carewell

November 14, 2007

Take your medicine on time

Filed under: healthcare, medicine, Uncategorized — Tags: , — infobit @ 4:22 pm

med minder

Whether you take medicine for a condition or you just have to take your vitamins and minerals on a regular basis, there are always those occasions when you just plain forget to take them or maybe you have had to go our quickly and forgot while you were getting ready, there is nothing worse than that. Fortunately there are few ideas that can save you from having to remember to take your medicine.

Med minder has been designed to allow people the freedom of worrying about their pills, this can be the elderly as well as everyone else, the medicine is initially divided into the days and placed into the compartments, which can the be opened at the specific time.

The device has an LCD display which indicates the frequency, date and time etc, there are also LED lights which flash to the alert the user that it is time to take their medicine as well as an audible sound, so they have all the bases covered.

This is great idea especially when people are self medicating as there is no possibility of them taking overdoses either, these devices could be used by nursing staff who visiting people at home, the device can then be set to the required settings and then the only thing that the patient needs to do is take the medicine as directed, no more worrying about the frequency.

Source [Engadget]

In Medicine, Life Imitates Art

Filed under: Blogroll — Tags: , , , — infobit @ 3:43 pm

Sillouette scanner

Gadgets can be really cool. But when they’re really cool and save a life, that’s even cooler. And when it’s based on technology from the movies, well, it doesn’t get much cooler than that. And even though this gadget looks more like Dr. Beverly Crusher’s Tricorder in StarTrek, it’s actually based on Academy Award winning technology from The Lord of the Rings Trilogy.

Allow me to explain.

Peter Jackson needed a better way to create the character of Gollum as he was unsatisfied with the way in which computer generated characters appeared and, more importantly, moved. He turned to New Zealand based WETA Workshop who developed a device that would use both motion capture and lasers to get an exact digital image of not only his body’s movements, but of the body’s density itself. The result was groundbreaking and Peter Jackson took home an Academy Award for Best Visual Effects.

But in the real world, the technology has even more important applications. A handheld medical scanner, called an SilhouetteMobile, scans and stores information about a patient’s wounds – this includes the width and depth. This means that doctors and nurses can now track healing of a patient’s wounds over time and more accurately project how a particular treatment is working. In addition, eye doctors can use the technology to more accurately map the eye – which is very useful for lasik, glasses, and other opthomological treatments.

Source – SciFi Tech

April 7, 2007

liver transplants -high cost-low expertise

Filed under: Blogroll — Tags: , — infobit @ 12:18 am

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Liver transplants plagued by high cost, lack of expertise

Rita Dutta – Mumbai

High cost and failure rate due to lack of professional expertise deal a crippling blow to more than half a lakh patients in India requiring orthotopic liver transplantations (OLT) every year. Experts highlight the need to address the issue at various levels including laymen and general practitioners alike as late referrals have restricted patients from availing successful liver transplants.

The gravity of the situation is reflected in the fact that while patients listed for OLT would not live beyond one to two years, not more than 10 OLTs are conducted annually and only around 100 patients have received transplant in India so far.

According to estimates, a 400-500 bed hospital, would have at least 100 patients dying of liver disease annually, who could have been saved by a transplant. Says Dr Gourdas Choudhuri, head of the department of gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, “In our institute, with 60 beds in gastroenterology, the mortality rate of admitted patients (2000 per year), most of whom are serious to critical, is around 10 per cent (200 deaths per year), of which 70 per cent (140 deaths per year) is due to liver failure. Most of them would be considered potential candidates for liver transplantation.”

A major bottleneck is the whopping cost of transplant, which ranges from Rs four lakh to Rs 25 lakh. The expensive UW solution, plasma fractioners, blood cell separators, blood bank support, prolonged ICU stay (from two weeks to a month) and immunosuppressants contribute to the cost.

Explains a consultant in surgical gastroenterology and specialist in hepato-biliary-pancreatic disorders and liver transplantation Dr Sudeep Shah of P D Hinduja Hospital, “The UW solution preservative costs Rs 20,000 a litre and one requires at least three litres of it. In addition is the cost of two supramajor surgeries, on the donor and the recipient. And at least 12 units of blood, platelets and fresh frozen plasma are to be kept ready for the surgery.” Reportedly, some hospitals hire chartered flights to get livers from other cities, adding another Rs four to Rs five lakh to the procedure.

According to managing director and liver transplant specialist of Hyderabad-based Global Hospital Dr K Ravindranath, lack of co-ordination between liver surgeon, liver specialist, anaesthesiologist, immunologist and lab medicine specialist has plagued liver transplantation. “With most specialists being attached to various hospitals, it’s difficult to bring them on one platform at the same time. The hospital management should be blamed for their short-sightedness regarding this,” said Dr Ravindranath, who has conducted 12 OLTs at Global Hospital, out of which 10 have been successful.

