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Chairman of the Board CONTENTS Viveck Goenka DIGITALTOOLS AS MEDICAL Sr. Vice President-BPD DEVICES FOR TRANSFORMATION OF Neil Viegas HEALTHCARE SERVICES Asst. Vice President-BPD Dr Paritosh Basu, Senior Professor, NMIMS School of Harit Mohanty Business Management elaborates on some potential applications of digital platforms and tools that can help Editor implement India’s National Digital Health Blueprint Viveka Roychowdhury* successfully | P-28 BUREAUS PUBLIC HEALTH STRATEGY CANCER CARE DIAGNOSTICS Mumbai Lakshmipriya Nair 9 HOW DISEASE SURVEILLANCE Delhi CAN CHANGE Akanki Sharma THE HEALTHCARE SITUATION IN DESIGN INDIA Asst. Art Director Pravin Temble P13: INTERVIEW P22: INTERVIEW P24: INTERVIEW Chief Designer SHISHIR AGARWAL DR BANDANA SHARAN THOMAS JOHN Prasad Tate MD, Director-Research of APAC Managing Director, Terumo India Biotech Agappe Diagnostics Senior Designer Rekha Bisht 25 DIAGNOSIS IS BETTER THAN Senior Artist DISEASE Rakesh Sharma RADIOLOGY Digital Team Viraj Mehta (Head of Internet) 26 CHEST CT ILLUMI- 26 DIGITAL BREAST NATES MORTALITY TOMOSYNTHESIS Marketing Team RISK IN PEOPLE WITH REDUCES RATE OF Rajesh Bhatkal COPD INTERVAL CANCERS Ambuj Kumar Ashish Rampure Express Healthcare® Debnarayan Dutta Regd. With RNI No.MAHENG/2007/22045. Postal Regd.No.MCS/162/2019-21. Printed and Published by Vaidehi Thakar on behalf of The Indian Express (P) Limited and Printed at The Indian Express Press, Plot No.EL-208, TTC Industrial Area, Mahape, Navi Mumbai-400710 and PRODUCTION General Manager Published at Mafatlal Centre, 7th floor, Ramnath Goenka Marg, Nariman Point, Mumbai 400021. BR Tipnis Editor: Viveka Roychowdhury.* (Editorial & Administrative Offices: Mafatlal Centre, 7th floor, Ramnath Goenka Marg, Nariman Point, Mumbai 400021) Production Co-ordinator * Responsible for selection of news under the PRB Act. Copyright © 2017. The Indian Express (P) Ltd. All rights reserved throughout the world. Dhananjay Nidre Reproduction in any manner, electronic or otherwise, in whole or in part, without prior written permission is prohibited. Scheduling & Coordination 7EXPRESS HEALTHCARE Arvind Mane May 2021 CIRCULATION Circulation Team Mohan Varadkar
EDITOR’S NOTE Wanted: A PLI scheme for doctors, nurses? Last year, 736 doctors lost their lives due Unfortunately, various states should maintain an official record of to COVID-19, says Dr Jayesh Lele, doctors and healthcare workers affected and died due to secretary general, IMA. This year's COVID-19 with their vaccination status. As per IMA, second wave has already claimed 126 nurses cannot be this is not being hence the association has stepped in doctors. At one point, 49 of these doctors assembled and to collect this data. IMA has also created a were from one state alone: Bihar. COVID Martyrs Fund, from which Rs 1.6 crore rolled off a has already been disbursed to families of deceased Besides COVID-19, doctors and nurses are also production line doctors. perishing in fires breaking out in ICUs. Often caused by malfunctioning or overheated ventilators, Keeping in mind that monetary incentives cannot medical personnel are particularly vulnerable as be the sole motivation for healthcare professionals their PPE catch fire while they try to save their who are after all risking their lives when they take up colleagues and patients. We are also hearing of young COVID-19 duties, what could be considered a fair doctors driven to suicide, anguished by the lives they incentive? could not save due to lack of oxygen and medicines. Exhausted doctors, nurses are taking to social A notification from the Himachal Pradesh govern- media to literally beg patients with mild ment dated May 3, announced incentives ranging COVID-19 symptoms to not insist on blocking a from Rs 3000 per month for fourth and fifth-year hospital bed/oxygenator when all they need is home MBBS students, contractual doctors, and junior and quarantine. senior residents; to Rs 1500 per month for nursing students, contractual lab staff and GNM third-year To fight any war, we need soldiers and students. ammunition. Looks like we are running short on both counts in the war against COVID-19. Dr Wankhedkar calls this a “cruel joke by the Himachal Pradesh government”, reminding us that But while more manufacturing units could be of- it works out to just Rs 100- Rs 50 per day. fered the Production Linked Incentive (PLI) scheme to make more medicines, vaccines, ventilators etc, The Supreme Court had to intervene before the doctors and nurses cannot be assembled and rolled May 3 decision from the PMO. The apex court's off a production line. April 30 response to a PIL asked for details on medical oxygen supplies, medicines and procuring vaccines In fact, the government’s PLI scheme for medical for all. devices and medical device parks will hopefully ease the shortage of medical equipment (see cover story in It also asked the government how many families May edition: Making med-devices for Bharat and the of medical personnel who died of COVID-19 were still world) awaiting clearance of their insurance claims under the Pradhan Mantri Garib Kalyan Package which Worse, doctors are already warning us to be had been extended to around 22 lakh healthcare prepared for the third surge, projected in June-July professionals. this year. This only means more doctors and nurses, at least 20 per cent trained for ICU duty, will be needed. The apex court also drew attention to how health- care professionals who got infected in the line of duty Which is why Prime Minister Modi’s moves on were often left to fend for themselves without beds, May 3 to boost the availability of medical personnel to oxygen or medicines for themselves or their family fight COVID-19 are very welcome and in line with members. most of the suggestions of healthcare associations. The SC's response also mentioned that the cen- But here too more could have been done. For tral government should examine and ensure that in example, Dr Ravi Wankhedkar, Chairman, IMA addition to the schemes it had framed, other facili- Covid Registry terms the decision to postpone the ties such as the availability of food, resting facilities PG NEET exam for at least four more months as between work, transportation, non-deduction of “retrograde” as it will keep the more than 1 lakh leave etc should be provided to healthcare profes- MBBS doctors who keep appearing for PG NEET sionals on COVID-19 duty. year after year, out of the healthcare delivery system, adding to the burden of “serving junior doctors who It is these facilities that will motivate healthcare are already physically and mentally fatigued.” professionals, more than the monetary incentives, but it is sad that the Supreme Court had to step in It is unfortunate that we still hear of patients’ before we realised that we cannot fight COVID-19 relatives attacking medical staff, as recently hap- without doctors, nurses, lab technicians, etc. After pened at Apollo Hospital’s Sarita Vihar, Delhi facil- all, as Dr Devi Shetty put it, beds and ventilators ity. No doubt the demise of their family member due to don’t treat patients, it's doctors and nurses who treat the unavailability of an ICU bed is tragic but taking and save lives. the lives or injuring doctors and nurses puts more patients at risk. VIVEKA ROYCHOWDHURY Editor [email protected] Unfortunately, it is not just patients and relatives [email protected] who take medical staff for granted. For instance, the health department of the Government of India and 8 EXPRESS HEALTHCARE May 2021
PUBLIC HEALTH OPINION How disease surveillance can change the healthcare situation in India Dr Vikram tremoflo® C-100 Venkateswaran, a doctor turned Shaping New Perspectives on Pulmonary Function technologist, and Founder of Ÿ Compact & portable device for use with laptop, tablet Healthcare India, or PC believes that we should take full Ÿ Fast and easy measurements as patient requires to advantage of the breathe quietly advances already made by Ÿ Patented oscillator technology breath through institutes like the vibrating mesh Integrated Disease Ÿ Works on forced oscillometry technique AOS Surveillance technology Programme and private entities Ÿ Quick and fast start up of system due to its portability like the Virology Ÿ Meets & exceeds ERJ2003, 22:1026-1041 Institute in Ÿ Measures all standard parameters Manipal to take healthcare in Call 18002098998 to book a demo India from being reactive to For enquiries contact : [email protected] | Website : www.schillerindia.com | Toll-Free No. : 1-800-2098998 proactive Swiss H.Q.: SCHILLER AG, Altgasse 68, P. O. Box 1052, CH - 6341 Baar, Switzerland. Indian Corporate Office: SCHILLER Healthcare India Pvt Ltd., Advance House, Makwana Rd, In November 2020, the nodal of- O . Andheri Kurla Road, Marol Naka Metro Station, Andheri (East), Mumbai - 400 059. fice of the Integrated Disease Tel.: + 91- 09152380310, +91-22 61523333/ 29209141 | Fax: +91-22-29209142 Surveillance Programme Factory : No. 15/5 & 15/6, Vazhuthavur Road, Kurumbapet, Puducherry 605009 (IDSP) was alerted about CIN : U33110MH1997PTC111307 suspected cases of Mumps in a lo- cal village of Punjab. Mumps is a vi- All registered trademarks acknowledged ral infection and is caused by Mumps Virus which is a Paramyx- ovirus, with an incubation period of 15-20 days. It affects mostly children and not surprisingly the observation came from the local village school which had 21 students. The local health workers along with the epidemiologists visited the school and immediately isolated Continued on Page 11 9EXPRESS HEALTHCARE May 2021
PUBLIC HEALTH Continued from Page 9 caseloads. Coronavirus pandemic We can also look at the social toms and seek cure). Disease surveillance in is showing us how difficult it is for media feed from users who A similar mobile application COVID-19 the infected children. They gave our ecosystem to handle indicated their ailments – directly symptomatic relief to the affected pandemics. (by looking at the feed that saw called 'Flu Near You' was being COVID-19 has aptly demonstrated children which were nine in num- people discussing their illness or in- used in the US to record flu cases the use of disease surveillance for ber and spent the week educating With the rise of internet con- dicating that they were unwell on during the season. Some of these the reporting and managing of the and managing the health condi- nectivity and digital media in India, social media) or indirectly (by might have inaccurate reporting by pandemic. While the global nature tions of the local residents to en- it is no surprise that both state and analysing the number of people the users but it still gives the of the pandemic makes it one of the sure that the epidemic does not local authorities are looking at searching websites like Google, healthcare system a sense of what worst outbreaks since the Spanish spread. The efforts of this team leveraging that data to detect out- looking to investigate their symp- is happening in the various districts were successful as the cases sub- breaks and intervene in advance. in the country. Continued on Page 12 sided and the infection managed. This is a good case of the success of the IDSP that has been running in India since 1997. Recently it has been expanded to 23 states and all UTs. What is disease surveillance? Disease surveillance is a system that uses digital technologies to col- lect data from multiple sources in real-time or near real-time and can help indicate the potential of a dis- ease outbreak in certain locations, thereby enabling the government to take steps to control the situa- tion. The idea is to take action right at the beginning at the local level to ensure that it does not spread regionally or nationally putting the entire healthcare machinery at strain. Many Western countries have been doing so already, where they rely on hospital and lab reporting, digital monitoring and social media data to prevent and manage out- breaks. For instance, the US was able to identify cases of Ebola around nine days before the World Health Organisation declared the Ebola epidemic using a software that mines social media. This soft- ware, part of an infectious disease surveillance system, was able to pick up instances of a “mystery haemor- rhagic fever” from among the vari- ous entries listed on government websites, local news sites, and social networks, correlating it with Ebola. This is not different from the case in Punjab above which was identified mostly because of the re- porting on local health workers who were visiting the school in Punjab as part of their weekly reporting on the local disease patterns. How can it help India? The key to managing India’s health- care situation is proactive interven- tion and prevention. While manag- ing a population with our size is not going to be easy following tradi- tional intervention will not help either as we really don’t have the infrastructure to handle the 11EXPRESS HEALTHCARE May 2021
PUBLIC HEALTH Continued from Page 11 What India needs next Flu, daily reporting of the numbers and Fortunately, India already has an Integrated tracking of data from the various state and Disease Surveillance Programme as dis- local hospitals has helped the ecosystem de- cussed at the beginning of the article. Most fine a plan to tackle the situation. While data of the work done by this programme never has been shared with the Ministry of Health makes news as the outbreaks are contained. and Family Welfare for the tracking of the The main move will be to bolster that pro- coronavirus, very few instances of sharing of gramme leveraging digital. Today, the lead such data have been permitted in the past. time from getting data from the local author- The idea is to identify 15-16 disease conditions ities – Primary Health Centers, Community that impact India the most and data on those Health Centers to district hospitals is long. conditions to be shared with the national pro- The P Forms and N Forms that are filled and gram for better tracking and management. scanned take time. This helps not only the hospitals and the There is a move to digitise the pro- authorities but also others in the healthcare gramme using the mobile application but it ecosystem like pharma companies to manage is taking longer than expected. The launch of their supply chains and for medical devices the India Stack and the integration with it to ensure the availability of equipment. should accelerate the growth of the IDSP. Weather data Leveraging digital and social media data is a critical step. While the data from the hos- We can take the disease surveillance system pitals and healthcare centres are genuine case records and resemble structured data, STATEMENT ABOUT OWNERSHIP AND OTHER PARTICULARS OF COVID-19 has aptly demonstrated the use EXPRESS HEALTHCARE, MUMBAI, AS REQUIRED UNDER RULE 8 of disease surveillance for the reporting OF THE REGISTRATION OF NEWSPAPERS (CENTRAL) RULES, 1956 and managing of the pandemic. Daily reporting of the numbers and tracking of FORM IV data from the various state and local (SEE RULE 8) hospitals has helped the ecosystem define a plan to tackle the situation 1. Place of Publication : Mafatlal Centre, 7th floor, Ramnath Goenka Marg, Nariman Point, Mumbai 400021 2. Periodicity of its publication : Monthly 3. Printer’s Name : Ms. Vaidehi Thakar Whether citizen of India : Yes Address : Mafatlal Centre, 7th floor, Ramnath Goenka Marg, one step ahead by integrating weather data integrating with unstructured data coming Nariman Point, Mumbai 400021 into it. Weather plays a big role in the spread from digital and social media sources would of infectious diseases and also in aggravating give us the complete picture. Finally, adding 4. Publisher’s Name : Ms. Vaidehi Thakar certain conditions like asthma. Countries like weather data to it will complete the picture. Whether citizen of India : Yes Germany, Japan and UK have already started Weather plays an active role in determining Address : Mafatlal Centre, 7th floor, incorporating weather data into their disease our health and adding that into the mix will surveillance programmes. Germany tracks complete the picture. Ramnath Goenka Marg, ultraviolet radiation from the sun in its fore- Nariman Point, Mumbai 400021 casts. It also tracks pollen a known cause of We have a unique opportunity in India to allergies and other factors in its advisory for build a healthcare surveillance/ disease sur- 5. Editor’s Name : Ms. Viveka Roychowdhury the local regions. veillance system unlike anyone else. We should Whether citizen of India : Yes take full