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WWW.B WHE ALTHCARE WORLD.C OM BW H E A LT H CA R E FEBRUARY 2024 3 A Year of Progress EDITOR-IN-CHIEF’S NOTE Dear reader, As we enter 2024, we must keep courage and compassion at the forefront. History is proof that all success stories are centred around these two aspects. And, not going too far back, look at the pandemic. The biggest learning is to move forward fearlessly, albeit with compassion for self and others. This is especially true when the going gets tough. This magazine focuses on healthcare trends, which we will see throughout the year. Personalised wellness has gained prominence, with genetic testing, microbiome analysis, and wearable trackers guiding tailored approaches to diet, exercise and sleep. Advancements in precision medicine, leveraging gene editing and targeted therapies, will revolutionise healthcare, offering more effective and personalised treatments. Artificial Intelligence (AI) will continue to play a pivotal role, with AI-powered diagnostics, virtual assistants and personalised treatment recommendations becoming commonplace. Mental health continues to remain central to achieving holistic wellbeing. We will see increased access to services like online therapy platforms and workplace initiatives promoting well-being. Wearable devices are evolving beyond step counting, monitoring sleep, stress levels, and heart health, and providing valuable health insights. Additionally, telehealth is here to stay, offering convenient and accessible healthcare options, especially in rural areas or for those with limited mobility. These trends collectively shape the healthcare narrative, emphasising a proactive and individualised approach to well-being in the coming year. You will read about all this in articles and features in the magazine. Further, we spotlight mergers and acquisitions (M&A) in the healthcare and pharmaceutical sectors that are here to stay, with private equity also taking a greater interest than ever in India’s health ecosystem. Industry insiders say that the post-Covid years have been a boon for private equity investments and M&A activities. According to them, M&A activity in the Indian healthcare sector took place between 2018 and 2022, with a total deal value of $35 billion. This represents an increase in deal value compared to the previous fiveyear period. The experts following these deals in 2023 estimate that private equity investments alone will contribute over $6 billion to the total deal value in the healthcare and pharmaceutical industries, with $3.4 billion coming from M&A activity in the first eight to nine months of 2023. According to them, the number of M&A transactions completed through October has already exceeded the total for 2022 by 20 per cent. In addition, we have our regular features that you enjoy reading. Write in with your feedback. Happy New Year! “The test of our progress is not whether we add more to the abundance of those who have much; it is whether we provide enough for those who have too little.” Franklin D. Roosevelt [email protected] ANNURAG BATRA
4 BW H E A LT H CA R E FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM India’s Healthcare: From Growth to Transformation FROM THE CEO’s D E S K Healthcare is one of the sectors that, I feel, got a lot of attention in 2023. A surge of technological innovation is reshaping India’s healthcare landscape. As the world’s fifth-largest healthcare market, the industry is leveraging technological advancements in all areas to pave the way for personalised, preventive care via predictive healthcare models. Additional investments, including a private equity infusion, helped the hospital sector’s growth. Another change that I have noticed is a rise in hospital beds, facilities, and specialty services in Tier 2 cities. Medical technology is rapidly growing, with a projected $50 billion market by 2050. While “Made in India” initiatives promote domestic manufacturing, high-precision equipment imports continue. To dominate this growing market, India has to show both financial viability and a cultural shift towards goods that are manufactured locally. Government initiatives are boosting accessibility through the widespread use of generic medicines and comprehensive medical insurance programmes for low-income people. Patient safety and quality are also gaining traction, thanks to increased awareness among hospitals and patients. Medical education must evolve to reflect the changing healthcare landscape. Integrating cutting-edge technologies, such as robotics, into training is essential. Meanwhile, the medical tourism industry has made a remarkable recovery since the pandemic. India’s emphasis on quality, which provides global standards at reasonable prices, is a winning formula for accelerating growth and redefining its position in the global healthcare industry. Nursing education and diagnostics are two critical areas of focus for India’s healthcare system. Increased investments in colleges and facilities are helping to address the nursing talent shortage, but more work is needed to meet domestic and global demand. Meanwhile, the fragmented diagnostics industry is undergoing a positive shift towards consolidation and novel models, particularly in imaging and pathology. India’s healthcare landscape is brimming with exciting opportunities for industry expansion and overall well-being. Senior care is an especially promising subsegment. It is poised for significant growth, expanding beyond basic needs to include mental health and therapeutic services. Looking ahead, 2024 promises even greater advances in healthcare, building on the solid foundation established in 2023. The future holds numerous opportunities for a higher quality of life, thanks to technological advancements, accessibility initiatives, and a growing emphasis on well-being. You will find more about the sector in the articles in this edition of BW Healthcare World. Doctors, you will find an interesting viewpoint on how medical professionals can benefit from their efforts to build their personal brand. I hope you find it useful. Happy reading! Harbinder Narula CEO, BW Healthcare World &BW Wellbeing World [email protected]
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8 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM FEBRUARY 2024 40 10 12 32 54 80 82 48 56 14 16 CONT COVER STORY COLUMNS HEALTH BULLETIN Dr Girdhar Gyani Director General, Association of Healthcare Providers India Dr R. Kishore Pediatrician, Cloudnine Hospitals Surendran Chemmenkottil CEO, Metropolis Healthcare Anil Matai Director General, OPPI Rajiv Nath MD, Hindustan Syringes & Medical Devices Dr Kunak Sinkar Holy Family, Bandra Kamna Chhibber HOD &Psychologist, Fortis Healthcare Palak Mehta Founder & CEO, Vegan First Suzy Singh Author, Mental Health Therapist & Relationship Counselor Now They Expand After a remarkable turnaround, Max Healthcare India (MHIL) is set to expand. Most of this expansion is geared towards strengthening what they already have, by adding capacity to existing hospitals, investing in cutting edge technology and skilling their technicians. Another key growth area is medical education. On cover : Dr Sanjeev Singh, Medical Director, Amrita Institute of Medical Sciences & Research Centre. Abhay Soi, MD, Max Healthcare. Dr Sandeep Budhiraja, Group Medical Director, Max Healthcare. Dr Girdhar Gyani, Director General, Association of Healthcare Providers India. Dr Basant Garg, Additional CEO, National Health Authority. fifffflffiflffflfffflfflflfffl fffflfflfl fl fl fl fffflfl flflfflffiflffflffi fflffifl ffl flfffl fffl fl fflffi TOWARDS $612 BN BY 2025 fl fl fl FEBRUARY 2024 | Rs 300 A PROMISING YEAR AHEAD DR SANJEEV SINGH ABHAY SOI DR GIRDHAR GYANI DR SANDEEP BUDHIRAJA DR BASANT GARG Festival Of Spirituality
WWW.B WHE ALTHCARE WORLD.C OM BW HE ALTHCARE FEBRUARY 2024 9 Personal Branding Health and Climate Change Effect of Pollution on Women’s Health Medical Tourism The pages in BW Businessworld that are labelled BWi or Promotions contain sponsored content. They are entirely generated by an advertiser or the marketing department of BW Businessworld. Also, the inserts being distributed along with some copies of the magazine are advertorials /advertisements.These pages should not be confused with BW Businessworld’s editorial content. Cover design by SHIV KUMAR 40 18 34 60 74 86 TOTAL NO. OF PAGES INCLUDING COVER 100 ENTS Spotlight In Conversation 22 Dr Sudhir P Srivastava Founder, SS Innovations 38 Viren Shetty Executive Vice Chairman Narayana Health 46 Dr Sanjeev Singh Medical Director, Amrita Institute of Medical Sciences & Research Centre LAST WORD Dr Basant Garg Additional CEO, National Health Authority Now They Expand After a remarkable turnaround, Max Healthcare India (MHIL) is set to expand. Most of this expansion is geared towards strengthening what they already have, by adding capacity to existing hospitals, investing in cutting edge technology and skilling their technicians. Another key growth area is medical education. In-depth
10 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM Feeling Down? Nourish Your Gut, Fight Depression Ayushman Bharat Achieves 30 Crore Milestone By Arya Rakshita By Arya Rakshita HEALTH BULLETIN The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) celebrated the issuance of over 30 crore Ayushman cards on January 12, 2024, according to the Ministry of Health and Family Welfare. This pivotal healthcare initiative, led by the National Health Authority (NHA), aims to provide Rs 5 lakh in annual coverage for secondary and tertiary care hospitalisation to 12 crore beneficiary families. The creation of Ayushman cards, a fundamental activity under AB PMJAY, has seen unwavering efforts to ensure that every beneficiary has an A recent December 2023 study published in JAMA Psychiatry by Stanford University provides an intriguing perspective for those dealing with depression. The study looked at the gut bacteria of over 1,500 people and discovered a significant difference in two key players: Faecalibacterium and Coprococcus. Beneficial bacteria, which have been found to be significantly lower in people suffering from depression, produce metabolites that nourish gut cells, reduce inflammation, and influence brain function. The implications are ground breaking. The study suggests that nurturing these gut bacteria through probiotics, dietary changes, or even fecal microbiota transplants could lead to a breakthrough in treating depression. While more research is needed to fully understand the intricate relationship between gut bacteria and mental health, the findings point to a promising avenue for personAyushman card. The scheme is making remarkable progress, with over 16.7 crore Ayushman cards created in the last two fiscal years and more than 7.5 crore cards created in 2023-24 alone. The introduction of the Ayushman App, which allows beneficiaries to create cards from their mobile phones, has been vital. The app’s self-verification feature makes the process easier, and it has received over 52 lakh downloads since its launch on September 13, 2023. The state with the most Ayushman cards (4.83 crore) is Uttar Pradesh, followed by Madhya Pradesh and Maharashtra. The scheme is not only meeting numerical targets, but it is also working toward gender parity, with female beneficiaries receiving 49 per cent of all cards issued. According to the Ministry, AB PM-JAY has facilitated 6.2 crore hospital admissions, saving the poor and vulnerable population more than Rs 1.25 lakh crore in out-of-pocket expenses. For eligible beneficiaries across India, the Ayushman card has become a symbol of equity, empowerment, and healthcare assurance. alised, holistic approaches to depression management. So, the next time you’re feeling down, consider your gut’s message: a path to a brighter emotional landscape may just lie in nurturing its beneficial bacteria.
