March 2008 606

Preparing for the HEALTHCARE BOOM : Sarita Falcao, Research Associate,eHEALTH

9 million jobs are expected to be created in the health care industry by 2012. Find out where, why and who stand to gain the most.

Looking to the rapidly increasing demand of specialists in Hospital and Health Management, the Institute of Health Management Research (IHMR), Bangalore, is preparing professionals to take up middle and senior level managerial positions in corporate hospitals like Fortis, Max, Apollo, Escorts and Wockhardt; International health care organizations like UNICEF, UNFPA, UNDP, Care, Futures Group, Population Services International; IT companies like TCS and Covansys that work on health care solutions and health insurance companies or TPAs like Bajaj Allianz, Raksha, Tata AIG and other health based organizations.

Their Post Graduate Professional Program in Hospital Management (PGPHM), scheduled to begin in February, is an 11 month full time course. The Institute will conduct two programs this year and students will have the option of specialising in:
a) Hospital Operations Management
b) Marketing Management
c) Finance & Accounts
d) Strategy Management

BIOINFORMATICS
Major institutes/universities in India, offering a specialised course are:

  • Institute of Bioinformatics and Applied Biotechnology (IBAB), Bangalore
  • Indian Institute of Technology Delhi (Biochemical Engineering and Biotechnology), and IIT Kharagpur.  You need to qualify IIT-JEE Entrance exam for admission into IITs
  • Jawaharlal Nehru University  (Advanced Graduate Diploma in Bioinformatics)
  • Madurai Kamaraj University, Madurai
  • The University of Pune, Maharashtra (Advanced Diploma in Bioinformatics)
  • Bioinformatics Institute of India, Sector 62 Noida ( U.P ). Correspondence course on one year Industry Program in Bioinformatics, Biomedical Informatics, Clinical Trial and Clinical Research, Pharma Regulatory Affairs, Biotechnology. Institute is also offering various online Program through www.biionline.org
  • Mar Athanasios College for Advanced Studies (MACFAST),  Thiruvalla, Kerala

CHEMIFORMATICS

The combination of chemical synthesis, biological screening and data-mining approaches used to guide drug discovery and development, will be the most sought after science in coming future. The integration of cheminformatics with related disciplines such as genomics, proteomics and the application of these sciences are the most sought-after careers worldwide.

Institute of Cheminformatics Studies offers a one year  Post Graduate Diploma course in Cheminformatics.
C-56A/28, Sector – 62Noida – 201301, UP(INDIA), Tel : 0120 – 4320801/02
Mob: 09312355740
E-mail: reply@cheminformaticscentre.org  Mobile: 09312355740
Website: www.cheminformaticscentre.org

Though the course is open to students from all streams of medicine, preference is given to graduates of MBBS, Dental Surgery, Physiotherapy, Occupational Therapy, BAMS (Ayurvedic), Yoga & Naturopathy and Homeopathy.

As part of the training, students work with hospitals and health care organizations  in the country or abroad for a period of four weeks to understand the structure of the organisations, their activities and workflow. Proof of the popularity and necessity of such a course is borne out by the 100 percent placement rate of past batches.

The IHMR branch in Jaipur, Rajasthan offers a two-year post graduate program in Hospital and Health Management. It recently began offering a specialisation in IT in health c are, along with other options of Health, Hospital and Pharmaceutical Management. The programme’s highly selective admission process ensures representation of diverse educational and work backgrounds.

The course, which is also open to graduates from any stream (subject to a management aptitude test), is aimed at developing trained professional managers with requisite skills in planning and operating management techniques; diagnosing and solving management problems; and acquiring consultancy skills. This is with a view to prepare them to manage hospitals and pharmaceutical and health care institutions in developing countries both in the public and the private sectors, to meet the rising demand for quality care.

Currently there are 837 medical, dental, nursing and pharmacology colleges with an annual intake capacity of less than 40,000 annually. Medical education infrastructure in India has grown rapidly over the past 15 years. However, some states like Jharkhand, Madhya Pradesh and Tamil Nadu still have a high doctor to population ratio of over 1:20,000. This reflects not just the lack of manpower, but also the uneven and highly skewed distribution of medical personnel in favour of economically developed and urban areas.

In the medium to long term, this translates into a range of auxiliary industries and in turn, millions of new job opportunities. Educational institutions are fast realising the need to cater to these sectoral needs � both numerical and qualitative. Apart from doctors and nurses, paramedical staff, entrepreneurs, health insurance employees, hospital managers, business managers and other such non-clinical personnel are required.

