July 2010

Nova Medical Centers :: Establishing concept of day care surgeries

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Day care surgery or Ambulatory Surgery is a concept that is heralding change in ways of thinking and performing surgeries in the field of medicine. Established in May 2009, Nova Medical Centers has been a pioneer in the field of day care surgeries and has been responsible for increasing awareness about the option of single day surgeries, Sangita Ghosh De of eHealth explores.

With the growing concept of day care surgeries and its fast increasing adoption rate by the medical centres, Nova Medical Centers, the specialised day care surgery centre, has recently opened its second centre at Sadashivnagar, Bangalore. The inauguration of the new centre is part of Nova’s plan of establishing their presence across the country. Nova Medical Centres plans to develop 25 such centres across India by 2012.

Commenting on the scenario, Girish Rao, MD&CEO, Nova Medical Center said, “The openning of the second centre at Sadashivnagar is a reflection of our commitment to making world-class surgical care more accessible. Even as the urban populace grows busier, day care surgery centres will enable them to avail surgical care without having to spend too
much time.”

Day care surgery or Ambulatory Surgery is a concept that is heralding change in ways of thinking and performing surgeries in the field of medicine. At a day and age where life is governed by time, the option of availing quality surgical care in the span of a day is a blessing for individuals and their families. Daycare surgeries represent the  fact that a patient does not stay overnight at a healthcare centre and gets discharged in within a day. As a patient is treated in an outpatient setting, it is also known as Outpatient Surgery.

Researches say that around 70% of the total surgeries performed globally are day care surgeries and this trend is also on the rise in India recently. In India, almost60% of all surgeries can be done in a day care mode as the current infrastructure supports. In day care surgeries, in just one year, Nova has completed 650 surgeries  in Bangalore.

The genesis

Day care surgery has been into practice for quite some time in developed countries like the US. In fact it’s become increasingly popular all over the world for many reasons. Firstly, with the advances in technology, doctors have been able to perform minimally invasive surgical (MIS) procedures, secondly, the newer drugs used for anaesthesia allow patients to recover consciousness very quickly, so that they can go home soon after the surgery is over, and lastly, since modern painkillers are more powerful, patients experience much less pain after the operation and they can successfully relieve the pain themselves by taking these medications at home.

Studies worldwide have shown that day care surgery delivers the same high quality care as that given to hospital patients are much economical. On an average, research conducted in the USA has shown that procedures at day care surgery centres cost 50% less than those at hospitals, confirms Nova.

In the modern day hospitals, a post-operative patient is discharged as soon as the critical period or immediate post- perative nursing needs have been met with. This is evidenced by the establishment of plenty of day care surgical centres in the West.

Day care surgery has been defined by the Royal College of Surgeons as when the patient is admitted for investigation or operation on a planned non-resident basis and who nonetheless requires facilities for recovery. This definition excludes upper and lower GI endoscopies, outpatient procedures such as flexible cystoscopy, and minor superficial surgery under local anaesthetic.

The cases are usually carried out under local, regional or General Anaesthesia (GA) or monitored anaesthesia. Facilities and standards of care in the day care surgical unit must be comparable to those provided for in-patient. The patient is to be formally admitted to day care unit, full work up and documentation is to be done and there should be facilities to observe the patient for 12 hours and with the possibility of admission.

Girish Rao
MD & CEO, Nova Medical Centers

“Technology and equipments play crucial role in day care surgeries”

Nova Medical Centers is a multi speciality surgical centre, where the cost of the surgery depends upon type of the procedure and duration, which usually ranges between INR 5000 – INR 1,25,000.

What is the total market size of day care surgeries in India? What is Nova’s business model? 

The day care surgery market in India is pegged at INR 1819 crore of the overall surgery market at INR 4600 crore. Nova’s unique business model is based on a partnership between the company and a team of 40 established surgeons from multiple specialties. In each centre, which costs approximately INR 8-10 crores, a surgeon with atleast 10 years of experience is invited to be a partner and has to make a minimum investment of INR 5 lakh and maximum upto INR 10 lakh. Also at Nova, a surgeon doesn’t have to share his professional fees, in fact, as an addition as a partner he has a share in profits of his respective centre.