1 Crore Strong! India’s Mission Takes Giant Leap Against Sickle Cell Disease By Arya Rakshita WWW.B WHE ALTHCARE WORLD.C OM BW HE ALTHCARE FEBRUARY 2024 11 The comprehensive programme is in mission mode, focusing on sickle cell anaemia screening, prevention, and management in tribal and high-prevalence areas across the states and union territories. The mission, which targets 278 districts in 17 states with high prevalence of Sickle Cell Disease, including Gujarat, Maharashtra, Rajasthan, Madhya Pradesh, and others, represents an important step toward eliminating this genetic blood disorder. Mental Health Takes Centre Stage at Work By Kavi Bhandari As part of the National Sickle Cell Anaemia Elimination Mission, the Health Ministry has surpassed the milestone of screening more than one crore people for sickle cell disease. The mission, which was launched by the Prime Minister on July 1, 2023, in Shahdol, Madhya Pradesh, aims to screen 7 crore people in three years. Sickle Cell Disease is a genetic blood disorder that affects patients throughout their lives. It is more common in India’s tribal population, but it also affects non-tribals. environment. Employee Assistance Programmes (EAP) are evolving into comprehensive platforms that address employees’ diverse mental health needs. EAP, as a thoughtful approach, is not only limited to crisis intervention but also oversees a wide range of services such as counseling, stress management, and wellness resources. According to the Global Insurance Brokers (GLOBAL) Annual Health and Benefits Survey 2023, 46 per cent of participants highlighted the urgent need for better mental health support programs at workplaces. Workplaces are now investing in novel and comprehensive approaches to foster a positive and supportive work environment for their employees. Employers will continue to recognise the importance of adopting holistic, tech-driven, and personalised approaches to support their workforce’s mental well-being in 2024. As these trends gain traction and are adopted, future workplaces are poised to become places where mental health is prioritised and supported through technology and the human touch. Gamification is another emerging trend that many workplaces are using to engage employees and promote mental well-being. Gamified applications are designed to make mental health initiatives more accessible by combining AI and human touch. Employees can take part in wellness challenges, mindfulness activities, and team-building exercises to create a positive work
12 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM COLUMN The most durable and widely cited definition of healthcare quality was formulated by the Institute of Medicine Mapping Quality Of INDIA’S HEALTHCARE JOURNEY Dr Girdhar Gyani Over the years, healthcare has continued to be identified with philanthropy and therefore did not use modern tools like TQM, LEAN, and SIX SIGMA. The 21st century has dramatically changed the way healthcare is emerging as a key component of the service sector, with quality taking the front seat. The most durable and widely cited definition of healthcare quality was formulated by the Institute of Medicine (IOM) in 1990. According to the IOM, “quality consists of the degree to which health services for individuals and populations increase the likelihood of desired health outcomes (quality principles), are consistent with current professional knowledge (professional practitioner skill) and meet the expectations of healthcare users (the marketplace).” Healthcare Journey in India The first formal initiative to improve India’s health system came when the BHORE committee was constituted in 1943 to assess healthcare needs and make recommendations for their development. The committee’s recommendations submitted in 1946 did have a significant influence on shaping the healthcare policies in India after independence in 1947. It strongly suggests investing in public health systems. However, because of other priorities like housing, roads, power, water, infrastructure, and healthcare, the requisite finances could not be allotted. This paved the way for the private sector to pitch in, and the first initiative came through Apollo Group in 1983, founded by Dr Prathap Reddy. This opened the door for other corporate groups to invest in the health system to the extent that the private sector has become the leading provider, with a 70 per cent share in general and an 85 per cent share in critical or tertiary care. In terms of investment, the private sector has contributed more than 3 per cent of GDP, compared to less than 2 per cent by government.
WWW.B W HE ALTHCARE WORLD.C OM HE ALTHCARE WORLD.C OM BW HE ALTHCARE FEBRUARY 2024 13 India’s Healthcare Quality Journey At the beginning of the 21st century, India has a sizable presence in the private sector, including some hospitals setting up state-of-the-art facilities. This attracted the attention of overseas patients. Looking at the increasing inflow of overseas patients and their queries about accreditation, resulted in a question raised in India’s Parliament in March 2005, which was referred to the Ministry of Health and Family Welfare (MOHFW). By this time, MOHFW was getting services from the Quality Council of India to get the hospitals assessed for empanelment in the Central Government Health Scheme (CGHS). QCI was using accredited certification bodies for ISO 9000 by its accreditation board, i.e., the National Accreditation Board for Certification Bodies (NABCB). India’s Healthcare Accreditation Programme First and foremost, the requirement for any accreditation was to draft an accreditation standard and get it approved by the requisite accreditation agency, in this case, ISQua. A technical committee was constituted by the Secretary-General, with Lt Col (Dr) Pawan Kapoor as Chair and Dr Murali Srinivas as Co-chair. The first meeting was held on June 27, 2005, and that marked the beginning of India’s healthcare accreditation journey. The committee was made up of five eminent doctors and one standard-writing expert. The committee came up with the final draft in December 2005, which got approved by the NABH Board in The first formal initiative to improve India’s health system came when the Bhore committee was constituted in 1943 to assess healthcare needs The author is DG, Association of Healthcare Providers of India (AHPI), Past SG, Quality Council of India (QCI) January 2006. The standard was formally launched in February 2006, followed by a series of sensitization programmes to spread awareness among hospitals. Concurrently, about 100 assessors among clinicians, nursing staff, and hospital administrators were identified and trained. NABH’s Impact on Public Health Quality, by its very nature, thrives in an open and competitive market. Payers and regulatory agencies can also drive demand for quality. None of these factors apply to public-sector hospitals. The launch of NABH in February 2006, as such, was seen as a quality initiative for private and corporate sector hospitals. But going by the fact that quality in healthcare is also aimed at improving patient safety, it applies across all sectors. One of the prominent children’s hospitals, CNBC became the first government hospital, based out of Delhi, to receive full accreditation by NABH during 2009–10. This prompted a few other state governments, including MP, AP, Assam, Karnataka, and J&K, to sign an MOU with QCI for the implementation of the NABH standard in their district hospitals. NABH, during 2010–11, achieved the milestone of accrediting 100 hospitals. NABH progressively launched accreditation for AYUSH hospitals, dental clinics, radiology centers, and eye hospitals. NABH International NABH got a big boost as it received an invitation from the Philippines to launch accreditation there. The Memorandum of Understanding was signed in 2010-11. Simultaneously, Iran came forward and signed the MOU. There was interest shown by the UAE. NABH launched its international wing as NABH-International, or, in short, NABH-I. In 2011, NABH got an invitation from Pakistan to conduct an awareness programme for doctors on NABH accreditation. A team comprising of Dr Girdhar Gyani, CEO-NABH, Dr Zainab Zaidi, Dydirector NABH and Dr Sanjeev Singh, senior assessor of NABH, visited Karachi and trained about 80 doctors on NABH standards. DR GIRDHAR GYANI
14 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM COLUMN By Surendran Chemmenkottil I n the ever-evolving landscape of healthcare, the diagnostic sector stands as a beacon of transformation, heralding a new era of precision and technology. With a remarkable surge in growth and development throughout 2023, this critical industry is not merely adapting to change but spearheading a paradigm shift. As we stand on the cusp of 2024, it is imperative to delve into the emerging trends, the rising demand, and the promising growth trajectory that lie ahead for diagnostics. Technological Advancements: The Driving Force At the core of the diagnostic sector’s growth is the rapid advancement of technology. In 2023, groundbreaking strides in diagnostic techniques and instruments elevated accuracy and efficiency. Artificial intelligence (AI) and sophisticated imaging techniques revolutionised disease monitoring and detection, setting the stage for a new era. According to a March 2023 report by Polaris Market Research, the Indian diagnostic services market is expected to soar from $14.57 billion in 2022 to an impressive $43.57 billion by 2032 As we enter 2024, the sector’s pivotal role is evident in a projected threefold increase in market value. According to a March 2023 report by Polaris Market Research, the Indian diagnostic services market is expected to soar from $14.57 billion in 2022 to an impressive $43.57 billion by 2032. This robust growth projection showcases the sector’s resilience and positions it for significant expansion over the next decade. AI, Machine Learning, and Data Analytics: Catalysts for Change In 2023, AI, machine learning, and data analytics played pivotal roles in accelerating diagnostic speed and accuracy. These technologies not only paved the way for personalised treatments but also laid the foundation for a deeper integration in the upcoming year, heralding a revolution in the diagnostic landscape. Molecular diagnostics, particularly in genomics and proteomics, emerged as key players in 2023. Identifying genetic markers, predicting disease susceptibility, and customising treatments became possible, marking a shift towards precision medicine. Metropolis, for instance, expanded capabilities in Molecular Diagnostics, Oncology, Cytogenetics, and introduced complex tests using Next Generation Sequencing (NGS) Technology in 2023. The ongoing growth of molecular diagnostics in 2024 is poised to bring substantial change. Decentralised Diagnostics and Point-of-Care Testing: Meeting the Need for Speed Driven by the demand for quick and decentralised diagnostics, 2023 witnessed the rise of point-of-care testing. Providing rapid results at or close to the patient, this approach gained popularity for facilitating swift decisionmaking, shorter turnaround times, and improved patient outcomes. As we enter 2024, this trend is expected to gain further momentum, offering Diagnostics in 2024: Pioneering tomorrow’s health with Precision and Technology
WWW.B WHE ALTHCARE WORLD.C OM BW HE ALTHCARE FEBRUARY 2024 15 care accessibility and quality. By reaching remote areas and distributing specialised services efficiently, it ensures timely and accurate diagnoses. The reduction of waiting times, optimised resource utilisation, and integration of cutting-edge technologies enhance overall efficiency. Collaboration among healthcare providers fosters knowledge exchange and seamless data sharing, contributing to a holistic approach to patient care. WWW.B WHE ALTHCARE WORLD.C OM The author is the CEO at Metropolis Healthcare Driven by the demand for quick and decentralised diagnostics, 2023 witnessed the rise of point-of-care testing. Providing rapid results at or close to the patient, this approach gained popularity for facilitating swift decision-making, shorter turnaround times, and improved patient outcomes The demand for wellness evaluations, preventive screenings, and routine diagnostics is on the rise, presenting diagnostic service providers with a burgeoning market efficiency and accessibility in diagnostic processes. Preventive Healthcare: A Cultural Shift A significant trend propelling the diagnostic industry’s growth is the increasing awareness and consciousness of personal health. The cultural shift towards health consciousness has prompted individuals to actively seek preventive health check-ups. The demand for wellness evaluations, preventive screenings, and routine diagnostics is on the rise, presenting diagnostic service providers with a burgeoning market. The growing number of health-conscious individuals seeking proactive health management solutions signifies the increasing importance of preventive healthcare. Diagnostic Network Expansion: Increasing Accessibility to Healthcare Expanding diagnostic networks is crucial for revolutionising healthUltimately, network expansion not only improves public health outcomes but also places patients at the centre of a more accessible and responsive healthcare system. At Metropolis, we currently operate more than 180 labs and 3900 plus patient collection centres nationwide and we are on the course of adding 90 labs and 1800 service centres over the next three years. The Synergy of Digital Capabilities and Omnichannel Presence in Healthcare Digital capabilities and omnichannel presence play a pivotal role in transforming the diagnostics landscape, offering increased accessibility, efficiency, and personalised experiences. Telehealth and online appointment scheduling enhance accessibility, enabling individuals to receive timely and convenient healthcare. Omnichannel presence ensures a seamless experience across various touch points, fostering better patient engagement. This approach streamlines the diagnostic process and facilitates effective communication between healthcare professionals and patients. Looking Ahead: A Shaping Force in Healthcare Provision In conclusion, the Indian diagnostic services industry is on the brink of historic expansion and change in 2024. Fueled by technological innovations, evolving healthcare practices, and heightened public awareness of health issues, the sector is well-positioned to redefine the healthcare landscape. Diagnostics serves as a shining example of innovation and development, providing a glimpse into a healthcare future where efficiency, accessibility, and precision converge to create a healthier society.
