To increase the quality of care, developed countries had already initiated incentive payment model to encourage and reward healthcare providers (hospitals, public health centers, school-based hospitals, and group practices) for delivering high-quality care.

Centre for Medicare and Medicaid Services, United States has developed value-based purchasing program rewarding the healthcare providers who had provided quality care to their patients.

Similarly, in 2017 the Singapore Health Ministry started to focus on the quality of care. Healthcare system in India pays the provider for the quantity of care, not for quality care and has not initiated any policies with regards to the increase in quality of care.

Mr. Bhargav Dasgupta, Managing Director, and CEO of ICICI Lombard in a recent press release about Indian government increasing GDP for healthcare to 2.5 said, it is a good move and this spending can be used to initiate quality programs. To measure the quality of care, the government should implement Quality metric tools in the major areas of medical error namely, reduce medication and hospital-acquired infection.

The quality metric tool will help the Indian Health Ministry to assess whether the provider has delivered high-quality care. For example, to assess whether a hospital has delivered high-quality care in prescribing medication to the patient with upper respiratory tract infection, the provider should report how many patients are being prescribed with proper antibiotics – for how many days.

Suppose the first year if the provider proves that 100 patients were prescribed with proper antibiotics then the number of patients should increase to 10% each year and finally achieve 100% goal in the consecutive year. The government should reward the provider with the incentive for providing evidence of high-quality care. Once two major medical errors have been addressed and controlled, the government can use the same model to all the areas of medical error. Hence, this incentive program will eventually increase the quality of care and decrease the cost of healthcare. This incentive program should be initiated first in government hospitals, profit hospitals, and physician group practice. This will further attract more medical tourist to India due to the high quality of care.

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.

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

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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.

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.)

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With the commitment to giving an encouraging platform to innovators and aspiring start ups, InnovatioCuris (IC) was created as a knowledge based platform to exchange best practices of healthcare innovations across the globe by conducting international conferences, and extending the same message in internationally-acclaimed, quarterly magazine named “InnoHEALTH”, complimentary webinars and training.

On the third day of the event, a special seminar was hosted by IC Innovator Club (IC)2 with its first meeting held on 20 Sept 2017 at India International Center (IIC, Annexe), New Delhi.

The club brought all innovators, investors, start up, technology persons, policy makers, health experts and legal advisers under one large umbrella to be members and hold hands by sharing success stories and challenges and to incubate their ideas to take the dream and vision of India forward. It has a very strong band of advisers to support the activity of club and mentor projects. The aim is to bring down healthcare delivery cost yet maintain quality through innovations. IC has an outreach of 30,000 people globally to share its activities. The first of the club meetings was supported by Amity University, represented by Dr. Ajit Kumar Nagpal and three of the leading investors in the field of health and medical facilities.

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

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A voice to raise concern about the increasing cost of health and medical facilities was given a platform at the two-day InnoHEALTH 2017 that was hosted on September 18th and 19th in the capital. In the second year of its running, the event was co-hosted by InnovatioCuris and Indiattitude that extended a stage for innovations in the field of health and medicine.

Addressing the large gathering of doctors and high-profile professionals from the industry, Dr V.K. Singh, the visionary behind this event conveyed that the prime objective of this mega event is to contribute towards bringing down the healthcare delivery cost yet maintaining the quality.

InnoHEALTH 2017 helped in doing so by creating deliberations among policy makers, industry and academia on topics linked with Innovations in Hospitals, diagnostics, medical devices, pharma, biotech, digital healthcare and new delivery models.

The conference saw an attendance of around 250 Delegates with an overwhelming response of 170 on the very first day including 50 elite speakers from all over the world.

H.E. Riho Kruuv, Estonian Ambassador to India, DG Armed Forces Medical Services and Prof. Anil Gupta known for his work of innovations were some of the key speakers. The attendance saw presence from renowned healthcare personalities such as Dr. Arvind Lal of Lal Pathlabs, Dr. Ravi Gaur CEO Oncquest Labs, Dr. Padam Khanna – NHSRC, Mr. Partha Dey – IBM India, Mr. R Rengarajan Iyengar from HCL Healthcare.

On the first day of the power-packed two-day event, the conference hosted a B2B meeting to connect the Indian stakeholders with a visiting European Union delegation pertaining to innovative health sector companies. The companies were selected through a competitive program with a focus on cost-effective innovations for the Indian market.

With the objective of making it an international platform for the industry professionals with similar aims and goals, the conference had very high-profile brands, corporate and government organizations shouldering their support. Conference also hosted young innovators award.

The big boost in the confidence and capabilities of the conference was extended by the Embassy of Estonia, as the country partner. Other leading partners included, NHSRC representatives of MoHFW, Government of India, Public Health Foundation of India; CAHO as the association of accredited hospitals of India and AHPI that represents more than 10,000 private healthcare providers. IAMI brought in the clinicians involved in healthcare analytics while ScanBalt brings the outreach to more than 22,000 professionals in 11 European countries.

There were many more that contributed feathers to the hat to make InnoHEALTH 2017 a very successful event in terms of the perceived outcome.

The two-day event saw some very insightful discussions on, Innovations for Hospitals; Diagnostics of Tomorrow; Innovations for Affordable Healthcare – A Medical Device Perspective and Public Health and Biotech, on the first day of the conference.

The second day started off with a very informative keynote address by Professor Rishikesha T. Krishnan of IIM Indore. He is a Director and Professor of Strategic Management at the Indian Institute of Management in Indore.

It was followed by discussions on Healthcare Beyond Hospitals; Innovations in the Pharma Sector; Digital Health: Giving birth to new delivery models and fostering innovations, finally followed by Challenges and Redefining Healthcare Landscape.

The last two sessions of the day opened a very important chapter in the field of innovations in health sector. Indian and international companies were given a platform to make their pitch claiming the coveted Innovations titles. The finale was the dispensing of Young Innovations Awards.

Overwhelmed by the encouraging response this year, the organizers announced the dates for the next InnoHEALTH 2018, to take place on 5th – 6th October 2018, with a raised hope to come back next year keeping shared goals in healthcare with only, bigger, better and meatier roles for all stakeholders.

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

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