Whatever fell beyond this boundary was probably not considered Ayurveda. In recent years, with newfound pride in its legacy, Ayurveda has regained its vitality to reclaim its rightful place.

In recent times, people seem to have regained interest in discovering different ways to stay  healthy for a long time into their old age. In sickness too, people often face a dilemma of choosing treatment from two available systems: modern or alternative. The former has built  its foundation on biomedical experiments and the latter has evolved from a lived human  experience of centuries. Alternative, which is also known as complementary medicine,  includes an array of systems ranging from scientific to folklore. It includes Yoga, acupuncture,  traditional Chinese medicine, and AYUSH. The AYUSH systems, which stands for Ayurveda,  Unani, Siddha, and Homeopathy, have an established conceptual framework – proven and  unproven – about the working of the normal human body, etiology of diseases and their therapy.  

Ayurveda, a tradition of India for over 5000 years, reached its zenith around 100 BC by which its earliest stalwarts had created a cogent system, which had a logical strong foundation, a  well-constructed edifice, and a demarcated boundary. Whatever fell beyond this boundary  was probably not considered Ayurveda. The authors, Charka, Susruta, Vagabhat and others compiled experience, gained over previous centuries, in well-defined texts like Charka  Samhita, Susruta Samhita, Ashtang Hridaya and others. Their intuition, observations, logic, and ethics set high standards for the pursuit of knowledge, which guided this tradition for a  long time. 

The treatises of Susruta and Charaka were translated into Chinese language in the 5th century  and into Arabic and Persian languages in the 8th century. The Arabic translation reached Europe  by the 12th century. The British showed some interest in Ayurvedic systems but after 1835, with  the passage of the English Education Act, they discouraged Ayurvedic and other native  systems and gave preference to practice of western medicine. For the past many centuries, the  system was not able to maintain original vigor and the knowledge withered or remained static.  

In recent years, with newfound pride in its legacy, Ayurveda has regained its vitality to  reclaim its rightful place. Many institutions have been working on different paths to reach a  common goal: seek the truth in ancient knowledge, preserve what is known and unravel the  unknown. After centuries of dormancy, multiple paths are reasserting the relevance of  Ayurveda. 

The path of the purists and preservationists:

The purists believe in the divine wisdom of  Ayurveda, which originated from Brahma who passed it to Prajapati who in turn handed it to  Atreya and so on. Among the Vedas, it is Atharva Veda, which describes diseases and therapy in a systemic manner, though there are references to diseases in the earlier Rig Veda. The purists follow the Ashtang (eight-fold) system of Vagabhat, which includes Kaya Chikitsa  (Internal medicine), Shalakya Tantra (Head, Eye and ENT), Shalya Tantra (Surgery), Agada  Tantra (Toxicology), Bhuta Vidya (Psychiatry), Kaumara Bhritya (Pediatrics), Rasayana  (Antiageing therapeutics) and Vajikarna (Fertility, aphrodisiacs). The classic practitioners  follow the ancient practices in letter and spirit, which they consider perfect and need no  modification.

Traditional practice:

The followers of this path are Ayurvedic doctors who get training from  government accredited Ayurvedic medical colleges. Their training includes curriculum like 

1. anatomy, physiology, and microbiology, which later culminates in learning Ayurvedic texts  from ancient masters like Vagabhat. They use traditional Ayurvedic methods and biochemical  tests and radiology to arrive at a diagnosis. Many traditional practitioners have no  compunction in using western medicines to treat their patients even if they are forbidden. 

Commercial:

In recent times people from all societies seem to have rediscovered the benefits  of plants and herbs in health and disease. Two reliable market reports estimate that the herbal  market size of the world could reach between 168 billion USD and 428 billion USD by 2026.  WHO estimates that approximately 3.5 billion people in developing countries use plant-based medicines. At present, half the medicines in the market have natural origin. 

