Categories
Public Health

Diabetes levels drop marginally in India as per Novo Nordisk Foundation Study

Diabetes is a cause for greatest concern in India. The reason for that is many fold. But the most prominent among them is that diabetes is the foundation on which many other diseases come into play. As you know, diabetes is a condition and not a disease, and usually starts with the body’s inability to maintain the insulin level in the blood. As you know, diabetes is a condition and not a disease and usually starts with the body’s inability to maintain the sugar levels in the blood.

This could be a result of genetic makeup or also from the pancreas inability to produce insulin. But the most common co factor is stress. In 2018 Novo Nordisk had launched a diabetes impact challenge, in which they wanted to maintain a diabetes index to measure the HPA one c levels in the body.

HbA1C measures the Association of the glucose molecule with the red blood cell. As a red blood cell has a life of 120 days. This measure gives us an average of the sugar levels in the body for 120 days, and it’s a much better, and reliable measure of the sugar levels as compared to fasting, and post prandial blood sugar levels that were used earlier. In its recent finding the Novo Nordisk Foundation which produces this result figured out that from October 2019 to September 2020. The HbA1C levels have marginally dropped in India. Currently they are at 8.48 per cent. They ideally should be below 6.

By, the average HbA1C once he level was recorded at 8.48% for the year from October 2019 to 20. But this collection happened over 30 Indian cities with a vast average respondent rate of 55 years, or which of the 57% were men and 43% were women. Again you can see the testing levels among women are less and this is another area of concern.

The Indian diabetes care index which was also launched in 2018, to improve the diabetes care in the country has been providing a real time view of the average HbA1C levels in India.

According to the Novo Nordisk foundation, there are more than 77 million diabetics in the country. And the country, the total spend on diabetes is around INR 64,000 crores.

The second issue that comes up is that with COVID-19, it is clearly proven that anybody with comorbidity or with underlying conditions like diabetes, was more predisposed to, you know, to health issues. And it is clearly established that diabetes affects a lot of body parts, especially extremities like hands and feet, heart, circulatory system, and your kidneys. Your eyes, and overall suppresses your immune system.

I have written about diabetes and its implications on health, many times earlier, including these articles which you can refer to help you get a better understanding of what can be done.

What does this mean for you?

1)      Monitor-  I think 55 is a bit too late to check what your sugar levels are. The most important thing is to start monitoring it from the mid-30’s onwards. If India has risen to 71 million diabetics overnight. It is primarily because the awareness has increased. And the constant checking is possible.

2)      Detect- Get a blood sugar monitor machine. I think it’s very important, a very good investment, along with a Blood Pressure machine. I think these are solid investments that you should make, whether you have an HDTV or the latest Apple gadget. It doesn’t matter but these schedules can really save your life.

3)      Reduce Stress- Diabetes is related to stress to great extent, higher stress higher sugar levels, and higher and lower the body’s ability to deal with the sugar let’s see where is it that is causing stress for you and how you can mitigate it, you might do yoga and meditation to manage the stress, but the ultimate aim should be eliminate the source of stress.

4)      Watch out for added sugar- Last but not the least, which is sugar intake added sugar is the biggest reason why insulin intolerance is happening in the body. So, it is important to figure out if there is added sugar that you are eating which you are not aware of, which could have been causing this problem.

5)      Exercise if your medicine- Workout in the open for 150 minutes a week. This could be a simple walk or cycling or swimming.

As always, it is important for you to stay healthy. Stay safe. Own your health. You have to do it; nobody else will take care of.

Sources: https://www.biospectrumindia.com/news/79/17555/average-hba1c-level-registers-marginal-improvement-in-india.html

Categories
Public Health

Closing the Oxygen Gap in Covid19

Oxygen is essential. It is a key treatment for a wide range of diseases that affect all parts of the population—but it’s often overlooked in health system planning for a number of reasons. It is both a medicine and a device, has complex delivery infrastructure, requires proper training for health workers and sustainable maintenance plans for oxygen equipment, and should be supported by sufficient budget.

While medical oxygen remains an essential commodity for improving a variety of health outcomes, the COVID-19 pandemic has spotlighted its importance as the first line treatment for COVID-19 patients struggling to breathe.  However, many countries, including India, face a gap in access to medical oxygen, leaving many health facilities in these communities unequipped to meet the level of patient demand.  

