Monday, 26 May, 2008


ASSO/PR/527 May 26, 2008
Easy access of Visa facilities often permitted by India to overseas patients coupled with best emerging medical infrastructure facilities in its large and tertiary towns, prospects of India Medical Tourism becoming a lead foreign exchange earners will grow to an extent of Rs. 8000 crore by 2012.
The above findings are arrived at The Associated Chambers of Commerce and Industry of India (ASSOCHAM) on Prospects of Medical Tourism for Higher Forex Earning' under the supervision of its Health Committee chaired by Chairman, Sir Ganga Ram Hospital, Dr. B K Rao in which other lead doctors from Medicity Moolchand, AIIMS, Max etc. are involved.
Releasing the ASSOCHAM estimates, its President, Mr. Venugopal N. Dhoot pointed out that currently, the earnings accrued through medical tourism annually are estimated at Rs.3500 crore.
"The primary reasons as to why medical tourism would flourish in India include much more lower medical costs for various ailments such as bone narrow transparent, bye-pass surgery, knee surgery and liver transplant as compared to western countries".
As a result of higher and very expensive medical costs in the western countries, patients from economies of scale including Africa, Gulf and various Asian countries have started exploring medical treatment in hospitals located in various well-to do places in India because its medical infrastructure has geared up to provide them non-subsidized medical treatment at much more lower costs which are many times considered reasonable, adds Mr. Dhoot.
The other reasons as to why India would emerge as a lead hub for excellent medical treatment is because of its strength of highly qualified medical professionals and even equally higher qualities of availability of nurses. India has about 7 lakh qualified doctors and numbers of qualified nursing graduates and diploma holders are equally good and of high professional caliber who are content and satisfied with reasonable professional feels.
A comparison of treatment costs is given in the tabulated form, comparing India's cost of medical treatment with countries such as USA, UK and Thailand :
Comparison of Treatment cost ($)
Medical Treatment
Bone marrow transplant
More than 2,00,000
Up to2,00,000
Up to 62,500
Bye – pass Surgery
15,000- 20,000
Around 20,000
14, 250
Knee surgery
Liver transplant
This said Mr. Dhoot is the major advantage which works in favour of India as a result of which movement of patients from various developing and developed countries would shift towards India as its hospital infrastructure is not only confined to large metros but equally getting better in tertiary towns in which the cost of living is still lower with quality of supreme nature.
Still other reasons for medical tourism getting wide spread in India is because of its strength of traditional treatment in homeopathy, naturapathy, ayurvedic, unani etc. which are becoming popular because of their non-side effects, said Mr. Dhoot.
The Indian healthcare policy is getting adequately recongised from the policy makers as in India health spends in proportion to its GDP is about 1% which the government is gradually trying to increase. The increase in health GDP ratio would amount to proliferation of new health facilities as well as their centres for patients and such centres of excellence will finally be able to accommodate overseas patients as with increasing health facilities, its health infrastructure would still move for better and find acceptance in great deal of patients. Therefore, the prospects of medical tourism in India would be of super facilities and holds an excellent future, concluded Mr. Dhoot.
Source: Koteshwar Prasad Dobhal

Friday, 16 May, 2008

Revenue Cycle Management Healthcare


The Indian share of BPO revenues from the offshoring of revenue cycle management (RCM) services is estimated at USD 125 million for the year 2006. This report Research the total revenues from this segment to reach USD 410 million by 2011.
Two of the “core” processes in revenue cycle management (RCM) services are medical coding and billing. In this report, we have discussed billing and coding within the context of RCM services. The emphasis (and estimates) for this report relate to medical coding and billing. Medical transcription, which is another “specialized” service not offered by “generic” BPOs has not been covered in this report, and revenue and manpower estimates exclude medical transcription.
The RCM industry in India is still at a nascent stage. While there are certain large vendors offering end-to-end RCM services such as Perot Systems, Apollo Health Street, Zavata and Ajuba there are few others focused on offering certain specific services such as medical coding, payment posting, accounts receivable, etc.
It has been recognized four vendors as potential winners in this space: Ajuba, Apollo Health Street, Perot Systems and Zavata.
The report provides an overview of the buyer scenario and an in-depth analysis of the Indian vendor space along with profiles of major industry players. The report is designed to help:
US hospitals, physician groups and US based RCM companies looking to outsource/offshorePotential vendors / facilitators to assess opportunitiesOutsourcing consultants to evaluate and compare the offerings of vendorsOutsourcing consultants to evaluate and compare the offerings of vendorsResearchers looking for detailed information on RCM offshoringThis study is based on secondary data as well as extensive interviews with key people at various BPOs (captive as well as third-party) in India.
Source :

Why To Invest In INDIAN Healthcare?

