Rotary International’s India National PolioPlus Committee (INPPC) commenced the ‘National Orientation and Planning Meet’ (NOPM) on Polio in the city, today. The event began with the inaugural ceremony  amidst senior officials from the India Polio campaign. The meet recognizing the role Rotary leaders (all volunteer members from different professional fields) play in their community will deliberate upon the way forward for the campaign particularly in sustaining the eradication goal in the wake of “zero’ polio status in the country.

At this annual meet on Polio, incoming Rotary leaders (2013-2014) were entrusted and motivated to lead the Polio eradication effort. The meet was graced by representatives from Government of India and from partner agencies like WHO, UNICEF along with the Rotary International’s senior leaders, National Committee Members, District Governors, District PolioPlus Chairmen and other special invitees.

The new Rotary leadership from 34 Rotary districts across the country committed themselves to advancing Rotary’s humanitarian goals foremost being global eradication of Polio. Observing India’s role in guising other endemic nations in the fight against Polio, Dr. Robert Scott, Chairman-International PolioPlus Committee of Rotary International said, “Considering the demographics, sheer size of India, the programme implementation and dedication from all and the achievement is commendable. If India can do it for Polio, so can the others. India is a shining example and the endemic nations are looking up to it for lessons and best practices”.

Ms. Anuradha Gupta, IAS, Additional Secretary and Mission Director (NRHM), Ministry of Health and Family Welfare, GOI was also present during the meet. She stressed upon the importance of routine immunization in preventing Polio and other childhood diseases.

We are only 9 months away from achieving the regional Polio-free certification. “India reported the last wild polio virus type 1 case in Howrah, West Bengal, on January 13, 2011. If the eradication effort is complacent now, polio could rebound quickly, potentially paralyzing thousands of children a year”, said Mr. Deepak Kapur, Chairman India National PolioPlus Committee, the volunteer body that is entrusted to spearhead the campaign for Rotary in India.

“Polio still exists in Pakistan, Nigeria and Afghanistan, where it has never been stopped”, said Dr. Sunil Bahl, Deputy Project Manager, NPSP – WHO, the technical experts that manages the surveillance and monitoring of wild Polio virus in India. “The danger prevails as India shares borders with these neighboring countries where Poliovirus has been rampant last year”, Bahl added.

To make Polio history, GPEI has recently presented a 6 year plan ‘2013-2018 Polio Eradication and Endgame Strategic Plan’. Public health experts have said that ‘if the polio eradication campaign succeeds, the world would not only declare it the second disease to be eradicated after smallpox’; it would also save billions of dollars and not to mention millions of children from a crippling future. A 2010 analysis found that if polio transmission were to be stopped by 2015 the net benefit from reduced treatment costs and productivity gains would be about $40 billion to $50 billion by 2035.

The meet called upon Rotarians from all across the country to excel their efforts in achieving Rotary’s humanitarian goals. Since India is inching closer towards regional Polio Free certification, Rotarians pledged to continue their efforts in keeping India Polio-free forever. This meet was a platform to strengthen the resolve, identify the challenges and strengths and also to motivate Rotarian (volunteer members) for the task ahead. Additionally, the NOPM served as a perfect platform to earmark new targets and milestones – particularly 100% coverage on National and sub-National Immunization Days (NIDs/SNIDs) and the strengthening of Routine Immunization amongst others.

An oral vaccine, Rotavac will be administered to infants in three dose course at the age of 6, 10 and 14 weeks. It will be given along with routine immunizations recommended at these ages. The vaccine efficacy compares favourably with the efficacy of the currently licensed vaccines. Presently, GlaxoSmithKline and Merck market effective rotavirus vaccine.

The commercial availability of the vaccine will be done only after getting a clearance from the Drugs Controller General of India (DCGI). “With its low price and strong efficacy, the vaccine has the potential to reduce the incidence of severe diarrhoea caused by rotavirus, “Dr M K Bhan Advisor to the Indian Academy of Pediatrics and former secretary of department of biotechnology said.

