September 29, 2008

Denied Supreme Court nod for admissions, 2 medical colleges get Health Ministry OK same day

Anbumani Ramadoss’s Health Ministry last week permitted two private medical colleges to take in more students even though a Supreme Court order, the very same day, had denied permission to both colleges saying their facilities were “inadequate”.
The Ministry on September 26 allowed Index Medical College (Indore) and Rohilkhand Medical College (Bareilly) to enroll students for academic year 2008-09 on grounds that a Central team from Safdarjung Hospital had found both institutions to house “adequate facilities”.

The Ministry’s approval was dispatched to both colleges the same day the Supreme Court bench of Chief Justice K G Balakrishnan and Justice P Sathasivam directed the Government to deny admissions for 2008-09 in the colleges based on the inspection report submitted by the government lawyer.

“Gopal Subramanium, learned Additional Solicitor General, appearing for Union of India, stated that the inspection was also conducted but the percentage of the teaching staff in various departments and other facilities were inadequate and the petitioner-institution cannot be given permission,” says the court order of September 26.

Apollo Hospitals, Merck arm to set up Diabetes Clinics

Apollo Hospitals group along with MSD Pharmaceuticals, a subsidiary of US drug major Merck & Co, is setting up "Diabetes Clinics" to tackle diabetes in the country.

According to Apollo group chairman Pratap C Reddy, it is proposed to set up 200 sugar clinics across the country. With each clinic costing up to Rs 25 lakh, the entire programme involves an investment of over Rs 40 crore.

" We will set up 50 clinics in the next six months", Reddy said adding that all Apollo hospitals in the country would start offering these facilities in a month's span.

At present, two such clinics are operational in Hyderabad on a pilot basis. There is also a proposal to launch stand alone sugar clinics where the incidence of diabetes is high.

Stating that " this is a war against diabetes, which has reached epidemic level in the country", MSD Pharmaceuticals managing director, Naveen A Rao, said that MSD was only providing backoffice platform for the programme and " there is no financial part to it".

Doctors say a big ‘no’ to rural posting

Out of 872 selected for primary and community centres, only 69 joined duty, says Health minister
Very few doctors had joined service in the rural areas in the last eight months despite the fact that such orders had been given to hundreds of doctors, Health and Family Welfare Minister Jay Narayan Vyas told the state Assembly on Saturday.

Out of a total 872 appointments of allopathic doctors between January 1 and August 31, 2008 for primary health and community centres in the rural areas, only 69 turned up to join their duties. Vyas said the rest did not even intimate about not joining their duties. Even doctors belonging to Scheduled Castes and Scheduled Tribes did not show much interest in serving in the rural areas, he said.

He said out of the 52 SC doctors given appointments, only five turned up for duty. The corresponding figure was 13 out of 116 for ST candidates and 20 of 405 for general category candidates. He said it was not only allopathic doctors who had shown reluctance to serve in the rural areas. Out of the 238 homoeopathic doctors given appointments, only 98 came forward to join in the rural health centres. Only 457 of the 607 ayurvedic doctors appointed, joined their duties, he added.

September 28, 2008

Open Source Drug Discover to develop affordable medicines for tropical diseases

India's initiative on the Open Source Drug Discover (OSDD) will begin a new era in the development of affordable medicines especially for the tropical diseases, Union Minister for Science and Technology Kapil Sibal said on Saturday.

Indian and Asian scientists have to design different paradigms and architectures to tackle these diseases like tuberculosis, malaria, kala azar through the OSDD, he said while inaugurating the 13th international 'Human Genome Meeting' here.

"No multinational company will invest in drugs for these diseases, because the paying capacity of the afflicted population cannot meet the expectations of profit. Therefore, I am sure that the OSDD will progressively cover all such diseases afflicting India and the whole developing world," Sibal said.

Stressing on the need for more participation of scientists from all disciplines, he said the OSDD allows everybody to join in the drug discovery process and it is the way forward.

The OSDD initiative by the Council of Scientific and Industrial Research (CSIR) will allow the scientists to discover new molecules which can be then taken for further R&D with the help of various funding agencies including drug discovery companies. Its a platform for new ideas on a non- exclusive basis, he said.

The Minister invited private participation in this huge endeavour of human genome to invest in a big way which opens way for predictive and preventive medicines. This cannot be done only by the government alone, he said.

Pvt medical colleges under purview of RTI Act

Private medical and engineering non-aided colleges can no longer choose to hide information sought under the right to information act, 2005.

In a landmark order, information commissioner for Nagpur and Amravati Vilas Patil has made it compulsory for all private engineering and medical colleges to reveal information under RTI to every applicant. These colleges had earlier refused to provide information on the pretext that they were beyond the purview of the Act.

The order was delivered in response to an appeal filed by Rajkumar Bhoyar against first appellate officer, principal of Yashwantrao Chavan College of engineering (YCCE), Wanadongri and YCCE public information officer.

Earlier, private engineering and medical institutions refused to divulge information under RTI to applicants as they "were not governed by the government nor they received any government grant and hence the RTI was not applicable to them, Patil told TOI and said he took help of two Supreme Court judgments for passing the order.

"As per verdict of apex court, all private engineering and medical institutions were governed by the University Grants Commission (UGC), All India Council for Technical Education (AICTE) and the Medical Council of India (MCI)," Patil said.

September 26, 2008

iSoft India gives shape to world's largest health project

Healthcare software provider iSoft on Thursday said that its Indian R&D team is developing a solution what it described as the world’s largest civilian IT healthcare project.

The Lorenzo software application, which will link nearly two-thirds of the hospitals in the United Kingdom, will also be launched in Europe, Australia and Germany in November, iSoft executive chairman & CEO Gary Cohen said at the opening of the company’s global product development centre here.

iSoft was acquired by Australia’s IBA Health Group in 2007. Hospitals will also be connected to general practitioners, allowing patients in the UK to get themselves treated at any clinic in the country without the need for re-entering data. The solution can be extended to any part of the world, managing director S Govind said.

“The entire solution, which is for linking up all the hospitals as well operations with the hospitals is being developed and rolled out from the India development centre,” he observed.