advantage of the advances already Address : Mafatlal Centre, 7th floor, In my book Own Your Health, I discuss made by institutes like the IDSP and the pri- how Japan has managed to integrate vate entities like the Virology Institute in Mani- Ramnath Goenka Marg, weather data into its disease surveillance pal to take healthcare in India from being re- Nariman Point, Mumbai 400021 programme. Japan undertook health- active to proactive. It can bring together weather forecasting by including Ultra Violet various stakeholders like healthcare profes- 6. Name and address of individuals : The Indian Express (P) Ltd (UV) forecasting, adjusted to skin type as sionals (who on their own don’t tend to use dig- who own the newspaper Mafatlal Centre, 7th floor, part of its surveillance mechanism in 2008. ital media for creating awareness on diseases), Ramnath Goenka Marg, The country has been divided into 39 regions patients (who need authentic medical informa- AND Nariman Point, Mumbai 400021 based on significant differences in terms of tion online), and healthcare providers (like hos- Shareholders holding more than lifestyles, clothing, and sensibilities of resi- pitals and clinics who can share disease infor- One per cent of the total capital : Indian Express Holdings & Entp dents. This is just another example of why mation) to comprehensively tackle disease and Private Limited an integrated programme is critical for its symptoms. The beginning has already been Mafatlal Centre, 7th floor, tracking health. made, but it’s time to make it a more mature Ramnath Goenka Marg, system for wellness and preventive care. Nariman Point, Mumbai 400021 The NHS in the UK tracks cold weather conditions and warns trust hospitals References : Mr. Viveck Goenka & Mr. Anant Goenka on not only infections but also on cases Mafatlal Centre, 7th floor, of trauma. The city of Chicago has been https://www.idsp.nic.in/showfile.php?lid=5014 Ramnath Goenka Marg, tracking food poisoning as part of its move to https://www.thenewsminute.com/article/how- Nariman Point, Mumbai 400021 track foodborne diseases. The system digital-disease-surveillance-systems-could- uses Twitter to identify epicentres of such have-prevented-delhi-dengue-outbreak-50556 : Mr. Shekhar Gupta & Mrs. Neelam Jolly outbreaks. www.healthcare-in-india.net C-6/53, Safdarjung Development Area New Delhi 110 016 I, Vaidehi Thakar, hereby declare that the particulars given above are true and to the best of my knowledge and belief. Date : 1/3/2021 sd/- Vaidehi Thakar Publisher 12 EXPRESS HEALTHCARE May 2021
STRATEGY INTERVIEW At Terumo, we consider India to be a very important market for us Shishir Agarwal, MD, Terumo India, as part of the 100-year-old Japanese Terumo Corporation, that serves to advance access of high-quality medical devices to patients and medical practitioners in India, firmly believes that Terumo India can be a very strong and reliable partner for India’s developing healthcare ecosystem. He details Terumo's game plan for India to Viveka Roychowdhury What are the trends in the Culturally, the Japanese are medical devices industry, known to invest and build for globally and in India? the long term.This focus on I see three dominant trends building for the long-term shaping the global medical coupled with the great devices industry that is significance we place on applicable to India as well. values such as trust, care and respect, makes Japanese Firstly, governments companies highly around the world are actively dependable partners for the trying to reduce the overall long term cost of healthcare, for patients as well as healthcare healthcare? How does this the long-term coupled with ecosystem in the country. stronger as an organisation. systems. This benefit the patient and the great significance we There is also growing After the sudden dip in the correspondingly puts caregiver population in place on values such as trust, awareness and appreciation market during Q1 last year, pressure on companies to India? care and respect, makes for high-quality products. We we’ve had a sharp rebound in optimise costs and enhance Japanese companies Japanese companies highly at Terumo India look forward our performance, recovering the efficiency of their generally are quite well- dependable partners for the to enhancing affordable patient faster than the market. operations. known for their thriving high long term. care in India through our high- tech innovation ecosystem. quality products and solutions. We expect to have a few The second major trend is This continues to be an area I therefore firmly believe important additions to our the impact of technology. The of strength in our being able that we can be a very strong What is Terumo's game portfolio this year and will traditional value chain as we to bring best-in-class and reliable partner for plan for India, in terms of continue to invest in our know it is getting technology to innovate for India’s developing healthcare target CAGR for the next digitalisation journey as we transformed by integrating patients. But more ecosystem. few years? How has the look to further scale up artificial intelligence, importantly, culturally, the pandemic impacted these commercial models and stay predictive technology, and Japanese are known to invest At Terumo, we consider growth plans? focused on supporting more to provide a service and build for the long term. India to be a very important Although 2020 presented doctors and patients in layer over products and There are so many Japanese market for us. It has great many challenges, we have making procedures safer and provide customers a more companies, including ours, potential for growth with a been able to respond to the effective. integrated solution. that are over a hundred years huge underserved population. market context with old. This focus on building for The Indian Government is resilience and have emerged [email protected] Thirdly, and perhaps most committed to investing in [email protected] importantly, the healthcare developing the healthcare ecosystem is progressively becoming more patient- centric. While it may not be so apparent yet, there is a pronounced shift from treatment and cure to prevention. I think this augurs well for the entire healthcare ecosystem. What does the Japanese value system, cultural framework and work ethics mean for Indian 13EXPRESS HEALTHCARE May 2021
cover ) 14 EXPRESS HEALTHCARE May 2021
Atmanirbharta in life-saving medical devices was the proclaimed goal when policymakers launched a Production Linked Incentive (PLI) scheme, supplemented by the creation of medical device parks. Industry and states responded with enthusiasm to the sector’s ‘Make in India’ moment but a year down the line, remain disappointed with the implementation. Just 14 of the 28 applications made under the PLI scheme have been approved till March this year. 16 states applied to develop medical device parks but there is no news yet of any fresh approvals. Industry experts suggest ways to speed up the initiative By Viveka Roychowdhury 15EXPRESS HEALTHCARE May 2021
cover ) Afew days before sanctioned Rs 400 crore for the the tune of 85 per cent of the Vital stats of India’s in India is estimated to be $11 the national lock- setting up of four medical de- total domestic demand of medical device sector billion, with a projected CAGR down of last year, vice parks, with common infra- medical devices and thus there of 14.8 per cent and is expected on March 21, structure facilities. is no argument that being The growth potential of the to reach $11.86 billion in 2021-22 2020, the Union self-reliant in this most crucial medical devices sector is the and $ 65 billion by 2024 and $50 Cabinet gave details of two The second policy extended sector is vital from a health highest among all sectors in billion by 2025. approved schemes aimed at the Production Linked Incen- security perspective. India’s healthcare market, with spurring local manufacturing of tive (PLI) Scheme to the local the country ranking as the With 100 per cent FDI medical devices. medical devices sector, setting If anything, the COVID-19 fourth largest market for allowed under the automatic aside Rs 3,420 crore for this pandemic has underlined our medical devices in Asia. route for both brownfield and Hailed as part of Prime venture. The two schemes will dependence on other nations greenfield medical device Minister Modi’s flagship Make run over the next five years i.e. for a range of medical supplies As per Invest India, India's setups, the sector has report- in India/AtmaNirbhar Bharat from 2020-21 to 2024-25. from medicines to oxygen national investment facilitation edly seen strong FDI inflows campaign, the first scheme concentrators and the like. agency, the current market size which reflect the confidence of India depends on imports to of the medical device industry Over the next three to There is a need to We need to make India The large players will four years, we have a increase the PLI great again, not only by create the currents planned investments of incentive to at least 15 attracting overseas which will assist the Rs 100 crore for setting per cent for five years MNCs but supporting the small players in their up the manufacturing of to help local Indian Champions who flight and the small medical devices manufacturers become are the only fall back players will bring the global players option in every crisis frugality and innovation Dr Shravan Subramanyam including COVID which will benefit the Suresh Vazirani large players and push MD, Wipro GE Healthcare Rajiv Nath the ecosystem forward Founder Chairman, Transasia –Erba International Group Forum Coordinator, Association of Pavan Choudary of Companies Indian Medical Device Industry and MD, Hindustan Syringes and Chairman & Director General, Medical Devices Medical Technology Association of India and MD, Vygon India 16 EXPRESS HEALTHCARE May 2021
global players in the Indian market. As per the Invest India site, since April 2000, the sector has seen $2.1 billion in FDI, of which $600 million was re- ceived in the last five years. Singapore, the US, Europe, and Japan are key investors and the sectors that attracted the most FDI are equipment and instruments, and second, consumables and implants. Around 65 per cent of the medical device manufacturers in India are mostly domestic players operating in the consumables segment and catering to local consumption with limited exports. As per Invest India, large MNCs dom- inate the high technology end of the medical devices market with extensive service networks. There are 750–800 domestic medical devices manufacturers in India, with an average invest- ment of $2.3–2.7 million and an average turnover of $6.2-6.9 Ensure optimal If the PLI scheme is Investments in the utilisation of existing extended to the manufacturing of million. parks before setting up nutraceutical industry, it high-tech medical devices the new medical device will stimulate the needed will happen when global There are six medical parks across the four investment to grow in companies start seeing states. Then existing size and scale. This will volume-linked cost devices manufacturing parks could serve as help make India one of advantages in making the models for the inception the best manufacturing shift. Over time, with “clusters” in the country, in- of new medtech parks of hubs in naturals and stable, practical and long- the future botanicals term policies we will see cluding Andhra Pradesh, the efforts bear fruits Pavan Mocherla Sanjaya Mariwala Telangana, Tamil Nadu, and Shishir Agarwal India Chair, Founder President, Association of Kerala who got in-principle Asia Pacific Medical Technology Herbal and Nutraceuticals MD, Association and MD, India and South Manufacturers of India and Executive Terumo India approval for new medical Asia, BD CMD, OmniActive Health Technologies devices parks in 2019. (See box: Investment opportunities in India’s medical devices segment) Status check While there is unanimous What’s good … India (MTaI) and MD, Vygon thanks to the scheme. support for the schemes, there India states that the PLI Pavan Mocherla, Asia One year down the line, what is is also disappointment that Almost all association chiefs scheme is “undoubtedly a step the progress on these two the implementation has echo Rajiv Nath, Forum Coordi- in the right direction which has Pacific Medical Technology schemes? lagged. Thus there are many nator, Association of Indian been taken through adequate Association’s (APACMed) India suggestions that a lot more Medical Device Industry consultation with the industry Chair, and MD, India, South According to Achal Chawla, can, and must, be done for so (AiMeD) who says that these within the bundle of constraints Asia, BD, believes that the Tax Partner, EY India and vital a sector. Especially as the (two schemes) are very which were there around the “recently introduced PLI Divya Bhushan, Director, COVID-19 pandemic shows no welcome Make in India generic PLI scheme system.” scheme for medical devices is Tax, EY India, the Govern- signs of disappearing and will enabling initiatives and the first He points out that it has already highly commendable as it ment of India has received 28 keep rearing its head in waves, motivation of its kind. achieved partial success, and a serves as an attractive incentive applications under the PLI most likely over the next few few thousand crores of invest- for medical devices to be scheme, of which, 14 applica- years. Pavan Choudary, Chairman ments are expected to come in, manufactured locally, both for tions have been approved till & Director General, Medical domestic use as well as for March 2021. Technology Association of Likewise, the Government has received 16 applications from different states, showing an interest in the development of medical device parks. Market buzz has it that the states are getting antsy that there is still no word on which applications have been accepted. 17EXPRESS HEALTHCARE May 2021
cover ) exports. The scheme also rein- competitive by a few percent- which can be import substi- successful when we become the printing, testing, and sterilisa- age points. He ties it in with manufacturing hub for the tion facilities. These existing forces the government’s com- how the company is “constantly tuted in the short term in three world. And in order to partici- parks could then serve as looking for innovation in ‘super- pate in global and regional models for the inception of new mitment to strengthen India’s value’ products. What that ways. value chains, import tariffs will medtech parks of the future.” entails – is a relentless search have to be correspondingly cal- manufacturing capabilities for products and features that Firstly, identifying how the ibrated. Last and most impor- Making India great again are designed for India… made tant, a scheme of such magni- which in turn, helps to attract for India-use and even priced in small and medium scale compa- tude cannot be monitored by Nath of AiMeD too makes the an affordable range, for the routine mechanisms. It will same point that existing clus- foreign investments in a broad multitude of India-hospital nies can enter the ring because require a comprehensive, tech- ters need to be strengthened. needs, spread across the differ- nically evolved approach with He gives examples of how this range of medical device product ent tiered cities.” more than 90 per cent of the appropriate growth strategies, can be done by encouraging the to develop a global ecosystem.” development of low-cost plastic segments ranging from capital Giving the perspective from companies in this sector belong disposables in Gujarat and the IVD sector, Suresh Vazirani, Strategy for medtech Delhi NCR, surgical textiles equipment, implantable Founder Chairman, Transa- to the SME space. parks based in Coimbatore, sia–Erba International Group of orthopaedic implants in devices, diagnostics, and Companies says that the PLI Secondly, giving more time Speaking about medtech parks, Gujarat, Maharashtra and scheme “is a good start and will Vazirani emphasises that “their Delhi NCR, IOL in Tamil Nadu consumables.” incentivise domestic manufac- to MNCs who may be inter- success will be critical for the and Gujarat. turers to engage in high-value sector’s future. However, most At an individual company production. It can make Indian ested to apply for the scheme, of the medtech parks provide Similarly, medical electron- manufacturers globally com- no other support other than the ics could be strengthened in level, Dr Shravan Subra- petitive, attract investment in as such decisions