16 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM COLUMN By Dr Kishore Kumar Women’s healthcare in India is a dynamic landscape that reflects both progress and persistent challenges. Over the years, concerted efforts have been made to enhance maternal health, family planning services, and address issues related to non-communicable diseases and violence against women. However, a closer examination reveals a nuanced narrative shaped by regional variations, socioeconomic factors, and cultural influences. Earlier this year, a study by experts from India and Harvard University showed that women in India go through gender bias, resulting in limited or no access to quality healthcare. Many stereotypes in India forbid women from speaking out about the health issues. My question is: why? Women were previously viewed as a homogenous group with limited nutritional targets beyond pregnancy and lactation. However, recent years have witnessed greater attention being given to menopausal requirements. State of Maternal Healthcare While maternal health has witnessed significant improvements, with a notable increase in the number of women accessing antenatal care and opting for institutional deliveries, government initiatives like the Janani Suraksha Yojana, launched in 2005, have played a pivotal role in incentivising pregnant women to seek professional care during childbirth. This has contributed to a reduction in maternal mortality rates, a key indicator of maternal health. Despite these positive strides, regional disparities persist. Maternal mortality rates vary across states, underscoring the need for targeted interventions in regions with inadequate healthcare infrastructure. In more remote and underserved areas, women face hurdles such as limited transportation, sparse healthcare facilities, and a lack of awareness regarding maternal health. There are good lessons from private health care players like Cloudnine, where maternal mortality is less than 2 per 1,00,000 births, which can only benefit from private-public partnerships. State of Reproductive Healthcare Reproductive health, encompassing family planning and awareness, remains a critical aspect of women’s healthcare in India. Family planning services are available, but their effectiveness is contingent upon education and awareness. Cultural norms and misconceptions about contraceptive methods can act as barriers, necessitating comprehenThe state of women’s healthcare in India reflects a mixed landscape of progress and challenges Gender Bias in Healthcare: A Persistent Disparity
WWW.B W HE ALTHCARE WORLD.C OM HE ALTHCARE WORLD.C OM BW HE ALTHCARE FEBRUARY 2024 17 The author is Founder Chairman& Executive Director, Cloudnine Group of Hospitals, Bengaluru sive educational campaigns to dispel myths and empower women to make informed choices. State of Non-communicable diseases Non-communicable diseases (NCDs) pose an escalating threat to women’s health in India. Breast and cervical cancers are on the rise. Early detection and timely treatment are crucial in mitigating the impact of these diseases. While awareness campaigns have been initiated, enhancing screening facilities and promoting regular health check-ups for women, especially in rural areas, is imperative. Overcoming societal taboos associated with breast and cervical health is also an ongoing challenge that requires a multifaceted approach involving education, community engagement, and healthcare infrastructure development. Many women are suffering from Polycystic Ovarian Syndrome (PCOS), which leads to difficulty in conceiving. Many of these symptoms can be reversed with proper nutrition. Our unpublished data from Cloudnine shows that more than 15 per cent of women who fail to conceive have PCOS; approximately 30 per cent of pregnant women develop active thyroid disease (hypothyroidism) during pregnancy; more than 15 per cent of women go through premature labour for unknown reasons; and lately, 12 to 15 per cent of women develop gestational diabetes during pregnancy. Aren’t these statistics alarming and need attention? In addition, the role of HPV vaccinations in the prevention of cervical cancer in women needs more attention. Mental Health Mental health is another dimension of women’s well-being that is gaining recognition. The stigmatisation of mental health issues often deters women from seeking help. Integrating mental health services into primary healthcare, raising awareness and fostering supportive communities are essential steps. Prevention of postpartum depression with appropriate support treatment is essential. Violence Against Women Violence against women, encompassing domestic violence and other forms of abuse, represents a significant public health concern. Initiatives focused on education, awareness, and creating support networks for survivors are essential components of a comprehensive strategy to combat violence against women. Shortage of Doctors Furthermore, a shortage of doctors has exacerbated the problem. According to the National Health Profile 2018, published by the Indian government every year, the South Asian country has one doctor for every 11,082 people—a figure that is 11 times more than the WHO’s standard of one doctor for every 1,000 people. Seventy-five per cent of India’s health care infrastructure is based in urban areas. Way Forward “We are what we eat” really summarises the issues of women’s health. One must accept that our diets and nutrition have changed drastically over the last few years. In conclusion, the state of women’s healthcare in India reflects a mixed landscape of progress and challenges. Strengthening healthcare infrastructure, addressing societal norms, and fostering a holistic approach that encompasses physical, reproductive, and mental health are integral to ensuring the comprehensive well-being of women across India. We need to build awareness along with an increased focus on preventive care. Maternal mortality rates vary across states, underscoring the need for targeted interventions in regions with inadequate healthcare infrastructure. DR KISHORE KUMAR
18 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM OPINION By Harbinder Narula Traditionally, a medical professional’s practice has grown through word-ofmouth. However, in today’s digital age, word-of-mouth extends beyond those who have walked through the clinics’ doors to anyone who appears to have an opinion about the doctor based on hearsay. Medical professionals must establish their authority. This authority does not refer to your seniority in the organisation or hierarchy-based authority, but rather to a doctor’s expertise in a specific subject matter or expert area. Patients gain confidence and faith when they know they are in the hands of a specialist and authority in their field. It elicits feelings of assurPersonal branding is one of the most powerful ways to establish a presence while also demonstrating credibility Word on the Web: How Doctors Can Build Brands
WWW.B W HE ALTHCARE WORLD.C OM HE ALTHCARE WORLD.C OM BW HE ALTHCARE FEBRUARY 2024 19 ance and faith that you are in good hands. Doctors, who are well-known for their knowledge, skills, and experience, are considered authorities in their fields. However, for most people, it took decades of practice to establish. Most people may not have made a conscious effort, which is why it took so long. Also, there were fewer doctors in the past, and the flow of information may have been limited. Because there are more doctors now, competition has increased, as has the need to be discovered and establish one’s existence. Doctors must instil confidence in their patients’ minds to elicit the faith that will allow them to respond to treatment more effectively. What Is A Personal Brand? A personal brand is a perception formed in the minds of those around you about the type of person you are and what it might be like to interact with you professionally or personally. This perception establishes what to expect, which is also known as a brand promise in marketing terms. How Does A Doctor Establish A Personal Brand? There are two possible answers. One is the strategic process of deciding what to do, and the other is tactical action using various tools. The Strategic Process Establish Visibility Doctors will only get patients if they are aware of their existence. The age-old practice of word-of-mouth remains relevant, but how it occurs today has changed. Technology has made it more efficient and impersonal. The risks are also increased because the doctors have little or no control over what people write about them on the internet. Demonstrating Values: Nowadays, the patient’s relationship with healthcare begins with suspicion. Today, it is the responsibility of doctors to instil trust in the minds of their patients by demonstrating what they stand for. Communicate Their Philosophy On Health What the doctor’s philosophy is about their area of expertise will help people understand them better. People are interested in whether the doctor typically recommends surgeries or believes that surgery should be avoided unless necessary. People observe and form an opinion that they believe to be true. Demonstrate Knowledge Sharing the knowledge that can help people get the right information not only benefits society, but some people may choose to contact the doctor if this resonates with them. Consider Things That Have Worked: Build Own Website Doctor’s website showcases what you want to show while allowing you to change information at any time without relying on any platform. The website engages the user and provides useful information Jeff Bezos Your brand is what is spoken about you when you are not in the room. such as directions, pre/post-operative information, about the doctor, treatment options, and insurance options, among other things. All of this makes their planned visit more predictable, which makes people feel more at ease. Create A Social Media Presence Naturally, you should go where your prospective patients are. Also, because we are living in connected times and are all humans, it contributes to the development of that human connection. Patients and their families can identify with the values exemplified here and feel a connection. Engage With Media And Participate In Events Engaging with the media not only increases visibility but also credibility. Media engagement enables practitioners to establish themselves as subject matter experts. This demonstrates a promise of what their patients can expect if they contact them.
