2. Sensors to detect milk adulteration

According to a recent research published in the Food Analytical Methods Journal, IIT Hyderabad has developed a sensor-chip based detector system to detect adulteration in milk. This helps to measure the pH levels of milk through an indicator paper that changes color due to acidity of the milk. Currently,methods like chromatography and spectroscopy are used to detect milk adulteration, which are quite expensive, so the researchers at IIT used a relatively cost-effective process called ‘electro spinning’ to produce halochromic paper-like material made of nano- sized nylon fibres and load edit with a combination of three dyes.

They have also developed algorithms that can be incorporated on the mobile phones to accurately detect the color change. The algorithm captured the colors of the sensor strips after dipping in milk using the mobile phone camera and the data was then transformed into pH ranges. On testing with milk spiked with various combinations of contaminants, they found near-perfect classification with accuracy of 99.71%.

In order to get comprehensive milk quality check systems that can be incorporated in mobile phones or any other hand aids the team now aims to study the effects of mobile phone cameras and lighting on detection efficiency and hopes to develop sensors for other physical properties like conductivity and refractive index and integrate them with the pH detection unit.

SOURCE: www.timesnownews.com

3. TestCard: A card sized urine test at home

The UK-based Med Tech Startup Test Card has created a postcard- sized urine test that can be done at home and is very much similar to a pregnancy test, which is analyzed by an accompanying app to provide immediate results.The postcard has an embedded, pull-out urine test. The urine test has no electronic component involved in its usage. The postcard test is likely to be launched in the UK in April 2019. In the near future, TestCard also plans to screen diabetes products in India.

4. IOTA Bioscience creates body sensor smaller than sand grain

An American biotechnology Startup, Iota Biosciences founded in 2017 by Carmena and Michel Maharbiz has recently raised 15 million dollars for its in body sensor which is smaller than sand grain.

The University of California in a micro electrode research developed the sensors called ‘neural dust’ which then transfers the data wirelessly from inside the body.The Co-CEOs hold exclusive rights to neural dust technology which offers revolutionary therapeutic applications for various chronic health conditions from inflammation to motor disorders and eventually cognitive impairment.

The advantage of this small-sized sensor is that it uses ultrasound avoiding any danger that is associated with wire and battery-provided implants. Since they are smaller and can be implanted deeper into the human body than traditional ones available, neural dust can interfere directly with specific nerve clusters allowing more precise diagnostics and treatments. Iota’s devices can concurrently record information and stimulate nerves giving near instantaneous closed-loop therapies that could better treat diseases from the inside out.

SOURCE: TimesNow

5. Wand… Pacemaker for the brain

Scientists at University of California have created a wireless device called ‘WAND’ which works like a pacemaker for the brain and may aid in the treatment of disorders like epilepsy and Parkinson’s disease. Wand is a neuro stimulator that can monitor and stimulate the brain with electric current. This device is autonomous and can simultaneously stimulate and record electrical signals in the brain.

About the author

Dr. Avantika Batish, working as the Director Strategy and Healthcare at International Health Emergency Learning and Preparedness. She is also a guest faculty for MBA (HR) and MBA Healthcare Management at various B-Schools and is a soft skills trainer.

Top 3 Latest Healthcare Innovations for the month of May

The meeting saw some very eminent and important speakers from around the healthcare industry. The first keynote was given by Dr. Vibha Jain, AGM IT, Max Healthcare. The keynote was about how AI improves the patient doctor communication?

The rise of the Internet of Things and Artificial Intelligence is critical to the digital transformation of modern healthcare as far as healthcare monitoring and delivery are concerned. The aim of patient and doctor communication is to create a good and caring relationship, facilitate exchange of information for accurate diagnosis and treatment, and including patients in decision making and counseling. But whether  the doctors are able to create a caring relationship or whether the patients are satisfied with the care, is the point of concern With the evolving technology, can Artificial Intelligence empower healthcare and improve patient doctor communication? There can be endless possibilities in medical imaging and diagnostics, patient care, RnD and management.

One of the patient doctor communications medium is voice. Companies like Google and amazon are out with devices which are voice based and are betting heavily on voice based skills. As these companies are market movers, the question arises: Are we investing in making voice  one of the skills needed to help the patients?

