Sandeep Napa

Digital health and Healthcare IT conference at the BioAsia 2015 convention

The Healthcare conferences at the BioAsia 2015 convention, in Hyderabad, India, were launched by Pradeep Chandra, IAS, Special Chief Secretary, Government of Telangana. The Digital health and Healthcare IT conference at the BioAsia 2015 convention, was a much anticipated event. The first session was on whether India was ready for the rapid technological changes shaping healthcare globally. Sangita Reddy , the Joint MD of Apollo Hospitals in India, gave a rather articulate and delightful talk on her transformative experience, implementing telemedicine in India. She felt that India is uniquely positioned to leapfrog legacy technologies to unified, standardized EMRs, especially after the health ministry has purchased a national license to SNOMED-CT. Data mining would be the next logical step to improve standard of care and predict outcomes. BVR Mohan Reddy the Executive Chairman of Cyient Technologies spoke about how IoT (internet of things) applications improve asset utilization and bring down maintenance costs of MRI machines, X Ray machines among other diagnostic equipment. Cyient is also working on Google Gass based solutions to leverage IoT in industrial applications.

The second session dealt with use of technology by the medical fraternity in India. Aravindakshan T S Y, the national manager for industry solutions for health from Microsoft India, touched upon engaged patient experience and how Microsoft is uniquely positioned to leverage the power of cloud computing to provide geographical freedom to providers and consumers. The pervasiveness of technology can really streamline the care continuum. Dr Anthony Vipin Das who is the chief advisor to the government and a collaborator at MIT Media Lab was the moderator of this session. Dr Sai Praveen, a consultant intensivist and pulmonologist at Apollo Hospitals talked about the rise of pervasive point of care diagnostic devices. It was sad to learn how 2 weeks of an ICU stay can bankrupt 25% of his patients but timely interventions at the point of care can reduce the length of stay and improve outcomes. Dr Jitesh Bhatt, the general manager of Vodafone India emphasized the importance of solutions that make business sense in his pilot studies in India.

Aravind Microsoft

Analytics driven insight to improve healthcare effectiveness was the theme of the final session. Sudpita Ghosh, a partner at PwC India, moderated the session. Dr Sukumar, Presiden of Optimal Strategix Group clarified the role of analytics in healthcare and stressed upon the importance of having objectives before looking at clean data. Dr Ruchi Das, the CEO of HealthCursor Consulting group spoke about teletriage systems and stressed upon the importance of mining health data acquired with consent to generate actionable insights. As a public health expert she described how context was a big problem in India in her understanding of public health issues and how centralized resource scheduling can really impact the delivery of care to the common man. Martin Kelly, CEO of HealthXL Ireland spoke about how his company fostered collaborations between the biggest healthcare corporations such as Cleveland Clinic, Partners Healthcare, Novartis, IBM among others, and established startups looking for the right industry partners to take their companies to the next level.

The winners of the healthcare hackathon conducted at BioAsia were an inspiring reminder of the power of frugal innovation. Sharath, Manikanta and Vijayabhaskar all students from a prestigious engineering college put their education to good use in developing a self feeding utensil for the disabled. An electomechanical assistive device to impact the lives of 26 million people, all in under 30$ is certainly impressive.

 

I am pleasantly surprised and frankly excited about the opportunities in digital health and Healthcare IT in India. The challenges of being a startup company are daunting but we at HealSpace are a persistently passionate bunch ! Feel free to email me at: sandeepnapa@healspace.co and reach out to me on LinkedIn at: in.linkedin.com/in/sandeepnapa/

Rapid Diagnostics Conference at the BioAsia 2015 Convention in Hyderabad, India

The Rapid Diagnostics Conference at the BioAsia 2015 Convention was inaugurated by Dr V Lakshmi, the Head of Department of Microbiology at the prestigious Nizams Institute of Medical Sciences, in Hyderabad, India. In her inaugural speech, she touched upon the evolution of diagnostic technologies and the trends in the industry favoring rapid diagnostics, a technology that potentially involves components such as Nanotechnology, BioMEMS (biomedical microelectromechanical systems), microfluidics, Lab-on-a-chip and RT-PCR (Reverse transcriptase polymerase chain reaction).