20 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM Walk The Talk? People form an impression of the doctor based on what they read/ hear about him. When they consult the doctor, they make a decision that will either strengthen or change their perception, leaving a lasting impression based on genuine engagement. At this point, the doctor’s brand is established. Do Keep These In Mind When embarking on the journey to establish a personal brand, a doctor must manage expectations. Here are a few things to remember: It Takes Time Personal branding is about establishing credibility beyond visibility, which will occur over time as people engage with the doctor, and form and share their opinions. It Is A Continuous Process Personal branding is a never-ending process. More and more people are working to establish their brand. Out of sight, out of mind. The doctor’s visibility may be declining due to competition strengthening their brand. It Costs And Is Not Cheap Building a brand, including on social media, is not cheap. It takes time and mindfulness. This means that a practitioner may require assistance beyond their skills to ensure continuity and establish a professional image. It must communicate clearly, consistently and with authenticity. Whatever a practitioner believes in and wishes to demonstrate must be done clearly. This necessitates consistency in messaging, frequency, and the promise being created and actual experience. That is, it must be genuine and not personify who they are not. The Agency May Not Be Able To Substitute The Doctor An agency can assist the practitioner, but a personal brand is exactly that: personal. An agency can assist in increasing visibility, which may lead to engagement, but the practitioner must walk the walk. A doctor must create an experience that validates the doctor’s reputation. Stand For Something To Stand Out A doctor who has a strong opinion about something must express it. This will help you stand out from the crowd and build a tribe or community of people who share your values. The Doctor’s Team Demonstrates The Doctor’s Values Most of the time, the doctor is not the first person apatient meets in a clinic or hospital. The team that interacts with the patient establishes expectations. A perception is formed as a result of expectation. The doctor’s team is responsible for being the doctor’s and the practice’s brand ambassadors. Nurture The Brand Champions Some patients will have complete trust in the doctor because of how the doctor has affected their lives. They will bear witness to the doctor’s skills and personal values. They will be the doctor’s brand champion, speaking about the doctor even when he or she is not present. Doctors’ practices must cultivate an increasing number of brand champions. This procedure also assists the doctor in staying on track to do better. According to Jeff Bezos, “Your brand is what is spoken about you when you are not in the room.” Personal branding is one of the most powerful ways to establish a presence while also demonstrating credibility. While mostunderstated, it appears to have worked for most successful practitioners, perhaps unknowingly, but with changing times and increased competition, it is imperative to bring consciousness and mindfully nurture a doctor’s brand. OPINION
EXCEPTIONAL MANAGERS: LEADING, SUCCEEDING, INSPIRING! #IAmExceptional OF THE YEAR 2023 EXCEPTIONAL MANAGERS NOMINATE NOW Scan to Nominate APARNA SENGUPTA Group Director -Revenue BW Businessworld TALEES RIZVI Director BW People & BW CFO World DR. ANNURAG BATRA Chairman & Editor-in-Chief BW Businessworld & Founder, exchange4media AP PARIGI Co-Founder Radio Mirchi Times OOH Media ATUL SOBTI Director General, SCOPE Former CMD, BHEL DR. SANGEETA SHAH BHARDWAJ Acting Director Management Development Institute Gurgaon SK BOSE Director Administrative Staff College of India New Delhi Centre DR. PUNAM SAHGAL Former Dean & Professor IIM Lucknow JURY MEMBERS Award Categories and Exceptional Managers from other functions Exceptional HR Managers Exceptional Marketing Managers Exceptional Finance Managers Exceptional Sales Manager Exceptional Information Technology Managers Exceptional Operations Managers Exceptional Facility Managers Exceptional R & D Manager Exceptional Supply Chain Managers Exceptional Accounts Managers Exceptional Admin Managers For Nominations: Akash Kumar Pandey | +91 7898908944 [email protected] Ashish Kumar | +91 97179 22747 [email protected] Aditi Rawat | +91 9873431912 [email protected] For Speaking Opportunity: Reeti Gupta | +91 98996 10630 [email protected] For Community Collaboration: Talees Rizvi | +91 93106 34007 [email protected] For Sponsorship: Anjeet Trivedi | [email protected] | +91 9818122217 CS Rajaraman | [email protected] | +91 9342262859 Deepak Bhatt | [email protected] | +91 9429423232 Kiran Dedhia | [email protected] | +91 9833399009 Rajeev Chauhan | [email protected] | +91 9811820301 Ravi Khatri | [email protected] | +91 9891315715 Sajjad Mohammad | [email protected] | +91 9911855935 Saurabh Jain | [email protected] | +91 9911334633 Shruti Arora | [email protected] | +91 79826 28913 Somyajit Sengupta | [email protected] | +91 9818247444 Faizuz Ahamed | [email protected] | +91 98206 68333 Santosh B Singh | [email protected] | +91 9820129879 EVENT PARTNERS
22 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM Q&A right, not a privilege, and that patients everywhere should have access to the best possible care. I decided to work on this mission because I wanted to change the course of surgery. The goal is to economically innovate within the country, be proud of our accomplishments, and reduce reliance on imported medical devices. The driving force is to make India proud while also benefiting patients worldwide. It all comes down to destiny and a deep love for our motherland. What are your thoughts on the concept of ‘local’ in our country? Is it real, and how has it created opportunities in the rapidly growing post-pandemic healthcare industry? With a population of 1.4 billion people and 70,000 hospitals, there is a growDr Sudhir P Srivastava, Founder of SS Innovations Private Limited, in an exclusive conversation with Harbinder Narula, BW Healthcare World, talks about revolutionising minimally invasive surgical solutions, the future of healthcare and robotics in India, and more What drew you back to India at a time when everyone wanted to work in the United States? Destiny and my love for my motherland drive me. The goal is to make a difference in healthcare, particularly in India, where access to care is limited. Initially focused on launching robotic programmes in 2011, the high cost limited our ability to make them widely available. As I witnessed the transformative benefits of robotic surgery, my determination to make quality healthcare a global right grew. I believe that healthcare is a
WWW.B W HE ALTHCARE WORLD.C OM HE ALTHCARE WORLD.C OM BW HE ALTHCARE FEBRUARY 2024 23 for robotic surgery, addressing the needs of the world’s underserved. I want to incorporate robotic surgery into postgraduate curricula and government insurance plans, making it more accessible to a larger population. This strategic move has the potential to position India as a global hub for medical tourism as well as an exporter of low-cost robotic systems. Addressing the challenges of education and affordability in robotic surgery, how can the perception of equipment manufactured in India be overcome, especially in comparison to products from Europe or the Western world? At one-third the cost, SSI’s robotic system maintains superior quality, outperforming the global leader in features and performance. The system’s excellence is demonstrated by over 500 complication-free surgeries, including complex cardiac procedures. The benefit of being a new entrant is that it allows for continuous technological advancement. I envision using telemedicine to decentralize excellence and address underserved areas. SSI’s goal is to democratize access to advanced medical procedures by incorporating cutting-edge features such as virtual mixed reality. Despite historical obstacles, India’s talent pool is capable, and the country is poised for medical technology greatness. With India’s proven success in other solutions in India. Despite the challenges posed by an expanding disease spectrum, the large population allows for effective interventions. India is well-known for providing high-quality medical care at a low cost, making it an ideal setting for the launch of new healthcare platforms. The sheer volume of cases enables faster implementation, extensive data collection for research, and faster development. The success of initiatives such as SSI’s medical devices demonstrates Indian engineers’ ability to develop sophisticated technologies. This benefits not only the country’s healthcare evolution, but it also aligns with the goal of self-sufficiency. Increased investment in medical devices is critical for India to achieve true self-sufficiency. TOP OF FORM It is admirable that robotic surgeries have begun in India. What are your thoughts on the size of the market and India’s potential to become a global robotic surgery hub? Despite having 70,000 hospitals, India has had fewer than 200 robotic systems in the last two decades, owing to cost and the learning curve. With over 500 cases completed in a short period of time, various institutions are exciting. According to the global context, India contributed only around 10,000 to 11,000 robotic surgeries out of approximately 1.6 million last year, indicating a vast untapped market. India is quickly becoming a centre At one-third the cost, SSI’s robotic system maintains superior quality, outperforming the global leader in features and performance. The system’s excellence is demonstrated by over 500 complication-free surgeries, including complex cardiac procedures.
24 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM fields, it is possible to retain skilled labor. With its burgeoning startup ecosystem and government support, I believe India is poised to take the lead in medical technology globally. Can you outline the challenges that Indian manufacturers face in the healthcare sector, and what steps do you believe the government should take to support and promote growth in this industry? The current reliance on imported electronic components must change, and investing in indigenous technologies is critical to achieving self-sufficiency. As demonstrated by the successful Chandrayaan mission, the government’s leadership in creating an investment-friendly environment can pave the way for increased indigenous development and manufacturing. Once a supportive ecosystem is established, the private sector will likely follow suit, and there is a positive trend in this direction, particularly in industries such as semiconductors and motors. Overall, the goal is to make India self-sufficient in major imports and to promote growth in a variety of sectors. Manufacturers face challenges from their reliance on imports, including high duties impacting costs. By removing these impediments, cost savings can be passed on to end users. Are there similar legal implications for doctors performing robotic surgeries compared to traditional surgeries? Medical device industries, including SSI, adhere to stringent safety standards such as ISO 13485 and are regulated by bodies such as CDSCO. The SSI mantra has been thoroughly tested, ensuring that there are no device-related complications. Compliance with high standards is crucial for patient safety and industry confidence. How did SSI perform in 2023, and what are your expectations for the organisation in 2024? SSI has made significant progress by 2023, with many hospitals evaluating our systems, the government interested in incorporating robotic surgery into education, and efforts to address the problem of refurbished equipment dumping. This year has seen the validation of technology, numerous launches, and ongoing improvements. Regulatory approvals for approximately 120 countries are in the works, and initiatives for US FDA and CE approval have been launched. Collaborations with prestigious institutions such as Johns Hopkins and Harvard are currently underway. For 2024, we anticipate rapid progress in India and around the world, with a focus on multicenter trials, novel technologies, scaling-up fundraising, and the development of a pediatric robotic system. Although India remains a significant launch platform, our global outlook includes partnerships and infrastructure development for greater accessibility. What do you see as the next steps in the future of the Indian healthcare industry in 2024? Furthermore, what breakthroughs or advancements in robotics in healthcare can we anticipate in the coming year? In India, plans include expanding to more centers, conducting trials, and collaborating with educational institutions. Teleproctoring and telesurgery are two initiatives that will provide remote guidance, making training more accessible and cost-effective. With increased awareness, government support, and surgeon interest, the Indian robotic market is poised for growth. The collaboration of skilled engineers and medical specialists in India has the potential to position the country as a healthcare equipment hub. The transformation is underway, thanks to those who are committed and willing to invest resources. Q&A
COMMEMORATING STEPS TOWARDS AN INCLUSIVE PLANET SUMMIT & AWARDS 2023 BWPEOPLEDEI BWPEOPLEDEI NOMINATE NOW DEI INITIATIVE AWARDS DEI LEADERSHIP AWARDS DEI Strategy Award HR DEI Awards Employee Network Award Women Advancement Award Disability Inclusion Award DEI Pioneering Initiative Award Social Inclusion Award DEI Business Leader Award Advancing Gender Equality Award Advancing LGBTIQA+ Inclusion Award Diversity Ally of the Year Best DEI Consultancy Outstanding Diversity Network Holistic Inclusion Workspace Award Best Diversity Employer Inspirational Role Model of the Year DEI Business Leader Award HR Champion of the Year in DEI DEI Champion of Change Award Lifetime Achievement (Jury Choice) AWARD CATEGORIES For Nominations: Akash Kumar Pandey | +91 7898908944 | [email protected] Ashish Kumar | +91 97179 22747 | [email protected] Aditi Rawat | +91 9873431912 | [email protected] For Speaking Opportunity: Reeti Gupta | +91 98996 10630 | [email protected] For Sponsorship: Aparna Sengupta | [email protected] | +91 9958000128 Anjeet Trivedi | [email protected] | +91 9818122217 CS Rajaraman | [email protected] | +91 9342262859 Deepak Bhatt | [email protected] | +91 9429423232 Kiran Dedhia | [email protected] | +91 9833399009 Rajeev Chauhan | [email protected] | +91 9811820301 Ravi Khatri | [email protected] | +91 9891315715 Sajjad Mohammad | [email protected] | +91 9911855935 Saurabh Jain | [email protected] | +91 9911334633 Shruti Arora | [email protected] | +91 79826 28913 Somyajit Sengupta | [email protected] | +91 9818247444 For Community Collaboration: Talees Rizvi | [email protected] | +91 93106 34007
26 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM IN-DEPTH By Shivam Tyagi The top deal of the year came in April when Temasek, a sovereign wealth fund based in Singapore, invested $2 billion in Manipal Hospitals. Healthcare & Pharma Boom: M&A DRIVES GROWTH STORY