People with chronic conditions are often advised to follow detailed treatment plans; end-of-life care often requires many complex (and emotionally draining) decisions; options for treating certain diseases are increasing drastically. How much could health outcomes be improved with more effective communication between patients and healthcare providers?

One of the panelists brought light on how the voice is substantial to the patient doctor communication. Voice as an input is a useful tool as it gets us more data to refine our systems and algorithms. Voice as an output have some issues in the current scenario, as the synthesis is not real, it is hard to deploy the voice based system. Also there is a language barrier, as the systems are mostly deployed in English, there lacks trust and empathy. There is a vast opportunity to make these systems demographically viable. The question now arises is, if we use a chat bot or a bot service, can we have an authentication that it is a bot speaking not a human being.

Countries like Sweden have a white label application which helps the patient to communicate to the hospital or doctor by the help of a virtual appointment. This makes the environment conducive. In India, big hospitals like Max healthcare can also come up with the same system to improve the patient interaction with the hospital. Government can also come up with a plan to incentify the hospitals and doctors to use this kind of application.

As we are heading towards connected health, efficient communication between doctor and patient is just a small step towards faster healthcare delivery. The pace and evolving changes in the segment of healthcare extend right across the spectrum – from the development of new treatments and medicines to the front line delivery of innovative and paramount outpatient and emergency care. Surprisingly, it is at the front line where the most amazing advancements are happening and where the advantages are registering in the biggest volumes.

With this much advancement in connected health technology we have silos in the process. Healthcare providers apparatus needs to dismantle silos to usher in jointness communication between the doctor and patient. Can we leverage digital tech to manage patient life-cycle for convenience and safety? Max healthcare is also working on many measures to help the patient such as, billing transparency and estimation of the cost, bed allocation, risk assurance etc. Implication of all these is the journey/life-cycle of the patient improves. It gives a holistic care to the patients.

The core is to maximise value for patients: that is, achieving the best outcomes at the lowest cost. In this scenario the AI is helping the healthcare providers to move away from a supply-driven health care system organized around what physicians do and toward a patient-centered system organized around what patients need.

Growing demand for out-patient and at-home care along with connectivity advancements are also driving the use of devices powered by the IoT and AI. Today, privately-based medical insurers are making use of two-way smartphone applications for smartly connecting general practitioners with customers when it comes to initial consultation and diagnosis.

This serves as a cost-efficient option for avoiding a probably unnecessary in-person consultation for a minor ailment. The next steps ahead for this is to accurately and completely share vitals with medical practitioners on a real-time basis. This will be beneficial to enable multi-faceted tele-health services by making use of affordable devices for interfacing users together. It also proves useful for data transmission through connected devices like monitors, pacemakers, and other devices.

It is evident that the core of the connected health is made of technology, but we are not talking about just tools and devices here. This topic is relevant also from a philosophical, ethical and business point of view.

Government and private payer policies are shifting toward the use of connected health; We will likely see increasing adoption of connected health services by hospitals and providers as health care systems move towards holistic care to patients. It is the innovation and execution of information-based technologies that are likely to be transformative in improving health in a world of increasingly restrained resources. And in that effort, the newly empowered consumer is likely to lead the way.

This is a growing area of health care, and despite current challenges, presents significant opportunities for health care improvement. If you are not considering connected heath and Artificial intelligence in healthcare, now is the time!

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Smart Apps

The global smartphone users’ count is expected to surpass 2.5 billion by 2019. This exponential base of users is expected to influence the fate of health and fitness apps, which have already increased by more than 30% since 2016 (as on current date). It is estimated that almost 75% of current active mobile users run their health and fitness apps at least twice a week. With increased awareness among the mass population, people are leveraging technology to take better control of their health conditions such as asthma, infertility, obesity, and diabetes, etc. Moreover, the plethora of user data churned out from these apps are helping the market researchers access unparalleled volume of data for further in-depth and precise insights.