in global com- land. This has to change. Maharashtra, Karnataka and the areas of core competency Medtech parks should consider Tamil Naidu by providing labo- manyam, MD, Wipro GE and cutting-edge technology; panies easily take a year to get themselves as an integral part ratories, research linkages with ensure efficiencies; create of the eco-system and should local universities, common Healthcare explains what his economies of scale; enhance ex-com and Board approvals handhold the industrial units to R&D and tool room facilities, exports and make India an inte- help them get all necessary sterilisation facilities, regula- company found attractive about gral part of the global supply after the business case Government approvals in a tory support, consultancy and chain.” short time.” training services, permanent the PLI scheme saying, “The development. exhibition/showrooms, confer- Shishir Agarwal, MD, The general consensus is ence sharing and start-up facil- production link incentive is an Terumo India, a Japanese Mocherla also echoes this, that strengthening existing in- itating centres etc. company, also terms it a “wel- frastructure needs to be priori- excellent opportunity for come step to make healthcare suggesting that to ensure the tised rather than starting from Additionally, Nath suggests more affordable and accessible scratch, which could jumpstart that medtech parks can be enabling ‘self-reliance’ for India, to patients in India.” scheme is widely adopted, it is the process and save precious created with common product time. categories with common tech- in a critical industry (during Hinting that we will not see worth considering that the du- nologies so that they are results overnight, he predicts, Mocherla hails the govern- specialised, interdependent these pandemic times) – med- “Initially, it is likely to create ration for submission of appli- ment’s initiative of promoting cooperative clusters around key more activity in the mid to low medtech parks in India to boost common raw material/compo- ical devices. As a country, we technology, high volume cate- cations is extended to two to infrastructural capacity as a nent suppliers. gory (of) manufacturing. Invest- “huge stride towards develop- still import a large portion of ments in the manufacturing of three years instead of the cur- ing a robust manufacturing For example, he cites that high-tech medical devices will ecosystem for medical devices AMTZ at Vishakhapatnam in the medical equipment … and happen when global companies rent timeline of two to three in India. These parks would not Andhra Pradesh was envisaged start seeing volume-linked cost only significantly reduce costs to be focused on medical with PLI, private/local compa- advantages in making the shift. months, as MNCs typically of manufacturing but also im- electronics with mother units of Over time, with stable, practical prove accessibility and afford- X-Ray tubes (to attract X-Ray nies will be enticed to increase and long-term policies we will have long planning cycles when ability of medical devices for the manufacturers), magnetic coils see the efforts bear fruits.” Indian population, thus improv- (to attract manufacturing of CT their supply chain footprint in it comes to making investment ing the overall quality of health- scans and MRI equipment) and … and what’s not care delivery.” EMC testing to aiding manufac- India… first to increase our lo- decisions on where to base their turing of large medical MNCs and domestic companies But he also points out, “it is electronic equipment. calisation potential, and eventu- do differ but also agree on the production plants. prudent to ensure optimal utili- improvements needed to make sation of the existing parks Similarly, Nath/AiMeD ally to unleash our capabilities the PLI and med-tech cluster Third on Choudary’s list is to before setting up the new recommends that Nagpur’s schemes better. medical device parks across the MIHAN SEZ in Maharashtra for the world. To be a part of bring convergence between the four states. To better support and Karnal in Haryana should Choudary of MTaI feels that and scale up these existing clus- focus on orthopaedic implants such a pivotal moment in the the PLI scheme can be im- benefits offered by this scheme ters such as those in Haryana, and surgical instruments by proved further by seeing if the Maharashtra, and Trivandrum, inviting and supporting a stain- evolution of India’s Healthcare medical device and equipment and other moves which the it would help if we develop an- less steel alloy manufacturer universe can be covered more cillary industries and provide instead of the industry being ecosystem… any company comprehensively especially government is making, like the common warehousing, 3D dependent on expensive with respect to those products imports from Sweden etc. It would be honoured to receive medical device parks. the PLI nod from the Depart- Nath of AiMeD has a sepa- ment of Pharmaceuticals, rate wish list for the govern- Government of India.” ment to nurture domestic com- Wipro GE did get the nod to panies to create Indian MNCs, participate in the PLI scheme by extending the PLI scheme to and Dr Subramanyam says that all medical electronics; over the next three to four drugs/vaccine delivery years, they have planned invest- devices/technologies, and ments of approximately Rs 100 thirdly, all implants. crores for setting up the manu- Nath makes the important facturing of medical devices. He point that the investment needs sees the PLI scheme as a com- to cover all investments, includ- bination of import substitution ing land, building and plant, and a higher growth rate pro- machinery and utilities as with pelled by lower cost leading to medical devices, buildings and additional revenues. utilities are designed around a As the dependency shifts to process, for example, clean Wipro GE Healthcare’s local rooms, power backups, ETP, air manufacturing hub over the conditioning etc. next few years, he anticipates Vazirani of Transasia points that the need for importing out that the largest share of the these target products will PLI scheme rests with the auto- naturally decrease. Thus mobile sector. He wishes that making India more self-reliant the government would have for these devices. outlaid a larger amount for the He also points out that the medtech and IVD sector various schemes brought in by as well. the Government do play a As per Vazirani, “The (PLI) part in making the devices scheme will be completely 18 EXPRESS HEALTHCARE May 2021
should also have a strategically INVESTMENT OPPORTUNITIES IN INDIA’S MEDICAL DEVICES SEGMENT sion to recognise the role of located logistics hub for med- domestic companies (owned by ical equipment online traders Projects/promoters: 7 Indians) who “have valiantly and for national distributors Opportunity: $264.94 million fought competition and risked considering its central distance Private projects: 4 investments within the adverse to all parts of India. Government projects: 3 12 per cent to 15 per cent Major investors listed: 3M, Abbott, Baxter, Boston Scientific, B Braun disability factor and not only For Chennai, AiMeD’s rec- survived but tried to grow.” ommendation is to develop a MEDICAL EQUIPMENT MANUFACTURING PROJECTS medical park focused on instru- According to Nath, the ments like medical electronics Promoter Type Status of project Location Total Project Cost growth of the local medical de- and IVD. Whereas Trivandrum, Private sector $135 million vice sector has been stunted Kerala’s medical park should fo- Under West Sikkim due to lack of adequate infra- cus on latex and rubber tech- implementation, structure, supply chain and nology with a commonly shared tender awarded Last updated: logistics; high cost of finance; zero discharge effluent treat- August 2020 inadequate availability and cost ment centre. of quality power; limited design State government At idea stage Kerala $67.5 million capabilities; and finally, low Moving up the map of India, focus on R&D and skill Nath suggests that UP’s Noida State PSU/State Under development Sultanpur Medical $33.75 million development. should focus on small consumer Nodal Agency Devices Park, electronics and mid-sized elec- Telangana Interestingly, Nath specifies tronics along with IVD reagents that AiMeD doesn’t seek direct in collaboration with NIB. Last updated: subsidy for their members / August 2020 investors. Instead, they seek a Hyderabad, Telangana revenue support model and should focus on medical electri- Private sector DPR/Feasibility Palghar Medical $27 million CAPEX reduction assistance by cal equipment and implants Study in Progress Factory way of a coordinating role of needing clinical research stud- Upgradation state/ centre/medical device ies while Karnataka’s medical Project, park developer and most park should focus on embedded Maharashtra important, supporting policies and standalone software, AI that don’t cost (and will bring and IoT app-based products. Joint venture DPR/Feasibility Last updated: $0.68 million more revenue to Government) Study in Progress August 2020 by making manufacturing in The rationale for AiMeD’s India gain a competitive advan- suggestions is that the focus of Atal Nagar Health tage over imports. Otherwise, an existing or created cluster ATMS Project, he warns that “these parks will needs to be on shared back- Chhattisgarh remain as greenfield parks and ward integrated resources to not create humming factories provide economies of scale and Private sector Project completed Last updated on: $0.81 million that generate employment.” interdependent expertise of February 1, 2021 core skills and technologies that AMTZ: A model medtech are complementary but not dis- Hospital oxygen zone ruptive competition to existing manufacturing clusters. Projects that encour- plant Choudary of MTaI as well as oth- age import substitution need to ers single out the Andhra be encouraged and prioritised Private sector Idea stage Last updated on: $0.2 million Pradesh Medtech Zone (AMTZ) considering the volume August 9, 2020 as an example of a medical de- and range of medical devices vice park that is already doing that continue to be imported. Instant Diagnostics very well. He urges that the other Devices parks should also be developed Nath mentions that AiMeD Manufacturing Unit around either the defence manu- had recommended this model [Pune, facturing corridors which are re- to the Government of Andhra Maharashtra] energising thanks to the impetus Pradesh and Chief Minister the government is providing Chandra Babu Naidu for the Last Updated on: there or the already existing state’s AMTZ which is now con- August 9, 2020 manufacturing/ancillary hubs. sidered a model medical park. (Source: Invest India) Furthermore, MTaI’s view is He mentions that the other that all the PLI schemes should locations coming up in a again, not only by attracting who historically wish to profit ticals (DOP) for announcing be seen holistically and when- planned manner are possibly at overseas MNCs but supporting from our market but are shy of this Scheme in March and ever synergies are possible these Hyderabad and possibly at Nag- the Indian champions who are risking investments in creating giving further details, AiMeD’s should be maximised to alter the pur, Bangalore, Gujarat, the only fallback option in every factories.” request that as in the case of manufacturing profile of the Haryana, Tamil Nadu and Ker- crisis including COVID, vis a vis MeitY’s PLI Scheme, DOP country. Larger PLI schemes ala, Noida and Baddi whose overseas MNC owned company So, while he is thankful to should consider a special provi- that have significant synergy state governments have been the Department of Pharmaceu- with medtech should be kept in in contact with AiMeD and mind and driven together indicated interest. interdepartmentally. The large Nath is of the opinion that “we need to make India great 19EXPRESS HEALTHCARE May 2021
cover ) players will create the currents “Make in India and the goal I-LAB was conceived and devel- And tweak it as per the require- nation to invest in marketing which will assist the small play- for an Atma Nirbhar Bharat oped at a lightning speed and ments of this sector. new concepts, and lack of stan- ers in their flight and the small can provide the required fillip to manufactured and assembled in dard guidelines/ policies for players will bring the frugality achieve this growth. To add to a record time of eight days. In fact more sectors are manufacturing and quality con- and innovation which will bene- that, the pandemic has further clamouring to be part of the PLI trol. The medical device sector fit the large players and push the provided the necessary impetus I-LAB was conceived by the and cluster scheme. is relatively one of the more re- ecosystem forward, is Choud- to scale-up domestic produc- government to ensure testing fa- cent additions to the PLI scheme hary’s reasoning. tion,” is Vazirani’s analysis. cilities in lakhs of villages that do Sanjaya Mariwala, Founder and while the work done not have any COVID testing President of the Association of has been commendable, the PLI for IVD sector He alludes to the fact that the labs. I-LAB functions like a typi- Herbal and Nutraceuticals Man- pandemic makes the rollout of Government of India is begin- cal pathology lab with sample ufacturers of India (AHNM) and the PLI and med-tech park However, Vazirani is disap- ning to recognise the impor- collection, diagnostics, and re- Executive CMD, OmniActive scheme more crucial than other pointed that currently, the PLI tance of diagnostics in prevent- porting. The entire process of Health Technologies makes a sectors. scheme offers incentives of just ing and treatment of diseases, collection, testing and issuing of case for the nutraceutical sector, three to five per cent for the IVD pointing to the allocation of Rs reports is governed by the guide- pointing out that if the PLI In fact, one of the completed industry. “Such low incentive is 64,000 crores in the budget for lines issued by ICMR. scheme is extended to the nu- projects listed on the Invest In- too small to make India a global FY 2021-22, with a focus on pre- traceutical industry, it will stimu- dia site is an oxygen manufactur- player. There is a need to in- ventive healthcare. He feels this But though it was a great ini- late the needed investment to ing plant in a hospital. Another crease the PLI incentive to at should aid in boosting local man- tiative, Vazirani rues the fact that grow in size and scale. This will project is an instant diagnostics least 15 per cent for five years to ufacturing of diagnostic equip- the GoI did not decide to provide help make India one of the best devices manufacturing unit in help local manufacturers be- ment and test kits in India. an I-LAB to every district of In- manufacturing hubs in naturals Pune, Maharashtra. come global players,” is his take. dia to cater to the needs of all the and botanicals. In fact, the med-tech park villages in each district. If this Thus no other sector saves He points out that the cur- model has already benefited was done, he feels it would have As Mariwala points out, nu- lives, creates jobs and makes the rent COVID-19 pandemic has Transasia Bio-Medicals with a greatly helped contain the recent traceutical manufacturing is a country part of a global manu- shown that diagnostics is an es- partnership with AMTZ for var- spread of COVID-19 in thousands complex process and heavily de- facturing ecosystem. Hopefully, sential part of preventive health- ious launches like the mobile of villages. pendent on raw material avail- med-tech and med device com- care in every country. He does COVID-19 test lab to help faster ability. Proximity to the farms is panies, as well as the state gov- concede that the domestic diag- and safer testing across India, Good policy, slow very critical for both research as ernments who hope to partner nostic industry is still at a nas- called Infectious Disease Diag- implementation? well as manufacturing. While with them, will not have to wait cent stage, estimated at $9 bil- nostic Lab (iLAB), made at this is an advantage for India, much longer for their proposals lion (around Rs 675 billion) and Transasia’s Vizag manufactur- The consensus is that while not enough investors are consid- to become a reality. is expected to grow at a CAGR of ing facility at AMTZ. there is nothing wrong with the ering this sector due to a fear of approximately 15 per cent over PLI and med-tech cluster technology, lack of willingness to [email protected] the next five years. Thanks to the facilities and schemes, policymakers need to involve themselves in agricul- [email protected] expertise from AMTZ and DBT, speed up the implementation. ture and supply chains, disincli- CONTRIBUTOR’S CHECKLIST ● Express Healthcare accepts editorial management and professionals in the hospital department and e-mail address for material for the regular columns and from industry. 