WWW.B W HE ALTHCARE WORLD.C OM HE ALTHCARE WORLD.C OM BW HE ALTHCARE FEBRUARY 2024 27 combined healthcare and pharmaceutical investments made by private equity firms in India accounted for a mere 5 per cent of the total deal value prior to the Covid pandemic. As of right now, the percentage has increased to 12 per cent in 2023. “The PE deal value, which used to be $1–2 billion odd pre-Covid, has consistently touched upwards of $4 billion in the past two to three years. In terms of private equity inflow into the sector this year, so far in the first 7-8 months, $5 billion has happened, excluding the Blackstone deal. The speed and velocity of fund flow into this sector are significantly expanding,” says Kaivaan Movdawalla, Partner and Healthcare Leader, EY Parthenon. Why Healthcare Is PE’s Favourite The top deal of the year came in April when Temasek, a sovereign The season of mergers and acquisitions (M&A) in the healthcare and pharmaceutical sectors is here to stay, with private equity also taking a greater interest than ever in India’s health ecosystem. Industry insiders say that the post-Covid years have been a boon for private equity investments and M&A activities. According to them, M&A activity in the Indian healthcare sector took place between 2018 and 2022, with a total deal value of $35 billion. This represents a healthy increase in deal value compared to the previous five-year period. The experts following these deals in 2023 estimate that private equity investments alone will contribute over $6 billion to the total deal value in the healthcare and pharmaceutical industries, with $3.4 billion coming from M&A activity in the first eight to nine months of 2023. According to them, the number of M&A transactions completed through October has already exceeded the total for 2022 by 20 per cent. India is becoming an increasingly desirable location for private equity (PE) firms for a variety of reasons, including the demographic dividend and rising per capita income. Ernest & Young data indicates that the India is becoming an increasingly desirable location for private equity firms for a variety of reasons, including the demographic dividend and rising per capita income
28 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM wealth fund based in Singapore, invested $2 billion in Manipal Hospitals. Currently, the PE firm owns a 59 per cent share in India’s secondlargest hospital chain. While US-based PE firm Blackstone has taken over two of the biggest chains in south India—Care Hospitals and Kims Hospitals—in a deal valued at around $1 billion. According to the data by EY, healthcare has garnered more investments from PE firms—from 4 per cent of the total deal value of India in 2017 to 10 per cent in 2023. Comparatively, the pharma sector has only moved by one per cent from 1 per cent in 2017 to 2 per cent in 2023. “India has secular demand-supply drivers; we’ve got a very high disease burden, an expanding middle class with growing purchasing power, rising penetration of private health insurance, and the Ayushman Bharat scheme, which has unlocked the demand at the bottom of the pyramid,” says Movdawalla. He further says that post-Covid, much greater momentum is being witnessed in organised or quality private healthcare, which is attracting a heavy inflow of PE money. In Indian metros, the total bed density remains largely uncapitalised with 2.5 to 3.5 beds per 1000 population, and for quality hospitals that are accredited by NABH, the bed density falls to 0.4 per 1000 population. For quality beds, today there is a demand-supply gap of 20–30 per cent, Movdawalla says. Pharma Leads The M&A Activity The pharmaceutical sector commands a majority in M&A activities, with a 4 per cent deal value of the total M&A activity happening across sectors in India versus a 1 per cent deal value of the healthcare sector. Experts say pharmaceuticals have traditionally enjoyed strong M&A activity given the scale of the sector, the large number of assets in the sector and attractive growth tailwinds. They further highlight that presently, the pharmaceutical sector is undergoing a consolidation trend in the domestic market, driven by margin pressure. “There is an emphasis on expanding capacities within India, particularly in Contract Development and Manufacturing Organisation (CDMO), Active Pharmaceutical Ingredient (API) manufacturing and Biosimilar businesses,” says Bhanu Prakash Kalmath S J, Partner, Grant Thornton Bharat. In the M&A universe, the famous washing powder brand Nirma foraying into pharmaceuticals wa s t he big gest mover. “In 2023, the Nirma-Glenmark Life Sciences deal, valued at $689 million, constituted more than one-third of the total M&A deal value until October 2023. Additionally, four deals, each exceeding $100 million, contributed to the year-on-year increase. These include the Serum Life Sciences-Biocon Biologics deal valued at $150 million, the IPCA Labs-Unichem Labs deal worth $126 million, the Dr Reddy-Mayne Pharma deal amounting to $105 million, and the Manipal HealthAMRI Hospitals deal valued at USD 280 million,” says Kalmath S. J. IN-DEPTH
WWW.B WHE ALTHCARE WORLD.C OM BW HE ALTHCARE FEBRUARY 2024 29 Key Drivers In M&A, PE Investments Industry voices claim that the interests that appear to be driving consolidation have remained constant over time. On the other hand, PE firms are acting as financial sponsors in the pharmaceutical and healthcare industries, particularly for assets that are differentiated and scaled up. This, coupled with global supply chain realignment, especially diversification from China during the pandemic, continues to drive increased investments in India. PE firms typically have a seven-year window, allowing them enough time to exit with a premium on their invested value; however, in healthcare, the window is only three to five years, say experts, which makes for quick returns in the shortest possible window. “PE activity has also been driven by the rationale of developing platform assets by deploying an inorganic roll-up strategy, with the key benefits of this strategy being larger scale, greater diversification, expansion of capabilities, and the ability to harvest revenue and cost synergies, all of which ultimately improve asset quality at exit for the PE owner,” states Subhakanta Bal, Managing Director, Rothschild & Co. Trade activity in pharmaceuticals, especially in the B2B segment, continued to be strong, Bal says. He says that trade activity has been driven by a desire to enhance market share and plug specific whitespaces from a therapy area standpoint. In certain therapeutic areas, organic growth has been lower than expectations, making acquisitions a preferred alternative, Bal adds. Experts say that pharmaceutical companies are willing to expand into high-growth segments such as high-potential APIs, oncology, peptides, and injectables. Nutraceutical ingredients are also witnessing interest from PE funds on the back of strong growth driven by rising consumer awareness and a shift towards preventive care. On the other hand, in healthcare, larger chains are acquiring smaller providers to expand their footprints. “Single specialty segments, especially IVF, motherhood, childcare, Total PE Investment In Healthcare, Pharma 7,000 6,000 5,000 4,000 3,000 2,000 1,000 0 2017 2018 2019 2020 2021 2022 Source: EY 2023
30 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM and eyecare, are experiencing increased activity. Some notable transactions include ASG Hospitals-Vasan Eye Care and Asia Healthcare-Asian Institute of Nephrology and Urology,” says Kalmath SJ. A Decade of Growth for Healthcare, Pharma Given the scope to increase access across the health ecosystem enabled by multiple macro drivers such as a rise in per capita income and an increase in insurance penetration, experts maintain that the Indian healthcare sector will be a multi-decade secular growth story gauging strong investor interest across pharmaceuticals, healthcare services, and, increasingly, medical devices. “With multiple companies scaling up in the MedTech space, there is a rise in interest from financial sponsors. We could also see more inbound trade M&A activity in the MedTech space as overseas companies look to expand their footprint and get access to commercial infrastructure in India,” says Bal. In Tier 1 and 2 cities, where a large chunk of India’s GDP growth will happen, Movdawalla envisions a surge in affordable healthcare. Providers will adapt their models to ensure everyone, regardless of income, has access to quality care. “Tier 1 and 2 cities are where a large part of India’s GDP growth is going to happen; they will become a very important growth engine of this healthcare market. Doctors would want to come there with the patients, becoming value-conscious and aspirational. And they have an unmet demand, and as one provides quality healthcare, these markets will expand exponentially,” Movdawalla adds. Industry experts remain optimistic for the healthcare and pharma sectors in 2024, driven by promising signs of recovery in the country’s deal activity. They say that despite short-term fluctuations, the industry demonstrates significant long-term investment potential, particularly in the segments that gained traction in 2023. Industry voices say that the healthcare sector is insular to external shocks that guarantee revenue growth of 10-12 per cent. They contend that the future deal environment in healthcare and pharma will continue to attract PE investors with an estimated $3 to $4 billion of deal value in 2024. “Every private equity firm has healthcare ranking second in its portfolio. This is the decade of healthcare in India,” says Movdawalla. IN-DEPTH
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32 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM COLUMN By Anil Matai As we stand on the threshold of a new year, the pharmaceutical sector prepares to stride into a future brimming with transformative innovations and ground-breaking advancements. The year 2023 was a testament to an unyielding commitment to progress within our industry. As we gaze ahead into 2024, it’s imperative to shine a light on the imminent trends poised to redefine the pharmaceutical landscape. Personalised Medicine and Advanced Therapies The dawn of personalised medicine is upon us, propelled by remarkable strides in genomics, precision medicine, and targeted therapies. Going forward, we foresee a surge in advanced therapies such as gene editing, cell and gene therapies, and the evolution of precision oncology. These innovative treatments hold the potential to revolutionise patient care by tailoring interventions to individual genetic profiles, ushering in an era of unparalleled efficacy and minimised side effects. Digital Revolution and Health-Tech Integration The convergence of healthcare and technology continues to accelerate, catalysing a paradigm shift in healthcare delivery. The integration of digital health solutions, encompassing telemedicine, AI-powered diagnostics, wearable devices, and remote patient monitoring, is set to redefine patient engagement and clinical outcomes. In 2024, we anticipate further strides in leveraging these technologies to optimise healthcare access and delivery across diverse demographics and geographies. Sustainable Practices and Accessible Healthcare The pursuit of sustainability is becoming intrinsic to pharmaceutical operations. Over the next year, our industry’s commitment to eco-friendly manufacturing practices, sustainable packaging, and reducing the carbon footprint will gain momentum. Simultaneously, fostering equitable access to healthcare remains a pivotal focus. Pharma To Focus More On CYBERSECURITY We foresee a surge in advanced therapies such as gene editing, cell and gene therapies, and the evolution of precision oncology
WWW.B W HE ALTHCARE WORLD.C OM HE ALTHCARE WORLD.C OM BW HE ALTHCARE FEBRUARY 2024 33 ANIL MATAI The author is Director General, OPPI Artificial Intelligence and data-driven technologies are poised to redefine drug discovery, optimise clinical trials, and enhance patient care Collaborative efforts to ensure affordable and accessible medications for all, addressing global health disparities, will continue to be at the forefront of our endeavours. AI and Data-Driven Innovations Artificial Intelligence (AI) and data-driven technologies are poised to redefine drug discovery, optimise clinical trials, and enhance patient care. The integration of AI and machine learning algorithms will further accelerate the identification of drug targets, streamline R&D processes, and enable more precise diagnostics and treatment decisions. Harnessing the power of data will propel us towards more efficient and targeted therapies. Increasing Focus on Emerging Markets Recognising the vast potential and unmet needs in emerging markets, the pharmaceutical industry is intensifying its focus on these regions. Efforts taken to tailor strategies and develop innovative solutions specifically for these markets will witness a significant upsurge. This includes introducing region-specific medications and collaborating with local healthcare providers to ensure improved access to quality healthcare. Regulatory Agility and Collaboration In an era of rapid innovation, regulatory adaptability is paramount. Collaborative efforts between industry stakeholders and regulatory bodies are crucial to navigate the evolving landscape while upholding stringent safety, efficacy and quality standards. In 2024, fostering a regulatory environment that nurtures innovation and facilitates the swift introduction of novel therapies will be imperative to expedite patient access to transformative treatments. Following the WHO GMP guidelines and maintaining uncompromising quality throughout these processes ensures the reliability and safety of pharmaceutical products, building trust among stakeholders and benefiting patients globally. Data Privacy and Security in Healthcare With the increasing adoption of digital health solutions, safeguarding patient data becomes paramount. A heightened emphasis on data privacy and cybersecurity within healthcare systems will take centre stage. The industry will witness advancements in secure data-sharing protocols, encryption technologies, and robust cybersecurity measures to protect sensitive patient information. Building and maintaining trust in digital healthcare platforms will be crucial for widespread adoption and successful integration into patient care. Resilience and Pre- paredness for Global Health Crises The experiences of recent global health crises have underscored the importance of preparedness and resilience within the pharmaceutical sector. The industry will continue to focus on fortifying supply chains, ensuring ample reserves of critical medications, and developing rapid response mechanisms to tackle unforeseen health emergencies. Collaboration between governments, healthcare organisations, and pharmaceutical companies will be pivotal in strengthening global readiness to mitigate the impact of future crises on public health. As we embark on the journey that is 2024, the pharmaceutical industry stands at the helm of an era defined by innovation, collaboration, and a steadfast commitment to global healthcare excellence.