Smart Pills

The smart pill technology includes a wireless capsule, a receiver, and the software, which investigates and categorizes the gathered information from the patient who consumes the pill. It is an emerging technology, which is witnessing an upsurge in demand and is expected to show significant potential in the diagnostics domain in the future. The technology is used to detect gastrointestinal (GI) conditions and offers the physicians with information relating to several parameters such as pH, temperature and GI tract pressure.

For instance, the first digital pill -Abilify MyCite (approved in November 2017 by the US Food and Drug Administration) is used to track patients’ medication data. This is a venture between Tokyo-based Otsuka and California-based Proteus Digital Health (digital medicine service provider). The other key players operating in the smart pill technologies market include Novartis AG, Given Imaging Ltd., Philips Healthcare, Smartpill Inc., Olympus Medical Technology, Medtronic, Pentax Medical Co., Siemens Healthineers, Stryker Corp., GE Healthcare, and Boston Scientific Corp.

Smart Wearables

Smart wearable medical devices are small electronic products (consisting of sensors) which have computational competence. These devices are entrenched into items, which are attached to different body parts of the user. They can resemble watches, eyeglasses, clothing, contact lenses, shoes, or even jewelry.

Few of the latest smart health monitoring wearables in the global market include:

• Apple Watch Series 4 (healthcare app)
• Pebble Health (health monitoring app)
• Zephyr BioPatch (wireless monitoring device)
• Muse headband (brain-sensing monitoring headband)
• AliveCor Heart Monitor (smartphone-based ECG device)
• Garmin Forerunner 935 (GPS-enabled heart rate monitoring device)

Precisely, the Apple Watch Series 4 is embedded with an ability to automatically inform hospital service providers if a user becomes immobile for a stipulated period of time. This device assists people to become healthier, simultaneously storing real-time data which can be analyzed by healthcare professionals via remote patient monitoring, ensuring more precise and perceptive data for better healthcare practices. Moreover, AI can continuously monitor healthcare data and transfer the same to hospitals when necessary.

Conclusion

Upcoming healthcare technologies such as Smart Healthcare and AI are gradually renovating healthcare practices and are set to experience further innovations in the recent future. A significant number of healthcare experts are unquestionably banking on smart healthcare as a growing number of patients are keen to use these technologies and apps to improve their lifestyles. However, it is impossible to contemplate every research aspect of smart healthcare, considering its broad facets. Hence, as a result of the emergence of Smart Technology, healthcare stakeholders now should focus on imperative subjects such as security and privacy, ethics, training, biomarkers, genetics and personalized medicines, robotic-enhanced environments, human-computer interaction, and so on. The future is endless and exponential!

About the author

Victor Mukherjee is currently working as an Assistant Manager – Healthcare Practice, Infoholic Research

The Inaugural ceremony was graced by Mr. Prabal Chakraborty, Vice President & Managing Director, Boston Scientific India. The ceremony was also graced by Dr. Vidya Yeravdekar, Pro-Chancellor, SIU and Dr. Rajani Gupte, Vice Chancellor, SIU. Mr. Prabal Chakraborty mentioned that the complexity of healthcare is arising due to multiple stakeholders, multiple information flows, unstable geopolitical environment, and multiple decision-making processes. Dr. Rajiv Yeravdekar, Dean, Faculty of Health & Biological Sciences, SIU justified the concept of SYMHEALTH by a small story of a young boy who tried to search for god and succeeded. Dr. Rajani Gupte talked about the inter-departmental connections and platform where students get to inculcate skills like teamwork and hard work. Dr. Vidya Yeravdekar explained the need to have communication skills along with other pre-requisite skills in health sciences. Dr. S. B. Mujumdar, Founder and President, Symbiosis; Chancellor, Symbiosis International (Deemed University) emphasized on the need of the hour to have a healthy mind and a healthy body.

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The first session was on Public Health Agenda for India by Dr. Sanjay Zodpey, Vice President, Public Health Foundation of India.