Healthcare delivery is one of the largest service-sector industries in India
Estimated revenue of about US$30 billion (FY 2006)
Industry growth at over 12% p.a. in the past four years
Large domestic market complemented by the inflow of medical tourists
Medical tourists have increased almost twenty-fold from 10,000 in 2000 to about 1,80,000–2,00,000 in 2006

The industry is fragmented with a large number of independent, privately-run hospital and healthcare centres
Private healthcare providers account for almost 70%-80% of the total spend
Government sector and corporate employers account for the rest
Private sector corporate entities like Apollo Hospitals, Wockhardt Hospitals and Fortis Healthcare have aggressive expansion plans
Indian hospitals are gaining reputation globally as ‘quality’ service providers
Many Indian hospitals have secured accreditation from the British Standards Institute and Joint Commission on Accreditation of Healthcare Organisations
NHS, UK has indicated India as a preferred destination for surgery.

100% FDI is permitted for all health related services under the automatic route
Infrastructure status accorded to hospitals:
Lower tariffs and higher depreciation on medical equipment
Income-tax exemption for five years to hospitals in rural areas.

Top Private Healthcare Providers in India

Player Revenues (US$ million) Number of Hospitals Beds
Apollo Hospitals 212 (2007) 45 4,148
Wockhardt Hospitals 37 (2006) 8 1,390
Fortis Healthcare 30 (2007) 13 1,790
Manipal Group NA 16 5,659
Source: Company websites, Capitaline Database

The industry is expected to grow at 15% p.a. to US$60 billion by 2010
Medical tourism is expected to become a US$2 billion industry by 2010
Significant growth in healthcare BPO: Expected to become a US$4.5 billion industry by 2008

High growth domestic market arising from:
Increasing health awareness: Share in total private consumption expenditure has increased from 3.5% (1993-94) to 5.3% (2000-01).
Expected to increase further
Increasing penetration of Health insurance
Rapid growth in private sector companies owning and managing hospitals
High growth in medical tourism
Cost of comparable treatment is on average 1/8th to 1/5th of those in western countries
Opportunities exist in multiple segments along the value chain
Service Providers: Curative and preventive in primary, secondary and tertiary care
Diagnostics Services: Imaging and pathology labs
Infrastructure: Hospitals, Diagnostic centres
Health Insurance: Less than 10% of population is covered by health insurance. Medical Insurance premium income is expected to grow to US$3.8 billion by 2012
*44% growth in Health Insurance during 2006-2007
Healthcare BPO: Medical billing, disease coding, forms processing and claims adjudication
Training: Large opportunity for training doctors, managers, nurses and technicians
Investment opportunity of over US$25 billion by 2010

Source: IBEF, Indian Healthcare Foundation, India Country Commercial Guide 2002

Sunday, 11 May, 2008

India's foray into telemedicine face difficulties

India's attempts to make a foray into the world of telemedicine has not made much headway, especially due to foreign data processing laws and difficulties in certification of qualifications of Indian telemedicine providers, the Planning Commission has said. Rising costs and dearth of medical personnel have created pressures for public health care providers in developed countries to explore the possibility of electronic delivery of services across the borders and they looking for opportunities to outsource diagnostic services to private health care providers. What is relevant is the emergence of opportunities for Indian service providers to supply telemedicine services to developed countries in such segments as diagnostics, dermatology, opthalmology and psychiatry, a high-level group of the Commission observed in a report. The group notes that a number of telemedicine centres are already operating in the country. In 2001, the Indian Space Research Organisation launched a pilot project that connects 78 hospitals in remote areas to super speciality hospitals in the cities. In a recent study it has been reported that supply of telemedicine services from India has not taken off in a big way, except to the United States and Singapore. The client base of telemedicine business in the US has increased in recent years to scores of hospitals and the National Healthcare Group of the Singapore has tied up with Indian telemedicine institutes for providing teleradiology services to designated hospitals in Singapore, the study said. The potential with respect to the European Union has not been translated into actual business as yet on account of a number of factors such as data protection laws of EU members states and difficulties in certification of qualifications and accreditation of Indian telemedicine providers by the authorities in EU member states. There are issues as well that come in the way such as malpractice policies, liability insurance and jurisdiction issues for settling disputes that might arise. One of the main problems impeding growth of supply of telemedicine services by Indian service providers is the large variation in the quality of medical professionals with graduate and post-graduate qualifications produced by institutions across the country, which is a major constraint in receiving recognition from oversees medical authorities, the report said. However, with the government's decision to recognise degrees from foreign universities of English speaking countries, the problem would be addressed to a large extent. Telemedicine has also opened up possibilities of professionals providing expert healthcare services in remote rural areas from their locations in cities, the report said.
Source: economic times

