19 Cardiac pacemaker ....................................... 73

20 Central gas pipe line accessories................. 76

21 Coagulometer................................................ 27

22 Colour doppler ............................................. 75

23 Cord clamp.................................................... 75

24 CPAP mask.................................................... 73

25 Custom fabrication......................................... 9

26 Desktop pulse oximeter............................. 15

27 Diagnostic equipment.................................. 27

28 Disinfectant product .................................... 25

29 Disposable plastic glove ............................... 75

30 Disposable probes......................................... 73

31 Doppler.......................................................... 63

32 Dual surface phototherapy.......................... 74

33 Dual syringe infusion pump....................... 15

34 ECG .............................................................. 63

35 ECG accessories ............................................ 74

36 ECG machine................................................ 75

37 ECG paper roll.............................................. 74

38 Electric injection moulding machine......... 68

39 Electrode gel .................................................. 74

40 Electrolyte analyser....................................... 27

41 Electronic patient recorderFront Inside Cover

42 EMR ...................................Front Inside Cover

43 Endocervical brush....................................... 67

44 Engineered woodfl oor ................................. 29

45 Exhibition - Healthex 2011 ......................... 22

46 Exhibition - Medicall 2011.......................... 50

47 Exhibition - Meditec Clinika 2011............. 54

48 Face mask .................................................... 75

49 Foetal monitor ........................................ 15, 63

50 Fixer................................................................ 74

51 Fogging machine .......................................... 74

52 Fully automatic biochemistry analyser...... 27

53 Fumigation .................................................... 74

54 Gynaec examination coach ....................... 67

55 Halogen light....................Back Inside Cover

56 HIV aids kit................................................... 75

57 Hospital bed .................................................. 86

58 Hospital consultancy.................................... 71

59 Hospital curtain.............................................. 5

60 Hospital furniture................................... 23, 67

61 Hospital furniture & accessories................. 71

62 Hospital furniture/OT equipment ............. 35

63 Hospital information sytem........................ 71

64 ICU bed........................................................ 67

65 IHC/ ISH staining system ........................... 70

66 Imported cardiac OT table.......................... 69

67 Imported general surgery OT table............ 69

68 Imported hospital furniture / equipment . 86

69 Imported laparoscopy OT table ................. 69

70 Imported LED light...................................... 69

71 Imported neurosurgery OT table............... 69

72 Imported orthopaedics OT table................ 69

73 Imported OT light........................................ 69

74 Intensive care ventilator............................... 15

75 Kaematology analyser................................ 27

76 Labels ........................................................... 62

77 Laminate fl oor .............................................. 29

78 Lamp .............................................................. 68

79 Lancet steel/ plastic needle .......................... 75

80 Laser-based tool setting system................... 68

Sl No Product Pg No Sl No Product Pg No

Dear Reader,

‘Modern Medicare’ solicits original, well-written, application-oriented, unpublished articles that reflect your

valuable experience and expertise in the pharmaceutical industry.

You can send us Technical Articles, Case Studies and Product Write-ups. The length of the article should not

exceed 2000 words, while that of a product write-up should not exceed 200 words.

The articles should preferably reach us in soft copy (either E-mail or a CD). The text should be in

MS Word format and images in 300 DPI resolution & JPG format.

The final decision regarding the selection and publication of the articles shall rest solely with

‘Modern Medicare’. Authors whose articles are published will receive a complimentary copy of that particular

issue and an honorarium cheque.

Published by Infomedia 18 Ltd, ‘Modern Medicare’ is India’s leading magazine on healthcare, and related

equipment & technologies. This monthly magazine was launched in December 2004 and provides the

latest and most apt updates exclusively for the medical fraternity. Moreover, ‘Modern Medicare’ acts as

a sourcebook that facilitates buying decisions for this key sector - hospitals, specialty clinics, pathology

labs, nursing homes and doctors - and brings out highly useful business information on various healthcare

facets such as surgeries, procedures, technologies, equipment et al. So get going and rush your articles,

write-ups, etc…

Thanking you,

Yours sincerely,

An invite that rewards as well...

Manas BastiaEditor

Infomedia 18 Limited‘A’ Wing, Ruby House,J K Sawant Marg, Dadar (W)Mumbai 400 028 India

T +91 22 3024 5000F +91 22 3003 4499E manas@infomedia18.inW www.modernmedicare.in