34 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM IN-DEPTH By Shivam Tyagi While 124 nations embraced the link between health and climate at COP28, the question remains: will this translate into impactful carbon emission reductions? HEALTH TAKES CENTRE STAGE AT COP28 I n a historic first, public health was formally linked to climate change at COP28. On December 3, a landmark declaration signed by 124 countries in Dubai pledged to illuminate the intricate ties between rising temperatures and human health. The day witnessed a support fund of $1 billion for the mitigation and implementation of programmes emphasising the transformation of health systems, notifying environmental determinants of health, and protecting those at risk. The consensus aims to prepare healthcare systems to cope with climate change while acknowledging the government’s role in protecting the health of its people. In the Paris agreement signed at COP21 in 2015, nations pledged to reduce their carbon footprint to limit the global temperature rise to 1.5 degrees Celsius compared with pre-industrial levels. According to a UN report, this mark was breached for 86 days in 2023, which the experts say is partly due to the global carbon footprint and partly to the El Nino effect.
WWW.B WHE ALTHCARE WORLD.C OM BW HE ALTHCARE FEBRUARY 2024 35 According to Lancet’s Countdown Health and Climate Change report 2023, extreme weather events are becoming more frequent, with the transmission of fatal infectious diseases rising due to the climate’s suitability for the vectors to breed. The life-threatening events are causing food and shelter insecurity for millions of people around the world, the report says. But the question is: will combining health and climate make any difference in slowing down the destruction that climate change is causing? A Welcome But Delayed Step Climate change experts believe that the inclusion of health in climate change has been long overdue and was finally taken at COP28 as nations globally continue to witness increasing industrialisation, carbon emissions from fossil fuel usage, and irresponsible practices by individuals and organisations. “This is a great welcome step but a delayed step. Climate change has a direct impact on human health, and with the inclusion of health at COP28, public health has gone from margins to mainstream. The global community has come together to understand the impact of climate change, which will result in building adaptations to fight it,” says Abinash Mohanty, Sector Head, Climate Change and Sustainability, IPE Global. Vikram Vora, Medical Director, Indian Sub-Continent, International SOS, says that having health included in the main climate action agenda has the potential to inform, educate, and concert a global effort towards reducing the risks that such actions pose to human health. “Whether this leads to a positive change in global emissions and related public health consequences will be dependent upon the commitment that nations exhibit in managing their carbon footprints and in helping other countries adopt,” adds Vora. Prime Minister Narendra Modi attended COP28 and outlined the nation’s carbon emission targets and committed to reduce the emission intensity by 45 per cent by 2030. He also said that India will increase the share of non-fossil fuels to 50 per cent and achieve the net zero target by 2030. Despite being two of the world’s top carbon contributors, the governments of India and the US did not sign the climate and health declaration in Dubai. Climate policy experts say that the declaration will augment new aggressive steps towards cleaner energy and sustainable cooling from the members. But for India, the road is not that easy, as access to clean, green and affordable energy is still a bigger challenge. “Although we will double our solar capacity by 2030, and have improved our renewable energy bucket, we are still in the leapfrogging stage, striving to be a $5 trillion economy, and we cannot aggressively change everything as this will lead to a disbalance between the creation of jobs and sustainability,” says Mohanty. Is Indian Healthcare Climate Ready? In India, the effects of climate change are already being felt in the form of severe heat waves, increased air pollution, and a rise in infectious diseases. Experts say that reduced agricultural productivity and job losses will result from climate change. “Due to extreme heat waves, India is going to lose 30 million jobs by 2030, and the country’s agricultural productivity will also come down by 10 per cent. Furthermore, as people get exposed to prolonged heat, it will result in different kinds of health ailments,” says Mohanty. Industry voices further contend that there is a significant urban-rural healthcare resource gap in India, demanding an urgent need to ensure healthcare availability for all. “Striking a balance between setting up this health infrastructure using climate-friendly methods while simultaneously ensuring healthcare access for all is a climate health resilience challenge that India faces,” says Vohra. WWW.B WHE ALTHCARE WORLD.C OM Despite being two of the world’s top carbon contributors, the governments of India and the US did not sign the climate and health declaration in Dubai
38 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM Q&A THE COUNTRY IS BECOMING RICHER, BUT ALSO SICKER In an exclusive interview with BW Healthcare World, Dr Viren Shetty, Executive Vice Chairman and Director of Narayana Health, discusses the evolving healthcare landscape. Dr Shetty, who joined Narayana Hrudyalaya’s hospital engineering department in 2004, played a crucial role in designing and commissioning key facilities for the Narayana Health Group In light of your time at Narayana Hrudayalaya, what changes have you seen in India regarding the healthcare business and the role of hospitals? While the fundamental aspects of our healthcare business haven’t changed since 2004 or even 1904, a significant shift has occurred in customer awareness. People now realise healthcare is accessible, safe and affordable. Unlike the early 1990s, when a heart condition was often seen as incurable, today there’s a mindset shift. Dr Shetty’s challenge then was convincing people of the available solutions. Post-Covid, this awareness has intensified, with people seeking treatment for advanced conditions and diverse procedures, reflecting a notable change in customer mindset and openness to medical advancements. What challenges prompted the re-evaluation of Narayana Hospitals’ branding as it evolved, encompassing the establishment of centres of excellence and overall institutional growth? The short answer is that our shift to health signifies our aspiration to go beyond being solely a cardiac care provider. While cardiac care remains a primary focus due to its prevalence among Indians, the term “health” reflects our commitment to a broader spectrum of healthcare services. Additionally, the change to Narayana Health aligns with the practicality of pronunciation, maintaining the essence of our name. Why have you chosen to shift from primarily being a Cardiac Care Institute to becoming a comprehensive healthcare delivery institution, and why the change from ‘Hrudayalaya’ to ‘Narayana Health’? Narayana will become the parent brand as we expand into various healthrelated ventures, including clinics, pharmacies, and potentially health insurance. These endeavours align with our broader vision of being a comprehensive healthcare brand, even beyond the hospital setting. How do you plan to expand the reach of the institution across the country, transitioning from a hospital to a broader healthcare institution? Scaling has been a major challenge in healthcare due to the traditional model of large hospitals in tier-one locations. To overcome this, we are diversify-
WWW.B W HE ALTHCARE WORLD.C OM HE ALTHCARE WORLD.C OM BW HE ALTHCARE FEBRUARY 2024 39 DR VIREN SHETTY ing our approach by building smaller hospitals, focused care centres, clinics, and pharmacies. Our future goal is to provide integrated care, incorporating virtual care through phone consultations and addressing various health needs beyond major hospital visits. This initiative, named Narayana Health Integrated Care, aims to play a role in patients’ lives by offering a range of healthcare services, acknowledging that hospital visits are rare compared to other health-related events. This shift aims to address non-communicable diseases and lifestyle issues more effectively. How can we address the shortage of nurses and paramedical staff, along with retention issues, to ensure a sustainable healthcare workforce in the future? The migration of doctors and nurses abroad is a positive aspect, reflecting the attractiveness of the healthcare field. While it leads to significant attrition, especially among nurses, it necessitates continuous training and development efforts. Many hospitals, including ours, have nursing colleges to address this challenge. Training nurses, even if they eventually work abroad, contributes to the global healthcare workforce and serves as a positive example for aspiring individuals. Is Narayana Health planning to launch operator-led insurance soon? Narayana Health aims to launch operator-led insurance, aligning with Dr Shetty’s vision of affordable healthcare. With diminishing returns on cost reduction, the focus shifts to efficiency and throughput. The insurance programme prioritises preventive care, aiming to keep individuals healthy and reduce hospital visits. This initiative represents a shift from merely offering cost-effective surgeries to providing comprehensive healthcare for everyone. How do you envision the future of Narayana Health Integrated Services in overcoming the challenge of engaging individuals in preventive healthcare? The key lies in aligning incentives. If individuals are motivated and institutions are committed to keeping patients healthy, the impact can be substantial. Our vision is to go beyond traditional healthcare, creating a comprehensive approach that empowers individuals to proactively manage their well-being. We aim to shift the mindset, providing resources for a healthier life outside hospital walls, fostering awareness, and encouraging proactive health measures. It’s about creating a joint effort for a healthier, more informed society.
40 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM IN-DEPTH In an exclusive conversation Abhay Soi, Chairman and Managing Director of Max Healthcare Institute speaks to Jyotsna Sharma of BW Businessworld about his focus on delivering world -class care and the group’s intention to further medical education in India. Excerpts. Photograph by Vilas Kalgutker ‘Since we began our journey, our focus has been to bring care to healthcare’ Please tell me about your collaboration with Tihar for skill development. As a part of our CSR initiatives, we are focused on skill development and water conservation. We just announced the launch of the Max Skill Training for Sustainable Livelihoods programme in association with Tihar Jail, which aligns with our focus on skilling. This is one of the largest corporate sector partnerships with Tihar Jail for a skill training programme in India, that aims to further correctional reform for 1200 inmates. It aims to further strengthen the rehabilitation programme at Tihar Jail that focuses on education, vocational training, and therapy to reduce recidivism rates and promote successful integration into society. Someone asked me about the optics of employing people who have served time. My answer is simple, those who want to work, will put in a lot of effort to work hard and keep their jobs. Human beings have the ability to reform and change. Isn’t it our responsibility to help each other?