He started his session by stating the 21st-century challenges in healthcare in India and the need to have a healthy population. He did a comparative study of healthcare status in 1947 India and the status at present. He emphasized the poverty status, gender inequality, the situation of sanitation and education in India as compared to the data available globally. He also discussed health landscape indices regarding immunization coverage, sustainable health goals index, related to health and wellbeing, life expectancy, infant mortality rate, etc. He stressed upon the need for government to increase the amount of GDP expenditure in the healthcare sector to have a positive impact on indices like life expectancy and national per capita income. He also talked about the challenges associated with the low expenditure on healthcare, the shortage of clinical and non-clinical staff. He also touched upon the topic of Universal Health Coverage and the point to be focused upon: affordability of healthcare, quality health service and financial protection to the public. He ended the session with the note “Creating ‘Swasth Bharat’ along with ‘Swachh Bharat”.

Mr. Bhaskar Nerurkar, Head, Health Bajaj Allianz ltd started the session with a little humor and introduced his co-panelists. Ms. Gayatri Iyer, Regional Manager, NIC then proceeded with her speech introducing the concept behind RSBY (Rashtriya Swasthya Bima Yojna), Ayushman Bharat and NHPS (National Health Protection Scheme). She also talked about the initial Planning commission and its transformation into NITI Aayog. She concluded her speech by perks and eligibility of the scheme. The session was then proceeded by Mr. Bhaskar where he started by appreciating Symbiosis International University for their educational services by saying that ‘Pune is the home of education and Symbiosis is the kitchen’. He talked about the aspects and the need to have Ayushman Bharat and Pradhan Mantri Jan Aarogya Yojana (PMJAY) from the insurance sector’s perspective.

The session then moved forward to Mr. Arunesh Punetha, Regional Director, Narayana Health who discussed about the anticipated challenges for public and private healthcare providers like the low rate of packages being made available to the clinical staff and the shortage of health workforce. He gave his insights on the Michael Porter’s model of ‘Agenda for Value Transformation’ with patient centricity at the core. He ended the session with a talk about PMJAY and its influence on public health.

Dr. Sanjay Gupte, Medico-Legal Expert began the session by talking about the types of law in healthcare statutory and case laws. He projected the issues by focusing on the interpretation of law changes as per circumstances, unlicensed practitioners, quacks and midwifery. He gave an overview on consent for sterilization, MTP, PCPNDT Act, surrogacy laws passed by loksabha, altruistic surrogacy with the help of many case studies. He spoke about the punishments for the failure to report or to record a case. He gave his inputs on medical negligence and its implications. He majorly focused on euthanasia in India i.e., withdrawal of life supports to patients. He concluded the session by talking about the latest changes in medical acts.

Mr. Rohit Sathe, President, Health Systems, Philips headed the panel discussion and began the session by introducing Philips and their mission and vision. His session was mainly focused on 4 components- accessibility, speed & accuracy, value solutions and innovations.

The session then moved forward to Mr. Vidhi Prasad K V, Head, Wipro GE South Asia. He talked about medical technology. He also touched upon the E-commerce portal for service parts & accessories like Medtronics, Siemens, Philips, etc.

Mr. Surendra Deodhar, VP, Reliance Life Sciences Pvt Ltd took over the session and proceeded to talk about equitable distribution of medicines in India, especially in rural areas, where access to these privileges is a challenge.

The session was concluded by a small Q-A session between the speakers and the audience.

Dr. Simmardeep Singh Gill, COO CK Birla Group Kolkata, began his session by touching upon the very concept of strategic leadership. He talked about the increment in competition and other factors with the help of forecasted charts based on reported data. He also described the challenges associated with the business models. These include: low public spending and high out of pocket spending, talent shortage and high attrition, fragmented industry and lack of standardization. He spoke about the widening trust deficit between the patient and the provider. He stressed about the high asset business model which has put a lot of strain in the financial metrics like sinking valuation, margin pressure an payout of insurance players. Micro insurance was given key importance. He concluded by sharing with us the growth story of CMRI which majorly focused on procurement optimization, patient experience, clinician engagement and manpower optimization.