Some 900 people from its Indian R&D team are working on the Lorenzo project. In India, iSoft has tie-ups with Artemis Hospital of Apollo Tyres in Gurgaon and the Satya Sai hospitals in Bangalore and Puttaparthi.

The company is also installing solutions for the Medicity group in Gurgaon and is targetting adding 100 hospitals to its list of clients next year.

iSoft, which has 1,800 employees at its Bangalore and Chennai facilities, will hire 200 more by next year. It has grown by 50% in the last 12 months. Mr Govind said. The company closed its disaster recovery centre in Hyderabad earlier this month and moved the operations to Bangalore and Chennai.

About four-fifths of iSoft’s $500-million revenue in 2007-08 came from Europe, while Asia, Australia and New Zealand accounted for the rest.

September 24, 2008

Apollo Hospitals to set up 250 small health centres

The Tamil Nadu-based Apollo Hospitals group will set up 250 small hospitals across the country including the north-east by 2013, a senior company official said here on Monday.

"We will increase our network in eastern and north-eastern India by setting up more hospitals to provide health services at the doorsteps of the people in the region," Apollo Hospitals CEO Rupali Basu told reporters here.

"Equipped with the latest technology, the existing 41 hospitals of the Apollo group have been providing international standard healthcare facilities in different parts of India," Basu said.

"Tie-ups have been established with various governments of eastern India to provide healthcare to government hospitals," she added.

According to Basu, the group has now decided to expand, taking up an ambitious project to set up 250 small hospitals in both urban and semi-urban centres across India.

Doctors lack Empathy: Study

Empathy- identifying with and understanding another person’s situation and feelings- is an important factor in a patient-doctor relationship. But a latest study published in the September 22 issue of ‘Archives of Internal Medicine’ says that doctors don’t empathize with the plight of their cancer patients.

Doctors are very able in addressing issues such as medication, missed appointments and pain etc. but when it comes to responding to the ‘existential’ concerns, such as questions regarding life and death of the patient, the doctors failed.

Study author Dr. Diane Morse, an assistant professor of medicine and psychiatry at the University of Rochester Medical Center, in New York, said, “physicians only responded to 10 percent of empathic opportunities and, when patients raised existential concerns, physicians tended to shift more to biomedical responses.”

Morse added, “Physicians had trouble addressing the bulk of concerns, which were about patient fears, concerns about death or dying, or worsening conditions.”

The relationship between a patient and his physician is much more than mere medical treatment, pointed out Dr. Arthur Frankel, a professor of medicine at the Texas A & M Health Science Center College of Medicine.

He said that if in cancer care, the doctor is not able to form a close bond with the patient, then there is a big question on what exactly he’s doing.

“We can hopefully, at times, make suggestions or do things with patients that may buy some time and, in some cases, long-term remissions. But, by and large, the major job of an oncologist is to bond with the patient and the patient’s family and help them with a crisis,” added Frankel, who’s also director of the Cancer Center, Cancer Research Institute and Division of Haematology/Oncology at Scott & White Hospital in Temple, Texas.

It has been found that if physicians, residents and medical students provide more empathy to the patients, they themselves experience more satisfaction and less burnout.

In order to conduct the present research study, Morse and her colleagues took into consideration 20 audio-recorded and transcribed interactions between male patients with lung cancer and their thoracic surgeons or oncologists.

The researchers noticed 384 “empathic opportunities”, but found that physicians replied empathically to only 39 of them. An average of less than two empathic responses from the doctor was recorded for each encounter. Empathic opportunities included patients’ statements such as “This is kind of overwhelming” and “I’m fighting it”.

Even if the doctors did empathize, half the time it was in the last third of the encounter, even though patients kept raising concerns throughout the interaction.

Morse said, “The bulk of patients’ concerns are existential and physicians don’t necessarily have to do something to fix it. Just acknowledging it, in and of itself, can be very helpful and it doesn’t take a lot of time.”

September 23, 2008

Doctors forego pay to serve the flood-hit

They say where there is a will, there is a way, and doctors at the All India Institute of Medical Sciences (AIIMS) know how to use this adage to get their way.
On being refused permission to work as volunteers in the flood-hit districts of Bihar, 18 doctors from AIIMS took leave from hospital and did what their hearts wanted them to do, on their own time.

When the Union health ministry turned down their request for leave, they went on leave without pay and traveled to Bihar with their own money. “Soon, our savings will run out and we won’t have money left to stay on. We know our duty is to
help those in need but a little support from the government would have made it possible for us to stay here longer,” says
Dr Harsh, who returned on September 21 after spending almost eight days there.

“More doctors want to go and help but unless the ministry sanctions official leave, many would opt out as everyone needs an income to support their families,” says Dr Harsh.

The young doctors — all junior and senior residents, between ages 25 and 30 years — have been working in tough conditions in the flood-affected districts in north Bihar since September 6. Even the sudden death of a Mumbai medico hasn’t deterred them from staying on.

With no help from the state or central government, these doctors have set up health clinics in districts with non-existing health infrastructure.

In some areas, the local government has still not reached the marooned thousands at risk of death and disease.

These doctors have set up a health camp at Bhutiya canal with support of Delhi University students. Over 50, 000 people
live along the 8-km long canal, which is 300km from Saharsa, which boasts of the district’s only civil hospital. “It is a scary situation out here. There are few state doctors, almost all of whom are posted at district hospitals from where there is no attempt to reach the isolated clusters.

While medicines for the more common diseases like diarrhoea, cold and fever are available, nothing is being done for more serious and infectious diseases like tuberculosis, malaria or jaundice,” said Dr Saket Mani, junior resident, from AIIMS.

The doctors have rented a dilapidated house in Saharsa and travel 300-400km each day to treat people in remote hamlets.

“The situation here is extremely appalling and there is a dire need of doctors,” said Dr Mani.

“We see more than 500 patients everyday but that is just not enough. The state to intervene before its too late,” he added.

When this reporter visited Bhutiya canal, there was just one source of underground water for 50,000 people and no toilets.

