Policy Archives - InnoHEALTH magazine

HEALTH 2.0: Sustainable healthcare in COVID-19 pandemic

InnoHEALTH Magazine — Tue, 09 Jun 2020 07:10:13 +0000

The detrimental effect of the outbreak of COVID-19[the disease caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-COV-2)] was evident not only on global healthcare systems but also on other aspects of human life.

The World Health Organisation (WHO) declared the COVID-19 outbreak as a global emergency on 30th January 2020. According to various scientific literatures, and a response to ‘flatten the curve’ governments have enforced border shutdowns, travel restrictions and quarantine in countries which constitute the world’s largest economies.All these factors have anticipated the fears of an impending economic crisis and recession.

The COVID-19 pandemic has caused an unprecedented challenge for healthcare systems worldwide with healthcare workers as the frontline warriors .
In upcoming times there may be a higher surge in cases reporting critical situations or may be even fatalities due to previously existing illnesses like Chronic Heart Failure, Chronic Renal Failure, COPD, etc. getting complicated because of improper or not adequately managed.

Several reports have shown the predicamemt of patients having chronic diseases and those require proper medical maneuvering other than COVID-19 infected patients.The overall revenue generation for hospitals and healthcare sectors were greatly affected e.g an official data from a 350 bedded hospital in NCR reports more than 50 % reduction in bed occupancy rate and more than 60 % reduction in routine elective procedures thus making the system very fragile.

Maharashtra Govt. has undertaken 80 percent of private hospital beds with capping of treatment costs Another such step has been taken by the Delhi Govt which has directed the private hospitals with capacity of 50 beds or more to provide 20 % of its total capacity for COVID-19 patients.

With the prevalence of such regulations, adequate measures are taken to safeguard the workforce of the organization. With such regulations, it becomes foremost important to take adequate measures to protect our workforce amid this health crisis as they are the only weapons all through this fight. For enabling life towards getting near to normal , first thing that has to be made sustainable is the healthcare system.

THE PROBLEM STATEMENT

Patients with similar symptoms (influenza like symptoms) with pre-existing conditions like cardiac ailments and respiratory issues, are facing lot of trouble in getting routine management as well as emergency management because of projected COVID 19 stigma
Upcoming conditions with similar presentation like Dengue, Malaria in South East Asian countries will make situation more complicated thus pose further challenges in healthcare system
Healthcare workers (HCWs) has to embrace the the Quarantine in masses because of accidental exposure from a patient tested positive after routine admission
Collapse of health system in terms of providing adequate health services and revenue to sustain hospitals viability

In short our health system includes both public sector and corporate sector are facing issue at every step whether it is:

Containment of disease
Proper handling to emergencies due to non COVID-19 chronic illnesses
Protection of HCWS (almost 321 HCWs has been tested positive across DELHI)
Sustainability

OBJECTIVES

Combat ongoing crisis in best possible and efficient mannerto minimise the incidence of COVID-19 infection among HCWs
Proper redressal of Patients suffering from chronic illnesses and impending life threatening emergencies related to such illnesses
Anticipate upcoming seasonal illness like Dengue and Malaria and take optimum measures to reduce chances of further crisis with these upcoming health threats
Develop a sustainable system where both the public health sector and private sector collaborate to fight this Pandemic crisis
Develop a system where the corporate health system reaches their maximum capacity in terms of services and also the revenue

POLICY SUGGESTIONS

Every center starts functioning in a ZONED MANNER i.e they get divided into zones viz. Red, Yellow and Green
Functioning of Non-COVID Zoned Hospital (may have reserved bed for COVID-19)

INTRAHOSPITAL ZONING

Non-COVID ZONED HOSPITAL gets divided in the following:

RED zone: Consists of Emergency Room , RED ICU and RED Ward
- Every HCW working in Red Zone works with all precautions including PPEs. (LEVEL 4)
- Patient treated as per his condition with all necessary monitoring and investigations thereby making things more clear
- First COVID-19 testing done at Red zone
- If patient is tested positive for COVID-19 then the patient is shifted to COVID center and if report comes out negative then patient is transferred to Yellow zone
ORANGE or YELLOW zone: Consists of another ORANGE ICU and an ORANGE WARD
- Only patient once tested negative for COVID Negative gets entry to Yellow / Orange zone
- Health care workers use at least level 2 PPE adjunct with an antiviral kit
  Patient are treated as per the symptoms with all necessary monitoring.
- Clinical follow up of patient done with investigations like CBC to look for lymphopenia, coagulation profile to look for any derangement, LDH levels and serial Chest X-rays to look for radiological evidences .
- Also any suspected patient to be kept in isolation or cabin with Negative pressure if available
- Second COVID-19 testing done at Orange/ Yellow zone in case of any suspect either clinically or derangement in any of the significant investigations
- If patient is unfortunately tested Positive , patient is referred to COVID Unit
- If Second report also comes out Negative , then patient is transferred to Green zone
GREEN zone: consists of GREEN ICU and GREEN Ward
- Patient that has been tested as COVID-19 negative twice is admitted in Green Zone
- HCWs use N95 and Gloves only
- Patients are treated as per his condition including all necessary monitoring and investigations
- Patients gets discharged from Green zone

