Medicine Archives - InnoHEALTH magazine

Public wants both Ayurveda and modern medicine: How Technology can facilitate this?

InnoHEALTH magazine digital team — Thu, 23 Jun 2022 10:06:50 +0000

The controversy

There have often been Ayurveda and modern systems of medicine. Recently this debate kicked off after controversial remarks of Baba Ramdev ridiculing modern medicine as ‘stupid’ and questioning its ineffectiveness as many doctors lost their lives to it. These remarks during the pandemic were dangerous as it undermined the faith of the public in the proven scientific interventions which saved many lives during unprecedented times of misery and death. Modern medicine’s contribution to improve health and longevity cannot be denied. An average Indian’s life is around 70 years today compared to around 32 years at the time of independence. The substantial decline in infant, child and maternal mortality, eradication of smallpox, yaws and polio and elimination of neonatal and maternal tetanus to name a few achievements of modern medicine.

The current debate tends to further polarise – either you are with Ayurveda or allopathy—there is no room for the majority of people who think that both methods are beneficial to the public.

The Health Ministry promptly expressed its disapproval over Ramdev’s remarks, issuing a letter to the Yoga Guru to retract his statements. Ramdev complied with it and withdrew his statement. But he continues to ask questions on effectiveness of allopathy in treating various diseases in his Yoga training sessions and other platforms. The current debate tends to further polarise – either you are with Ayurveda or allopathy—there is no room for the majority of people who think that both methods are beneficial to the public. In India, the public has a deep rooted, millennia-old belief in Ayurveda. It is reflected in sociocultural traditional health practices seen in almost every household in India. Though modern medicine has saved millions of lives, it can certainly be further enriched with evidence-based Ayurvedic philosophy, practices, and treatments. It is a marvelous achievement of modern science to have developed effective vaccines to prevent COVID-19.

India’s western-influenced education system, inherited from Lord Macauley, labels all traditional wisdom including Ayurveda as unscientific and inferior. This mindset needs to change to scientifically evaluate practices and treatment in Ayurveda and other traditional systems of medicine and accept these to maximise the benefit to the common man.

Strengthening evidence-based practice of Ayurveda and Allopathy

Doctors who follow science believe that modern medical practice is evidence-based and continuously evolving as we learn from research and other sources including traditional systems. Ayurveda (Charak Samhita) also has a system of verification and is different from modern medicine and it looks for proof (pramana) which includes Aaprtopdesha (expert opinion), pratyaksham (observation), anumaan (inference) and yukti (reason and experimentation). In modern medicine the power of evidence from these ‘pramana’ in considered low as compared to evidence that emerges from randomized controlled double-blind trials, meta-analysis, and systematic reviews. The Ayurvedic system of pramana (proof) can be strengthened with modern medicine’s approach of strengthening evidence using these recent methods to improve its credibility, acceptance and trust.

People want both Ayurveda and Allopathy to treat their health problems:

The Ayurvedic philosophy and beliefs are widely accepted not only in India but are gaining more acceptance even in the western world. A study across 18 states in India (NHSRC, 2010) showed that 73% of people used home remedies, mostly influenced by Ayurveda, for treatment of their most recent sickness episode. For common ailments such as cough, cold, diarrhoea, minor cuts, burns, insect bites etc, 50-98% used home remedies, mostly Ayurvedic practices. The reasons ascribed by the people for this include; previous experience in family and community as it worked; strong belief that it heals; easy to use; inexpensive; easy availability etc. The public has deep-rooted faith in Ayurveda. They often use these together. Local health traditions and customs, influenced by Ayurveda for thousands of years, have become part of home remedies and become an important way of life in both health and sickness.

Both Ayurveda and Allopathy may not be perfect systems by themselves but together offer a better chance to prevent and alleviate suffering and misery of people from diseases. To build credibility, we need to avoid premature claims of effectiveness of various treatments. These premature claims were seen both by Ayurveda and modern medicine during COVID pandemic. The claims of effectiveness of interventions such as hydroxychloroquine in prevention and plasma therapy in treatment of COVID were dropped when evidence suggested that these do not work. Ayurvedic practitioners at times are adamant that ayurvedic treatments and practices are never harmful. There is a need to be open, honest and transparent to build credibility of a system. NHSRC (2010) study also found high utilization of AYUSH services in states such as Tamil Nadu and Kerala refuting the argument that people resort to them because of inaccessible or unaffordable modern health services. The study found that 70% of the allopathic doctors in the government system felt that AYUSH systems are not redundant and can be strengthened. They emphasized the need for research and documentation in AYUSH.

Need for a better understanding of Ayurveda and Allopathy

Ayurveda is a comprehensive system of medicine that evolved in India which uses a range of treatments, including panchakarma (‘five actions’), yoga, massage, acupuncture, and herbal medicine, to encourage health and wellbeing. Ayurveda makes use of natural herbs, extracts, plants, and some metals and claims that ‘all Ayurvedic remedies are close to nature and do no harm’. Though modern medicine practitioners have seen serious side effects of some ayurvedic medicines such as those treatments containing lead and other heavy metals.

Need for a better understanding of Ayurveda and Allopathy

Contrary to the common belief especially among Ayurveda practitioners, Allopathy not only works to treat symptoms and illness but also has effective interventions, such as vaccines, to prevent diseases. Pharmaceutical drugs play a major role in allopathy. The modern medicine, as it is practiced today, is very different from Allopathy which had its origins in Greece about 2,400 years ago, when it included purgatives, catharsis, bloodletting etc. Most of these practices have been discarded, as modern medicine looks for evidence on effectiveness of interventions based on research. There is always a profound discussion on proving which intervention is better and a biased conclusion may be counterproductive and undermine public trust. Pharmaceutical drugs play a major role in allopathy. Drugs are developed either to alleviate the symptoms of the diseases directly or alter the way the body responds to it. Drugs do generally cure diseases but sometimes their side effects affect the patient adversely.

AI is helping modern medicine practitioners in many ways. The evidence-based AYUSH interventions for common health conditions can be integrated into these.

Approach	Addresses the root cause as understood in Ayurveda	compounds, medical devices and surgical interventions Achieves cure and prevention through antibiotics, address physiological processes and vaccines.
Treatment	Facilitates natural healing process which may take more time	Quicker relief in acute and life-threatening ailments and control of disease and symptoms
Side Effects	Claim no side effects. However, side effects of preparations such as heavy metals used are well known when these patients go for treatment in modern medicine	The side effects of each medicine and intervention and their frequency are documented. Hence side effects are well known.
Evidence for medicines and treatments	Anecdotal evidence. The process may lead to inefficiency and irreversible side effects which are not acknowledged	Each intervention is tested during the elaborate trials in animals and humans and even when in use in the market. Only when benefits outweigh side effects are these medicines approved.
Cost	Inexpensive	Expensive and the cost of treatment is going up over time.
Malpractices	Less common	Pharmaceutical companies and corporate hospitals often ‘blamed’ for putting commercial interest above patient’s interest

As India is still grappling with the resurgent coronavirus outbreak and persistent increase in non-communicable diseases, both the Ayurveda and Allopathy practitioners need to realise that both treatments coexist, without the need to discredit the other. Ayurveda and Allopathy have unique characteristics that distinguish one from the other. It, however, does not mean that there should be a debate over the supremacy of one treatment over the other. Each of them has proven beneficial in treating patients, and therefore they both deserve to serve humanity in their own way. The debate, if at all, should be on how best to integrate the two systems to benefit the public.

Ayurvedic and Allopathy as complementary systems

Modern medicine is the perfect tool in cases of serious illnesses. Ayurveda looks at keeping people healthy and correcting the imbalance which is the cause of diseases. For non-communicable diseases Ayurveda with Yoga and meditation can effectively improve life style and Allopathic provide medications such as metformin to a weary pancreas, in diabetes, to release more insulin or give insulin and for high blood pressure give medicines which bring it down and prevent damage it causes to heart, brain, kidneys and eyes. Thus complementing each other to improve outcome and improve quality of life.

Under the National Health Mission, the government has collaborated with AYUSH and modern medicine practitioners in the government health facilities. The government also encourages cross referral of cases from Ayurveda and other AYUSH systems to modern medicine and vice versa to benefit the public.There is collaborative research being done in institutions such as AIIMS Delhi and new AIIMS. Kshar Sutra, an Ayurvedic treatment for piles emerged as an effective and easy treatment that could be tried before resorting to surgery.

Many new AIIMS have herbal gardens in the campus to grow herbal ayurvedic medicines and promote research and complementary approaches to treat patients. Ayurveda promotion should be based on science and not politics. Political will is needed but too much politicization becomes counterproductive

Both Ayurvedic physicians and MBBS doctors take oaths (Charak Shapath and Hippocratic oath) to act in the best interest of the patients.

