The very mention of triglycerides or cholesterol makes us think of heart disease. Although these molecules are circulating in our blood all the time, their amount needs to be precisely controlled for us to remain healthy. A group of Indian scientists has figured out mechanism by which liver maintains a balance of triglycerides in blood.
Triglycerides are main components of fat, and molecules called very-low-density lipoproteins, or VLDLs, carry them. Although liver works efficiently to control amounts of triglycerides in blood, the mechanism by which it does so has remained unclear. Scientists at the Tata Institute of Fundamental Research Mumbai, Indian Institute of Science in Bangalore and Indian Institute of Science Education and Research in Pune have deciphered this crucial mechanism.
Researchers have identified the role of a motor protein, Kinesin, in this mechanism. Kinesin acts as a carrier of lipid droplets that contain fat molecules and assists in transport and secretion of triglycerides outside the liver cells. It has been shown that insulin regulates this secretion. Since the amount of insulin varies with food intake, so does the secretion of triglycerides into the blood.
During fasting (when we have not eaten for a long period or when we are sleeping), kinesin detaches from lipid droplets. There is no secretion and thus fat accumulates in liver while the reverse happens during the “fed state”. This maintains the amount of circulating fat in the blood. These studies have been performed on rats and the findings published recently in journal Proceedings of National Academy of Science.
Researchers are further extending this work for more in-depth studies. “We are testing how rare phospholipids control triglyceride secretion across fed/fasted states. We are also developing an invivo model where we can test the effect of disrupting the mechanism of controlled triglyceride secretion,” Dr Roop Mallik of TIFR told India Science Wire.
Apart from its role in regulating the fat secretion, the team has found that Kinesin is important for replication of hepatitis C virus that infects liver. “It is known that lipid droplets are important for HCV to replicate. We found that the Kinesin motor is required for HCV replication. Perhaps targeted interference against kinesin on lipid droplets can be used to block HCV infection. We plan to take this direction of research further”, explained Dr Mallik.
The team included Priyanka Rai, Mukesh Kumar, Pradeep Barak and Roop Mallik from TIFR, Mumbai; Geetika Sharma and Saumitra Das from IISc Bangalore; and Siddhesh S. Kamat from IISER Pune. The work was funded by Department of Atomic Energy, Wellcome Trust–Department of Biotechnology India Alliance and CSIR.
This article was first published by India Science Wire.
Putting the patient first - insights for hospitals to meet customer service expectations
These emerging solutions are a fine balance between technology and the human touch.
As customers become more vocal and assertive of their needs, their expectations are changing across industries. Consequently, customer service has gone from being a hygiene factor to actively influencing the customer’s choice of product or service. This trend is also being seen in the healthcare segment. Today good healthcare service is no longer defined by just qualified doctors and the quality of medical treatment offered. The overall ambience, convenience, hospitality and the warmth and friendliness of staff is becoming a crucial way for hospitals to differentiate themselves.
A study by the Deloitte Centre for Health Solutions in fact indicates that good patient experience is also excellent from a profitability point of view. The study, conducted in the US, analyzed the impact of hospital ratings by patients on overall margins and return on assets. It revealed that hospitals with high patient-reported experience scores have higher profitability. For instance, hospitals with ‘excellent’ consumer assessment scores between 2008 and 2014 had a net margin of 4.7 percent, on average, as compared to just 1.8 percent for hospitals with ‘low’ scores.
This clearly indicates that good customer service in hospitals boosts loyalty and goodwill as well as financial performance.Many healthcare service providers are thus putting their efforts behind: understanding constantly evolving customer expectations, solving long-standing problems in hospital management (such as long check-out times) and proactively offering a better experience by leveraging technology and human interface.
The evolving patient
Healthcare service customers, who comprise both the patient and his or her family and friends, are more exposed today to high standards of service across industries. As a result, hospitals are putting patient care right on top of their priorities. An example of this in action can be seen in the Sir Ganga Ram Hospital. In July 2015, the hospital launched a ‘Smart OPD’ system — an integrated mobile health system under which the entire medical ecosystem of the hospital was brought together on a digital app. Patients could use the app to book/reschedule doctor’s appointments and doctors could use it to access a patient’s medical history, write prescriptions and schedule appointments. To further aid the process, IT assistants were provided to help those uncomfortable with technology.
The need for such initiatives and the evolving nature of patient care were among the central themes of the recently concluded Abbott Hospital Leadership Summit. The speakers included pundits from marketing and customer relations along with leaders in the healthcare space.
Among them was the illustrious speaker Larry Hochman, a globally recognised name in customer service. According to Mr. Hochman, who has worked with British Airways and Air Miles, patients are rapidly evolving from passive recipients of treatment to active consumers who are evaluating their overall experience with a hospital on social media and creating a ‘word-of-mouth’ economy. He talks about this in the video below.
As the video says, with social media and other public platforms being available today to share experiences, hospitals need to ensure that every customer walks away with a good experience.
The promise gap
In his address, Mr. Hochman also spoke at length about the ‘promise gap’ — the difference between what a company promises to deliver and what it actually delivers. In the video given below, he explains the concept in detail. As the gap grows wider, the potential for customer dissatisfaction increases.
So how do hospitals differentiate themselves with this evolved set of customers? How do they ensure that the promise gap remains small? “You can create a unique value only through relationships, because that is something that is not manufactured. It is about people, it’s a human thing,” says Mr. Hochman in the video below.
As Mr. Hochman and others in the discussion panel point out, the key to delivering a good customer experience is to instil a culture of empathy and hospitality across the organisation. Whether it is small things like smiling at patients, educating them at every step about their illness or listening to them to understand their fears, every action needs to be geared towards making the customer feel that they made the correct decision by getting treated at that hospital. This is also why, Dr. Nandkumar Jairam, Chairman and Group Medical Director, Columbia Asia, talked about the need for hospitals to train and hire people with soft skills and qualities such as empathy and the ability to listen.
Striking the balance
Bridging the promise gap also involves a balance between technology and the human touch. Dr. Robert Pearl, Executive Director and CEO of The Permanente Medical Group, who also spoke at the event, wrote about the example of Dr. Devi Shetty’s Narayana Health Hospitals. He writes that their team of surgeons typically performs about 900 procedures a month which is equivalent to what most U.S. university hospitals do in a year. The hospitals employ cutting edge technology and other simple innovations to improve efficiency and patient care.
The insights gained from Narayana’s model show that while technology increases efficiency of processes, what really makes a difference to customers are the human touch-points. As Mr. Hochman says, “Human touch points matter more because there are less and less of them today and are therefore crucial to the whole customer experience.”
By putting customers at the core of their thinking, many hospitals have been able to apply innovative solutions to solve age old problems. For example, Max Healthcare, introduced paramedics on motorcycles to circumvent heavy traffic and respond faster to critical emergencies. While ambulances reach 30 minutes after a call, the motorcycles reach in just 17 minutes. In the first three months, two lives were saved because of this customer-centric innovation.
Hospitals are also looking at data and consumer research to identify consumer pain points. Rajit Mehta, the MD and CEO of Max Healthcare Institute, who was a panelist at the summit, spoke of the importance of data to understand patient needs. His organisation used consumer research to identify three critical areas that needed work - discharge and admission processes for IPD patients and wait-time for OPD patients. To improve wait-time, they incentivised people to book appointments online. They also installed digital kiosks where customers could punch in their details to get an appointment quickly.
These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott 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.