ANTICIPATED CHALLENGES

ZONING of the hospital itself may be a challenge as common AHUs . But this can be managed with little extra efforts and adequate planning and therefore allowing areas into a particular zone so that areas sharing common AHU comprise of either RED zone or Orange zone only
Reallocation of healthcare workers in respective areas
Rotational duty rosters and Post duty Quarantine followed by Covid testing before rejoining
Additional cost of the PPE kits and additional Covid 19 test , this can sum up to around 8k- 10k per patient
Adjunct Formulations

ANTICIPATED ADVANTAGES

Protection of healthcare workers – with double testing and proper zoning of hospitals depending upon the risk associated, can achieve a system where minimize of the infection among HCWs by using proper PPEs depending upon the zones
We will be able to cater to life-saving emergencies efficiently, also the routine services can be escalated with such kind of strategies
The hospitals can achieve a system where they can provide their services near to normal (pre-covid times) thereby reaching a sustainable system both in terms of services and revenue generation

The current article mentions the zoning of a hospital for handling the emergency admissions, likewise for routine health services as well such zoning can be formulated and adopted. E.g. an elective surgery can be performed by performing a pre-admission COVID-19 test and then admitting the patient in ORANGE zone ward isolation rooms and then performing another test if required.

Recently there has been guidelines by Delhi govt suggesting a division of NonCovid hospitals into Risk Zones ( i.e mild , moderate, and severe ) addressing the issue of infection among HCWs and thereby suggesting the use of a different level of PPEs in different zones depending upon the risk associated . Also the advisory states formation of Holding area (corresponds to Red zone) for patients with influenza like illness (ILI ) in Non-Covid hospitals.

We appreciate the authorities for addressing the problem and taking such suggestions into consideration while forming the advisories and formulating the guidelines . Though there can be much more that can be done to achieve a more sustainable system which helps us fight the current pandemic in much more efficient manner as in our consideration achieving a SUSTAINABLE HEALTH SYSTEM ( HEALTH 2.0 ) is the only weapon amidst this crisis that can help us reach a safe bank.

Authored by Dr. Kulsaurabh & Dr. Yachika

Dr. Kulsaurabh is working as Intensivist at Fortis Escorts , New Delhi. Has done his MBBS and MD from PGIMS , Rohtak. Loves to be a part of an ecosystem working for any sought of development to overcome ongoing challenges. Presently holding a position as Joint Secretary, Federation of Resident Doctor association , FORDA.

Dr. Yachika completed MBBS from PGIMS Rohtak and has secured a respectable rank at NEET PG and will be joining a PG course.

The post HEALTH 2.0: Sustainable healthcare in COVID-19 pandemic appeared first on InnoHEALTH magazine.

How Crucial is DISHA Act for Healthcare Industry?

InnoHEALTH Magazine — Mon, 17 Dec 2018 08:56:22 +0000

“A journey of a thousand miles begins with a single step.” The Digital Information Security in Healthcare Act (‘DISHA’) is that firm first step taken by the Indian Government in the long journey to secure the healthcare data of patients in India. The question we need to ask ourselves is that Why DISHA is the need of the hour? Why do we need to safeguard the electronic health record in hospitals?

The draft of the act was made public in November 2017 by Ministry of Health and Family Welfare. The word ‘Disha’ means direction, the GoI has taken the first step in the direction of safeguarding the digital health record. For this InnovatioCuris has also taken the first step towards having a concrete discussion about ‘Challenges in the implementation and opportunities for making health sector DISHA and data protection ready’. There were panelists from various renowned government, private hospitals, and healthcare IT firms.

The first session was about the ‘Challenges in the implementation of DISHA’. The panelists were happy that InnovatioCuris has taken an initiative to critically discuss the challenges a hospital will face once the act becomes the law. All the panelists agreed that the act lacks various aspects. Few concerns that bother the clinicians are, that who will give the consent if the patient is unconscious.

The ambulances have the capability that it sends the health records from the ambulance to hospital before the patient reaches the hospital for doctors to study the emergency cases. In this scenario, what should be done if a patient denies the consent for sharing the data at a later stage? Should the clinical establishments discard the already shared health record or should they handover the same to the owner (in this case, patient) or what should be done. There are no set protocols defined in the act for such cases.

A question was put forward, does the patient has the authority to edit their health record, or can they view, who have seen their health record. A healthy discussion took place where we got to know that citizens of Estonia have chip cards, where one can see their health record and can also see the logs of who has accessed their health record. This made us realize, that India as a nation state can use Aadhar card as a mechanism, where we can log in into a portal and get to see health records.

The third challenge that came forward was interoperability of health records. As the record lies with the custodian, not the patient, editing and viewing of it can be done by the clinical establishments. The health record can be shared by the clinical establishments to another, but there is no standard on how to transfer it. Data integrity is a point of concern, which is not mentioned in the act.

One of the challenges that came into light was according to ‘Clinical Establishment Act Standards for Hospital[2]’ the hospital has to keep health information and statistics in respect of national programmes, notifiable diseases, and emergencies/disasters/epidemics and furnish the same to the district authorities in the prescribed formats and frequency. The question is what if the patient does not give consent. The proposed act should have a provision where the clinical establishments are liable to take the health data.

As we have unstructured healthcare facilities in India, the act should also empower the clinical establishments by various means to keep the data safe. As of now the DISHA is a proposed act, not a law and has lots of loopholes. It also lacks in many aspects discussed earlier. This is just a start and the government should take necessary steps to improve it.