Technology to promote Ayurveda and modern medicine for public benefit

The government plans to roll out a ‘One Nation, One Health System’ policy by 2030, to integrate modern and traditional systems of medicine like allopathy, homoeopathy and Ayurveda in medical practice, education and research. Technology can be an effective vehicle for this integration for the population to get the maximum benefits from various systems of medicine. The government has taken many initiatives to bring technology to improve healthcare in both AYUSH and the Ministry of Health and Family Welfare. However, there are hardly any initiatives to use technology to integrate various systems of medicine. The technology can help in accelerating the integration in various systems of medicine and its smooth operationalization to move towards ‘One Nation, One Health System’ policy. Given below are some suggestions:

Health and Wellbeing: Yoga and meditation have proven their utility to improve health and wellbeing of the people. The current government has helped the UN to have International Yoga Day on 21st June to promote yoga across the world. Yoga can be integrated with other initiatives of modern medicine to address current epidemic of life style related noncommunicable diseases such as high blood pressure, diabetes, cancer, cerebrovascular diseases such as stroke, mental health problems. Improved health and wellbeing will also reduce probability of infectious diseases and mortality.
Integrated AI based treatment protocols: AI is helping modern medicine practitioners in many ways. The evidence-based AYUSH interventions for common health conditions can be integrated into these. The AI experts need to work with joint medical teams drawn from the relevant systems of medicine.
Online Orientation of the current medical and Ayurveda practitioners and medical students of all systems of medicine to understand basics of other systems of medicine in prevention and treatment of common conditions during their basic and speciality trainings. This will help them understand the philosophy and approaches of other systems of medicine in the best interest of the patient.
Integrate the current technology initiatives including technology incubators and Health Technology Assessment (HTA) to improve quality and access to health care are being run parallel in Ayurveda and modern medicine. There is a need to engage practitioners of other systems of medicine for better integration from the initial stages of application of technology in healthcare.
Digitization of all medicines from all systems of medicine at one platform. It should include all medicines from drug trial stage to use that will bring transparency, standardization, drug control, quality control, decision support and continuity of care.
Uniform standards of drug trial: The drug trial registries of both AYUSH and MoHFW should be brought together and be available to the general public on one digital platform. This will build trust among practitioners and the general public that indigenous medicines are subject to the same standards.
Standardization and Quality Control of Ayurvedic drugs as per modern medicine standards. This will strengthen scientific validation of ayurvedic medicines and increase the trust of the public and practitioners of modern medicine.
Use modern scientific technological approaches in Ayurveda such as nanotechnology, molecular docking, molecular dynamics etc to strengthen the efficacy of Ayurvedic medicines.

The current debate is unnecessary, short sighted, discriminatory, counterproductive and self-protective. It must change how the two systems can work together for the larger benefit of the society. Both Ayurvedic physicians and MBBS doctors take oaths (Charak Shapath and Hippocratic oath) to act in the best interest of the patients. The best interest of the patients can be served only if they use the best available treatment irrespective of the system it comes from. The general public will benefit more if the two systems work closely together. The debate should shift to how to bring the two systems together to accelerate improvement in health of the people. Technology is being used in a big way to improve quality and access to health in both traditional and modern medicine. Both the Ministry of AYUSH and Ministry of Health and Family Welfare are spearheading the use of technology. There is a strong need to use technology to integrate the various systems to maximize health benefits to the public and accelerate the government’s policy of ‘One Country, One System’ by 2030.

Composed by: “Dr Sanjiv Kumar is a public health physician with 45 years of experience across more than 30 countries in South Asia,Africa, Central Asia and Central eastern Europe. He was Dean and later Director, International Institute of Health Management Research. New Delhi. He was also Executive Director at National Health Systems Resource Centre, Ministry of Health and Family Welfare, India. He led development of many policy and strategic documents to improve health in India including Guidelines for treatment of conditions of public health significance and National Health Policy 2017 and was a member of the core group to prepare National Health Research Policy, 2021. He has contributed to 125 scientific literature, books and chapters and has also been conferred with many accolades including UNICEF awards for his professional contribution. Presently he is the Founder Chairperson and Managing Trustee, Three Domain Health Leadership Foundation and develops and conducts training in leadership. “

“Prof Neeta Kumar did MD in Pathology from the AIIMS, New Delhi and worked in progressively responsible positions at national and international at AIIMS and MAMC. She was Visiting Professor at University Hospital of Geneva and Aga Khan University Hospital, Nairobi. She was a consultant to WHO HQ in many areas especially in cancer control. Currently she is working as Professor and Head, General Pathology, Jamia Millia Islamia, New Delhi. She has special interest in medical education and research. She is Course Co- director for the various training workshops for since 2013. She was also chairperson of the internal research review committee at Jamia. She is a prolific scientific writer and has published more than 150 scientific papers, contributed chapters in WHO publications.”

“Dr Debleena Bhattacharya is presently Assistant Professor in Marwadi University (MU), Rajkot, Gujarat. Prior to joining MU, she has worked as Project coordinator for BIRAC-SRISTI PMU, a joint venture of Govt. of India and NGO located in Gujarat. She received her doctoral degree from IIT Dhanbad and her area of interest is wastewater treatment, environmental biotechnology, and molecular genomics. She has authored a book published by CRC Press, U.S.A alongwith scientific papers & book chapters.”

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Interview with 1mg

InnoHEALTH Magazine — Wed, 27 May 2020 11:03:28 +0000

The responses have been given by Ankur Gigras, VP, E-commerce of 1mg

What are the objectives and your vision to start this organization?

1mg was launched in 2015 with a vision to make healthcare accessible, understandable and affordable. In the last five years, we’ve fundamentally disrupted healthcare in India and have emerged as clear leaders of the fast evolving digital health ecosystem.

Here is a look at what we have achieved so far:

~35% share of category amongst medical apps; 350m monthly page views on 1mg platform
Integrated Healthcare Platform: “Wiki” for healthcare information & India’s largest ePharmacy, eDiagnostics and eConsultation lines of business
Strong supply chain across India and a fast growing profitable B2B business line [Pharma distribution & Phlebotomist network]
Strong ecosystem partnerships with unique integrations with Insurance, Hospitals & Pharmacos to deploy novel models of healthcare delivery to patients across India

Patient centricity forms the core of our values. In the times that we are currently in, a digital healthcare platform is incomplete without online consults or telemedicine. We believe in offering our users a complete treatment cycle: from online consultations to ePharmacy and Lab tests.

What do you think needs to change in the health sector?

In healthcare, the information around our medicines and lab tests is either unavailable or incomprehensible to us, and that is the biggest change the sector needed to go through. Hence, with an aim to democratise healthcare, we decided to create a platform that stood for transparent, authentic and accessible information for all.

Unavailability of doctors due to a low patient to doctor ratio is another issue faced by the healthcare sector, especially in rural areas. With our video, audio and chat consultations, we hope to reduce that gap.

What tools and resources do you propose to bring these shifts in healthcare delivery?

In addition to the transaction & information services, we have built and launched many popular digital health tools such as medicine reminders, digital health locker, emergency profile etc. We also work on several unique models for patient support programs, digital health education programs, insurance solutions etc;

eConsults or telemedicine is another tool that we believe can bring about this shift. With most people practicing social distancing and minimizing contact, online doctor consultations, as per the guidelines issued by the Government of India, seem to be the safest option of seeking expert medical opinion and diagnosis.

Can you share about your business model?

1mg operates on a marketplace model where we have tie ups with licensed pharmacies, accredited diagnostic labs and with registered doctors/medical professionals. 1mg is an information technology platform on a digital and electronic network and acts as a facilitator between a buyer and a seller. The business model of 1mg is tied to the online transactions completed by consumers for Pharmacy and Diagnostics. The partners pay a small commission to us for bringing them orders and as volumes drive up, so will the profitability. As consumer usage increases, we would try and also introduce other monetization models through advertising. However, we are going to keep the offering free for consumers. [ lil’ bit on how econsults operates]

As mentioned earlier, patient centricity has always been our focus. 1mg believes in taking care of the needs of the patients, bringing about transparency and making healthcare accessible to all. We started out as a content platform for all health and medicine related information and later on went on to become an ecommerce platform.

What is the key strategy you adopted for acquisition?

1mg is a leader in the industry, with a ~35% share of category amongst all medical apps in India. So far, we have received over 350m monthly page views on our digital platform. Our app downloads have crossed 33 million till date.

It was possible for us to acquire such a huge user base only after we built enough trust among the people with the authentic information we provided. A major chunk of our customers are those users who came to our platform to consume health content.

