WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 51 lead this digitalization. 5G will optimize not only internet performance but will also improve productivity, help in cost cutting, and experience real-time feedback. All of these will ensure greater economic output. The primary difference between 4G and 5G is the speed and lesser lag time between the transmission of data between the device and the base station. With all of the projections, 5G comes with its health impacts which can be quite hazardous for people’s wellbeing. 5G base stations will use less power and will be much smaller in size due to which numerous ‘Small cells’ will be installed in residential and commercial areas to be able to connect to many more devices and offer faster speeds. This rise in small cells will increase the health risk as the electromagnetic waves will penetrate almost each and every square inch of our living, working and public spaces. EFFECTS OF 5G SPECTRUM ON HUMAN HEALTH The EMR emissions from telecom The EMR emissions from telecom antennas have proven negative impacts on human health. 5G will lead to a large amount of radiation emission, which would cause higher stress on the human body, lower immunity and result in various short- term and long-term health issues antennas has proven negative impacts on human health. 5G will lead to a large amount of radiation emission, which would cause higher stress on the human body, lower immunity and result in various short term and long term health issues. 5G will need more tower installations which increases the amount of radiation in the environment. High-speed devices will emit and absorb 100 times more radio frequencies compared to the devices we have now. The World Health Organization’s International Agency for Research on Cancer (IARC) states that more research is needed to make sure whether these radio frequencies trigger certain types of cancer. Other health impacts include eye damage, ageing of the skin and other skin-related issues, infertility, slow or abnormal brain development in children, lack of attention, heart diseases, sleep disruption, depression, etc. The health hazards of the 5G spectrum are a controversial topic since it has not been tested as yet through any major research or study, however we can’t deny the impacts of EMR emissions, which has been backed up with enough evidence medically in India and Internationally. The government should make efforts to encourage more research on whether 5G spectrum causes adverse effects on health parameters before welcoming 5G in India, because India is already suffering from enough social, economic, and political issues. Introducing 5G without proper research might just add up to those issues. However, we can never unsee the health impacts which initially might feel negligible but can take serious turns. The world has already seen the face of a very massive pandemic and here comes the question of whether we accept 5G in it’s current state as it is for the merits it is bringing with it, or modify it with added layers of safety which exists today with health tech organizations working in this domain and having solutions which enable smart devices and technologies like 5G to be used more safely and responsibly by consumers.
52 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM HEALTH IS MORE THAN JUST WEALTH Despite all our Covid learnings, and all the panic, pain and health issues that each of us saw all around us, have we learnt enough? By Srinath Sridharan Does the old proverb - “health is wealth” - need repurposing ? The rush toward individual wealth creation and chasing monetary benefits is not wrong. But the purpose of life being only those, is the worrying issue. Health and wellness has been a side-thought for most of us. We have probably never paid special emphasis on preventive healthcare and proactive wellness measures. Health has been seen as a fad, and a fashionable statement to chase. With the Indian demographics being a younger one of having a median age of 31 years, and 65 per cent of the population being under 35 years of age, health and wealth are two topics that have to converge. But not yet. For a younger demographics nation, ageing and lifestyle-diseases as people age is a larger socio economic burden too. With the current statistics seemingly loaded against us, we have to work harder if we don’t want the tag of being the Obesity & DiabeIN FOCUS SRINATH SRIDHARAN Corporate Advisor
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 53 tes capital of the world. With Covid, as a society, we did demonstrate our ability in behavioural transformation towards positive personal health and hygiene. We saw an uptick in seeking health insurance coverage, starting of on better fitness and nutrition programmes, as well as preventive health monitoring and medical check-ups. Covid also increased the adoption of virtual healthcare. Will those last? I am a skeptic here. Despite all our Covid learnings, and all the panic, pain and health issues that each of us saw all around us, have we learnt enough ? Have we sustained a better health regime ? Have we started working in getting our public health infrastructure efficient ? Wealth is probably easier to earn and accumulate than good health. It is therefore, essential to build on its goodness. INDIAN HEALTHCARE INFRASTRUCTURE The healthcare sector is one of India’s largest sectors, in terms of revenue and employment. The sector includes hospitals, medical clinics, outsourcing of clinical / diagnostic / medical services based out of India, medical devices, telemedicine, medical tourism, health insurance, medical equipment, and clinical trials. To serve a stratified population of over 1.2 billion people who have different affordability patterns is a challenge to any industry. While it is an opportunity for brands to serve those audiences, from a public-good perspective, it is a tough task for healthcare policy makers. As we see advances in the medical field, as well as the ability to use digital tools for public healthcare, the opportunity to offer better access and health equity to our citizens would improve. India’s healthcare delivery system is categorised into two major components – public and private. The government, i.e. public healthcare system, comprises limited secondary and tertiary care institutions in key cities and focuses on providing basic healthcare facilities in the form of primary healthcare centres (PHCs) in rural areas. The private sector provides the majority of secondary, tertiary, and quaternary care institutions with major concentration in metros, tier-1 and tier-2 cities. By the Indian Public Health standards (IPHS), the delivery of primary healthcare is designed to provide an integrated curative, preventive, and promotive care to the rural population, through subcentres, primary health centres (PHC), and community health centres (CHC); secondary care is delivered through district and subdistrict hospitals, and tertiary care at regional/central level institutions or super-speciality hospitals. The Indian healthcare sector has challenges of inadequate distribution of healthcare service providers and the need for low cost (and yet, impactful) healthcare solutions for increasing diseases (especially chronic ones). India has a doctor-topatient ratio of 1:1456 – much lower than the 1:1,000 recommended by the World Health Organization. India also has a huge shortage of doctors, nurses and paramedics. The government spends just 1.1 per cent of GDP on healthcare. The rural and urban populations of India have varied experiences with healthcare. Over 70 per cent healthcare infrastructure can be found in urban India, where only 25 per cent of the Indian population lives! This means that nearly 3/4th of the population living in rural areas lack even primary healthcare facilities ! No doubt this has spurred the government to open more medical schools towards capacity building. At present, there are 23 AIIMS campuses in India out of which 19 are functional and the rest are under construction. The private sector has struggled with returns on investments (RoI) due to various reasons. However, The government spends just 1.1 per cent of GDP on healthcare. The rural and urban populations of India have varied experiences with healthcare. Over 70 per cent healthcare infrastructure can be found in urban India, where only 25 per cent of the Indian population lives. This means that nearly 3/4th of the population living in rural areas lack even primary healthcare facilities As of Nov 2022, there are over 7,500 HealthTech startups in India. But we don’t have large health unicorns, or healthcare startups that impact millions of consumers. We need more healthcare startups and a few pioneering ones that can break through the traditional healthcare incumbents
54 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM IN-DEPTH with proliferation of technology and digital tools, especially in the field of medicine, it could prove to be a game-changer. To a large extent, public healthcare is heavily dependent on “processes”; to this effect, the Indian healthcare system needs to “up its game” in building leanprocesses that are contemporary to the current and evolving needs of the population. And it can bring wider affordability and healthcare accessibility by including digital tools in its thinking. Through Ayushman Bharat, the government is providing insurance coverage to over 500 million citizens. This changing role of the government from a provider to a payer will have long-term implications for increasing accessibility for the entire population. Universal healthcare is possible only if it is a budgetary, political and economic priority. Hopefully India will keep increasing its national budget on healthcare – not just in care and cure, but in preventive healthcare as well. TRENDS 2023 While there have been much progress and innovations for commercial scale, this trend estimation article assumes only those trends that would have impact on society in the calendar year ahead. So it excludes digital healthcare for the time being as the author believes that it would take more than two to three years for deeper impact. Similar is the argument for excluding Access to affordable drugs, patents licensing, affordable health infra. While the necessary policy initiatives have started, it is yet to trickle down into pricing and access benefit for the consumers. India certainly hosts a unique barrage of problems with regard to healthcare as well those similar to that of other countries like staffing discrepancies, high expenditures, a shortage of physicians and skilled workers. Currently, but for a few outliers, most healthcare providers (hospitals, clinics, etc.) are not patient-centric. They have been built with doctors who have god-like status. The care given is medical, and not much emotional or health-literacy support is given to the families of the patient being treated. This space is waiting to be disrupted. TREND - 1 : BASIC PERSONAL HEALTH AND WELLNESS AWARENESS Even if an individual has much wealth or all the advantages in life, her / his life will not be worth living if his health is weak. Fuelled by advances in medical sciences and consumerisation of diagnostic technologies, nutraceuticals are becoming an integral part of treatment for specific issues as well as holistic health and wellness. For instance, consumers can now access genomic tests that make their detailed health profiles available without much effort, opening up several new use cases for nutraceutical companies. Combined with the use of digital technology and the emergence of ecommerce and direct-toconsumer models, consumers are entering the age of unprecedented access to high-quality and effective nutrition and supplements made to suit their needs. Will a larger section of our population be guided by their proactiveness toward better personal health and awareness? I opine that we would. TREND - 2 : MENTAL HEALTH IS NOT UNDER A CARPET In the last few years, the conversation around mental health has become more mainstream, with people talking more openly about their struggles. But how has this shift impacted the way in which Indians perceive and understand mental health-related issues? Mental health literacy is the gateway for mental health interventions in India. There is a lack of awareness which can lead to overlooking, misjudging or dismissing the signs that someone needs help. How can we rectify this gap? I observe that we are opening up more to discuss this topic. India will do better with
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 55 Combined with the use of digital technology and the emergence of ecommerce and direct-to-consumer models, consumers are entering the age of unprecedented access to highquality and effective nutrition and supplements made to suit their needs conversations, especially open ones, about mental health. And this year ahead could see more such themes emerging for societal good. TREND - 3 : HEALTH INSURANCE A NEED AND NOT A LUXURY Insurance is becoming a need. At this point, healthcare inflation is high, and the affordability of healthcare services is a question mark. A NITI Aayog report titled Health Insurance for India’s Missing Middle launched in October 2021 mentions that, “Relatively low health insurance coverage, and costlier provision of health services in the private sector drive India’s high out-ofpocket expenditure (OOPE). Despite the decline in the past few years, India’s OOPE as percent of current health spending is 63 per cent, significantly above the average for lower-middle income countries,and amongst the highest in the world. High OOPE poses financial risk to individuals.” We have world class healthcare in urban areas, but public healthcare continues to be overcrowded and underfunded. Investments in public hospitals and primary healthcare centres are not enough, given the sheer size and healthcare needs of our population. However, medicines continue to constitute a large part of the OOPE because they are not financed by the state. Rising income levels, an ageing population, growing health awareness and a changing attitude towards preventive healthcare is expected to boost healthcare services demand in the future. The current health insurance penetration is a low single digit, in fact one of the lowest health insurance penetrations in the world, with only 18 per cent of people in urban areas and 14 per cent in rural areas covered under any kind of health insurance – privately acquired or government scheme. Health insurance penetration in India is extremely low due to limited reach, and lack of awareness and education. Around 75 per cent of Indians pay for medical services from their pocket. They are not covered by any government or private health insurance scheme. None of us are strangers to stories of policyholders having poor experiences with insurance companies. Another factor plaguing the policyholders in India is the fact that most policies cover only hospitalisation costs. Other matured economies cover hospitalisation along with clinical visits and medication. Of late, select policies have started offering OPD. Hope the insurance sector will adopt digital tools for making consumer convenience and data access for better and sharper risk underwriting. For example, wearables are becoming a part of daily usage, and with reduced pricing, could see higher adoption across the country. TREND - 4 : INVESTM E N T S I N N E W E R HEALTHCARE INFRA ACROSS INDIA The Government of India, in 2021, as part of a Rs 6.29 lakh crore fiscal stimulus package, had initiated a loan guarantee scheme for setting up private hospitals or to upgrade them. It is said that not a single hospital has come up under this Rs 50,000-crore loan guarantee scheme. Under this LGSCAS, scheduled commercial banks were allowed to provide credit, with interest rate capped at 7.95 per cent per annum, for projects in the healthcare sector. A maximum of Rs 100 crore per project was eligible for disbursal. The loans could be given for setting up, modernising or upgrading hospitals, clinics, dispensaries, medical colleges, pathology labs and diagnostics centres, or for upgrading facilities for manufacturing vaccines and oxygen plants, and to install critical medical equipment. The question to think about is the business viability of setting up medical centres across non-metros. Can 2023 see the beginnings for newer healthcare infrastructure coming up in non-metros? Also one wonders that despite such a demand for healthcare, why is it that healthcare businesses are seemingly unviable or unprofitable? TREND - 5 : HEALTHCARE STARTUPS As of November 2022, there are over 7,500 HealthTech startups in India. But we don’t have large health unicorns, or healthcare startups that impact millions of consumers. We need more healthcare startups and a few pioneering ones that can break through the traditional healthcare incumbents. The Indian market can offer sufficient patient volumes in probably creating one of the largest consumer focussed healthcare companies in the world. The healthcare startup community has to reimagine healthcare, and bring their obsession to consumers and technology to the core. It is possible to create a strong digital health ecosystem that serves hundreds of millions of Indians and could take a few more years. This is where policy encouragement, backed by visionary investors in funding these startups, comes in.