The COVID-19 pandemic has spotlighted the role of medical oxygen as a lifesaving therapy for patients struggling to breathe. It also pushed to the surface the long-existing issue of oxygen access gap, as it created an overwhelming demand for oxygen technologies and supplies across many health facilities in LMICs.

Closing this gap will require an integrated set of solutions and investment in strengthening the oxygen delivery systems, including resilient oxygen markets—from demand planning to financing to supply and distribution systems. PATH the Chicago based Not for Profit organisation has been working in India for many years. In the past they have worked on areas like providing contraception to remote areas of the country by tying up with India Posts, you can read that story here- Link.

Now they have launched the “Markets Matter: Closing the Oxygen Gap” initiative, this campaign puts a spotlight on the role that efficient markets play in scaling up #OxygenAccess. Now is the time to add your voice and help close the oxygen gap!

We have a chance to move some of the solutions forward now to ensure a rapid response to the pandemic, as well as build a sustained platform for the future. Now is the time to use our voices to elevate these important messages about the need to prioritize oxygen access amidst the COVID-19 pandemic – and beyond.  

You can get involved as well, please download the campaign material from this link and share it within your network. Looking forward to all your support.

Categories
Healthcare Delivery

Neuroendocrine Tumours: Management and Treatment

Do you know what is common to Steve Jobs and Irfan Khan? Well apart from the fact that both were brilliant individuals and masters of their field, they also suffered from Neuroendocrine Tumours and died as a result of those.

Steve Jobs – Source CNBC

So what is a Neuroendocrine Tumour?

A Neuroendocrine Tumour or NET is a specific tumour affecting the endocrine glands. Specifically a variant known as the Carcinoid Tumour is very common and lethal. It affects the Gastrointestinal Track (Stomach), Intestine, Lungs, Pancreas, Testicles and Ovaries.

This is the distribution of the NET – Carcinoid Tumours

  • Intestines -39%
  • Rectum-15%
  • Lungs -10%
  • Appendix -7%
  • Colon-7%
  • Pancease-3%
  • Liver-1%

Both Steve Jobs and Irfan Khan has the variety that grows in the Pancreas. Interestingly NETs strike later in life mostly around the 50s and 60s. Also there is a misconception that NETs are benign, but in reality there is nothing like a benign NET, according to Dr P Jagannath at Lilavati Hospital, this misleading information was one of the reasons Steve Jobs did not aggressively treat his condition when he was diagnosed.

The Treatment

  1. Surgery- The number one line of treatment seems to be surgery. This is specially if the tumour is detected early and has not spread. Another minimal invasive surgery is Laparoscopic surgery.
  2. Radiation- If the NET has spread then radiation is the best line of treatment. Both external beam radiation and internal beam radiation called brachytherapy are options that are available.
  3. Medication- A new medication called Everolimus has emerged on the scene that controls the tumour for a long time.

Innovation in treatment and therapies

1) PPRT – Peptide receptor Radionuclide Therapy – A radio isotope based therapy is showing good result specially in Pancreatic NETs, acts like a magic bullet just eliminating the cancer leaving the other healthy cells intact.

2) DOTA NOC – Scanning method is specifically helpful in treating gastrointestinal NETs.

The diagnosis and successful cure of NETs depends on early detection. The symptoms depend on the site of the tumour. Example in cases with Pancreatic NET, patients might see dizziness and increased fainting as blood sugar levels are not in line with the expectations as the tumour releases Insulin.

In conclusion, India has made many advances in the detection, cure and management of NETs. There is a registry of NET cases with the India chapter of the Asia Pacific Neuroendocrine Tumour Society. Also hospitals like Lilavati, KEM, JJ Hospital are all leading the charge on the treatment of NETs.

Categories
Dental Practice

Dental Practice Management- Strategy

Dental Surgery is a key part of the healthcare ecosystem. If you look at it closely we see that most of the health and wellness starts from digestion and the entire process of digestion starts from the mouth. Dental Surgeons play a very critical part of the ecosystem.

I took some time last week to put out a series of videos to help dentists to relook at their practice and their clinic. Here is a brief highlight on the first in the series- Strategy.