The health care informatics sector alone employs over 8000 professionals. Application maintenance, system integration, application development, product reengineering/maintenance and Health Insurance Portability and Accountability Act (HIPAA) consulting are the main services outsourced. In 2007 India produced the most number of 120 HL7 (Health Level 7) certified professionals worldwide. HL7 is the main standard for data exchange in the health provider market. E-health is a fast emerging field which is shaping medical informatics, public health and business. It refers to health services and information delivered or  enhanced through the Internet and related technologies.

CLINICAL RESEARCH

The clinical research industry continues to expand, creating new and lucrative vistas of employment. The average nominal annual salary growth across all the positions is 4% as against less than 1% for other segments. India’s pharmaceutical market, the second largest in Asia, is growing by over 9% per annum. Mc Kinsey estimates that the outsourced pharmaceutical clinical trial industry will touch INR 5,000 by 2010, requiring 50,000 professionals. As the amount of clinical research expands, a large number of researchers, trainers and business development managers will be required. Industry analysts expect total clinical research spending in India to increase by more than 30% annually through 2010. Over 250,000 positions remain vacant worldwide and salaries start at Rs. 2.4 lacs p.a. and go to over Rs. 15 lacs p.a. for professional with less than 5 years experience.

In 2007, the Indian Clinical Research Institute (ICRI) started an M.Sc. in clinical research in collaboration with Cranfield University, UK, at Delhi, Mumbai, Ahmedabad and Bangalore. It covers general pharmacology, clinical data management, business management, health economics, marketing and industry training. The course is designed to provide strong functional skills and the ability to integrate and apply them in different management settings. This is in addition to the Post Graduate Diploma in Advanced Clinical Research which it already offers.

However, India is yet to establish that it has a critical mass of specialist health care professionals to become a major hub of outsourced health medical service.

The Indian health care industry is undergoing rapid expansion, driven by a host of factors and stimulants. Consistently high GDP growth rates are reflected in the growing demand for a variety of high-quality health services. The Indian Clinical Research Association (ICRA) estimates the current industry potential to be INR 1,408 billion (US$ 30 billion). This includes retail pharmaceutical, health care services, medical and diagnostic equipment and supplies. Private players are providing over 80% of services and this figure is expected to further increase in the near future. This segment includes private practitioners, for-profit hospitals/nursing homes and charitable hospitals. Says Shivinder Mohan Singh, CEO & MD, Fortis Healthcare, “I am looking forward to the government granting “Infrastructure Status” to the healthcare sector. I expect the government to support robust public health programmes. I also hope the government provides a policy framework to facilitate consolidation.” The government also needs to budget for medical insurance premiums to help those who can’t afford quality medical care.

Several major international health care companies are setting up shop in the country and government and private industry reports indicate that the pharmaceutical sector is growing at over 7% annually. The cardio-vascular (15%) and anti-diabetic (10-12%) industries show an even higher growth rate. As a result, numerous large Indian companies have entered health care delivery. Max India, Ranbaxy, Escorts, Wockhardt and Birla are some of the big players who have entered the arena of speciality hospitals. SRL-Ranbaxy, Nicholas Piramal and Dr. Lal’s have expanded their laboratory services significantly in recent years.

With its large pool of technical talent and fast paced infrastructure development, India stands to gain tremendously from this labour-intensive industry.

This year, payer spending is estimated to increase to            US$  7.5 billion and provider spending is likely to touch US$ 26.7 billion. Approximately 60% of international health care organisations outsource more than half their IT operations. Projects worth billions of dollars are also in the pipeline. Accenture, EDS, CGEY, FCG, Keane and IBM are some of the biggest players in this market.

A gradually aging population has its specific demands. Cardiac, diabetes and central nervous system � related specialties are urgently required to serve relevant population segments. High-stress levels are putting pressure on existing facilities which are facing a serious shortage of manpower and grossly inadequate infrastructure.
Another factor which needs to be taken into account is the polarisation of currently available services. Rural India remains under served, throwing up significant possibilities for advances in telemedicine, e-health and low-cost infrastructure.