This partnership in social innovation shows how the biomedical science has progressed, he said adding: “The safety profile of the vaccine is outstanding. I am confident that the efficacy will improve with time.”

“ This is an important scientific breakthrough against rotavirus infections, the most severe and lethal cause of childhood diarrhoea,” DBT secretary Dr K VijayRaghvan said.

The clinical results he said indicated that the vaccine if licensed could save the lives of thousands of children every year.

“ This represents the successful development of a novel vaccine from the developing world which can be matched with global standards.” Dr Krishna M Ella, Chairman and Managing Director of Bharat Biotech said.

By Dr PM Murali, President, ABLE India

Biotechnology remains a great hope for the country with its potential to impact health, food and energy security and effect environmental remediation.Despite the challenges in the last three years with the global financial crises, the Indian biotech industry
grew steadily at close to 20 percent per annum in revenues. The next three years should be even more exciting.With the new leadership team at ABLE achieving tangible advocacy impact we will see the industry charting a strong course ahead.ABLE’s ten successful years in India has been a great journey to boost the biotech sector in the country which has grown many fold over the years and the domestic industry is now recognised globally in terms of its talent and research prowess. We are very happy to announce awards for outstanding contribution to the Indian biotech sector which will encourage all stakeholders to enable the industry to grow exponentially.According to the statement issued by the ABLE, few of key roadblocks that the industry is currently facing are the fuzzy regulatory environment that is delaying the developments in the area. Healthcare sector is the most regulated in the world and delaying development further would hamper the progress of bringing out vital healthcare products. Also, the Government should come up with an affordable health policy that clearly states how Intellectual Property (IP) rights of innovative companies are protected.This will cast away the doubts that foreign companies have in setting research and development facilities in India. Although opportunities are available, connection and communication is required for bridging the gap.Today the market size is USD five billion and expected to go over 80 billion by 2025 with a current growth rate of 18-21 percent.ABLE has played an essential role in assisting the Government to develop a road map for the next decade in association with the Department of Biotechnology (DBT), Government of India.This lays the foundation for the industry to grow to a USD 100 billion industry.Additionally, ABLE has also helped to devise the roadmap for biosimilars,which was done in association with Department of Pharmaceuticals (DoP),outlining the new bio-economy.The key highlights where ABLE has played a role in assisting the Government include –
• Development of a road map for the next decade done in association with the Department of Biotechnology,Government of India
• Road map for Biosimilars done in association with Department of Pharmaceutical, Government of India
• Biosimilars guidelines successfully launched by the Government last year to guide the growth of this industry.

ABLE provides roadmap for the biotech Industry, building the Biotechnology Entrepreneurship Students team (BEST) and North East Life Science Entrepreneurship (NEST) programs,the BioInvest Program and the International promotion of Brand India through organising the India Pavilion in various BIO Shows for encouraging students. The biotechnology companiesneed a balance between investment and regulation

Dr Ashok Kumar Mahapatra

When you were appointed as the Director of AIIMS, you said that your aim was to make AIIMS, Bhubaneswar a world class institution and take it to the level of AIIMS, Delhi. How successful have you been so far?
I spent 37 years in AIIMS, Delhi and also served as a director of Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow. The aim of coming from Delhi to Bhubaneswar is to create a center of excellence, a small nucleus in Odisha which is practically one of the middle order states in India; it is neither in the lowest strata nor in the highest strata like Gujarat, Kerala, Maharashtra, etc. Here, the people are simple, per capita income is low so affordable optimal healthcare services is highly required. And as you know that many States in India, including Odisha have not created any Government medical colleges in the last 50 years. I joined my MBBS in 1970 in Berhampur Medical College that is the last medical college Government of India created in 1962. I think, health has not prioritised as it should have been.Health being state subject, state Government is equally responsible as the federal Government for this apathy.