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INSIGHT Boost manufacturing of medical devices to accomplish ‘Atmanirbhar’ Bharat Mission Achal Chawla, Tax Partner, EY India and Divya Bhushan, Director, Tax, EY India opine that the new scheme for medical devices and creation of medical device parks would certainly empower the creation of a comprehensive healthcare network that can provide capital intensive facilities required by devices manufacturers along with contemporary manufacturing units capable of playing a critical role in meeting the country’s demand The COVID pandemic Achal Chawla, Tax Partner, cancer diagnostics, medical im- Divya Bhushan, Director, Tax, equipment, the importance of has brought unprece- EY India aging tools, ultrasonic scans EY India which cannot be overempha- dented attention to a and PCR technologies is slated sised in present times. nation’s need for self-suffi- pacemakers. to go down post its implementa- cilities to drive domestic pro- ciency in medical devices, sup- In order to qualify for in- tion. duction smoothly. Additional The new scheme for med- plies and echoed the vitality of common warehouse and logis- ical devices and creation of being ‘AtmaNirbhar.’ centives under the scheme, ap- In addition to hopefully tics facilities which also help medical device parks would plicants will have to fulfil the making India self-sufficient by reduce transportation and certainly empower the cre- Recognising the need of the minimum threshold invest- meeting its demand for med- warehouse cost. ation of a comprehensive times, in July 2020, the Gov- ment criteria of Rs180 crores, ical devices through locally healthcare network that can ernment of India announced as also the minimum threshold produced supply, this ambi- Presently, the Government provide the capital intensive the following incentive of incremental sales (over the tious initiative of the Govern- has received 16 applications facilities required by devices schemes to reduce depend- base year), ranging from Rs ment is also expected to put In- from different states, showing manufacturers along with con- ency on imports of medical de- 120 crores to Rs 560 crores. dia on the global map as a key an interest in the development temporary manufacturing vices, promote domestic manu- exporter of medical devices. of medical device parks. units capable of playing a criti- facturing of medical devices, Once eligible, the incentive cal role in meeting the coun- and help create a robust infra- will be granted at the rate of Presently, the Government Looking at success stories try’s demand, especially dur- structure: five per cent, for a period of of India has received 28 appli- of such parks in the past, it ing the current crisis. ◗ Production Linked Incentive five years (FY 2021-22 to 2025- cations under the PLI scheme, would not be amiss to mention Scheme for Promoting Domes- 26). of which, 14 applications have the Andhra Pradesh MedTech It would invigorate confi- tic Manufacturing of Medical been approved till March 2021. Zone which was approved by dence further if the Govern- Devices, with incentive outlay PLI scheme is indeed reflec- the Government in 2019. The ment relaxed the threshold for of Rs 3,420 crores (PLI tive of Government’s intention Supplementing the PLI Park produced ventilators, minimum incremental sales of Scheme) to promote an ‘AtmaNirbhar’ scheme is the scheme for the COVID diagnostic kits, N-95 Rs 560 crores and investment ◗ Promotion of Medical Device Bharat as the country’s cur- Promotion of Medical Device masks and Personal Protective of Rs 180 crores, as it will en- Parks, with incentive outlay of rent dependence on higher-end Parks. The scheme will help Equipment kits. Equipment – able a greater outreach of the Rs 400 crores medical products such as strengthen the country’s infra- schemes if the window is re- structure base such as compo- opened for fresh applications. Under the PLI Scheme, in- nent testing centres, create a Time is of the essence, so centives will be given to eligi- common warehouse and logis- speedy implementation of the ble players in specified seg- tics base, and attract large in- scheme is key. Any additional ments i.e. cancer vestment in medical devices allocation of budget for setting care/radiotherapy medical de- segments. up more parks could also help vices, radiology and imaging boost production in the near medical devices (both ionising Under this scheme, Gov- future. and non-ionising radiation ernment announced its inten- products) and nuclear imaging tion to establish four medical One is optimistic in looking devices, anaesthetics and car- device parks of Rs 100 crores to a future where we are self- dio-respiratory medical de- per park or 70 per cent (90 per sufficient, as now, more than vices including catheters of cent in the case of North East- ever, COVID has re-empha- cardiorespiratory category ern States) of the project cost sised the importance of a road and renal care medical de- of common infrastructure fa- map to self-sufficiency. The vices, all implants including cilities, whichever is less. above schemes are indeed a implantable electronic devices step forward in this direction. like cochlear implants and By incentivising such med- ical parks, the government will (Views expressed are personal) create world-class standard testing and infrastructure fa- 21EXPRESS HEALTHCARE May 2021
CANCER CARE INTERVIEW In India, immunotherapy has emerged as a highly successful strategy to treat malignancies In March 2020, APAC Biotech received the Indian patent for their cancer immunotherapy product APCEDEN, designed for cancer patients who have exhausted all conventional modalities of treatment. Backed by an advisory board of oncologists from India’s leading hospitals, the CDSCO-approved treatment has reportedly proven success in giving these patients median life benefit along with significantly improving their quality of life. Dr Bandana Sharan, Director-Research, APAC Biotech, reviews the development of the therapy, its scope, and the infrastructure and staff support hospitals need to put in place to offer personalised cancer immunotherapy, in an interaction with Viveka Roychowdhury How does personalised Limitations of the conventional mode of cancer low efficacy is not restricted cancer immunotherapy treatment regimen have paved the way towards to only chemotherapy, but work? What is the risk- more specific, safe, effective and autologous also to other prevailing benefit ratio compared with mode of customised immunotherapy, which cancer treatments as well. It existing therapies? harnesses a patient’s own immune system to is very important, that several Cancer is a devastating fight cancer personal factors should be disease that takes the lives of considered before selecting a hundreds of thousands of cancer treatment as, the people every year. There are effectiveness of these four main types of standard treatments depends on many cancer treatments: surgery, independent factors, such as radiation therapy, the type of cancer, carcinoma chemotherapy, and stage, site of the cancer immunotherapy. Due to development, metastasis, and disease heterogeneity, also patient associated factors standard treatments, such as such as age, immune and chemotherapy or radiation, genetic predisposition and are effective in only a subset overall health. of the patient population. The development of tumours can Thus, these limitations of have several different the conventional mode of underlying genetic factors cancer treatment regimen and may express dissimilar have paved the way towards proteins in one patient versus more specific, safe, effective another. This inherent and autologous mode of unpredictability of cancer customised immunotherapy, development lends itself to which harnesses a patient’s the growing need for own immune system to fight precision and personalised cancer. Immunotherapy medicine. treatments include monoclonal antibodies The role of chemotherapy (mAbs), checkpoint to overall survival benefit is inhibitors, cytokines, only approximately 4.3 per dendritic cell-based cent, due to the limited immunotherapy vaccines, and specificity of chemotherapy chimeric antigen receptor drugs. In spite of this, (CAR) T- cell therapies. The chemotherapy has been the adoption of dendritic cell- standard of care in treating based therapy vaccines (DCT) several types of cancers, and has steered the field of cancer oftentimes it may be the only treatment toward the concept option treatment available of precision and personalised that a patient receives. This medicine (PPM), in which 22 EXPRESS HEALTHCARE May 2021
therapy selection is tailored massive participation of prostate cancer, colorectal the DCT is a blood bank for marketing team was deployed to each individual. At APAC dendritic cells in optimally cancer and non-small cell conducting leukaphareses, and it’s the perseverance of Biotech through dendritic activating the immune system lung cancer (NSCLC). which most of the big the current research and cell-based immunotherapy, against specific cancer. hospitals possess. Our development team in securing we try to naturally mimic the How common is such services are currently present the authorisations from immune system to fight The results of our clinical therapy in India? How many in urban areas only. various hospitals. The cancer. trial suggest a significant patients use such company does plan to deploy survival benefit of 199 days for treatments annually? How many hospitals are a marketing and business The benefits of this the APCEDEN therapy In India, immunotherapy has part of the company's development team post the therapy include its proven treatment group when emerged to be a highly current network? Are there investment. safety and complete self- compared with the control successful strategy for plans to expand this derived autologous mode of group (356 vs 157 days). The treating malignancies in the network and if so, how will What is the increase in the action to foster the host event-free survival time of last decade. APAC Biotech is the 'manufacturing' number of patients treated immune surveillance system APCEDEN therapy was 439 a pioneer in such scale up? year-on-year? that gets activated through days in patients who advancement by being the Currently, the company has The number of patients has mature dendritic cells primed demonstrated an objective only Indian company which eight hospitals in its network: increased year on year with with an array of tumour response at first evaluation as has received a patent for their Sir Ganga Ram Hospital, nearly, 40 patients in the year antigens (derived from the per immune-related response DCT technology, approval Apollo Hospital- Indraprastha 2018, 60 patients treated with patient’s own tumour tissue) criteria. APCEDEN from Central Drugs Standard (Delhi), Hyderabad, Medanta DCT in 2019 and despite the that is infused back into the demonstrated highly Control Organisation Mediciti- Gurugram, Fortis COVID-19 crisis we have patient. The risk involves convincing survival benefits, (CDSCO), Directorate Hospital- Gurugram to name successfully treated 20 negligible side effects such as enhanced quality of life in General of Health Services, a few. They are also slowly patients in 2020. In the month mild fever in a few of the refractory cancer patients of January 2021, we have reported cases as evident banked nearly 20 tumours. from our clinical trial and Currently, the company has eight hospitals other studies performed on in its network: Sir Ganga Ram Hospital, What are the other DC-based vaccines globally. Apollo Hospital- Indraprastha (Delhi), Hyderabad, products and services Medanta Mediciti- Gurugram, under development? How does APCEDEN work? Fortis Hospital- Gurugram to name a few The latest facilities added Can you share the results of towards our product clinical trials done on the with stabilised cancer disease Ministry of Health & Family expanding to cover more enhancement include: product, in terms of median when compared with the Welfare, Government of India cities. The company is at the ◗ Keep My Tumour that life benefit, quality of life, control group. and manufacturing licence moment looking to raise funds includes Cryopreserving other markers? from Food and Drug to expand its network and to Cancer patient's tumours Our product APCEDEN is an What are the published Administration, Haryana scale up its manufacturing alive which helps them to autologous monocyte (CD14+) research papers on this State Government, thus capacity. benefit from Advancing derived Dendritic Cell (DC) product? contributing towards Indian Cancer treatments and based personalised APAC Biotech has six major economy and Make in India Do such patients receive diagnostic technologies that Immunotherapy that publications in international concept. APAC Biotech’s help to cover these expenses will be developed in the activates the patient’s peer-reviewed journals. Here Central Lab in Gurgaon is under any government future. immune system against is the link for the publications GMP (Good Manufacturing schemes? ◗ LTR-MEMVAXRALEUCEL: specific cancer. It acts by https://www.apacbiotech.com/ Practices) facility accredited Yes, patients receive cover The LTRM vaccine stimulating the production of immunotherapyresearch by ICMR and DCGI. We benefits for prostate cancer technology works by immune cells produced advance in the understanding under the government “tricking” the immune naturally in the body, that What is the average cost of of the dynamic interaction scheme through ECGHS. system into treating cancer target and attack cancer cells. such therapies? between the immune system as it would a viral infection DC itself is an immune cell Immunotherapy products are and cancer, and this has Does insurance cover such through the reprogramming involved in the recognition, sold for approximately resulted in the development therapies? of powerful immune cells processing and presentation $93,000 in the US and similar of a number of novel Yes, there have been a few known as dendritic cells. The of foreign antigens to the T- treatments in China costs therapeutic strategies that selective cases where some treatment is personalised cells in the effector arm of the around $30,000. APCEDEN harness several aspects of the TPAs have covered the cost of (e.g. uses the patient’s own immune system. Although developed by APAC, in immune system to treat DCT. tumour protein and own dendritic cells are the most comparison, costs cancer. About 50 patients are tumour mRNA amplified), potent Antigen Presenting approximately $10,000 (Rs being treated annually What has been the financial and like any successful Cells (APCs), they are usually 7.50 lakhs which includes the through APCEDEN. performance of the vaccine, is designed to be not present in adequate hospital charges). company over the past 12 long-lasting and quantities to allow for an What infrastructure and years? dramatically reduce the risk effective immune response in What kinds of cancers can staff support do hospitals Up until 2017, before the of future relapse. LTR-M will cancer patients. Dendritic cell be treated with this need to put in place to offer government authorisation, be tried on two very lethal therapy thus involves product? personalised cancer the company was purely cancer indications namely harvesting monocytes from Theoretically, we can treat all immunotherapy? Are such involved in research and GBM (Glioblastoma the cancer patient and solid tumours with services only present in processes to secure multiforme) and PDAC processing them in the APCEDEN, but as per DCGI urban areas? government approvals. The (Pancreatic ductal laboratory to differentiate approval, we can treat four The most crucial financial performance has not adenocarcinoma) where into mature antigen- indications: ovarian cancer, infrastructure required for been substantial as no median overall survival is presenting dendritic cells close to 1-1.5 years only. primed with patient-specific tumour antigens which are [email protected] then infused back into the [email protected] patient in order to allow 23EXPRESS HEALTHCARE May 2021