WWW.B W HE ALTHCARE WORLD.C OM HE ALTHCARE WORLD.C OM BW HE ALTHCARE FEBRUARY 2024 41 Over the last few years, what is it that you could have done differently? There are several things. Since we began our journey, our focus has been to bring care to healthcare. Our priority is to serve, can we serve better? Of course, we can. We really got behind this and continue to see where we can improve and add value. Let me give you a couple of examples. Take the patient journey, which includes the process of admission, the people they interact with, and the infrastructure. We looked at all touchpoints and assessed how we can do better. We instituted a simple measure that if a patient calls any of our hospitals across the country and the phone is not answered in five rings, the next three rings will be on the COOs phone, and if that is not answered, it will be mine. The first month we instituted this, my phone rang twice and has not rung since. Then there is the concept of personal touch, we insist that the leadership team visit the hospitals and not rely purely on the data being sent to them. Nothing can beat taking feedback personally and meeting people. So, you see our focus has always been to get into the details and improve processes and systems wherever we can. And, we will continue to do so. Please tell us about your plans of expansion. We are massively underserved in India when it comes to quality healthcare, the figures are something like 100,000 private hospital beds for all of India, which is a meagre number when compared to our requirement. It is the government hospitals really, that are shouldering the burden of providing healthcare. And, now with people having access to insurance, private hospitals are in demand, which in turn means there is demand to build infrastructure. We have announced expansion at a cost of Rs 5,000 crore over the next four years. We are adding 2,600 beds over the 3,500 that we have through greenfield, brownfield expansions, and mergers and acquisitions (M&A). We have a brownfield expansion in Dwarka, adding 300 beds built in 8.2-acre land slated to start some time in Q1 FY 24. Then, a new wing is under construction at Nanavati Max Hospital, which when completed will add another 600 beds to the hospital, making it one of the largest private healthcare facilities in Western India. There is a lot more planned. Medical education is another area of focus, right? Yes, that’s right. We taught close to 10,000 students last year across various medical programmes, and are very keen on having our own medical college here in Delhi. Both research and academics are at the core of what we do, we have published more than 2,000 papers over the last five years for both international and domestic journals. In fact, we have several international students who come in to study with us. Please tell me about your focus on technology. Robotics has been a large investment for us. To start with, we got the machines on pay-per-use. But within a year, we doubled the number of machines. It is in a way natural progression since we want to use cutting-edge technology. Further, our investment in the Max My Health App has enhanced patient experience, enabled easier access to clinicians and has helped patients access all their health records in one place. There have been approximately five lakh downloads in less than a year. The app does 100 video consults daily, with 40 per cent of users viewing their electronic medical records. 80 per cent of our doctors who have outpatient clinics at the hospital have signed up on the app. Who has access to the patient data? Only the patient, the referring and treating doctors have access to the medical records. Your view on the Indian health tech sector. There is a huge amount of innovation and disruption taking place in the health tech sector. From a consumer standpoint we don’t necessarily have to be the first to embrace technology, but when we do it must be the right technology. For hospitals like us to adopt it, it has to be proven, scalable and the technology should have the ability to learn on its own. Your view on government to increase GDP spend. The government is doing its bit. The spend has gone up however, we have a large population and a responsibility towards providing quality healthcare. In addition to the government doing their part, the private sector too has a responsibility to be efficient and provide best-in-class healthcare. “Max My Health App has enhanced patient experience, enabled easier access to clinicians and has helped patients access all their health records in one place”
42 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM NOW THEY EXPAND IN-DEPTH HEN SPEAKING about Max Healthcare India (MHIL), Industry watchers always talk about the transformation of the group, from reporting a loss of Rs 50 crore in 2018 to Profit After Tax (PAT) of Rs 1,328 crore in 2023. Its Earnings before interest, taxes, depreciation, and amortisation (EBITDA) grew from Rs 222 crore in 2018 to Rs 1,636 crore in 2023, clocking a growth of over 635 per cent - it has been quite a turnaround. And, one that undoubtedly took a lot of sweat and hard work from the leadership and their teams. MHIL closed FY23 with a revenue of Rs 6,236 crore, a jump of 2.1 times in past four years, a remarkable growth story indeed. “Today, we are a debt free company and have a huge opportunity to expand organically and inorganically” says Abhay Soi, Chairman and Managing Director of Max Healthcare. The group now looks to expand. This expansion entails strengthening what they have, by adding capacity to existing hospitals, investing in technology and skilling their technicians. Further, the group has been focused on medical education, which is another area of growth. BW Businessworld spoke to the leadership at Max Healthcare about their expansion plans, and commitment to deliver best in class care. Moving forward In Delhi-NCR, they have plans for a brownfield expansion in Dwarka, adding 300 beds. A brownfield expansion in Shalimar Bagh, adding 100 beds. Two in Saket, one that would provide medical services to a 500-bed hospital, and the construction of a new wing at Max Smart Super Speciality Hospital, adding 600 beds to the network. In Patparganj, they have acquired Eqova Healthcare, to aid development of and provide medical services to a 400-bed hospital. A greenfield project in Gurgaon that will add 500 beds to the network. Further, a new wing is under construction at Nanavati Max Hospital, Mumbai. When completed will add
WWW.B WHE ALTHCARE WORLD.C OM BW HE ALTHCARE FEBRUARY 2024 43 After a remarkable turnaround, Max Healthcare India (MHIL) is set to expand. Most of this expansion is geared towards strengthening what they already have, by adding capacity to existing hospitals, investing in cutting edge technology and skilling their technicians. Another key growth area is medical education. ByJyotsna Sharma
44 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM another 600 beds to the hospital, making it one of the largest private healthcare facility in Western India. Work to add another 100 beds to the Max Hospital, Mohali has also begun. All in all they plan to add 2,600 beds to the network over the next four years. This month, MHIL announced the execution of binding Share Purchase Agreement (SPA) for acquisition of 100 per cent stake of Starlit Medical Centre for Rs 940 crore. This would grant them entry into Lucknow. What aids growth? Some focus areas for the group are: Technology Investing in technology is central to the growth of any business. Over the last few years, the Indian healthcare industry has embraced technology and seen rapid advancement across patient care, diagnostics and research. Take Telemedicine for in- IN-DEPTH stance, it has been a gamechanger for the delivery of care in our country. The Max group has invested in the latest medical technology across their hospitals, including 17 robotic systems. “We have specialised robots such as Da Vinci Xi, ExcelsiusGPS and the Stryker Mako Robots” says Dr Budhiraja, Group Medical Director, Max Healthcare. He further adds “the use of robotics has enabled us to conduct minimally invasive surgeries across multiple specialities like Oncology, UrolUmesh Gupta, Chief People Officer, Max Healthcare Abhay Soi, Chairman and Managing Director, Max Healthcare Dr Sandeep Budhiraja, Group Medical Director, Max Healthcare Photograph by Vilas Kalgutker ogy, GI Surgeries, Obstetrics and Gynaecology, Transplants, Spine Surgeries and Orthopaedics. Providing high levels of precision and accuracy.” The leadership at Max believes investments in state-of-the-art infrastructure, technology and equipment will empower them to provide better clinical outcomes, and minimise hospital stays for patients. They have invested considerable time and effort in creating the Max My Health App, which has helped enhance patient experience, enabled easier access to clinicians and created a convenient repository of healthcare records for patients. This app has seen approximately five lakh downloads in less than a year. Clinicians have been quick to support it, with 80 per cent of the Max hospital doctors who have outpatient clinics at the hospital signing up. 100 video consults are done on a daily basis through the app. Skilling The biggest strength of any organisation is its people, and in keeping
WWW.B WHE ALTHCARE WORLD.C OM BW HE ALTHCARE FEBRUARY 2024 45 YOGESH SAREEN,CFO, “We are in expansion mode, and a large part of the expansion is brownfield, which means it will be a faster ramp up. Our focus is to do it on time, maintain quality and keep within the cost structure laid out. Another focus is to optimise existing networks. And, of course, patient care has always been central to everything we do ” DR MRADUL KAUSHIK, COO, “When we look at any process we look at four basic aspects to make it efficient - it should make healthcare simpler, safer, faster, and economical for the patient” ANAS ABDUL WAJID, Chief Sales & Marketing Officer, “Our focus will largely be on driving medical value tourism (MVT) from international markets. If we compare H1 of this year to the previous year, there has been a growth of 25 per cent. At present, 10 per cent of our revenue comes from MVT and this is expected to grow significantly in the coming years” PRASHANT SINGH, Director IT & Chief Information Officer, “Cybersecurity is and will remain a key focus area for us. In fact, we successfully thwarted a ransomware attack on our systems last year” with this the group is investing in skilling and training programmes. Over the next couple of years they plan to train more than five thousand nurses and paramedics. To this end, they plan on open nursing and paramedical colleges, and have recruitment offices for nursing across India. They have partnered with IIM Kashipur to launch a nine-month Post Graduate Programme in Hospital Management. “We started our paramedical education vertical in 2021 , we had 60 student when we began, and today we have 1200 students. Further, in the last two years, we have trained more than 2,000 nurses and close to 3,000 general duty assistants in our hospitals under the guidance of Ministry of Skill Development and Entrepreneurship” says Umesh Gupta, Chief People Officer, Max Healthcare. Medical education is the way forward “All our hospitals are teaching hospitals and we are keen on having a medical college here in Delhi,” says Soi. When one speaks to the leadership of Max their focus on medical education is clear. They have raised over $2 million in grants in the last seven years and have completed nearly 500 research projects. At the moment, they have 120 research projects ongoing, that include close to 100 sponsored clinical trials and 22 funded research studies. As a part of their commitment to research and academics, they have collaborated with IIT Delhi, BITS Pilani, Imperial College, London, Royal College of Surgeons, Deakin University, Australia, George Washington University USA, and others. Dr Budhiraja stresses the fact that clinical excellence and research go hand-in-hand. For a doctor to deliver the best care, research and academics is essential. “We are a centre of education for post graduate and super speciality programmes. Our teaching arm Max Institute of Medical Excellence (MIME) registered close to 10,000 students in various academic programmes last year.”