D +91 22 3003 4669

Product Index

83April 2011 I

Sl No Product Pg No

81 LED lights with multi

colour................................Back Inside Cover

82 LED photo therapy unit .............................. 72

83 LED tubelight................................................ 74

84 Medical aprons/gown ................................ 75

85 Medical equipment ...................................... 31

86 Medical furniture.......................................... 41

87 Medical refrigerator...................................... 67

88 Medical/surgical & IR lamp ........................ 75

89 Microscope bulb ........................................... 75

90 Mobile light ........................Back Inside Cover

91 Multi parameter defi brillator ...................... 15

92 Multipera monitor........................................ 75

93 Nebuilser................................................ 63, 79

94 Needle & syringe destroyer ......................... 75

95 Neonantal transport ventilator ................... 15

96 Nuclear magnetic resonance

spectrometer ............................................... 73

97 Nuneb PRO nebuliser.................................. 79

98 Online B2B marketplace ....................... 7, 83

99 Operation table ............................................ 67

100 OT / examination light................................ 86

101 OT table ................. 76, 86, Back Inside Cover

102 Outdoor wood fl oor..................................... 29

103 Over head phototherapy.............................. 74

104 Oxygen concentrator.................................... 70

105 Oxygen fl owmeter ........................................ 86

106 Oxygenator .................................................... 63

107 Patient monitoring system........................ 63

108 Patient privacy system.................................... 9

109 Patient safety system .................................... 51

110 Patient transfer system................................. 69

111 Pedal suction ................................................. 39

112 Pendant .........................69, Back Inside Cover

113 Pergolas & outdoor cladding ...................... 29

114 Plain thermal paper roll............................... 74

115 Portable colour doppler............................... 75

116 Portable ventilator ........................................ 75

117 Powder coated & stainless steel

furniture ...................................................... 81

118 Prep razor ...................................................... 75

119 Printer ............................................................ 62

120 Prosthetic and orthotic services.................. 17

121 Pulse oximeter & NIBP monitor................ 75

122 PW ultrasound scanner............................... 75

123 Rapid endotoxin detection system........... 75

124 Recovery bed ................................................. 67

125 Remote operated OT table .......................... 76

126 Respiratory humidifi er................................. 74

127 Resuscitation unit ......................................... 71

128 Scandoc DICOM workstation .................. 13

129 Scopy doc endoscopy IMS .......................... 13

130 Self-adhesive tape ......................................... 72

131 Sensor controlled suction sytem................. 11

132 Shoe cover ..................................................... 75

133 Skin blade ...................................................... 75

134 Slid wood fl oor ............................................. 29

135 SME fi nance .................................................. 33

136 SME loan ....................................................... 57

137 Solar power.................................................... 74

138 Sphygmomanometer.................................... 86

139 Spot light ............................Back Inside Cover

140 Surgical / ICU pendant................................ 86

141 Surgical diathermy........................................ 11

142 Surgical gloves-sterile ................................... 75

143 Surgical instrument...................................... 86

144 Surgical light.................................................. 11

145 Surgical pump............................................... 11

146 Swab stick ...................................................... 68

147 Tourniquet................................................... 55

148 Ultrasound gel ............................................ 74

149 Ultrasound scanner................................ 63, 75

150 ULV fogging machine .................................. 74

151 UV medical therapy lamp........................... 75

152 Ventilator ............................................... 72, 75

153 Vinyl fl oor...................................................... 29

154 Vital signs monitor....................................... 75

155 X imager C-arm memory.......................... 13

156 X-ray developer liquid ................................. 74

157 X-ray developer powder .............................. 74

158 X-ray fi xer liquid .......................................... 74

159 X-ray fi xer powder ....................................... 74

160 X-ray machine......................................... 63, 75

161 X-ray viewer .................................................. 86

Sl No Product Pg No Sl No Product Pg No

Advertisers’ List

84 I April 2011

Aavanor Systems Pvt Ltd .FIC

