Setting New Trends in R & D : Dr Prem Nair, AIMS

Started in 1998, Amrita Institute of Medical Science, Kochi, has a massive healthcare infrastructure with over 26,00,000 sq. ft of built-up area spread over 94 acres. The hospital has 25 modern operating theatres, 210 equipped intensive-care beds, a fully computerised and networked Hospital Information System (HIS), a fully digital radiology department, a 24/7 telemedicine service and a NABL accredited clinical laboratory.

In an interview with eHealth, AIMS’s Medical Director, Dr Prem Nair, talks about his hospital’s significant achievements, recent Health IT initiatives and future plans. Excerpts:


What has been your most recent professional milestone?

The liver transplant programme which started two years ago is the most important achievement for us professionally, medically and administratively. Unlike other transplants, liver transplant requires co-ordinated efforts from a large team of  physicians, social workers, support personnel, laboratory personnel, and other professionals from various medical disciplines. It also requires a large infrastructural and critical care support. With legions of patients coming in for a transplant at AIMS, we consider it as our very proud achievement.

Could you detail upon AIMS’s remarkable achievements in the past one year?

Over the years we have expanded our inpatient and outpatient services. We have gone up from 5,50,000 to 6,50,000 lakhs outpatients. Our inpatient activity has also increased from 40,000 to 42,000 last year. Overall, we have registered a growth of 12 per cent annually. In the last 2 years, AIMS has been receiving a large number of international patients from all over the world. Their numbers have increased so much that we have had to develop a special facility to accommodate these patients and their relatives. We consider it an important achievement because of the trust these patients bestow on us. We have also expanded our medical services through the outreach programme to the Andaman and Nicobar Islands and the Lakshadweep Islands.  We are also looking at starting the outreach programmes within Kerala. Additionally, we have also set up many primary health centres in rural Kerala.

On the technology front, we always have had the latest biomedical equipments. We have also maintained a very high quality of imaging. And, we have developed centers of excellence which are multi-disciplinary in nature. For instance, we have set up the Department of Head and Neck where a multi-disciplinary team of specialists in the fields of head and neck surgery, plastic surgery, maxillofacial surgery, neurosurgery and otorhinolaryngology look at the management of complex ailments which require multi-disciplinary approach. Also, we have a NABL recognised fully-automated laboratory with a very high level of quality control. The laboratory is operational 24×7 and conducts all kinds of routine biochemical, hematologic, pathologic and micro-biologic investigations. In addition, we also have an advanced diagnostic laboratory that does all the molecular diagnostics.

One of the areas of concern that we are addressing very vigorously is in the field of research where we are looking at the lowest cost of a particular service, so that we are able to provide fairly remarkable amount of healthcare services including surgeries at a very low cost.

Could you brief us about the new initiatives being undertaken by the hospital in the areas of  academics and research?

We have added numerous Post Graduate programmes in medicine, pharmacy, nursing, dentistry; Masters programme in basic sciences; and Doctoral programme in basic sciences as well as in clinical areas.

AIMS has received accreditation from the most reputed certification bodies, such as, National Accreditation Board for Hospitals and Healthcare Providers (NABH) and National Assessment and Accreditation Council (NAAC) for the educational programmes. We have also received an A grade from the UGC, which is the highest in its field. We have been certified by NABL and ISO also. Over the past several years, we have initiated some innovative educational programmes like Physician Assistant where we provide an M.Sc. degree in Allied Health Sciences. Other disciplines are Perfusion Technology, Diabetes Sciences, Diabetes Education, Medical Laboratory Technology, Neuro-Electro- Physiology, Respiratory Therapy, Cardio Vascular Technology.

The recent most important development at AIMS is starting a major research initiative. AIMS has been awarded research protocols from funding agencies such as the Department of Biotechnology (GOI), the Department of Science and Technology (GOI), the Indian Council of Medical Research, National Institute of Health, USA, and the State Department of Science, Technology and Environment and numerous industry grants to start a very major research initiative. So, the major push is on research. It’s a very uncommon feature of a hospital in India. I say this because there are very few  hospitals in India that have initiated major research and educational programmes.

How has the hospital’s IT preparedness improved patient care, streamlined the hospital operations and increased the productivity of its facilities?

We are probably the only hospital in India to start an integrated Hospital Information System (HIS) from the very first day of operation. We have both administrative and clinical information systems as well as PACS from the very beginning. Subsequently, our indigenously developed HIS system has evolved substantially over a period of time. Our HIS system provides a network system linking every area of hospital function from finance to purchasing, admission to discharge and from radiology imaging to histopathological imaging. We also maintain electronic medical records. Therefore, ours is a paperless system. The HIS has a strong influence on the hospital’s functions since it’s implementation. To give you an example, all internal and external communication in AIMS is done  through emails, which saves paper. A major advantage of implementing HIS has been the improvement in patient care. For instance, patient care data is available instantly at the point of care because the system allows centralised access to all organisational and patient data through a single web interface to any authorised user. We have also been adding substantially large number of reporting modules. They are of use to the administration as we get  real time information on administrative measurables department-wise, institute-wise, patient number and procedure number. It enables us  to do real time costing department-wise and doctor-wise, and look at some of the wastages that can be prevented or reduced. We also conduct audits based on follow-up materials that can be very quickly picked up from the HIS.

One of the areas of concern that we are addressing very vigorously is in the field of research where we are looking at the lowest cost of a particular service, so that we are able to provide fairly remarkable amount of healthcare services including surgeries at a very low cost.

What are the recent innovative developments at Amrita Technologies?

Amrita Technologies is developing an eHealth grid which would link multiple institutions at the tertiary level in the form of a horizontal link, and vertical link down from the tertiary to the primary health centres to sub centres. We are looking at some models and pilot projects where we can provide a grid concept to make available patient-care information across regions and populations. We are very excited about this project as it’s going to have a major impact on health care.

Are there, at present, any programmes or schemes to provide affordable health care facilities to the common man?

The hospital has 500 beds reserved for the poor in the general ward where they get free medical treatment. We are working with the government on a public-private partnership mode to provide cost-effective health care to people with a very basic health insurance programme. AIMS runs charitable programmes funded by funds that the ashram receives. The hospital’s founder Sri Mata Amritananadamayi runs a large number of  humanitarian activities  funded by donations from millions of devotees. A large chunk of the donations received, goes not just into healthcare, but also in other projects, such as, building houses for the poor, providing pensions for widows or elderly women, schools for the poor, old age homes etc.

One of the areas of concern that we are addressing very vigorously is in the field of research where we are looking at the lowest cost of a particular service, so that we are able to provide fairly remarkable amount of healthcare services including surgeries at a very low cost in a controlled environment. Also, we are the only institution who is at the forefront of Palliative care. We are looking at setting up a society where members of the community make a very minimal contribution and support each other in the geriatric age group or chronically-ill age group. The community members are trained to go to the homes, check on basic medical parameters,  collect blood samples and send it to the health centres. This can dramatically reduce the cost of healthcare and improve the quality of life of the patient and their family.   



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