“Now an NGO has installed half a dozen water pumps,” says Dr Harsh.

“We can’t stay here for ever. Only God knows what will happen of these people if the state does not react in time,” said a worried Dr Mani.

September 20, 2008

Apollo Hospitals to build medical health records repository

Apollo Hospitals Enterprise Ltd is “keen to be pioneers” in establishing a National Electronic Medical Records repository. The repository will store all medical details of a person from his birth to death, according to Sangitha Reddy, Executive Director, Apollo Hospitals.

Apollo Hospitals to divest 49% stake in pharma arm

Addressing a press conference here on Thursday, Ms Reddy said access to medical records is essential to help patients in emergencies.

Apollo intends to foray into pharmaceuticals

Universal id

Recently, the Chairman of the Apollo group, Dr Pratap Reddy, had spoken of a project that would give each of Apollo’s patients a unique Universal Hospital Identification Number (UHIN). The number would enable any doctor anywhere in the world to access the medical history of the patient. Dr Reddy had said that Apollo was working with Tata Consultancy Services for the project.

More India business stories | Get the latest Sensex update

The repository would be the storage point from where the UHIN would access the records.

Reddy observed that in India, one could transfer money electronically, but there was no system of transferring medical records.

Aragonda project

Addressing the media, Dr Reddy said that Apollo Hospitals would set up an integrated Health Knowledge City in Aragonda, Andhra Pradesh at an investment of about Rs 1,000 crore.

He said that the Apollo would partner with a couple of players to develop the Apollo Aragonda Health Knowledge City in 100 acres. It would have an integrated facility with simulation of lab, classroom, hospital, medical college and residential.

More India business stories | Get the latest Sensex update

Industry forecast

According to a McKinsey study the Indian healthcare industry is expected to grow $190 billion in the next two decades. To meet this demand the country would require trained medical workforce, cheaper technology and better infrastructure. At present, India has about 5 lakh doctors and 7.3 lakh nurses, but the country requires an additional 6.71 lakh doctors and 18.7 lakh nurses.

September 18, 2008

CSIR initiative to develop low-cost TB medicines

The Council of Scientific and Industrial Research on Monday launched a new initiative to develop low cost drugs for infectious diseases like tuberculosis that afflict mainly the poor in India and other developing countries. Big pharmaceutical companies do not spare much resources for these for want of adequate returns.

The initiative is in the form of a web portal, which would provide a platform for researchers in the academia, industry and institutes across the world to share their knowledge and ideas and conduct collaborative research on a voluntary basis.

The ‘open source drug discovery’ programme draws its inspiration from the success of the open source movements in software and the Human Genome Sequencing Project. The website is based on the popular Wiki-based model and is designed to enable anyone to contribute or modify content in a collaborative mode. The ideas will be reviewed by experts and the contributors can get certificates and even monetary rewards if their contributions prove useful.

The initiative makes use of the recent developments in bioinformatics, which have enabled research to identify potential drugs by comparing on computer, potential disease targets against large chemical databases. The website will host different types of data on the pathogens and the various tools needed for data analysis. Further, it will have a discussion forum for members to share ideas.

Launching the programme, Union Minister for Science and Technology Kapil Sibal said a core committee of expert scientists would monitor the process closely. The discovery of new potential drugs would be in the public domain, thus precluding any monopoly.

He said the CSIR in collaboration with international philanthropic agencies such as Bill and Melinda Gates Foundation would then provide resources to conduct clinical trials and other such steps required to bring the medicines to the market place. The potential drugs would be made generic as soon as they were discovered to ensure that the drug prices were kept low.

The programme would initially focus on tuberculosis, since though it was a leading cause of death from bacterial infection in the world, no major advancement in treatment had emerged over the past half a century, particularly since market forces discouraged big pharma firms from developing drugs for such diseases as they had a long gestation period, heavy research and development costs and low returns.

According to the World Health Organisation one-third of the world’s population was currently infected with TB. The estimated incidence of the disease in India was 1.8 million new cases annually and 3,70,00 deaths occurred due to it every year, making it an average of two deaths every three minutes.

Addressing a press conference after the launch, CSIR Director General Samir Brahmachari said the website would be open to all – scientists, researchers, academicians, doctors, software professionals, traditional healers, and industry. Even lay persons, who had some useful idea or the other to contribute could share them on the website. “A bright IIT student could get some ideas. He just needs to open his computer sitting in his hostel room and post his or her ideas on the website.”

Among others, the Global Research Alliance, which comprises government and non-profit research organisations around the world, Jawaharlal Nehru University, University of Hyderabad, Delhi University, Sun Microsystems, TCG Lifesciences and LeadInvent Technologies have already extended their support for the programme, he added.

Indian-American gets nuclear medicine research 'Nobel'

An Indian-American physician- scientist has been honoured with the prestigious Benedict Cassen Prize this year, considered the equivalent of a Nobel in the field of nuclear medicine research.

Mathew L Thakur, a professor of radiology and radiation oncology in Thomas Jefferson University of Philadelphia, was conferred the biennial USD 25,000 award instituted by Society for Nuclear Medicine, an international scientific organisation, at its 55th Annual Meeting in New Orleans recently.

Thakur's work focused on developing and evaluating radiopharmaceuticals for diagnostic imaging and therapy. Described as a molecular imaging pioneer who has helped change the shape of modern medicine, Thakur finds himself among an elite group of only eight other researchers who have been awarded the Cassen Prize.

"Dr Thakur's research has truly advanced excellence in health care," Sue Weiss, executive director of the Society's Education and Research Foundation which funds the award, said.

"In science, nothing is more gratifying and encouraging than recognition by peers," Thakur said.

Thakur has a bachelor's degree in chemistry from Bombay University, and a master's degree in analytical chemistry and a doctorate in radiochemistry from London University. He was a visiting scholar at the Washington University School of Medicine, St Louis and associate professor of radiology at the Yale University School of Medicine.

His current research interests include the diagnosis and treatment of breast cancer, prostate cancer and pancreatic cancer and the development of imaging techniques for venous thrombosis, pulmonary embolism and gene expression, the Society said in a press statement.