Medical Tourism in India- Benefits and threats

Our ancestors traveled to hot springs and other water bodies for their medicinal value. Rich and famous especially from developing nations have always traveled to advanced countries for the best treatment. But today, these journeys seem to have another purpose, holidaying, and are categorized as ‘medical tourism’. Another peculiarity is reversal of tourist traffic from developed nations to third world for cheaper treatment. But it is confusing how a sick person can be on a holiday and enjoy leisure like any other tourist. Ignoring this fundamental question, medical tourism is being promoted across the world.Medical tourism, an unexplored segment, is still in its infancy in India. About one and half lakh tourists visited India in 2003 for special treatment and/or advanced surgery, as compared to one million to Thailand, and they have mixed response and experience. This figure increased by about 30,000 in the following year in India. They prefer India because it is affordable as compared to treatment in their own countries. Private hospitals are making deliberate efforts to attract medical tourists for better profits. The Ministry of Health and Family Welfare and the Ministry of Tourism have set up a task force to design a strategy for health tourism. However, popularity of traditional Indian medicines is no more a secret. Kerala has been offering ayurveda services from many years to both international and domestic tourists. OpportunitiesAs per a study conducted by McKinsey & Company and Confederation of Indian Industry (CII) India can serve one million medical tourists every year and generate revenue ranging from INR 50 billion to INR 100 billion by 2012. Its biggest pull is lower costs even for advanced treatments. One pays a fraction of what one spends in the West. India can offer a bunch of services including ayurveda, homeopathy, mediation, yoga, and allopathy for better living and enhanced health benefits unlike any other medical tourism destinations.
If these estimates are to be believed, there would be many consequent benefits and opportunities to be harnessed skillfully as motive and needs of a leisure tourist and a medical tourist are diametrically opposite. A leisure tourist visits India mainly for fun and relaxation, while a medical tourist wishes to get rid of an ailment. A comprehensive and dynamic approach is required to serve this new breed of tourists. An alliance of various sectors including tourism, pharmaceuticals, hospitals, hotels, food suppliers to hospitals, restaurants, etc is a must. Hospitals need to cater to specific food habits of medical tourists from different cultures. Hotels have to provide rooms with extra/special facilities and specially trained staff to look after their ailing guests or patients recuperating from surgery or other medical procedures. Private hospitals are likely to generate huge profits which would be considered as exports. In view of success of private ventures, public hospitals’ management may have to pull their sock up to capture a small piece of the cake. Finally, some of public sector hospitals may become better places for both domestic and international patients. The tourism players would have another category of tourists to look after and extra source of income. However, medical tour packaging needs collaboration with different principals like hospitals besides the traditional ones. Multiplier effect would be strong and have wide spread reach. Development of medical tourism segment would help, to some extent, in reversing the brain drain especially those of doctors and other medical staff as hospitals with foreign trained personnel would be preferred. With increasing number of patients, new jobs at various levels would be created. Hospitals may acquire a status of ‘Hospital-cum-Hotel/Medical Hotels/ Treatment Hotels/Health Hotels’. Another reason to travel abroad is need for immediate treatment for which they might have to wait for a few months to a year in their own country. Non residents of India (NRI), people from poor countries (Bangladesh, African nations) and developed nations could be prospective client for the Indian health-care sector. ThreatsThis vibrant picture has many holes warranting serious attention of major stakeholders. To begin with, ‘medical visa’ and associated immigration norms need attention. Increase in demand for medical services from foreign tourists may lead to price hike. It may adversely affect Indians who are not as rich as foreign tourists earning in dollars/GBP/Euro and can certainly afford to pay a bit of extra for treatment as compared to locals still saving substantially. The image of India vis-à-vis other Asian countries is not that strong. I wonder how tourists who otherwise fantasize India as a country of laidback attitude, underprivileged, and poor hygienic condition would like to be treated in Indian hospitals just for the sake of lower cost. The number of medical tourists to India would also depend on how many patients are actually willing and can afford to travel abroad when they are sick. This reminds me of one incident (there are many more) that may also happen in hospitals and may have far reaching implications. I bought a leather purse from a shop in Colaba, Mumbai. I handed over seven notes of one hundred each to the shop keeper and was expecting forty five bucks back. But he returned only forty. When I counted and found five less, I checked with him whether there was a mistake in counting/billing. He replied with a broad smile, no we mainly sell to foreigners and they do not demand small change. He found the demand strange as INR 5/- has no value probably for foreigners and those catering to them. If same thought occupies hospital owners and staff, what will happen to Indian patients who earn far less than their counterparts in developed countries? Preference would be given to foreigners for the sake of profits as private hospitals are eyeing at medical tourism segment to increase their profits like other business communities. This needs to be dealt with in advance. In local health care sector, as existing infrastructure is not sufficient to fulfill the needs of Indians, arrival of foreign patients would add more competition and difficulties. Star hospitals’ capacity is under-utilized, while public hospitals are over crowded. Especially a technology based approach would hit common Indian hard as many of them can not afford advanced technologies imported from the West. Why health care providers and governments of countries from where medical tourists hail would let their business go to their rivals? For instance, British government has already taken preventive measures by putting three hours flying limit for patients wishing to visit foreign medical destination. To become the leading medical tourism destination, India needs special infrastructure, good connectivity between principal cities, fast immigration process, accreditation of Indian hospitals and world class hospitals. Further, how the Indian government plans to handle cases of medical negligence as one bad case/incident draws undue flak from developed nations. What about post treatment/surgery issues after returning to homeland? Whether patients can afford to come again and again to India if needed? What about tourists suffering from contagious diseases? Estimates for medical tourism sector look very optimistic but to achieve them requires resources and serious commitment. All stakeholders have to ensure that foreign patients should not be given undue importance overlooking locals as it would set a bad precedent on the pretext of ‘Athithi Devo Bahav’.
Source: Associated content

