Healthcare Delivery

Surgical Case Study: Dr. Pramod Reddy, Medicover Hospitals treats a patient with Aortic Dissection through the Frozen Elephant Trunk Technique

A young male student of 20-years from Nagpur reported with Aortic Dissection with Marfan Syndrome – an inherited disorder that affects the connective tissue at Medicover Hospitals, Hitech City Hyderabad. Aortic dissection is a medical emergency in which the inner layer of the large blood vessel branching off the heart (aorta) tears. Patient presents with severe chest or upper back pain that radiates to the neck or down the back, loss of consciousness and shortness of breath.

Aortic dissection is relatively uncommon. The condition most frequently occurs in men in their 60s and 70s. An aortic dissection occurs in a weakened area of the aortic wall. Chronic high blood pressure may stress the aortic tissue, making it more susceptible to tearing.

Dr Pramod Reddy, Medicover Hospitals Hyderabad explaining the procedure

Also seen in people born with a condition associated with a weakened and enlarged Aorta, such as Marfan syndrome, bicuspid aortic valve, or other rarer conditions associated with weakening of the walls of the blood vessels. Aortic dissection can quickly lead to death from not enough blood flow to the heart or complete rupture of the aorta.

Dr Pramod Reddy, Chief Cardiothoracic and Aortic Surgeon, Medicover Hospitals and teamcarried out this complex procedure by replacing half of the aorta from the aortic root by using new technique called FROZEN ELEPHANT TRUNK. The complex nature of the procedure is that the main arteries which supplies blood to the brain and heart are present in the affected part and requires precision care and expertise to repair and replace the aorta from the root.

The images of the procedure, before the surgery and after repair, as you can see the dissection has been treated

Dr Pramod further explained that the patient is required to be put under Deep Hypothermic Circulatory Arrest – which means cooling the patient’s body to a temperature of around 18-20 degrees and stopping blood circulation to the entire body except the brain for a period of 45 minutes.

“Mortality rate in such cases is 30-40%. There is also a chance of a stroke and Paraplegia.

Dr Pramod Reddy, Chief Cardio Thoracic Surgeon, Medicover Hospitals, Hyderabad

The entire procedure is expected to be done during the window of Deep Hypothermic Circulatory Arrest and any delay would result in losing the patient.

Dr Pramod Reddy & the team successfully carried out the procedure and stabilized the patient. The patient is now recovering and would soon be leading a normal life.

Very few centers across the globe perform this surgery. Usually, this procedure is done in a two-stage process, but we were able to successfully manage the whole procedure in a single stage which is done by using a special tube with a stent. (FROZEN ELEPHANT TRUNK TECHNIQUE). This technique reduces the necessity for subsequent additional operations and therefore may improve long-term survival.

(This case study has been developed by Dr. Pramod Reddy and his team at Medicover Hospitals, Hyderabad)

Public Health

Road accidents killed more people than Covid19 in India

Something in India kills one person every 4 minutes.

If you think it is Covid19 or some infectious disease you are wrong, this is more lethal and dangerous than cancer. It is not even the usual suspects like Diabetes…then what is it?

It is road accidents? Surprised? You should not be …

Last month a team member had to take some time off to see to the last rites of a relative who had died in a collision. Incidentally the death of the family member led to other unintended consequences for the family. Just the next day I got news of a bunch of medicos who had died on the way to Goa after a school reunion.

According to reports from Ministry of Road Transport and Highways, the numbers are very concerning. India has lost 80,000 people this year to road fatalities. That is almost 13% of all deaths due to road accidents globally. This is despite the fact that India has only 1% of registered vehicles globally. So while this is a worry there is little by way of data that can help us understand the reasons for these numbers.

Let’s look at this phenomenon globally.

Road traffic continues to be a major developmental issue, a public health concern and is a leading cause of death and injury across the World killing more than 1.35 million globally as reported in the Global Status report on Road Safety 2018 with 90% of these casualties taking place in the developing countries. These are the leading causes of death for children aged 4-14 and for young adults below the age of 29 years.

54% of those killed are pedestrians, cyclists and motor cycle drivers.

Road accidents in India kill almost 1.5 lakh people annually. Accordingly, India accounts for almost 11% of the accident related deaths in the World.