September 16, 2008

InfoLogix Launches HealthTrax 2.0 to Help Hospitals Automate Time-Consuming Asset and Patient Tracking

InfoLogix, Inc. , a leading technology provider of enterprise mobility and advanced wireless asset tracking solutions for the healthcare and commercial industries, announced today a new version of its innovative HealthTrax Wireless Asset Tracking Solution(TM), which enables healthcare organizations to leverage mobile technologies to automate mission-critical and labor- intensive tasks.

The HealthTrax 2.0 solution draws upon sophisticated Real-Time Location System (RTLS) and Radio-Frequency Identification (RFID) wireless technologies to collect and analyze real-time information, providing stakeholders with visibility into resource and asset locations as well as delivering vital telemetry data. Through a wireless network of small RFID transmitter tags, HealthTrax 2.0 pinpoints the location of specific assets and people throughout a hospital, making real-time information continuously available at the enterprise level. HealthTrax 2.0 can be configured to eliminate a variety of process inefficiencies often found in healthcare environments and can seamlessly automate the following functions:

Patient Location Tracking - HealthTrax 2.0 enables hospitals to accurately track the real-time status and location of patients throughout their facility to actively monitor resource requirements, alleviate potential bottlenecks and enhance patient safety. Through an easy-to-use, web-based search and view tool or handheld application, healthcare administrators can collect and aggregate valuable patient information to analyze long-term patient trends for improvement in the allocation of specialized equipment, patient rooms and medical personnel.

Asset Location Tracking - The HealthTrax solution allows hospitals to operate more efficiently by improving their ability to track the specific location and status of critical, transient assets such as wheelchairs, infusion pumps, ventilators, etc. HealthTrax 2.0 features advanced mapping and reporting capabilities that enable instantaneous feedback on an asset's location and status, enabling healthcare professionals to spend more time with patients and less time searching for necessary equipment.

Temperature Monitoring - HealthTrax 2.0 automates the collection and monitoring of sensitive temperature data for refrigerated items such as blood products, medications, vaccines and tissue samples that require strictly- regulated, temperature-storage procedures. The HealthTrax solution encompasses a powerful alert management capability which allows technicians to automatically receive an alert if a refrigerator's tag reports a temperature change of more than five degrees, decreasing compliance costs associated with storage procedures and preventing damage to costly inventories.

"Healthcare organizations are constantly looking to find new ways to decrease costs and increase operational efficiencies," said Barry Runyon, Research VP, Gartner, Inc. "Wireless and mobility applications offer them a way to retrieve and analyze a wide-variety of information quickly, providing them with a timely, accurate and comprehensive view of the operational side of their business, thus enabling them to make the necessary workflow improvements."

"The launch of HealthTrax 2.0 underscores our commitment to developing mobility solutions that address the real-world challenges our customers are facing," noted David Gulian, president and CEO of InfoLogix. "Being able to access high-quality information in new ways is fundamentally changing healthcare delivery, and we're pleased to provide our healthcare customers with increasingly advanced mobility solutions, like HealthTrax 2.0, to save them valuable time and money."

September 15, 2008

What ails the medical profession?

He was a family physician, consultant and, above all, a caring friend.
There was a time, not long ago, when patients considered doctors as demigods. The doc was so much a part of the patient’s family that even personal matters were discussed and advice sought. He was part of get-togethers and his opinion mattered, on almost every issue.

The reasons were the three ‘A’s: Affordability, Accessibility and Amiability. In simple terms, the doctor was easily approachable, the best of treatment was not beyond the patient’s means and the doctor’s empathetic stance gave a consoling touch to the suffering person. He was a family physician, consultant and, above all, a caring friend.

In the same breath, one must add that medical care in India three decades ago consisted mostly of primary care at the villages and two-tier cities, and secondary care in the metros. Sophisticated gadgets for diagnosis didn’t exist and the pharmaceutical industry was in its nascent stage — even lifesaving drugs had to be imported and were a privilege of the elite and the powerful. ‘Corporate hospital’ was unknown terminology.

Changing times
However, in the past two decades. things have changed. We are proud that our doctors are second to none in their ability and clinical acumen. The hospital industry is booming and medical treatment attracts patients from South East Asia and the Middle East, adding to the economy boom.

Today a coronary by-pass or renal transplant is within the reach of the upper middle class, and thanks to the enterprise of both medical and non medical entrepreneurs, life-saving equipment and tertiary hospitals are now available even in two-tier cities.

But these advancements have also ushered in certain problems. Patients don’t find the three important ‘A’s in the medical profession any more.

Safeguarding interests
Doctors are confined to their air conditioned chambers, and to reach them one has to pass through a secretary or the reception crew at the hospital. Not an easy proposition for an uneducated person!

In an era of growing awareness of consumer protection among patients and fears of litigation, doctors view every patient with suspicion — in other words as a potential litigant. Therefore, in a bid to safeguard his interest, the doctors go for opinions from super-specialities and order a battery of investigations before starting treatment or suggesting surgery. Naturally cost escalates and, when things go wrong, the doctor in question is cursed and vilified. In a fast developing country like ours, it is imperative on the part of the government and medical community to promote the latest in the field of medicine. At the same time a delicate balance is the need of the hour.

The solution lies in the hands of the doctor. He has to spend enough time explaining the pros and cons of treatment, maintain a sympathetic approach and explain in detail every procedure, the cost and the pitfalls. Adopting these measures alone will place the medical profession on a pedestal again.

Dr. Ashraf was awarded the B.C. Roy national award for 2006 for Medico-Social Relief. E-mail: try_drashraf@sify.com

September 14, 2008

Medical Interns Suffer Negative Effects Due to Heavy Workload

A study in the September 10 issue of JAMA, a theme issue on medical education, says that medical interns who experience an increase in their on-call workload are more likely to get less sleep while on call, have longer shift durations and participate less in educational activities.