Profit drives the followers of this path. The marketing campaigns make generous use of well meaning words like organic, natural, herbal, antioxidant, detox. Market compulsions lead to  claims that these products promote health, wellness, strength, cure diseases and are harmless  without side effects. Such claims may not be Illegal but are often unsubstantiated.  

Currently, India has a small share of the world market, partly because of poor R&D and  quality standards. For international acceptance, recourse to clever marketing is essential but  not sufficient. Integration with international markets would be possible if Ayurveda pursues  intellectually honest research through established scientific methods to establish its veracity. The seekers of truth in ancient times used analytic methods available then and in modern  times we should not be reluctant to use the tools of science available now. The integrated  R&D could extend to manufacturing to match international quality. This could yield  enormous economic benefits.

Public health:

Ayurveda has inherent strength in its philosophy to contribute vastly to public  health. Unfortunately, this strength remains underutilized. An Ayurvedic public health  system, with its holistic approach, could lead common folks to a healthier lifestyle. With its  development and investment, an effective Ayurvedic health system could lead many public  health functions: prevention of the preventable diseases, improving nutrition, promotion of  physical activity, Yoga, mental health, and rehabilitation of the disabled. A dedicated public  health system based on Ayurvedic principles will go a long way to reduce disease burden.

Advocacy:

Activists and believers have pursued this path to persuade the government to  become enablers of an AYUSH eco-system. Their efforts have succeeded in opening new  organizational structures, institutions, and funding for various avenues of growth. More needs  to be done in basic research, standardization of therapy, patent laws, consumer protection and  integrated education.

Integrative medicine:

Healthcare will flourish when we harmonize the biomedical system  with Ayurveda; for too long these two have been running on parallel and often antagonistic  tracks. It helps vested interests to keep the two systems in conflict; it is time to find synergies  between them. The results of such merger should be quantifiable, replicable, and verifiable.  Making the impact quantifiable avoids inscrutable jargon which is a part of intuitive claims. Two myths prevail about Ayurveda. One held by biomedical doctors, who decry Ayurveda as  quackery and the second perpetuated by Ayurvedic practitioners that their treatment has no  bad side effects. Both are wrong. Here are two true stories from real life to counter both myths. 

A close friend had severe vertigo; his head would swirl unless he lied down immobile. These  episodes affected his personal and professional life. He spent a few years in treatment from  many modern medicine doctors including one at a reputed academic center but got no relief.  Out of desperation, he went to a prominent Ayurvedic clinic and under their therapy he got  considerable relief.  

In contrast, another friend was treated by an Ayurvedic doctor for abdominal pain, which  worsened despite the caring diligence of the doctor. After many months, when she switched to  a modern medicine doctor, it was too late. She succumbed to her disease and died soon after,  partly due to her disease and partly due to toxicity of the herbal drugs. The implication of these stories is that modern medicine should discard its smug superiority  and Ayurveda should shed off its halo of holiness. None of them can claim to be a panacea.  

Doctors already in practice could be offered courses both in Ayurveda and modern medicine to enhance their skills.

Integration of the two systems could happen in the medical college or later at practitioner  level. Students enrolled in modern medical colleges could take a course in Ayurveda; those  who want to specialize could be offered advanced courses following MBBS. Doctors already in  practice could be offered courses both in Ayurveda and modern medicine to enhance their  skills. Over the long run, the two-track medical education of Ayurveda and modern  biomedical medicine could be integrated into a single track; synthesis of the two systems  could evolve into a modern Indian system for healthcare delivery. The consumer would  benefit if she were not faced with the dilemma of choice.

Biomedical model:

Last two centuries have seen marked advances in understanding health  and disease by studying the human body as a biological machine. Investigators of the biomedical  model have developed a molecular basis of understanding the normal and abnormal  functions of the human body in health and disease. New diagnostic technology has evolved in  tandem to understand what was mysterious before. Therapeutic knowledge has exploded in  this field of biomedical models so that humans now live longer and healthier than even before  in history.  