As per the consortium of Delhi IIT & DMITS, commissioned by MORTH to estimate the socio-economic costs of road accidents, the total estimated socio economic cost of road accidents reported by India in 2018 was Rs 1,47,114 crores which was equivalent to 0.77% of the nation’s GDP.

What is more concerning being that there is no change in the number of accidents or the deaths and injuries due to those accidents over the last 5 years? Incidentally the only casualty of the farmer protests so far in the country was an individual who lost control of his tractor and succumbed to his injuries, which will put down the cause of his death to road accident. The below table tells the rest of the story.

Number of accidents and subsequent deaths from 2015-2019 in India

Interestingly national and state highways which account for a mere 5% of the roads account for almost 50% of the accidents and subsequent fatalities. The highways are the preferred mode of transport for both passengers and freight in the country.

I think it would make sense for everyone to download this report and read it. It has a more direct impact than the toolkit that has been in news for all the wrong reasons.

So is there light at the end of the tunnel?

Well these seems to be some interesting statistics from Tamil Nadu that might be helpful. The state accounts for the highest number of road accidents. In 2019 there were 57,228 odd accidents in the state that accounted for almost 12.7% of the accidents in the entire country. While the absolute number is high, what it hides is a 10% decrease over 2018 numbers. While it tops in the number of accidents, the deaths due to accidents is lower at 10,525 (Nationally in 5th place) which also marks a 13.8% decrease in the number of deaths over 2018. I have taken the number purposely for 2019 as 2020 road traffic numbers are far lower due to the pandemic.

All this data is available for public consumption on this site.

So what has Tamilnadu done that can be followed as a framework across other states? Well for starters it has taken these key steps

  • Analysis of exact reasons for the accidents, crunching this data to ensure that root cause identification is done and those recurring causes are eliminated
  • Ensuring that ambulance is available and reaches the crash site within 13 minutes, reducing the loss of life
  • Analyzing crash sites and making changes in the road structure and barricade protection to reduce recurrence of accidents
  • Availability of medical personnel near to chronic crash sites
  • Educating drivers on public safety
  • Enforcing safety drives by the police
  • Last but not the least smooth coordination between the various agencies – Police, Hospitals, National High Authority and Ministry of Roads and Surface Transport among others

While this looks like a good model to start with, I believe these is a lot more that needs to be done. I would continue the above but add the following to the list

  • Encourage safe driving lessons at all schools, especially for classes 11 and 12. This should be ideally continued to the first year to college, where most drivers would get their first license
  • Continue to work with OEMs and Auto Manufacturers to ensure safety norms, protocols and education is continued when a buyer walks into the dealership to buy a vehicle
  • Constant education to pedestrians, cyclists and motor cycle and 2 wheel riders, as these are the sections most affected by road accidents these are the categories that we should speak to more and make them aware of the dangers of road
  • Encourage train travel, it is beyond doubt that the trains have a much better safety record than the roads and we should encourage more people to pick up trains to mode of passenger transport, reducing the chances of accidents by road
  • Collect data and act on it locally, I think we seem to be more interested in national issues but we need to act locally to help build up the numbers nationally

The loss to family, society and country through road accidents is immense. From a healthcare perspective, these accidents add to the burden of a healthcare system that is bursting at the seams. A death every 4 minutes that is avoidable is something the system can ill afford.

So drive safe and stay heathy…..

Healthcare Delivery

Help Vihaan Sharma get treated for Burkitt’s Lymphoma

A few days ago we were tagged on Twitter in a story where the father of a 3-year-old Vihaan Sharma had reached out to us to help him raise funds for his treatment. While many such requests come our way, we wanted to help the child but befire that we had to verify the genuineness of the case.

Original Tweet from the handle – @VihaanS88920491

While offline methods to verify the validity of the case did not work out due to restrictions on the sharing of patient information, the hospital, Manipal Hospitals in Jaipur themselves confirmed the case through their Twitter handle.