What are the factors that influence market innovation and its impact on your organization?

To put it simply, the needs of the customers impact market innovation. For example, in the current times as the world is battling COVID-19, there is an urgent need for authentic and updated information around the same. So, we took it upon us to keep people informed. We experimented with different forms of content like ebooks, mailers, app notifications, website landing pages and more to help people consume as much authentic and medically accurate information as possible.

What are your strategies to deal with your competitor and what makes you different from others?

Being an integrated healthcare platform, 1mg enjoys leadership position and is driving the digital healthcare innovation in the country. Today, 1mg has become the most preferred integrated healthcare app for consumers/patients, and we clearly stand-out in the competition in terms of

Relevance and speed of search results for users
Quality of medical data/content available on our platforms, which is kept up-to-date at all times
Predictive algorithms and machine learning

We have great respect for our competitors but our qualities and values set us apart from the pack:

Clarity of vision – Since day one, 1mg has believed in integrated healthcare as the only model of healthcare that works for a consumer. We believed in it even before it was fashionable and for the last 5 years, we have worked very hard to make it happen. Our thought process, our innovation is naturally ahead of time.
Superlative team – We have one of the best teams in the Indian internet space, with leaders who have built and led large consumer businesses or healthcare divisions. We have also had the good fortune of having worked (or known) each other for a really long period of time. As a result, our team has a very high degree of trust and works in a very agile and collaborative fashion to achieve quick results.
Clarity in values – Since the very beginning, we have been clear about the values we want to uphold at 1mg:
- Our value of “done is better than perfect” enables us to rapidly innovate and test real products out in the market
- Our value of “Be CEO” empower individuals to take charge and do what’s right without an organizational bureaucracy holding them back
- Our value of “accountability with empathy” ensures meritocracy
- And our value of “team before individual” enshrines collaboration

We strongly believe that this is our winning formula.

With respect to telemedicines, we are one of the firsts to introduce audio and video consults, as well as COVID-19 specific consults.

What were the challenges you faced in initial days and how are they different today’s scenario, especially during this pandemic and what is your role in that?

Access to healthcare has been a challenge even before the pandemic, and health tech companies have tried everything to knit the gap existing in the healthcare system, be it telemedicine, online doctor consultation, mobile hospitals, etc. But, with the demand surging due to Covid-19 across different parts of the country, health tech companies are witnessing a new behavioural shift in Tier 2 and Tier 3 cities, which is here to stay.

Do you see any major growth opportunity in the post COVID-19 world?

Doctors have now started recognising the need for technology to engage better with their patient base. Hospitals too have become receptive of the change, as most of them are seeing a 40%-50% reduction in footfall. Suddenly they have started to feel the pain that they are not connected with the patient when they are at home. Onboarding doctors on telemedicine platforms has been a major challenge in the sector. Realising which, existing telemedicine companies have even adapted to models like collaborating with hospitals, or local pharmacy chains.

In the post-COVID-19 world, we believe that consumer behaviour would shift towards teleconsultations. The consumer’s fundamental pain point has never been about saving money on healthcare or ignoring it, it’s always about access. Going to a doctor’s clinic, waiting for two hours, and having to leave work early is often seen as an inconvenience. But with telemedicine they can consult the doctor anywhere without having to go through the hassle of visiting a clinic.

Further, the involvement of corporates and insurance companies in digital healthcare is also expected to go up.*

Share a bit more about the culture and values of your company? What is important to you and why?

Our value of “done is better than perfect” enables us to rapidly innovate and test real products out in the market.
Our value of “Be CEO” empowers individuals to take charge and do what’s right without an organizational bureaucracy holding them back.
Our value of “accountability with empathy” ensures meritocracy.
And our value of “team before individual” enshrines collaboration

We strongly believe that this is our winning formula.

What are your Future plans and any message for our readers?

Since the inception of 1mg we have always believed that technology and data will fundamentally change healthcare delivery. 1mg has already changed the healthcare landscape by making consumer centric integrated healthcare real. Over the years we have invested significantly in product and supply chain and most of the investments will continue or get accelerated. Some areas which will see disproportionate investment will be the ones below:

AI and Machine Learning – Artificial Intelligence will fundamentally change healthcare and will make it personalized, predictive and preventive. With billions of healthcare data points, 1mg is already working on cutting edge AI models and we will continue to accelerate work in that direction. Our most recent peer review journal publication on teleconsultation is proof of our deep capabilities.
New healthcare models – It’s clear that at 1mg’s scale, we now have the ability to enable new healthcare models for the ecosystem. These models, such as smart hospitals, outpatient insurance etc. will be the models of the future and will make healthcare accessible and affordable. Accessibility and affordability are 2 core pillars of 1mg’s vision.
Integrated Care plans – Using the 1mg platform, our goal is to enable truly integrated outpatient care in the country. Such a plan will provide a patient with continuity of care both online and offline and across all their healthcare service needs.

We strongly believe that product and technology are our core strengths at 1mg and ones that have and will continue to help us deliver superlative value to a healthcare consumer.

Interviewed by Disha Soni & Dr Prateek Malhotra

The post Interview with 1mg appeared first on InnoHEALTH magazine.

Are you filling the Health Insurance Claim?

InnoHEALTH Magazine — Fri, 10 Jan 2020 08:21:32 +0000

5 things to watch out for when filing health insurance claim
The insurance company lives with the lurking fear of being trapped in fraudulent activities. And therefore, they follow the strict evidence checking rule in the claims process. Only when the insurance company is satisfied with all the evidence and proof, they will allow the claimant to get out of the line of fire.
You don’t need to find an escape route as you are not fraudulent instead you need to know how to get out of the line of fire like a hero. To know-how, read the 5 things to watch out for when filing a health insurance claim below:
1. Duly filled claim form
A medical claim form is an application form that every insurance company demands to start the claim process. Generally, the claim form comes with two sections Part A & Part B. Part A includes A to G sections that need to be filled by the claimant and Part B is filled by the hospital. Part A of form informs the insurer about the incident, medical expenses, and details of the policyholder and dependent who needs coverage, details of hospitalization, and a checklist of documents that one needs to submit with the claim form to the insurer. To avoid mistakes, fill the medical reimbursement claim form with the help of the SureClaim expert.
Also Read: Trends which will drive the healthcare industry in 2020
2. Intimation & claim within the time limits
The insurance company expects the insured to intimate the insurance company about the hospitalization 3 days before for planned hospitalization and within 24 hours in emergency hospitalization. Once the intimation is done, you can file a claim within 30 days from the date of hospitalization. On exceeding this time limit, you will have to submit the reason for the delay with your claim, failing which your claim can get delayed.
Also Read: Universal Health: Swachh India, Fit India, New India
3. Whether treatment is covered or not
Having a health insurance policy doesn’t mean that you can claim any medical expenses arising out of any medical conditions. Every health insurance plan comes with certain limitations mentioned in the terms and conditions of the policy. Before filing a claim, you must read the policy wordings which include the exclusion list and all the terms and conditions of your policy. Claim filed for anything that falls under the limitation or exclusion list will be rejected by the insurance company.
Also Read: Your New Year’s Health Resolution for 2020
4. Documents
After filing a claim form, you need to submit the documents as evidence and proof of the incident. The documents should be in the order that it should include the first consultation letter to all the medical bills related to medicine, hospitalization, lab reports and for which you are covered under the policy. The documentation process plays a very crucial role in your claim process as the entire decision of approval depends upon the documents you have submitted to your insurer. When people fail to justify the medical expenses by not submitting the supporting documents, the insurance company raises query which makes the process complex and time taking. It is important to note that all the supporting documents are to be submitted in original to the insurance company.
Also Read: Foods that Keep You Warm in Winter
5. Submit it to the right address
Now when you are ready with your duly filled claim form and all the supporting documents, it is time to verify the correct address of your insurer to send your claim. This point might sound obvious but let me tell you insurance companies have a specific address to receive the claim and process them. Make sure you find the correct address and send your claim via mail or submit by hand to the right address.
Also Read: Rising Pollution in the City Intensifying Cases of COPD
Insurance companies take somewhere around 5 to 7 weeks to process your claim. Wait, your job is still not complete, you will have to do a regular follow-up of your claim with your insurer. First, you will have to verify if the insurance company has received your claim. Second, you will have to follow up for your claim id, which is usually generated by the insurance company within 3 to 4 days after receiving your claim documents. Third, take regular follow-up with your insurer for your claim status via call or online.

About the author

Anuj Jindal co-founded SureClaim to fix the broken claim experience of insurance customers. He believes technology can play a major role in empowering customers. His understanding is shaped by his decade long stint in healthcare and health-tech companies.