According to UNICEF, 40 percent of all the children under three years old are underweight and 61 percent of adolescent girls are anemic. Don’t you think these are bigger challenges related to nutrition, medical care and education in Odisha?
You are absolutely right, India has about 400 million children and amongst the children, probably 50 percent of malnourished children of the world will be in India.It’s not that children are malnourished only in Odisha, your figure might be absolutely right, but even in Gujarat which is an affluent state faces same problem. When the same question was asked to Chief Minister, he said people are dieting. We cannot cover up our crime by giving answers like that. We have to really know the reason why the children are malnourished. It’s an international concern, because if we want to have intellectual, highly educated and highly productive adults then you have to look after them since the pediatric age. If a child is malnourished, he cannot be educated well because his performance will be bad. So you are absolutely right, this is a big challenge for the healthcare people and the administrator to see that our children are fed very well with balanced diet.

Government at the center and state, both are running various welfare schemes to eradicate poverty but they seem to have little or no impact on the life of people at grass root level, why it is so?
All over India, the public distribution system (PDS) has nearly not worked out. It’s not necessary that rice sold in Rupee One or two will benefit the public unless it reaches the intended beneficiaries. Many of the Central Government and State Government policies all over India do not work out because the policies are made only in the parliament and the assemblies across the country, when it comes to grassroots level people don’t get the benefit as in some cases they don’t incorporate adequately the regional aspiration or diversity. For example, in 1952, we started our Family Planning Programme, we are the first country in the world to have family planning programme but that was not given the adequate dividend, We also had malaria control programme, tuberculosis control prpgramme, about 12 million people suffer from tuberculosis in India every year and half a million die.
There is nothing wrong in planning, we are absolutely a master planner, we plan very well and spend money but when at the ground level somewhere down the line the people who are involved with implementation, they default. So if you give one rupee rice or even distribute it for free, it may not reach the people. The sad story is that in our country about 20-30 percent food grains are eaten up by the rats or get rotten in the godown, yet it’s ironical that people don’t get food. So it is something, where our policy makers, administrators and parliamentarian need to think. As you know Food Safety Bill has not yet been passed by the Parliament. Even if it is passed by the Parliament, what is the guarantee that the poorest of poor in the small tribal areas will get the food? So there is lot more to think and do and I, as a human being, get demoralised, when I see people are dying of malnutrition, children are malnourished, especially because I look after the pediatric age group in Neurosurgery. I sometimes operate upon a two kilograms child and face the challenge of saving a small baby of two kilograms with brain tumour. So for me, a healthy baby is always a welcome step for the country.

You have come from Delhi to Bhubaneswar to serve in tier-II city but young doctors are reluctant to serve in rural areas. What is the best way of overcoming this challenge?
I think it is a real challenge all over India. To take the doctors to the village is not only difficult, it’s totally impossible. With the materialistic life we lead during the MBBS course and when you have to give up this life to go to a village where there is no electricity, no water, and there is no proper road, you will think that you are going from some heaven to hell. It is not only true for the Government doctors alone; same applies to the engineers, lecturers and IAS officers. When you see a doctor who completes his MBBS at the age of 23-24 he is at par with engineer, IAS officer and a lecturer. They all get promotion in their career but an MBBS doctor will join as an MBBS and retire as an MBBS. He will not get any promotion over the 30 years time. At times, public may blame doctors for various shortcomings but they do not understand in the circumstance our doctors serve.