DIAGNOSTICS INTERVIEW The IVD market will be driven by technology, leading to the development of new devices that use high-end software Thomas John, Managing Director, Agappe Diagnostics, shares details about the trends, opportunities and challenges in India's IVD diagnostics sector and divulges the company's strategies for growth, in an interview with Lakshmipriya Nair What are some of the major rather than products. developments in the IVD market Molecular diagnostic tools will in recent years? Give us an overview of the drivers and dominate the market, as much as deterrents to the growth of the molecular science is going to Indian IVD diagnostics market. dominate the clinical field. Pre- One of the major developments in analytics is also expected to be recent years includes the advent of another main driver. Technology automated in vitro diagnostic tools adoption is likely to be faster owing that are efficient, accurate, and to the changes in end-use. One of the error-free in diagnosis. This has in main deterrence is the nature of the turn led to a big boost in the IVD sector itself. It is price sensitive manufacture of reagents, triggered and often witnesses intense by research and development competition in the development of initiatives in this area. All these instruments and reagents. The developments have taken place second deterrent is multiple because of the increase in the regulatory and standardisation prevalence of cancer, autoimmune mechanisms that stymie the diseases, and inflammatory application of new technology. conditions. We are witnessing the Currently, there is a lack of clarity on emergence of point-of-care these matters which is preventing analysers, laboratory-based Indian companies from making big analysers, handheld personal in vitro investments. diagnostics tools etc. Tell us about the shifts that this Agappe Diagnostics is the first sphere is witnessing as a result of Indian company to indigenously the COVID-19 pandemic. What are develop and commercially make the major lessons learnt from this available the three-part haematology health crisis and its management? analyser, that too during the peak of A significant development brought the COVID-19 pandemic. We are also by the COVID-19 pandemic is that all the first Indian IVD company to major players — Doctors, launch IoT-based semi-automated researchers, regulatory authorities, clinical chemistry analysers. We are the diagnostics industry, health the first Indian company to develop delivery systems — came together to the RT-lamp based COVID test kit, fight the virus. As the pandemic goes approved by ICMR and CDSCO through its course, it is important to sanction. These test kits have been take this initiative forward in tandem accredited by NABL for use by with the fight against the pandemic. laboratories. COVID-19 has taught a lot of In the coming days, the IVD lessons. Firstly, it brought out the market will be driven by technology, importance of molecular diagnostics leading to the development of new in the precise diagnosis of diseases. devices that use high-end software. It also showed up the big gap in the The focus will be on technology availability of reliable molecular 24 EXPRESS HEALTHCARE May 2021
diagnostic tools to carry out confirmatory manufacturers achieve the scales of tests and the need for affordable diagnostics revenue/sales to beget the benefits of the PLI technology with faster turnaround of results. scheme. The absence of a strong local IVD manufacturing sector could be felt during the What are your recommendations to ensure pandemic. Despite all these, our experience the sustainability of the IVD sector in the shows that the pandemic has witnessed the long run to achieve true Atmanirbharta? emergence of several indigenously developed India has always laid emphasis on technologies. Medical devices/IVD 'HealthCare for All'. Preventive health is one companies have incurred considerable of the major components of this policy. expenditure in R&D for developing COVID-19 Diagnostics plays an important role in detection and prognosis kits and other preventive health since most of the diseases consumables. are diagnosed at the pre-hospitalisation stage. Over 15-20 per cent of the health care cost is At Agappe, we have given emphasis on accounted for by pre-hospitalisation or pre- technology, investing over five per cent of our surgery diagnosis. These tests are not revenues in R&D. As mentioned earlier, we covered by insurance. To ensure the launched the three-part haematology analyser sustainability of the IVD sector and truly and the COVID-test kit. The IVD sector has an achieve Atmanirbharta, pre-hospitalisation important role to play because the shift will be and pre-surgery diagnosis should be brought to pre-analytics and post-COVID prognosis, under the insurance coverage. If necessary, even as the co-morbidities become exposed in the government should bring in new the post-pandemic phase. Preventive legislation or move an amendment to the healthcare will also play a major role, existing insurance laws to facilitate this. Such requiring the Government to seriously rethink a change will go a long way in achieving its strategies. preventive health and further the national goals of 'Healthcare For All'. Apart from the How has the government’s thrust on Make fact that it would ensure the sector’s in India and support for indigenous sustainability in terms of technology manufacturing of medical devices helped development and affordable products, it the IVD diagnostics sector? How is Agappe would address the healthcare issues of the Diagnostics poised to benefit from these rural population. schemes and policies? The Government of India’s medical devices Tell us about Agappe’s plans for the next policy and the PLI scheme have been widely three years. Any major investments and welcomed by the industry. collaborations in the pipeline? After launching the first semi automated But one should understand that the specific protein system in India in the year Medical Devices policy pre-dates COVID-19 2011, today we control the protein estimation pandemic. Therefore, its outcome must be in India and the neighbouring market, making evaluated in the context of the pandemic and specific protein-based diagnosis and the lessons it has taught us. As mentioned prognosis affordable to the masses. Our earlier, the pandemic exposed the virtual non- recent launch of Mispa Count X, the first existence of a local home-grown industry. Made-in-India, three-part haematology analyser is another milestone towards our We strongly hold the view that the “Made commitment to Aatmanirbhar Bharat as in India” products must be competitive on envisaged by our government. Our aim is to quality as well as cost-effectiveness. The focus become the number one IVD company in India should be on technology solutions developed by 2025. locally through strong R&D to meet our nation’s needs. We also require an ecosystem What is the change that Agappe intends to to commercialise innovations and incremental bring about in India’s diagnostics sector? innovations into reliable products. In this How are you working towards it? context, the Government policies need to be Agappe is always known as a true innovator in fine-tuned further so that investments in the the IVD sector, bringing out revolutionary IVD industry goes hand in hand with products. Our success mantras are innovations and technology development. Innovation, Quality and Affordability. We have industry-industry partnerships and industry- We feel that both challenge and academia partnerships to enhance our opportunity lie in recognition and rewarding product portfolio. We are planning to of Innovations and incremental innovations of introduce compact and user-friendly systems domestic Medical Devices/ IVD industries, in haematology, clinical chemistry, particularly those companies that have immunology and molecular diagnosis. Our invested time, energy and funds to make aim is to bring in affordable solution in the IVD “Make in India” happen. To take this forward, segment to address the masses in India and we suggest that expenditure in R&D incurred nearby developing countries. by domestic/homegrown IVD companies be considered for reward and factored into the [email protected] PLI scheme. [email protected] Secondly, the Government should announce a Preferential Purchase policy and Pricing policy. This will go a long way in assisting domestic/homegrown IVD 25EXPRESS HEALTHCARE May 2021
DIAGNOSTICS Diagnosis is better than disease Rajesh Patel, CEO, IVD - India, Trivitron Healthcare elaborates on the crucial role played by diagnostic tests at every step of disease management – diagnosis, monitoring, screening and prognosis There are rights to cial role at every step of dis- Diagnosis tic test detects a possible con- a particular illness, to find out which we are entitled, ease management – diagnosis, dition or confirms the lack of if the illness has begun to de- simply by virtue of our monitoring, screening and Diagnosis helps find out if a one. Sometimes diseases need velop quietly. These tests are humanity. Among all the prognosis. patient is suffering from a to be studied over and over for sometimes applied to popula- rights to which we are enti- specific condition. A diagnos- not just their nature but also tions at community levels and tled, health care may be the their stage or degree of devel- are therefore affordable and most intersectional and cru- opment. Diagnostic tests form easily accessible by all. cial. Universal health care is the framework with which crucial to the ability of the healthcare professionals are Prognosis most marginalized segments able to better assess the effec- of any population to live lives tiveness of the chosen treat- Prognosis is a little far- of dignity. And for better ment in stopping the progres- fetched, in that it helps assess healthcare, the need for detec- sion of the disease. the likelihood of developing a tion and timely treatment has disease in the near or distant clearly emerged as the need of Monitoring future, thereby assisting a pa- the hour. In healthcare, diag- tient to take necessary pre- nosis helps improve patient Some chronic diseases cannot cautions much earlier than re- care, contributes to be cured, but the chosen quired of him. Genetic tests, protecting a patient’s treatment, medications, hor- for instance, analyse a pa- health and in some cases even mones and lifestyle changes tient’s predisposition for de- helps limit healthcare can go a long way in avoiding veloping a disease, allowing spending. a worse situation in the fu- the patient and his doctor to ture. Monitoring look for de- be more attentive to discover- For over half a century crease or increase in the dis- ing early signs and to take that has gone by, innovations ease, which helps in multiple preventive measures. in diagnostics transformed treatment options. the practice of medicine. Ad- Thus, diagnosis is integral vancements in technology Screening to the process of detecting, have further enabled the de- treating, producing accurate velopment of new generations Some diseases like the mod- results and curing illnesses. of diagnostic tests. These ern COVID-19, while in the ini- Diagnostic tests impact major technologies have revolu- tial stages, may present mini- healthcare decisions, though tionised healthcare, by mum or no symptoms at all. it also relies on an accurate in- guiding timely medical This is where screening terpretation of the test re- intervention. comes into play. Screening sults, judgment and an expert studies patients who do not bent of mind in prescribing Diagnostic tests play a cru- yet present any symptoms for the treatment. 26 EXPRESS HEALTHCARE May 2021
RADIOLOGY Chest CTilluminates mortality risk in people with COPD A greater amount of intermuscular fat was associated with higher mortality rates Body composition infor- suggested in several chronic Dr Bluemke, along with Farhad rates. Existing research has of adverse health events. mation derived from illnesses. Pishgar and Shadpour linked higher levels of inter- Body composition assess- routine chest CTs can Demehri from Johns Hopkins muscular fat with diabetes and provide important information Chest CT is often used to School of Medicine, and insulin resistance. ments taken from chest CT on the overall health of people characterise COPD, screen for colleagues used chest CT ex- also present an opportunity for with chronic obstructive lung cancer, or plan for surgical ams to study the associations Higher subcutaneous artificial intelligence-derived pulmonary disease (COPD), in- options. Beyond lung assess- between imaging-derived soft adipose tissue, in contrast, was algorithms that could quickly cluding their risk of all-cause ment, these exams offer an tissue markers and all-cause linked to lower risks of and automatically add risk mortality, according to a study opportunity to assess obesity mortality in COPD. all-cause mortality. assessment to the imaging published in Radiology. and sarcopenia through soft- report. tissue biomarkers. The study group was made The authors convincingly COPD is a group of chronic, up of 2,994 participants drawn showed fat in the muscle was “I expect that more studies progressive lung diseases like “Chest CT scans have long from the Multi-Ethnic Study of much more predictive of in the future will begin looking emphysema and chronic bron- focused on the lungs or heart. Atherosclerosis (MESA), a bad outcomes than a simple at all information on the CT, chitis that affect about 30 mil- Few prior investigators have large trial investigating the distribution of subcutaneous rather than just one organ at a lion people in the US alone. It is evaluated muscle quality, bone roles of imaging-derived soft- fat. time,” Dr Bluemke said. “Clini- frequently associated with obe- density, or degeneration of the tissue and bone markers for cians will need thresholds sity and sarcopenia, a loss of spine as an index of overall predicting outcomes relevant The findings point to a when to intervene when fat or muscle mass and strength. health. These are readily avail- to cardiopulmonary diseases. role for body composition bone abnormalities become Obesity is associated with able and quantifiable in these Of the 265 patients in the study assessment in people with severe.” lower mortality in patients with CT examinations,” said study group with COPD, 49 (18 per COPD who undergo chest CT. COPD. The longer survival co-author and Radiology editor cent) died over the follow-up Such assessments are readily The study was just the rates of obese patients com- David A Bluemke from the period. obtainable in clinical practice. latest to tap into imaging data pared to leaner counterparts, a University of Wisconsin School from the MESA trial, a phenomenon known as the of Medicine and Public Health A greater amount of In theory, CT-derived body collaboration involving more “obesity paradox,” has been in Madison, Wisconsin. intermuscular fat was associ- composition assessments than 6,000 men and women ated with higher mortality would provide an opportunity from six communities across For the new study, for earlier interventions in the US. patients who face a higher risk Digital breast tomosynthesis reduces rate of interval cancers A reduction in the interval cancer rate when using DBT might be attributed to improved detection of rapidly growing cancers with poorer prognosis, possibly contributing to lower breast cancer mortality Screening with digital breast would not have caused harm to reduction in the interval cancer The interval cancer rate in cancer screening. However, Dr tomosynthesis (DBT) re- the patient in their lifetime. rate when using DBT might be the patients screened with DBT Johnson cautioned that other duces the rate of interval breast attributed to improved detection and digital mammography was trials have not shown signifi- cancers compared to screening The rate of interval can- of rapidly growing cancers with 1.6 per 1,000 screened, signifi- cantly reduced interval cancer with digital mammography, cers—cancers that arise be- poorer prognosis, possibly con- cantly lower than 2.8 per 1000 in rates in DBT screening com- according to a study published in tween routine screenings—of- tributing to lower breast cancer the group screened with digital pared to digital mammography Radiology. The study adds to a fers one way to better elucidate mortality. mammography only. The screening. And interval cancer growing body of evidence sup- screening benefits. They are interval cancers in the trial rates, while important, are not porting DBT as a breast cancer considered more aggressive