Strategy is a key to a successful business, a dental clinic is no different. The first step is

  1. Think Local, Act Local – It is important for the dentist to look at his local ecosystem, and understand the people that live in 2-5 KM radius of the clinic. Attention needs to be paid to their demographics, Age , Gender and Lifestyle.
  2. What Dental Services Would they Need- The next step is to extrapolate what services these communities would need. For example if there are many senior citizens living in that area, they may need more of Prosthodontic services.
  3. Finally Are you in a position to provide those services?- This is a critical step. If the demand is there but you are unable to supply it then it is best to look at another area. The services should be close to your core competency and your ability to provide them will be the key to success.

Please do let me know your your thoughts and ideas and I will be happy to respond to them. I will be sharing a lot more of my thoughts on topic in subsequent posts.

Categories
Healthcare Technology Uncategorized

Patient Experience in the Digital world

In January 30 2020, India recorded its first case for Corona Virus popularly known as Covid19. Since then India has seen a series of lockdowns and as we inch towards somewhat of a partial recovery, the question around the state of our healthcare system has become centre stage again.

Since the 1940’s where the Bhore committee gave its recommendations for developing the healthcare structure in India, as a nation we have been playing catch up with demand far exceeding the supply in terms of doctors, diagnostic equipment, hospital beds and medicines.

In addition the wellness programs have been struggling and preventive measures have not been very successful. In this context the corner stone of the healthcare system in India has become the hospital.

What determines a successful healthcare intervention is patient experience. Today with the advent of telehealth and the guidelines given by Medical Council of India, it becomes even more important for hospitals to focus on patient experience and add to the growth of the industry.

What determines a successful healthcare intervention is an excellent patient experience #Healthcare #DigitalHealth

What is Patient Experience?

Private hospitals have long tracked patient satisfaction ratings, but they didn’t always carry great significance. While all hospitals want happy patients, most hospitals have been historically plagued with the “doctor knows best” mentality — a mentality where clinical outcomes outweigh “touchy-feely” indicators such as patient satisfaction or overall patient experience.

However, in recent years, some leading institutions in India have begun to focus more heavily on providing an outstanding patient experience. Drivers for this include growing consumerism and transparency for healthcare services and increased interest from both consumers and providers in patient-centred care.

Why Patient Experience is important to Hospitals?

Healthcare consumers increasingly view their experience with a provider as a key consideration for determining if they’ll return to or recommend the provider, largely because it remains one of the few ways consumers can differentiate providers. Over the past few decades, clinical outcomes have improved dramatically, and patients no longer view favourable outcomes as a key differentiator as these are expected. What remains is the patient’s overall experience, which encompasses everything from customer service to patient-centeredness and care coordination among providers. 

Also given the growth of Tele Health, it would become even more important for hospitals to focus on patient experience in order to create a favourable experience and create the hook that would bring patients and others in the community back to the hospital.

The key is how you make the patients feel

Key Parameters of Patient Experience in a Hospital

While there are many parameters that determine patient experience, we have tried to list down a few key ones that might influence the satisfaction index more than the others.

  1. Patient Appointment Experience
  2. Patient Online Portal
  3. Social Media and Digital Out Reach
  4. Facility for the In-Patient Service and Emergency Service
  5. Patient’s Access to medical Records
  6. Patient Information
  7. Clinical Outcomes
  8. Value Added Service

“The art of medicine consists of amusing the patient while nature cures the disease”

Voltaire

While many of these parameters are difficult to understand or assess, as part of this report we have identified Social Media as a parameter that we would like to evaluate. In order to do so, we have identified 6 Hospitals across India. These hospitals are

  1. AIIMS
  2. Apollo Hospitals
  3. Fortis
  4. Manipal Health
  5. Narayana Health
  6. Kokilaben Dhirubhai Ambani Hospital

We have tried to mix it up between hospitals from the government sector and private sector and also among general hospitals and super speciality hospitals. Below is our analysis of the key parameters between the social media presence of these major hospitals.

I believe that Social media is an indicative parameter. It shows whether there is a foundational maturity in the digital program of the hospital. Also, a lot of patient experience is visible by the comments and interactions with the hospital’s social media channels.

The findings of our analysis are captured in the report below.

Download the Report

Would be happy to discuss and see how you can build your digital experience for patient engagement. Do write in to discuss.