T : +91-44-26208920

E : enquiry@aavanor.com

W : www.aavanor.com

Amkay Product Pvt Ltd 75

T : +91-22-61317600

E : info@amkayproducts.com

W : www.amkayproducts.com

Anand Medicaids Pvt Ltd 39

T : +91-11-25225225

E : sales@anandind.com

W : www.anandind.com

Apollo Hospitals 51

T : +91-09866072433

E : patientsft@gmail.com

W : www.apollohospitals.com

Bangalore International Exhibition Centre 22

T : +91-80-65833234

E : suresh@bies.co.in

W : www.healthex.co.in

BPL Limited 63

T : +91-80-22270134

E : sales.healthcare@bpl.in

W : www.bpl.in/healthcare

Charles River 75

T : +91-80-25588175

E : india.customercare@crl.com

W : www.charlsriverindia.com

Compamedic Instruments Pvt Ltd 74

T : +91-11-43085193

E : sales@compamedic.com

W : www.compamedic.com

Endolite India Ltd 17

T : +91-11-45689955

E : endolite@vsnl.com

W : www.endoliteindia.com

G S Health Care Products Pvt Ltd 76

T : +91-33-24881574

E : hecapr@vsnl.net

W : www.gshealthcareproducts.com

Godrej Interio 41

T : +91-22-67962419

E : interiohospital@godrej.com

W : www.godrejinterio.com

Great Eastern Impex Pvt Ltd 62

T : +91-11-2347431/32

E : sales@geipl.com

W : www.geipl.com

Hospaccx India System 71

T : +91-09845208778

E : hospaccx.india@gmail.com

W : www.hospaccxindia.org

India Mart Intermesh Ltd 7, 83

T : +1800-200-4444

E : pr@indiamart.com

W : www.indiamart.com

Industrial Electronic & Allied Prod 55

T : +91-20-24222538

E : ieap@vsnl.com

W : www.diamondbp.com

Krupa Electro Divice 74

T : +91-09879003188

E : krupaelectrodivice@gmail.com

W : www.krupaelectrodivice.com

Lonza India Pvt Ltd 25

T : +91-22-43424000

E : prajakta.sonavane@lonza.com

W : www.lonza.com

MS Enterprises 86

T : +91-866-2442786

E : moinmsent@yahoo.co.in

W : www.accura-healthcare.org

Magna Tek Enterprises 69, BIC

T : +91-40-66668036

E : sales@magnatekenterprises.com

W : www.magnatekenterprises.com

Medexpert Isha Homes 50

T : +91-9840326020/9360707022

E : :info@medicall.in

W : www.medicall.in

Meditech Engineers Pvt Ltd 31

T : +91-11-45545238

E : marketinguk@meditech-india.com

W : www.meditech-india.com

Advertiser’s Name & Contact Details Pg No Advertiser’s Name & Contact Details Pg No Advertiser’s Name & Contact Details Pg No

To know more about the advertisers in this magazine, refer to our ‘Advertiser’s Index’ or write to us at mmedit@infomedia18.in or call us at +91-22-3003 4640 or fax us at +91-22-3003 4499 and we will send your

enquiries to the advertisers directly to help you source better.

Advertisers’ List

85April 2011 I

Our consistent advertisers

Advertiser’s Name & Contact Details Pg No Advertiser’s Name & Contact Details Pg No Advertiser’s Name & Contact Details Pg No

Meditek Engineers 67

T : +91-09822092808

E : meditekfur@hotmail.com

Medsynaptic Pvt Ltd 13

T : +91-20-25443349

E : sales@medsynaptic.com

W : www.medsynaptic.com

Meelan Hospital Steel Furniture 81

T : +91-20-24262562

E : sales@meelanhospicare.com

W : www.meelanhospicare.com

Monash International Ltd 27

T : +91-11-24378779

E : contact@clindiagindia.com

MRK Healthcare 79

T : +91-22-23748371

E : info@mrkhealthcare.com

W : www.mrkhealthcare.com

Narula Udyog (India) Pvt Ltd 35

T : +91-11-42463777

E : ptn@medikraft.com

W : www.medikraft.com

Orbitz Exhibitions Pvt Ltd 54

T : +91-22-39504586

E : info@meditec-clinika.com

W : www.meditec-clinika.com

Photochem Labs Pvt Ltd 74

T : +91-79-22732989

E : info@photochemlab.com

W : www.photochemlab.com

R D Plast Pvt Ltd 9

T : +91-11-25891219

E : rdplast@bol.net.in

W : www.rdplast.in

Radiant Enterprise 74

T : +91-79-26449120

E : radiant_enterp@rediffmail.com

W : www.fogstarindia.com

Rational Health Care Systems 75

T : +91-40-30727676

E : rational_hcs@yahoo.com

W : www.rationalhs.com

Saga Enviro Pvt Ltd 75

T : +91-40-27713368

E : drfischer@vedgroup.net

W : www.vedgroup.net

Sanghvi Eurotech Pvt Ltd 45

T : +91-20-41242691

W : www.sanghvieurotech.com

Schiller Healthcare India Pvt Ltd 15

T : +91-22-66920520

E : rita@schillerindia.com

W : www.schillerindia.com

Siemens Ltd 19

W : www.siemens.com/pharma

Space Labs Health Care .BC

T : +91-40-39803687

E : info@spacelabs.com

W : www.spacelabshealthcare.com

Spark Meditech Pvt Ltd 11

T : +91-484-2341335

E : sparkmeditech@gmail.com

Square Foot (Classic Floorings &

Interiors Pvt Ltd) 29

T : +91-22-40476211

E : sucheta@squarefoot.co.in

W : www.squarefoot.co.in

Sreelakshmi Traders 72

T : +91-44-24343343

E : sreelakshmitraders@gmail.com

W : www.sreelakshmitraders.com

Standard Chartered Bank 57

T : +91-22-22850877

E : raahatmohammed@sc.com

W : www.standardchartered.co.in

State Bank Of India 33

T : +1800 11 22 11/ 18004253800

E : contactcentre@sbi.co.in

W : www.sbi.co.in

Transasia Bio-Medicalsp Ltd 3

T : +91-22-40309000

E : transasia@transasia.co.in

W : www.transasia.co.in

United Surgical Industries 23

T : +91-11-22149600

E : info@unitedsurgical.co.in

W : www.uniserg.com

Window Techs 5

T : +91-11-29992146

E : window_techs@yahoo.co.in

W : www.hospitalcurtains.in

88

RNI No: MAHENG 2007 / 21987 Postal Regd No:G2 / NMD 73 / 2011-13

Posted at Mumbai PatrikaChannel Sorting Offi ce- GPO,

Mumbai 400 001, On 11th & 12th of Every Month.

WPP Licence No: MR / Tech / WPP-352 / Navi Mumbai 2011-12

Date Of Publication: 8th Of Every Month

RNI No: MAHENG 2007 / 21987

Postal Regd No:KA / BG GPO / 2563 / 2011-13

Posted at MBC, Bangalore GPO, On 13th & 14th Of Every Month

Date Of Publication: 8th Of Every Month