Sunday, 4 May, 2008

RFID and Healthcare India

Imagine the hospital of the future where unnecessary expenses will be cut and more patient lives will be saved. Say goodbye to the inefficiencies of the old hospital and welcome the new, highly cost-effective system of asset and personnel tracking, patient care, and billing, the keystone of which will be radio frequency identification (RFID) technology.
RFID envisions such a world. The applications for the healthcare industry are several, asset tracking, patient tracking, staff location, baby monitoring, blood bank distribution, etc. Here I define two such applications:
Asset Tracking:Healthcare facilities invest CRORES of Rupees in upgrading and maintaining expensive equipment that aid the healthcare professional in the diagnosis, treatment and monitoring of patients. It is incumbent on these professionals to maximize the use of such machines to maintain cost controls and yet meet the ever evolving and extremely dynamic needs of the patients. When the equipment needed is not readily available this leads to many undesirable outcomes:
(1) Staff are then sent scrambling through many corridors, sometimes over many floors to find the equipment they need,(2) The Facility procures added machinery that taxes capital resources while existing assets remain under-utilized and(3) The patients very well being could be at risk without the machine available at the time it is needed.
RFID technology solves all of the above by simply affixing an RFID tag to the equipment and strategically locating readers throughout the area of operations where the hardware is needed. In this way, as the device passes through a read point, it is registered in the applications software in real time to be in that area. In this way, staff will know what area of the facility each piece of equipment is located when they really need to have it. The results are less time wasted for healthcare professionals scrambling to find equipment, better utilization of existing assets that reduces capital expenditures and most importantly, a patient gets the best care available reducing the likelihood of liability because of poor health care services.
Patient Tracking Solutions:Hospitals and Health Care facilities are more concerned these days about having the ability to accurately track their patients. Whether its dispensing medication or identifying the individual for procedures or pulling up a history of treatment on a patient; RFID technology is a way to manage the information much more efficiently.
An RFID system is used for accurately locating and tracking people, equipment and objects in a hospital. The system is designed to track hospital assets, curb excess expenditures, increase safety and ensure security and access control by placing small radio frequency identification devices, or RFID tags on people and objects.
Hospitals and Emergency Medical Services (EMS) are facing daily challenges especially when responding to disasters, such as severe weather conditions, toxic chemical spills and terrorism. They need to manage a large quantity of patients from the disaster area to nearby hospitals effectively and efficiently.
The responsibility for the safety of patients, who may be missing from hospital beds or emergency wards rests with the healthcare worker. RFID makes tracking patients easier giving care takers the ability for fast, accurate identification and verification.
a) Encoded RFID Bracelet data can be read through bed linens, so patients don’t have to be disturbed when sleeping. They can be used with fixed readers in doorways and corridors, to help staff keep track of ambulatory patients.
b) RFID Bracelet solutions can encode patient information in RFID tags to have better tracking performance especially when access to a remote database is not available.
c) RFID Bracelet solutions provide a convenient, one-step solution for patient IDs. Text or graphics are produced directly on the Bracelet. There is no need for handwritten or typed inserts, or stick-on labels, which saves time and eliminates a potential point of failure.
Newborn Baby Tracking Solutions:For the most part, the Maternity Ward is thankfully a great source for joy and celebration as new family members are welcomed into the world. The ward staff shares some of this joy by playing their part throughout the labor and the post-partum care of mother and newborn child. However anxiety levels rise for the patients, families and staff when there are complications during the labor and/or when the newborn needs neonatal care. In many of these instances the baby and the mother need to be separated, a scenario that creates anxiety. Anxiety can easily turn to anger and a possible law suit when there is a mother-baby mix up; the wrong baby being sent to the wrong mother for the crucial early bonding period, breast-feeding etc.
RFID technology will help both these difficult and challenging situations. At the time of admittance the mother is provided with a patient’s RFID tag that will start the process of tracking all procedures relevant to that labor. Once the child is born, an ankle tag is provided to the baby as well and immediately cross-referenced to the baby’s mother and the mother’s tag.
Family Access to Babies in Neonatal Care:In the case of the newborn needing neonatal care, family members are almost as anxious as the new mother, to greet and bond with the new family member. When the newborn needs to be in an intensive care unit (ICU) this becomes very difficult due to the restricted access in the ICU. RFID solves this problem by making available to families the ability to view on a computer monitor outside of the ICU the key data about the baby, a photograph, the height, weight, skin color and temperature after keying in, for example, the mother’s family name and first name.
Mother-Baby Mix-ups Eliminated:Even when the mix up is uncovered moments after the mistake is made, this can cause heightened levels of anger and dissatisfaction with the services rendered. Any mother-baby mix up is a potential liability to the hospital. This scenario can be guaranteed not to happen when staff follows a procedure of reading the baby’s tag and then reading the mother’s tag and re-confirming the match that was initiated at the birth.
However,This is not a very new technology,But RFID can be a boon in disguise.if used judiciously and wisely in terms of Healthcare In India.