The post Are you filling the Health Insurance Claim? appeared first on InnoHEALTH magazine.

InnoBRIDGE Sweden 2019 : Report

InnoHEALTH Magazine — Fri, 31 May 2019 04:56:06 +0000

Executive summary

InnoBRIDGE is an initiative of InnovatioCuris (IC) along with Swedish partners, Swecare and Business Region Gothenburg, where the primary aim is to create a seamless access platform for the Indian healthcare stakeholders to the Swedish healthcare stakeholders, to strengthen healthcare collaboration between Indian healthcare organizations and the Swedish organizations and showcase the best of Swedish healthcare to the Indian delegates.

Innovation unit in Hospitals

The hospitals that we visited had an innovation unit running over ten years and have formalized the innovation process. From sourcing of unmet needs from stakeholders (patients, care providers etc) to running of an innovation marathon. Such an intervention can be beneficial for hospitals in India and a collaboration can be sought from interested Swedish hospitals to launch such trainings and innovation programs.

Developing healthcare AI

Through the intervention of innovation units in hospitals and county level regional initiatives, Swedish agencies are evolving the understanding of developing AI solutions. With possibilities to pay with data to develop AI tools, hands-on experiments about trying latest AI tools to build an informative position are some of the considerations already being made at the Swedish end. There is a natural synergy between India and Sweden on the topic of AI^[1]. India can offer data to build AI and can gain from the Swedish expertise of processes and considerations to be made for collecting and refining data. These synergies were discussed at the India Nordic Seminar by stakeholders in detail from both sides.

New Innovation Model of large private companies to incubate SMEs

A path breaking innovation model, which is experimented by AstraZeneca in form of AZ Bioventures at their Gothenborg site was a key showcase of the visit. Home to some 30 SMEs for last 5 years, the model has already resulted in 5 Initial Public Offers to some billion dollar successes. The model was discussed in last year’s Davos Summit^[2] and now actively being taken up by other corporates like ABB, Volvo in Sweden and AkzoNobel in Netherlands as an inspiration to unlock innovation in the ecosystem.

Also Read:
Sweden-India Collaboration in Health Sector
Indo-Swedish Collaboration

Day 1

Figure 1 - Indian delegation with Swecare members at H2 Health Hub

The visit started with a visit to H2 Health Hub in Stockholm which is a coworking space where Nordic Health Tech startups can connect, collaborate and share their innovations. Currently, there are 45 startups representing 26 countries in this space. The Indian delegation met representatives from the Swedish Ministry of Health, Swecare, SMEs and startups comprising of medical technologies, wellness, Health IT, mental health, pharmaceutical, radiology solutions, etc. The Sweden Ministry of Health representative shared his views on how Sweden is facilitating cross-border collaboration with India by using innovation to increase social impact such as the 10-years MoU signed between Sweden and AIIMS Jodhpur aimed at learning and exchanging best practices. The discussion also pointed out the India-Sweden collaborative industrial research and development program between Vinnova (Swedish government agency) and GITA (executing organization under the Department of Science and Technology, India). The collaboration aims at innovation projects linked to addressing global challenges such as climate change and sustainable developments.

Figure 2 - Visit to EMPE diagnostics at Karolinska Institute Campus

The Indian delegates got an opportunity to go around the Karolinska Institute (KI), Sweden’s largest medical university, and academic research center. Since 1901, the Nobel Assembly at KI has selected the Nobel laureates in Physiology or Medicine. The prime institute has university hospital, science park and innovation center. EMPE diagnostics which has background from KI and in collaboration with KI researchers presented their rapid diagnostic solution for Tuberculosis (Tb). The test uses DNA sequencing which can correctly identify virus or bacteria and their antimicrobial resistance within 2 hrs. India has around 86,000 new cases of Tb per day and 1.7 billion people at risk. Considering these statistics, EMPE through InnovatioCuris (IC) are looking forward to venture into the Indian market.

Next was a visit to Karolinska Hospital and its Innovation Unit which has collaboration with 8 EU countries. The Region Stockholm has a policy for innovation i.e. every organization should have an innovation center. The Innovation Center is a great model which encourage and engage all stakeholders, such as health professionals, patients, medical researchers and industrial partners to address unmet needs in hospital services through innovation. The innovation activities happen in day-to-day work at all levels and across each department. The center helps identify needs, define areas for innovation and develop the best solution. There is also a certification course for innovation leaders and managers. The center showcased project I-AID (Integrated AI Diagnostics) which aims to accelerate the development and implementation of artificial intelligence (AI) in healthcare initially focusing on medical imaging and physiology. This is a learning for Indian healthcare sector wherein the hospitals foster innovation in their own setting by creating an environment where ideas can become reality.

Figure 3 - Indian delegation appreciating the serene and modern setting of Karolinska University Hospital

A part of the Indian delegation also visited the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU). Health Technology Assessment (HTA) involves systematic independent assessment of a method, including side-effects, cost-effectiveness, and ethical implications. SBU is one of the oldest organizations in the field of HTA and expressed interest in collaborating with India.

Figure 4 - Indian delegation members with SBU Staff, Sophie Werko

Day 2

The second day was in Uppsala, the fourth largest city in Sweden. Uppsala University is the oldest university in Sweden. The visit started with Region Uppsala where the delegation was welcomed by the chairman of the board, Vivianne Macdisi. Region Uppsala Innovation has a R&D department for 2 hospitals, primary care centers, and mobile units. The ideas from employees, patients, and relatives are collected by each hospital unit’s idea coordinator. The ideas are assessed and approved by idea counsel. The feedback on the idea is conveyed to the ideator. Region Uppsala innovation also organizes a workshop called innovation race where companies and innovators such as employees generate ideas and work together towards the idea.

The county also has Uppsala Innovation Center (UIC) which is the world’s fourth-best university-affiliated business incubator. UIC offers business development programs and supports innovative startups and growth companies to commercialize, scale-up and access the international market. UIC provides expert help, awareness and knowledge for companies, and a national platform to connect the best companies.

Figure 5 - Dr V K Singh from Indian delegation presented his healthcare innovation book to the chairman of Swecare board and Uppsala regional council, Ms Vivianne Macdisi

Day 3

The delegation had the opportunity to attend e-health matchmaking event, Vitalis which is the largest eHealth event in Scandinavian. Vitalis themes included Artificial Intelligence, IoT, Decision support, medical imaging, home care, elderly care, remote health care, and robotics.

The Business Region Gothenburg and Swecare organized a special seminar ‘AI and Collaborations in AI and Innovation’^[3]. The keynote speech was given by Linda Swirtun, program manager of Vinnova, Sweden’s government agency for innovation. Vinnova funds healthcare/life sciences innovation projects and research by collaborating internationally. Under the Swedish- Indian Innovation Partnership, the Swedish companies can collaborate with companies in India in joint research and innovation projects to address global challenges such as climate change and sustainable development. The corporate-driven collaborations can be in the area of smart cities and clean technologies, digitalization, and IoT.

Figure 6 - Linda Swirtun sharing the first keynote about India Sweden Collaboration

The panel discussions had representatives from the Nordic-Baltic region and India. The first panel focused on the transnational collaborations between the two regions and its challenges. Rohini Pimple, RICH, Dr V K Singh, InnovatioCuris, Dr Sandeep Bhalla, PHFI, Kingshuk Poddar, Medivalley Incubator represented the Indian side. Lars Lindskold, Swelife AI Institute, Iris Ohrn, Business Region Gothenburg, Jaanus Pikani, Scanbalt Forum and Magnus Bjorsne, AZ BioVenturehub represented the Nordic Baltic side. The session was moderated by Shampa Bari of Swecare. The Indian panelist discussed how the current government has been very supportive and driving innovation in all sectors. There have been changes in policies and regulations which has led to a smooth process for collaborations. India has huge data which can be used to develop AI tools by countries like Sweden. Also, knowledge sharing between the regions could be beneficial. The panelist further discussed the unmet needs, and public-private partnership models working in India. The research cluster of India shared the opportunities of life sciences. The government incubation center shared how it can be a soft-landing spot for Nordic-Baltic companies for medical devices. The representative from the Public Health Foundation of India discussed the challenges in public health in India and how capacity building can be done at scale. The Nordic-Baltic panelist emphasized on the various technologies which are relevant for India. In addition, the representative from Business Region Gothenburg stated that it is easier to do research collaboration – to test and validate one’s product in Sweden as compared to others. Furthermore, the Nordic/Baltic region has a strong IP protection regime. Therefore, the collaboration will be a win-win situation for both the regions.