For the new study, Dr John- generally had non-favorable the only measure when evaluat- screening tool with important than cancers detected during a son and colleagues compared in- characteristics. ing the potential benefits from advantages over mammography. screening exam. terval cancer rates in Sweden’s DBT in screening. population-based Malmö Breast The reduced interval cancer DBT works by capturing a “Interval cancers have, in Tomosynthesis Screening Trial rate after screening with “Other factors, such as series of X-ray images of the general, a more aggressive with those from an age-matched DBT could translate into cancer types detected and breast from different angles. biological profile than screen- control group of patients who screening benefits, according to cost-benefit, have to be taken Previous research has shown detected cancers,” said study underwent digital mammogra- Dr Johnson. into account,” Dr Johnson said. that it has a higher sensitivity for lead author Kristin Johnson, ra- phy at the same center. breast cancer detection than diology resident at Skåne Uni- “One could speculate that Toward that end, the digital mammography. versity Hospital in Malmö, and The study group included al- some of the additional cancers researchers are working on a Ph.D. student at Lund Univer- most 15,000 women who were detected in DBT screening cost-benefit analysis of the The impact of these addi- sity, Sweden. “This means that screened with DBT and digital would have been diagnosed as Malmö Breast Tomosynthesis tional DBT-detected cancers is the prognosis is less favorable mammography between 2010 interval cancers if not detected Screening Trial. They are also not fully understood. While they for interval cancers compared to and 2015. Those women were by DBT,” she said. analysing the trial for false may constitute a screening bene- screen-detected cancers.” matched with a control group of positive recalls, those instances fit, they could also contribute to more than 26,000 women who The results support the when patients are called back overdiagnosis, a term for the Interval cancer detection had only digital mammography growing evidence of DBT as a for additional screening for diagnosis of early-stage, rate reporting is required in screening during the same time screening modality with suspicious findings that end up slow-growing cancers that many screening programs as an period. potential to replace digital being benign. indicator of effectiveness. A mammography in future breast 27EXPRESS HEALTHCARE May 2021
IT@HEALTHCARE Digital tools as medical devices for transformation of healthcare services Dr Paritosh Basu, Senior Professor, NMIMS School of Business Management elaborates on some potential applications of digital platforms and tools that can help implement India’s National Digital Health Blueprint successfully The COVID-19 virus has care, better access, universal for achieving related legal pro- equipment, devices, oxygen; attending doctors’ computers. exposed the healthcare health coverage, and inclusive- visions and objectives outlined and related logistical With such interventions, doc- shortcomings of nations ness”, and Paragraph 5.4 of the in the NHP and NDHB. This arrangements, etc. tors would even be able across the world, forcing us all NDHB further outlines “Meth- process would forestall citizens’ to monitor patients’ sleeping to realise the magnitude of the ods & Instruments recom- anxiety towards digital enslave- The results from such stud- patterns. chasm in our infrastructure for mended by NDHB’. All these, in- ment. ies would help in identifying ■ Software as a medical healthcare service delivery. All ter alia, reveal the government’s trends in citizens’ health condi- device: The software used for countries, irrespective of their objectives and intent for appli- Such a platform can be de- tions segmented by age groups, all the above digital solutions levels of economic development, cations of digital tools and plat- signed with a pyramidical node gender, comorbidities, geogra- would serve as a medical device have been caught underpre- forms, for delivering healthcare structure, from individual citi- phy, etc., and insightful infer- for improved speed and quality pared, and India is no exception services with a smile. zens at the base, to local munici- ences drawn about the efficacy service deliveries, and would to this stark reality. palities/panchayats, to district of medical tests, treatment help prompt accurate diagnoses Here are some potential ap- and state levels. It can be inte- methodologies and drugs ad- and treatment-related decisions Globally, countries have re- plications of digital platforms grated with the similar platform ministered. The aforemen- for saving precious lives. Edge alised that preventive measures and tools that can help imple- of the federal government for in- tioned blockchain platform can computing software would help reduce burdens of hospitalisa- ment India’s National Digital teroperability. This design be seamlessly integrated to en- in reducing load and accelerate tion, intensive care, and expen- Health Blueprint successfully: would help in achieving coopera- sure the collection of data with- data processing. Software used sive treatments. The quicker ■ Blockchain-based health- tive federalism, which is out any human intervention and for the ‘AmazingTrio’, viz., the response time, the lesser care platform: A blockchain NDHB’s fourth objective. maintaining only one version of Blockchain, IoT and AI, would would be the intensity of crises technology-based platform can ■ Cognitive intelligence and the truth. After all these fast update Blockchain nodes escalating with unmanageable seamlessly record and help data analytics: The fifth objec- processes are performed, the using RPA and Bots. It is also dimensions. Universal altruism medical and health manage- tive of NDHB is to promote following objectives of NDHB advisable to introduce Central should be the mantra for ensur- ment right from expression of health data analytics and med- would, in all probability, become Bank Digital Currency for ing collaboration among stake- need to settlement of pay- ical research. Applications of achieved realities: enabling blockchain platforms holders within and across all na- ments/availing of government Artificial Intelligence (AI), Ma- ◗ Enhancing the efficiency and in the impromptu settlement of tions and multilateral agencies. grants. It can also update, stack chine Learning (ML) and Big effectiveness of governing financial transactions. and store citizens’ identity, Data Analytics would help in healthcare services across all ■ Digital Health Passport for For any healthcare infra- health data and documents in a achieving this objective. Digi- strata of society with speed and international travelling: The structure, the major building retrievable digital library. The talised core health data, various timeliness, day is not far when international blocks are collection, safe stor- encryption of all inputs facili- test reports, doctors’ prescrip- ◗ Ensuring quality of healthcare, and domestic travellers would age and analytics of data related tates safety, privacy, security, tions, surgical history, etc., can and need to carry another passport to citizens’ health and medical immutability, auditability, and all be retrieved directly from the ◗ Leveraging the legacy infor- to cross sovereign/state bound- conditions across societal transparency, for patients as digital library. Films for X-Rays, mation systems already existing aries other than the one issued strata, service providers, manu- well as medical services Sonography, CT Scans, etc., can in the health sector. by immigration authorities. This facturers of medicines and de- providers. Authorised partici- also be analysed for predictive ◗ Integration of equipment and Health Passport would be digi- vices, results from their applica- pants of this platform would analysis and diagnosis. devices tally issued and managed by the tions, and research. This should have two separate keys for ac- ■ Integration of equipment same Blockchain Platform. be supported by appropriate cessing and performing trans- Similar research-oriented and devices: Digital transfor- documentation following a pre- actions from individual nodes of data analyses can also be con- mation of diagnostic tests, tele- India has taken on a colossal scribed set of guidelines. One the ‘Distributed Ledger Plat- ducted for service providers, treatment, robotic surgical pro- challenge in embarking on this would not come to a different form’, which Blockchain is syn- such as insurance providers, cedures, and the like, would help long journey in the quest to en- conclusion even if the present onymously known as. Because hospitals, doctors, paramedics, in interconnecting and updating sure good health for all. Yet, pandemic is taken out of our cal- of all these features, the infor- pathological and radiological events and records online on a none can conclude that it is not culations. Well-defined policy mation contents of the platform laboratories; manufacturers of real-time basis. We have already achievable. Our nation must de- guidelines with an orchestrated would be near impossible to be medicines, medical kits, witnessed the impact of APIs rive benefits from its vibrant plan for action is the clarion call hacked, modified, erased, or ex- and Bluetooth in instances such startup ecosystem and cerebral of the day. ploited with ulterior motives. as connecting smart stetho- innovators, and there is an im- scopes enabling doctors to view mediate need to coordinate the India’s National Digital This platform operates with a ECGs on their smartphones. efforts of all stakeholders. Health Blueprint digitally embedded ‘Super Tools such as Internet of Body Smart Contract’ and event-spe- (IoB), integrated into a patient’s Reference In July 2020, NITI Aayog cific smart Contracts’, to be dig- body, and Internet of things shared India’s National Digital itally signed by and between (IoTs), integrated into Sonogra- http://www.innoventionians. Health Blueprint (NDHB) as a stakeholders with/without mod- phers, CT Scanners, Ventila- com/wp-content/up- sequel to the National Health ification(s). The terms of such tors, etc., would help in trans- loads/2020/09/13th-Monthly- Policy, 2017 (NHP). This Policy contracts typically ensure com- mitting signals directly to the Column-Digital-Transforma- laid down the key principles of pliance with policies and SOPs tion-September-2020-1.pdf “… citizen-centricity, quality of 28 EXPRESS HEALTHCARE May 2021
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HEALTHCARE TRACKER INTERVIEW GE’s Centricity High Acuity – Critical Care solution has helped with better patient outcomes in the ICU Dr Sunil Kumar Garg is a Senior Consultant from the Institute of Critical Care Medicine and the Founder of Saiman Healthcare. Saiman Healthcare prides itself in bringing critical care to patient’s homes at an affordable cost. Dr Garg recently adopted GE’s Centricity High Acuity – Critical Care solutions. Here he tells us how remote monitoring devices are making a significant difference to the way critical care is shaping in India and how this is redefining the future of Indian healthcare What made you start and overwhelmed with analytics prompt and trigger probably helps in faster It’s just a matter of time Saiman Healthcare? patient data, prescriptions, real-time clinical experts recovery. before remote patient care After completing my MBBS management, and with video support. So, we devices become a household and MD from Rajasthan in monitoring. are always there for our How has this impacted your name. With less severe cases 2007, I did my higher training patients and this instils hospital’s functioning? showing up at hospitals, in Critical Care Medicine in That’s why we decided to confidence in them, which It has helped us on two more beds can be allocated to Delhi. While working at a leverage GE’s Centricity fronts. One, in terms of needy and critical patients, multi-speciality hospital Virtual Care solution. An providing thebest possible accurate and timely care can there, I saw ahuge gap that easy-to-use and easy-to-train care to our patients,and two, be provided to patients at all needed to be filled. Although device, it provides the ICU empowering our staff with times, making disease many speciality hospitals are staff with 24/7 support, the confidence to handle management more efficient providing intensive care eliminates the need for a critical cases seamlessly. and effective. around the capital, their dedicated virtual solution, Where earlier we were skyrocketing prices would and leverages existing struggling to track and What metrics are you often drive the patients back integration. monitor patient treatment tracking to measure home. While cost and limited and care through WhatsApp improvements in care beds were my concerns, I How have your patients and legacy systems, today delivery? believe healing happens taken to this new form of our nurses can provide There has been tremendous faster at home, where you are treatment? Are they diligent ICU care from their improvement in the way surrounded by your loved comfortable with the command centre, which intensive care is carried out ones and positive vibes. doctor not present manages all the patients’ today. We can constantly That’s why I decided to bring physically? data single-handed. monitor our patients and quality critical care to What’s better? The doctor maintain protocol standards patients’ homes. Today, we present virtually or not How has patient treatment even with a high volume of are operating in and around present at all? One doctor changed since adopting patients. The disease Delhi, we plan to scale up to cannot tend to every patient Centricity High Acuity? exposure threat to the tier 2 and tier 3 cities soon 24/7. That’s the reason we This solution has helped with clinicians has been and slowly make ‘ICU at adopted the centricity better patient outcomes in minimized. Data home’ a reality across India. solution. Now the patients the ICU. From our earlier management and archiving stay home and heal faster. nurses to patient ratio of 3:1, have become simple, which What made you adopt GE’s Centricity Virtual Care today we have moved to 2:1. leaves the nursing staff with Centricity Solutions? solution and its advanced more time to take care of the Critical patients require patients and not focus on the constant and continuous GE’s Centricity Virtual Care solution is an administrative work. monitoring. With the doctor easy-to-use and easy-to-train device. It provides to patient ratio so the ICU staff with 24/7 support, eliminates the need For support, contact: inadequate, we were faced for a dedicated virtual solution, and leverages 1800-102-7750, with various challenges in existing integration 1800-419-7750, terms of providing timely 1800-425-7255 or care to our patients through 1800-425-8025 | other means. Our clinicians [email protected] | and staff were overworked [email protected] 31EXPRESS HEALTHCARE May 2021