There are groups of investigators, who are diligently using modern tools to unravel the  ancient knowledge. Some excellent work has been published in scientific journals and can be  searched in medical knowledge data banks like PubMed and others. To globalize the  knowledge and products of Ayurveda, we should meet international standards of research and product approval. The current gold standard is publication is a high impact peer reviewed  journal and approval from the FDA, USA. A serious inquiry into the ancient may reveal  kernels of truth and some fallacies. We should be bold to discard the fallacies and welcome  the truth. 

Like many others in this field, our group, Atrimed (Named after sage Atreya, teacher of  Charaka and Susruta) has also been working on an integrated Ayurvedic-biomedical model. Since 2003 we have been investigating the molecular basis of ancient therapeutics. We  believe that plants, which have evolved for over 2 billion years, can inspire new drug discovery. Plants are factories of nature. Phytochemicals and secondary metabolites can lead to new  bioactive compounds. 

In the last two decades, Atrimed group has diligently built a library of all previously published  Phyto-molecules and established a repository of real extracts from plants mentioned in  Ayurveda. Atrimed also experimented in preserving endangered plant species in tissue  culture. The virtual and real library could possibly be one be the largest in the world.

Such research necessitates the use of trans disciplinary teams to use technology from many  labs. Some examples are recombinant technology to produce target protein; molecular  biology to study biological reactions; tissue culture to study the effect of investigational  molecules on living cells. Atrimed uses computational chemistry and a docking software to  study these phytochemicals and has developed a software to predict absorption, distribution,  metabolism, excretion, and toxicity. To understand the therapeutic value of nutrition we are  developing software to see the effect of food at molecular level, which may help in  understanding the poly-pharmacology of various Ayurvedic drugs. Atrimed has also succeeded in developing plant molecules with verifiable anti-viral activity both in lab and clinical setting. 

Atrimed has collaborated with many reputed institutions. Some of them are Rajiv Gandhi  Institute of Technology, Bangalore Bio-innovations Center, Rastriya Vidyalaya College of  Engineering, Nitte center for animal studies, Nitte Gulabi Shetty Memorial Institute of  Pharmaceutical Sciences, Institute of sciences Bhubaneshwar, Regional Center of  Biotechnology Faridabad. Our company Atrimed has been awarded by Biotechnology Industry Research Assistance Council (BIRAC) and recognized by many government and  private organizations. 

The work of the Atrimed group has led to development of over one hundred effective products,  which meet international standards of safety. Some products have been retested for safety in  European labs to ensure they are free from toxic metals and pesticides. Manufactured in C GMP or FDA approved facilities, some of the products have been registered with FDA. As a  result of high-quality work, Atrimed products are selling in India and many countries abroad. 

Regulators and consumers:

The recent Ayurvedic resurgence forms but a minuscule part of  the health and wellness universe. The private and public initiatives can expand only if  enabled by the government and accepted by the global consumer. From the regulatory  authorities in becoming enablers to people becoming informed consumers, all intermediary  stake holders need to participate in rejuvenating this tradition. The regulators could help evolve the market with a multi-pronged initiative, which would  include new laws for intellectual property, new integrated medical training, funding of  original research and controlling fake claims in marketing. 

The growth of Ayurveda also requires an informed consumer who is equipped to utilize Ayurvedic or modern medicine. As many diseases are self-limiting, either one may suffice but  the decision is critical when the disease demands an expert’s help for recovery. Ideally, the  treating physician would keep the patient’s best interest foremost and guide her towards the  best available treatment. But it gets muddled due to financial incentive the physician gets by  providing treatment. In both modern and AYUSH systems, the practitioners range from  altruistic to commercial, from competent to charlatans. Perhaps the ethics of ancient  physicians are as important as modern technology. Ethical partitioners and empowered  consumers probably provide are the best guardians for reinvigorating Ayurveda.  

In our euphoria of novel discoveries, the ancient wisdom has been,  unfortunately, relegated to an inferior status because of perceived low utility. But discarding  ancient wisdom of our inheritance may be inimical to achieve the target of a healthier and happier human life. The rejuvenation of Ayurveda needs a new impetus, which integrates the  traditional intuitive method with the analytical reductionist method of western science. The  tradition of Ayurveda deserves neither derision nor worship; it needs honest investigation to  establish its validity globally.