You cannot have a bank or ATM at a place where there is no electricity but you do have a Primary Health Care (PHC), that’s why across the country about 30 percent of the doctor posts in PHCs are vacant. Our ambitious plan such as National Rural Health Mission (NRHM) will have lots of doctors in village but they have not created any infrastructure where the doctor can stay or their children  and get education. Suppose, I am a doctor and posted at a PHC for the next 10 years, where do my children go for studies? So posting is  bigger issue. If you have a teacher who is underpaid, a policeman who is underpaid, a doctor who is underpaid, an underpaid person will always be craving for more money to meet his daily needs. So he cannot deliver the goals in a depressed and agonistic state of mind. There are more needs and no money. If you are giving a doctor Rs. 12,000 rupees in NRHM, you have done the greatest injustice to humanity rather than to the doctor, because no doctor will work in such circumstances. So the best way forward are to create conducive environment and at least put in place minimum infrastructure.

Odisha has the second largest population of tribal in India; they are the one who is least served. How we can reach them with better healthcare services?
May be half of Odisha’s population is tribal, but we have got 8 or 10 states in India with tribal population. The tribal population across India has the lowest occupational status and also less education and high infant mortality rate. So it is a challenge not only in Odisha but all over India. And I am sure the doctors who are educated in city will never go to the tribal areas to see their shortcomings. So it is
a challenge socially, financially and from healthcare point of view. But if you have to really take the medicine to the grassroots level where the doctors are not willing to go, then we have to manage the healthcare services by paramedical people like pharmacists, technicians and nurses, because their ambition and a doctor’s ambition is totally different. In such a scenario, ehealth or telemedicine has good role to play. We can have a programme like tribal telemedicine, where we can trainsome people in telemedicine and post them in tribal areas with the video conferencing system. The patient comes to him, he interacts with the patient and communicates with us and accordingly deal with patient.A good telemedicine strategy through consultation can serve the community exponentially.

What is EECP all about?

Enhanced External Counter Pulsation is a non-invasive cardiovascular treatment for patients who have heart disease (single or multi vessel blocks), congestive heart failure and/or repeat of signs and symptoms after surgical treatment and also for those prone to heart ailments due to various other factors.

Who needs EECP?

People suffering from chest pain (on exertion, at rest, continuous, occasionally) , blocks, family history, high cholesterol, abnormal and sedentary lifestyle, smokers, unhealthy diet, excessive alcohol, obesity and such hypertension, diabetes and other conditions involving poor blood circulation are ideal candidates for EECP. Recent studies have shown a drastic dip in the prevalent age group suffering from cardiac disease. From an older age group, cardiac disease is now found to hit 40-55 year olds due to their sedentary lifestyle, stress and obesity.
Also, any patient suffering from coronary artery disease is a potential candidate for EECP. In addition EECP is especially beneficial for:
• Patients who have had persistent heart disease symptoms despite having undergone angioplasty or bypass surgery.
• Patients who cannot undergo surgery due to other medical conditions like diabetics, hypertensions or renal impairment.
• Patients who just don’t want to go under the knife.
• Patients who are heavily dependent on medications or have to cut down their activities in order to avoid angina.
What is the treatment procedure of EECP?
1. Time: One hour a day for 35 sessions or 2 hours a day with a 6 hours gap as advised by cardiologist.
2: Procedure: A typical EECP session would be like this – the patient is made to lie on a padded table and three large inflatable cuffs (like the blood pressure cuff) are strapped to his/her legs. The patient’s heart is monitored via the ECG display on the machine, which in turn regulates the inflation and deflation of the cuffs. EECP gives you two benefits. One is that it pumps blood to the coronary arteries and second is that the deflating action creates a vacuum in the arteries when the heart begins to beat.
3. Prerequisites: Treatment is so simple that there are no serious prerequisites. Patients need to have finished meals 2 hours prior and wear tight elastic fitting pants during treatment.

What are the advantages of EECP?

EECP is entirely non-invasive. No medications are given specifically for the treatment but the routine medications given to strengthen the heart and for diabetes, hypertension and cholesterol reduction need to be continued. The treatment is so simple that the patient feels a drastic improvement from symptoms thereby a sense of well being and an enhanced quality of life.

What are the effects of EECP?