In 2003, the Accreditation Council for Graduate Medical Education (ACGME) restricted resident duty hours in an attempt to reduce resident fatigue and the likelihood of fatigue-related errors that could harm patients. Further restrictions in resident duty hours are being considered. “Yet, little attention has focused on the risks associated with work intensification. Further limitations on duty hours without any attempt to address work intensification may result in residents doing the same amount of work in less time, which could undermine resident welfare and patient safety,” the authors write.

Vineet M. Arora, M.D., M.A., of the University of Chicago, and colleagues examined whether increased on-call intern workload, as measured by the number of new admissions on-call and the number of previously admitted patients remaining on the service, was associated with reductions in on-call sleep, increased total shift duration, and lower likelihood of participation in educational activities (such as lectures or bedside teaching). The study, conducted from July 2003 through June 2005, included 56 medical interns observed during 1,100 call nights.

The researchers found that average sleep duration on-call was 2.8 hours and that average shift duration was 29.9 hours. Approximately 30 percent of shifts were deemed noncompliant with duty hours (greater than 30.5 hours). Analysis indicated that each new on-call admission early in the academic year was associated with less sleep (-10.5 minutes). A significant association between admission workload and shift duration also was observed. For each new on-call admission early in the academic year, shift duration increased by 13.2 minutes. Call nights during the week and early in the academic year were associated with the most sleep loss and longest shift durations.

A higher number of previously admitted patients remaining on the service was associated with a lower odds of participation in educational activities. Interns reported spending 11 percent of their time in educational activities.

“These findings raise concerns about the possibility of future duty-hour restrictions in the absence of corresponding limits on workload,” the authors write. “Our study highlights the importance of considering reductions in on-call admissions as a strategy to alleviate sleep deprivation and ensure compliance with duty hours for interns early in the academic year in a traditional extended-duty shift model.”

Government to review MTP Act

WHEN JUSTICE is delayed on earth, the gracious hands of the Lord does it in heaven and its echo reaches the earth. When such is the intensity, man reconsiders his faults and tries to tighten his loose ends. Want to know more?

Remember, Niketa Mehta and Haresh Mehta, the couple who filed a petition in the court seeking to abort their first issue who was destined to be born with acute medical anomalies. But the Mehtas lost their case on the basis of Medical Termination of Pregnancy (MTP) Act, 1971, which limits the period of abortion only up to 20 weeks. The final verdict came and disappointment spelled over the couple. They just left everything to their fate. But God was kind enough and Niketa suffered a miscarriage. Isn’t it a miracle, but miracles do happen in this wonderful world of human beings! In the backdrop of this particular case, the government is now reviewing the MTP Act.

Is the MTP Act, 1971, not old enough to be applied today? Is it going to become the plight of even more Mehtas in the future? Why the period of abortion should not be extended over 20 weeks?

In a bid to answer all such relevant questions, the health ministry under the aegis of health minister Anbumani Ramadoss, is contemplating over the revival of the MTP Act, 1971, to extend the period of medical termination of pregnancy from 20 weeks to 24 weeks. The debate doesn’t end here, what if some medical anomalies are discovered after 24 weeks – will the little life be allowed to come into this world? The clock is ticking and the debate is still open with many more ifs and buts! Still a long way to go….

September 06, 2008

HP aims to sign up with 2,000 hospitals

Technology solutions major Hewlett-Packard has set a target of signing up with about 2,000 small and medium-sized hospitals in the country by the end of the current fiscal. The US-based company will provide IT infrastructure to hospitals in the 50-500 bed range in association with partners that provide IT services, Ashok Pamidi, Director-SMB and Enterprise Partners, Technology Solutions Group, told Business Line.

“Hospitals today are looking at automating many aspects of their healthcare business through IT adoption. Moreover, unlike many other sectors, the healthcare sector is fairly organised in the country,” he said on the sidelines of a news conference recently. Currently HP has associations with around 12 hospitals in the country.

While HP provides the technological backbone related to the IT infrastructure, its partners would act as systems integrators who would specialise in providing the relevant software and local support. Bangalore-based Wipro is one of HP`s partners.

The time-saving aspect of IT is the most critical reason for IT outsourcing — especially when it comes to ERP implementation — by small and medium hospitals. Moreover, hospitals are able to better integrate the various aspects of their business (such as their pharmaceutical retail outlets) and thus it allows them superior control over their inventories. HP is targeting deals worth over Rs 1 crore from hospitals. IBM, TCS, HCL and Satyam are among the other blue chip companies that have significant interest in this space

Moreover, the company is also keen to tie up with hospitals having more than 500 beds. “For large hospitals, we provide our own software , which is translated from Spanish to English. That is our own intellectual property and we call it hospital management information systems,” said Pamidi.

Health insurance premium reduced

Union Finance Minister P Chidambaram announced that the cost of health insurance premium under the Universal Health Insurance Scheme (UHIS) has been reduced from today to attract more number of people.

Speaking at the inauguration of Apollo Reach Hospitals here, he said, "For an individual the premium amount under UHIS was Rs 365 per annum, but now it would be Rs 300." For a family of five members, the premium which was costing Rs 548 per annum has been reduced to Rs 450 per annum and for a family of seven members, it has been reduced from Rs 730 per annum to Rs 600 per annum, he said.

In addition to this, the age limit under the UHIS has also been increased from 65 years to 70 years, Chidambaram said, adding the pre-existing diseases which were not included earlier had been included under UHIS and the maternity benefit has also been extended from today.

"There is no substitute for comprehensive health system. We must marry public medical system and private medical care, as it would provide modern finance, modern technology and modern information systems," he said.

The Apollo Reach Hospitals is an initiative of Apollo Hospitals Group for providing health-care for semi-urban and rural areas.

September 05, 2008

C-DAC software to aid healthcare sector

If the new software developed by the Centre for Development of Advanced Computing (CDAC ) is accepted by medical equipment manufacturers and service providers, patients with medical history will no longer need to worry about maintaining their records and its compatability with different softwares.

Through the medical informatics standards software development kit (SDK), the C-DAC aims to achieve globally maintained standards as defined by international and national organisations.