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Dr. Cherian, Ms. Shraddha, and Mr. Rohit Ghosh, who joined remotely, were welcomed by Mr. Sachin Gaur, Executive Editor of InnoHEALTH magazine. He emphasized the importance of using AI in the medical industry with a brief overview of the meeting’s agenda  and the flow of the session. The questions planned to be asked  to the experts were in the realm of comprehension, such as what it takes to make an AI product successful in a clinical setting? From a technical standpoint as well as in terms of the actual obstacles and challenges they confront. Participants in the meeting are more likely to obtain insights and learn some crucial lessons if they are aiming to create a business.

Mr. Gaur welcomed the first panelist for this club meeting Mr. Rohit Ghosh who is the founding member and Chief strategy officer of Qure.ai.

Mr. Rohit discussed the difficulties they confront on the ground while installing AI. He added that Qure.AI has deployed AI in approximately 50 countries and 500 hospitals in the United States, the United Kingdom, Europe, Africa, Southeast Asia, and Asia. For smooth running of the installation, he devised a plan to comprehend some of the problems and lessons learned in due course and those he will be sharing during the session.

He initiated his questionnaire session with the first question on AI, “Do you need to enlarge the data sets for training?” “Could you explain the difficulties here”? He reciprocated that indeed the datasets for training are the most important item for any AI company. His company Qure.Ai has almost finished processing 4.2 million photos for a chest x-ray algorithm they developed. He underlined the need of using data sets for training, as this leads to accuracy. Although delta improvement necessitates a large amount of data where any amount of data counts. 

In response to the second question, “How can we measure completeness of data, representation of groups, and other such things?” He explained that complete data is a theoretical concept where fluctuations such as regional, disease, and seasonal variations, are data sets that should be addressed more. He underlined the hardship to track down all of the data.

His next question was, “How objective are the ground truths of your training data sets, and what can you do to improve the quality objective of ground truth?” In response, Mr. Rohit stated that in AI, you must have an objective function, however in real life or reports, ground truths are not always as objective, such as when radiologists do not always take complete background of the case. So, the need to train any algorithm becomes important. Now, to improve their ground regularity quality, they’ve standardised ground truthing techniques, such as having a panel of radiologists review reports instead of just one. Another thing they have implemented  is to construct a complete NLP ( National Language propository) terms that they use to represent such findings. Therefore it uses multiple reads instead of one to get the objective that a person normally gets from physicians.

“Are the outcomes the system gives explainable and interpretable to clinicians?” comes the next inquiry. Do you have a way to visualise and explain them in a more user-friendly interface or report”? According to Mr. Rohit, explainability is at the heart of machine learning and AI research at the moment, but in his interactions with physicians and radiologists, it is a minor problem because clinicians are already familiar with AI medical imaging.

The next question is what happens when AI and physicians disagree. Is it true that they provide feedback? He justified the query by explaining that there are times when AI and physicians disagree, but just because one result differs from the other does not mean the AI is erroneous. So they have a discordance meeting to discuss the cases that are discordant. Then it’s assessed by a panel, which gathers any discrepancies and trains the AI to release future versions.

The next topic was how to provide feedback on your system’s performance in a clinical situation. The discordance meeting has already been explained by him and there is also post-market surveillance alongwith a FDA regulatory approval for the algorithms. A subset of everyday assessments is also examined by a panel in order to determine whether AI is making the correct decisions. Qure reads exam samples and then rereads them. AI is just used to ensure that the quality is up to par on a daily basis.

“Does Deployment Change Care Pathways?” was the next question in the discussion. Is there a way to retrofit or intervene? In response, Mr Ghosh elucidated  that retrofitting and intervention are both possible as it alters care patterns in some regions. Qure.AI has been able to make a difference since receiving WHO approval for TB diagnosis. The entire TB diagnosis takes one hour.