56 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM 6th Healthcare Excellence - Summit and Awards BW Businessworld Since the pandemic the healthcare sector has evolved to a solutionoriented industry. There is now more focus on preventive healthcare, which is considered a prerogative of the patients, who habitually consult frontline healthcare professionals VISUAL ESSAY Striving For A Better Tomorrow Inaugural address by Dr Annurag Batra Keynote address by Dr Deepika Saraf on ‘The Weakest Link In India’s Health System : ‘What It is and How it Can be Addressed’: Dr Shreeraj Deshpande talks of the ‘Future of Health Insurance In India’ Reducing Diagnostic Errors – Role That Technology Will Play: (L to R ) Mr Sanjeev Vashishta, Dr Arjun Dang, Dr Deepika Saraf, Dr Kabir Mahajan, VIRTUAL – Dr Tathagato Rai Dastidar Senior Care – Offering Holistic Care: (L to R ) Mr Harbinder Narula, Mr Vivek Srivastava, Dr Pradeep Gupta, VIRTUAL – Mr Vaibhav T ewari
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 57 Dr Vedam Ramprasad talks of the ‘Potential, Promise And Pitfalls of Genomic Medicine’ Dr Adityanarayan talks of the ‘Role Of Blockchain in the Healthcare Space’ Public Health Policy and Role of Remote Monitoring in Making This a Reality: (L to R ) Dr Urvashi Prasad, Mr Amit Singh & Mr Lokesh Prasad Genomics and the Pharma Industry : (L to R )- Mr Shivam Tyagi, Dr Vedam Ramprasad and Mr Vishwanath Swarup India – Affordable Destination to Destination of Choice (Medical Tourism): (L to R ) – Mr Shivam Tyagi, Dr Abhay Sinha, Mr Rajeev Taneja, Mr Danish Ahmed, Mr Vinay Aggarwal & Dr Tarun Girotri
58 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM VISUAL ESSAY Accessibility Of Healthcare - New Paradigm To Accessing Healthcare Services. (L to R ) Mr. Sunil Thakur, Mr.Harbinder Narula, Mr. Satish Kannan A Conversation: Good Doctor vs Honest Doctor. (L to R ) Dr. D. K. Das, Dr. (Prof.) Y. K. Gupta, Mr. Harbinder Narula, Dr. Atul Mohan Kochhar, Dr. Vaibhav Kapoor Winners - Group Photo India @ 100 : Opportunities And Challenges For The Journey Of Indian Vaccine Industry Dr. Sajjan Yadav Emcee For The Day Aditya Malik What Does It Take For A Healthcare Company To Become A Unicorn In India (L to R ) Mr. Harbinder Narula, Dr. Vaibhav Kapoor
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 59 Over the last few years India has made giant strides in the way healthcare is delivered and managed. In the post-pandemic world healthcare has especially acquired significance. The Indian healthcare ecosystem is re-innovating to integrate technology and to move forward at a brisk pace, which is the need of the hour. When the public health crisis progressively engulfed the world, healthcare professionals, doctors, nurses, pharmacists, healthcare entrepreneurs and scientists rose to the occasion to mitigate the risks and provide better healthcare facilities to the masses. The BW Healthcare World Excellence Awards identifies the brightest healthcare leaders who have redefined their chosen domains and excelled in them, with expertise, empathy, innovation and foresight. The list looks at unique business ideas and the people powering them. While each one may not have built a billion-dollar business, they are all committed to serve the nation by helping to provide the gift of good health to its citizens. BW Healthcare World’s Excellence Awards measure success, not just in terms of money, revenues, valuations and profits, but also in the way of innovative ideas and social impact covering the last mile. Now that India is the fifth largest economy in the world, healthcare is really the jewel in its crown. The Excellence Awards identify and felicitate the innovators, disruptors, founders and CEOs of this crucial and fast growing sector of the Indian economy. The eminent jury was chaired by Dr Y.K. Gupta , President, AIIMS (Jammu and Bhopal). Other jury members included Dr Annurag Batra Chairman & Editor-in-Chief, BW Businessworld & Founder, Exchange4Media; Dr Sahajanand Singh, President, IMA; Dr Atul Mohan Kochhar, CEO, NABH; Dr D. K. Das, Senior ConsultantOrthopaedics and Joint Replacement Surgeon, Founder & Director of CMK Healthcare Pvt. Ltd. (curemyknee. com); Dr Neelam Kler, Neonatologist, Sir Gangaram Hospital, New Delhi (Padma Awardee); Mr Vishwanath Swarup, COO, BSV; Mr Rajiv Nath, Forum Coordinator, Association of Indian Medical Device Industry (AiMeD); Mr Sudhir Mishra, Founder & Managing Partner, Trust Legal and Dr Sonia Lal Gupta, Director, Metro Group of Hospitals, Consultant Neurologist (Stroke and Headache Specialist) and Co-Founder, Voice of Health. The numerous nominations received were presented before the jury after a rigorous process of shortlisting. The jury carefully scrutinised all the nominations and selected the top leaders, innovators and doctors who have disrupted and revolutionised the field of healthcare with their contribution. The winners were honoured and felicitated at a grand event organised at Imperial Hotel, New Delhi. The jury chair Dr Y.K. Sinha joined virtually. He congratulated the winners and acknowledged the great work that all the participants had been doing. “It was a pleasure to be in the jury of the Sixth edition of the BW Healthcare World Excellence Awards. There were various entries from big corporates, small startups, professionals and standalone practitioners. It was very challenging to decide the best among them. It was a great experience. There were a lot of learnings and motivations,” Dr Sinha said. HONOURING EXCELLENCE IN HEALTHCARE BW Healthcare World Excellence Awards brings together the brightest healthcare leaders who have redefined their chosen domains and excelled in them, with expertise, empathy, innovation and foresight By Team BW
60 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM Dr Singhvi started by saying that “In the last decade we faced challenges while we were studying at the All India Institute of Medical Sciences (AIIMS), Delhi, and these challenges were always about the quality of services or the quality of healthcare, particularly eye care, which was available in metro cities, but not in Tier2 and Tier-3 cities of India. That is where the whole concept of how ASG should offer quality eye care in Tier-2 and Tier-3 cities came about. The idea was to deliver quality eye care which the patients demanded, as well as expected from people who studied at premier institutes.” According to him that is what the journey has been about – providing quality healthcare in Tier-2 and Tier-3 cities. The real challenge as of now is how to retain the doctors in remote areas. ASG Eye Hospitals have centres in Srinagar, Guwahati, Hajipur, Muzaffarpur, Patna, Jamshedpur, Dhanbad, but the challenge is to retain doctors in these places. ASG have made it a mission to train doctors. And, apart from financial security, the kind of professional satisfaction the doctors get by going to these cities to treat patients, is rewarding in the long-term. The pandemic made everything difficult, he stated. The Prime Minister announced that elective surgeries would take a backseat and these surgeries would have to be held up for some time till the situation got better. Dr Singhvi said, “We are practically dealing with eye care which is a non-emergency service. To manage our colleagues, employees, company staff, managerial staff, i.e. more than 2,000 people, without any financial support from anywhere was a tough time. However, tough times make companies stronger. Now there is a pragmatic shift of patients to eye care and why I say so is because people have started understanding the importance of infrastructure, and hyper-local market development especially since the pandemic when movement was restricted.” According to Dr Singhvi, people in Tier-2 and Tier-3 cities have suddenly seen a disruption in patient care where every hospital, every eye care facility is situated. He also mentioned that Covid-19 gave them an opportunity where people were forced to come to their hospitals and once they got to see a similar level of delivery of healthcare or eye care which they got in metro cities, there was a surge in demand. “We are running four parallel streams as of now. One is the organic engine, our greenfield hospitals where we open 10 to 12 hospitals every year and these are going to be typical Tier-2 and Tier-3 projects. Second is the inorganic or partnership models which we have developed over the last three years where we have already partnered with 5 to 6 of them and we are in the process of partnering with 23 to 24 more practices in India. Thirdly, over the next one-and-a-half to two years we are expanding further and lastly, how do we standardise practices at the district level, because that is a big box that is going to open another 600 to 700 districts of India which will come into play,” Dr Singhvi mentions. The fourth model is going to be huge. He said that there is an epidemic of diabetes coming to India, and it affects our retina and kidneys. Early treatment in the next 20 to 25 years is going to be available. Dr Arun Singhvi, MD and CEO, ASG Eye Hospitals speaks about how they are going all out to deliver quality eye care in Tier-2 and Tier-3 cities WINNERS By Kavi Bhandari Quality Eye Care DR ARUN SINGHVI
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 61 According to Dr Arjun Dang, CEO, Dr Dangs Labs, winning the award means a lot to him and his entire team as they bent over backwards and worked tirelessly for the last two years WINNERS By Kavi Bhandari We have close to 250 team members currently and I would say from our housekeeping to our top-most doctor, I with folded hands acknowledge and also want to say that I am nothing without them,” Dr Dang said. According to him, the trends and challenges they are witnessing in their sector, even though diagnostics has been in the limelight in the last couple of years due to the pandemic, are that as the image of lucrativeness in the diagnostics sector rightly portrays, there have been a lot of bigger players, corporates, pharmaceutical companies and hospitals which have jumped on to the bandwagon. Dr Dang shared, “Moving forward it also seems like there might be commoditisation, but what I feel personally is that there is a lot of scope to add value to the entire paradigm of diagnostics. Why I say this is because I am very confident that post-Covid the awareness of good quality tests is something that has risen significantly and even the common man now understands two important things – firstly, the same test might be available at different rates which different organisations offer, but obviously the quality varies, and secondly, diagnostics comprises of about 5 to 8 per cent of expenditure in the entire healthcare journey. We are keeping our fingers crossed as all we can do is work hard with a crystal clear vision of serving the nation.” He also mentioned that there are a lot of new innovations and novel initiatives that are going on and primarily they are focusing a lot on research. Research grade testing is what Dr Dangs Labs are also focusing on and they partnered with Bharat Biotech and also Biological E when they released their Covaxin and Corvebax vaccines, respectively. He stated that they have worked with a lot of vaccine manufacturers and are also conducting various clinical trials with private and public institutes. They are going to continue to work in the clinical trials segment along with the routine diagnostics segment. “Overall we feel that it is always about creating more value rather than only volumes as we do see that we live in a huge country with different patients having different requirements. You do have the public infrastructure that is available to the masses at free or almost no cost and although we do a lot of charity, we have a large organisation with a large footprint that takes our quality services to a large group of people,” he said. Their vision is to expand organically and to start with large cities initially and then move on to smaller cities. Striving To Provide Better Diagnostics Services DR ARJUN DANG
62 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM Dr Sonal Dixit, Regional Head of Medical Services – North and West Cluster, Manipal Hospitals, has an experience of more than two decades in the healthcare industry. She spoke about the good work her organisation is doing and how they are being acknowledged for their efforts. She also talked about the trends and challenges in the healthcare sector and how they are tackling them. “I believe the weakest link in the healthcare industry today is lack of skilled manpower. Being a healthcare administrator, that’s the major challenge I face. We can invest in equipment and have the best infrastructure, but unless we have skilled technicians, paramedics, doctors, nurses etc. we won’t be able to deliver quality care to the patient,” she said. She also believes that the other challenge is concentration of healthcare services in certain areas. Reaching out to remote areas through technology, AI (Artificial Intelligence) and telemedicine, she said that everyone should be working towards changing the current scenario. “Unless we do that, the total concentration of healthcare services will be in urban areas and in Tier-1 and Tier-2 cities, whereas remote areas will lack such services”, she explained. She stated that she is very lucky to be a part of Manipal Hospitals, which is on an expansion spree. Today, Manipal Hospitals is the second largest chain of hospitals and healthcare providers in India. She shared, “What is important and what makes Manipal Hospitals different is the fact that despite having so many hospitals and operating in many cities, everyone’s interests are subordinate to a patient’s needs. It is our endeavour to ensure that patient satisfaction score is just not a statistic and whatever we do is beneficial to the patient.” Dr Dixit wants to ensure that they always practice evidence-based medicine and they have patient-centric hospitals, and not a physician-centric practice which is based on the whims and fancies of individuals. Moreover, she feels that process-oriented and Standard Operating Procedures (SOPs)-oriented practice provides a safe environment for the patients. Also, offering them best services and at the minimum cost is critical. According to her, in the last two years there has been a paradigm shift in the approach to patient care, the reason being that the patients have become more aware. Hospitals today should do all they can to provide quality services to patients. She also hopes this awareness results in preventive healthcare comprising of tests and annual health check-ups. She added that it is important for a patient to trust doctors. “Google knowledge can’t be 100 per cent correct and medicine is both a science and an art. It is not only 100 per cent science as there is a lot of art in managing patients,” she concluded. Nominated in the category of ‘Individual Excellence in Healthcare’ at the 6th edition of the BW Healthcare World Excellence Awards and winning the award, Dr Sonal Dixit describes how their sole focus is on providing quality care to the patient WINNERS By Kavi Bhandari A Patient-Centric Model DR SONAL DIXIT