Manipal Hospital confirming the case

Burkitt’s Lymphoma is a type of Non-Hodgkins Lymphoma that is caused due to cancerous growth in the B Cells of the body. It spreads rapidly if left untreated. The reason why it is dangerous is that it seriously hampers the immunity of the patient. There two types of Burkitt’s Lymphoma African- endemic to children in Africa and Sporadic which is more global. The Sporadic variety is attributed to Epstein Barr Virus (EBV)

Typical Symptoms include

  • Loss of appetite.
  • Weight loss.
  • Fatigue.
  • Night sweats.
  • Unexplained fever.

Vihaan is admitted to Manipal Hospital in Jaipur and is receiving treatment from Dr. Satyendra Katewa who is the head of the Department of Oncology. Vihaan’s parents have set up this link in Milaap where you can support the treatment. They have raised close to INR 9 Lakhs for the treatment while the ask for the treatment is INR 17 Lakhs. The link to the site where you can contribute is here-

Please do contribute with whatever help you can, while times are tough, and things are uncertain, it is our ability to do good, that would go a long way in establishing Ram Rajya of the 22nds century.

Do let us know if you have any questions or concerns and we would be happy to address them.

Healthcare Delivery

Surgical Case Study: Medicover Hospitals-Transcatheter Aortic Value Replacement (TAVR)

(Below is a case study from the Medicover Hospitals in Hyderabad)

A 65-year-old male with systemic hypertension presented with Class II DOE. He had undergone IVUS-guided PTCA to LMCA and mid LAD along with PTA to left ICA in 2015. He has a history of peripheral artery disease (right leg claudication), severe restrictive and obstructive lung defect, and S/P right iliac stenting (2015).

2D Echo showing calcified bicuspid Aortic valve

Further evaluation of the echocardiography revealed a bicuspid aortic valve with severe calcified aortic stenosis. He approached us for transcatheter aortic valve implantation/replacement (TAVI/TAVR). Transcatheter aortic valve replacement was a necessary option due to his high-risk surgical profile (renal dysfunction, COPD, bicuspid valve, and coronary status) and to improve his quality of life.

CT with Aortic valve dimensions

After discussion with the Heart Team (Interventional Cardiologists, Cardiac Surgeons, and Cardiac Anaesthetists), we decided to go ahead with TAVR under conscious sedation due to poor lung function. After thorough CT analysis, we proceeded with a 23 mm Sapien-3 valve, which was deployed through the femoral artery.

We used Preclose ProGlide Closure device to manage the arterial puncture site. The procedure was completed within an hour and a half, and the aortic valve gradient reduced from 107/70 to 20/11. The aortic valve was replaced in a single sitting without the need for coronary revascularization and conversion to open-heart surgery. He was mobilized within two days and discharged on day 5.

Coronary Angiographic image showing Transcatheter Aortic value implantation of 26 mm Sapiens -3 valve

TAVR is an excellent alternative for all patients with high surgical risk (STS score > 4, Logistic Euro Score > 10, Re-do surgery and post-chest radiotherapy patients, and patients with multiple-organ dysfunction).

Authorerd by  Dr. Sharath Reddy & Team, Medicover Hospitals, Hitech City, Hyderabad

Healthcare Technology

Evolving Leadership in Healthcare: In discussion with Health Tech Leader Ravi Ramaswamy

Healthcare is at the cusp of change. To drive any change, we need an evolution in the way of thinking. This tone has to be set on the top hence we need a change in the thinking of the leaders.

In the first part of the series, I am talking to Health Tech leader Ravi Ramaswamy, CEO of RV Consultants. A veteran of the health tech industry, Ravi has lead global giants like GE Healthcare and Philips to market success. Here are the extracts from the conversation.

Dr Vikram Venkateswaran:  Dear Ravi, thank you for taking time out of your schedule, and talking to me on this very interesting series. So the first question is, you know because you’ve seen it all when you started healthcare was in a different state in the country. Now today we are talking about a lot of big things. Also, you always talk about how it’s an ecosystem play. We should not think in silos; can we work together today you’re trying to bring various parties together right that’s essentially what you’re trying to do. So why do you think that new, new thinking is required on leadership for healthcare today?

Ravi Ramaswamy: Thank you for inviting me and I think this is a very important question. I think we have to look at it from multiple aspects. There is a certain play, which the technology has brought in. There is a certain play, which the players have the providers of healthcare have brought it. There is a certain play which the consumers themselves have brought in, given the fact that the, the consumer centricity has gone quite a bit.