Finally, what value does your technology add to the healthcare process, such as improving the quality of clinical decision-making systems, automating manual processes, or something else? What do you do to build consensus on the impact? In your perspective, clinicians perceive a gain to the extent you foresee, so what do you do to build consensus on the impact? They’re basically increasing patient outcomes, according to Mr.Ghosh. 

At Qure.ai, one of the use cases is to reduce work burden and manual labour. Radiologists’ turnaround time should be reduced so that reports may be produced more quickly and accurately. Early detection of severe disease and prompt treatment are essential.

In AI, there is a lot of agreement. There is a lot of maturity in the ecosystem right now. Rohit’s part of the meeting came to an end with that.

What value does your technology add to the healthcare process, such as improving the quality of clinical decision-making systems, automating manual processes, or something else? What do you do to build consensus on the impact?.

Sachin Gaur moderating the session welcomed the next panelist Dr. Cherian, Co-founder at Synapsica

Dr. Cherian introduced himself and gave an overview of Synapsica’s work. In terms of the data sets, he and Mr. Ghosh had different viewpoints. He told us that they have enough data and are working to extend their data sets so that they can build more features and capabilities in AI using the tools they already have. He noted that data preparation, objective ground truthing of data cleansing, and knowing how it will impact your AI system not just in terms of money but also in terms of time are all expensive inputs into the system so it is critical to maintain a sense of equilibrium. From a medical standpoint, adding additional data does not necessarily imply that the AI’s output will improve. You can construct more accurate algorithms by using updated algorithms and technological advances that can be used for learning from more data sets. The output is influenced by the quality of the algorithms.

Dr. Cherian agreed with Mr Ghosh that there is no clear technique to measure the completeness of data sets while responding to the next question. The only way to know if your AI is functioning well enough on the data it has been fed is to conduct a real-time clinical setting trial.

Moving on to the next question, he told us that at Synapsica, they do multiple rounds of annotation and take intermittent consensus to achieve an objective to use a true analogy as AI is like a dumb kid, and if one want that dumb kid to excel in trials where it is tested against multiple radiologists, then one would have to hand hold the AI to learn from multiple radiologists rather than a single radiologists. We compared our results to ground rules established by several technologists, which is one simple means of ensuring objectivity in the ground truths put into the AI system.

The method you use to compile your data or ground truth also contributes significantly to objectivity. When looking at the photos, picking out the observations is fairly objective. People can recognise the description by looking at the image, then use the description in conjunction with current medical criteria to come up with an interpretation. This also aids in the development of AI that is more understandable.

In addition to the answer to the next question, Dr. Cherian stated that the majority of AI businesses are preparing annotated photos, highlighting specific areas, and using masking technologies so that radiologists can see and comprehend the problem. They also provide radiologists with engagement, which they believe is vital as every AI outcome won’t be accurate all of the time. He went on to say that they think of AI as a junior radiologist in training who provides a report, which is then reviewed by senior radiologists who make modifications. We may learn where we are going wrong and what needs to be fixed by using feedback. The next question was answered by this.

Moving on to the following question: How does your deployment alter the care pathway, and can it be retrofitted? Yes, he replied, we can refit. While looking at the results of AI, radiologists should not switch to different systems because any or all of the efficiency gained from AI will be lost. In response to the question of changing the care pathway, he added that most AI solutions will improve the efficiency of the existing pathway and, in the next step, possibly change the overall clinical care pathway.

Moving on to the last question, Dr. Cherian explained that their AI system focuses on improving the efficiency of radiologists in reading and interpreting this type of exam, which is their main focus. They were able to achieve their goals of reducing the 15 minute time taken to 7 minutes for today’s cases by radiologists, and it involves automation of the manual processes that a radiologist will typically spend while reading and interpreting those types of exam. He also stressed the need to reduce burnout. A number of disorders may be made more sensitive with AI.