Figure 7 - First panel had regions and clusters from both sides discussing collaboration

The second panel brought together hands-on experts on AI both from the developer and user side. Indian side was represented by Pradeep Mathapati, HCL, Deepali Jetley, Qwazent Healthcare. Swedish side was represented by Annie Chandy from LUDC, Devdatt Dhubhashi from Chalmers University of Technology and Peter Soderman from Karolinska University Hospital. The session was moderated by Sachin Gaur from InnovatioCuris. The panel discussed in depth the challenges of AI development and how processes are evolving at the end of the health system to collect and refine data. Interesting observations were made on the role of data in AI, future job roles for AI in health sector and business models that may emerge when the providers and IT players collaborate.

Figure 8 - Panel 2 keynote was shared by Pradeep Mathapati from HCL Germany office

Day 4

The last day gave a perspective about the second largest city of Sweden, Gothenburg. The delegation was welcomed by Business Region Gothenburg, West Swedish Chamber of Commerce, and Surgical Science. Surgical Science have virtual reality simulators for surgeries like evidence-based laparoscopic and endoscopic training. The representative of West Swedish Chamber of Commerce discussed why Sweden is interested in investing in India as it is an emerging market after China, and it is a volume market with rich data. India also has a large pool of highly skilled IT professionals. On the other hand, Sweden is one of the world’s largest 10 economies and has become one of the most innovative countries in the world. Sweden is home to companies like Volvo, Ericsson, SKF, Spotify, Skype, IKEA, etc. The Indian team visited the Sahlgrenska University hospital along with Gothia Forum, which has 54 clinics in West Sweden for clinical trials.

Figure 9 - Expert from Surgical Science ready to give us a handson training on various surgeries (ofcourse simulated)

Furthermore we visited Biobank West, a Swedish Biobank showed their infrastructure where they store the blood and tissue samples. Companies such as Surgical Science, Biobank West are actively looking out for collaboration with India.

Figure 10 - Site visit of Gothia Forum, Swedish Bio Bank

The last stop was at the famous Swedish pharmaceutical company Astra Zeneca (AZ) which has been ranked number one in IDEA Pharma’s Pharmaceutical Innovation Index (PII). An interesting model has been adopted by AZ called AZ BioVenture Hub. It is a collaborative innovation ecosystem for emerging biotech, medtech companies, and academic groups to strengthen competitiveness in the Nordic life science industry. AZ provides space to the SMEs and an opportunity to interact with highly-skilled AZ professionals. In addition, the SMEs can use the state-of-the-art lab facilities and infrastructure of AZ. Currently, there are thirty companies in the AZ BioVenture Hub.

Figure 11 - Indian delegation with Magnus, Pernila and Jesper from AZ BioVentures and GoCo City

AZ has also enabled a bigger initiative called as GoCo Health Innovation City. GoCo will be a collaborative innovation ecosystem with more than 30 companies working in biotech, medtech, and academia. This city will be completed in eight years and will have co-innovation programs and services such as networking events, experienced facilitators to mentor the innovator, connecting members with similar challenges, growth guides. It will be a place for focused work and healthy living.

Figure 12 - Field visit to the site of planned GoCo Health City

The way forward

Sweden being the global innovation leader and start-up hotbed can be a great example for India. The country has an innovation policy and each county is working towards it. It is focusing on the unmet needs of the population and fostering a culture of innovation. The Swedish innovations can be plugged into the Indian ecosystem and vice versa. Innovation is fostered by opening boundaries, by gathering insights and information from new connections, and by sharing knowledge. Keeping this in mind, InnoBRIDGE was envisioned and continuously working towards other collaborations.

We look forward to build on the initial interests among stakeholders from both sides in form of knowledge webinars, physical visits and signing of MoUs in cases of where the concrete plans emerge. The next milestone for us would be InnoHEALTH 2019, 4-5 October where interested Swedish stakeholders plan to visit us in India and hopefully by then we would have progressed on some of the existing discussions. Also, some of our Indian delegates look forward to participate in Vitalis next year!

Send your comments / feedback to sachin@innovatiocuris.com

References

To know more about the InnoBRIDGE Sweden 2019 program and details of Indian delegation, you may visit innovatiocuris.com/innobridge/innobridge-2019

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Integrating Technologies to Better Healthcare

InnoHEALTH Magazine — Wed, 17 Apr 2019 09:57:49 +0000

Age and disease demographics are changing rapidly across the globe. The number of people above 65 years is expected to double and constitute nearly 17% of the world population by 2050. The chronic disease incidence rate is expected to rise to 57% by 2020. These figures highlight the need to enhance the quality and efficiency of care with quick response time to health-related emergencies.

Ideas that cut across medicine, biological and engineering sciences, material design, and system innovations are converging to address these challenges. The shift is going to be from legacy products like pacemaker and imaging systems to wearables for general fitness tracking and gait monitoring. Taking a step further, researchers are now developing and testing more focused miniaturized bioelectronic devices for recording and analyzing health data for detecting determinants of health and for medical interventions.

In diagnostics, non-invasive bioelectronic skin sensors that measure analytes in biofluids like saliva, tears, and sweat are showing promising results in assessing stress levels and detecting conditions like diabetes and cystic fibrosis. Researchers from the All India Institute of Medical Sciences (AIIMS) and Indian Institute of Technology (IIT) Delhi have developed a biosensor for detecting glucose in saliva samples for diabetes detection. The results can directly be viewed on the user’s smartphone. Many such studies are now underway in India.

Also Read: Healthy Lives: Everyone, Everywhere

Conductive gels and patch sensors resembling fashion accessories are also being developed to record cardiac, brain and muscle activity which could complement the traditional blood analysis and clinical examinations. Mechano-acoustic skin sensors that measure speech patterns and internal body sounds, like swallowing, are being explored to quantitatively measure the impact of rehabilitation in patients, such as those recovering from a stroke.

In treatment, miniscule implants placed inside the body can cross the blood-brain barrier and deliver the drug directly at the target site, even in hard-to-reach internal organs. Such devices have shown promising results in laboratory settings in reducing side effects and toxicity while increasing overall drug efficacy. This could also ensure patient compliance, a step further to the recently approved digital pill, especially in patients on long care and those with compromised cognition.

Certain implants can also electrically stimulate cardiac or brain tissues to treat conditions like irregular heartbeat, certain motor disorders, and cognitive impairments. Other implants like artificial retina and cochlear implants, restore functionalities of damaged tissues. These interventions, being referred to as ‘Bioceuticals’, could restructure conventional therapeutic options for more efficient outcomes.

In India, a lot of work has now started in this sphere. Results from a few studies have started trickling in, with most of them in development or early stages of testing. Research findings in the journal Scientific Reports by researchers from IIT Kharagpur earlier this year reported bio impedimetric analysis of cancer cells that efficiently distinguishes their aggressiveness by measuring electric field impedance in laboratory conditions. In another study published in the journal Sensors earlier this year, researchers at IIT Delhi developed a novel low-cost prosthesis based on sensors to enable normal gait kinematics, i.e. motion analysis, for lower limb amputees.

IIT Kharagpur is setting up a Bioelectronics Innovation Laboratory that aims to develop battery-free implantable miniaturized engineering systems for treatment of brain, nerve, muscle or spinal cord disorders by restoring missing neural functions. The proposed coin-sized implant will be powered wirelessly and will combine brain activity testing like electrical simulation, bio-potential recording and neuro-chemical sensing for use in rehabilitation and prosthesis.

Also Read: India’s First Smartphone Insertable Cardiac Monitor

Round-the-clock data collected from bioelectronic devices could replace the present time-point investigations and lead to better management of the health condition of patients. In addition, data from multiple people can help develop artificial intelligence algorithms and predictive tools. Such tools have already started showing analytic performance similar, and sometimes better than manual inspection by a specialist physician. In countries like India, that suffer from a shortage of qualified doctors in remote areas, such devices have immense potential. However, data standardization, data security, and privacy protection must be addressed and regulated before rolling out such interventions.

In the next few years, health monitoring, neural prosthetics, and biochemical prosthetics are expected to drive major developments in this space. Although the monitoring devices have already started testing the market in niche patient segments, it may take the implants another 5-10 years to reach health centers as they make their way through developmental and regulatory checkpoints.

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Medical IoT: Future of Connected Health

InnoHEALTH Magazine — Sun, 03 Mar 2019 05:50:51 +0000

InnovatioCuris Foundation of Healthcare & Excellence (ICFHE) and IIT-Delhi jointly hosted a panel discussion on Medical IoT: Future of connected health, as an emerging development area. Below is a journalistic account of discussions and decisions made during the Innovators’ club meeting held on Saturday, 2 March 2019.