Institutes offering Hospital Administration to

Medical Students

  • Administrative Staff College of India, Bella Vista, Khairatabad, Raj Bhavan Road, Hyderabad-500 082. (In association with the Hinduja Foundation)
  • All India Institute of Local Self Government, Sthanikraj Bhavan, CD Barfiwala Marg, Andheri West, Mumbai-58
  • All India Institute of Medical Sciences (AIIMS) Ansari Nagar, New Delhi-110 029
  • Apollo Institute of Hospital Administration, Apollo Hospital Campus, JubileeHills, Hyderabad-500 033
  • Armed Forces Medical College, Sholapur Road, Pune
  • ASCI-Hinduja Institute of Healthcare Management, ASCI College Park, Banjara Hills, Road #3, Hyderabad-500 034
  • Birla Institute of Science and Technology, Pilani-333 031, Rajasthan
  • Birla Institute of Technology, Mestra, Ranchi-835 125, Bihar
    Christian Medical College, Vellore-632 002, TN
  • Department of Management Studies, Madurai Kamaraj University, Palkalai Nagar, Madurai-625 021
  • Faculty of Management Studies, University of Delhi, Delhi-110 007
  • Indian Institute of Health Management Research (IHMR), Opp. Sanganer Airport,
    Jaipur-302 011
  • IHMR, Bangalore
  • Institute of Management Studies, Devi Ahalya Viswa vidyalaya, Indore-452 001, Madhya Pradesh
  • Manipal Academy of Higher Education, University Building, Madhav Nagar, Manipal- 576 119, Karnataka
  • National Institute of Health and Family Welfare, New Mehrauli Road, Munirka, New Delhi-110 067
  • School of Medical Education, Gandhi Nagar, Kottayam-686 008, Kerala
  • Tata Institute of Social Sciences, Deonar, Mumbai-88

Non-Medical Students

  • Tata Institute of Social Science, Sion- Trombay Road, Deonar, Mumbai- 400088
  • Apollo Institute of Hospital Administration,
  • Apollo Hospital Campus, Jubilee Hills, Hyderabad-500033
  • Indian Institute of Health Management Research (IIHMR), 1, Prabhu Dayal Marg, Sanganer Airport, Jaipur-302011
  • Sri Ramachandra Medical College & Research Institute (Deemed University), Porur, Chennai-600116. Admission is
    usually on the basis of a competitive entrance examination.
  • Indian Institute of Social Welfare and Business Management
    Management House, College Square West, Kolkata-700 073
    Phone :+91-33-22413648 /3756 /5792
    /8694, Fax : +91-33-2241 3975
  • Symbiosis Centre of Health Care
    Senapati Bapat Road
    Pune – 411004

Professionals in the health care industry today, need to also tap the possibilities offered by advancements in ICT to ensure that their skills have the maximum reach. The extreme shortage of specialists can be mitigated to some extent through ‘virtual’ consultation and online sharing of patient information. The Indian job market requires professionals with a blend of technological, medical and managerial skills in order to keep pace with the  major advances in data communication systems and networks.

The first initiative in this field was taken by the National Informatics Centre (NIC). The NIC state centres use teleconsultation on a regular basis to upgrade the knowledge of medical professionals in the North East, Uttrakhand, Lakshadweep, Maharashtra, Jammu and Kashmir and Orissa.

Ehealth Care Foundation’s (eHCF) School of Medical Informatics has a long-distance certificate course in Medical Informatics aimed at improving the ICT knowledge of general practitioners, surgeons  and paramedics. Now with its fourth batch, the course contents include case studies on deployment of Windows Vista in Hospitals,  exposure to Hospital Management Software and electronic health recording.

Apollo Telemedicine Networking Foundation (ATNF) has developed the first formal short course in Asia on Telehealth Technology. It is designed ‘to anticipate the demand for people with skills to deliver and manage  new health care delivery systems’.

According to estimates, health and wellness is a INR 40,000 crore category, growing at nearly 15% annually. While analysts put the current countrywide demand – supply gap for doctors between 200,000 and 300,000, Ernst & Young estimates that the country will need at least 1.2 million doctors to treat one in thousand population by 2012 (as against 600,000 in 2005). Exim Bank estimates that revenue generation from health care tourism in 2006 was over US$ 600 million.

The concept of ‘health cities’ has already caught on. Moreover, India is a young country with about a fifth of the population under 24 years of age. Policy makers have an important role to play and face major challenges to ensure an appropriate supply and distribution of trained health workers and to manage their performance in delivery of services.

Human resources are the crucial core of a health system, but they have been a neglected component of health-system development. The demands on health systems have escalated in low income countries, in the form of the Millennium Development Goals and new targets for more access to HIV/AIDS treatment. Apart from the short supply of human resources to cater to our growing health care needs, there is a parallel need to maintain a high quality of education and education systems and the productivity of the health workforce. Expansion of continuing medical education (CME) facilities is also urgently required.

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