Thursday, 1 May, 2008

The Healthcare Internet Business Model

What new business models in health care, based on the Internet, are rising to the fore? What do they do that's different? And how do they address some eternal issues of patient care: not only good health, but also quality, choice and trust?
Here is the Discussion- "Reshaping Markets and Industries."
For the following ,I alloted six hat thinking to my friends..RED HAT= Emotional analysis,
White Hat= Facts n figures, Black Hat= careful ,Yellow hat= positive, Green Hat= creativity,Blue hat=Cool Hat, an Organising hat.
Yellow says- Most health care marketing in the past was centered around physicians. The basis of competition in the near future would shift to one driven by consumer satisfaction and quality.
White says- "It's really incredible when you compare [health care] to other industries, and ask what information is available to consumers that influences choice: choice of physician, choice of where to have procedures done, ability to access meaningful and useful information … It's incredible that this industry has so little information of this type that's actively used.
Green Says: Emerging frontier is online continuing medical education. There is lot to be used and learnt.
Blue Says: health care and the Internet are ideally suited for each other "because no one wants to pay for either..:)
Green Says: there should be an "integrated delivery group",giving patients and physicians within the network an ability to conduct a myriad of activities online. These tasks can range from refilling prescriptions to accessing personal MRI (magnetic resonance imaging) records.
Black Says: I think more safely, It should be an Exchange that links patients with local health care providers who offer preferred rates. Services include everything from traditional medical procedures to alternative treatments that are not usually covered by health insurance, such as laser eye surgery and infertility counseling.
Red Says: For the exchange to work, there has to be a value proposition for both sides.Better go to the Providers and ask them to Set their own rate, set a fair rate, set it based on what kind of available capacity you have in your office and on what you think your value proposition is to consumers.
Black Says- Selling on Internet is a hard sell. Rules apply to Internet health care. "If we don't offer quality, people won't come back."
Yellow says: The moment we will feel pressure from a large endorsing/Co-branding pharmaceutical company to make one particular clinical trial sound more appealing, we're out of business. We better stay unbiased and act as a third party exchange.
Black says: I agree, we cannot behave like a defunct site that allegedly solicites Rupees to recommend certain hospitals.
White Says: The company should be paid by consumers,When the consumer knows that, it makes all the difference in the world.

PREPARE for Impact- Artificial Intelligence Promises a New Paradigm for Healthcare

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