The software development kit was officially unveiled at C-DAC's new campus in Aundh on Tuesday. S. Ramakrishnan, director general of C-DAC , said, "Health is an evergreen area and in each zone, be it hospitals, research institutions or clinics, where interactions take place, telemedicine has become a compelling choice and hence, we decided to launch this kit."

Medical original equipment manufacturers (OEM) and independent software vendors (ISV) are a critical part of the healthcare delivery chain. There are many systems with a gamut of technologies available from such manufacturers, he added.

"When these systems become proprietary, data exchange and communication with them is a major problem which pushes up the cost of health care system. The national task force on tele-medicine mooted by the Union Ministry of Health and Family Welfare recommended a host of medical informatics and IT standards to be adopted by manufacturers and users in order to promote lowcost solutions and easy exchange of data. The I-T Department then approached us and we came up with SDK," Gaur Sunder, the team coordinator, said.

Post offices may soon sell medicines

Besides posting a letter you may also stop at a post office to pop up a pill. Postal department is considering using its 1.5-lakh-strong network across the country to sell over-the-counter (OTC) medicines, including painkillers, medicines for diarrhoea, essential cold and cough medicines and contraceptives.

OTC drugs are medicines that can be bought without a doctor’s prescription. Companies are planning to start pilot projects in Uttar Pradesh, Madhya Pradesh and Maharashtra from the next quarter, Novartis V-C and managing director Ranjit Shahani said. About half-a-dozen pharma companies are expected to be involved in the pilot project.

The move would increase the market of OTC drugs. Major players like Novartis, Dabur, Ranbaxy, Cipla, GlaxoSmithKline, Pfizer and Zandu control nearly 51% of the total over-the-counter market. The project will involve the department of pharmaceuticals and DoP. “This may be a PPP project and would be implemented by DoP and the concerned pharma companies,” a government official said.

The move is aimed at ensuring accessibility of over-the-counter drugs in the rural areas. There are about 1,50,000 post offices across the country. “We have been in talks with the government to use the network to sell over-the-counter drugs. However, since different ministries are involved, implementation of the proposal is taking a bit of a time. So, we have decided to start with the pilot project in three states for the time being,” said Mr Shahani.

“While there are close to 4,50,000 chemists across the country, companies are willing to use the supply chain and logistic facilities of the post offices and petrol pumps to make medicines available in remote areas,” a pharma analyst said.

September 03, 2008

Apollo plans to set up 250 speciality hospitals

In a move to reach out to smaller towns and cities in the country, Apollo Hospitals Group has chalked out a Rs 10,000 crore investment plan to set up 250 small and medium sized multi-specialty hospitals aggregating to 31,250 beds over the next seven years.

These hospitals will have a typical size of 100-150 beds each and will be set up under a new brand name ‘Apollo Reach’. These 250 hospitals will be set up in three phases with the first phase completed over the next 24 months, second phase in the next 36 months and the final phase in the 24 months.

The group plans to fund the Apollo Reach network with a combination of debt and equity. The first phase of 25 hospitals that will cost Rs 1000 crore will have infusion of promoters’ equity (through warrant conversions) to the extent of Rs 160 crore. The group will use its current cash reserve of Rs 400 crore to part fund the project and will depend on the year’s cash flow to the extent of Rs 150 crore. The balance Rs 290 crore to fund the first phase will be debt.

Land has been procured in 11 cities and towns most of which are in Andhra Pradesh and Tamil Nadu. The group has also identified land to be bought in 17 other locations all over India.

The group chairman, Pratap C Reddy said that finding qualified doctors to run these hospitals will be the biggest challenge, particularly since they will be working in small cities and towns. He said a separate team has been set up to identify and hire medical and non-medical professionals to run these hospitals. The union government had recently announced a five year tax holiday to hospitals set up in non-metro cities. Hospitals are free to choose the five years that it wants to claim tax holiday. “In smaller towns it will not be possible to make profit in the first five year,” Reddy said.

As part of this new plan the group also plans to set up India’s first health knowledge city in Chittoor in Andhra Pradesh, which is also Reddy’s home town. The group has acquired 100 acres for this.

The Apollo Reach hospitals have been conceived with a basic premise that each of these, on an average will bring in revenue of Rs 40 crore a year from the third or fourth year of operations with profits coming in beyond the fifth year.

To find a steady source of doctors and other medical professionals to run its hospitals Apollo Hospitals Group also plans to set up medical colleges in four or five cities. The group has narrowed on Chittoor, Ahmedabad, Kolkata, Madurai as possible town where these colleges will come. To start with, each of these will enroll 100 students and increase it later. The cost of setting up each of these colleges is estimated to Rs 110 crore and each will also have a 600-bed hospital.

Doctors For You launches relief operations in Bihar

Doctors For You, a social organisation of doctors, has launched a relief operation in Bihar in association with Indian Railways and Youth For Equality. Over 1,500 specialist doctors and other volunteers have been pressed into service. They will not only be treating the injured & diseased, but also be preparing to tackle the aftermath of the floods. Indian Railways is providing all Infra structure support to Doctors For You for this initiative.

Mr. Ravikant Singh, Chief Coordinator, Doctors For You, said that “In the first phase of operation, we will be targeting the six worst affected districts namely, Supaul, Saharsa, Madhepura, Araria, Purnia & Katihar. Our interim relief team is already in the process of setting up control rooms at Mansi & Katihar railway stations for this operation. In the 2nd phase, we will be undertaking rehabilitative work for 3 month after the floodwaters recede.”

He further added that “We appeal to all to help the victims of this catastrophe by sending food, clothes, medicines, waterproof tents, cooking utensils & water purification plants.
We also appeal to media to create awareness against the possibility of an epidemic after the flood waters recede. People from all walks of society must come together to deal with this human tragedy. We call upon every human being with a conscience to show solidarity with the victims of this catastrophe by immediately extending all kinds of help in our relief, rescue & rehabilitation operations. Next week or next month may be too late.”

"Recently, there was controversy that doctors avoid rural postings, here is an example of doctors willing to go to rural places by themselves to help people in distress", said Dr KaushalKant Mishra, President, Youth for Equality.