The second panel discussed on ‘Opportunities for making health sector DISHA and data protection ready’. The panelist consisted of CIO of path labs, owners of healthcare IT firms, who shared relevant thoughts and comments. The panel started the discussion on why do we need the act and what are the benefits of the act. Panelist were grateful to the government to bring the act. They told that the clinical establishments will take steps to increase the safety of the health record.

The gaps in the technology for generation, storage and transmission will be lowered down. Sectors such as banking, financing and insurance have structured their data, but this lacks in healthcare. Detailed scope of security features are missing from the act, this would help the companies to design the software from the ground up by using security as an important consideration.

The imminent threat is in the software which are already in place and have not been patched or the system has not been upgraded. The good news is that many have an audit trail in built in their system, which track any CRUD(creation, read, update, delete) of the records. The discussion contributed a fruitful thought: Data at rest is not encrypted. The question that arises is what is preventing the healthcare IT companies to encrypt the data at rest.

One of the challenge in the DISHA is that, the owner of the data must be informed of any breach of the privacy or confidentiality of their digital health record within three days. But according to IBM report it takes on an average of 197 days to detect a breach[1]. How can the Healthcare IT companies safeguard the health record and let the owner know about the breach. The solution is to encrypt the tables in the database, but that might hamper the performance.

It is a huge opportunity for the stakeholder to bring standards in the act. DISHA might have only completed its first round of comments from the public and stakeholders, it can be expected that the revisions made based on the feedback will churn out a more refined version of the act. In any case, it is evident from the draft that the government has really pushed to provide additional security, privacy and confidentiality for individuals, with respect to their digital health record.

The post How Crucial is DISHA Act for Healthcare Industry? appeared first on InnoHEALTH magazine.

GDPR – General Data Protection Regulation

InnoHEALTH Magazine — Tue, 01 May 2018 07:31:06 +0000

General Data Protection Regulation (GDPR) is proposed by the European Parliament and Council to secure data and privacy of the citizens of European Union. It addresses the export of personal data outside the EU. The GDPR aims primarily to give control to citizens and residents over their personal data and to simplify the regulatory environment for international business by unifying the regulation within the EU.

The General Data Protection Regulation (GDPR) standardizes data protection law across all 28 EU countries and imposes strict new rules on controlling and processing personally identifiable information (PII). It also extends the protection of personal data and data protection rights by giving control back to EU residents. GDPR replaces the 1995 EU Data Protection Directive, and goes into force on May 25, 2018. It also supersedes the 1998 UK Data Protection Act.

This regulation GDPR applies to all organizations holding and processing EU resident’s personal data, regardless of geographic location. Many organisations outside the EU are unaware that the EU GDPR regulation applies to them as well. If an organization offers goods or services to, or monitors the behavior of EU residents, it must meet GDPR compliance requirements.

The aim of giving citizens more control over their information, GDPR ensures citizens can ask to access their data at “reasonable intervals”, with controllers having a month to comply with these requests. Both controllers and processors must make clear how they collect citizens’ information, what purposes they use it for, and the ways in which they process the data. The legislation also says that firms must use plain language to convey these things clearly and coherently to citizens: it’s time to wave goodbye to those confusing, dense terms and conditions.

Citizens have the right to access any information a company holds on them, and the right to know why that data is being processed, how long it’s stored for, and who gets to see it. Where possible, data controllers should provide secure, direct access for citizens to review what information a controller stores about them.

If a business suffers a data breach in the form of a loss, alteration of data, or unlawful access to personal information, such a breach needs to be reported to a Data Protection Authority within 72 hours of your organization becoming aware of it. If the breach results in discrimination, fraud or identity theft, financial loss, damage to reputation, loss of confidentiality of personal data, then the breach will need to be reported to the citizen as well.

Breaches can result in a fine of € 10M or 2% of a company’s annual revenue, whichever is greater. More serious breaches could result in a fine € 20M or 4% of a company’s annual revenue, whichever is greater. Apart from this, the Data Protection Authority can impose a complete ban on data processing operations by an organization.

One can also check similar article on Digital Information Security in Healthcare Act proposed by Indian government here.

The post GDPR – General Data Protection Regulation appeared first on InnoHEALTH magazine.

Hospitals designing bats for a fresh look

InnoHEALTH Magazine — Tue, 01 May 2018 05:49:51 +0000

Planning and Designing Healthcare Facilities
A lean, innovative, and evidence-based approach
Book written by Dr. V.K. Singh & Prof. Paul Lilrank

[vc_single_image image=”3855″ img_size=”500×300″ alignment=”center” style=”vc_box_shadow_border” onclick=”custom_link” img_link_target=”_blank” link=”https://amzn.to/2w3wpiu”]

Hitting newsstands in the United States of America and India simultaneously, A New Book–Planning and Designing Healthcare Facilities: A Lean, Innovative and Evidence based approach by Dr V.K. Singh and Prof. Paul Lillrank call for a fresh approach in designing new age hospitals in the wake of emerging new normal in the healthcare sector.

Authors say modern medicine is founded on the scientific pursuit for knowledge about the human body and its pathologies. Science builds theories and tests them against evidence. The scientific method should now be applied to the design of hospitals and health service systems. This is the rationale for evidence – based design.

According to authors, lean and innovation complement each other. Lean means creating more value for customers with fewer resources. Innovation is a process of translating an idea into goods or services that create value for which customer is ready to pay. The General Hospital is still a valid concept and is not going to disappear anytime soon, particularly in parts of the world where public health is poor, resources are scarce, and a majority of people is underserved. While visions are always welcome, the task at hand, and the theme of this book, is to improve on the Dominant Design, the standard General Hospital.