Let’s look at other industries, like telecom, mobile phone and the associated apps have brought in a very different social connect to what is actually happening. People like my mother at 85, she reaches out to her sister for comparing notes on medicines and doctor prescriptions. This is the creation of a healthcare ecosystem of referrals and sharing medical best practices amongst two individuals

So in that sense, what you’re trying to see is the type of a social Connect, which my mother does at 85. I didn’t see when she was maybe at 65, almost 20 years back. She never even wanted a mobile phone even when I offered to buy her one.

But now with the surrounding ecosystem has grown What is it is also putting the sort of pressure on her to try and see how do she be one with the surrounding. So that is one aspect.

So, the impact of a parallel development in another sector is trying to sort of push a certain amount of growth in the healthcare space itself.

Second one is the role of internet itself.

Almost 30 years ago my boss had asked me to check for the end suppliers to one of our suppliers for printer material. I remember going to the US embassy in Delhi and spending hours there looking through the books to see the name of the supplier for the printer material and finally found it. But today it is a click of a button.

So the power of networking the power of Internet has brought to for access to data in a very different form.

Now number three is the technology itself.

The technology is evolved considerably considering where we were to where we are today.

Take the manufacturing space SMT was being introduced, way back in the 1985. In fact, the first time when I saw in 1985 floppy drive in Japan, it was aha for me, because I had never seen that before. It was just about introduced and basically a three-and-a-half-inch drive storing one megabyte of data that was a big deal for us in those days.

But then if you look at what technology has done for us. It has sort of brought in a very different. There is so much of power that is being packed in fact, a simple mobile phone, that is almost as powerful as a supercomputer of what existed in the 80s. So that is the type of compute power that you bring in and along with that, the processing power has gone up, the algorithms are better and the decision support systems that are, that are driven, that has also gone up so technology has also played a substantial role in this evolution.

Number four is the commercial business innovation, people have started coming together they have felt the need that a siloed approach is not going to work. Because as data gains pre-eminence, you find that it is going at some point in time it is going to be device agnostic.

Ravi Ramaswamy , CEO RV Consultants, EX GE Healthcare, EX Philips

Dr Vikram Venkateswaran: Very interesting train of thought- Innovation in other industries, role of internet, technology and commercial business innovation are helping us build this ecosystem in India, but what about this last statement on being device agnostic, can you help me understand that as well?

Ravi Ramaswamy: The device is only going to give you the data the balance of the insights and the interpretation is done by the software piece, and the decision support systems which run well above the devices per se. We have seen significant growth in that space as well. If you look at the industry, healthcare has gone leaps and bounds in terms of its capability in diagnostics and getting into the realm of personalised medicine.

Earlier where they used to go the doctor would say, He will take an X ray of a liver or he will do an ultrasound of a lever, and he will look, do a, a CT of Oliver, but each of these were looked at as independent polarities today what the doctor says is, hey I want to look at it as a whole.

Therefore, give me a technology by which I’m able to fuse all this to reconstruct the liver in its true form, so that I can do a much better diagnosis, and he doesn’t stop there. He says, now what I want to do is to go to a tissue level. I want to go to a molecular level, and I want to go down to a genomic level, to see what is it,

The problem, that you’re trying to fix it at the root itself. So the depth to which medicine has gone is significant. Last but not the least, you find that the competition to the traditional healthcare companies like Siemens or GE or Philips is coming, not from the big guys alone, but also from the unconventional players like the Amazon and the Google and Microsoft, which in the earlier days was simply not there.

Microsoft was never into healthcare; neither was Google into healthcare neither was Amazon into healthcare. They were happy selling their own operating system, Amazon was happy with this bookstore. But, so basically what you see is there is a complete change in the environment. And that has resulted in a very different thinking that is needed in today’s world, which simply did not exist the past. In the past did not need it. today it just needed.

Another good example are the start-ups. Yesterday when he was talking to somebody saying that they are building an app store where medical applications are put on a Play Store. From where you download the application, use it for what you need and then pay it on an asset on a per use basis, without really owning the algorithm per se. So, the business model is also evolved and therefore you find that all the changes that we talked about, you find that the conventional old leadership will simply cannot work in today’s world, and therefore the new, therefore the need for a new world for the, for our leadership in the new world.