Those who want to volunteer (Medical or Non Medical), please contact:

Dr. Ravikant Singh, Chief Coordinator, "Doctors For You": +91-9324334359
Jainendra Kumar, Patron, "Doctors For You": +91 – 9811382902
Dr KaushalKant Mishra, President, Youth for Equality,+91-9868340420

For extending any material &/or financial support, kindly contact:
Helpline Numbers –
Mumbai: +91 - 9324334359, 9821871945
New Delhi: +91 – 9811382902,9868340420
Patna: +91 – 9308022326, 9234616135

Indian Medical Association elects its president

G Samaram has been unanimously elected the National President of Indian Medical Association (IMA) for the year 2009-2010.

This was announced by the association in a release here today.

Samaram had served the apex body of the medicos as state president, central working committee member and national vice-president of the IMA, the release said.

Born on July 30, 1939 in Machilipatnam in Andhra Pradesh, Samaram attained his MBBS degree from Rangaraya Medical College, Kakinada and started private practice in Vijayawada in 1970.

He is also a social worker and has been organising various programmes for street children.

He was insturmental in promoting National Integration Camps.

Hot technology that could change health care

Advances in health care run the gamut from mind-boggling medicines to simple Web solutions that, if adopted, could slice huge slabs of fat from a bloated system.

Whatever form innovation takes in the coming years, much of it will spring from start-ups, not pharma and tech giants. "Little companies can work on something that's not proven and that has a higher risk," says Brenda Gavin, founding partner of Quaker BioVentures in Philadelphia and former director of GlaxoSmithKlein's venture fund. If they can find enough funding, entrepreneurs "basically can go for the gold."

But it's not just the risk of failure that hampers big companies' search for game-changing breakthroughs. It's the constant demand to generate revenue in the here and now to cover all the overhead and hit aggressive growth targets.

"Small companies are much more nimble, so they can react quickly," says Jack Lasersohn, a partner in the Vertical Group, a Summit, N.J., venture capital fund that specializes in medical technology and biotechnology. "You take an idea, and a few months later you can have a company."

Another structural issue: Health care is an extremely splintered industry. Many new areas of research--such as personalized medicine and digital document retrieval--don't fit neatly into established divisions within big companies, ultimately thwarting capital investment.

"Too many investors have failed to understand what health care is as an industry," says Ralph Sabin, a managing director at Pacific Venture Group in San Diego. "[It] isn't like financial services or manufacturing. It's an area dominated by nurses, physicians, hospitals and insurance companies and all kinds of different constituencies."

All of that spells huge opportunities for tech-savvy start-ups--and new hope for sick patients in need of better, less expensive care.

Philadelphia-based Hx Technologies wants to unlock the power of computer networks (a very '90s concept) and suck costs out of the system by making it easier to transport diagnostic images like CT scans. Amazingly, shuttling these images to doctors for second and third opinions is still done the old-fashioned way--by hand. That can lead to duplicative and potentially dangerous testing. (Hence President George Bush's mandate that a majority of Americans have electronic health records by 2014.)

Launched in 2000, Hx Technologies estimates that it can eliminate extra tests--and save the U.S. medical system $5 billion to $6 billion a year--by storing medical images so they can be accessed in encrypted form over the Internet. Hx collects setup fees and monthly rent from insurance companies to use the system; doctors and hospitals use it for fee. Tommy Thompson, former secretary of the U.S. Department of Health and Human Services, sits on the board.

The challenge: For this technology to truly take off, Hx will have to blanket the entire hospital system--and that may take a bit more than the $5 million it's managed to raise thus far from investors including the National Institutes of Health, RK Ventures and Next Stage Capital.

Nurses don't need to schlep bandages and food--robots can do it better and cheaper, figures Aethon, a Pittsburgh-based developer of mobile robots that use radio frequency identification technology to track and fetch medical supplies. Founded in 2002, the company has raised about $22 million from the likes of Draper Triangle Ventures and Pacific Venture Group.

Aethon's robots, which it leases for between $1,500 and $2,000 a month, now zip throughout the hallways and supply closets of 100 hospitals in the U.S. Among them: "Tug," a self-navigating, battery-powered bot the size of a small suitcase that attaches directly to hospital carts and can carry up to 800 pounds. Tug can pick up, sort and deliver medical supplies and meals and run blood samples to labs; he can even ride elevators and open doors.

If you think that stuff is straight out of Star Trek, how about "growing" new organs from the very patients that need them? Launched in 2004, Tengion, based in East Norriton, Pa., aims to do just that.

The process: A doctor takes a tissue sample from a diseased organ and sends it to Tengion's facility. There, the cells responsible for growth of new tissue are reproduced in a biodegradable "scaffold" made in the shape of the diseased portion of the organ. Several weeks later, surgeons implant the new organ/scaffold structure, leaving the patient's body to absorb the new organ and excrete the scaffold. Unlike those who receive organ transplants, Tengion's patients, in theory, won't need to be on a lifetime regimen of anti-rejection medicine.

So far, the company has invented a way of making a "neo-bladder" based on a patient's own tissue, and has filed for 70 patents covering the entire process. It plans to eventually move into manufacturing other organs and tissues, including kidneys, blood vessels, hearts, livers and nerves.

Tengion has already raised $150 million in total financing from the likes of Bain Capital, Johnson & Johnson Development Corporation (the consumer giant's VC arm), Oak Investment Partners and Quaker BioVentures. Not that success is right around the corner--the FDA won't approve the process until early next decade, says Gary Sender, Tengion's chief financial officer.

Then there's the whole push toward truly personalized medicine, which could fundamentally alter the way diseases are diagnosed and treated. Until now, doctors have relied on the law of averages: Clinical drug trials yield data on how many people are helped by a particular treatment; if the success rate is high enough, that treatment gets the nod.

But as the human genome is better understood, it's becoming apparent that diseases like cancer can be treated in specific ways, based on a patient's individual genetic code. "Nothing should cause us to expect that one person's cancer or arthritis or heart disease is like other patients," says Brook Byers, partner at the Menlo Park, Calif. venture giant Kleiner Perkins Caulfield & Byers. "Standardized treatments will shift to personalized and tailored ones with better outcomes and lower costs." Personalized medicine has been Kleiner Perkins' primary area of investment for its life sciences division.