HEALTHCARE TRACKER INTERVIEW Venue Go is able to show clinicians everything in one go from head to foot in the shortest time possible Prof Dr N Ganapathy is the Chairman of Dhanvantri Hospitals situated in Erode, TN. He is specialised in Critical Care. He has led the hospital in the use of cutting-edge diagnostic and clinical tools for medical treatment and interventions. This has made treatments accessible to the rural and semi-urban populace while providing basic healthcare, with techniques that are on par with international standards. Below he tells us how the use of Venue Goby GE Healthcare, a Point of Care Ultrasound has made a significant difference to the way treatment outcomes are managed in his hospital How are common workflow quickly replacing a physician’s what is happening even at the so they know what to do and papers published on this. With gaps addressed with the use stethoscope. tissue level. I wholeheartedly conduct early diagnosis using rampant cases of Pulmonary of Ultrasound? How is the Venue Go product suggest this device to be made first level indicators. In Fibrosis and Toxicology, this Working in a hospital in a making a difference in your mandatory in the MBBS normal circumstances, we get machine helps visualise small town like Erode can be clinical practice over the curriculum, internship and in 8-10 cases at our hospital. improvement of the lung very demanding given the previous generation of final year medicine. Students Each case takes 60-90 condition thereby impacting large number of patients we Ultrasound? should be focused and trained minutes with this machine, for treatment. It shows see - both in-patient and Being a bedside portable in point of care in-depth examination from improvement of oxygen across remote areas. Patient machine, it is able to show us ultrasonography. head to foot including arteries, saturation, tissue repairs and management is a time clinicians everything in one go bones, soft and hard tissue. more. intensive process that needs from head to foot in the Senior staff nurses are This machine saves time in the coming together of several shortest time possible. already getting trained in this, emergencies and critical care Bronchoscopy and culture different modalities and cases. sensitivity which is normally procedures. Having a varied We’ve been carrying the done for lung problems takes set of diagnostic tools often stethoscope, ultrasound and How does lung sonography time to assess, and we often means long waiting times to so many tools with us help in respiratory diseases begin treatment for such take major critical decisions. everywhere. Now one such as current pandemic? conditions before reports This impacts morbidity and intelligent, precise machine In case of COVID-19 and other come in. With this ultrasound, mortality outcomes and can can do everything. Previously, respiratory diseases, reading we can see changes almost prove labour and cost a stethoscope was used to get lung scores is unimaginably immediately, whether patient intensive. Having the Point of heart rate, but now the good through this machine, is deteriorating or improving. Care Ultrasound machine has POCUS probe can be placed and MRI doesn’t need to be It helps pre-empt diagnosis been a boon in reducing directly on the heart to know done. There are several and doesn’t require shifting of several of these diagnostic patients during MRI, because impediments - accuracy of Lung Score everything happens at the procedures, efficacy of bedside. outcomes, progress of treatment and making a What is the future of tangible and significant Artificial Intelligence in impact on the people we treat. Point of Care Ultrasound space? Since how long have you Artificial intelligence is been using Ultrasound for revolutionising medicine, Point of Care applications? giving us new precise Point of Care Ultrasound is a perspectives to use our skills very good tool being used in and treatments. Using the AI our hospital since 2000. For tools of Venue Go, i.e. Auto B- the last 20 years, it has made a Lines and Auto IVC, helps in big difference in the way providing quick diagnosis, diagnostic tools are accessed early treatment and getting and used. In today’s times patients back to their daily ultrasound is no more the lives faster. This also helps in purview of a specialist but is equipping students better for the long run. 32 EXPRESS HEALTHCARE May 2021
HEALTHCARE TRACKER Radiometer Medical India launches 24/7 Toll-Free Helpline Number for its customers This helpline number was commissioned from April 15, 2021 to help improve customer service Radiometer Medical ter Medical will allow Service Global Services & Customer allowing our Service Engi- access to Radiometer leading India announced the Engineers to remotely moni- Support, Anders Myhre was neers to remotely trou- to less downtime, if any. At the launch of its 24/7 tor and access the analyser. quoted as saying, “Delivering bleshoot, ensuring speedy end of the day it is about service helpline through uninterrupted customer resolution, remote security ensuring a positive experience single Toll-free number 1800- Speaking on this occasion, service and expertise have al- updates, reduced downtime and an enhanced level of 266-3837 for its customers in Radiometer Medical India, ways been our focal point. and improved productivity at satisfaction to all our India which will commence General Manager, Smit Dave The unprecedented COVID customer’s site.” Diagnosing customers.” from April 15, 2021. In the was quoted as saying, “In crit- wake of the pandemic, ensur- crisis has however made it the analyser remotely will al- Radiometer Medical India ing timely and quality service ical care settings, time is quite challenging. Amidst the low the service team in quick aims to deliver unmatched to every customer gained a lot LIFE. There is no technology travel restrictions, it wasn’t closure of cases of break- customer service support to of impetus, making the need in the world which cannot face easy for the Service Engi- down, sparing the Service every customer at all corners of timely support exceptional a breakdown. By having a neers to be available at cus- Engineers time to resolve of India with an effort to re- and more pronounced. 24/7 customer support on Toll tomer’s site to attend break- more cases every day. duce complexity and increase Free number, we expect to re- down calls, given that several automation. The launch of this 24/7 duce the TAT during such installations are at remote lo- Ana Magalhaes, Radiome- helpline service will give an breakdowns and thus stand cations in India. The launch ter Medical, Director – Cus- About Radiometer extra boost to the Customer shoulder to shoulder to our of 24/7 toll-free helpline is tomer Experience & Training, Medical service efforts made by clients. We want to be avail- our promise to support our stated, “With a dedicated Radiometer Medical India so able all the time. That is our customers round the clock. helpline number, our team of Radiometer is a medical de- far. Having a 24/7 dedicated purpose, our value proposi- This helpline will further har- Service Engineers will be just vice company. At Radiometer, toll-free number will allow the tion – Whatever comes next, ness the existing capability of a phone call away from our our mission is to help care- customers to reach out to the we make sure life comes first.” remote diagnosis of analy- customers. The 24/7 helpline givers make diagnostic deci- Service Team whenever there sers through LIVE Connect, will ensure customers have sions that save lives. We help is a need to troubleshoot. It Adding to that, Radiome- convenient, round-the-clock develop products and solu- will be handled by a team of ter Medical, Vice President – tions that provide healthcare proficient Service Engineers professionals with the critical who will be equipped to diag- information they need in nose the breakdown of the acute care diagnostics. Our analysers and take necessary diverse community of col- pre-emptive actions in allo- leagues share a common iden- cating the resources in case tity, mindset, and purpose to the site needs to be visited. empower caregivers to make Backend integration of this diagnostic decisions to im- helpline with LIVE Connect, prove patient care, because the exclusive remote service for us, answering what’s next solution offered by Radiome- in health care starts with what comes first – life. 33EXPRESS HEALTHCARE May 2021
HEALTHCARE TRACKER CASE STUDY Remote solution improves cardiac care GE’s remote consult ECG solution comprises a cardiology information system that integrates, manages and streamlines the flow of cardiac information Cardiac care challenges in a potable, compact solution with a solution is robust, scalable and centers, the lab currently gener- representation of cases at terti- North East India central hub integrated with re- integrates with devices as varied ates more than 600 reports ary care setups followed by high mote medical devices for the re- as across 13 centers. An unexpected risk of mortality. To date, India clocks 2.1 million porting and analysis of medical Cardiac assessment system for positive outcome of the solution deaths every year - with rural data - was developed in 2018. Exercise Testing to Ambulatory has been the accidental discov- \"Cardiac care has made residents overtaking the urban ECG’s, streamlining workflow ery of underlying health condi- progress in leaps and bounds in populace. 1 While thought to be “When I saw patients losing and clinical benefits. tions by specialists prior to elec- India…though access to quality more prone to infectious their life due to lack of such basic tive surgeries, thereby reducing and timely care is still a big road- diseases, now the northeastern facilities, I knew something has Built along the hub and spoke complications and morbidity. In- block especially in rural commu- belt in India is facing health to be done. Saving lives by model, the ECG systems were in- frastructure and setup costs nities…where reliable equipment conditions arising from lifestyle ensuring early detection was stalled at Guwahati’s primary fa- have reduced. The solution has and expertise would be major disorders. the only motivation when I cility as well as various hospitals also shown capabilities of func- challenges…hence people would decided to invest in this and clinics around the state. tioning in transit while patients delay seeking consultations and ECG machines, the critical project,\" - Dr Das. Nurses and technicians were are moved from ambulance to conducting investigations diagnostic tool for heart ailments trained to use the simple solution healthcare centers. despite complaints and is available mostly in urban GE’s remote consult ECG and interface with the central fa- symptoms. I congratulate and areas, but their penetration in solution cility, while expert cardiologists “Before the installation of Re- thank Dr Bikash Rai Das and rural setups - especially tier 2 reviewed the ECG graphs 24/7. mote Consult ECG Solution, it team for being the early adopter and 3 cities - remains largely Lightweight, compact, and re- would take a week to get the ECG and mastering the Remote inadequate., with most quiring minimal connectivity experts operating almost with a quick turn-around-time, Feeling the beat of impact data interpreted, now it takes 10 consult ECG technology exclusively in cities. the solution comprises a minutes, and seamless commu- well to save precious lives from cardiology information system Within 7-8 months, the solution nication with physicians and car- the day one they started using The need for a solution that that integrates, manages and was extended to more than 25 fa- diologists seated across remote the Remote Consult ECG could increase cardiac care pene- streamlines the flow of cardiac cilities in Assam, including some areas of the state.” - Bijit Rai Das, solution.\" – Amit Mohan, tration in this market, break- information. The system con- of the most remote parts of the Chief IT Manager, Accurate Labs Business Head - LCS & LCS through the infrastructure chal- nects data with diagnosis. Com- region. The review of ECG re- Digital, GE Healthcare South lenges and harness better prising a central hub with the Ac- ports by trained cardiologists There are very few practicing Asia diagnostic interpretations cuRate Lab as the centre of 24/7, significantly improved cardiologists in most remote lo- prompted Dr Bikash Rai Das, excellence, the solution acquires quick medical interventions en- cations in India. As per recent The work with AccuRate Cardio Thoracic Surgeon and patient data from general physi- suring positive results. Tertiary statistics, India has ~4,000 Labs on the Remote Consult Chief Cardiologist at AccuRate cians at nodal centers across re- care physicians who directly in- cardiologists, while 88,000 are ECG Solution is an exciting and Labs Guwahati reach out to mote parts of Assam, analyzing teracted with patients, received needed to cater to the popula- encouraging demonstration of GE Healthcare to address the and interpreting the data for fur- well-interpreted reports within tion. In few states and regions, GE Healthcare's commitment to problem. ther diagnosis and treatment. 10 minutes of conducting ECG on the presence of cardiologist is optimize medical solutions to Unlike the traditional ECG, the patients. From 33 reports being negligible. Thus, sparsity in make high-quality healthcare As a result, GE Healthcare’s generated per month across five specialists has led to delayed more accessible to all. Remote Consult ECG Solution - 34 EXPRESS HEALTHCARE May 2021
HEALTHCARE TRACKER ThoracicVCAR: New age technology from GE Among other benefits, it improves the lung segmentation and brings enhanced functionalities for parenchyma analysis to identify different ranges of HU variances within the segmented lung fields Chest and lung scans measurements of the lungs to analysis. Using Thoracic Recently released new ver- variances within the segmented make up 20 per cent of aid in the assessment of lung VCAR, users can generate a sion of Thoracic VCAR im- lung fields. It helps to character- all computed tomogra- disease. The application blends clear, concise report that com- proves the lung segmentation ize and quantify areas of low and phy (CT) scans globally and automated lung and airway municates vital medical infor- and brings enhanced functional- high attenuation within the currently, this number is much segmentation with basic re- mation to referring physicians ities for parenchyma analysis to lungs and disease patterns such higher for India which is grap- view and advanced lung tissue and patients. identify different ranges of HU as Ground Glass Opacity or vas- pling with a highly infectious cular dilatation which could be second wave of COVID-19 1 presented in pneumonia or COVID-19 patients. Chest and lung CT scans are often used to help assess To learn more about deadly conditions like pneumo- Thoracic VCAR , visit nia, and viral respiratory infec- https://www.gehealthcare.in/pro tions showing imaging patterns ducts/advanced- including Ground Glass Opac- visualization/all- ity, which could be present in applications/thoracic-vcar COVID-19 patients.2So it’s vital 1. IMV 2019 CT Market Outlook that radiologists gather quick Report. and accurate patient data to 2. Forum of International Respi- make treatment decisions. ratory Societies. The Global Im- pact of Respiratory Disease – GE Healthcare’s Automated Second Edition. Sheffield, Euro- CT technology called Tho- pean Respiratory Society, 2017. racic VCAR gives its users the ability to make quantitative Building a smart IoMT ecosystem with GE Healthcare’s Mural Connect A‘Made in India’ initiative, Mural Connect is a hub that can be installed in an ICU or Operation Theatre and seamlessly connects to standard as well as life care solution devices ‘Mural Connect’ is an intelligent necting various patient parameters to to perform remote upgrades, is management of pre-operative data hub developed in 2020 continuous monitoring of the smallest requiring very minimal human spaces. that can be connected to any kind of data, from enabling clinical decision intervention. medical device. Developed as one of GE making to ensuring interventions in a As R Sureshkumar, CTO, LCS & Ul- Healthcare’s first future-ready smart timely manner. Mural Connect’s stand How the product works trasound, GE Healthcare, South Asia products, it plugs into the company’s as a true IoT for GEHealthcare is fur- says, “Conceptualized to liberate data vision of crafting next generation tech- ther strengthened by the device’s ability A ‘Made in India’ initiative, from field devices and make it useful, nology tools underlined by the IoMT Mural Connect is a hub that GEHealthcare’s Mural Connect helps (Internet of Medical Things). Mural can be installed in an ICU or provide meaningful insights to cus- Connect is a truly collaborative, cohe- Operation Theatre and seam- tomers. It helps clinicians make right sive product poised to transform lessly connects to standard as choices from clinical and operational healthcare treatment both for the pa- well as life care solution devices points of view. Firstly, the hub enables tient and medical fraternity. such as Unity IV, Clarity box for plugging in of additional digital LCS so- anaesthesia. Conceptualized as lutions. Secondly, it helps service gener- As a central smart hub, the Mural an open source system, the hub ation team access plenty of unseen Connect device has boundless capabil- integrates with medical apps medical opportunities. Thirdly, this is ities, facets of which will be released built on top of it. At the bedside a significant step in building an IoMT over time. It has the ability to interface it integrates to the Ventilator, BP mon- ecosystem for medical clinical plat- through WiFi and Bluetooth with var- itor, Heart Rate monitor. Remotely it is forms. The possibilities of impacts are ious medical devices located in ICU/OR instantly patchable, with all interfaces endless - remote monitoring, consoli- helps in aggregating patient data, brought into a single, upgradeable for- dation of EMR records, dashboard of which can be accessed remotely or via mat to liberate data from machines se- every hospital bed, understanding of the cloud. The possibilities of data ag- curely. While the current purpose is complex data and following patient gregation are far-reaching; from con- digitization of hospitals, the next phase progress.” 35EXPRESS HEALTHCARE May 2021
