Radiology Archives - InnoHEALTH magazine

Epilepsy is the Fourth Most Common Neurological Disorder

InnoHEALTH Magazine — Wed, 23 Oct 2019 11:04:03 +0000

Artificial Intelligence can help decode epileptic brains. Epilepsy is the fourth most common neurological disorder affecting nearly 65 million people worldwide. The seizures or ‘fits’ as is commonly known, arise due to unusual electrical activity in the brain and is the chief symptom of epilepsy. Neither dependent on age or gender, the onset of the seizure is unpredictable without a set pattern of frequency of occurrence or severity, often posing a challenge to the caregiver.

Did you know that one student commits suicide every hour in India?

Although epilepsy can be related to previous brain injuries or genetic factors, neurologists have found unprovoked, recurrent seizures in healthy individuals too. How and why these seizures occur remains a mystery. However, research has found that the source of seizures is within the brain. In other words, the brain itself is the generator of epilepsy.

Spatial maps of top 10 networks: If the origin is within the brain, then are there any fingerprints that can be detected? Does the brain often tell-tale signs which can be mapped to predict the tendency of epilepsy?

Reason for Aggression After Drink

Seeking answers to these questions, a team of interdisciplinary researchers conducted a study to peep inside epileptic brains. The results indicate that there exist independent neural networks that can carry disease sensitive information about the anomaly. With the help of machine learning models and artificial intelligence, researchers were able to detect and reveal the hidden patterns.

“Epilepsy is not a disorder but the manifesting of something from within the brain’s electrical activity. Interestingly, each one of us has the neural map of epilepsy within our brain. It is only when the network gets fired and manifests externally, in a recurrent manner, it becomes disorder or epilepsy,” explained Dr. Tapan Kumar Gandhi, lead researcher of the study from Indian Institute of TechnologyDelhi, while speaking to India Science Wire.

The usual diagnosing tool for epilepsy is by EEG (Electroencephalography) readings of epileptic patterns and visible symptoms like convulsions, loss of consciousness or sensory disturbances.

Existing studies reveal specific patterns that represent synchronous activities of sensory, auditory, cognitive and other functions. These activities are indicated by the change in blood flow to the brain and seen as BOLD signals or changes in the Blood-Oxygen-Level-Dependent output.

Recent developments in Magnetic Resonance Imaging or MRI help picture these activities in the brain and detect the cause of seizures such as a lesion or scar. However, MRI is not very useful when a seizure flares up. Whereas, functional MRI — another scanning method — can record regional interactions in the brain when a particular task is being performed.

In 1995, Indian researchers had found that the brain shows prominent neural network connections even in its resting state. Termed as resting-state functional MRI or rsfMRI, the images from this scanning indicate neural patterns in an individual’s brain even when no action is performed.

In the present study, the team utilized rsfMRI technique and performed brain scans on individuals with Temporal Lobe Epilepsy (TLE), which is the most common form of epilepsy.

Dr. Gandhi said, “We hypothesized that there could be ‘disease-specific networks’ in epilepsy prone brain that can be identified with the help of the machine learning model.” Machine learning involves artificial intelligence to read live data instead of pre-programmed information. Such a building block of a machine is analogous to a neuron cell in the brain.

Researchers used a tool called Support Vector Machine (SVM) to deal with the complex and non-linear data obtained from the scans. By using another algorithm called Elastic-net based ranking, the relevant features of the neuroimaging data were extracted. The signals were integrated to reveal the patterns.

The team conducted a pilot study on 132 subjects – 42 with epilepsy, and the rest with healthy individuals. Parameters like age, gender, history of epilepsy, genetic predisposition, incidents of injuries, medications and more, were taken into account. The epilepsy patients underwent three rsfMRI while those in the healthy group were scanned once.

In all, 88 independent components or networks were obtained from the whole brain imaging data and fed as input to the SVM. From the patterns, top 10 strong networks were correlated with clinical features using another standard method called Pearson’s Correlation to generate the rsfMRI epileptic neural networks.

From the pattern inputs, the SVM could identify epileptic individuals to an accuracy of 97.5% and specific lobes in the brain responsible for the condition. The model also revealed correlations such as the age of onset, frequency of seizures, or duration of illness.