He mentioned that reaching a consensus is difficult, especially when it comes to radiologists who have been working in a certain way for a long time, and their work was done in a different way with AI. Now that they have resumed work and have worked for a long time, AI comes in and asks them to change their work behaviours, that is the most difficult part. The best part of AI is to have a documented proof of accuracy for the items, which will provide the professional the confidence in using the product. Apart from all this there is another issue to consider is for usability. With aforementioned words Dr. Cherian’s session came to a conclusion.

There are times when AI and physicians disagree, but just because one result differs from the other does not mean the AI is erroneous.

Mr. Gaur invited next and last panelist for day’s session Ms. Shraddha Mittal, Implementation Associate CARING Analytics platform(CARPL).

Ms. Mittal began by highlighting some of the hurdles that these AI solutions face on a regular basis when it comes to using them in real-world clinical workflows. She stated that CARPL is trying to become a single enabling player that provides healthcare providers global access to the greatest AI in medical imaging solutions while also ensuring that these AI solutions are seamlessly integrated into their day-to-day imaging workflow. She went on to say that they are in the process of deploying these solutions throughout their partner hospital sites around the world, resulting in CARPL being used in various locations on many continents. They are stationed at Thomas Jefferson University’s academic centres in the United States. They’re collaborating with Stanford’s Army Center, Mass General Hospitals, and other institutions in the area. She went on to say that they are highly active in Brazil at Albert Einstein Hospital and other imaging centres across the world. They are used in India at various hospitals and the Mahajan diagnostic chain.

Some of the issues, according to Shraddha initiates as healthcare providers are unaware of the existence of these AI solutions and their access alongwith with the knowledge to integrate the AI solutions into their daily workflow.

She described the lifecycle that CARPL conducts to effectively integrate AI solutions into hospital medical imaging operations with an attempt to add value to both AI developers and healthcare providers in this ecosystem. The IT infrastructure, she explained, is a key hurdle when it comes to deploying AI technologies in the healthcare ecosystem. As a result, they tend to shorten this period, and their relationship with AI partners is structured in such a way that they want them to concentrate on integrating their solutions. Then it’s up to them to spread that answer to as many hospitals as possible around the world. After that, they help with the integration of the AI technology into a hospital. 

She mentioned that CARPL allows AI engineers to concentrate on designing more robust solutions as well as the deployment side of moving those solutions from the bench to the clinic. She informed us about the projects they are presently working on, as well as how CARPL can be used as a single interface to provide feedback from all around the world to AI developers in real time. When it comes to onboarding solutions, she stated that they are always on the lookout for high-accuracy solutions, ideally with FDA and CE licences. They’ve also assisted a few businesses in obtaining FDA approval. She finished by stating that CARPL is expanding into a variety of fields.

AI is a new way of thinking that needs to go, but that it should be remembered as a tool to assist medical professionals, not as a replacement for medicine, medical personnel, or doctors.

The club meeting then progressed to Q&A sessions.

Mr. Gaur and Dr. Singh wrapped up the meeting. Conclusive note by Mr. Sachin stated that AI in science is about knowing what we don’t know, not about money or productivity.

After that, Dr. V.K. Singh thanked the panellists and participants and elucidated that AI is a new way of thinking that needs to go, but that it should be remembered as a tool to assist medical professionals, not as a replacement for medicine, medical personnel, or doctors. He stated that he has faith in our people because of the vast amount of data we have because some of our states have more people than any other country. He thanked everyone for their participation in the meeting.

Composed by: “Clarion Smith Kodamanchili.”