The post tea break proceedings of day one of SYMHEALTH 2019 began with two parallel sessions. The first session was chaired by Dr. Satpathy, Director, School of Public Health, KIIT Deemed University. He talked in detail about the conceptual meaning of Universal Health Coverage (UHC). He emphasized on the need to have quality medicine, quality treatment, skilled workforce and the public should not face any difficulties while accessing them. He also stated the importance of having Primary Health Centres (PHCs), their efficiency and effectiveness in providing health to all. He stated that 80% of the Health needs can be taken care at PHCs. Further, he addressed the myths regarding Universal Health Coverage. He then proceeded to describe some key facts about UHC and its association with the World Health Organization (WHO). He concluded the session by talking about NRHM and Health Service Providers.

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The second parallel session on Pharmacovigilance & Clinical Data Management was conducted by Dr. Raman Gangakhedkar, Head, Epidemiology & Communicable Diseases, ICMR. He started his session with elaborating on why is pharmacovigilance required. He stated that the aim of pharmacovigilance is to detect unknown AEs at earliest and ensure patient safety. He did a comparative analysis of clinical trials and use after approval.

This analysis was done on the basis of the number of participants, the total duration of observation, vulnerable population, pharmacogenetics, concomitant medicines, and dose and duration. He spoke in detail about the increasing scope of pharmacovigilance. He spoke about the key stakeholders in pharmacovigilance. He spoke in detail about Nevirapine and post-exposure prophylaxis. He further emphasized the importance of the Periodic Safety Update Report (PSUR). Inputs regarding the mandatory data fields in reporting were provided. Role of Indian pharmacopeia commission topic was touched upon by sir. Sir primarily spoke about the importance of the Bradford Hill criteria. He further gave an overview of the national AEH surveillance and emphasized on the ICSR processor. Lastly, sir spoke about IC025 and disproportionate reporting. Sir concluded by saying that pharmacovigilance is an important activity for safety and that good data quality and its completeness is critical in signal detection.

Mr. Lalit Mistry, Director of Healthcare, KPMG began his session by talking about the emerging health trends in India and speaking about the future of consulting in healthcare. He talked about the potential impact on the healthcare industry by the emerging medical technology innovations, treatment innovations, proactive wellness, and digital health. He discussed the drivers of healthcare; the drivers being technology improvements, market forces, costs, regulatory reform, and consumerism. Mr. Mistry then proceeded to talk about the major broad buckets of consultancy sector including project management, management consulting, HR consulting, etc. He stated the fact that healthcare consulting market in India is fragmented and underdeveloped mainly in operations, clinical and strategy consulting. He then concluded the session by giving a brief overview about the career path prospect in healthcare consulting and the skills required like number crunching, report writing, communication skills and the ability to travel in short periods of time and domain knowledge. The session was proceeded by a Q-A session between the speaker and the audience.

The day concluded with sessions on Emerging roles & Opportunities for Healthcare management professionals by Dr. Dinesh Pashankar, Associate Professor, Yale University, USA. He spoke about the equitable distribution of medical equipment’s devices & pharma products. The Department of Pharmaceuticals of India is working towards the initiative to source at least 50% of these domestically so as to reduce procurement and heavy import charges and also make these easily available.

The day concluded with session by Dr. Col. Ajay Gangoli, Group Medical Director, Apollo Health & Lifestyle Ltd. He talked about the Multiple Dimensions of Communication in Health Care Industry. He stated that the purpose of disseminating health information is to influence personal health choices by improving health literacy.

Day 2: Saturday, April 20, 2019

Day 2 of SYMHEALTH 2019 opened up with paper presentations by delegates. There were 4 candidates who presented on various topics.

The second session of the day was an engaging talk on Corporate Social Responsibility in Healthcare by Dr. Sitarama Budaraju, Consultant, Healthcare Projects, Tata Trust. He introduced top 10 healthcare CSR projects in India in 2018. He spoke about the current health status. He touched upon the supply side constraints namely Human resource for health infrastructure, Health financing, Pharmaceutical, and supply chain and Technology. He emphasized the training of peripheral health workers in soft skills. He ended his session by focusing on the importance of documentation support.