Evidence-based design (EBD) emphasizes credible evidence to influence design. It works on well-defined problems, applies a multidisciplinary perspective, involves users and customers, establishes quantitative performance measures for critical variables, and uses tests and simulations throughout the design process.

Prof. Lillrank along with Riikka-Leena Leskelä and Olli Tolkki say the hospital has traditionally been seen as a production site like a factory where flows of material, people, energy and information combine with fixed assets. In modern manufacturing, the factory has evolved into supply networks. In a similar vein, the modern hospital is seen as a node in a regional service system. A hospital design initiative should therefore begin with a master plan that defines the hospital’s place and role in a broader health service system.

Dr. Singh in a chapter on ‘Patient First, Functions Next and Design Later’ along with Mr. S K Biswas says the evolution of hospital design principles has gone through stages.

The first was ‘functions follow design’, as services had to be adapted to whatever structures were available. Next came ‘design follows functions’. Various professional groups lined out their requirements in terms of floor space and layout. More recently, the concept ‘Design follows first patients, then functions’ has been adopted. The emphasis now is on integrating the needs of patients, hospital functions, and functionaries in hospital design.

In a chapter, ‘Green Hospitals and Sustainable solution to Healthcare Facility’, Mr. Rajeev Boudhankar says as important parts of the modern urban landscape, hospitals must adopt environmentally friendly and sustainable designs and technologies. Green hospitals use energy, water, materials and land more efficiently than conventional buildings.

With more natural light and better air quality, green buildings contribute to improved health, comfort, and productivity. The LEED 2009 for Healthcare Green Building Rating System is a set of performance standards for certifying healthcare facilities.

In ‘Designing a Patient-centric Healthcare Facility Using Lean Methodology’, Mr. John Gallagher, Kim Chaney and Ron Kwon say 2P (Process Preparation) is a Lean design tool that helps to organize the flow of activity in a way that results in the least amount of waste. This chapter details how it worked when Concord Hillside Medical Associates, a multi-specialty group practice part of Harvard Vanguard Medical Associates near Boston, applied it in a major facility design project.

Likewise, in an article on ‘Creating safer healthcare environments using an evidence-based design process, Dr. Anjali Joseph, Ellen Taylor and Xiaobo Quan say a growing body of research shows that the healthcare built environment impacts safety outcomes such as infections, medication errors, falls, and staff injuries. Latent conditions that adversely impact patient safety are built into the physical environment during the planning, design, and construction phases. Design decisions should be proactively evaluated by engaging users from different disciplines such as infection control, nursing, risk managers, and environmental services. Emerging tools such as the Safety Risk Assessment (SRA) toolkit provide a structured way to apply evidence-based design to improve patient safety.

[vc_single_image image=”3848″ img_size=”500×300″ alignment=”center” onclick=”link_image”]

Dr. Singh and Dr. Biswas in another chapter on ‘Evidence Based Design in Hospitals – Theory to Implementation’ opine that the principles of Lean Healthcare support Evidence Based Design. Lean calls for the identification of all major stakeholders and specifying what they consider valuable. Stakeholder value can be grouped into the basic categories tangibility, reliability, responsiveness, assurance and empathy. When these requirements are not met, processes create waste.

EBD analyze the constraints that need to be addressed. The design process covers several stages, initial hypothetical design, process design, service design, and empirical design. These principles are detailed in a case in a hospital in Kolkata.

On Virtual Hospitals of Future, IT expert Sachin Gaur says the Information and Communication Technologies (ICT), particularly smart and wearable devices, have the potential to break constraints of time and location. Physical installations may turn virtual, and centralized services may be decentralized. Assessing the potential of new technologies, the CIMO -methodology of Evaluation Science can be employed. It asks the questions, what is the context in which technology is applied through what kinds of interventions, and which mechanisms are activated to produce which outcomes?

On ‘Redefining Healthcare of Tomorrow in Smart City’, Dr Singh and Ms. Nimisha Singh say the three pillars of the smart city are-people, process, technology, and the information flows that bind them together as an optimized whole. The Smart Cities Mission under the leadership of Prime Minister Narendra Modi is an initiative towards urbanization. Smart cities require smart healthcare.

With the Internet of things (IoT), layers of smartness are being added to the hospitals, such as remote monitoring, chronic disease management, medication management, patient self-management, and workflow management.

In a Chapter titled ‘Delivering Inclusive Intelligent Healthcare’ by Innovative and Comprehensive e-Health System, Dr. Kuo Shou-Jen and Lai Chien-Wen aver that the chapter is based on a case study of Changhua Christian Healthcare System (CCH), Taiwan. CCH has been a pioneer in implementing sophisticated new technologies. The case emphasizes the importance of the combination of high tech with human touch.

In a chapter on ‘Planning Safe Hospitals’, Ms. Sushma Guleria says that the Hyogo Framework for Action 2005-2015 (HFA) spells out the challenge to substantially reduce the impact of disasters and to make risk reduction an essential component of development policies and programs. Risk reduction planning should be integrated into the health sector to make hospitals safe from disasters and strengthen their capacity to remain functional in disaster situations. Hospitals need to have disaster management plans and to evaluate their performance by implementing the Hospital Safety Index used widely to gather information for sound decision making.