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From the inception of medical science, there is heavy reliance on research to find ways to detect and combat dreadful medical conditions. While the many of the diseases known are curable thanks to the advances in technology and innovations in research, there are still some that call for more attention and a more precise treatment plan.
One such medical condition is Sepsis – a life-threatening disease affecting more than 30 million people globally every year. Sepsis is a medical condition when the body’s response to a present infection damages its own tissues and organs resulting in death or serious illness. If not treated at the initial stages sepsis can trigger low blood pressure resulting in organ malfunction or even worse, a condition called septic shock.
Antibiotic treatment of sepsis patients often relies on clinical observation and educated guesswork as clinicians wait for a culture to determine whether the infection is bacterial, viral, or possibly fungal. But with the U.S. Food and Drug Administration’s (FDA) recent approval of automated platforms for procalcitonin assays and mounting evidence of PCT’s value as a biomarker, hospital laboratories are turning to PCT to diagnose sepsis and guide antimicrobial stewardship.
The world has acknowledged sepsis as a life-threatening condition and a challenge for the medical industry to combat. The Global Sepsis Alliance is an organisation working at the forefront to increase awareness about the disease and globally.
Over the past six years, Thermo Fisher has worked with the Global Sepsis Alliance and other advocates to raise awareness of the signs and symptoms of sepsis.
Thermo Fisher Scientific- a world leader in serving science is committed to providing exceptional laboratory tools to assess the risk of bacterial infection relating to sepsis with the B·R·A·H·M·S PCT (Procalcitonin) biomarker assay. The B∙R∙A∙H∙M∙S PCT assay provides information on the presence and severity of bacterial infection, helping physicians in emergency departments, intensive care units and other critical care units decide whether to initiate antibiotic therapy in patients and when to safely discontinue antibiotics in patients with lower respiratory tract infections (LRTI) and sepsis, without compromising patient safety.
B·R·A·H·M·S PCT (Procalcitonin) supports responsible use of antibiotics
The overuse of antibiotics is a global problem but the B·R·A·H·M·S Procalcitonin assay can help guide the judicious use of antibiotics. Credible evidence from several reproducible, randomized clinical trials with more than 10,000 patients support B·R·A·H·M·S PCT as an effective tool to safely reduce antibiotic exposure in patients. It has a proven utility across diverse clinical settings. In addition to other clinical criteria, these assays enable quick decision making by the clinicians, be it for starting antibiotic therapy or its safe discontinuation. B·R·A·H·M·S PCT greatly helps to reduce prescriptions, tailor the therapy duration to individual patient needs and finally supports to save costs.
There is a sheer need to develop and manufacture novel diagnostic testing tools that not only improve early diagnosis and treatment of life- threatening diseases like Sepsis, but also to provide high-quality immunodiagnostic assays to immensely support medical professionals and patients to get closer to a future without such dreadful infections.

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The critical care environment has undergone significant alterations in the past several years. This has happened because our lifestyles in the fast-paced lives of modern India are ensuring that most people, in the age group of 30-50 years are falling prey to life-threatening cardiac diseases and strokes, in addition to diabetes, hypertension, cancers, liver, kidney and lung diseases – these diseases being called Non-Communicable Diseases or NCDs. They are now responsible for killing more than 65% of our population says Dr Arvind Lal, known for his diagnostic labs across the country.

Flagging concerns on such trends, these patients need high-cost intensive care, be it for complications of heart attacks, strokes, diabetes, hypertension, cancer or lung diseases. This is where the importance of Point-of-care testing (POCT) comes in. It helps in almost diagnosing the patient instantly and improves the physician’s ability to take immediate corrective action and decreases hospital stay. One such test is Troponin – that has revolutionized cardiac care by diagnosing heart attacks or myocardial infarction.

This article is based on the keynote address on the occasion of 2nd Annual International InnoHEALTH Conference 2017 – ‘Transforming Healthcare Through Innovation’ in New Delhi, said there are numerous promising diagnostic technologies. The key message is that in a country where 70% of the population lives in rural surroundings, ‘it is our duty to rapidly adopt disruptive innovative affordable technologies including telemedicine. Thus, our underserved population would be able to avail of the best treatment possible and bring in massive visible change’. He said the importance of bringing quality healthcare needs no reminder and the time has come for India to change the direction of healthcare for the masses.