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 63 Dr Mahesh Mylarappa, Chief of Medical Services, Manipal Hospitals, Hebbal speaks about how they have been instrumental in helping patients to access quality healthcare at home WINNERS By Kavi Bhandari Dr Mylarappa started off by stating that the effort they have put in to bring about change in people’s lives by offering them the services that they needed in the comfort of their homes has been massive. “Getting a doctor to see them, diabetic reports, monitoring their lifestyle, reducing sugar levels, and also giving them a very active and a very healthy lifestyle in terms of diet and fitness as well as a stress-free life are a few methods of our strategy,” he said. According to him, the challenges start with acceptance by the people, especially when it comes to a virtual consultation, though post-Covid virtual consultations are being accepted. Currently they are working on educating people about the efficacy of having a virtual experience via online consultations with doctors. “Our future plans involve educating more people in multiple sectors – they can be the educational sector, government sector, private sector, students as well as working professionals,” he stated. He also went on to say that the roadmap ahead will focus on getting upgraded on a daily basis. Many healthcare providers are thinking about giving people more opportunities to get treated, hence there will be no more illness and well-being will be the new mantra from now on. He said that the vision looks clear though there will be challenges and hiccups. And, since everyone is working on a daily basis to improvise things, he feels very positive about their overall mission. They are looking forward to helping many more people and are doing so with a positive mindset. Offering holistic healthcare at home DR MAHESH MYLARAPPA
64 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM How are you feeling after winning this award? It’s not merely about winning this award. But for the purpose for which we got this accolade. Presently, we are servicing the people of this nation and the authorities. We are supporting the hospital network across the company and the country as well. And that in itself is a great feeling. This award actually goes to the ground staff, the Emergency Medical Technicians (EMTs), the pilots, and the paramedics who actually did this on the ground. What are the trends and challenges that you are witnessing as the Head of your organisation? The healthcare and health tech segment is a very fragmented unorganised sector so far. We are a b2b, b2c organisation. We are an emergency response platform, which has strong credentials around clinical services and on tech enablement. We run a hospital’s emergency response, which means, we answer emergency calls in under 45 seconds. We have also partnered with them to run their ambulance network, end to end, which means we enable them to become the fastest to reach the patient, if the patient requires an ambulance from a specific hospital, or let’s say on the roadside, in short, it is similar to an Uber/ Ola model. And our vision is to be the 911 of India. Our founder and CEO of StanPlus, Prabhdeep Singh, laid down that vision. He built a company around it and raised capital. Very soon we will launch ourselves aggressively on Direct-to-Consumer (D2C) model as well. If we can solve for emergency, we can solve for the electives, planning as well, whether there are patients who require help packages, whether there are patients who require support in diagnostics, whether there are employees of those corporates, for example, maternity benefits, elderly care, home care. What is the primary focus of your organisation? I’ll say our laser sharp focus is on emergency response at this point of time. We are focusing primarily on training, i.e. clinical training. So from the pilot to the paramedic, our staff is for Basic Life Support (BLS), and now being trained on Advanced Cardiac Life Support (ACLS) on a regular basis. So it’s not one-time training, they go to a training regime when they join, but there is a quarterly training programme for them. It is continuous and it is ever-evolving. What is your company’s future roadmap for healthcare technology? In general, I believe that the health tech startup industry will consolidate over the next two years. Having said that, for the segment, we are in, we are really the leaders. You take an example of diagnostics, there are pan-India chains, there are regional chains. As far as emergency response is concerned, that’s where we are as a segment. We’re really having the first-mover advantage at this point of time. In an exclusive interview with BW Healthcare World, Gurjit Singh, COO and Founding Member, StanPlus, speaks on the pivotal role of emergency response in healthcare WINNERS “Our laser sharp focus is on emergency response” GURJIT SINGH By Bhupendra Paintola
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 65 Dr Naveen Kumar Arya, MD, Ayurveda Yogashram Remedies said, “Over the years, the scenario in the field of Ayurveda has changed totally and it has become the voice of the world.” Dr Arya won the BW Healthcare World Excellence Award for his organisation’s contribution to Ayurveda. Ayurveda Yogashram Remedies has been offering Ayurvedic treatment and therapy for the last 18 years and has treated more than 1,000 patients during the pandemic. Over time, Ayurveda has reached its peak level making every treatment possible. The Covid-19 pandemic has made people turn towards Ayurveda but still a lot of people need more information about the medical system. Dr Arya said that the Ayush Ministry has come out with various protocols regarding the treatment of Covid, but the biggest challenge is during emergency situations, they have to make people believe that Ayurveda has the treatment for the virus. Being questioned on whether Ayurveda is a slow process or not, Dr Arya said, “Ayurveda is not a slow process. In fact, Ayurveda is a fast process, it is effective in emergency conditions, and it has zero side effects. Also, Ayurveda is the only therapy that tells you that if you are healthy, what you can do to maintain your health.” Talking about the activities of the organisation, Dr Arya said that the Yogasharam is dealing with customers from 27 countries under the aegis of medical tourism. “We want to scale this up for all chronic disorders as well as stress management. In fact, for stress management, customers from all 27 countries are coming to us in order to learn about Ayurveda, its principles, yoga therapy, natural therapy, panchkarma therapy, etc.,” he said. The future of Ayurveda is paving a prosperous way ahead. Dr Arya said, “After India, the world’s top buyer of herbal medicines is USA, second is Australia, third is New Zealand and fourth is UK. In USA, the total share of the herbal industry in the medical field is 27 per cent. I am sure that in future Ayurveda will be the only medical system around the world along with which we can add medical tourism for treating chronic disorders, mind and stress management.” “I’m confident that in the next 5 to 10 years India will become one of the top global destinations for medical tourism not only for stress management but for treating chronic disorders also that are incurable as of now,” he said. Lastly, Dr Naveen Kumar Arya expressed his gratitude for being honoured with the BW Healthcare World Excellence Awards. Dr Naveen Kumar Arya, Managing Director, Ayurveda Yogashram Remedies speaks about the efficacy of Ayurvedic treatments in the current scenario By Sneha Patro Ayurveda A Key Driver In Medical Tourism DR NAVEEN KUMAR ARYA WINNERS
66 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM Pregnancy with complications is becoming a common issue these days. According to the World Health Organisation (WHO), almost 15 per cent of pregnant women are at risk of developing complications during pregnancy. While complications can also occur due to stress and anxiety suffered by the mother. However, to tackle such problems, an initiative called “Virtue Baby” was started that offers comprehensive services in the areas of maternity, gynaecology, fertility, neonatal intensive care, paediatrics, dermatology, cosmetology and trichology. Dr Nitika Sobti, Additional Director - Obstetrics and Gynaecology, Cloudnine Group of Hospitals started the initiative in 2013 through her experiments with pregnancy, spirituality and its scientific applications. She discovered that a mother’s thoughts and feelings have immense power to completely influence the character of her child. “I started my work to counsel pregnant women so that they know everything while creating a new life. In 2014, YouTube became the medium through which I started talking to them. With time, I saw a drop in caesarean rates and complications among the patients,” she said. HOLISTIC CARE Virtue Baby represents the mother’s holistic care of thoughts and emotions and is involved in the overall physical and emotional development of the baby, producing hormones that have a long-lasting effect on the child’s personality. This includes educating parents on the significance of the Garbha-sanskar. The goal of the initiative is to calm the body and soul, reduce anxiety, boost immunity, and give a mother pure energy levels so she can have a healthy baby. Talking about the coming years of Virtue Baby, Dr Sobti said, “My vision is that every pregnant mother gets guidance in a click of the mouse. So, I have books, and meditation sessions for them to listen to every day. Apart from that, I’m working on the pregnancy sessions. So people just need to listen to those for a few hours and understand how mind and body are related. As we are in a digital world now, I’m trying to make all the things available at the fingertips of a pregnant mother.” DETECTING THE ACTUAL PROBLEM Postpartum depression is a serious mental illness that affects the brain, behaviour and physical health, and it can be seen mostly in pregnant ladies. Postpartum means the time after childbirth when most women feel sad, within a few days of giving birth. If this lasts for more than two weeks, it turns into depression. Dr Sobti said that a survey done in the USA showed that only one out of ten women, that is 70 per cent was diagnosed with postpartum depression, while in India 85 per cent of the mothers are depressed after delivery. This affects the development of the child. While speaking about diseases, Dr Sobti indicated the key reason a child gets into different health issues is due to the state of mind of the mother while she is pregnant. “We do not talk about adverse childhood experiences but are talking about cancer, diabetes, hypertension whose roots go into those nine months when a lady is pregnant. Those nine months is a very critical time because all the multiplications happen at that time. We need to take care of that so that the load of these diseases is less,” she said. Dr NitikaSobti concluded by informing about the success Virtue Baby is achieving while fulfilling its vision. Virtue Baby, an initiative by Dr Nitika Sobti offers maternity, gynaecology, and fertility services, among others WINNERS Towards Good Prenatal Care DR NITIKA SOBTI By Sneha Patro
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 67 With more than 35 years of experience, Dr Sita Rajan, Senior Consultant - Obstetrics and Gynaecology, Manipal Hospitals, Bengaluru is dedicated to providing world-class services to patients with treatments for diseases during pregnancy. Dr Rajan has expertise in hysterectomy, high-risk pregnancy management, infertility, fibroids, vulvar disorders, ovarian cysts removal and general gynaecology surgeries She has treated many complex medical cases and is known for her attention to detail, accurate diagnosis, and compassionate care for her patients. On receiving the BW Healthcare World Excellence Award, Dr Rajan expressed her gratitude. Talking about the challenges in the healthcare sector, she said, “The biggest challenge is to bust the myths people tend to get misinformed about on the internet. To make people understand and convince them that what they read on the internet is not always 100 per cent true is a bigger challenge.” Covid-19 being the devastating two-year pandemic for all sectors around the world, had been a challenge to the healthcare department too. Dr Rajan said, “We had to deal with Covid positive patients, and take safety measures for ourselves. Most importantly, when Covid started, no one knew what was the best way to go ahead, but things have become clearer and have settled down, so that’s a relief.” Dr Rajan also conveyed her determination to train more people in future and to make sure they understand ethical practices, follow methodologies and rules. “Training them ethically as well as technically is most important for me now. One might be skilled but dedication is also what counts, so this is what I would like to pass on to the younger generations,” she said. Talking about the roadmap of the healthcare sector, Dr Rajan elucidated on the new technologies that are being used at Manipal Hospitals. “Obstetrics is more about childbearing, and our technology is more towards diagnostic tools, but the ultimate thing is doing the doctor’s job, and improving skills is what is important,” she said. Dr Rajan further said that by improving skills one can reduce dependence on unnecessary investigations or surgeries. Apart from that, much of the healthcare services are available in urban areas, while the rural areas are always left out. So rural areas also need to be provided with healthcare services. Dr Sita Rajan, Senior Consultant - Obstetrics and Gynaecology, Manipal Hospitals, Bengaluru elucidates on how they are working towards building a better healthcare system WINNERS By Sneha Patro Building A Better Healthcare System DR SITA RAJAN
68 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM Orthopaedics is one of the branches which is ever evolving because of the continuous use of artificial intelligence as well as products,” said Dr Sunil G Kini, Senior Consultant - Joint Replacement and Arthroscopy, Manipal Hospitals, Bengaluru. When one talks about joint replacements, then the number of artificial joints relacements in India is projected to grow at the highest rate in the world from 2020 to 2026. Talking about joint replacements in orthopaedics, Dr Kini said that these implants are modified with time. “15 years back when joint replacements were being done, we used to say that the implants are going to last for 10 years, but now with improvised ceramic joint replacements, the average shelf-life of implants is around 25-30 years,” he said. As per Dr Kini, the shelf-life and techniques of implants have been improvised with robotics as well, and now precision is what is being looked at. Talking about the current plans of Manipal Hospitals, Dr Kini said, “In terms of orthopaedics, we are planning to get the latest technologies. Robotics technology is much beneficial for patients, also it works well, so we are planning to use it in our institution as well. Apart from this, we do a lot of exclusive work to get a lot of patients from overseas in our Bengaluru centre.” The pandemic being a huge blow to all hospitals in general, also affected Manipal Hospitals in the first one- and-a-half years. Dr Kini said that during the first and the second wave, the services saw a decline of up to 60-70 per cent. Then in mid 2021, it picked up and has now exceeded the pre-Covid numbers. The hospital is receiving a larger number of patients as compared to pre-Covid numbers. “It has been a boon, and the healthcare margin is only going to improve over the years,” he said. The orthopaedic sector being one of the evolving branches will grow with newer approaches, rehab processes, artificial intelligence, and robotics. Dr Kini said, “For joint replacement cases, we have integrated with partners in Fitbit industries. They offer Fitbit watches by which we can track how many steps one can do post a joint replacement, and what medicines one can take, and there’s a constant interaction between the doctors and the patients.” Orthopaedics is one of the branches which is ever evolving because of the continuous use of artificial intelligence as well as improvised products, says Dr Sunil G. Kini, Senior Consultant - Joint Replacement and Arthroscopy, Manipal Hospitals, Bengaluru By Sneha Patro Improving Patient Care in Orthopaedics DR SUNIL G. KINI WINNERS
