Day care surgery or AmbulatoryÂ Surgery is a concept that isÂ heralding change in waysÂ of thinking and performingÂ surgeries in the field ofÂ medicine. Established in MayÂ 2009, Nova Medical CentersÂ has been a pioneer in the fieldÂ of day care surgeries and hasÂ been responsible for increasingÂ awareness about the option ofÂ single day surgeries, SangitaÂ Ghosh De of eHealth explores.
With the growingÂ concept of dayÂ care surgeries andÂ its fast increasingÂ adoption rate by the medical centres,Â Nova Medical Centers, the specialised dayÂ care surgery centre, has recently openedÂ its second centre at Sadashivnagar,Â Bangalore. The inauguration of the newÂ centre is part of Novaâs plan of establishingÂ their presence across the country. NovaÂ Medical Centres plans to develop 25 suchÂ centres across India by 2012.
Commenting on the scenario, GirishÂ Rao, MD&CEO, Nova Medical CenterÂ said, âThe openning of the second centreÂ at Sadashivnagar is a reflection of ourÂ commitment to making world-classÂ surgical care more accessible. Even as theÂ urban populace grows busier, day careÂ surgery centres will enable them to availÂ surgical care without having to spend too
Day care surgery or AmbulatoryÂ Surgery is a concept that is heraldingÂ change in ways of thinking andÂ performing surgeries in the field ofÂ medicine. At a day and age where life isÂ governed by time, the option of availingÂ quality surgical care in the span of a dayÂ is a blessing for individuals and theirÂ families.Â Daycare surgeries represent the Â fact that a patient does not stay overnightÂ at a healthcare centre and gets dischargedÂ in within a day. As a patient is treated inÂ an outpatient setting, it is also known asÂ Outpatient Surgery.
Researches say that around 70% of theÂ total surgeries performed globally are dayÂ care surgeries and this trend is also onÂ the rise in India recently. In India, almost60% of all surgeries can be done in a dayÂ care mode as the current infrastructureÂ supports. In day care surgeries, in just oneÂ year, Nova has completed 650 surgeries Â in Bangalore.
Day care surgery has been intoÂ practice for quite some time in developedÂ countries like the US. In fact itâs becomeÂ increasingly popular all over the worldÂ for many reasons. Firstly, with theÂ advances in technology, doctors haveÂ been able to perform minimally invasiveÂ surgical (MIS) procedures, secondly, theÂ newer drugs used for anaesthesia allowÂ patients to recover consciousness veryÂ quickly, so that they can go home soonÂ after the surgery is over, and lastly, sinceÂ modern painkillers are more powerful,Â patients experience much less pain afterÂ the operation and they can successfullyÂ relieve the pain themselves by takingÂ these medications at home.
Studies worldwide have shown thatÂ day care surgery delivers the same highÂ quality care as that given to hospitalÂ patients are much economical. On anÂ average, research conducted in the USAÂ has shown that procedures at day careÂ surgery centres cost 50% less than thoseÂ at hospitals, confirms Nova.
In the modern day hospitals, aÂ post-operative patient is discharged asÂ soon as the critical period or immediateÂ post- perative nursing needs have beenÂ met with. This is evidenced by the establishmentÂ of plenty of day care surgicalÂ centres in the West.
Day care surgery has been definedÂ by the Royal College of Surgeons asÂ when the patient is admitted forÂ investigation or operation on a plannedÂ non-resident basis and who nonethelessÂ requires facilities for recovery. ThisÂ definition excludes upper and lowerÂ GI endoscopies, outpatient proceduresÂ such as flexible cystoscopy, andÂ minor superficial surgery under localÂ anaesthetic.
The cases are usually carried out underÂ local, regional or General AnaesthesiaÂ (GA) or monitored anaesthesia. FacilitiesÂ and standards of care in the day careÂ surgical unit must be comparable to thoseÂ provided for in-patient. The patient is toÂ be formally admitted to day care unit, fullÂ work up and documentation is to be doneÂ and there should be facilities to observe the patient for 12 hours and with theÂ possibility of admission.
MD & CEO,Â Nova Medical Centers
âTechnology and equipmentsÂ play crucial role in dayÂ care surgeriesâ
Nova Medical Centers is a multi speciality surgicalÂ centre, where the cost of the surgery depends uponÂ type of the procedure and duration, which usuallyÂ ranges between INR 5000 â INR 1,25,000.
What is the total marketÂ size of day care surgeriesÂ in India? What is NovaâsÂ business model?Â
The day care surgery market in IndiaÂ is pegged at INR 1819 crore of the overallÂ surgery market at INR 4600 crore. NovaâsÂ unique business model is based on aÂ partnership between the company andÂ a team of 40 established surgeons fromÂ multiple specialties. In each centre, whichÂ costs approximately INR 8-10 crores, aÂ surgeon with atleast 10 years of experienceÂ is invited to be a partner and has to makeÂ a minimum investment of INR 5 lakhÂ and maximum upto INR 10 lakh. Also atÂ Nova, a surgeon doesnât have to share hisÂ professional fees, in fact, as an addition asÂ a partner he has a share in profits of hisÂ respective centre.