In an article on ‘Designing Innovative Facilities: Contamination & Security Hazards at Hospitals’, Dr. Singh along with Dr. Raman Chawala emphasis on the danger of chemical, biological, radiological, nuclear and explosive (CBRNE) related terrorism which pose a contamination threat to healthcare institutions. Designing innovative resilience can provide long term and effective solutions by establishing a rigorous framework that can accelerate adaptation and ability to recover from any known and unknown contamination security and safety hazards.

‘Adapt or Obsolesce: The evolution of the Singapore Health System’, Matthew Saunders said Singapore is an advanced country of small size with a single party dominated political system. This has made it agile and able to respond quickly to changing circumstance in ways that differ from larger and more complex polities. Singapore faces the same challenges as other developing countries, including ageing society, non-communicable diseases and healthcare cost inflation, while it is well positioned to implement advanced technologies, such as electronic patient records and smart solutions. Singapore highlights the systemic nature of healthcare, where service production, facility design, finance, and regulation require innovative approaches to integration.

Dr. B. R. Shetty, Founder and Chairman, NMC Healthcare, Abu Dhabi, United Arab Emirates in his foreword said, “The book is a timely effort to discuss various concepts and tools to reduce delivery costs and maintain high quality by the means of planning a hospital with an eye on operations. It details experiences from around the globe. The authors strive to integrate several strains of thought: Lean, Innovation, Patient Centricity, and Evidence–based designs. This is what the healthcare industry needs.

Want to write for InnoHEALTH? send us your article at magazine@innovatiocuris.com

Read all the issues of InnoHEALTH magazine:
InnoHEALTH Volume 1 Issue 1 (July to September 2016) – https://goo.gl/iWAwN2
InnoHEALTH Volume 1 Issue 2 (October to December 2016) – https://goo.gl/4GGMJz
InnoHEALTH Volume 2 Issue 1 (January to March 2017) – https://goo.gl/DEyKnw
InnoHEALTH Volume 2 Issue 2 (April to June 2017) – https://goo.gl/Nv3eev
InnoHEALTH Volume 2 Issue 3 (July to September 2017) – https://goo.gl/MCVjd6
InnoHEALTH Volume 2 Issue 4 (October to December 2017) – http://amzn.to/2B2UMLw
InnoHEALTH Volume 3 Issue 1 (January to March 2018) – https://goo.gl/fksdQx
InnoHEALTH Volume 3 Issue 2 (April to June 2018) – https://goo.gl/grbtRo

Connect with InnovatioCuris on:
Facebook: https://www.facebook.com/innovatiocuris
Twitter: https://twitter.com/innovatiocuris
LinkedIn: https://www.linkedin.com/groups/7043791
Stay updated about IC, visit: www.innovatiocuris.com

The post Hospitals designing bats for a fresh look appeared first on InnoHEALTH magazine.

The future of healthcare

InnoHEALTH Magazine — Fri, 27 Apr 2018 07:35:04 +0000

Digital Health: Giving Birth to New Delivery Models and Fostering Innovations

Imagine a world where patient information is accurate, accessible, reliable, and safe. The opportunities and benefits are endless: availability, accuracy, portability and privacy of patient information, confidence on the information in an emergency, ease in searching and finding patterns, medical and post ops management with proactive reminders influencing patient behavior, and minimizing insurance and substance abuse. In recent times, we have seen tremendous progress in the evolution of cloud technology. Cloud enables easy access to shared configurable technology resources that can be utilized to rapidly create and deploy new services.

[vc_single_image image=”3827″ img_size=”500×300″ alignment=”center” onclick=”link_image”]

[vc_single_image image=”3828″ img_size=”500×300″ alignment=”center” onclick=”link_image”]

Followings are the some of the key challenges that remain to improve healthcare:
• Investment – Compared to the other countries, very small % of Indian GDP is spent on developing healthcare which is about 100 times less than the United States.
• Geography – A wide gap remains between rural and urban healthcare. Most of our healthcare resources are concentrated in big cities leaving the rural areas with no or almost no resources to meet the growing healthcare need.
• Infrastructure – The number of hospitals and health centers in India are far less than what is required. Except for a few super specialty hospitals, most of the hospitals and health centers in India do not have proper infrastructure to provide quality services.

[vc_single_image image=”3824″ img_size=”312×376″ alignment=”center” onclick=”link_image”]

It makes sense then that in India where there is always a huge gap between demand and availability of quality healthcare that cloud technology can play a huge role. Cloud based technology solutions can be leveraged to provide efficient and high-quality services in healthcare at an affordable price for remote locations with little to no infrastructure. With the advancement of technology, cloud is becoming more and more secured and compliant with regulations. Adopting cloud based technology solutions will all organizations engaged in healthcare to focus more on their core activities and reduce utilization of resources that manage technology.

Key research tells us that with digitization of medical data, medical knowledge has increased by 2 times or more in past 3 to 5 years. The way cloud is being adopted more and more by the industry globally and with the growing need for collaboration, flexibility and improved patient care, we can say that cloud will eventually become a commonplace in the industry.

As seen in countries that have developed healthcare systems, these capabilities were key in the development of healthcare to a point where no avenue is left unexplored in the strive towards improvement of healthcare for its citizens.

While the road to these advances may have been littered with challenges, impediments, false starts and hurdles, technologies today and the lessons learned therein will allow developing nations to avoid such pitfalls and leapfrog their healthcare eco-system into the future!