Dr. Anirudha Malpani, Director & Founder, Malpani Ventures discussed the common beliefs among the people that doctors are dinosaurs i.e. they work in older ways than embracing any new technology. He said these days’ people practice eminence-based medicine, not evidence-based medicines. He stated that self-diagnosis and self-prescription are very common among the people and wrongful. He further spoke about different innovations such as Heart buds – using the smartphone as the stethoscope, smartphone-based ECG monitor, peek – smartphone-based eye testing kit, etc. He said that the doctors see the patients daily, doctors know the patients then why should they wait for the engineers to do the innovation. He concluded the session by saying that patients should receive information therapy from doctors. He also appreciated word of mouth marketing approach. His whole session was focused on “Patient as Partner approach” and how communication is the key. The session was full of jocular remarks that made the session very interesting.

The session was anchored by Col. Ajay Gangoli, Group Medical Director, Apollo Health & Lifestyle. He introduced the other speakers. Col. Gangoli gave introductory of the topic than Ms. Nishi Saini took over.

Ms. Nishi Saini, Head- North, Clove Dental Clinics started the session with Clove dental clinics’ inception. She spoke about clove dental history and its vision and mission. She showed a various graph showing clinics and dentist. She explained how to manage the services at such a big scale smoothly. She spoke about talent management under which she focused on intelligent recruitment. She concluded by showing various aspects where Clove serves the need of the society. She concluded by showing various aspects where Clove serves the need of the society.

Mr. George Chemban, Business Head, Suburban Diagnostics started his session with an introduction about his company Suburban Diagnostic which was started by Dr. and Ms. Sanjay Arora. He stated that doctor-patient relationships are transactional in nature. He focused on the essentials for creating a chain of business units by specifying the business strategy and alignment of goals, standardization for customer experience, standardization of people and processes and standardization of technology.

Mr. Anand Mote, COO, Aster Hospital started his lecture by speaking about why healthcare chains are required. He replicated the lecture by third man’s view of setting a healthcare system. He spoke about the changing landscapes in healthcare chains where he spoke about the global players who are entering the Indian market, availability of capital and importance of well-informed customers. He gave a brief about types of healthcare facilities. He also gave a basic template for setting up and managing a chain of healthcare facilities. He ended the session by explaining how the brand is created and perceived in the healthcare system.

The valedictory ceremony on May 20, 2019, was graced by Surg. Vice Admiral Ravi Kalra, NM,VSM, Director and Commandant, Armed Forces Medical College, Pune; Dr. Sanjeev Kumar, IAS Divisional Commissioner, Nagpur, Dr. Rajani Gupte, Vice Chancellor, SIU & Dr. Rajiv Yeravdekar, Dean, Faculty of Health & Biological Sciences (FoHBS).

Around 1000 to 1200 healthcare professionals, from across the country comprising of professionals from diverse verticals of the healthcare sector including domains of Hospital & Healthcare Management, Medico-Legal Systems, Medical Insurance, Clinical Research, Healthcare IT professionals, General practitioners, Specialists & Doctors from Allied Health Sciences, Policymakers & Administrators, Representatives of the Pharma sector, Representatives of Civil Society Organizations and Representatives of private and public Healthcare sector organizations participated in this event.

SYMHEALTH 2019 | 19 – 20 April 2019

In a recent healthcare conference, the people were unaware when I spoke about how on October 21, 2013, the former US Vice President Dick Cheney’s doctors disabled his pacemaker’s wireless capabilities to thwart possible assassination attempts. To this, everyone had an issue on accountability. It remains unanswered that who would be liable, the doctor, hospital, company which provided pacemaker or the insurance company. Amidst all this, nobody was concerned about the patient as none present there questioned it. Maybe we are awaiting a major catastrophe to happen to put our minds to work. It is our endeavor to equip the healthcare community to this aspect of digital health.

Cybersecurity is a major concern for patient safety and healthcare infrastructure. The health records, data, hospital information system and individual medical devices are all targets. The vulnerability is in technology and lack of awareness of staff. There are many examples to quote wherein hospitals have become the victim of attacks. A recent audit of a corporate hospital in Delhi by our team revealed that 80% of equipment is vulnerable to cyber attack, thus, risking the patients. Healthcare providers are not sensitized to issue as required hence this magazine is dedicated to Cybersecurity. We have named it Cyber4Healthcare and even launched a training program in the healthcare domain to update knowledge of this extremely important topic. There is an immediate necessity that we invest in staff and equipment to make our systems robust enough to protect them from cyber-attacks.