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 69 What does this award mean to you? Winning the “Most innovative startup of the Year” award means a lot. And it gives us a lot of confidence to move forward and build a business in a bigger way. What are your current plans? And what are you looking to do in the future? Our whole objective is very much aligned with what the Modi government is trying to do. So, at this point, digital health is at the forefront of government policy, beginning with the national digital health mission, In an exclusive interview with BW Healthcare World, Tarun Gupta, Founder and CEO of VaidyaRX speaks on digital healthcare as a solution provider “Exciting Times Ahead For The Healthtech Sector” TARUN GUPTA WINNERS and our concept, our idea of VaidyaRX, which caters to patients, doctors, and pharmacists and is extremely patient-centric and revolves around digital health, is in sync with India’s overall policy and with the goal of actually helping patients at the grassroot level. Currently our product, which is a software as a service platform, is live on Android at this point, and we are solving a very critical follow-up prescription care problem. We realise that most patients don’t even understand their prescription. A simple thing that the medicine has to be taken with milk, without milk, at night, what does BDS (twice a day) stand for? What does TDS (thrice a day) stand for? KYP, which stands for “know your prescription,” is the name we gave to our flagship product. We are building the Oberoi of telehealth where we are actually aggregating all the doctors who have retired from top institutes to give a service for second opinions. Last but not the least, our actions have had an impact on our ecosystem. So we have patients who are doctors. And now we have also got local and retail pharmacists into our ecosystem where the patients can actually order within five kilometers of a doctor’s clinic through his prescription, which is a digital prescription. How do you think the roadmap of healthtech sector will look like in coming years in India? I believe these are exciting times. We are surprised that within the first few months of our product’s release, we haved around 50,000 users, and a large number of doctors are in fact reaching out to us to become a part of our platform, including pharmacists. Today everyone is looking at digital healthcare as a solution provider. Technology is an enabler. AI is an enabler. And of course, policymakers are pushing it at all levels. By Bhupendra Paintola
70 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM How are you feeling about getting this award? It feels really great. It’s an honour and I’m grateful to the entire BW team. We at Medulance have always believed in collective efforts. And, till date we have saved around eight lakh lives. In the last two years, the meaning of the terminology ‘saving lives’ has changed a lot. What’s your take on that? I totally agree with that. My father passed away due to Covid last year. Hence, I actually realise the impact of saving lives. Speaking from a sector perspective, what are you’ll doing when it comes to handling emergencies? We’re integrating with different partners and different technologies so that access isn’t a problem on the ground, and we will work day in and day out to improve the quality of emergency medical transportation, how things can be done, and how the ground force needs to be really educated and trained so that they can handle any emergency. So that’s how we just keep on working on training them as well. What are some of the ventures that you are looking forward to? There are a lot of things in the pipeline, and technology has helped us in the emergency domain. And we continue to innovate on a daily basis to do so. What in your opinion is the future roadmap for healthcare technology in India? Considering government initiatives like digital card, single policy, etc., these are small initiatives. So these are seeds, you won’t see the benefits right now. But, in the next ten years, you’ll see how much health tech has helped in mapping your emergency details with a single number or mapping different details to services. In fact, simple, unique IDs can also help any emergency department or any other department during a crisis. In an exclusive interview with BW Healthcare World, Ravjot Singh Arora, Co-founder, Medulance speaks on the road ahead for improving the quality of emergency medical transportation WINNERS “Technology Has Helped Us In The Emergency Domain” RAVJOT ARORA By Bhupendra Paintola
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 71 What does winning this award mean to you? First of all, thanks for choosing us to be one of the winners. It holds great value for us. It gets us going, the acknowledgement by the media, or by the people for the good work that we’re doing. It certainly is something which we cherish. And certainly the team gets encouraged by these accolades. The credit goes to the people in the company, who are working relentlessly, day after day, with all the ups and downs that we have witnessed over the last few years. What are the trends and challenges you see in the field of pathology today? We have to understand that the market is huge, there is a big gap between the supply of superior quality diagnostic services, and the demand for it. So, the demand is only going to go northward. Not many people were aware about diagnostics, but after Covid people have started investing in healthcare requirements and understand the value of being healthy. As a result, diagnostics has taken the shape that it has, and we believe that people, particularly those in smaller cities, should not have to travel 50 or 100 kilometres to meet their diagnostics needs. The main challenge we face is a lack of trained and qualified personnel. As you would be aware, in our country, we have got more than 125,000 labs, but only about 13,000 qualified MD doctors, MD pathologists or MD biochemists or MD microbiologists, who are there to take care of these labs. The second issue is related to the quality of services. There’s a huge dearth of labs that provide quality services. And thirdly, we have to make the services available at affordable prices. When it comes to pathology, what is the roadmap you see for the next decade or so when you include health tech startups that provide diagnostic services at an affordable price while also providing quality? Diagnostics is an integral part of healthcare. 70 per cent of the clinical decisions are taken after getting the investigations done, whether they are pathology or radiology investigations. If the number of labs that are recreated is only 1.5 per cent to 2 per cent, that’s not a good sign. So, I think at the very least we should create awareness in the minds of the masses, in the minds of the doctors, to usher in patients to the labs, where they can be certain of the quality or accuracy of the report. The communication between the pathologist who has done the test and the clinician who has palpated the patient will be a game changer. If they exchange notes, they will be able to make a proper diagnosis, the doctor will be able to understand the prognosis and revise it for the patient, and the treatment will start at an early stage. In an sinterview with BW Healthcare World, Sanjeev Vashishta, MD & CEO, PathKind Diagnostics speaks on the growing demand for high- quality diagnostic services in India “The Market For Diagnostic Services Is Huge” SANJEEV VASHISHTA By Bhupendra Paintola
74 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM ARTIFICIAL INTELLIGENCE MAY REVOLUTIONIZE DRUG DISCOVERY The use of machine learning models to search medical data and uncover insights to help improve health outcomes and patient experiences is referred to as artificial intelligence in medicine. Artificial intelligence (AI) is rapidly becoming an integral part of modern healthcare in the wake of recent advances in computer science and informatics By Raheel Shah Artificial intelligence (AI) algorithms and other AIpowered applications are helping medical professionals in clinical settings and ongoing research.Artificial intelligence is also becoming more widely used in the pharmaceutical industry, raising both excitement and concerns about its longterm viability and potential. In recent years, a slew of companies, ranging from large pharmaceuticals to startups, have cast AI as a panacea that will transform the industry. Clinical decision support and imaging analysis are currently the most common roles for AI in medical settings. Clinical decision support tools assist providers in making decisions about treatments, medications, mental health, and other patient needs by providing them with quick access to relevant information or research. The goal of drug discovery is to find new medicines that can help prevent or treat a specific disease. Although there are numerous types of drugs, many COLUMN RAHEEL SHAH Director of BDR Pharmaceutics Pvt Limited. are small chemically synthesised molecules that can specifically bind to a target molecule – typically a protein involved in a disease. Traditionally, researchers screened large libraries of molecules to identify candidates for drug development. Although rational structure-based drug design has become more common over time, it still necessitates multiple rounds of design, synthesis and testing today. Because it is difficult to predict which chemical structure will have both the desired biological effects and the properties required to become an effective drug, the drug discovery process remains costly and
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 75 Repurposing previously known drugs or late-stage drug candidates into new therapeutic areas is a preferred strategy for many biopharmaceutical companies because it reduces the risk of unexpected toxicity or side effects in human trials while also requiring less R&D spend existing data to gain new biological insights. Target identification, biomarker development, and patient stratification will all benefit from the technology. Current drug discovery methods are time-consuming, unreliable, cruel, and expensive. Artificial intelligence is transforming drug discovery and development by increasing clinical trial efficiency and enabling more agile and experimental working methods. The ability to match drug interventions with individual patients is one of the more time- and cost-saving applications of artificial intelligence, reducing work that previously required trial and error. Machine learning models can predict a patient’s response to potential drug treatments by inferring potential relationships between factors that may influence the results, such as the body’s ability to absorb the compounds, the distribution of those compounds throughout the body, and a person’s metabolism. Biomarker development is an important task not only in the context of medical diagnostics, but also in the drug discovery and development process. For budget-constrained pharmaceutical companies, repurposing drugs appears to be one of the most immediate areas where AI-based technologies can provide significant value. Repurposing previously known drugs or late-stage drug candidates into new therapeutic areas is a preferred strategy for many biopharmaceutical companies because it reduces the risk of unexpected toxicity or side effects in human trials while also requiring less R&D spend. Compliance to a drug study protocol by voluntary participants in clinical studies is a major issue for pharmaceutical companies. If patients in a drug study violate trial rules, they must be removed from the study or risk tainting the drug study results. One of the most important aspects of a successful drug trial is ensuring that participants take the prescribed dosage of the studied drug on time. That is why having a method to ensure drug adherence is critical.Artificial intelligence can separate the good apples from the bad by using remote monitoring and algorithms to evaluate test results. In the case of medicines or drugs prescribed under standard care, AI can be used to understand patient behaviour. This allows a greater number of patients to benefit from the potential drug, influencing the overall progression of the disease condition. Pharma companies all over the world are gathering a variety of data points, such as patients’ genes, in order to simulate and improve clinical trial outcomes. As a result, another advantage of AI in drug discovery is that it drastically reduces the time required to complete drug trials. Today, however, we are attempting to solve for much more complex diseases and combat them with greater accuracy, safety, and efficacy than previous treatments. Fortunately, we now live in a time when there is a wealth of data about human biology available, as well as the ability to analyse large amounts of that data, thanks to inexpensive and powerful technology. The potential of AI to address these complex diseases has grown significantly, but so has the difficulty of finding treatments and cures. time consuming. Drug discovery is critical in the fight against diseases. The search for new and better drugs is never-ending, whether it is for a newly spreading pandemic or a wellknown incurable disease. For drug discovery, two popular screening methods are currently in use: classical pharmacology and reverse pharmacology. Traditional pharmacology investigates natural products and plant extracts for therapeutic effects. In contrast, reverse pharmacology entails determining the function and role of the molecule (gene/protein) targeted by the disease. Both screening methods yield a large number of potential targets, which are further sorted based on target validation and pre-clinical animal testing. The current drug discovery process takes nearly half a decade before the drug is tested on humans. Artificial intelligence is paving the way for much safer and more dependable drug discovery and development techniques. It overcomes traditional R&D’s various challenges and constraints by analysing
76 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM DATA INTEROPERABILITY By using data interoperability to access and analyze data from a wide range of sources, healthcare providers and researchers can gain a more comprehensive understanding of the factors that influence one’s health and develop targeted interventions to improve care and outcomes COLUMN By Anupam Gupta UNLOCKING CAPABILITIES OF THE HEALTH ECOSYSTEM ANUPAM GUPTA Vice President Data Science, Optum Global Solutions (India) Data interoperability in the healthcare industry refers to the ability of different healthcare systems, devices and applications to exchange and interpret data accurately and efficiently. This is important because it allows different healthcare organizations and providers to access and use patient data in a uniform and meaningful way, thereby improving the quality of care and patient outcomes, reducing errors and costs, and enabling research and innovation. For example, if a patient sees multiple doctors at different clinics or hospitals, each of these providers may have their own electronic health record (EHR) system. Without data interoperability, it would be difficult for these providers to access and use the patient’s health data from other systems. With data interoperability, these providers can access and use patient’s data from any EHR system, which can help them make more informed decisions about the patient’s care. Overall, data interoperability is a complex and multifaceted issue in the healthcare industry, but it is also a vital part of making healthcare simpler and more effective for everyone.