This speech was followed up by four presentations by companies in this vertical. Dr Vijay Mathur, who heads the R&D of Diasys Technologies spoke about the low cost cartridge based Point of Care Testing (POCT) technology that their company has developed. They currently hold about ten patents and have recently acquired the diagnostics business of Piramal Healthcare, a pharmaceutical company in India. It is so disruptive that the results of the test are out in three minutes flat.  They have a Q3 2015 launch plan, with an aggressive pricing strategy, the device costs less than $800.

Sadhana Seth from Siemens Healthcare discussed how Siemens was uniquely positioned as pioneers and market leaders in the space, followed by how they have managed to capture the market leading position by partnering with major hospitals in India.  She also launched the handheld coagulation device that gives results in under two minutes. They also have a strong informatics backing to help care providers deliver care in the most effective way possible, by minimizing redundancies and closing loops whenever possible.

This was followed up by an interesting session presented by Dr. Ravi Vinayak, VP of Sales and Business Development of BioMed Diagnostics, which makes diagnostic kits for microbiology applications. Their customers include the likes of Quest Diagnostics. A simple solution called InTray, that potentially replaces petri dishes was showcased at the conference. Their solution for liquid media is called InPouch.

BioMed

The last presenter was Dr Sumit Mitra whose company MolBio, specializes in developing rapid diagnostics for communicable diseases. Their solution for detecting, Bacillus tuberculosis, a bacterium (that casues TB) and Trichomonas vaginalis, a common STD causing pathogen have received accolades in the industry.

This session was followed up by Dr Shantikumar Nair’s presentation on advances in Nanosciences and Molecular Medicine in India and an interesting session on current technologies and trends in POCT by Dr Quadri, (Indian Council for Medical Research) Dr Gupta (Professor , IIT Delhi) and Dr Kumar (Managing Director, Xcyton, India)

The session concluded with a discussion on the regulatory oversight of POCT technology in India. The speakers, Dr Walia (Indian Council for Medical Research) and Dr Kumar (CEO of RAS Lifesciences) spoke about the industry, national and international perspectives of Rapid Diagnostic Assays.

Digital Health and Healthcare IT Conference at the 2015 BioAsia Forum

BioAsia is a global business forum in the biotechnology vertical, providing a platform for diverse stakeholders such as biotech and bio-pharma companies, research institutions, investors, service providers, policy makers, regulators and analysts to interact and explore collaborations. The participants include Genome Valley, Federation of Asian Biotech Associations and Pharmaceutical Export Promotion Council, all headquartered in Hyderabad, India.

The 2015 BioAsia Digital Health and Healthcare IT conference is an international effort to bring together professionals in healthcare informatics, telemedicine, HIS, electronic health records, remote diagnostic and therapeutic tools.The one day session on February 4 2015, at HICC Hyderabad, has three sessions in all, followed by a social event for networking.

The first session’s focus is on whether India is ready for the rapid technological changes shaping healthcare globally. The speaker panel would discuss issues ranging from technology adoption, challenges and strategies to innovate in this space and future trends. Dr Rana Mehta (Executive Director, PwC India), Rajendra Pratap Gupta (Chairman – India & India Representative, Personal Connected Health Alliance, India) BVR Mohan Reddy (Founder and Executive Chairman, Cyient and Vice-Chairman of NASSCOM, India) will speak at this session.

Medical fraternity’s adoption of Healthcare IT in healthcare institutions in India is the theme of the second session, which would also touch upon suitable strategies and global best practices. The panelists include Sangita Reddy (Joint MD, Apollo Hospitals, India) Dr. Balasubramaniam (Research Director, LV Prasad Eye Institute, India), Srinivas Prasad ‎(CEO, Philips Innovation Campus, India) Dr Jitesh Bhatt (General Manager, M- Healthcare (Innovations), Vodafone India Limited)

The third session would explore analytics driven insight for improving healthcare effectiveness. The role of analytics to make data actionable, leveraging ERP and CRM tools for providers, the need for collaboration and the way ahead for analytics in healthcare. The speakers at this panel include Dr. R. Sukumar (President and Founder, Optimal Strategix Group, USA), Mark Allan (Executive Director, Max Institute of Healthcare Management) Ameera Shah (MD Promoter & CEO, Metropolis Healthcare Ltd.)

