In the news: New ‘test and treat’ HIV policy, Cipla vs the pharma pricing regulator and more

A wrap of the health news over the past week.

New HIV policy

On Friday, the government launched a new policy for the treatment of people with HIV and AIDS. The national AIDS control programme will now treat anyone found HIV positive, irrespective of their CD4 count.

CD4 T cells are immune system cells that are targeted by the Human Immunodeficiency Virus. So far, the government has been providing free treatment to only those with CD4 counts below 500 and therefore at greater risk of contracting serious illnesses because of their compromised immune systems. Health Minister JP Nadda announced of Friday that as soon as a person is tested and found to be positive, they will be given antiretroviral therapy, irrespective of their CD count or the clinical stage of the illness.

There are and estimates 21 lakh people in India with HIV infection but only aout 14 lakh have been identified. In view of this, the government has also revised testing guidelines to reach out to vulnerable communities and, after counseling them anf with their consent, test members for HIV.

Health groups have welcomed the government’s decision to expand free treatment for HIV and AIDS. Director of UNAIDS for Asia-Pacific Steve Kraus told The Hindustan Times that the new policy would help contribute towards the goal of ending AIDS in India by 2030. The AIDS Society of India has also applauded the government’s move.

The government is also developing a National Strategic Plan for HIV control for the next seven years with the aim of ending AIDS in India.

Meanwhile, the global charity AIDS Healthcare Foundation launched a free condom store in India and the world, with the aim of reducing the number of new HIV infections. The store called Love Condoms allows organisations and individuals to place orders by phone or email to get condoms delivered to their doorsteps in any major city in India.

Cipla takes on NPPA on asthma drugs

On Saturday, the Delhi High Court sought the government’s response to plea by pharmaceutical company Cipla that the government had erroneously capped the prices of three asthma drugs, the Hindustan Times reported.

Cipla has contended that the National Pharmaceutical Pricing Authority or NPPA in a notification on April 1 “wrongly attempted” to apply the ceiling price for metered dose inhalers to the powdered form of the three drugs. Metered dose inhalers make the drug available in aerosol form.

Cipla’s advocates claimed that the authority capped the price of the powdered form of the drugs without following the procedure laid down in the Drug Price Control Orders, 2013. The powdered form of the drugs are are sold under the brand names Budecort, Tiova Rotacaps and Foracort.

During the hearing, the court asked the government whether the NPPA had made such a mistake to which the government’s counsel said that the powdered drug had not been erroneously clubbed with metered dose inhaler in the notification revising the cap on their prices. The court has now issued a notice to the Ministry of Chemicals and Fertilisers and the NPPA and sought their replies by the hearing on May 12.

Delhi to prepare for dengue

Anticipating outbreaks of vector-borne diseases later this year, Delhi’s Lieutenant-Governor Anil Baijal has directed hospitals and medical institutions to keeps beds ready for dengue and chikungunya patients. Baijal was visiting Lok Nayak Hospital, GP Pant Institute and the Guru Nanak Eye Centre on Saturday to check on health facilites when he issued these directions.

The medical superintendent of informed Baijal that wards had been set aside for dengue and chikungunya patients. Baijal also instructed the hospital to ensure that patients with complications, like the elderly, were attended to with care.

Delhi has already seen 27 dengue and 79 chikungunya cases till mid-April this year. The city witnessed one of its worst outbreak of the two diseases last monsoon season with a total of 4,431 dengue cases and 7,760 chikungunya cases reported.

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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 marketing team and not by the editorial staff.