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 77 Another key aspect of the future of data interoperability in the US healthcare system is likely arecords. EHRs are digital versions of a patient’s medical history that can be accessed and used by different healthcare providers. The widespread adoption of EHRs can help facilitate the exchange and use of data across different healthcare systems and enhance the use of AI to improve care and outcomes WHY SEAMLESS DATA EXCHANGE IS IMPORTANT IN HEALTHCARE According to Markets and Markets forecast for Healthcare Interoperability Solutions1, the global healthcare interoperability solutions’ market is projected to reach $5.7 billion by 2026. When different healthcare systems and providers can access and use data from a wide range of sources, they can get a more comprehensive view of a patient’s health history and current health status. This can help them identify potential issues that may not be apparent when looking at data from a single source. In addition, data interoperability can also help improve health outcomes by enabling the use of data analytics tools and techniques to identify trends and patterns that can inform the development of new treatments and interventions. For example, data analytics can help identify risk factors for certain conditions or identify patterns in patient behaviour that may be contributing to poor health. By using data interoperability to access and analyze data from a wide range of sources, healthcare providers and researchers can gain a more comprehensive understanding of the factors that influence one’s health and develop targeted interventions to improve care and outcomes. However, lack of data interoperability is an important area of concern in the healthcare industry. DATA INTEROPERABILITY CHALLENGES IN HEALTHCARE One of the main challenges of data interoperability in healthcare is the lack of standardization in data formats, terminologies, and protocols. This makes it difficult to exchange data between different systems and to combine data from different sources. To address this issue, there have been efforts to develop standardized data models, such as the Fast Healthcare Interoperability Resources (FHIR) standard, which aims to facilitate the exchange of healthcare data. Another challenge is the lack of trust and security in data sharing, as healthcare data is sensitive and personal. There are concerns about the privacy and confidentiality of patient data, as well as the potential for misuse or abuse of data. To address these concerns, it is important to implement strong security measures and adhere to relevant regulations and policies, such as the Health Insurance Portability and Accountability Act (HIPAA). By addressing these challenges and implementing effective solutions, it is possible to improve data interoperability and enable the use of data analytics to drive better health outcomes. DRIVING BETTER, DATADRIVEN INSIGHTS FOR HEALTHCARE There are several ongoing initiatives and efforts aimed at improving data interoperability in the US healthcare system, including the use of standardized application programming interfaces (APIs) and the adoption of interoperability standards such as HL7 and FHIR. In addition, there is likely to be an increased focus on using data analytics and artificial intelligence (AI) to improve the exchange and use of data in the healthcare industry. For example, machine learning algorithms may be used to extract and analyze data from different sources, or to identify patterns and trends that can inform the development of new treatments and interventions. Another key aspect of the future of data interoperability in the US healthcare system is likely to be the increased adoption of EHRs. Electronic health records are digital versions of a patient’s medical history that can be accessed and used by different healthcare providers. The widespread adoption of EHRs can help facilitate the exchange and use of data across different healthcare systems and enhance the use of AI to improve care and outcomes. Overall, the future of data interoperability in the US healthcare system is likely to involve a combination of technological advances, the adoption of interoperability standards, and the increased use of data analytics and AI to improve the exchange and use of data in the healthcare industry. Development and adoption of interoperability standards would be crucial in connecting people, insights, data and technology to help make the health system work better for everyone.
78 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM ELECTIVE SURGERIES OF TOMORROW Ahead of the pandemic, there has been a regular flow of patients for elective surgeries that contribute almost 50 per cent of the revenues of many hospitals By Dr Vaibhav Kapoor YEAR AHEAD DR VAIBHAV KAPOOR, Co-founder Pristyn Care Elective surgeries have been around for as long as general surgeries and are normally scheduled according to a patient’s convenience in most cases. These include piles, kidney stones, hernias, cataracts, vascular, lipomas, joint replacements, and cosmetic dental procedures. Newage healthcare providers which are democratising surgical care in India have facilitated many of these surgeries in recent years. Ahead of the pandemic, there has been a regular flow of patients for elective surgeries that contribute almost 50 per cent of the revenues of many hospitals. The Covid-19 pandemic severely affected elective surgeries with more than 5.8 lakh such procedures delayed or canceled due to the lockdown to prevent the spread of the virus. A long-term effect of the postponement of elective surgeries is that some cases may require emergency surgeries and survival rates could go down. Earlier this year, elective surgeries in hospitals took a hit again amid the third wave of Covid-19 with the government’s focus shifting more toward Covid care, but most hospitals and clinics resumed elective surgeries by the end of February. The resumption saw a surge in elective procedures with a 20-30 per cent increase compared with prepandemic levels, as people who had canceled surgeries for fear of Covid infections in the last two years rushed to get those done. FUTURE OF ELECTIVE SURGERY The market for elective surgery in India is a booming one estimated at $30 billion with a 15 per cent annual rate of growth. But 90 per cent of the market is fragmented while the rest has organised players in the form of big hospital chains. New-age healthcare providers are the new kids on the block turning the elective surgery market on its head. Given the sise of India’s population and the volume of elective surgeries, the future of this segment is bright but challenging. New-age healthcare providers who are trying
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 79 MAXIMISING PRODUCTIVITY, MEETING DEMAND These healthcare providers prefer asset-light business models to cut costs. In order to maximise productivity, they must create a robust secondary healthcare ecosystem which can be done by transforming thousands of medical facilities into multispecialty surgical centers not only in tier-one cities but also in tier-two and tier-three towns countrywide. Outpatient appointments can often be an irritant but these healthcare providers can eliminate this pain point by booking a patient’s slot at the hospital for treatment and follow-ups and saving time. A dedicated care buddy accompanying the patient through the hospital journey can smoothen the exercise. With elective surgeries expected to see a continuous rise, these healthcare providers will have to stay at the top of the game to meet the demand of patients by deploying the latest technologies and ensuring that their surgeons continue to deliver top-quality care. POST- COVID SCENARIO While elective surgeries spiked after the Covid-19 pandemic, medical inflation on the heels of the pandemic has only worsened, forcing many patients to postpone elective procedures. The delay of thousands of such procedures could act as a speed breaker for the progress of healthcare in India. Some elective procedures are more time-sensitive than others, and delays could increase morbidity or mortality. Deferring elective surgeries for vision repair, knee replacement or gallstone removal for a longer period can worsen the quality of life and healthcare experience for patients. Around 60 per cent of elective surgeries are postponed due to financial reasons. Ironically, a high disease burden in India means there could be a huge number of short-stay elective surgeries, although these are yet to become a priority for those who need them. At the current rate, the Nigti Aayog estimates that only 30-35 per cent of patients undergo surgery in India as compared to 60-65 per cent globally. New-age healthcare players are critical to ensuring that elective surgery frequency does not slow down. India’s elective surgery market can grow on the back of increasing awareness among the young population and the availability of cutting-edge equipment for a wide range of surgical procedures. New-age healthcare providers have leveraged diagnostics, outpatient services, and perioperative care which are essential components of elective care, and have built up a strong distribution channel to chart remarkable growth and are poised to become a one-stop solution for all health issues in the secondary care space. hard to make elective surgeries affordable and accessible with tailormade schemes, must increase focus on improving patient care and experience and must leverage data to drive improvement. Patient data is now being generated in an increasing number of settings through different systems and modalities, and integration of that data along the patient journey is gaining more importance. A patient-first approach with meticulous process management, which includes standardisation of clinical and operational processes, extensive use of new technologies and analytics will be another prerequisite for them to expand the business. Along with these, the new-age healthcare providers will need to focus on clinical leadership to enforce quality control measures which will ensure that the clinicians and para-medical staff work to their best abilities. High-quality leadership will lead to the delivery of improved quality and efficiency. New-age healthcare providers must adopt newer technologies and solutions to deliver care in a convenient and empowering manner.