Healthcare is a right – and access to good healthcare should not depend on where one lives and how much he or she earns. But sadly, that is exactly what plagues India’s healthcare today, he lamented. India faces a severe shortage of both hard infrastructure and talent. With about one doctor and one functional bed per 1000 population, healthcare is truly underserved in India. Add to this the regional imbalances and variations in healthcare delivery. The healthcare infrastructure is skewed towards urban over rural India.

Although rural India accounts for about 70% of the population, it has less than one-third of the nation’s hospitals, doctors and beds, resulting in large disparities in health outcomes across urban and rural India. British Medical Journal (BMJ) has observed that there is a remarkable saving of lives in India if good healthcare facilities consisting of operation theatres, surgeons, anaesthetists, blood banks are available within 50 kilometres of the patient providing quality medical services within the ‘golden hour’.

Though there has been a sea change in the last five decades, India now needs to reinvent the field of diagnostics as laboratory tests are responsible for 70% of all clinical or medical decisions.

In today’s life where internet rules the roost, the patients have become very knowledgeable, thanks to the globalisation of healthcare, and are demanding very high-quality healthcare for themselves. They are insisting on a very wholesome and satisfying experience rather than being told that the ‘treatment is over’.

Soon, a time will come when the tests shall be ordered by the patients based on clinical history and clinical findings that shall be answered by an Artificial Intelligence (AI) application. Artificial intelligence has already found several areas in healthcare from the design of treatment plans to assist in repetitive jobs to medication management and drug designing. The most obvious application of artificial intelligence in healthcare is data management. Collecting it, storing it, normalizing it, tracing its lineage – it may well be the first step in revolutionizing the existing healthcare systems.

Recently, the AI research branch of the search giant, Google, launched its Google Deepmind Health project, which is used to mine the data of medical records in order to provide better and faster health services. The project is in its initial phase, and at present, they are working with Moorfields Eye Hospital of NHS Foundation Trust, UK to improve eye treatment.

Just a few years ago the patient after giving the sample used to come back in the evening to the lab to collect a physical copy of the test report. This was replaced by making the report available on the internet that could be downloaded by the patient in the comfort of his home. These days this has been further replaced by making available an App on his mobile phone wherein he can book an appointment for the sample to be collected at home and the report being later available on the same mobile App.

‘IBM Watson, whose headquarters I had the privilege of visiting a few months back in the Silicon Valley, is an AI-based engine that has launched its special program for oncologists to provide clinicians evidence-based treatment options. The program has an advanced ability to analyze the meaning and context of structured and unstructured data in clinical notes and reports in its encyclopedic memory that may be critical to selecting a treatment pathway’. IBM launched another algorithm called Medical Sieve. It is an ambitious long-term exploratory project to build a next-generation ‘cognitive health assistant’ that is able to analyze radiology images to spot and detect abnormalities faster and more reliably. This shall help radiologists in the future to look at the most complicated cases where human supervision is essential.

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The lab-on-a-chip (LOC) is another device that integrates one or several laboratory functions on a single integrated circuit (commonly called a “chip”) of only a few square centimetres to achieve automation and high throughput screening. Imagine that a patient comes to one of our 2,100 collection centres in the remote tier three or tier four towns in India with the high fever. We take a drop of blood from his finger and inform the clinician almost immediately that the patient is suffering from Chikungunya and not from Malaria or Typhoid, or Dengue fever or Japanese Encephalitis – all in a matter of minutes! The driving notion behind POCT is to bring the test conveniently and immediately to the patient. Needless to add, the patient’s data by POCT shall be made available to update the patient’s electronic health records (EHR).

Talking about POCT Instruments: Currently, two broad type of POCT instruments are available: Small benchtop analyzers (for example, blood gas and electrolyte systems) and handheld, single-use devices (such as urine albumin, blood glucose, and coagulation tests). Now let us talk about if POCT is Boon or Bane? The strong point of POCT is speed and the rapidity with which it shall save lives in emergencies. As India marches towards quality healthcare delivery, in course of time regulatory compliances shall have to be adhered to in the interest of the patient’s health.

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