We at InnovatioCuris always strive to sensitize the healthcare providers with new technologies and our next issue would focus on IoMT or connected healthcare which is overtaking the segment rapidly. However, we should always keep in mind that we are master of technologies and not the other way around. Can humane touch be replaced by technology? The trend nowadays is that we are leaving human ingenuity behind and are being heavily dependent on technology. There is a need to understand the benefits and challenges of newer devices, technology, and thinking. Let us consider how we can balance traditional to modern approach in today’s world and get the best of both worlds. Let our readers share their experiences by writing for the magazine to benefit all.

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 companies who pitched and the expert panel were:
Companies Pitching:
● DocOnline Health India Pvt. Ltd.
● EMPE Diagnostics
● HealthCubed India Private Limited
Expert Panel:
● Adarsh Sharma, Financial Expert
● Sohini Mandal, Lawyer
● Nidhi Gani, Regulatory Expert
● Dr Vidur Mahajan, Industry leader
● Vishal Gandhi, Investment banker
● Dr Ravi Gaur, Industry leader
● Kshitij Chaudhary, Investment facilitator

Ajit Nair, DocOnline Health India Pvt. Ltd presented A Doctor Consultation Platform. Their core product offerings include – Last mile Clinical Delivery Platform/E Clinic Solution. They also enable a Clinical marketplace for their customers. DocOnline Health provides Doctor Consultation via video/audio and chat. Our Product is a secure platform ensuring data privacy. Provide Electronic Health Records for our customers. Doctor Consultations are provided in multiple regional languages. Flexible platform to derive clinical insights and Artificial Intelligence.

Pawan Asalapuram – EMPE Diagnostics presented his EMPE’s indigenous, customized test kits that can provide YES/NO answer in 60 min by developing visual signals and provides reliable clinical information already during the first contact point between the doctor and the patient. Our affordable tests are designed to operate even in resource-limited clinical laboratories, including medical camps.

Sridhar Ramanathan, HealthCubed India Private Limited has enabled better diagnosis for a patient by creating an ecosystem comprising of a multi-parameter point of care device operated with an easy to use the software on a mobile platform. It can screen for Vitals, Non Communicable diseases, and infectious diseases. It can expand the number of tests from 24 today to 65 based on user needs. Data is instantly backed-up in the cloud for further analysis.

Young Indian Innovators Compete with Best Brains

Sumit Puri, in his keynote, addressed the digital innovations in healthcare in three contexts: Industry context, future of healthcare through digitization and used the cases in Max Healthcare – IoT and AI etc.

Today’s patients are informed, savvy and social too. They are looking for: Convenience, reduced cost, improved outcomes, efficient processes, personalized care.

[vc_single_image image=”4854″ img_size=”500×300″ alignment=”center” onclick=”link_image”]

Digital is about user interactions and experience powered by Technology. Digital in Healthcare is empowering us to reduce cost, increase quality and enable wellness! – Sumit Puri. Emphasized on the utilization of Data from multiple sources like customer experience, patient safety, cost, and operational efficiency and growth to provide insights. He shared his plans on leveraging IoT at Max Healthcare through Connected, Coordinated and Integrated ecosystem with the focus on the patient. Proposed a dedicated, 24×7, technology-enabled clinician monitoring cell, digitized remote patient monitoring during emergency ambulance transfer. MAX BIKE RESPONDERTM for immediate medical care during emergencies 13 mins each time, >150 lives saved since June’17.

The learnings from his keynote were
● Standardization of core systems
● An adaptive and iterative culture of Innovation
● Outside in patient-centric design
● Collaborative ecosystem
● Strong governance mechanisms with metrics
● Focus on user (Clinician) adoption

As we know digital has struggled to make a headway into Indian health sector in a big way so far. However, given the enabling building blocks, it seems that we are at the cusp of a new paradigm in the health sector. In this session, panelists discussed the topic of digital in three contexts, as we have representation from policymakers, IT experts, Hospitals to an insurance marketplace.