By this, researchers concluded that the independently derived rsfMRI contains epilepsy-related networks. ‘Our research establishes that with the help of machine learning methods, we can identify these networks, as we had hypothesized. Increased strength in these networks indicates the possibility of a progressing Temporal Lobe Epilepsy’, explained Dr.Gandhi.

The team included Rose Dawn Bharath, Sujas Bharadwaj, Sanjib Sinha, Kenchaiah Raghavendra, Ravindranadh C. Mundlamuri, Arivazhagan Arimappamagan, Malla Bhaskara Rao, Jamuna Rajeshwaran, Kandavel Thennarasu and Parthasarathy Satishchandra (National Institute of Mental Health and Neurosciences, Bengaluru); Tapan K. Gandhi and Jeetu Raj (IIT, Delhi); Rajanikant Panda (Universitè de Liège, Belgium); Ganne Chaitanya (Thomas Jefferson University, USA) and Kaushik K. Majumdar (Indian Statistical Institute, Bengaluru). The study results have been published in the journal European Radiology.

Credits: India Science Wire

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AI and IoT in Healthcare: Need of Future

InnoHEALTH Magazine — Wed, 10 Jul 2019 08:54:11 +0000

Healthcare is transitioning from human touch of doctors, nurses and allied health professionals to devices and now information technology. In today’s world, healthcare is buzzing with new domain of Artificial Intelligence (AI) or should it be called assisted intelligence, machine learning, big data, block chain, Internet of Things (IoT), connected healthcare, mHealth, eHealth, cybersecurity and many more. These terminologies are being used by many without knowing its definition,use and limitation. It is creating a new community of providers. All this is good as long as we are not servient to technology and we control it for the benefit of providers and patients. Even medical personnel these days want to diagnose without touching the patients, without any concern for evidence-based medicine,human touch and compassion. Technology has made big in-roads in healthcare,but should it dispense health professionals as few think.

There is no doubt AI and IoT are big help in radiology and early diagnosis of cancer etc. but can never replace human intervention. India is also fast changing to adopt new technologies. As per a recent estimate, AI has potential of bringing $957 billion to the Indian economy by 2035. This may be the cause for luring young professionals to this new domain.

AI, as described by the domain experts – application of AI in healthcare, can be classified into Descriptive, Predictive, and Prescriptive. Our effort here is to learn and share newer knowledge by various initiatives taken by us through our annual conference, magazines, training programs, club meetings, webinars and the most recent delegation to Sweden under InnoBRIDGE 2019 to learn the best practices and explore synergies. On the request of our stakeholders, the next planned initiative is InnoBRIDGE USA 2020.

This issue is based on the theme of AI & IoT in Healthcare. The next one would be on Unmet Needs in Healthcare: Leading to Innovation. Do share your views and research for the benefit of all who believe in change through innovation. Let us think more on the basic issues of healthcare and how we can use technology to improve healthcare for common man at an optimum cost.

Ideate, Innovate and Incubate for the Bottom of Pyramid. Let us strive together to make India a developed economy from an emerging economy. The population of1.3 billion should be an asset and not a liability for the nation. A healthy India only can make wealthy India.

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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

Back to home

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Healthcare IT market builds the foundation of Artificial Intelligence

InnoHEALTH Magazine — Thu, 28 Mar 2019 11:09:41 +0000

Healthcare IT market builds the foundation of Artificial Intelligence-based Healthcare System and creates lucrative Job Opportunities.

New Job opportunities, the reduced communication gap between a patient and a doctor, the artificial intelligence-based healthcare system, and the digitization has surely created an amazing era of healthcare IT.

Evaluation–Diagnosis–Treatment. This is the traditional and generally accepted method of a medical procedure. However, the healthcare sector has evolved over the last couple of years. Today’s healthcare is using a new, digital companion to determine how patients feel based on much more than their present medical condition. Healthcare information technology or healthcare IT is widely used by doctors, surgeons, and pharmacists to understand the medical information of patients and improve communication between doctors and patients.

What is the use of Healthcare IT?

The major advantage of the healthcare IT is that it reduces the communication gap between a patient and a doctor as the healthcare IT collects and converts the patient’s information from paper records and medical charts to electronic data. This migration provides direct access to patient’s information to doctors irrespective of their location and enables to share knowledge with other doctors than the current medication providers. Moreover, the doctor-recommended prescriptions can be transmitted electronically owing to the healthcare IT, which has improved efficiency and reduced the valuable time.