According to estimates, not more than 25 surgeons in India are trained to conduct liver surgery. Gangaram Hospital, Apollo Indrapastha and AIIMS in New Delhi, Global Hospital in Hyderabad, SGPGIMS in Lucknow, CMC-Vellore, SRMC and Stanley Medical College in Chennai, Jaslok Hospital and P D Hinduja Hospital in Mumbai conduct OLT.

Dr Sanjay Nagral, surgeon and liver transplant specialist, Jaslok Hospital, blames the lack of expertise on the part of medicos for patients not receiving OLTs. “OLT is not a regular surgical exercise. For conducting it, surgeons, physicians and anaesthesiologists need to receive special training from the US or the UK,” says Dr Nagral, who was in the team of surgeons which conducted a living-related liver transplant in India on a 14-year-old girl in 1998 at Jaslok Hospital.

OLT is technically difficult as it involves accurate dissection and suturing of several tissues from liver, blood vessels and bile ducts and needs two teams of surgeons and staff to work simultaneously, one on the donor and the other on the recipient. “A liver transplant is ten times more difficult than a heart or kidney transplant,” avers Dr Ravindranath.

Experts attribute lack of awareness among medicos and laymen alike for the less number of OLTs. Surgeons even complain of “lack of confidence” of physicians, GPs and gastroenterologists in referring patients for liver transplants to surgeons. “Physicians are not forthcoming about referring patients requiring liver transplant to us. And even if some are aware, they think it’s futile to inform patients about a technique which is not practiced widely,” rues Dr Nagral.

“Success breeds success and unless many liver transplants are performed, people will not have confidence and without confidence, we will not perform many,” says Dr Shah, who was in the team of surgeons which conducted a multi-organ transplant (kidney and liver) at Hinduja Hospital in January, 2004.

It’s to be noted that success rate of OLT in India is a modest 50 per cent in comparison with 80 per cent of the west. Many hospitals conducting OLT had initially recorded failures, indicating the complexity of the procedure. For instance, the first three liver transplants conducted at SGPGIMS four years ago, were not successful. For the remaining seven performed in the last one-and-a half year, the success rate has been around 50 per cent, informs Dr Choudhuri. According to Dr Ravindranath, around 50 per cent of the success of the transplant depends on the surgeons and the rest on the support services. “So, even if the surgeon conducts a successful transplant, improper support system can result in the patient losing his life,” says he. The life expectancy of 80 per cent of OLT patients is one year and 70 per cent for 10 years.“If the initial months after OLT are successfully passed, mortality rate is about 10 per cent in the next 10 years on an average.

Loss of the liver graft after the first year is less than five per cent and in a few cases, the original disease may relapse at some stage,” says Dr Shah.

Experts say that India would take a few more years to improve upon the success rate of OLT.

Others blame lack of networking between different hospitals for patients not receiving OLT. “Organ sharing is marred by regionalism. Though hospitals in Maharashtra have retrieval programme, they refuse to donate organs to other states,” laments an expert.

While the huge cost holds back patients from going to private hospitals, public hospitals do not evince interest because of the requirement of vast infrastructure. Says Dr Philip Abraham, a consultant gastroentrologist at P D Hinduja Hospital, “Public hospitals do not conduct OLTs as the infrastructure and costs involved for it can be utilised for treating a host of other ailments.”
Interestingly, medicos are hesitant about advocating live-related OLT than cadaveric, though both are permitted under the Transplantation Of Human Organs Act.
“In live-related donation, we are putting the life of the donor also at risk. That’s not ethical,” opines Dr Nagral. To which Dr Abraham adds that a surgeon should master OLT by cadaveric donation, before taking up live OLT.
They say the time has come for Indian hospitals to have a regular liver transplant programme as OLT costs abroad range from Rs 60 lakh to
Rs 80 lakh and listed Indian patients are not preferred over western patients abroad.

rita@expresshealthcaremgmt.com

Suggestions to improve liver transplant

  • More NGOs should come forward to subsidise the cost.
  • Awareness-creation among medicos to make transplants available to the needy.
  • Networking and organ sharing between different liver transplant centres.
  • Setting up adequate life support systems in more hospitals for maintaining the haemodynamic status of the brain dead till emotional, social and medical preparedness for cadaver organ donation are also required.
  • Necessary changes in law and medical practice to ensure cadaver organ donation on time.
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April 6, 2007

IHC stats july 2004

Filed under: healthcare, Uncategorized — Tags: , — infobit @ 11:25 pm
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Just a dose of healthcare statistics

Dhiraj Sharma

Healthcare is one of the most essential services in any growing society. Propelled by an affluent and health conscious growing middleclass, the healthcare industry in India grew by more than 13 per cent per annum in the last decade.

Market

India’s healthcare industry is estimated at Rs 1,500 billion or USD 34 billion. This works out to USD 34 per capita which is 6 per cent of GDP. Of this 15 per cent is publicly financed, four per cent is from social insurance, one per cent private insurance and the remaining 80 per cent being out of pocket as user fees (80 per cent of which goes to the private sector). Two thirds of the users are purely out-of pocket users and 90 per cent of them are from the poorest section.