What are the types of dayÂ care surgeries that NovaÂ offers?
At Nova we can perform over 700Â surgeries covering specialties like GeneralÂ Surgery, Gynaecology, Orthopedics,Â ENT, Opthalmology, Plastic & CosmeticÂ Surgery, Pediatric Surgery, Urology,Â Gastrointestinal procedures and Dental.
Nova Medical Centers at Koramangala,Â Bangalore has so far conducted close toÂ 650 surgeries in various specialities inÂ just one year of operations.
Nova is a multi speciality surgicalÂ center, the price range depends uponÂ type of surgery done, which usuallyÂ ranges between INR 5000 â INR 1,25,000,Â where a patient can save up to 30% toÂ 40% of the ammount he would spend inÂ a corporate hospital, because the modelÂ is efficient and capital expenses incurredÂ during a hospital stay are eliminated at a
day care center.
What is the role ofÂ technology and equipmentÂ in day care surgery inÂ terms of quality andÂ delivery?
Technology and specially designedÂ equipments plays a very crucial role inÂ day care environment, as advanced technologiesÂ and instruments for surgery areÂ bare essentials for any day care surgeryÂ success. And because of these advanceÂ technologies and instruments doctorsÂ can now perform various complicatedÂ and complex surgeries in lesser timeÂ with better efficiency and accuracy. AlsoÂ the latest technology helps in quickerÂ recovery.
What are the opportunitiesÂ and challenges in day careÂ surgeries in india?
In India there is immense opportunityÂ for day care surgery as there is a hugeÂ requirement for cost effective healthcareÂ in the country. With the GDP growing at Â the current rate, healthcare expenditureÂ will simultaneously expand in the nextÂ 5 Â years. Day care surgeries will hugelyÂ bridge the gap between the demand andÂ supply gap by providing cost effective andÂ superior care.Â The challenegs as in getting skilled Â surgical staff is quite a big problem.Â Fortunately, India has a large pool ofÂ surgeons who have a vast expertise and Â knowledge. As we expand and move fromÂ the big cities we need to explore the bestÂ to the available capacity.
What is the plan ofÂ expansion in India, and inÂ abroad, if any?
Right now the expansion plans ofÂ Nova are purely focussed within theÂ geographical boundaries of the country.Â We plan to open up 25 such centres across Â the country by 2012. In the coming monthsÂ we are planning to open two centres inÂ Mumbai and two in Delhi. Among the other cities identified for expansion intoÂ the top 10 cities in India include Chennai,Â Coimbatore, Hyderabad, Kolkata, Pune,Â Amritsar and Jaipur.
Pointing to the advantages
> Pre-booked date
> Shorter waiting lists
> Earlier mobilisation
> Minimal disruption of patientâsÂ personal life
> Earlier return to normal environment
> Reduced risk of cross-infection
> Less psychological disturbances inÂ children
> Lesser chances of cancellation of
The new beginning
Established in May 2009, NovaÂ Medical Centers has been a pioneer inÂ the field of day care surgeries and hasÂ been responsible for increasing awarenessÂ about the option of single day surgeries.Â The medical centres are equipped with theÂ best in terms of technology and equipmentÂ and the management and advisory boardÂ include experienced professionals whoÂ are amongst the pioneers in the field ofÂ day care surgery.
Nova develops, acquires, owns, andÂ operates ambulatory surgical centres inÂ partnership with physicians across India.Â Nova provides leading physicians fromÂ diverse specialties with comprehensiveÂ ultra-modern facilities comprisingÂ doctorâs offices, operating rooms,Â diagnostics, imaging, health check up area,Â pathology laboratory, and a pharmacy.Â By specialising only in day care procedures,Â Nova improves the patient experience,Â increases operating efficiency, and offersÂ unparalleled quality and affordability.
The business modelÂ
Nova is funded by the GTI Group,Â a New York based private investmentÂ company, and New Enterprise Associates,Â a leading global venture capital firm.
Novaâs business model is based on aÂ partnership between the company andÂ 40 established surgeons from multipleÂ specialties in each centre. Each centre hasÂ 4-5 operating rooms and is equipped withÂ state of the art equipment to undertakeÂ surgical procedures. The pre and postÂ operating beds/rooms are all equippedÂ with gas lines, monitoring equipment,Â defibrillator and are supervised by dutyÂ doctors and trained staff. AlthoughÂ the focus is on day care surgeries, eachÂ centre has provisions for overnight stayÂ including doctors and nurses as well. InÂ addition to surgical facilities, the centreÂ has outpatient consulting rooms andÂ diagnostics also.
Patient care and safety is core to NovaâsÂ ethos. Novaâs doctors and facilities utiliseÂ the latest technologies including surgicalÂ techniques, advances in anaesthesia andÂ equipment. According to Nova, it canÂ perform over 700 surgeries in General Â Surgery, Gynaecology, Orthopedics,ENT, Opthalmology, Plastic & CosmeticÂ Surgery, Pediatric Surgery, Urology,
Gastrointestinal procedures and DentalÂ through day care surgeries