Finally the session would conclude with 2 interesting invited talks by health futurists – Martin Kelly (CEO, HealthXL, Ireland) and Dr. Seemant Jauhari (CEO – Research & Innovations, Apollo Hospitals & Director – Apollo JVs, India). Head over to http://2015.bioasia.in for more details.

I am the cofounder of a stealth-mode startup called HealSpace, based out of Hyderabad, India. We are a small passionate team of physicians, data scientists, web developers and designers building clinical decision support tools among other things ! Feel free to email me at: sandeepnapa@healspace.co and reach out to me on LinkedIn at: in.linkedin.com/in/sandeepnapa/

Some musings from the Medscape EHR Report 2014

The humble Electronic Health Record (EHR) has come a long way since Lockheed uvnveiled a clinical data management system circa the sixties. It revolutionized the practice of Medicine. Medscape surveyed 18,575  practicing physcians for a year and these doctors had interesting things to say about how EHR use affects pratice operations and patient encounters.

More than 90% of the physican market has been pentrated by EHRs.

This is because majority of US healthcare institutions now use EHRs and there is a growing number of physicians who prefer being salaried hospital employees than having an independent practice. Hospitals are also buying up private clinics which clearly justifies an increasing trend in EHR adoption.

There is still a small reticent minority (7%) that chooses not to implement an EHR and it would be interesting to know the reasons for non implementation. Is it because they are too expensive where costs exceed benefits or it is it because they impede communication interfering with the Doctor-Patient relationship ?

 

Market Dynamics

Hospitals and large physician practices are dominated by the early movers in the EHR space. Epic, Allscripts and Cerner are the biggest players. In fact EPICs adoption is three times its nearest competitor, Cerner.

The vendor market for medium to small practices is fragmented and very competitive. The biggest players in this space are eClinical works, Next Gen and Practice Fusion. Others include Amazing Charts, e-MDs, Aprima, Care 360, and Medicat. One reason for the fragmentation is that physicians enjoy more freedom in choosing an EHR in a private practice setting than in a hospital setting.

There has been a shift in focus from EHRs that simply create an acceptable E&M note to ones that deal with new issues of care, clinical management and patient tracking.

Best EHRs out there

VA-CRPS is rated the best rated EHR for overall end user satisfaction. Practice fusion and Amazing Charts are tied up for second place, while Mdent and e-MDs are tied for thrid.

EHRs have traditionally been difficult to use and they still continue to be so. Some physicians may use multiple EHRs so interoperability may be something for a lot of vendors to think about.

Amazing Charts is popular with small practices probably for its ease of use for which the EHR received the highest rating. Practice Fusion and CPRS are also regarded highly given that ease of use determines phyisican perception and end user experience.

Vendor support is considered a critical component of physician satisfaction with an EHR product because practices cannot afford to lose time trying to work around  EHR problems. Practice Fusion has a freemium business model and is therefore rated highly on value for money. It is followed by Amazing Charts, CPRS, e-MDs and Medent.

Cloud based systems despite their problems with HIPAA compliance offer a more robust support system than a client site stand alone installation. Also it is more expensive for a vendor to send a support technician to the site than to have them work remotely in the cloud with the client to resolve the issue.

VA-CPRS is rated highly for integrated clinical management where all clinical data is presented in a simple easy to use format. Epic came a close second for data integration.Care Coordination demands this connectivity and EHR vendors seem to have recognized the need as well.

Interestingly inter-physcian consults who are not in the same system are probably more clinical discussion oriented and less dependent on EHRs themselves.

VA-CPRS scored the highest in all aspects of use as a clinical tool, including appropriateness of clinical content, ability to support the physician’s workflow, patient services, and patient portal.

Other Interesting Touchpoints

Since office workflow and staff management capabilities are not requirements for certification, EHRs are not incentivized to incorporate these features. Being familiar with an EHR leads to a greater sense of satisfaction in using it however there is a general sense of distrust when it comes to an EHR’s ability to guarantee patient privacy. The concern has increased from 17% to 77% of surveyed physicians in a span of just 2 years.

Takehome for Physicians

Doctors need to do more homework before they decide on their vendor. A lot of unpleasantness can be avoided if their expectations match vendor capabilities. Physicians may dislike their EHRs but they are less likely to migrate to a new system simply because of their frustration with their existing EHR. Finally, physician training in EHR use needs to precede deployment to reduce workflow errors and delays.