Healthcare IT is much more than just an electronic version of paper medical records. It includes previous maintained medical images by radiology departments and opinions of specialists on a certain method of treatment. In addition, the digital messages including emails, healthcare tips, chat logs, the day-to-day medical progress of a patient, and financial factors such as scheduling and billing fall under the sky of healthcare IT. However, these records must be stored and maintained carefully to prevent invasion of privacy. On the other hand, technological advancements and easily accessible facilities fuel the demand for healthcare IT. Roughly, two-thirds Americans have instant access to the internet, which eliminates a patient’s restrictions with medical consultants. The tech giants such as Microsoft, Apple, and other new start-ups are developing up-to-the-minute opportunities in the healthcare IT market by improving access to digital applications and providing efficient security features. This has increased demand for healthcare IT services, boosting the growth of the healthcare information technology market. According to a report published by Allied Market Research, the market is expected to register a CAGR of 13.2 % in the period 2014–2022.

Healthcare generates job opportunities

The growth of healthcare IT has created a surge in job opportunities in the IT sector. According to the U.S. Bureau of Labor Statistics, by the end of 2024, the need for healthcare and medical managers will boost by about 17 percent. The healthcare IT management jobs oversee the entire system process and its day-to-day operations. Healthcare providers are finding hard to pick employees for job positions such as development, analytics, coding, and research. Moreover, just the collection of healthcare data is not enough. Once that data is received, it needs to be analyzed by skilled professionals and constantly updated and improved. Therefore, coding experts are extremely essential to smoothly transfer the individual records of patients to a central hub, by changing the codes that could otherwise interrupt the transfer of information. It is estimated that the requirement of such new codes is nearly 130,000. Moreover, the IT specialists assist healthcare service providers to obey the federal guidelines for records, a collection of data and share to protect a patient’s privacy. Due to such requirements, there are ample IT companies and even start-ups that are launching new platforms to develop a sustainable healthcare IT department.

Recently, Javara Inc., a clinical research service organization, launched a platform that is focused on compelling innovative research partnerships, service, and technology to healthcare systems. Jennifer Byrne, the co-founder, and CEO of Javara stated that the new healthcare IT platform will bring better outcomes for patient-centered care, better economic results, and easier research delivery model to the biopharmaceutical sector.

Integration of Artificial Intelligence in Healthcare IT

It is no secret that the healthcare sector holds a humongous amount of data; if incorporated with artificial intelligence (AI), it will open innumerable opportunities in the future. Microsoft, one of the largest information technology companies, has been working on several healthcare-related projects. Recently, Microsoft made clear its exact intentions behind developing a Microsoft healthcare team. The company aims to create a cloud-based patients’ profile, push doctors to use more cloud-based services, and eventually develop an AI to analyze the huge data. Microsoft hired two industry past masters: Jim Weinstein and Joshua Mandel to help achieve this goal. Jim Weinstein, the former CEO of Dartmouth-Hitchcock Health System, will help the migration of healthcare data to the cloud. Joshua Mandel, ex-Google employee, will assist in building open cloud architecture for all healthcare service providers.

The prime motive behind the project is to find a way to shift healthcare data to the cloud without jeopardizing its confidentiality. This new team will be a part of Microsoft’s AI research division. Peter Lee, the head of Microsoft healthcare, explained, at Microsoft, we’re confident that many aspects of the IT foundations for healthcare will move from on-premise doctors’ offices and clinics to live in the cloud. We are taking concrete steps with an initial blueprint intended to standardize the process for the complaint, privacy-preserving movement of a patient’s personal health information to the cloud and the automated tracking of its exposure to machine learning and data science. The company wants to pave the way to create an open architecture that eventually helps doctors, nurses and healthcare service providers, and to allow more time for patients to spend face-to-face with the doctors. The new platform will open new opportunities for healthcare data to be shared and to protect its privacy. Such innovative projects and huge investments in healthcare AI proves that the incorporation of AI in healthcare IT will be a fruitful investment for the healthcare providers, and no doubt it will be a key to the bright future of healthcare sector.

About the author

Nikhil Bhusare is an Executive with Allied Market Research.