Dr Vikram Venkateswaran: There is interesting that you bring up Amazon because today they have invested in Apollo pharmacy, for example, and it is not a new thing for Amazon because they tried pharmacies in the past, during the 90s as well, and did not succeed but now they are back and we all know that Apple as well as Google as, as well as Microsoft is coming into the healthcare space primarily on the basis of data and technology. So, how do you think this new thinking will come in. Do you think it will come from a lot of relearning and learning from the traditional firms? Do you think it will come from the technology firms, or do you think this learning will come from our educational institutions where do you think this this new learning will come from?

Ravi Ramaswamy: Let’s look at the Med tech firms and in particular CT Scans.  Med Tech Firms always priced themselves saying, I am going to bring in a certain amount of capability within the device itself for diagnostics, you started with the 8 slice, then you went for a 16 slice CP then the 32, then a 64, then a 128 and the Toshiba came out the 256 Slice CT.

The same was the case in MRI you started off with the point to Tesla, then you had a one then you had a 1.5 Tesla, then somebody brought in a 3 Tesla and that people are also at some point in time we’re talking about 7 Tesla.

So, technology has also developed. Okay, but at some point in time, you ought to realise saying that it’s like a mobile, it’s like a mobile camera, whether you have anything more than a 10-megapixel camera whether it is 10 or 100, the image resolution that you’re going to see is the same. It doesn’t matter. Beyond that, what’s going to happen is, how am I going to take that 10 or that 100 megapixels and at that point 100 Megapexel can be a pain for you because of the data size that you need to transfer over the network without any added benefits for you.

Going back to the MRI for both applications or 1.5 Tesla is more than enough for you. You don’t require anything more than that. So, given that saturation has started to some point.

The stage is taking the data and interpreting meaningful insights out of it. And that is the job is predominantly done by the doctors. And so now if you have a doctor, who are able to look at this data, and then work with the Amazon and the Microsoft or the Google, who have phenomenal analytical capability in terms of driving analytics deep learning and what have you.

Then where is the need for the med tech companies then. So you will find that at some point in time technology, I can reduce exposure rate as then because the balance of it can be done by the software.

Take for example Phillips’s MRI. On a 3 Tesla machine. It takes about 40 minutes for a head scan for a brain scan. You do one thing you under us under sample that 20 minutes. And the balance of the image reconstruction which is done by the software. So what do you go and claim to the world I am able to do a scan in 20 minutes.

Okay, so the same story, can also be done by the Amazons and the Googles of the world, in conjunction with the clinical knowledge, which the hospital provides. And therefore, you will find that unless the med tech companies themselves don’t keep pace with this sort of AI, Data Science, ML and Deep Learning and what have you, you will find that they will be left behind by the Amazons and the Googles of the world, surely because of the intelligent, the analytical the analytics processing power, that these guys otherwise have.

Dr Vikram Venkateswaran: So the next wave of leadership, you’re saying will mostly either will be technology firms like Google and Amazon or, it also might be traditional healthcare firms trying to react to this new situation and bringing in some leadership in this area?

Ravi Ramaswamy: What I expect to see going forward is issues like interoperability that have always been a question.

Now we might see a situation where even the biggies collaborating between themselves. So then the data becomes portable, otherwise they have a challenge in hand. Okay, so there is going to be a collaboration of sort between the biggies, and it is in their interest that they come up with standardised protocols

And that is because again from the customer perspective, the hospital is still telling the manufacturer that I see guys. I don’t care whether you give me an MRI or a CT, you give me a solution for a care continuum. And the moment that happens, you would want to look for the best in class equipment across the segment.

For all you know it could be a Philips cath lab, it could be a MRI from Siemens and a CT from GE. And when you want to fuse all this. The provider is going to ask for a certain amount of interoperability between these devices otherwise you’re going to put pressure on you saying I don’t need your machine. So, the very fact that the world is now headed towards a solutions play rather than a modality play is also going to put sufficient pressure on the manufacturers from an interoperability perspective, and that once it happens, will also drive data integration data portability and what have you in the future. So, there is a big sequence of events that is being sort of lined up

Dr Vikram Venkateswaran: Now a kind of counter question. Do you see any role for educational institutions in this, even the medical institutions do you see any leadership coming out of them?