What are the types of day care surgeries that Nova offers?

At Nova we can perform over 700 surgeries covering specialties like General Surgery, Gynaecology, Orthopedics, ENT, Opthalmology, Plastic & Cosmetic Surgery, Pediatric Surgery, Urology, Gastrointestinal procedures and Dental.

Nova Medical Centers at Koramangala, Bangalore has so far conducted close to 650 surgeries in various specialities in just one year of operations.

Nova is a multi speciality surgical center, the price range depends upon type of surgery done, which usually ranges between INR 5000 – INR 1,25,000, where a patient can save up to 30% to 40% of the ammount he would spend in a corporate hospital, because the model is efficient and capital expenses incurred during a hospital stay are eliminated at a
day care center.

What is the role of technology and equipment in day care surgery in terms of quality and delivery?

Technology and specially designed equipments plays a very crucial role in day care environment, as advanced technologies and instruments for surgery are bare essentials for any day care surgery success. And because of these advance technologies and instruments doctors can now perform various complicated and complex surgeries in lesser time with better efficiency and accuracy. Also the latest technology helps in quicker recovery.

What are the opportunities and challenges in day care surgeries in india?

In India there is immense opportunity for day care surgery as there is a huge requirement for cost effective healthcare in the country. With the GDP growing at  the current rate, healthcare expenditure will simultaneously expand in the next 5  years. Day care surgeries will hugely bridge the gap between the demand and supply gap by providing cost effective and superior care. The challenegs as in getting skilled  surgical staff is quite a big problem. Fortunately, India has a large pool of surgeons who have a vast expertise and  knowledge. As we expand and move from the big cities we need to explore the best to the available capacity.

What is the plan of expansion in India, and in abroad, if any?

Right now the expansion plans of Nova are purely focussed within the geographical boundaries of the country. We plan to open up 25 such centres across  the country by 2012. In the coming months we are planning to open two centres in Mumbai and two in Delhi. Among the other cities identified for expansion into the top 10 cities in India include Chennai, Coimbatore, Hyderabad, Kolkata, Pune, Amritsar and Jaipur.

Pointing to the advantages
> Pre-booked date
> Shorter waiting lists
> Earlier mobilisation
> Minimal disruption of patient’s personal life
> Earlier return to normal environment
> Reduced risk of cross-infection
> Less psychological disturbances in children
> Lesser chances of cancellation of

The new beginning

Established in May 2009, Nova Medical Centers has been a pioneer in the field of day care surgeries and has been responsible for increasing awareness about the option of single day surgeries. The medical centres are equipped with the best in terms of technology and equipment and the management and advisory board include experienced professionals who are amongst the pioneers in the field of day care surgery.

Nova develops, acquires, owns, and operates ambulatory surgical centres in partnership with physicians across India. Nova provides leading physicians from diverse specialties with comprehensive ultra-modern facilities comprising doctor’s offices, operating rooms, diagnostics, imaging, health check up area, pathology laboratory, and a pharmacy. By specialising only in day care procedures, Nova improves the patient experience, increases operating efficiency, and offers unparalleled quality and affordability.

The business model 

Nova is funded by the GTI Group, a New York based private investment company, and New Enterprise Associates, a leading global venture capital firm.

Nova’s business model is based on a partnership between the company and 40 established surgeons from multiple specialties in each centre. Each centre has 4-5 operating rooms and is equipped with state of the art equipment to undertake surgical procedures. The pre and post operating beds/rooms are all equipped with gas lines, monitoring equipment, defibrillator and are supervised by duty doctors and trained staff. Although the focus is on day care surgeries, each centre has provisions for overnight stay including doctors and nurses as well. In addition to surgical facilities, the centre has outpatient consulting rooms and diagnostics also.

Patient care and safety is core to Nova’s ethos. Nova’s doctors and facilities utilise the latest technologies including surgical techniques, advances in anaesthesia and equipment. According to Nova, it can perform over 700 surgeries in General  Surgery, Gynaecology, Orthopedics,ENT, Opthalmology, Plastic & Cosmetic Surgery, Pediatric Surgery, Urology,
Gastrointestinal procedures and Dental through day care surgeries

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