Heart disease does not mean just blockages. It is a condition that affects your entire vascular system, from the brain to your toes. Merely opening up one or two isolated blockages is not the way to treat the condition. EECP in fact treats the entire vascular system, naturally bypassing any blockages.
Apart from this, EECP helps in creating new blood vessels and strengthens your heart, by releasing nitric oxide which relaxes your arteries. EECP also reduces inflammation in the blood vessels which leads to heart disease. Also, EECP is known to reduce stress and depression in patients suffering from heart disease due to improvement in symptoms and ability to go through normal work without pain, discomfort or anxiety.

Is EECP safe? Are there any side effects?

EECP is has a high standard of safety. The treatment is USA FDA approved and used by doctors in India and across the world to treat extremely ill cardiac patients where no medication and no procedure could provide relief. The only side effect of EECP is an increased feeling of well being, improvement in the quality of life and reduction in cardiac medication.

Dr. GN Shirbur

ENHANCED HEARTS,

BANGALORE

India’s largest generic drug manufacturer, has agreed to pay $500 million to the United States and individual States to resolve allegations by the law firm’s client, Dinesh S. Thakur, that Ranbaxy falsified drug data and systemically violated Current Good Manufacturing and Laboratory Practices resulting in substandard and unapproved drugs. The groundbreaking settlement is the largest of its kind against a generic drug manufacturer under the qui tam provisions of the False Claims Act (“FCA”).

Today’s settlement was due to the extraordinary efforts of whistleblower Dinesh Thakur. As a former Ranbaxy Director and Global Head, Research Information & Portfolio Management, Mr. Thakur learned of Ranbaxy’s wrongdoing and reported the findings to company management who failed to correct the problems. In 2005, Mr. Thakur left the company and reported the fraud to government authorities. For the next eight years, he worked to expose and document the complex and well-hidden fraud.

With the assistance of his counsel Andrew M. Beato and Bob Muse of Stein Mitchell Muse & Cipollone in Washington, DC, Mr. Thakur filed a whistleblower lawsuit in 2007 under the FCA detailing Ranbaxy’s violations. Filed in the United States District Court for the District of Maryland (Civ. No. 1:07-cv-00962-JFM), the lawsuit alleges that Ranbaxy caused false claims for payment to be submitted to government healthcare programs for numerous adulterated drugs. The FCA’s qui tam provisions allow whistleblowers to report fraud on a government program with the protection of a court-ordered seal and confidentiality, and receive a percentage of the amount recovered in a successful case.

Mr. Thakur’s lawsuit, which was joined by the Department of Justice and participating States, alleges wide-ranging manufacturing violations in Ranbaxy’s facilities in India and the United States, including inadequate testing to ensure that the drugs were safe, effective, free of cross-contamination, and manufactured in compliance with their approved specifications. Moreover, Mr. Thakur alleges that Ranbaxy falsified information about the drugs, including backdating tests and submitting false data where no tests were performed. The pervasive violations are alleged to have adulterated dozens of generic drugs purchased by government healthcare programs such as Medicare and Medicaid, as well as generic antiretroviral drugs purchased by the United States under the President’s Emergency Plan for AIDS Relief.

As a result of today’s $500 million settlement, the government will obtain approximately $350 million in civil penalties and $150 million in criminal penalties. Mr. Thakur will receive 21 percent of the federal and participating Medicaid States’ civil recoveries. Ranbaxy USA, Inc. has entered a plea of guilty to six felony counts in a criminal information filed by the United States, including introducing into commerce adulterated or misbranded drugs.

Andrew Beato, head of the False Claims Act and Whistleblower Practice Group at Stein Mitchell Muse & Cipollone and counsel to Mr. Thakur, stated that “This case was fueled by the extraordinary courage of Dinesh Thakur. Without expectation of gain and at great risk, he reported the fraud to ensure that patients’ health was not compromised by the quality of Ranbaxy drugs.” Mr. Beato said that “Nearly 80 percent of the generic drugs taken by American consumers trace to overseas manufacturing facilities. These drugs must comply with FDA quality and manufacturing requirements. The settlement today is a significant step toward achieving that outcome. The message is clear that there are severe consequences if a company breaks the rules and takes shortcuts that sacrifice drug quality in pursuit of profit.”

The settlement resolves a sweeping, multi-year investigation by numerous government agencies including the DOJ and FDA to uncover and document deficient current good manufacturing and laboratory practices affecting the quality of Ranbaxy’s generic drugs. It is the capstone to numerous legal actions against Ranbaxy growing out of the eight-year investigation started by Mr. Thakur’s disclosure of the problems to the government in 2005. These legal actions include (1) a 2007 FDA raid on Ranbaxy’s United States offices, (2) FDA’s imposition of its Application Integrity Policy on Ranbaxy plants in India due to pervasive data falsification in 2009, (3) FDA’s banning of more than 30 Ranbaxy drugs from entering the United States, (4) numerous FDA warning letters for manufacturing violations, and (5) the entry of a Consent Decree and permanent injunction prohibiting Ranbaxy from introducing into interstate commerce drugs made at various facilities in India and the United States.

Bob Muse, a partner at Stein Mitchell Muse & Cipollone, commented that “This high-profile case is a strong reminder of the power of the FCA and exemplifies the important role whistleblowers play in the public-private partnership to prevent government fraud. It is another confirmation that people who report fraud even beyond our borders can expect to be treated fairly and in a manner that encourages them to come forward.”

The settlement today reflects the extraordinary efforts of the United States Attorney’s Office for the District of Maryland, DOJ, FDA’s Office of Criminal Investigations, HHS, TRICARE, USAID, and State Medicaid Fraud Control Units to ensure the quality and safety of generic drugs.

Over 1,00,000 children, below the age of 11 months, die of diarrhoea annually in India which is the second leading killer of young children globally, after pneumonia. India accounts for the highest number of diarrhoeal deaths, a latest study has suggested.

A new international study published in the latest edition of the British medical journal The Lancet provides the clearest picture yet of the impact and most common causes of diarrhoeal diseases.

The Global Enteric Multicenter Study (GEMS) is the largest study ever conducted on diarrhoeal diseases in developing countries, enrolling more than 20,000 children from seven sites across Asia (including India) and Africa. With approximately 4,57,000 to 8,84,000 hospitalisations and two million outpatient clinic visits each year in Indian children, this study pinpoints the key causes of childhood diarrhoea and suggests a roadmap to save hundreds of thousands of lives.

GEMS, coordinated by the University of Maryland’s School of Medicine’s Center for Vaccine Development, confirmed rotavirus as the leading cause of diarrhoeal diseases among infants under 11 months across all sites and identified other top causes for which additional research is urgently needed.

GEMS evaluated nearly 40 pathogens to map each one’s relative contribution to diarrhoeal disease. Combining data from all seven study countries, GEMS found that approximately one in five children under the age of two suffer from moderate-to-severe diarrhoea (MSD) each year, which increased children’s risk of death 8.5 fold and lead to stunted growth over a two-month follow-up period.

In India, the study was conducted in Kolkata at the National Institute of Cholera and Enteric Diseases and overseen by Principal Investigator Dipika Sur. Similar to other GEMS sites, just four pathogens – rotavirus, Cryptosporidium, Shigella, and ST-ETEC – caused the majority of MSD cases in Kolkata. The overall incidence of MSD was higher in Kolkata than at any other study site.

Infants under 11 months at Kolkata showed the highest burden, with roughly 90 episodes of MSD per 100 children each year, nearly double the next highest-burden site Kenya.

“Without a full picture of which pathogens cause the most harm, it has been difficult to make evidence-based decisions around diarrhoeal disease control,” said Dr. Sur. “GEMS will fill in those critical gaps in knowledge and will help in governments to prioritise resources for research and action to reduce the burden of disease,” she added.

Expanding access to vaccines for rotavirus could save thousands of lives and help avoid numerous hospitalisations, thereby improving the lives of children and families while simultaneously reducing significant burden on the healthcare costs, the report suggested.

GEMS data suggested that accelerating research on vaccines, treatments and diagnostics for the three other leading pathogens – Shigella, Cryptosporidium and ST-ETEC, a type of E. coli – could have a similar impact. Prior to GEMS, Cryptosporidium was not considered a major cause of diarrhoeal disease and consequently, there is currently little research on this pathogen underway.

Across most sites, children with MSD grew significantly less in height in the two months following the diarrhoeal episode. Significantly, 61 per cent of deaths occurred more than one week after the children were diagnosed with MSD, when children may no longer be receiving care and 56 per cent of deaths among cases occurred at home, suggesting that earlier studies focusing only on death occurred in health centres may underestimate the real burden of MSD.

World Health Organisation (WHO) officials said on Sunday it seemed likely a new coronavirus that has killed at least 18 people in the Middle East and Europe could be passed between humans, but only after prolonged contact.

A virus from the same family triggered the outbreak of Severe Acute Respiratory Syndrome (SARS) that swept the world after emerging in Asia and killed 775 people in 2003.

On Sunday French authorities announced that a second man had been diagnosed with the disease after sharing a hospital room with France’s only other sufferer.

WHO Assistant Director-General Keiji Fukuda told reporters in Saudi Arabia, the site of the largest cluster of infections, there was no evidence so far the virus was able to sustain “generalised transmission in communities” – a scenario that would raise the spectre of a pandemic.

But he added: “Of most concern … is the fact that the different clusters seen in multiple countries … increasingly support the hypothesis that when there is close contact, this novel coronavirus can transmit from person to person.

“There is a need for countries to … increase levels of awareness,” he said.

A public health expert who declined to be identified, said “close contact” meant being in the same small, enclosed space with an infected person for a prolonged period.

Doctors in the U.S. are embracing electronic health records, even if reluctantly, with 93 percent reporting they actively use an EHR system, according to a new report from Accenture.

In addition, nearly half (45 percent) of U.S. doctors surveyed said they regularly access clinical data outside their own organization, illustrating the growing momentum of health information exchange. That’s a 32 percent increase since last year, according to an announcement.

In all, 3,700 physicians in eight countries were polled: Australia, Canada, England, France, Germany, Singapore, Spain and the U.S.

Seventy-six percent of doctors in all countries reported that EHRs and HIE have had a positive impact on their practice, such as via reduced medical errors (76 percent) and improved quality of data for clinical research (74 percent). U.S. doctors, however, were the least likely (38 percent) to report that using EHRs and HIE reduced their organization’s costs. They also cited cost as the single greatest barrier to technology adoption.

U.S. physicians reported using health IT for basic clinical tasks including:

Receiving alerts while seeing patients (45 percent)
Using electronic lab orders (57 percent), a 21 percent annual increase
Receiving test results directly into an EHR system (62 percent), a 24 percent annual increase

Doctors in the U.S. were more likely than their peers in other countries to routinely use IT capabilities, such as e-prescribing (65 percent) and entering patient notes into electronic medical records (78 percent).

That’s not to say they’re happy about it, though. The level of dissatisfaction among EHR clients seems to be growing, according to a survey published in March by the American College of Physicians and AmericanEHR Partners, a web-based resource for EHR system selection and implementation.

User satisfaction in the survey dropped by 12 percentage points between 2010 and 2012, with the “very dissatisfied” group growing by 10 percentage points.

Amid usability and financial woes, few physicians have achieved Meaningful Use. In addition, some patients view doctors who use EHRs as less capable.

Health Affairs reported that the average physician loses $44,000 over five years with the technology implementation, and that just one-fourth of practices see a five-year return on investment.