46 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM Q&A DESIGN, SUSTAINABILITY AND COMPASSION IN FOCUS What are the challenges faced by hospitals today? The industry is evolving with private equity investments, listings, and technological advancements. Challenges today include building a sustainable healthcare model, retaining talent, and addressing a drain in support services. Patient expectations have changed, demanding faster, more convenient, and more affordable healthcare. Balancing commercialisation with ethical practices is crucial. The industry must adapt, drawing lessons from other sectors to meet evolving challenges. How did you address challenges and incorporate solutions in designing the Amrita Institute of Medical Sciences and Research? While planning the hospital, we aspired for a setup akin to renowned institutions like Howard, Mayo, and Johns Hopkins. Our focus was on future readiness, incorporating high-end and cutting-edge technology into the design. We aimed to shift from a primarily curative approach to a more preventive one. How are efficiency and carbon footprint challenges addressed in the hospital’s design for a smooth workflow? We studied various national and international institutions, incorporating the best practices. Our design focuses on efficient parking and distinguishing faculty and staff areas. The outpatient model, inspired by the Mayo Clinic, ensures easy navigation, minimising patient anxiety. Registration, billing, nursing assessments, consultations, and sample collections all happen seamlessly in one location, aided by a pneumatic tube system for direct sample delivery. How do you get into technology in Delhi-NCR areas? Consultations and advanced diagnostics, including procedures like colonoscopy and endoscopy, are conveniently centralised for patient ease. Repeat consultations, medications, and pharmacy services are all in one location, streamlining the patient experience. The design prioritises a patient-centred approach, ensuring efficiency. Additionally, a dedicated faculty office optimises consultant time, allowing for acaIn an exclusive interview with Harbinder Narula, BW Healthcare World, Dr Sanjeev Singh, Medical Director at Amrita Institute of Medical Sciences, Delhi-NCR, and Chief Medical Superintendent, Amrita Institute of Medical Sciences, Kochi, discusses the impact of design thinking on healthcare service delivery and more
WWW.B W HE ALTHCARE WORLD.C OM HE ALTHCARE WORLD.C OM BW HE ALTHCARE FEBRUARY 2024 47 demic focus, research, and mentoring. The workflow is enhanced as nurses conduct evaluations, enabling doctors to seamlessly move from room to room, minimising patient wait times. Critical care design incorporates satellite nursing homes and efficient facilities for simultaneous patient evaluations. How is rehabilitation incorporated into the ICU setting? The patient-centric design focuses on safety, promoting rehab, and facilitating early ambulation. Bedside therapies are prioritised, and the cubicle is adaptable for various medical procedures, ensuring patient well-being. The design extends to diagnostics and support systems in the daycare setting. As a hospital leader, how do you balance the hospital’s profit and loss statement while maintaining a charitable mindset and securing the best resources for safe and patientcentred care? Balancing the hospital’s budget involves strategic decisions, improving footfall, and reducing operational costs. The focus is on delivering quality care to the masses while ensuring sustainability. Initiatives include outreach clinics, adopting villages, empowering women, promoting family physician concepts, and optimising expenses through technology. The goal is to increase revenue, lower costs, and benefit the public by maintaining a charitable mindset. The challenge lies in providing top-notch care while managing finances effectively. How did you incorporate sustainability and green processes into your hospital design, achieving breakthroughs in creating an eco-friendly healthcare facility? To prioritise sustainability, we established a fly ash plant for ecofriendly building materials. Soil testing guided our IGBC and GRIHA-compliant design. Rainwater harvesting, with 84 wells on 133 acres, created a zero-discharge campus. Efficient sewage treatment, three large ponds, and solar panels on facades reduced our environmental footprint. Absorbent tiles on walls and terraces maintain temperature consistency. Chiller plant technology focused on air conditioning efficiency, emphasising insulation, variable frequency designs, and VRB facilities. Our approach spans STP, ETP, solar energy integration, rainwater harvesting, and maximising natural light and ventilation for a sustainable hospital. Do you think that sustainability and revenue generation can go hand in hand? Yes, sustainability and revenue generation can go hand in hand in healthcare. With innovations, technology, and improved processes, there’s a positive shift towards a more viable, profitable, and qualitydriven healthcare environment. The future holds the promise of positive change, ensuring both financial viability and excellent patient care. Do healthcare institutions founded by doctor families have a tendency to commercialise, putting patient care at risk? How can we strike a balance between investment and compassion? Private equity’s growing interest in healthcare is fueled by technological advancements and promising returns. While investors aim for profitability, there’s a stated commitment to preserving professionalism. Collaborations with institutions like IITs highlight a robust healthcare focus. Balancing financial goals with ethical care delivery remains a challenge, addressing concerns of potential commercialisation and unethical practices. Public perception underscores the need for healthcare professionals to introspect. Programmes like those on spirituality in healthcare play a vital role in promoting a compassionate approach. Leaders must ensure that the nobility of the profession prevails over commercial motives. Maintaining a focus on compassionate healthcare delivery amid industry evolution is imperative. How do healthcare insights from 2023 influence your expectations for transformative changes in India’s healthcare industry in 2024? In 2024, we can anticipate cost-conscious healthcare, insurance sector growth to 28 per cent, expanded universal health coverage, increased integration of AI and technology for diagnostics, point-of-care advancements, affordable robotic surgery, government and international research support, and a crucial emphasis on preserving compassion and empathy in patient care.
48 BW HE ALTHCARE FEBRUARY 2024 WWW.B WHE ALTHCARE WORLD.C OM COLUMN By Rajiv Nath The Indian medical devices industry can expand from $12 billion to $50 billion by 2030 The prospects of the medical devices industry in India appear promising in 2024 as the sector continues to undergo significant advancements and growth. The expected implementation of the favourable National Medical Devices Policy 2023 under the supervision of Medical Device Promotion Council, and the expected functioning of the Medical Device Export Promotion Council, as well as the enforcement of Medical Device Rules making licensing mandatory for manufacturers and importers, is expected to further boost the industry by fostering a conducive business environment. Similarly, collaborations between domestic and international players are facilitating technology transfer and knowledge exchange, contributing to the development of cutting-edge medical devices within the country. As Medical Devices Industry To Grow Exponentially In 2024 India strives to enhance its position as a global player in the healthcare sector, the medical devices industry is likely to witness continued expansion, offering significant opportunities for growth, investment, and technological innovation during FY2024–25. Favourable Policies The Central Government notified the National Medical Devices Policy, 2023. It takes care of a multitude of industry needs, thus promising accelerated growth of the industry in the coming years. Similarly, the
WWW.B WHE ALTHCARE WORLD.C OM BW HE ALTHCARE FEBRUARY 2024 49 At present, India produces around $7.6 billion worth of medical devices, out of which $3.4 billion is exported and the remaining $4.2 billion is used domestically The author is Forum Coordinator, Association of Indian Medical Device Industry (AiMeD) launch of the Promotion of Research and Innovation in Pharma MedTech Sector (PRIP) Scheme and the National Policy on Research and Development and Innovation in Pharma-MedTech Sector is a noble and ambitious intent to support PM Narendra Modi’s vision of an Atmanirbhar Bharat, which is to make our country a world leader in manufacturing based on value addition. I personally feel the new policy and PRIP scheme will lead to a coordinated approach by bringing various institutions and R&D projects onto a common dashboard so that industry knows what’s going on and where one can connect to seek competitive advantage. A wholesome policy approach aligned with industry expectations will propel the domestic medical device industry to new heights. Job Creation Buoyancy and optimism apart, we need to take note of the sobering fact that the current domestic supply and exports are still far below potential. Local firms fulfill just 34.6 per cent of the $12 billion Indian market needs, while imports cover the remaining 64.4 per cent, costing $7.6 billion in FY2023. The Indian medical devices industry can expand from $12 billion to $50 billion by 2030, reducing import reliance to 35 per cent and boosting exports to $18 billion. This shift could create 1.5 million jobs. Export and Import At present, our top exports include cannulas, blood collection tubes, IV administration sets, medical waste disposable plastic bags, gloves for surgical purposes, spectacle lenses, intraocular lenses, ophthalmic implants, X-ray tubes, ECG, EEG, MRI machines, pulse oximeters, hand sanitizers, and orthopedic or fracture appliances. Right now, we are among the top 5–10 manufacturers in the world for syringes, needles, IV cannulas, surgical blades, surgical gloves, contraceptives, IOL lenses, orthopedic trauma implants, stents, and ventilators. Some of the high-end and critical equipment now being made in India include heart valves, joint implants, linear accelerators, Cath labs, robotic-assisted surgical systems, C-arms, high-end X-ray machines, mammography, radiotherapy equipment, fundus imaging, ophthalmic excimer lasers, endoscopes and endoscopic camera systems, molecular diagnostic systems, clinical chemistry analyzers, chemiluminescent immunoassay analyzers, 3D-4K laparoscopy systems, and high-end operating microscopes. The industry’s growth potential could surpass that of the smartphone sector due to India’s expanding health sector, projected to reach $600 billion by 2030. Currently, India produces around $7.6 billion worth of medical devices, out of which $3.4 billion is exported and the remaining $4.2 billion is used domestically. The annual demand for medical devices in India is valued at $11.8 billion, with the rest being covered by imports, totaling $7.6 billion. However, achieving the full potential of the sector will require further support as the sector faces a 15 per cent cost disability due to the high cost of power, long and expensive multiple regulatory approvals, supply chain inefficiencies, etc. What Should Be The Action Points For Our Govt? Increase the basic customs duty from 0-7.5 per cent to 15 per cent for devices as done for consumer electronics encouraging quality production and exports; remove the input tax credit for IGST on items with zero import duty to prevent unfair advantages over domestic producers; reduce GST from 18 per cent to 12 per cent in the few cases; and halt the import of used or old medical devices, ensuring safety, environmental protection, and domestic industry growth. We also want the government to bring in a separate law and regulatory framework separate from drugs for medical devices to enable faster access to rapid innovation while ensuring patient safety through a risk management regulatory approach followed in progressive countries. We should encourage affordable access to medical devices by ethical. Monitor the MRP of medical devices being imported and cap excessively artificially inflated MRP (10–20 times the import landed price to a maximum of 5 times) that’s being used as an inducement for unethical marketing. Healthcare access in India needs to be affordable and of high quality. If supported with the right kind of strategic policy implementation steps, our medical device industry, driven by healthcare investments, is set for rapid growth in years to come. RAJIV NATH
50 BW HE ALTHCARE JAN-FEB 2024 WWW.B WHE ALTHCARE WORLD.C OM 8 PILLARS OF MINDFULNESS FOR THE MODERN WOMAN Breathe, focus, slay your inner dragons, and conquer your day with calm and clarity Ofice life, a whirlwind of demands and deadlines, can test even the strongest woman. But amidst the emails and conference calls, pockets of peace await. Here are 8 pillars of mindfulness, like ancient swords forged for modern battles, to help you reclaim your well-being and slay the stress dragon: Sunrise Salutation: Greet the day with gentle stretches, yoga, or even a walk. Wake your body, quiet your mind Gratitude Glow: Before diving into the digital sea, acknowledge three things you're grateful for Tech Timeout: Treat yourself to 15-20 minutes of tech-free silence. Meditate, read, simply breathe... reclaim your inner space RECLAIM YOUR MORNING BREATHE AND BE PRESENT MOVE YOUR BODY, UNLEASH YOUR SPIRIT Mindful Messaging: Schedule email/message times and avoid constant notiffcations. Don't let digital tendrils hijack your focus Digital Detox Breaks: Every hour, break free from the screen. Walk, stretch, close your eyes and breathe Single-Tasking Samurai: Resist the multitasking trap. Focus on one task at a time for laser-sharp eficiency and reduced mental fatigue TAME THE TECH TIGER Staircase Safari: Ditch the elevator and scale the stairs. This small movement boost gets your blood fflowing, breaks up desk boredom Desk-Top Zen: Keep a stress ball or calming aromatherapy roller on your desk and let the stress melt away Power of Pause: Before a stressful meeting or task, take 3 deep breaths. This simple act activates your relaxation response Mini Meditations: Throughout the day, take 5-minute meditation breaks with apps like Headspace