Dr. V K Singh, InnovatioCuris is working towards healthcare disruptions in India to help reduce the healthcare delivery cost. Since the medical space is growing rapidly from 20 million markets to 70 million by 2025, describing a business opportunity for the younger ones and existing players of the Internet of Medical Things (IoMT), insisted on mastering the technology instead of technology mastering us!

Our inaugural speaker Dr. Partha Dey of IBM emphasized the importance of rapidly growing medical space in the next 5 to 7 years (million to billion to trillion) and that the numbers are promising. The question “Is there anything we can do to get our pie of the share from that increasing number?” Connecting internally (institution/hospitals) and with the outer world, there are two aspects. He went on to highlight a concern that connected health should be targeting illness rather than wellness. Illness market would have a better opportunity and that’s a fact of life.

Integration of many devices also causes a problem in the implementation of IoT in healthcare. The reasons can be many.One of them is that the medical stakeholders do not have any consensus regarding the consent, generation, storage and transmission of data. But IoT changes the way!

The need to change the way of delivering care/service should be our priority. A paradigm shift in the way of offering services through connected health services and emphasizing that privacy and security concerns are of utmost importance when it comes to connected health. Responsibility and accountability after acquiring data are very important. The question is how to analyze the data and get actionable insight. Analytics and IoT should be considered together for actionable insight. The challenge of interoperability has turned up with an increase in the number of devices being used.

Trends and Opportunities of Medical IoT

IoT or Internet of Things is not new, but it has been gaining traction at a very high pace. Since the inception of the word IoT, there has been an ongoing conversation about how it might change healthcare, improve patient safety, affordability and accessibility for patients.

Healthcare in India has a huge potential in terms of IoMT or medical IoT solutions. There will always be challenges and opportunities in this sector. Connected health is contributing towards the growth in space of IoT, but is lagging behind many other connected sectors.

One of the key challenges in developing the algorithm for medical devices such as CT scans and X-rays. Application of artificial intelligence and machine learning in healthcare should be cautiously done because in case of a CT scan if we miss a module it has life risk and hence should be used carefully and should be a well-validated clinical algorithm.

Since the infant mortality rate in India is twice the rest of the world, and that is certainly alarming as the bottom of the pyramid is affected; there is a company which focuses on the mortality rate of low weight birth babies. They have come up with developing a bracelet which diagnoses hypothermia in low birth weight babies. This was a very simple and innovative device, but then they analyzed the intermissions they can work on and came up with baby cradle. The main challenges to develop and design such a product is to cope with the cost factor and the startups definitely need funds to develop such a technology.

The goal of connected health is not just early identification of health issues, but also effective patient care and safety. Today IoT platforms support integration of medical devices and wearables. The need for security is as important as when it comes to IoT and accessing healthcare data and strengthening advocacy for connected health.

Things change very rapidly and in very small time, and IoT is taking shape with it. But who will fund the cost of development/ Can government help the industry in making such policies?

Business Models of Successful IOMT in India and Challenges

The IoT healthcare business strategy is not yet robust because it involves a set of elements with new requirements such as new operational processes and policies, new infrastructure systems, distributed target customers and transformed organizational structures. Therefore, there is a need for a new business model. The IoT technology opens a new dimension of business opportunities for healthcare companies and the IoT platform becomes a key artifact in this transformation. Early movers who are taking a proactive approach to establishing their IoT healthcare ecosystem will tap into new business models. In this part of the business model, the panel discussed the basis of pricing and the way of charging for a product or service. Besides this, the panel also discussed the ways of revenue generation.

While there are many benefits of the Internet of things in healthcare, it isn’t without its challenges. As with any new technology in healthcare, hospital and IT executives are concerned about data security and IoT device management. What are the potential barriers to IoT adoption and how healthcare IT can overcome those obstacles?

AI and IoT change the way healthcare is delivered and we obviously are on the cusp of a revolution. This definitely poses a fair amount of concerns but also huge possibilities. The panel also discussed how Medicare is 100th the cost per person when compared to Obama care. So clearly, there must be more innovations coming from IoT and AI; they are going to help us reduce the cost.

In the past, how people tried to use the data for the benefit of both patients and providers, starting from the patient side faced huge failures, as nobody was willing to pay. And that’s where the thinking came from that; how do we really make this work? How do we really turn this data into a business model? And that’s where they pivoted the model, working with providers and using their data sets. But then the question comes up, “Why the providers would share their data?”. Thus, the first pitching that started was to use the provider’s data for their patient care. And it didn’t work well. The whole narrative was, “What’s in it for providers?”.Therefore, the business model turned out to be, as we kept on talking to people, we realized that the data is going to be useful for provider’s revenue success, and then the same datasets will help the patients. A solution that they projected is to help retain the provider with patients’ data, grow their revenues and help in patient care.

The MedTech certainly seems more complex. Where they are trying to come out with a dermatology solution and oral health solution for serious diseases where a cell phone image taken from an off the shelf mobile phone camera is sent to an AI backend and it gives a diagnosis and possible treatment options for a variety of skin diseases, particularly oral cancer. Such cases are very prevalent. What the panelist found is a landscape extremely complex in terms of the business model because when someone comes out with something like this, then figuring out who would it be paying is difficult. And suddenly the AI and IoT thing comes up and say that it can perform this diagnosis at par the level and in certain cases better than certain trained specialists. This does not support their case.

One of the panelists shared her thoughts on important factors to concentrate and realize why health care has not moved digitally as compared to other industries like banking, insurance and how a lot of digital interventions can happen in healthcare. There are a whole lot of opportunities.

The main thing to focus on is What is the problem? What is the solution? And who’s going to pay you? Because that’s where the panelists believe that lots of startups have a scope.

The customer is one, the doctor is another and hospital, the other spectrum. So how to manage this change and address the change management. If you give a thought on what to overcome, it gives you a kind of value that you try and achieve success and how do we overcome the quality assurance issues, change issues, challenges that one sees in terms of adoption. Let’s say for the doctors, it took a hundred years to the doctor to adopt stethoscope. Today, it’s widely accepted. IoMT is something that is obviously very innovative, very useful. But then not every doctor will accept it right away. How does one plan to overcome that barrier? So, they might just want one to focus on change management issues.

There are three components of the IT embedment in a hospital. One is the business side of it, which gets adopted immediately. There’s just no resistance to it. The second side is the paramedical side of it; it has pathology, radiology, and other such things. They take a little time but they come on board. The learning curve is much shorter over there. The third one is the clinical side, which is the most difficult, as in a hospital system there are doctors who are most resistant to changes and the reason being their upbringing and learning of clinical practices in a certain way.

The question arises “How does one change their practices?” Changed management is already happening at the college level. The medical students who are coming out now are more hands-on and are accepting the new technological changes. We will have to wait a little while, but they will accept it. When we talk about a change in the management, the problem that arises is not specific to India only. In the USA, George Bush had said that he wanted EMR to be adopted by everyone within the next ten years. Surprisingly, he didn’t even get 15% conversion in those ten years.

It is important to secure the data and look over the cost implications of data security issues in connected health work moving forward. There is a need for appropriate interventions at the transition level of doctors and patients, as well as the importance of advocacy and awareness‐raising at community level about connected health. There is also a need for financial support for encouraging the tech enthusiasts of the country to address health issues in India with connected health solutions. One needs to understand customer value as well. How do we speak the right language in terms of what would appeal to that particular user or customer or doctor or hospital for that matter only then we will see more IoMT adoption happening. Yes, there is a need to understand the regulatory framework. Startups needs to adopt a lean structure in collaboration with the medical partners and come up with innovative solutions. India has a fantastic opportunity, but clearly it does need elements to come together and work together.

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AI Engraving Footprints on Healthcare Transcontinental Canvas

InnoHEALTH Magazine — Fri, 21 Dec 2018 07:22:38 +0000

SIR ALEXANDER FLEMING, the discoverer of Penicillin, shared the Nobel Prize for Medicine in 1945. But when he arrived in Stockholm to receive the award he had a bad cold. Throughout the ceremony, he used his handkerchief repeatedly. Later when he was leaving, his eyes were still watery, and he was still sniffing. One of the officials shook his head sympathetically and said, “No good for colds”. EE Edgar January 1965.

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But, it was a stunning discovery that changed the course of history. The active ingredient, which Fleming named Penicillin, turned out to be an infection-fighting agent of enormous potency. When it was finally recognized for what it was, the most efficacious life-saving drug in the world, Penicillin altered forever the treatment of bacterial infections.

Now, it is turn of AI (Artificial Intelligence) that is making fast forays in a broad-spectrum of disciplines, and medical diagnostics and treatment field is paving way for intrusion of AI.

Across the world, race is underway to exploit AI for good of patients. Many say it is not much away from tipping point: those who will take timely advantage of it or those who are set to miss the opportunity at the initial moments.