80 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM Quality Assurance for IMPROVED ACCESS TO QUALITY HEALTHCARE The new challenge before the Indian pharmaceutical industry is the current regulatory expectation of assuring the accuracy and consistency of the data generated over the product life cycle that is pivotal to product quality By Sanjay Kumar Jain COLUMN The Indian pharmaceutical industry is very dynamic, with a complex compliance st r uc t ure. Ind ia n pharma manufacturers export pharma products across the globe; hence several regulatory authorities such as India’s Central Drugs Standard Control Organisation (CDSCO), the United States FDA, the United Kingdom Medicines and Healthcare Products Regulatory Agency (MHRA), and other regulators guard it. The new challenge before the Indian pharmaceutical industry is the current regulatory expectation of assuring the accuracy and consistency of the data generated over the product life cycle that is pivotal to product quality. Pharmaceutical industry across the globe is facing multiple challenges in terms of quality assurance in various aspects. BY SANJAY KUMAR JAIN, President, India Operations, Amneal Pharmaceuticals
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 81 proper investigation and released batches have an impact on product quality and patient safety. The manufacturer must assume responsibility for the quality of pharmaceutical products to guarantee that they are fit for their intended use, meet the standards of the marketing authorisation, and do not endanger patients due to insufficient safety, quality, or efficacy. The following parameters have become critical in guaranteeing pharmaceutical quality assurance. DIGITISATION IN PHAR- MA INDUSTRY Digitisation in the pharmaceutical industry has helped in reducing the manual errors, avoiding breach of data integrity, improving efficiency, predictive analysis to strengthen the process and avoid product failures thus improving quality and reducing the cost of medicines. For example, digital and paperless laboratory has benefits such as atomisation of lab activity, complete traceability and transactional data review / approval through electronic system and increased efficiency of the analyst by reducing redundant data entry among others. Digitisation in the laboratory creates a positive impact in the mind of regulators. Regulators need completeness, consistency, and accuracy of data and verification during the audits. GOOD MANUFACTURING PRACTICES Good Manufacturing Practice (GMP) must be followed to ensure that quality of the medicines is consistently achieved. Every country has clear regulations for the manufacturing of the medicines, which gets updated on a regular basis, though sometimes reactively due to untoward incidents reported. To maintain compliance to the regulatory requirements, every individual working in the pharmaceutical manufacturing space should be oriented and trained to deliver as per these GMP requirements through rigorous on-going training programs. Keeping quality on top and following GMP is the only way of doing business in the pharmaceutical industry. Furthermore, GMP can help increase pharmaceutical export potential. The majority of nations throughout the world only allow the import and sale of pharmaceuticals that have been made in accordance with internationally recognised GMP standards. QUALITY ASSURANCE - GROWING FOOTPRINT FOR THE INDIAN PHARMA INDUSTRY Quality must be built in the product. This can be achieved when the organization has “Culture of Quality”, where quality is driven from Top to Bottom. Every individual in the organization contributes to build the quality of the product. Quality assurance plays an important role in developing the robust and sustainable quality system, training the employees for the system and delivering the drug product meeting all regulations, pre-determined specification, and achieving customer satisfaction. Digitisation in the pharmaceutical industry has helped in reducing the manual errors, avoiding breach of data integrity, improving efficiency, predictive analysis to strengthen the process and avoid product failures thus improving quality and reducing the cost of medicines The manufacturer must assume responsibility for the quality of pharmaceutical products to guarantee that they are fit for their intended use, meet the standards of the marketing authorisation, and do not endanger patients due to insufficient safety, quality, or efficacy CHALLENGES IN PHARMA Price Competition: Currently, across the globe, pharma manufacturers are facing high competition which is reducing their revenues and margins, making it difficult for companies to further invest in research and development. Data Integrity Issues: The pharmaceutical industry is a highly regulated industry and thus the manufacturing sites are audited at different stages of product life cycle by multiple authorities depending on the geographies the pharmaceutical company/manufacturing unit caters to. Data fraudulence, and manipulation has been identified in many organisations across the globe resulting in warning letters and import alerts impacting the business of the manufacturer. Poor Investigation of Quality issues: Most of the warning letters issued to pharma manufacturers across the globe have a common observation of poor investigation of quality issues like deviation, out of specification (OOS), customer complaints, etc. It becomes a concerning issue for the auditor specifically when the quality unit takes the decision to release the batches without
82 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM As the climate change crisis continues, the emerging trend will realign the responsibility for mitigating health and economic impacts shifts from governments and health authorities to businesses By Neeraj Balani COLUMN NEERAJ BALANI Managing Director, Indian Subcontinent, International SOS I n our last year’s International SOS risk outlook, we accurately predicted that geopolitical volatility would rise above prepandemic levels and that mental health and long Covid would be primary employee productivity disrupters to business in 2022. With the year ending, I wanted to reflect on several important variables we look out for key to remaining resilient in 2023. THE FORCES SHAPING OUR POSTPANDEMIC WORLD The immediate crisis of the Covid-19 pandemic may have passed, but businesses and governments have yet to reach calmer waters. Labour market shifts and talent shortages added to the mix. The legacy of the early waves of the virus is still being felt in economic turbulence and supply chain disruption. This disruption has been further deepened by geopolitical uncertainty and the Russia-Ukraine conflict. From increased tensions between the Quad and China to several profound changes in European government coalitions and instability across many developing countries. The pandemic led many people to re-evaluate their priorities, leading to a “great resignation”, with employee turnover hitting its highest levels in deClimate change and the threat to organisations
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 83 crises as we head into 2023. Infectious diseases have the potential to cause large numbers of illnesses and deaths, but also significant social and economic distress. The risks are foreseeable and rising. The magnitude of the risks to individuals, organisations and society should not be underestimated. Climate-related events are already affecting more than 1 in 4 organisations worldwide, according to Deloitte Global’s report. The public sector, consumer and life sciences/healthcare industries are the most worried about the business impacts of climate change, with over 80 per cent of executives in these sectors expressing apprehension about the planet’s future. Whilst health is often considered within the environmental, social and governance framework, public health experts argue that a greater focus is needed on employee wellbeing and global health equity if we are to lessen the impacts. Climate change is expected to accelerate mosquitoborne diseases as temperatures and standing water increase. We could see outbreaks of malaria, dengue fever and zika in places where they have never been present before, and more frequent outbreaks in areas where they already exist. Extreme heat and cold will affect new populations who may not be prepared for it. Power shortages may exacerbate the situation. Wildfires, floods, drought, and deforestation may bring wildlife closer to human habitation increasing the risk of new diseases evolving. We do not yet know the consequences of the permafrost melting and releasing novel oncefrozen pathogens. All these factors in combination with an increasing world population and density is a potentially potent mix for infectious disease outbreaks. Finally, while the Covid-19 pandemic has caused institutional exhaustion, we need to remain vigilant for the inevitable next influenza pandemic, so we cannot drop our guard. The risk of severe climate change is thus rising, posing physical threats to many firms. Most remain blind to these, often willfully so. They should start worrying about them. Here are a few necessary steps that we recommend towards managing and mitigating various potential risks: • Develop and execute a holistic Environmental, Social and Governance framework with health and intelligence at its core • Undertake risk assessments of existing and potential threats, incorporating forecasts for potential geographic extension of hasards due to climate change within the above framework • Crisis and business continuity plans should utilise an “all hasards” approach. Include known and potential health threats, with scenarios encompassing likely, as well as the unlikely worst case With changing geo-political scenarios and the looming climate change threat, corporate crisis management think tanks need to upgrade their expertise and focus more on simulations. We need to look more closely at the big picture for catastrophic global climate change events and make our environmental sustainability efforts as core tenets of organisations’ culture and brand identity. cades in many countries. Working for organisations that demonstrate purpose and a commitment to sustainability alongside pay is increasingly becoming important. Most of all, our recent risk outlook 2023 survey shows people want an employer that prioritises their mental health and well-being, and nurtures and develops them as a valued resource. These destabilising factors must be considered as strands in a complex web of risk to be understood and controlled for. They must be built into our forecasting and business continuity plans, crisis management scenarios and training. The need for climate change is impacting businesses and the ecosystem. A lot of organisations talk about climate change in line with sustainability and green energy and associated risks and rewards. However, it’s also important to examine climate change in convergence with other forces, such as urbanisation, deforestation and the rise in political destabilisation accompanied by an anti-science philosophy, which is a social force. “Climate Change as Systemic Financial Risk” is a growing topic in many CXO forums today. There is a general acceptance among leaders now that climate change is an existential threat and global priority, for nations, businesses and for individuals. Businesses have to examine the long-term implications for their workforce’s health, business models in light of climate extremes. Those implications range from heat stress to changing profiles of communicable diseases and natural calamities rate and intensity. International organisations must arm themselves with the best forecasts to predict extreme events. They must put in place preventive measures to protect their response plans to evacuate employees in the affected sones. Maintaining enthusiasm and commitment to reducing transmission is a difficult task, made even more challenging by competing Climate change is expected to accelerate mosquitoborne diseases as temperatures and standing water increase. We could see outbreaks of malaria, dengue fever and Zika in places where they have never been present before, and more frequent outbreaks in areas where they already exist
84 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM THE IMPORTANCE OF EMPLOYEE MENTAL HEALTH INTERVIEW Dr Mantosh Kumar, Senior Consultant & Clinical Lead (Inpatient) – Mental Health & Behavioural Sciences, Fortis Hospital, Gurgaon, talks to BW Healthcare World about employee burnout WHAT IS WORKPLACE MENTAL HEALTH AND WHY IS IT IMPORTANT? For most people, a greater part of adult life is spent in an office or a workplace. Work is an integral part of our lives. It gives meaning and a sense of purpose apart from helping in sustaining ourselves. But it can very well become the reason for stress and worries. This was more recognizable post-pandemic. A study reveals that 15 per cent of adults in work environments already have a diagnosed mental disorder and work-related stress can further aggravate the severity of these conditions. But it is now believed that the work environment and some factors at work can also negatively impact mental health. A recent study suggests that many employees are leaving their jobs because of a decline in their mental health that never experienced any mental health issues earlier. So a supportive and inclusive workplace, a place where discussion around mental health was done helps the employees feel safe that translates into better mental health and greater productivity. WHAT IS BURNOUT AND HOW COMMON IS IT? The result of chronic stress at work is called burnout. It was a term coined by psychologists in the 1970s to describe the state of exhaustion seen in doctors and nurses who worked for long hours without breaks sacrificing their own health. It was experienced as physical and mental exhaustion along with feelings of listlessness and the general feeling of inability to cope with work demands. Lately, the term burnout is now used not only for these doctors and nurses