Ravi Ramaswamy: Whenever I go to these campuses or wherever I sort of speak to some of these, Vice Chancellors and others a lot of people have asked me saying what are the difference between an American ecosystem and an Indian ecosystem.

One thing for sure, is the amount of interaction that a Stanford has with it’s with the ecosystem of the industry, which includes the payer, the provider and the med tech companies, you don’t get to see that in India.

Number two, the educational institutions they follow a system, or an academic system of SOP, which is more based on creating papers. Whereas, the, the latest and greatest of what the industry needs are, is never thought. And that’s possibly the reason when a new graduate joins the industry, It takes about nine months for him to even get his hands and feet wet. So from that perspective, one piece of advice that I’ve been giving these institutions is keep tab on what the industry needs are and try and see how you can build your syllabus to address that need so that when the student leaves the college he hits the ground and starts running.

Take for example security, privacy. How many of the colonists teach that year, there is hardly any, you can count.

Take Intellectual Property (IP), for example, how many people. How many colleges have even a course on IP, or even bring in a certain representation as to what an IP is intellectual property is all about data even more serious quality and regulatory hyperreal medical industry is a hyper regulated industry.

When I talk about the CDC, and FDA people turn around and ask what’s the full form. Now, that that ought to be and therefore, there is a certain amount of leadership that the educational institutions have to deliver.

There was one incident I remember when I was talking about MRI and CT, one of the professors came to me and asked me the difference between them. Now the professor himself has not seen one. So what do you expect the professor to teach the students on. So there ought to be a certain amount of sabbatical for the professor to come in, spend time in the medtech world, so that he is able to understand what the industry is heading towards he gets to absorb that portion of it so that he can go and impart it to his students. I think you really need to change the education as well.

Dr Vikram Venkateswaran: Very fascinating and great insights, then one last question what does the future healthcare leader look like, like what are the attributes he or she should have?

Ravi Ramaswamy: I see the future leader of healthcare as an interdisciplinary person who is adept in technology, as much as much as commercial innovation. He ought to be sort of embracing the start-up ecosystem and not believe on the fact that everything needs to be done in house. So, it ought to be a lot more collaborative with the ecosystem. You need to understand. You need to understand the fact that the competition for you is not coming from the traditional players but from the sort of niche and focused technology companies, and therefore we adapt and hands on in terms of playing around with technology.

So the era of people managers in healthcare is over we would need but more like a techno functional leader who is able to sort of roll, roll up his sleeves and get into the depth of it, to understand what the hell is going on, and at the same time be savvy, be smart enough to understand that certain commercial innovations have to be baked into the design process itself as it is never going to hit the road. So you need to have a well-rounded personality, and it’s going to be. It’s going to be very different than the traditional people managers whom you have seen are just sort of one functional expert coming to the top, I think that won’t work anymore.

Dr. Vikram Venkateswaran: Dear Ravi Thank you for your time

Healthcare Technology

The Virtual Blockchain in Healthcare Summit

Blockchain in healthcare has been an area of immense interest to me. I believe that a system of records available real-time would solve a lot of the issues that we see in healthcare today. As part of my efforts to build consensus and understand how Blockchain can solve some of the issues in the healthcare ecosystem, I regularly connect with healthcare leaders through events, conferences, and forums. 

Virtual Blockchain in Healthcare Symposium #VBIHS2020 is poised to be a platform where people related to the healthcare industry can gain in-depth knowledge on how blockchain can leverage the healthcare industry in present & future pandemics. It also convenes the necessary resources to drive systemic transformation and unleash the full potential of blockchain in the healthcare industry.

I am anticipating meeting around 10-15 healthcare leaders as part of the event, interacting across 4 sessions and ability to talk to more than 20 solution providers and influencers. 