Greater efficiencies that allow practices to increase patient volume, such as reducing documentation times, are among the ways that have been suggested to improve ROI.

“Centralised Management System (CMS) helps us to improve accessibility and uniformity in our services”

How do you think the upcoming technologies can help in providing healthcare to all? What are the latest medical equipments procured by your hospital and has raised standards?
Technology is more than a tool. When used optimally and efficiently, it provides desired outcomes with minimum cost, as also applicability in delivery system and extensive shelf-life. It also helps to optimise results, even with limited resources. Taking this
into contemplation, we have endeavoured to achieve the following in our organisation —
•Use of latest diagnostic tools in consonance with the major diseases we treat in our organisation — for example,video microscopy (folliscope) for trichology, advance skin analyser for dermatology, and spirometry for respiratory diseases •For accessibility of patients to reach our doctors, we launched our cyberclinic a decade ago for treating the maximum number of patients in a year. We also launched mhealth, where patients can send us queries with minimum effort through mobile phone
•To improve accessibility of doctors within the organisation and for patients to take second opinion, we started telemedicine services — where patients can be seen by our ‘medical expert team’ sitting afar from the clinics,where the patient has enrolled for treatment. This has augmented our services and made us expand our reach efficiently •The use of a centralised ‘Clinic Management System’ has worked well for us — this helps us to maintain clinical records of our patients. The current trend of ‘floating’ population is also no problem, because all records are available at our clinics, across the country, at the click of the mouse>>How to maintain leadership status in the industry, and set new benchmarks

About the Hospital

Founded in 1982 by Dr Mukesh Batra, Dr Batra’s Positive Health Clinic has come a long way today with 105 clinics spread across 46 cities in India, Dubai and UK.It provides state-of-the-art services to more than half a million people from all over the world, with the numbers growing steadily. Transparency in business and abiding by their fundamental principles has brought Dr Batra’s a long way in developing and maintaining excellent relations with customers. The commitment and dedication in providing customers with the best service helped Dr Batra’s to become the world’s largest homeopathic corporate.

What are the IT investments your hospital has made over the years?
Total IT solution for patient care, right from registration, follow-up and continual cycle of treatment is undertaken. Total online real system, accessible from all locations by staff at all levels — doctors, management, PROs etc. has been introduced along with total online MIS, which provides the latest status to all concerned — to manage the business. A range of totally automated e-mail/SMS systems for patients — for reminders and follow-ups and comprehensive system to monitor patient experience and satisfaction has been achieved by the hospital.We have invested in both software and hardware.
We have online ERP and specialised software for HR, including attendance, leave, rota duties and payroll management and  performance appraisals. We firmly believe that ICT is a game changer for our operations,because it not only helps us to cut down errors to the ‘barest’ minimum, but also enhances the quality of our operations and services for our patients.

What are your views on the regulatory issues of healthcare?
Regulation in healthcare should be made with the intent of minimising errors and enhancing maximum safety juxtaposed by optimum efforts, while taking into account the local conditions. Plagiarising regulations from other state authorities’ increases costof healthcare delivery; it also does not significantly add to the quality of medical care. Regulatory issues in healthcare for alternative systems of medicine are not well-defined yet — especially in case of OPD clinic set up. It is difficult to find a benchmark. It appears to be more self-regulatory — this has prompted us to incorporate all possible standards practiced in top-class conventional clinics into our chain of clinics.
Since we also dispense medicines within our premises, we provide medicines procured from a homoeopathic pharma company, which follows GMP and all national and international guidelines and protocols. Medicines are provided to the patients in ‘blister-packing.’ This is done with no human hand ‘touching’ the medicines, while packing and with minimum paperwork.
True to our mission, it has been our policyto provide prompt and effective healthcare systems and homeopathic treatment services,which meet the needs of patients, through competent staff and excellent infrastructure