August 2014

A Single Minded Focus on Orthopaedics

Dr Harshvardhan Hegde,
Dr Harshvardhan Hegde,

Dr Harshvardhan Hegde,
Director, Nova Orthopaedic and
Spine Hospital (NOSH)

Dr Harshvardhan Hegde, Medical Director, Nova Orthopaedic and Spine Hospital (NOSH) has been instrumental in the introduction of robot-assisted surgery. A single specialty hospital devoted only to Orthopaedic cases may seem ambitious, but he feels that the time is right for such hospitals in todays modern times. In a conversation with ENNs Rajesh K Sharma, he explains why he thinks so

The modern lifestyle is characterized by extremes: one the one hand, technology has made our lives sedentary through automobiles, computers, elevators etc, thereby turning us into couch potatoes; while on the other hand, we join gyms for exercises that stretch out bodies to their limits, often causing injuries. In absence of moderation, our bodies are pushed to the extremes of a sedentary lifestyle and extreme workouts. As a result, incidents of Orthopaedic cases are on the rise.
The commonest injury today is neck pain and back ache. It is also the most common reason for lay- off from work, says Dr Harshvardhan Hegde, Medical Director Orthopaedics at Nova Orthopaedic and Spine Hospital (NOSH). Also, injuries and death on road are very high, and very common. In fact, India has the worst record in road accidents, he says. The rise in the number of Ortho- paedic cases is also being attributed to the overall rise in life expectancy.
Dr Harshvardhan leads a team of seven doctors specializing in the various Orthopaedic disciplines at NOSH. In a market flush with multi specialty hospitals of all sizes, NOSH is a part of a growing trend of single specialty hospitals.
Explaining the thought behind a hospital devoted solely to Orthopaedics, Dr Hegde says that the benefits are tangible. Everything, right from consultation to deciding whether a patient needs surgery or not, to actually doing the surgery to rehabilitation is done here, he says. The hospital has taken the best in Orthopaedics from hospitals around the world, like transparency, archiving, equipments, OT space, infection control, processes, and used it here.
Being a single specialty hospital, the Operations Theaters (OTs) at NOSH are more focused. Unlike multi-specialty hospitals, the staff is trained solely for Orthopaedic matters. Also, since the OTs are used only for Orthopaedic cases, the amount of infection control needed is lesser than what would be required for a multi-purpose OT. A focused center like ours reduces the chances of infections, says Dr Hegde. Even the nurses, anaesthetists and ICUs are trained to manage Orthopaedic patients. So everything is very super specialized in that area. We can give a focused attention to our patients, he adds. Cost-wise too, Dr Hegde feels that single specialty hospitals help in keeping costs down. We dont need to send our nurses for different trainings. Orthopaedic needs are different from cardiac or neurological needs. If you are a focused hospital, you dont need to meet with the demands of other specialties, he says. Instead of creating large monoliths with lots of nurses and lots of managers, he feels, it is better to create small verticals which deliver healthcare at their best
The focus on Orthopaedics also extends to sports medicine, which has become a specialized area within the discipline. Contrary to what its name implies, it is not just sportspersons that require sports medicine. Even overzealous gym goers who pick up heavy weights without expert supervision and end up injuring their joints and tendons end up needing it.

“Seven Orthopaedic doctors being available on-site gives a lot of comfort to the patient”

NOSH is taking Orthopaedic surgery in India to the next level by introducing two new machines “ a Spinal Surgery Table and Radiolucent Wilson Frame, and the Mazor Roboticss Renaissance. With these installations, it aims to provide better services in the field of Orthopaedic surgeries. In fact, Mazor Robotics Renaissance is the first machine that is commercially available only for Orthopaedics. Its relevancy lies solely in spinal surgery and that too, in spinal instrumentation.
Explaining their significance, Dr Hegde says that the Spinal Surgery Table and Radiolucent Wilson Frame facilitates a 360 degree view of the spine during surgery. It allows the surgeon to access the anterior and posterior part of the anatomy without having to physically lift and turn the patient. The table does not inhibit the use of X-Ray and C-arm machines, allowing the surgeon to easily obtain any images during the surgery. This helps the surgeon immensely, as he can have images ready in real time for viewing.
The Mazor Robotics Renaissance is a machine created especially for spinal surgeries. The spinal region is a mesh of tiny nerves, Dr Hegde explains, and a slight error in judgment can damage the nerves, possi- bly causing grave complications. The Mazor Robotics Renaissance assists the doctor while placing screws in the spinal cord for its straightening. If you want to position screws to correct a deformity to stabilize a spine, then positioning a screw can be dangerous because potentially, you can injure the nerves. That injury is reduced almost to zero because of these robots, because it makes things very accurate, he says.
Together, the two instruments give NOSH an edge over other multispecialty hospitals that offer Orthopaedic surgeries. That, coupled with the fact that the chances of Hospital Acquired Infection (HAI) are lower in single specialty hospitals has Dr Hedge optimistic of the entire enterprise. In the future, he plans to open more single specialty hospitals in other cities, citing the positive response he has received for the current one, and also get into pain management. He is not too worried about compe- tition from the multi-specialty hos pitals, pointing to the fact that even the multi-specialty hospitals are specializing in a particular discipline at their branches, making them look like a single-specialty hospital. Seven Orthopaedic doctors being available on-site gives a lot of comfort to the patient, he concludes.

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