In India, AI ball has started rolling in the wake of the huge potential of the healthcare network and an ever-burgeoning population of 130 crore people. A discussion paper on National Strategy for Artificial Intelligence prepared by NITI Aayog team which included, Arnab Kumar, Punit Shukla, Aalekh Sharan, and Tanay Mahindru, came up for discussions recently and moves are afoot to proceed further.

The paper delved at length on various dimensions of AI. It said NITI Aayog is working with Microsoft and Forus Health to roll out the technology for early detection of diabetic retinopathy as a pilot project. 3Nethra, developed by Forus Health, is a portable device that can screen for common eye problems. Integrating AI capabilities to this device using Microsoft’s retinal imaging APIs enables operators of 3Nethra device to get AI-powered insights even when they are working at eye checkup camps in remote areas with nil or intermittent connectivity to the cloud.

The resultant technology solution also solves for quality issues with image capture and systems checks in place to evaluate the usability of the image captured.

AI-based healthcare solutions can also help in making healthcare services more proactive – moving from “sick” care to true “health” care, with emphasis on preventive techniques.

AI solutions can augment the scarce personnel and lab facilities; help overcome the barriers to access and solve the accessibility problem; through early detection, diagnostic, decision-making and treatment, cater to a large part of India.

Cancer screening and treatment, the paper says, is an area where AI provides tremendous scope for targeted large-scale interventions. India sees an incidence of more than 1 million new cases of cancer every year, and early detection and management can be crucial in an optimum cancer treatment regimen across the country.

NITI Aayog is in the advanced stage for launching a programme to develop a national repository of annotated and curated, despite the obvious economic potential, the healthcare sector in India remains multi-layered and complex and is ripe for disruption from emerging technologies at multiple levels.

It is probably the most intuitive and obvious use case primed for intervention by AI-driven solutions, as evidenced by the increasing activity from large corporates and start-ups alike in developing AI focused healthcare solutions.

Researchers said the Adoption of AI for healthcare applications is expected to see an exponential increase in the next few years. The increased advances in technology and interest and activity from innovators provides an opportunity for India to solve some of its long-existing challenges in providing appropriate healthcare to a large section of its population. AI combined with robotics and Internet of Medical Things (IoMT) could potentially be the new nervous system for healthcare, presenting solutions to address healthcare problems and helping the government in meeting the above objective pathology images. Another related project under discussions is an Imaging Biobank for Cancer.

In US, Viz.ai, Inc., an applied artificial intelligence healthcare company a few months back announced that the U.S. Food and Drug Administration (FDA) has granted a De Novo request for the first-ever Computer-Aided Triage and Notification Platform to identify Large Vessel Occlusion (LVO) strokes in CTA imaging. This regulatory clearance compliments Viz.ai’s recent European CE Mark for the product in January 2018.

“The Viz.ai LVO Stroke Platform is the first example of applied artificial intelligence software that seeks to augment the diagnostic and treatment pathway of critically unwell stroke patients,” said Dr. Chris Mansi, Neurosurgeon and Chief Executive Officer. “We are thrilled to bring artificial intelligence to healthcare in a way that works alongside physicians and helps get the right patient, to the right doctor at the right time.”

Stroke is a serious and time-sensitive medical condition that requires emergency care and can cause lasting brain damage, long-term disability, and death. A stroke occurs if the flow of oxygen-rich blood to a portion of the brain is blocked. When this happens 2 million brain cells die every minute. “This software device could benefit patients by notifying a specialist earlier thereby decreasing the time to treatment. Faster treatment may lessen the extent or progression of a stroke,” said Robert Ochs, Ph.D., Acting Deputy Director for Radiological Health, Office of In Vitro Diagnostics and Radiological Health in the FDA’s Center for Devices and Radiological Health.

The Viz.ai LVO Stroke Platform was developed using deep learning, a revolutionary technique where algorithms learn how to identify patterns in data from millions of prior examples. The Viz.ai system connects to a hospital CT scanner and alerts the stroke specialist that a suspected LVO stroke has been identified, sending the radiological images directly to their smartphone.

In a 300-patient performance study, the Viz.ai LVO Stroke Platform obtained an AUC of 0.91, identifying LVOs and alerting the relevant specialist with 90% sensitivity and specificity and a median scan to notification time of under 6 minutes. In over 95% of cases, the automatic notifications demonstrated faster notification of the specialist, saving between 6 and 206 minutes, with an average time saving of 52 minutes.

“Timely LVO stroke identification and transfer to a specialist hospital that can perform mechanical thrombectomy is the top priority for LVO stroke patients,” said Dr. Raul Nogueira, Professor of Neurology, Neurosurgery and Radiology at Emory University and the Immediate-Past President, Society of Vascular & Interventional Neurology. “This software is designed to help identify appropriate patients earlier and more often, and enable faster transfer and treatment, which, ultimately may result in improved patient outcomes.

Noted Cardiologist ERC Topol, who is Professor of Genomics and holds the Scripps endowed chair in innovative medicine, has now written a book that calls for the “creative destruction” of the current medical paradigm, which he believes has failed to keep up with the digitized world of interactivity, social media, computers, apps, and advanced engineering and electronics.

In his book, he lambasts current day medicine as being archaic and wasteful, making his case with a compelling blend of statistics, anecdotes. Prof. Topol believes that consumers teaming up with innovators in the med-digital world are the key to forcing change, which is certainly true. But how exactly will this work?

The NITI Aayog discussion paper says AI is a constellation of technologies that enables machines to act with higher levels of intelligence and emulate the human capabilities of sense, comprehend and act. Thus, computer vision and audio processing can actively perceive the world around them by acquiring and processing images, sound and speech.

The natural language processing and inference engines can enable AI systems to analyze and understand the information collected. An AI system can also act through technologies such as expert systems and inference engines or undertake actions in the physical world. These human capabilities are augmented by the ability to learn from experience and keep adapting over time. AI systems are finding ever-wider application to supplement these capabilities across enterprises as they grow in sophistication. The paper says healthcare is one of the most dynamic, yet challenging, sectors in India, and is expected to grow to USD 280 billion by 2020, at a CAGR of upwards of 16%, from the current ~USD 100 billion.

Adoption of AI for healthcare applications is expected to see an exponential increase in the next few years. Technology disruptions like AI are once-in-generation phenomenon, and hence large-scale adoption strategies, especially national strategies, need to strike a balance between narrow definitions of financial impact and the greater good. NITI Aayog has decided to focus on five sectors that are envisioned to benefit the most from AI in solving societal needs: a) Healthcare: increased access and affordability of quality healthcare; b) Agriculture: enhanced farmers’ income, increased farm productivity and reduction of wastage; c) Education: improved access and quality of education; d) Smart Cities and Infrastructure: efficient connectivity for the burgeoning urban population; and e) Smart Mobility and Transportation: smarter and safer modes of transportation and better traffic and congestion problems.

Yet, it faces major challenges of quality, accessibility, and affordability for a large section of the population:

A: Shortage of qualified healthcare professionals and services like qualified doctors, nurses, technicians and infrastructure: as evidenced in 0.76 doctors and 2.09 nurses per 1,000 population (as compared to WHO recommendations of 1 doctor and 2.5 nurses per 1,000 population respectively) and 1.3 hospital beds per 1,000 population as compared to WHO recommended 3.5 hospital beds per 1,000 population.

B: Non-uniform accessibility to healthcare across the country with physical access continuing to be the major barrier to both preventive and curative health services, and glaring disparity between rural and urban India. With most of the private facilities concentrated in and around tier 1 and tier 2 cities, patients have to travel substantial distances for basic and advanced healthcare services.

The problem is further accentuated by lack of consistent quality in healthcare across India, most of the services provided are individually driven rather than institution driven, and less than 2% of hospitals in India are accredited.

The post AI Engraving Footprints on Healthcare Transcontinental Canvas appeared first on InnoHEALTH magazine.

A Consequence of Modern Day Living – Burnout

InnoHEALTH Magazine — Thu, 13 Dec 2018 07:10:28 +0000

This is often how people unknowingly express the sensation of burnout. It is widely known that burnout is closely linked with stress, but it is much more than simply being tired, and it is often the case that the seriousness of burnout is overlooked.

HIGHLIGHTS

It possible to prevent burnout?
Burnout can happen to anyone and everyone
Burnout should not be underestimated

Have you ever heard someone say, “I’m exhausted”, or “I’m dead tired”? This is often how people unknowingly express the sensation of burnout. It is widely known that burnout is closely linked with stress, but it is much more than simply being tired, and it is often the case that the seriousness of burnout is overlooked.

