health check

In the news: Much-loved '20-rupees doctor' dies, bird flu reaches Karnataka and more

A wrap of health news over the past week.

On November 18, Dr V Balasubramaniam, who ran a clinic in Sidhapur area of Coimbatore in Tamil Nadu, died of cardiac arrest. The next morning, his funeral drew thousands of people, The News Minute reported.

Balasubramaniam used to charge his patients only Rs 20, earning him the moniker “ 20-rupees doctor” and the respect of thousands of people who came to him for treatment.

He started out charging his patients just Rs 2 for consultation and then gradually increased it over the years.

The crowd on the street where the funeral took place was so large that it had become difficult for policemen to control it, the report said.

WHO drops the term ‘counterfeit’ for generic medicines

In a boost to the campaign for global access to medicines, the World Health Organisation has dropped the term “counterfeit” for inferior quality Indian-made generic drugs exported to other countries, The Hindu reported.

The decision to drop the word was made on Wednesday, in a technical working group on draft working definitions of substandard/spurious/falsely-labelled/counterfeit medical products.

The WHO in a statement said that the term “counterfeit” was used in association of protection of intellectual property rights and decided to “expressly exclude the protection of intellectual property rights” in deciding on the definitions of not-of-standard drugs.

The WHO has, however, retained the word “falsified” to describe medicines of inferior quality.

The European Union Free Trade Agreement had reached a deadlock after affordable generic drugs were confiscated as illegal and counterfeit, often on their way to other South American countries.

Nearly 20 shipments of generic drugs including basic antibiotics and antiretrovirals, were detained while in transit from India to several developing countries via Europe between 2008-2009.

Leena Meghaney, South Asia head of non-profit, Médecins Sans Frontières, told the Hindu that generic drugs were labelled as counterfeit, creating a confusion that had taken away attention from substandard medicines.

Medicine shortage for patients with Wilsons’ Disease continues

Patients suffering from Wilson’s Disease – a genetic disease that prevents the body from removing extra copper – are facing an acute shortage of life saving drugs in the country, a Times of India report said.

High copper levels in the body can cause life-threatening organ damage. The drug, D-penicillamine, prevents poisonous accumulation of copper in the body.

Doctors working with patients suffering from the disease said that there has been a shortage of drugs since June.

D-penicillamine was placed under Drug Price Control Order a few years ago. On September 30, the Central Drug Standard Control Organisation held a meeting of selected drug makers to discuss the non-availability of the drug.

On September 30, the central drug regulator – the Central Drug Standard Control Organisation – convened a meeting of select drug makers to discuss the non-availability of D Penicillamine.

According to an online petition by Piyush Gattani, who suffers from Wilson’s Disease, the reason for the “real or artificial” shortage of this drug is the fact that the drug’s price has been fixed at Rs 138 per strip of 10 capsules. He said that it is no longer cost-effective for pharmaceutical companies to sell the medicine, as it is imported at a high cost to India and then capsuled.

Bird flu outbreak in Karnataka

After Delhi and Madhya Pradesh a birdflu outbreak has been reported in Karnataka, the World Organisation for Animal Health told Reuters on Friday.

The organisation confirmed that the Indian government confirmed H5N8 strain of the virus among birds in the village of Itagi, and 15,93 birds were at risk from the disease died or were culled.

In October, birds from National Zoological Park and other parts of Delhi and Madhya Pradesh’s Gwalior Zoo had died of avian flu. Experts had said that there is no reason to panic as the virus does not spread to humans easily.

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What hospitals can do to drive entrepreneurship and enhance patient experience

Hospitals can perform better by partnering with entrepreneurs and encouraging a culture of intrapreneurship focused on customer centricity.

At the Emory University Hospital in Atlanta, visitors don’t have to worry about navigating their way across the complex hospital premises. All they need to do is download wayfinding tools from the installed digital signage onto their smartphone and get step by step directions. Other hospitals have digital signage in surgical waiting rooms that share surgery updates with the anxious families waiting outside, or offer general information to visitors in waiting rooms. Many others use digital registration tools to reduce check-in time or have Smart TVs in patient rooms that serve educational and anxiety alleviating content.

Most of these tech enabled solutions have emerged as hospitals look for better ways to enhance patient experience – one of the top criteria in evaluating hospital performance. Patient experience accounts for 25% of a hospital’s Value-Based Purchasing (VBP) score as per the US government’s Centres for Medicare and Mediaid Services (CMS) programme. As a Mckinsey report says, hospitals need to break down a patient’s journey into various aspects, clinical and non-clinical, and seek ways of improving every touch point in the journey. As hospitals also need to focus on delivering quality healthcare, they are increasingly collaborating with entrepreneurs who offer such patient centric solutions or encouraging innovative intrapreneurship within the organization.

At the Hospital Leadership Summit hosted by Abbott, some of the speakers from diverse industry backgrounds brought up the role of entrepreneurship in order to deliver on patient experience.

Getting the best from collaborations

Speakers such as Dr Naresh Trehan, Chairman and Managing Director - Medanta Hospitals, and Meena Ganesh, CEO and MD - Portea Medical, who spoke at the panel discussion on “Are we fit for the world of new consumers?”, highlighted the importance of collaborating with entrepreneurs to fill the gaps in the patient experience eco system. As Dr Trehan says, “As healthcare service providers we are too steeped in our own work. So even though we may realize there are gaps in customer experience delivery, we don’t want to get distracted from our core job, which is healthcare delivery. We would rather leave the job of filling those gaps to an outsider who can do it well.”

Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

  • Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.