(Contributors: Kausik Bhattacharya, Johnson & Johnson, Sandipan Gangopadhyay, President and COO, Galaxe Solutions. Dheeraj Misra and Anusha Panduga also from Galaxe Solutions.)

Want to write for InnoHEALTH? send us your article at magazine@innovatiocuris.com

The post The future of healthcare appeared first on InnoHEALTH magazine.

Regulatory alignment play catch up

InnoHEALTH Magazine — Fri, 13 Apr 2018 10:58:02 +0000

Telemedicine is no longer a form of medicine to be practiced in the future; it is very much prevalent now and has seen a very rapid increase in its take up in this millennium.

TELEMEDICINE IS ONE WAY OF practicing medicine, which may provide opportunities and increase possibilities to effectively use available human and material resources. The possibilities offered by telemedicine must be open to all doctors over geographical borders. I, however, prefer to advance to Telehealth, which involves the distribution of health-related services and information via electronic information and telecommunication technologies.

The Health Resources and Services Administration (HRSA – an agency of the U.S. Department of Health and Human Services) distinguishes telehealth from telemedicine in its scope.

[vc_single_image image=”3678″ img_size=”1000×500″ alignment=”center” onclick=”link_image”]

According to HRSA, telemedicine only describes remote clinical services; such as diagnosis and monitoring, while telehealth includes preventative, promotive and curative care delivery. This includes the nonclinical applications like administration and provider education which makes telehealth the preferred modern terminology. There has been an exponential increase in practice of telehealth which has meant that the legal and regulatory environment has not progressed as swiftly, for example the Data Protection Act, 1998 (DPA) in the UK has been in effect since March 2000 but has lacked the teeth to actually address the need of the hour. This is set to change with a new regulation. From May 25, 2018, the new regulation will come into force, which is being called, General Data Protection Regulation (GDPR). This is a regulation of the European Union Parliament and has a direct effect.

It is also believed that the inculcation of GDPR will go ahead despite Brexit i.e. Britain (UK) leaving the European Union.

GDPR will have certain principles which are strong and stringent, though further clarity on each of these will be over time and by judicial decisions, it is certainly set to have more power.

Consent has always been considered of great importance, however, it has been more implicit under the DPA but under the new GDPR there will be a need for a clear explicit consent from individuals to collect data. The other changes with massive repercussions for businesses doing business within or with the UK and EU will be in regards to automated decision making tools; right to access and portability; penalties; accountability and privacy notices.

This includes the non-clinical applications like administration and provider education which makes telehealth the preferred modern terminology. There has been an exponential increase in practice of telehealth which has meant that the legal and regulatory environment has not progressed as swiftly, for example the Data Protection Act, 1998 (DPA) in the UK has been in effect since March 2000 but has lacked the teeth to actually address the need of the hour. This is set to change with a new regulation. From May 25, 2018, the new regulation will come into force, which is being called, General Data Protection Regulation (GDPR).

GDPR PRINCIPLES:
• Information to be processed fairly and lawfully
• The personal data must be collected for specified, explicit and legitimate purposes
• It should be adequate, relevant and not excessive for those purposes
• It should be accurate and up to date
• It should be kept no longer than is necessary for the purposes it is being processed for
• Maintain integrity and confidentiality
• There will be accountability

(The writer is a lawyer with a Diploma in Hospital Administration from India; Masters of Law in Intellectual Property Rights from the U.S.A, Masters of Science in Telemedicine & ehealth from the UK and years of experience in Telehealth law research.)

Want to write for InnoHEALTH? send us your article at magazine@innovatiocuris.com

The post Regulatory alignment play catch up appeared first on InnoHEALTH magazine.

Medical tourism needs systematic structure

InnoHEALTH Magazine — Thu, 05 Apr 2018 07:21:05 +0000

The Medical Tourism Industry, poised to be a whooping USD 8-9 Billion Industry in India by the year 2020, is highly unorganized & unstructured. According to various reports of Industrial bodies, Indian Medical Travel Industry or Healthcare services is growing at a compounded rate of 20-25 per cent.

The Medical and Wellness Industry in India, being a highly unorganized and unstructured industry, is currently driven by limited market players and requires a systematic structural presentation, according to an in-depth study titled “Medical Tourism Opportunities and Challenges”.

The study, conducted in Delhi and National Capital Region (NCR), found if structural development of the sector is ensured, it will facilitate creation of a level playing field for the medical & ancillary service providers which in turn will put the country as one of the most premier Medical Travel destination in the world.

Jitin Kapoor, Joint Secretary at International India Medical Tourism Congress (IIMTC), who spearheaded the study along with a team of researchers, told “Inno Health” in an exclusive interview that the Medical Tourism Industry is undoubtedly one of the most promising sector for the country’s economy, and shall be one of the major source of revenue generation, as well as job creation in near future.

The study finds positioning India in the world market as a bigger and valued prospect for medical travelers from around the world. Mr Kapoor, also a chartered accountant, recommended that there is a dire need to improve the local travel and accommodation facilities for the medical tourists. The available ancillary services need to be adequately marketed and showcased for the medical travelers as a lot of difficulty is faced by them due to lack of awareness.

According to him, the payment security for service providers as well as medical travelers needs to be developed through a dedicated digital payment platform.

A common organizing platform, integrating all the medical service providers, along with the related service providers is highly desirable. They are required to be brought on single digital platform which will assist in providing transparent and conducive environment leading to a positive feedback and in turn help the industry to flourish.