HEALTHCARE TRACKER Virosil:ASwiss,eco-friendly,chlorine-free fumigant Virosil is an eco-friendly formulation manufactured and marketed by Sanosil Biotech in technical collaboration with SANOSILAG of Switzerland SANOSIL BIOTECH, a An operation theatre can be product is 100 per cent Our formulation is presently thereby providing an microbe Mumbai-based company which made 100 per cent sterile within eco-friendly. This also being used in reputed hospitals free and a completely safe and is the first company to pioneer 60 minutes using Virosil as a fu- results in faster turnaround time and institutions in the health- sterile environment. the novel concept of eco-friendly migant. Healthcare workers will for OT’s and prevention of care industry as a very effective fumigation in operation theatres not face any irritation as our hospital acquired infections. fumigant and disinfectant The added benefits of Virosil in hospitals and healthcare in- is that it does not give any foul dustry with its product Virosil. odor, irritation to the eyes, re- Virosil completely replaces the quires no de-fumigation and is use of carcinogenic proven for- very safe and easy to handle as malin. The product, Virosil is per our recommendations. Our based on Hydrogen Peroxide formulation (Virosil) was being (H2O2) and Silver Ions. (nan- earlier marketed by Johnson & otechnology). The combination Johnson under the brand name of these two ingredients gives a Ecoshield. broad spectrum synergistic ac- The company also offers a tivity on all kinds of viruses, bac- customised disinfection audit on teria, fungi, yeasts, molds, proto- its website:www.sanosilbiotech.com zoa and algae. It is a clear, colourless, odourless, tasteless Contact disinfectant which is non-car- Sanosil Biotech, cinogenic, non-mutagenic, 1st Floor, Warden House, revolutionary and can be used Sir PM Road, Fort, where other chlorine based dis- Mumbai – 400 001, INDIA. infectants have been feared. Tel: 022 – 43112700 Email:[email protected] 36 EXPRESS HEALTHCARE May 2021
HEALTHCARE TRACKER Barco announces NEXXIS partnership with Sigma –JonesAVin India Partnership to leverage Barco’s leadership across Video-over-IP platform, Nexxis and surgical displays with a unique technology platform specifically designed for integration into digital OR Barco announced its corporate AV system integra- healthcare. Nexxis components are smaller area in the hospital is as mis- partnership with Sigma tors and has a pan-Indian net- Elaborating on the collabo- and use 50 pe cent less power. sion-critical as the operating – Jones AV to deliver work of offices and engineers. Nexxis is built on a future-proof theatre. We have been partners best-in-class digital experi- The synergies in Sigma – Jones ration, Rajiv Bhalla, Managing and scalable architecture by with Barco, deploying the ences in healthcare for its AV add value to hospitals by Director, Barco Electronics using network technology and Nexxis platform in Europe, next-gen operating room video bringing the long-standing ex- Systems said, “Barco’s partner- open standards. It also assures since early 2013 and it has integration solution Nexxis. perience in operating theatre ship with Sigma – Jones AV will best-in-class HD and 4K image never let us or any of our Barco leverages Nexxis, its integration from Europe with guarantee that our market- quality for mission-critical clients down.” video-over-IP platform for an unparalleled service leading technology is deployed medical imaging applications. digital integration in the oper- network and local experience. in India in the best way possi- The Sigma – Jones offices in ating room to deliver precise ble. It will not only help in deliv- “For us, it has been para- Bangalore feature a fully imagery, efficient workflow, Along with Sigma – Jones, ering cutting edge and future- mount to bring the right tech- equipped Nexxis 4K showroom and maximise flexibility across Barco has tied up with five proof OT integration solutions nology to the Indian market,” operating theatre, showcasing the increasingly complex Oper- partners across the Asia-Pa- built on our Nexxis platform said Raymond V Soans, Direc- the advantages of advanced 4K ating Room (OR) procedures cific region, including Heytech but also in giving clients the tor – Sales and Marketing of visualisation with near-zero la- globally. in Thailand, GET Medical in reassurance of great after-sales Sigma – Jones AV, “Indian tency, lossless true colour video Taiwan, MedEqual in Philip- service and customer care for hospitals are experiencing a over IP image distribution. As per a release, Jones AV is pines, Cetech in Vietnam and the long term. Sigma – Jones watershed moment and are one of the most successful Rutledge AV, A Diversified AV was the natural choice for leaping forward through the Besides showcasing the Barco Nexxis partners to have Company in Australia. With Barco’s India partnership as use of new technologies con- efficiency and patient safety developed a tried and tested these partnerships, Barco aims the company combines the tributing to better patient improvements through the use Nexxis platform. Featuring one to expand its presence in the experience and expertise of safety, improved infection of smart AV in integrated the- of the largest install bases and surgical sector across the two industry stalwarts” control, smarter working atres, the showroom also some of the most complex and APAC region and deliver cut- environments for staff and features advanced connectivity innovative solutions for fully ting-edge surgical displays to Every Nexxis component is safer and more efficient between the OT and lecture integrated state-of-the-art digital operating rooms designed and manufactured operations.” theatres for better and operating theatres across thereby increasing awareness with special attention to the advanced training of surgeons Europe, Sigma AVIT is one for the solutions available to protection of the environment “Quality is also key here,” and superior imaging for of India’s leading premium facilitate better and efficient and the sustainable use of said Ingo Aicher, Director, congresses and research natural resources. The latest Sigma – Jones AV, “no other collaborations. Medix Global announces winners of its Digital Health Innovation Challenge India The winning team will be awarded a cash prize and three months of mentorship with Medix Global’s team alongside potential investments and collaboration opportunities Fitterfly, a digital health tech digital therapeutics to the fore- via a mobile app. Wellthy Thera- solutions that will ensure that The three startups were start-up, was announced as front of medicine and India of- peutics designs clinically vali- people everywhere have access among the five finalists that the winner of the inaugural edi- ten referred to as the diabetes dated digital health interven- to quality healthcare services. made it to the last round from a tion of Digital Health Innovation capital of the world, the startup tions for chronic disease Developing digital health solu- diverse pool of over 110 appli- Challenge India hosted by is poised to help solve difficult management through a cloud- tions is the only way to do this at cants. The other startups that Medix Global, a global provider problems through innovative based technology stack and scale. The innovative business made it to the final round in- of innovative and digital solutions with a potential to analytical tools. models and exciting ideas we cluded Metamagics (GridSense) health and medical manage- impact a significant proportion witnessed today have tremen- and State of Mind.ai. The three ment solutions. of India’s population. Speaking on the occasion, dous potential to grow and even winning startups will also be eli- Sigal Atzmon, Founder & CEO, revolutionize how healthcare is gible for further potential fund- The Navi Mumbai based Stamurai and Wellthy Thera- Medix Global said, “We congrat- consumed and delivered. With ing and strategic collaborations startup offers personalised digi- peutics were selected as the ulate the winners of the first edi- Medix’s global expertise, we to help scale their ventures tal therapeutics programmes first and second runner ups tion of the Digital Health Inno- look forward to working with locally and outside of India. for diabetes, pregnancy, and respectively. Stamurai offers vation Challenge India. These them closely in making quality They will also receive three PCOS and obesity to deliver speech therapy for stuttering are very challenging times and healthcare services affordable months of mentorship with health outcomes. With Covid-19 and speech impairments now, more than ever, we need to and accessible for everyone.” Medix Global’s expert team. pushing remote monitoring and through an automated solution collaborate, innovate and find 37EXPRESS HEALTHCARE May 2021
HEALTHCARE TRACKER IITMandi researchers invent method to detect abnormal brain characteristics associated with Ischemic stroke The IIT Mandi team’s invention is based on the fact that intricate interactions between nerve cells (neurons) and blood vessels (vasculature), called the NeuroVascular Coupling (NVC) that regulates blood flow in the brain Innovators at the Indian In- Health and Medicine and the blood flow in the brain. Diseases explained Dr Chowdhury. logical diseases. In addition to de- stitute of Technology Mandi team has been recently granted a such as Ischemic stroke ad- In simpler terms, a benign tecting these abnormalities, this have invented a method to US patent for the invention. versely affect the NVC. Neu- method can pinpoint the location simultaneously study the varia- Dr Roy Chowdhury has collabo- roVascular Uncoupling results electrical current is given to the at which the uncoupling exists, tions in nerve functions and rated with Dr Abhijit Das, a in such cases, wherein, the nerve brain through electrodes, and the thereby providing a better brain blood flow associated with neurologist from Institute of impulses do not trigger the re- responses of the brain in terms of handle on the problem area. brain disorders such as Ischemic Neurosciences, Kolkata, and quired blood flow. Timely detec- nerve action and blood flow are stroke. The invented method Dr Anirban Dutta, an Assistant tion of NVC is critical for the simultaneously measured by “The simultaneous assess- helps in locating and classifying Professor in Restorative prevention, diagnosis, and treat- Electroencephalography (EEG) ment of nerve function and brain damaged sites (lesions) in the Neurorehabilitation from the ment of such diseases. and Near-infrared Spectroscopy blood circulation would allow brain, brought about, or leading Department of Biomedical (NIRS). While EEG and NIRS urgent treatment decisions to be to neurological diseases. Engineering, University at “Our method uses a multi- are already used independently, made quickly in cases of stroke Buffalo, US. The IIT Mandi modal brain stimulation system the prototype developed by IIT and hypertension,” said the lead Results of this study led by team’s invention is based on the to differentially stimulate differ- Mandi innovators combines researcher. The developed Dr Shubhajit Roy Chowdhury, fact that intricate interactions ent components of the neurovas- them into a single point-of-care device can also help in identify- Associate Professor, School of between nerve cells (neurons) cular unit (NVU) and observes unit to get a more accurate pic- ing the progress of diseases such Computing & Electrical Engi- and blood vessels (vasculature), the resultant electrical nerve sig- ture of the NVC. The data thus as Parkinson’s and can in fact neering, IIT Mandi, has been called the NeuroVascular nals by EEG (electroencephalog- obtained is fed into mathemati- predict occurrence of these dis- published in IEEE Journal of Coupling (NVC) that regulates raphy) and blood flow by near cal models to detect problems in eases even before presentation Translational Engineering in Infrared spectroscopy (NIRS),” NVC, which can point to neuro- of symptoms. IIT Madras, UK researchers develop paper-based sensor to detect AMR-triggering pollutants This research has been funded by DSTalong with UK’s Natural Environment Research Council and Engineering & Physical Sciences Research Council under Indo UKWater Quality Research Programme Indian Institute of Technology In IIT Madras, this pavanam added, “The way it have used these fabricated de- cost fabrication of the robust (IIT) Madras and UK re- research was led by Prof S works is that we use a porous vices for the detection of antibi- Laser Printed-Microfluidic Pa- searchers have developed a pa- Pushpavanam, Institute Chair substrate such as paper, which otics such as ciprofloxacin, bio- per-Based Analytical Sensors per-based sensor that can detect Professor, Department of enables us to use standard soft- cides such as triclosan and developed by IIT Madras will antimicrobial pollutants, which Chemical Engineering, IIT ware to print required designs heavy metals such as chromium, help to detect antimicrobials induce antimicrobial resistance Madras and Dr T Renganathan, on it. Once printed, the printer copper and lead. These devices easily in the parts per million in water bodies. This sensor Associate Professor, Depart- ink is deposited on the surface of can be used for antimicrobial re- range. It will also help u works on a ‘see and tell’ mecha- ment of Chemical Engineering, the paper. When heated this sistance surveillance in water nderstand the relationship be- nism that makes it logistically ef- IIT Madras. penetrates the thickness of the bodies.” tween AMR and AMR-trigger- fective for wide implementation. paper and forms a hydrophobic ing pollutants and assist Elaborating on the unique barrier through which liquid Highlighting how this sensor policymakers in framing solu- This research was first aspects of this research, Prof cannot pass. This allows us to di- is unique compared to existing tions to tackle grand societal reported through a journal Pushpavanam said, “Paper- rect the flow of liquid in prefer- technology, Dr Renganathan AMR challenge. publication in Nature Scientific based sensor offers an afford- ential directions through the ar- added, “We use a normal laser Reports and was acclaimed as able platform for various point- eas which are not printed and printer without any modification The novel strategy of com- one of the top 100 in chemistry. of-care applications as they are hydrophilic.” and it offers high resolution and bining adsorption based pre- support fluid flow based on a The practical applications of accuracy. The hydrophobic barri- concentration using reagents This research was funded by wicking action and governed by these sensors include: ers are compatible against or- that undergo a measurable Department of Science and capillary forces. This eliminates ◗ Environmental monitoring ganic solvents and high tempera- colour change enabled parts per Technology (DST), Government the requirement of a pump- ◗ Food safety analysis ture. The developed laser billion level detection of pollu- of India in bilateral collaboration to-flow liquids. We have come up ◗ Healthcare monitoring printed paper-based microflu- tants. The process utilises the with UK’s Natural Environ- with a novel method for the idic sensor is a viable option for easily available laser printer and ment Research Council and fabrication of paper- based de- Speaking about the current large scale manufacturing and hence offers tremendous poten- Engineering and Physical vices using a commercial laser Indo-UK project, Dr Ren- enables routine monitoring of tial for large scale sensor fabri- Sciences Research Council printer.” ganathan, Associate Professor, pollutants in both developed and cation. It could enable commu- (EPSRC) under the ‘Indo UK Department of Chemical Engi- resource constrained regions.” nity-driven microfluidics and Water Quality Research Speaking about the technical neering, IIT Madras, said, “We facilitate mass surveillance. Programme.’ aspects of this sensor, Prof Push- The novel strategy for low- 38 EXPRESS HEALTHCARE May 2021
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