Let us then ask the questions that need to be asked when talking about the subject of burnout. Is it possible to prevent burnout? How do we know when we have been exposed to either too much – positive or negative stress? How can we change our lifestyles accordingly to make the meaningful and sustained change to make ourselves more immune to burnout?

Stress is perception based

It is primarily our perception or evaluation of something that determines whether or not we become stressed. If we perceive an object to be too challenging or potentially dangerous in some way, the “flight” type of emotional and mental reactions surface, eventually influencing the body – this is the route of negative stress. If something is challenging enough and we deem the odds of success leading to a potential opportunity in our favour, the “fight” type of emotional and mental reactions occur, and we experience positive stress.

Regardless of the polarity of stress (positive or negative), biochemically your body reacts in the same way. Whenever our subconscious autopilot system detects a stressor, adrenaline and cortisol are released from our adrenal glands located on top of the kidneys. Our blood pressure rises, our muscles tense, heart rate elevates, and digestion is inhibited, all preparing us to either fight or take flight. We all have experienced this feeling, like a sudden rush. However, being constantly exposed to prolonged episodes of stress impacts the health of our body and reinforces unhealthy patterns mentally as well as emotionally. It can weaken the immune system, cause more regular mood swings, and can manifest as if being ‘on the ashes’, ultimately resulting in burnout.

However, whether it is a one-time major life event (think of a tsunami), or the constant day-to-day sub-threshold sensation of being ‘stressed’ (think minor but regular waves), at one point you’ll reach your breaking point where the stress reaction gives way to exhaustion, resulting in the sensations of feeling burnt out.

I can handle everything – Always! Burnout usually works in either of the two ways, more frequently as a manifestation of chronic stress, or the result of one sudden life-changing event. Because burnout is closely linked with increasing stress, you may already assume that this isn’t a result of one single event but is rather a question of lifestyle choices and skills to handle the inner turmoil that gets triggered by certain events.

Burnout can happen to anyone and everyone, however, there are certain types of people more prone than others. Those who are success or achievement oriented, so-called “career” people, managers and entrepreneurs tend to be more susceptible. They are the people who seem capable of anything. These sorts of people live for their work, strive for success and never switch off.

They are burdened with numerous to-do lists and they check their work emails on a Sunday. They are always on the go and find it difficult taking time out. They validate themselves based on their achievements and getting things done. Even during their vacation, they feel the need to be on the go, filling their days with planned activities and engagements. The bigger picture is very often completely lost; they just don’t seem to be able to stop the lifestyle of ‘busyness’.

When you look at that description you may notice that these people seem invincible, they don’t seem to complain and seem to be able to manage everything. However, their lives are filled with dangerous amounts of positive stress or eustress. Of course, this positive stress feels good in the beginning and is indeed useful because it helps to get things done and achieve goals. However, in positive stress ‘mobilizing us for action’ means the constant release of adrenaline and cortisol from the adrenal glands – the stress hormones.

From the perspective of burnout, it is irrelevant whether the events that lead to the need to mobilize are “positive” or “negative” and if this lifestyle becomes habitual, it can quickly lead to near addiction because one adrenaline rush primes the craving for another. Negative stress is not a problem because everyone already avoids it due to its association with negative feelings. Most of the cases of burnout today are caused by people “riding the wave” of positive stress because people do not expect it to be dangerous – on the contrary, it is almost actively encouraged and often glorified.

Lifestyle Changes – No Easy Way Out

It is very much the common and accepted prevailing attitude of our modern working world that it’s perfectly normal to be “stressed”. It is no wonder then that more and more of us are facing burnout.

In order to prevent or recover from burnout, we must adjust our whole lifestyle. Already the term “lifestyle” suggests that this is not just a minor phenomenon that can be simply fixed with a few good night’s sleep or a vacation. This is not a bacterial infection that can be cured by taking a few pills and then rushing back to our “normal” life where stress reaction is considered inevitable. It is this attitude that is what really needs changing leading to skills that help in handling reactions.

One must consider both the physical and psychological sides, understanding that psychological arousal leads to a stress reaction in the physical body. It’s not just about reassessing values, setting priorities or time management. The most crucial elements to address are the chronic emotional and mental reactions.

What can be done to prevent burnout from taking hold? By educating ourselves on how we function internally will help us further understand the problems associated with burnout. This will help you make better and more informed choices for yourself.

Learning relaxation exercises, in particular stress relieving breathing exercises will also help, but in essence it’s already alleviating a consequence caused by a reaction. It is important to take time out during our busy days to just sit and simply be. It seems obvious, but many of us feel guilty for investing in sufficient leisure time. Make it a point to put aside a certain time each week to do that thing you have been meaning to do, make good on that promise to meet a friend, do something with your loved ones, or do something entirely for yourself. Just make sure you do it. Making sure we are getting 7-9 hours per night of continuous quality sleep can make all the difference in how we think and feel.

Finally, try consulting a competent specialist, psychiatrist, psychologist, nutrition therapist, fitness trainer, or a yoga teacher to guide you in all directions – physical, emotional, mental, conscious and the self. Seek a solution that enables you to release automatic emotional reactions. You have found an effective method when the same situations do not trigger the reaction that was previously the problem.

CONCLUSION

Burnout should not be underestimated or downplayed as a mere side effect of modern day living. In understanding the physiological effects, we see just how dangerous burnout can be in the long-term. By implementing a lifestyle adjustment will ensure that burnout is prevented, however learning to discontinue emotional reactions that lead to stimulation of the adrenal glands is the key. Learning intra-personal skills and training awareness will naturally expand your understanding in many other areas of life, helping to transition from dealing with problematic consequences to skillfully creating your own destiny.

About the author

Dr. Helena Lass is a psychiatrist specialising in mental wellness and the founder of Wellness Orbit. She is passionate about entrepreneurship, medicine, functioning of the mind and the role of awareness in each of these areas. As a medical doctor, she has been treating patients for over 10 years. She is a well-known and highly sought-after public speaker on the topics of awareness and mental wellness.

The post A Consequence of Modern Day Living – Burnout appeared first on InnoHEALTH magazine.

Universal Health Coverage

InnoHEALTH Magazine — Tue, 13 Nov 2018 06:06:11 +0000

Partner State Session; Achieving Universal Health Coverage, Insurance Led Innovations, and AYUSH

Recent policy aiming at Universal Health Coverage, the launch of Ayushman Bharat, Ministry of Ayush are some of the key steps of the government of India. Insurance led innovations can come from market and state actors both.

The panel represented industry working in cutting-edge research on Ayurveda, industry leaders, home healthcare expert, leading hospital leader and internet driven insurance marketplace providers.

Dr. James P Kingsland started the session with his keynote by a short presentation of slides about the project on primary healthcare they are doing in India. Talked about Achieving Universal Health Coverage and quoted the following

“There is nothing new except what has been forgotten”

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Deliberated on possible ideas to further strengthen the Indian healthcare system, learning from other markets (NHS), offerings in the insurance sector, new care delivery models such as home healthcare offer and possibilities with alternative medicine and treatment lines. To tie all of this in a goal, which is to improve the quality of care and reduce the cost of care delivery.

Dr.James shared his work from the UK of the quadruple aim of building Healthcare system by mentioning that not only three aims but the fourth also existed and those are :

-Improving the health and wellbeing of the population
-Improving the individual outcomes & experience of care
-Reducing the per capita cost of care
-Fourth and important aim: Improving the experience of providing care

Systems with a strong generalist approach work best for access, equity and cost-effectiveness.

The supply of Primary Care Physicians is associated with improvements in population health inequalities. By contrast, specialist groups make little difference in health inequalities or cost-effective care.

Since a good system to primary care will lead to proper and optimum cost.

Ayushman Bharat is one of the largest schemes in India which will be covering 100 million poor and vulnerable families that acquits up to 500 million people. The panel discussed the key challenges anticipated in the different perspective since there were panelists from the different area of expertise.

Dr. Ganju anticipated the key challenges would be in – decrease financial risk of the population -improve population health, Dr. Gulati added his key points in care perspective that a measure of check and balances of money flow should be implemented in such a big scheme where huge amounts of funds are involved.

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Ramani stated that in a long run the sustainability of the scheme is very important to keep it running to be worthwhile for all the stakeholders involved.

Ganju was hoping good outcomes through AYUSHMAN BHARAT because of the IT structure that we have now can make many things redundant in lowering the administration cost.

The post Universal Health Coverage appeared first on InnoHEALTH magazine.

Hospitals designing bats for a fresh look

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

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

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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.

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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.

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Read all the issues of InnoHEALTH magazine:
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InnoHEALTH Volume 2 Issue 1 (January to March 2017) – https://goo.gl/DEyKnw
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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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