Healthcare statistics

India has 5,03,900 doctors, 7,37,000 nurses, 162 medical colleges, 143 pharmacy colleges and 3,50,000 chemists. There are 15,097 hospitals accounting for 8,70,161 hospital beds in India. There is an extensive three-tiered government healthcare infrastructure comprising 23,000 Primary Health Centres(PHC) and 1,37,000 sub-centres serving the semi-urban and rural areas and 3000 (CHC) Community Health Centres-(Source: OPPI 2000 Estimates)

India stands

  • India’s health expenditure is 5.6 per cent of GDP, whereas most established market economies spend 7-10 per cent of GDP on health. USA spends over 14 per cent.
  • US has 2,340 doctors as compared to India’s 143 doctors for very 10,000 people
  • On an average, 80 out of every 1,000 children die. This figure is just 9 in the US and 30 for every 1,000 in Thailand.
  • Life Expectancy in India is amongst the lowest at 55.5 years compared to US at 75.5 years and 66.5 years for Thailand.
  • Compared to Brazil’s 4300 beds, India has only 1,600 beds.

Potential

The potential of health services sector is immense in India as there are more than 140 million upper and middle class, growing at over four per cent per annum with combined annual income of over Rs 820,000 crore.

These people have confidence in healthcare products and services offered by private hospitals. The quality of healthcare has improved considerably with the availability of world class high-tech medical equipment and information technology. However, the low penetration of health insurance is limiting the growth of these world-class services.

Privatisation of insurance sector has led to spurt in health care services. Less than 10 per cent of the Indian population is covered by some form of health insurance. Insurance is expected to be the main driver for raising quality consciousness and increased demand for better standards, hospital accreditation and Patient / Management Information Systems.

The voluntary health insurance market estimated at Rs 4 billion is expected to be Rs 130 billion by 2005.

The healthcare business for IT services comprises of players like government, insurance companies, consumer and corporate hospitals is about Rs 500 crore which is a pittance compared to the contribution of healthcare industry to national GDP which is growing at a rate of about 10-15 percent annually.

The MBPO (medical business process outsourcing) will be the next boom the Indian knowledge economy will witness as it has massive potential for outsourcing within the US healthcare industry. This time outsourcing won’t be the once fashionable and now dead medical transcription, but would be more for processes like medical billing, claim processing, disease coding and forms processing which easily gives returns of USD 16-18 per person per hour, much higher than the billing rates in other BPO verticals.

According to a Frost and Sullivan Study, the Indian medical hardware market (equipment and devices) is estimated at Rs 65.32 billion in 2001, growing at 12 per cent per annum, which is almost double the market size in 1993.

With India becoming a healthcare destination, Health Tourism Industry, stands at Rs 1200-1500 crores, and growing at a rate of 30 per cent annually is bound to grow at a more faster rate.

Lower production costs and skilled workforce has attracted multinationals to set up R & D and production centres in India. In the long run these R&D centres will help develop low-cost medicines for the Indian market. The Astra-Zeneca centre in Bangalore is a testament to this.

The road ahead

In order to capitalise on all these opportunities, we have to create a conducive environment by:

Attracting investment

  • Granting infrastructure status to the healthcare sector.
  • Create fiscal policies, like providing low interest rate loans, introducing tax holidays for investment in low per capita income states, reducing import/excise duty for medical equipment, et cetera, to promote investment in healthcare services.
  • Facilitating various clearances and certification like medical registration number, building number, anti-pollution certificate etc.

Changing the legislation

  • Mandating the employers to buy group or individual medical insurance for their employees to ensure a certain minimum financial coverage.
  • Mandating the private sector units, that take advantage of improved fiscal policies, to commit resources to remote rural/under developed sectors.
  • Create an autonomous body to standardise on medical messaging, codes and vocabulary, content and format, identification standards and security.
  • Mandate the healthcare service providers to transmit selected patient data to the government for analysis. This data will be analysed to identify trends and evolve policies.
  • Create a national database of health care providers, their facilities and services. This will create awareness among the population towards quality health care.
  • Streamline the process of handling patient grievances.
  • Create a nation-wide agency to deal with patient requests like ambulance hotline, emergency/first-aid consultation, trauma help-line etc.

IT initiatives

  • Sharing of patient information between providers, with patient and payers.
  • Security and privacy services.
  • Need for standards for messaging, codes and vocabulary (CPT, ICD), content and format standards (MR, lab report)

To witness a successful revolution in healthcare, we need to bring these arrays of activities together. If this works for India over the next decade, the vast population living in rural and urban areas will bear the fruit of success

“If Information is Power, Health Information is Life.”

The writer is a business analyst with FCG Software Services (India) Pvt. Ltd.

Email:dsharma@fcg.com

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