[vc_single_image image=”3618″ img_size=”500×300″ alignment=”center” onclick=”link_image”]

[vc_empty_space]

Medical Tourism, also known as Health & Wellness tourism, in recent years, has been coined as a term to represent the movement of people from one place to another for their medical treatment care, and wellness needs. People from across the world travel to other countries for their surgical, medical, dental requirements, etc.

And at the same time make some time for family vacations, tours & travels to experience the local attractions of the destinations. Such movement has in itself evolved as one of the most rapidly growing industry integrating travel & tourism sector with healthcare and wellness sector; both being the most revenue generating sectors for an economy.

India, Thailand, Singapore, Malaysia, Greece, Peru, to name a few are some of the major Medical Travel destinations. This phenomenon has been actively prevalent in the healthcare sector across the globe for last one and half decade and is growing tremendously.

With high cost of treatment in the West, to the long waiting time for treatment in the EU Countries, the people from developed and industrialized nations are looking for destinations that have a ready availability for treatments with the facilities that are at par with their own country. The countries like Africa, Oman, Afghanistan, etc. are also looking for better healthcare infrastructure as compared to their own.

India can serve as an enormous potential destination for all the international medical travelers owing to its healthcare facilities that match the best in the world, along with a vast number of West trained medical practitioners. Another major factor is the cost effectiveness the Indian Healthcare sector provides viz-a-viz the International healthcare costs. People travelling for medical processes can get the treatment readily available and that too with a 5-Star Hospitality (in a fraction of the cost they incur in their own countries). Travelers also have an option to explore the country with amazing picturesque destinations, backed with rich heritage culture.

This exceptional combination has already made the Medical Tourism Industry worth 2.5 Billion USD in India, growing at a compounded rate of 20-25 per cent, as per various reports of Industrial Bodies.

Want to write for InnoHEALTH? send us your article at magazine@innovatiocuris.com

The post Medical tourism needs systematic structure appeared first on InnoHEALTH magazine.

India aims to eliminate TB by 2025

InnoHEALTH Magazine — Thu, 29 Mar 2018 10:37:01 +0000

[vc_single_image image=”3594″ img_size=”200×200″ alignment=”center” onclick=”link_image”]

Dr. Soumya Swaminanthan needs no introduction. The 58-year-old pediatrician and clinical scientist has been recently nominated as Deputy Director General of the World Health Organisation. Ms. Swaminanthan, the pioneer in Tuberculosis research, advocates the role of research to root out the disease as the country has the highest number of cases in the world.

India’s National Health Policy recognizes the key role that research plays in the development of a nation’s health. The India TB Research Consortium brings together diverse stakeholders to develop new tools – diagnostics, vaccines and drugs – to enable the country to take a leadership role in fast tracking translational TB research and find solutions for the world.

Dr. Soumya Swaminathan (Secretary, Department of Health Research, Ministry of Health & Family Welfare and Director General, ICMR) recently at the second International Scientific Advisory Group (ISAG) meeting, states India has the highest number of TB cases in the world. It is widely recognised that the field needs new tools to make a greater impact on this disease, including more sensitive diagnosis, preventive vaccines and new drugs to treat MDR-TB.

The India Tuberculosis Research Consortium (ITRC), formed by the Indian Council of Medical Research (ICMR), Delhi convened its second International Scientific Advisory Group (ISAG) meeting.

The ISAG comprises global experts in the areas of TB research and has been formed to advise the ITRC on developing and translating, research & development leads across four key thematic areas – diagnostics, vaccines, therapeutics and implementation research – taking into account the research leads in each area, available both nationally and internationally.

Dr. Barry R. Bloom (Distinguished Service Professor, Harvard University and Chair, ISAG) addressing the meeting states, “TB is now the largest single cause of death in the world from an infectious disease.

Hence, the Government of India has made a significant commitment to support research to prevent and control the disease in India.” India’s National Strategic Plan 2017 for TB elimination aims to achieve and maintain a cure rate of >85% in new sputum positive patients for TB and reduce incidence of new cases, to reach elimination status by the year 2025.

Want to write for InnoHEALTH? send us your article at magazine@innovatiocuris.com

The post India aims to eliminate TB by 2025 appeared first on InnoHEALTH magazine.

Menace of Non-Communicable diseases: A far reaching impact

InnoHEALTH Magazine — Wed, 28 Mar 2018 08:49:26 +0000

Non-communicable diseases (NCDs) represent a major peril to the economic growth and development and human health of any nation. The economic loss to India is pegged at $4.58 trillion before 2030 due to NCDs and mental health. The vicious cycle of high out-of-pocket expenditure on health, poor economic growth, workforce productivity loss and rising disease burden are intricately linked to the rising menace of NCDs.

The South Asian region─with a population of more than 1.7 billion─is experiencing a marked demographic transition─characterised by declining birth and death rates and an increasingly aging population. This increase in longevity has also been accompanied by a rise in the prevalence of NCDslike diabetes (78 million cases in 2015). India has the second highest number of diabetic patients in the world, at about 69 million, after China, and this figure is likely to reach 140 million by 2040 and almost half of them remain un-diagnosed. A recent study showed that seven out of ten diabetics in India – especially those in the 20-24 age group – do not take enough steps to control their blood sugar level – even after diagnosis.