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 85 sure activities in an attempt to manage work stress. What follows is a constant phase of stress and physical symptoms of fatigue and disturbances in sleep. It becomes more and more difficult to complete tasks and procrastination increases. They lose interest in work and become irritable with changes in behaviour like isolating themselves. After this, the stage of burnout arises where you typically get consumed by work and work-related thoughts. Performance at work deteriorates further and they make more mistakes or arenot able to meet deadlines. Emotionally and mental changes occur where it becomes more noticeable to others that they have become either cynical or withdrawn. If it progresses the person might collapse either mentally or physically. HOW DOES ONE IDENTIFY BURNOUT? Depending on the stage of burnout you will experience the effects of burnout. Initially, it may appear that you are just down or low in energy. Drained physically and mentally you may want to avoid all other activities thinking you have to save yourself for energy expenditure for work. Occasionally you might experience pain in the body, heaviness of the head and gastrointestinal symptoms like nausea and indigestion. As you progress in burnout, psychological changes appear like irritability and increasing cynicism towards work and even towards colleagues. On the other hand, few people experience what is called depersonalization with indifference towards work and feelings of numbness at work. You may find yourself wanting to leave early or taking frequent breaks from work. There is a decline in joy and a sense of accomplishment at work. This all results in poor performance at work which further makes one doubt their abilities. HOW TO MANAGE BURNOUT? Burnout can be managed effectively by making very small changes in the lifestyle of an individual. The first is to identify that you are experiencing burnout. Talk to your superiors and explain your current situation and see if taking a break from work can help resolve the stress. While you are at it, make sure that you are following a daily sleep-wake cycle. Make sure that your sleep is restful and between 6-8hours at night. Establish a relaxing bedtime ritual and avoid any form of stimulants in the evening including caffeine. Engage in a daily exercise regime which is good not only for your physical health but also for your mental health. It gives that needed boost of endorphins which naturally makes us happier and more content. Eating a well-balanced healthy diet is also important. Avoid processed sugars and packaged food items. Drink plenty of water to keep yourself hydrated. While at work take the help of your colleagues and superiors. Know your limitations and learn a new skill before taking on new challenges. If all this does not help then don’t hesitate to ask for help from an expert who can help you with your mental health. but also for any person at a workplace, who goes through feelings of exhaustion both physical and mental due to chronic stress, feels cynical and negative about the work environment and there is a reduction in their productivity at work. Employees often complain about being overworked, become irritable and fatigued and later experience feelings of failure and isolation. Over a long time if burnout is not addressed it can lead to dissatisfaction, poor performance at work and loss of job and can further lead to poor physical health and mental health issues like depression and anxiety. Many studies have been performed to assess burnout in different parts of the world. A consensus is that around 70 per cent-80 per cent of people have experienced burnout at work at some point in their lives. WHAT ARE THE STAGES OF BURNOUT? Burnout does not happen overnight. Slowly over weeks and months, the person experiences burnout which happens in stages. Initially, the person starts their job with enthusiasm and vigour, with a sense of drive and passion they push themselves to work harder. This happens at the expense of neglecting one’s personal needs and care. From here the person slowly experiences stress from time to time. It is not so pervasive and they can tackle this stress. The person further neglects any means of lei-
86 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM AI & MENTAL Cognitive technologies such as natural language HEALTH processing, deep learning and digital assistantsas well as augumented intelligence have the potential to revolutionise the diagnosis and treatment of mental patients from a remote location By Srinivas Iyengar The last two decades have been a boon to the area of biomimetics since mimicking a brain would need enormous amount of computing power along with variety of data requiring huge storage and compute. Given the rapid advancements and availability of cloud native resources, we are now equipped with such resources to digitally mimic biological systems. In this process of building technologies for mimicking the human brain, we have been finding use cases that these technologies can solve. Mental health has been the low hanging fruit invariably as studies are showing that at least 20 per cent of the world population would have some kind of mental issues which has been quite staggering to believe. We also have realised that there is also shortage of qualified resources in terms of caregivers who can participate in solving mental health issues. In earlier days, mental health was mostly associated with psychiIN FOCUS atric aspects which mainly dealt with mental illness, and distinction between mental health and mental illness was not clearly drawn. Hence there were misconceptions and lack of awareness around mental health issues. Today, the demarcation between mental illness and mental health has been quite clearly drawn with people not hesitant to get professional help. We must understand that mental health is important at every stage of life, and it can impact children as well as adults including aged people.Let us now focus on mental health and illness use cases that are being focused upon today using artificial intelligence. Artificial intelligence is the umbrella terminology and specific areas within it includes deep learning, augmented intelligence, edge computing, telehealth, XR etc.Be aware that future technologies like metaverse and
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 87 same information to care providers. The concept of augmented intelligence wherein the intelligence generated by machine is used by care providers to make necessary decisions. can also enable us to bring psychotherapy to more people who need it. Diagnosis of anxiety and depression is quite common nowadays and more openly treated in urban areas. Before even a patient is examined by a caregiver, their anxiety level detection is determined today using facial expressions and tone of voice etc. It is a bit more difficult to measure an individual’s depression or anxiety levels as many of the factors in mental health are subjective. Machine learning and deep learning methodologies are being used to build models which can aid in determining the level of anxiety. The data collected is also today used by clinical research organisations who are continuing research on anxiety and its relation to neurotransmitters. Conclusion You must note that mental health treatment is one of the most expensive disciplines today. Technology has helped gain importance in this specialty area of mental health. Humans have just scratched the surface of mapping the human brain and generating metrics on changes that happen. Artificial intelligence is the most important technology which can map the brain, its activity and thus enable to solve mental health problems. We can argue that AI for mental health could be a game changer and we are confident that there will be huge number of investments made in the next couple of decades to develop required solutions. As we look ahead, AI based mental health tools will have great potential in managing populations and facilitating well-being. These tools can be used to enable early detection, evaluate possible diagnosis, and recommend best fit treatment pathways. quantum computing are also seen as technologies which can make a huge difference in this field. Clinical research on neurological disorders like Parkinson’s, bi-polar, dementia and stroke are areas where there is a significant amount of research going on worldwide. Early diagnosis and treatment of such neurological disorders can make a huge difference in the life of a patient. We have still not come up with a solution to these disorders, but a lot of progress has been made in early diagnosis and treatment areas using technologies like deep learning. For example, researchers have found out that lab-grown stem cells can replace the ones that are destroyed by Parkinson’s disease. Significant investments are made to collect historical data in the following areas of medication history, social determinants of health and sleeping patterns for identifying the mental state of patient by utilising deep learning techniques. Virtual Therapeutics: Telehealth is seen as one technology which can aid psychotherapy, specifically bringing in care equity to people who are not near specialist care providers. When telehealth is clubbed with metaverse, it opens more possibilities of meta-assets being built which can aid psychotherapy which eventually could lead to be seen as preferred care pathway. Virtual therapies can increase diagnostics precision. Digital assessments using cognitive technologies including natural language processing, deep learning and digital assistants can act as virtual counselors which can interact with patients to gather basic information and make initial analysis of patient condition and share the SRINIVAS IYENGAR, VP and Head of Healthcare & Life Sciences, Happiest Minds Technologies
90 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM From wearables to wellness apps to AI personal trainers and augmented reality, technology has revolutionised people’s physical, emotional and mental wellbeing WELLNESS By Bhupendra Paintola Wellbeing in a society exists when it’s absolutely fine to say ‘one is not fine’. We seek help when we develop a cold, but talking about mental health is considered a taboo. When was the last time you took time off WELLNESS TECHNOLOGY from work for mental health reasons? We talk of conquering space while ignoring the importance of healthy mental space. According to the WHO, about 8,000,00 suicides are committed every year, making it the second-leading cause of death for individuals between the ages of 15 and 29 in 2016. There is a well-established link between suicide and mental health issues in high-income countries. Additionally, 280 million people suffer from depression worldwide. Mental health care is a luxury in India. According to sources, a typical counselling session costs around $ 41 or Rs 3,000. According to a Lancet article,
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 91 depression and anxiety, two of the most prevalent mental diseases, cost the world economy $1 trillion each year in lost productivity. In addition, there are just 0.3 psychiatrists per 1 lakh people in India. With digitalisation taking the business world by storm and pandemic-induced conditions, wellness has undergone a boom, with mental wellness marking a $121 billion market, according to estimates from the Global Wellness Institute. A Mintel survey states that roughly 50 per cent of Indians took to consuming healthier food and exercising during the pandemic. Further, the workplace wellness market is projected to grow to $66 billion by 2022. People have started realising that wellbeing is not only the ability to survive, but also to thrive. By leveraging digital technology, wellness companies become enablers for Personalized offerings: According to an Oracle survey, 82 per cent of workers think robots can support their mental health better than humans, and 68 per cent of respondents would rather speak with a robot about it than their manager. This reflects wellness technology as a true customised enabler. Fear of judgement, especially with regard to mental health, is another major reason why employees hesitate to participate in or seek help with sensitive issues like depression, burnout and addictions. Technology helps in providing an alternative to traditional modes of face-to-face counselling with remote or confidential helplines and access to appropriate support groups. Coaching in workplace: In 2021, UAE introduced a paradigm shift in workforce with a 4.5 days working week. Today, employee wellbeing is considered vital for productivity of companies worldwide. Digital platforms make it possible for workers to communicate and conveniently over 75 per cent of their waking time at work. A study commissioned by Oracle reveals that 82 per cent of employees prefer robots over humans to support their mental health. Hence, the ubiquitous role of technology becomes a requisite in our workplaces. Health-related costs as a result of employees’ reduced productivity can also be avoided by a company through wellness technologies. A study by the Centers for Disease Control and Prevention (CDC) estimated that businesses in the US lose over $225.8 billion per year to employee illness and injury. Today, organisations also have wellness policies like access to counsellors for mental health and nutrition, virtual yoga classes and more. Simple tracking and incentive systems: Wearables, wellness apps, digital biomarker apps, fitness and nutrition apps, and other technologies have revolutionised people’s well-being by allowing them to exercise and develop physical fitness at their leisure. They even have proficiency in tracking and improving stress and other mental health factors. The apps may even detect cognitive decline, which could be panacea for early warning of Alzheimer’s disease. It’s convenient, inexpensive and consumes less time and effort. Above all, there is no excuse to not exercise. There are AI personal trainers, as well as augmented reality technology that nurture emotional intelligence and instil mental wellbeing as a part of one’s daily routine. As a community, we are increasingly gravitating towards concepts like holistic wellness, sound bathing and wellness retreats, which have been embraced by certain sections of our society. However, this audience is limited to a niche. Hence, it is imperative that we cascade the concept of good health and wellness across India. India being home to the world’s There is a wellestablished link between suicide and mental health issues in high-income countries get healthcare. This encourages workers to continue working toward their health and fitness objectives. This reinforced the importance of the broader holistic dimensions of a well-lived life, bringing about a focus on career wellbeing. Organisations are embracing a new workplace with better communication, increased transparency, and a more participatory decisionmaking process, marking a shift from perfunctory wellness initiatives to the integration of technology in daily work life. Employers have also shifted their priorities to address the health of their employees, with the average employee spending
92 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM WELLNESS largest mobile users, there is an ever-growing dependency on technology among people, especially millennials and Gen Z. Moreover, with more than 65 per cent below the age of 35, we have the readiness and wherewithal to achieve wellbeing with the aid of wellness technology. The following are the ways in which technology helps attain wellbeing: Meditation and mindful- ness technology Chronic stress disrupts your body’s natural rhythm, lowering immunity and potentially leading to serious medical conditions. With more than three million individuals reportedly using meditation apps every day, meditation is the most sought-after option in this situation. According to a study published in Research and Markets, the market for mindfulness meditation apps is expected to be worth $4,206.1 million by 2027. Furthermore, existential crises, a very common phenomenon in youth, reinforce a tendency towards spiritual awareness and healthy living. All sources of information— books, podcasts, films, etc. are helpful in this regard. Physical wellness It constitutes five dimensions in the human body: food, water, breath, sleep and exercise. Food: People are losing weight sustainably rather than through detox and immunity diets, which have adverse long-term effects. WHO recommends eating whole foods, eating at proper times, and practising conscious portion control. Succumbing to emotional cravings, and eating out of compulsion to please the emotions leads to lifestyle diseases such as type 2 diabetes, hypertension and obesity. With assistance from technology people are opting for mindful nutritional choices that go a long way in achieving wellbeing. Water: People are not only consciously consuming ample water but also drinking healthy herbal decoctions as part of their diet routine. Sleep: Abnormal sleep patterns are the biggest threat to one’s wellness. Hence, without a doubt, there appears to be a surge in interest in digital sleep trackers. Breath: Breathing exercise, or pranayama, has proven valuable. Conscious breathing pacifies an individual both emotionally and mentally and helps maintain physical wellbeing. Exercise: People are preferring a digital fitness coach over stepping into a gym, especially amid the perils of Covid. These coaches in turn deploy accountability in oneself to track one’s fitness through ‘smart devices’. The WHO’s recommendation for adults is to work out regularly for 150 minutes per week. This also implies that workouts will shift from being goal-oriented to preventive in nature. Social Media: There is no doubt social media is a double-edged sword. Its ability to provide social warmth by interacting with others and entertainment has been linked to improved wellbeing. However, engaging in comparison on social media can be detrimental to your wellbeing. Moreover, it has also been observed that people with poor wellbeing refer to social media as a coping mechanism, but paradoxically, it may worsen the very feelings by acting as a temporary escape mechanism. However, social media also provides for ‘safe spaces’ where people can share their experience and receive empathy as well as support from others. Mood and habit trackers are the futuristic technologies that the wellbeing industry will be targeting. Yoga, too, has its moment in the sun with diversified applications among meditation, breathing exercises and diet modification. With celebrities like Deepika Padukone, Shaheen Bhatt, and Lady Gaga conveying experiences of depression in their lives, the stigma around mental health has diluted to some extent. It is imperative that we accept mental illness as we do physical illness. Depression and anxiety, two of the most prevalent mental diseases, cost the world economy $1 trillion each year in lost productivity