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Artificial Intelligence Coming Big Way in Healthcare Sector

InnoHEALTH Magazine — Mon, 19 Nov 2018 10:13:51 +0000

Brig Arvind Lal, CMD of Dr Lal Path Labs, is a pioneer in bringing laboratory services in India at par with the western world. In 1977, he took charge of the medical diagnostics laboratory founded in 1949 by his late father. Under his expert guidance and leadership, the initiative has become one of the most reputed laboratories in Asia, having to its credit quality accreditations from various national and international bodies.

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

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

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

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

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

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

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

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

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

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

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

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‘Wearable Tech is another area which I am personally very excited about. It has the potential to change the world as it helps people understand their own bodies by using mass data collected on a daily basis. From fitness bands to smartwatches to eye based wearables, they are being adopted widely. Take the case of Zephyr’s Anywhere Bio Patch which is an FDA-approved, small device that is attached to a patient’s chest and monitors their vitals minute-by-minute and collects medical-grade data for doctors’ use. These devices will connect our organs digitally, enabling disease detection at very early stages. It has the potential to bring down cardiac and other deaths drastically. This offers immense potential to do remote testing, monitoring and thus assisting the doctor in timely treatment’.

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Point of Care Testing: Technological advancements in laboratory automation, including POCT, and initiatives to increase patient satisfaction are transforming the clinical laboratory market. POCT has come a long way from a handful of simple tests to a multibillion-dollar global market that holds great promise for the future. Not so long ago, laboratory data would often arrive at the bedside too late to be of significant use in the active, continuing care of critically ill patients. Now, most clinicians acknowledge that POCT is a prerequisite for early recognition of life-threatening conditions as they require that laboratory results are made available in real-time and, if possible, at the critically ill patient’s point of care. The College of American Pathologists defines POCT as tests designed to be used at or near the site where the patient is located, that do not require permanent dedicated space, and that are performed outside the physical facilities of the clinical laboratories.

Examples include kits and instruments that are hand-carried or transported to the vicinity of the patient for immediate testing at that site (e.g. capillary blood glucose) or analytical instruments that are temporarily brought to a patient care location (like operating room, intensive care unit). In many cases, the simplicity was not achievable until technologies developed that was simple and affordable. For example, various kinds of urine test strips have been available for decades, but portable ultrasonography did not reach the stage of being advanced, affordable and widespread until recently. Similarly, pulse oximetry can test arterial oxygen saturation in a quick, simple, non-invasive, affordable way today, but in earlier eras, this required an intra-arterial needle puncture and a laboratory test. Thus, over decades, testing continues to move toward the point of care.

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

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

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TRIVITON HEALTHCARE LAUNCHED RADIOGRAPHY SYSTEM

InnoHEALTH Magazine — Tue, 25 Jul 2017 08:33:22 +0000

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DIGITAL RADIOGRAPHY SYSTEM: Ultisys launched by Triviton Healthcare
Dr. Avantika Batish is working as Director Strategy and Healthcare at International Health Emergency Learning and Preparedness. Also, guest faculty for MBA (HR) and MBA Healthcare Management at various B-Schools and is a soft skills trainer.

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Trivitron Healthcare’s radiology division Kiran Medical Systems has introduced its innovation driven Ultisys range of radiography products during the Arab Health Convention in Dubai 2017.

The ultisys platform has been indegenously designed and developed with a wide range of clinical applications involving general radiography. The system features a floor mounted x-ray system with a wide range of generator power options from 32 kW to 82 kW, choice of tethered or wireless flat panel detectors. It is seamlessly integrated through a powerful imaging software platform that provides a highly intuitive user interface and image processing that makes even the smallest bone and soft tissue details visible in superb resolution.

Kiran’s portfolio of radiology products includes the Infinity and Elite series surgical C-Arm systems available in 3.5kW and 5.0kW power output and the option of 1Kx1K digital imaging chain with advanced image processing capabilities; a comprehensive range of radiation protection products, anti-scatter x-ray grids and imaging accessories including computed radiography systems, dry films for DICOM printers, Screen Films, Analogue Cassettes and Screens.

Its manufacturing facilities are approved by US-FDA, SGS-UK and PMDA-Japan amongst others. With approximately 50-65 % of the entire components designed and manufactured from scratch in India, there is a significant cost reduction in the development of the equipment subsequently enabling to make the products available at affordable prices.

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