The Economic Impact of Diabetes, As per a study conducted by the Indian Institute of Public Health, the number of diabetes patients in the country is likely to go up to 120 million in next 20 years as against the current 70 million. On an average a diabetic patient spends about INR 25,000 annually to manage the disease and its associated complications. Beyond placing a financial strain on the patient due to treatment expenditures, poor management of diabetes significantly impacts the patients’ quality of life: it may lead to loss of productivity due to multiple hospital visits, elevating rates of absenteeism, diminishing the energy and focus of a productive workforce, and depleting critical workplace skills ultimately leading to reduced mobility and span of life. Diabetes related complications like kidney failure, nerve damage along with obesity, dyslipidemia and hypertension make diabetes management quite complex for clinicians.

In this context, it becomes important that healthcare professionals have access to more educational resources to remain updated about how to tackle the diabetes epidemic. But due to scarcity of time and high patient load in South Asian healthcare facilities, medical practitioners find it very difficult to update their knowledge. Remaining updated can help clinicians offer better diabetes management options to their patients.

A Possible Solution: E-Learning Courses e-Learning programs can help clinicians in acquiring skills required to address the growing complex management of diseases. E-learning courses can be tailored to fit the clinicians schedule, delivering content right at the moment when it is demanded by the doctor. Interactive e-learning programs also offer peer to peer learning, thus enabling clinicians to discuss learning from key cases. Those e-learning programs which also offer the opportunity of contact classes, offer a richer and immersive learning experience.

An effective e-learning program will incorporate guidelines for determining the correct and appropriate blend of instructional strategies, including on-line learning, face-to-face instruction, and skill demonstrations, thus facilitating the learning of a clinician far beyond than traditional learning materials. Unlike traditional CMEs, e-learning can be designed to be self-paced, and research has indicated that e-learning reduces the learning time by at least 25-60% when compared to traditional learning, which can be an added advantage for time-constrained clinicians.

Intelligent e-learning management systems also adapt and learn from the learners’ aptitude and change and deliver a personalized learning experience. The right mix of video, audio, and text content formats help to ensure that delivery of content is mapped to the medium most appropriate & relevant to concept development.

Keeping in mind these perspectives, a Six Months Certification Course in Diabetes in partnership with Fortis C-DOC Hospital was launched by BMJ in South Asia. This course is endorsed by the Royal College of Physicians. This is a six months online learning course offered in two formats: with hands-on training and online-only – to cater to the learning needs of clinicians in South Asia.

Courses such as these will go a long way in knowledge & skill upgradation for clinicians in areas which the country faces a high disease burden. Such courses are clinician-centric and learner-led, and have been developed keeping in mind the real and on-ground challenges faced by doctors in South Asia.

Want to write for InnoHEALTH? send us your article at magazine@innovatiocuris.com

The post Menace of Non-Communicable diseases: A far reaching impact appeared first on InnoHEALTH magazine.

Startup coordinates and e-health destination

InnoHEALTH Magazine — Tue, 30 Jan 2018 05:53:58 +0000

The startup coordinates and e-health destination

By Sachin Gaur, Director operations IC

Last year May 24-26, 2017 was big startup event Latitude 59 in Tallinn,Estonia. I attended the event and got a flavor of the startup scene and healthcare sector discussions were held. I aligned my visit to Estonia along with the visit of my meeting with CBHEALTHACCESS delegates, innovative healthcare companies from Finland, Sweden, Estonia and Latvia.

I could witness many startups and meet some friends. At any point in the premises of the conference there were over 1000 people and all engaged about future trends and opportunities. One way to know future is always by observing what problems best startups are engaged in solving. I could witness many biotech (genetics) based startup trying their hands on personalized medicine and new age diagnostics platform. Also, interesting was the cyber security companies.

One cyber security startup from Switzerland, OneVisage, that attracted my attention was working on 3D face scanning as authentication mechanism and looked promising for applications like online banking with your own face as your password. Estonia in general has made great advances in two areas, one that of e-governance including e-health and the other cyber security. Hence, it was no surprise for me to see both kind of startups flocking in conference and building upon the existing good work happening in that country. The other exciting thing to see was the countries collaborating and there were many international visitors including from India. Japanese and Finnish presence was quite visible.

There was also heavy promotion of e-residency program with some exciting announcements about easier account opening with a Finnish provider. It lured me also to try my hands on registering a company and post conference it took me only few minutes with the help of some local friends to register a company! Although, I am yet to make it fully functional, but that was already something for me.

The highlight for me was the healthcare session on the second day, which had a keynote by Nicky Hekster from IBM Watson. Nicky started by asking everyone in the room to standup and asked first those who have been to a hospital in last six months to sit down or someone in their close family. Next, he asked if they knew someone in friends/relatives who have been to the hospital. To my surprise there were only 2-3 people standing in the room which had over hundreds of people. This was a master tactic to drive the point home, that healthcare matters to all.

Followed by the keynote was a panel discussion, which comprised of panelists from USA, Finland, Germany, Italy, Netherlands and Estonia. They were healthcare practitioners, investors, incubators, startups and large company representatives. The session was interesting and demonstrated that how international best practices sharing and collaboration is need of the hour cutting across all type of stakeholders. I really enjoyed my two days not just in the conference but also in after parties with loads of intellectual discussions. Look forward being there again next year!

Want to write for InnoHEALTH? send us your article at magazine@innovatiocuris.com

The post Startup coordinates and e-health destination appeared first on InnoHEALTH magazine.