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 93 Science overall has always been a beautiful mystery and we, most of us, sadly enough never really get a chance to come close to this intriguing, exploratory world, especially the one around human life and genes, without getting intertwined in the associated complexities and medical jargon. Walter Isaacson, the author of The Code Breaker has the solution to this: He is inviting us to walk alongside the life of a super talented Nobel Prize winner Jennifer Doudna and, through her experiences help us navigate behind the scenes, in-lab moments, the selfless research and show us her and the unflinching pursuit of hundreds of others, to win the battle with bacteria and viruses, including the most recent coronavirus. This book is a marvellous saga of inventions, discoveries, drama, empathy and researchers’ dedications on one side; and the moral, ethical challenges concerning risky and dangerous gene edits for our future generations, on the other side. Weaved in is a vivid description of the life and world of these scientists who work so hard to bring a safe, healthy future for us and our children. Kudos to Isaacson who has as always shone in brilliance. He helps us peep into the lives of these wonderfully talented scientists, demonstrating to us the complex technical side of body functions, enzymes and genes; and also opening up a debate on the future uses of our gene editing prowess. This book touches upon some sensitive topics and enquires our conscience on Book Title: The Code Breaker Book Author: Walter Isaacson Number of pages: 560 Publisher: Simon and Schuster Price: Rs 410 the boundaries we need to draw when it comes to manipulating our genes for better lives. Whether it’s for treatment of diseases like Huntington’s or sickle cell or the controversial questions of modifying genes (editing out unwanted genes) for our kids “enhancements” makes a lot of us think, wondering if it is borderline messing with Mother Nature. A lot of us will find a wealth of information that directly, indirectly impacts us. It is also fascinating to read the age-old battle between viruses and bacteria and how the latter gave us clues to overcome the new viruses. This book is half the biography of Jennifer who spent her life discovering the code of life. She was told women cannot become scientists and ended up winning the Nobel Prize in 2020 along with Emmanuelle Charpentier. They along with other scientists paved the way for the transformation of the human race and achieved what we have today with the Coronavirus vaccines. It is bewildering how, for instance, in one of the approaches, a harmless virus is re-engineered genetically and delivered into the human system to make the spike protein of the coronavirus so that our human system can trigger antibodies. As they say, every step is a discovery of the miracle. This 500-plus-page book will refresh and amaze your mind about this highly competitive world where in the backdrop of hard work and camaraderie you will also see greed and personal battles. Pick it to revel in the triumph of hard-work and dedication and get a glimpse of all that is still work in progress as we all look forward to a disease free world that we want to gift our future generations. SCIENCE SAGAS BOOK REVIEW Reviewer RAJEEV SHARMA, Founder, Awrizon Digital Consultancy
94 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM Winter gives a sensation of pause because of how the cold seems to stop all of our activity. But meditating regularly during the winter months will benefit us greatly WELLBEING By Himalayan Siddhaa Akshar Your body will internally adjust to the shifting weather as the seasons change and the outer temperature declines. Even though the body is always changing, the Surya Nadi, or Sun channel, benefits from these changes in the winter. We can open the Surya nadi in the winter by engaging in Sun channel meditation. DEVELOPING YOUR SPIRITUAL VISION Your actual potential can be found through spirituality. The goal of spirituality is to widen your mind to possibilities that go beyond your current knowledge and perspective. You will master both identifying your objectives and goals as well as the means of achieving them through this spiritual training process and methodology. The darkness in winter is deeper and makes it the perfect time to find yourself. Here are a few techniques you can employ to grow yourself spiritually. WINTER: THE TIME TO DEVELOP OUR SPIRITUAL VISION SIDDHAA AKSHAR, Founder, Akshar Yoga Institutions, Himalaya Yoga Ashrama, World Yoga Organisation
WWW.BWHEALTHCAREWORLD.COM BW HE ALTHCARE FEEBRUARY 202 3 95 MEDITATION TECHNIQUE- TRATAKDHYAN Tratak on Flame What you need • A comfortable mat to sit on • A diya made of mud • Ghee or oil • Cotton wick • Match sticks • Stool or desk Tratak meditation is a type of meditation that enhances attention and concentration while also bringing about a great deal of clarity in life. A flame, the sun, the moon, or perhaps any other object or image might be the subject of this kind of meditation. It is recommended that you begin your practise and keep the duration for a minimum of 11 minutes and a maximum of 21 minutes if you are new to this meditation approach. • To prepare the diya, place a wick on it first, and then pour ghee or oil over it from the top. • Make sure the flame is facing in your direction and is at eye level by lighting the diya and setting it on a desk or stool. • Sit around 4 to 5 feet away from the flame. Not too far nor too near. • As you gaze at the flame, be careful not to strain your neck. Sit in a comfortable meditation stance that you can maintain throughout the procedure (Sukhasana or Padmasana are preferred asanas) • The following steps should be followed: • Lengthen your spine; • Place your palms on your knees, facing up; • Join your index and thumb fingers to hold the Gyaan Mudra; • Now, focus all of your attention on the flame by casting your gaze directly at it; • Watch how the flame’s tip moves; • Try to avoid blinking as much as possible; • If your thoughts wander, bring them back to the flame; • After practising, close your eyes for a while to relieve any eye strain BENEFITS • Reduces stress, brings you to the present moment, and increases self-awareness. It also induces pleasant thoughts, clears the mind of undesirable thoughts, strengthens the neurological system, helps you make better judgments, is good for eyesight, and memory. • As the ability to concentrate improves, the length should gradually be extended. For greatest effectiveness, this should be done late at night or early in the morning. You should do this now while there aren’t any other distractions, so it is better. You will gain additional advantages the more you practise. YOGA ASANAS 1. Dhanurasana – Bow Pose Lie down on your stomach, and bend your knees. Bring your ankles towards you as you hold them with your palms. Inhale and lift up your legs and arms as high as you can. Look up and hold the posture for a while. 2. Halasana – Plough Pose Lie on your back with your palms on the floor next to you. Lift your legs up 90 degrees with the help of your abdominal muscles. Press your palms firmly into the ground. Drop your legs back behind your head. Support your lower back with your palms as needed. Hold the pose for a few breaths. For a period of 15 to 20 seconds, hold the position.
96 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM WELLBEING 3. Chakrasana - Wheel pose Lie down. Rotate your arms at the shoulders while placing your hands on the ground on either side of your head. Inhale deeply and lift your entire body in an arch. The weight of your body should be distributed evenly among your four limbs. For a period of 15 to 20 seconds, hold the position. 4. Santolanasana – Plank Pose Lie on your stomach; place your palms under your shoulders; lift your upper body, pelvis, and knees up; grip the floor with your toes; check that your knees, pelvis, and spine are aligned; place your wrists exactly below your shoulders with your arms straight; and hold the fi - nal position for a while. 5. Paschimottanasana Formation of the Posture Stretch out your legs forward. Inhale and raise your arms up while keeping your back straight. Exhale and bend forward placing your upper body on your lower body. Reach and hold your toes with your fingers. KAPALBHATI PRANAYA - MA METHOD • Focus on taking a regular breath in and then expelling quickly, forcefully, and rhythmically. • By compressing your stomach, you can compel the diaphragm and lungs to release all the air they con - tain. • You should immediately inhale as you let your stomach expand. Yoga is a holistic instrument for show - ing someone how to obtain good health, inner serenity, and harmony. Yoga and spirituality involve the investigation of the self through meditation, asanas (physical postures), and breathing exer - cises known as pranyama. By providing us with insights into our cognitive pro - cesses and behavioural patterns, these techniques help us become more selfaware and aid in our spiritual growth.
#IAmExceptional Award Catogries For Nominations For Partnership & Speakership Akash Kumar Pandey [email protected] +91 7898908944 Reeti Gupta [email protected] +91 9899610630 Contact Celebrating Pillars of Successful Organisations Exceptional HR Managers Exceptional Marketing Managers Exceptional Advertising & PR Exceptional Finance Managers Exceptional Sales Manager Exceptional Information Technology Managers Exceptional Operations Managers Youngest Managers of the year Tech Innovator of the Year Woman of the Year Exceptional Facility Managers Exceptional R & D Manager Exceptional Supply Chain Managers Exceptional Accounts Managers BW Businessworld is pleased to announce the launch of the BW People: Exceptional Managers of the Year 2023. The award is established to honour remarkable talent that has supported the expansion and management e ectiveness of their respective organisations. Even though management trends can change so quickly, the market's acceptance of diversity and the expansion of the service sector have de ned the long-term trend in management. By providing more exibility with working hours, better retraining opportunities, creative performance metrics, managers are currently being trained to promote greater equality for women and minorities in the workplace. Managers who work in the service industry are being taught how to measure things di erently, support their employees better, and lead with greater charm. The awards are granted to managers and leaders who have diligently and strategically worked to advance their organisations, which has resulted in economic development and nation-building. There are categories for recognition of success in every aspect of the workplace, and the Awards are open to all enterprises across industries. NOMINATE NOW LAST DATE TO NOMINATE FEBRUARY 15, 2023
98 BW HE ALTHCARE FEBRUARY 2023 WWW.BWHEALTHCAREWORLD.COM The government and the private sector needs to spend more to tap into high-value opportunities that are unfolding LAST WORD By Shivam Tyagi I ndia is presently branded as the pharmacy of the world, known for its volumes in vaccines and generics, though the country now finds itself ripe to move onto the next chapter of being the leader in both volume as well as value. The Union Additional Secretary, Ministry of Finance, Department of Expenditure, Sajjan Singh Yadav in a conversation with BW Healthcare World said that it’s high time for India to transform into high value pharmaceuticals as the opportunities are tremendous. The Union Additional Secretary has recently also penned a book, India’s Vaccine Growth Story: From Cowpox To Vaccine Maitri, which explores how different vaccines have evolved and what the world used to do before the vaccines were discovered. How one got immunity from infectious diseases in that ancient era. Speaking specifically around vaccines, Yadav added that there are high value opportunities enfolding such as the therapeutic vaccines against non communicable diseases like for cancer, heart strokes and allergies. He said there are other vaccines which produce monoclonal antibodies for new infections and there is also more movement toHigh Time For Indian Pharma To Transform Into Value wards universal or broad spectrum vaccines. “So, the field is vastly open for Indian players to take a plant and expand our production not only in India, but to other countries and expand both in terms of value as well as volumes,” he said. On being asked if the public healthcare spend is optimal, Yadav replied that the spend is certainly not enough as a percentage of the GDP both in the government sector as well as in the private sector. He said that “It needs to work up from the state government point of view and from the union government as well as from the private expenditure. We have to spend more and that is reflected in the quality of healthcare and public health efforts which are needed.” Speaking on the outlook of the healthcare sector in coming years, Yadav said the government’s two pronged strategy through the Ayushman Bharat will improve the public health infrastructure and will boost the private healthcare system through the health insurance scheme of Pradhan Mantri Jan Arogya Yojna (PMJAY). “The target is to cover 50 crore vulnerable people who cannot afford healthcare under PMJAY for getting them secondary and tertiary healthcare facilities. So we have reached around only 20 crore people as of now but in the next three to four years I am sure that we will reach the target of 50 crore or even more people.” On being asked about the missing middle, Yadav said that we need to find those kinds of financial resources and collaborative funding and technology which will aid us in tapping the missing middle into the fold of a health insurance cover.
JURY MEMBERS 6th Edition SUMMIT & AWARDS 2022 NOMINATE NOW LAST DATE TO NOMINATE FEBRUARY 15, 2023 MARCH 2023 SCAN TO NOMINATE TALEES RIZVI Director BW People & BW CFO World Community NOOR FATHIMA WARSIA Group Editorial Director BW Businessworld RAJNISH KUMAR Chairman, BharatPe & Former Chairman, SBI DR. ANNURAG BATRA Chairman & Editor-in-Chief BW Businessworld & Founder, exchange4media SETHURATHNAM RAVI Managing Partner, Ravi Rajan & Company Chairman, TFCI and Former Chairman, Bombay Stock Exchange VISWANATH PS Managing Director & CEO Randstad India CMA P. RAJU IYER President The Institute of Cost Accountants of India SUBODH GUPTA Director (Finance) Bharat Heavy Electricals Ltd. VINOD GUPTA Managing Director VG Learning Destination For Nominations: Akash Kumar Pandey | +91 78989 08944 [email protected] For Speakership and Partnership: Reeti Gupta | +91 98996 10630 [email protected] FAN PARTNER DIGITAL MEDIA PARTNER COFFEE PARTNER BEVERAGE PARTNER MEDIA PARTNER SUPPORTING PARTNER KNOWLEDGE PARTNER ASSOCIATE PARTNER
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