Take its bet on fellow Menlo Park resident Pacific Biosciences. The company is working on a machine that doesn't just identify DNA strands, but can understand, based on a few drops of blood, how the strands are manufactured, so that they can be sequenced (copied) faster--dramatically speeding up the race for a host of powerful cures. Sequencing a person's entire DNA now takes about about three years; Pacific Biosciences thinks it can cut the time to three hours.

"If you could sequence people's DNA thousands of times faster, you could make disease research a software problem," says chief executive Hugh Martin.

Perfecting that process may take a while. Pacific doesn't expect its $300,000 to $500,000 machines to hit the market before 2013--but white-shoe investors, including Kleiner Perkins, MDV-Mohr Davidow Venture, and, more recently, Intel, have ponied up $178 million to make it happen

Patient Admission Prediction Tool software cuts waiting time at hospitals

A new software package, developed by researchers, helps hospital or emergency staff anticipate the rush of patients hour by hour for the day or the next week, even on holidays with varying dates, such as Easter.

The Patient Admission Prediction Tool (PAPT), designed by Australian e-Health Research Centre (AeHRC), can predict accurately how many patients will be present at emergency departments, their expected requirements and the number of admissions.

"Accurate forecasting will assist many areas of health management from basic bed management and staff resourcing to scheduling elective surgery - not to mention reducing stress for staff and improving patient outcomes," said David Green, director of emergency medicine at Gold Coast Hospital.

The software was developed by clinicians from Gold Coast and Toowoomba Hospitals and Griffith University and Queensland University of Technology, collaborating with AeHRCe.

"We've shown PAPT vastly improves successful prediction of patient presentation and admission in two hospitals with very different populations," said David Hansen, research director, AeHRC.

"Emergency departments already know there's a pattern to presentations and admissions, but existing models are very simplistic. PAPT uses historical data to provide an accurate prediction of the expected load on any day," he added.

The prototype PAPT package has a simple interface designed in consultation with those who will ultimately use it every day. "Over the next year we plan to assess and quantify the impact of using the forecasts," Hansen said.

The aim is to turn the prototype package into a product for hospital use. This work was presented at the 2008 Health Informatics Conference held in Melbourne Monday.

Insurers see retail health plans as next big thing

Managed healthcare may still be a far cry, although health insurance premium has swelled to around Rs 5,000 crore.

Health claims can be denied

Insurance biggies are now betting on big retail business in health, with the large private players coming up with new plans and innovative distribution channels to tap this promising segment.

Being in the state of good health

With medical inflation estimated to be around 15-17%, the awareness needs to be built up urgently is the common refrain. The scope of the health care market is said to be around Rs 60,000 crore but the share of insurance is at present less than 1%.

Developing healthy contempt is a must

Moreover, over 80% of the market is indemnity driven and is largely covered by mediclaim.

New business premium from health plans offered by life companies is still small at less than

Rs 100 crore and has a long way to go said life insurance officials. Out of the total premium garnered at present, retail is just about a share of 50% while the balance is from group plans.

Binay Agarwala, senior vice-president, health business and corporate strategy, ICICI Prudential Life, told DNA Money, “We feel that life companies have a huge retail presence, which will extend to health products as well. Health insurance is slightly different from pure life insurance. It is necessary to understand health insurance risks separately and price it.”

“We train our distribution forces differently as the pitch for health products is different from a life insurance product. Currently we have five core products and will look into variants in future.

It is a big challenge to create awareness and understanding of the need of health insurance products”, said Agarwala.

Some of the earlier life entrants into the health space are Tata AIG Life, ICICI Prudential and Bajaj Allianz, Reliance Life. Max New York Life, which, came up with a slew of health products, also proposes to tap the retail segment.

For Bajaj Allianz Life, health is one of its key verticals and the company expects to do Rs 120 crore of premium in the current year from the products that it has at present. It will be looking at various new products on women and children in the coming months.

Ujjaini Dasgupta, head, health insurance, Bajaj Allianz Life said, “Essentially standard mediclaim products are different from pure health plans with a life insurance element but with time and innovative products, customers will have a wide choice definitely”.

SBI Life Insurance CEO, U S Roy said, “There is a big segment and we propose to come in with innovative products in health”.

More India business stories

An Asian healthcare study by Credit Suisse that the private sector accounts for 80% of the healthcare expenditure with 64% being out of pocket and public health expenditure in India is among the lowest in the world at around 1% of the GDP.

September 01, 2008

Kerala's AYURVAID to set up 40 hospitals across India

After establishing two hospitals in Kerala, AYURVAID Hospitals has now finalised a national roll-out initiative, planning to have 40 Ayurveda hospitals integrated with modern medicine across the country, its Managing Director Rajiv Vasudevan said.

AYURVAID at present has a 15-bed hospital in Kochi and 60-bed one in Aluva and the third one - a 25-bed facility - is all set to be opened here, he said. Five more hospitals are planned in the first phase over the next six-eight months.

"We are looking at a mix of metros, tier-II cities and perhaps one tier-III city (for opening the five hospitals)", Vasudevan told PTI here. "The goal is to have 40 hospitals (both company-owned and company-managed) in four years".

Two-third of the proposed 40 hospitals would be 15-bed ones and the remaining 50-bed ones. "We will focus on bottom of the pyramid with 60 per cent of its capacity focussed on poor patients", he said.

AYURVAID has received a Rs 4.5 crore funding from Acumen, one of the world's largest fund for social ventures, with the latter picking up a minority state n the AYURVAID, a division of kerala First Health services Pvt Ltd.

This money is sufficient for expansion plans in the first phase, he said, indicating that funds for the bigger roll-out thereafter would not be a problem. "There is active interest by a lot of people in the sector", he said, also noting that establishing Ayurveda hospitals is not capital-intensive.

ShareThis

LinkWithin

Related Posts with Thumbnails

Categories