I am speaking on a panel on Healthcare ecosystem and how it can leverage Blockchain, but the other topics being discussed include 

–          Blockchain & Artificial intelligence,

–          E-Health & M-Health

–          Healthcare Data Exchange

–          Pharma Supply chain

–          Blockchain Applications

Below are some additional links for the event and I’m looking forward to meeting you all there.

Social Media Links,

Event Register Link:

Healthcare Technology

Blockchain in Healthcare

Healthcare today has been adopting new technology like never before. As a result of this we have many significant developments in recent days. Let’s take for instance the adoption of telemedicine by both patients and care providers alike during the Covid 19 pandemic. It is significant to note how quickly the ecosystem moved ahead and adopted the new standards and today we have multiple consultations on telemedicine.

Similarly, the development of the Covid19 vaccine has been possible partially due to the increased collaboration between the scientific community made possible by digital technologies.

Blockchain has become a game changer in the healthcare industry. It is a foundational technology with capabilities that go way beyond the traditional IT stack. With features like immutability, digital identity, encryption and real time updates, Blockchain has many of the features that would help the industry evolve to the next level. 

Last year Priyank Jani and I wrote a paper on Blockchain where we discussed how it could be implemented in the healthcare industry. Here is the link of the paper. 

But before we go forward let me quickly discuss what is Blockchain. 

Blockchain is a continuously growing list of records, called blocks, which are linked and secured using cryptography.  Each block contains, typically, a link to a previous block, a timestamp and transaction data. Transactions have to be approved by all users of the Blockchain to be stored and modifying an older block of data is impossible. Only updating of future records is permissible making the system secure (relatively speaking) and therefore reliable. This also means an entire Blockchain can serve as a secure ledger that records transactions, negating the need for multiple disparate trails of information.

We believe Indian healthcare has most to gain from the adoption of Blockchain technology. For starters, Blockchain allows all types of data to be integrated into the chain. This means one can add not just doctor prescriptions and treatment records but also nutrition information, fitness data, and recordings from medical devices (such as for blood pressure and diabetes patients) by patients themselves. Over time the presence of such longitudinal patient data means caregivers can better interpret disease symptoms and prescribe effective treatment that is customized to work for the patient. Currently, doctors rely on data from treating different patients to prescribe medication. The chances of success for such medication are about 50%. In many cases, doctors wait for feedback from patients to change the medication. With the availability of longitudinal patient data, doctors would know in advance what treatments are more likely to suit a patient in line with his/her health history.

If implemented over a large scale, Blockchain could help significantly lower healthcare costs in India. In addition, it can give multiple parties selective access to patient records ensuring data is not compromised. A survey report by IBM outlines the following healthcare areas benefiting from Blockchain: clinical trial records, patient health records, regulatory compliance, medical device data integration, treatment records, billing and claims, asset management (for hospital assets such as beds/ equipment available), and contract management (for hospitals).

I am really looking forward to the virtual Blockchain summit that is taking place on the 9h of December 2020. I plan to discuss with the various global leaders how Blockchain can be incorporated into the healthcare ecosystem. Do register if you are interested in discussing Blockchain and building a consensus in this area. The link for registration is here- Register | BlockChain in HealthCare

Digital Health

Digital Acceleration in Healthcare: 12 Mega-Trends Shaping its Transformation

In the last few months, I have been collaborating with global thought leaders on healthcare. We have been trying to understand what are the key megatrends driving healthcare especially in the context of the digital transformation of the industry.

The paper was a brain child of Harshad Bajpai, who leads thought leadership at Techment Technology . Other contributors are Helen Yu , Jay Sanders, M.D., and Christine K Jacobs

The essence of the paper is that the traditional health care model is over! And there is no going back. Some healthcare organizations at the current crossroad will use data and digital technologies to serve patients in new, unique, and innovative ways, others will grudgingly grapple with the change to see an inevitable decline.

Technology can add an astonishing amount of value in terms of cost and quality – over US$ 500 bn, and cut down the expenditure growth by 30%; you can further add the value of innovation, and yes, the potential of health tech is boundless!

Digital technology plays an important part in ensuring the quadruple aim-Access, Experience, Affordability, and Effectiveness. In the age of Google, Apple and Amazon, patients have begun to seek healthcare in accessible, engaging, and outcome-driven formats.

Please access your free to download copy at this link: