Healthcare in India
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Healthcare in India
Selection of Articles, Opinions, Discussions and News on Healthcare in India from all over the web covering Healthcare Policy, Healthcare Reform, News, Events, #HealthIT , Edipdemics, Chronic Diseases, #mHealth, #hcsmin ,
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Online Profile Management for Oncologists

An understanding of Online Profile Management for Oncologists, with an Indian perspective. 

Covers Digitally Aware Patients and Social Networks, The Need for Online Profile Management, an understanding of Local Reputation vs Global Reputation, Tips for How to do it while avoiding the traps and describing techniques for Maximizing Online Exposure for Oncologists 

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Court’s prescription for doctors!

Court’s prescription for doctors! | Healthcare in India |

Why every medical practitioner across the nation writes Illegible way on prescriptions?.

No government organisation had an answer for this and how it came in to practice, but finally the stage is set to curb the practice due to a sustained campaign of a Nalgonda based pharmacist as Medical Council of India General Body had resolved to issue guidelines asking the practitioners to use only capital letters on prescription.

The pharmacist, Chilukuri Paramathma, has said that he approached the High Court, Hyderabad, for banning the usage of present style of writing as it is leading to confusion in pharmacists. Unable to understand the prescriptions, he said that there are so many instances of pharmacists giving wrong medicine to patients that even led to disasters. He explained such an instance saying that a pharmacist working with a pharmacy chain store in Vidyanagar in Hyderabad had given ‘Tegrital’ Tablet instead of ‘Trental’ tablet to a pregnant woman as he misunderstood the prescription.

The ‘Trental’ tablet was intended for better blood circulation in pregnant woman, but Tegrital tablet is meant for abortion. As she got aborted after taking the tablet, that had turned into a big issue. Mr. Paramathma had gathered such 100 tablet names looks like homonyms in English which were presented before the High Court through a Public Interest Litigation.

A two-member Bench of the High Court comprising Chief Justice Kalyan Joythi Senguptha and Justice Sanjay Kumar had taken up the case for hearing on 24, February, 2014 and issued directions asking the Medical Council of India (MCI)and other stakeholders to take appropriate action.

The MCI had decided to issue guidelines asking the doctors to write the prescriptions only in capital letters in a general body meeting held on March 28. The decision of MCI along with a draft notification has been sent for Centre’s approval on June 9 this year. Once the Centre gives it’s nod, every medical practitioner in India will have to follow the guidelines to be issued by the Centre.

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Prescription Guidelines for Doctors In Maharashtra calls for much needed Standardization

Prescription Guidelines for Doctors In Maharashtra calls for much needed Standardization | Healthcare in India |

The medical council and healthcare government bodies on Friday released guidelines for doctors to write prescriptions. The sweeping guidelines are a welcome relief and will help reduce errors. Also they give a push to using technology to better comply with these standards and improve overall patient care.

The new guidelines include more information about the prescribing doctor, prescribed drugs and also patient information. Important parameters like the patients’ weight and age will help pharmacists also catch any errors at their end.

Prescription rules prepared by the Indian FDA on the basis of the Drug & Cosmetics Act suggest a uniform format, and advise writing or printing Drug Names in capital letters and also generic names of drugs as much as possible.

Using prescription software with basic patient information and pre-entered drug database will increase the doctor’s productivity in preparing such prescriptions and minimize errors during writing.

Here  is the first look at the actual printed guidelines as shared with Doctors

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Patient information to go online in government hospitals

Patient information to go online in government hospitals | Healthcare in India |

Soon, patients of Coimbatore Medical College and Hospital will not have to run from pillar to post with their entire case files to get treated. They can be paper-free when they come in for check-ups as all patient details would be available online.

A hospital management information system would be implemented at GH within a month or so, according to hospital sources.

On the first hospital visit, every patient would be registered in the system with name, photograph and basic health details.

Information recorded for each patient would include his ailment and treatment received. Subsequently, all patient details, including scans, tests and results would be updated into the database.

"The software would allow even scan copies to be uploaded and added to a patient's database, so it would be easy for the consultant to access all the data with the click of a mouse instead of poring over through different reports in a file," said a doctor.

When a patient gets registered, he will be given an identity card with an identification number. Whenever he visits any department in the hospital, he just has to show his card and number.

They would immediately access all his details.

"This is extremely helpful in the pharmacy, labs and scan centres, where sometimes patients do not know how to ask for the right test or scan and if the prescription written is illegible," said another doctor.

The hospital is likely to get around 180 computers for the system. Since GH is always congested with patients and doctors may not have time to key-in updates and details, especially during outpatient hours, they are planning to ask house surgeons and PG surgeons to help for this purpose.

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All the best!

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Doc, the Internet says I have cancer

Doc, the Internet says I have cancer | Healthcare in India |

The Internet is creating new-age hypochondriacs, an all-India doctors’ survey reveals

A recent survey, conducted across 27 cities including Mumbai, Pune, Delhi, Kolkata, Chennai, Bangalore, Hyderabad and Ahmedabad revealed that doctors have been struggling to deal with patients who use the internet to find out what ails them.

Making matters worse are hundreds of thousands of online forums where people discuss their ailments and symptoms, which often result in patients indulging in self-medication, and also end up arguing with doctors upon being told that their ailmentisnotevenclosetotheworsediseasestheyhad imagined, said majority of the 650 doctors who participated in the survey.

The doctors, including specialists and super specialists, termed people's increasing dependence on the internet to find medical cures and search for symptoms as a "major strain on the doctor-patient relationship".

Overloaded with information 
Forty-four per cent of the 650 doctors surveyed said that most of their patients were "overloaded with information", while 37 per cent doctors were of the opinion that their patients considered themselves "medical experts" after reading about the ailments on the internet.

As many as 38 per cent of the doctors surveyed said that majority of their patients who participated in online forums to discuss their ailments were "grossly misinformed" about the symptoms.

Dr Pratit Samdani, a general physician at the Breach Candy Hospital said he often comes across patients who imagine the worst after an online search of the ailments.

"One of my patients, a woman in her 30s, was convinced she was suffering from lung cancer. She had been coughing incessantly, and obviously the internet search said it was the most basic symptom of lung cancer. She assumed the worst, but it turned out to be a very minor infection," he said.

Dr Bharat Shivdasani, a cardiologist at Jaslok Hospital, said that it becomes difficult to convince patients who are loaded with "internet information". He said,"A few weeks ago,a man in his 40s visited me for consultation. He was convinced that he suffered from a heart ailment only because he was experiencing pain in left arm. When I told him that was not the case, he ended up arguing with me."

Samdani termed the internet a "medical menace", saying the woman who had assumed she was suffering from cancer insisted on undergoing a series of tests. "I spent an hour trying to convince her that she didn't need to undergo the tests. Internet cannot diagnose ailments or treat anyone," he said.

The survey, conducted by Ipsos Healthcare and Ruder Finn, an international public relations firm, aims to educate people on the dangers of 'over-information' when it comes to ailments. One such victim of medical overload, Dahisar resident Vikas Vyas, said he recently spent sleepless nights assuming the worst of diseases after searching the causes of throat pain on the internet.

The curse of internet 
Out of the 650 doctors surveyed, 44% said their patients were "overloaded with medical info gathered online". Thirty-seven per cent doctors said that many of their patients think of themselves as medical experts.

Fifty per cent of the doctors surveyed said internet has made their interaction with patients "difficult".

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Managing time is a major issue for all professionals in today’s fast paced world. This is even more so for many doctors, especially those who work at multiple locations: Clinics, Hospitals and Medical centers. Workshops on effective time management are regularly organized at different financial and IT firms to help hard working professionals. Gyan is imparted on setting Alerts for Reminders, and To Dos for Task management and the importance of diaries, blackberries and calendar reminders is emphasized here. 

Physicians have a slightly bigger problem. Their schedules are majorly dependent on set appointments with patients. While they do have other areas of concern, the majority of their daily schedules are built around patient appointments. What complicates this for a consulting doctor is that every day he may have different visiting hours at different locations. This makes Time management even more crucial for Physicians. 

Mandatory Requirements for an Appointment Management System:

  • It should allow for different mediums of Appointment Scheduling
    • E.g. Via a Website, Via A Phone Call, Via SMS
  • It should permit Rescheduling
  • It should be able to handle Walk-In Patients
  • Besides the process, the screens should be simple – Non IT friendly users should be able to easily use it
    • Color Coded Entries: Pending, Completed, No Show, Bill Pending
    • Point And Click with Minimum Data Entry
  • Should be rigid enough to prevent Scheduling Errors
  • Should Support Multiple Doctors and Multiple Specialties
  • Maintain 2 Daily Calendar Views
    • Appointment View for Front Desk staff, Online Portal
    • Scheduled Visits View for Physicians

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MCI shrinks own ambit, doctor bodies out of ethics code

MCI shrinks own ambit, doctor bodies out of ethics code | Healthcare in India |

In a bizarre move, the Medical Council of India(MCI) — the apex regulatory body of doctors and the medical practice in the country — has decided to shrink its own jurisdiction. It has reinterpreted its code of ethics regulations as being applicable only to individual doctors and not doctors' associations. 

Clause 6.8 of the Code of Medical Ethics Regulation 2002 clearly states that it pertains to "code of conduct for doctors and professional association of doctors in their relationship with pharmaceutical and allied health sector industry". However, the executive committee of the new MCI in its meeting on February 18 decided that the term "association of doctors" be deleted from the clause. It went on to add that any action it took it against any association of doctors by virtue of clause 6.8 shall be nullified and that such proceedings would stand annulled. 

In effect, the MCI has stated that the action it took against the Indian Medical Association (IMA) for endorsing products of Pepsi and Dabur in exchanges for crores of rupees or against the Indian Academy of Paediatrics for accepting funding from pharmaceutical companies will no longer be valid. 

"It is a ridiculous position. The MCI itself had argued in an affidavit filed in the Delhi high court that what is prohibited for an individual doctor cannot be done by the doctor along with another bunch of doctors by forming an association," said Dr K V Babu, who had filed the original complaint against the IMA for endorsing products. 

Endorsement is expressly forbidden by the code of ethics, which says that no doctor ought to endorse any commercial product or drug or therapeutic article. In November 2010, the MCI had initiated action against officer bearers of the IMA on the endorsement issue. When one of the office bearers challenged the removal of his name from the medical register for six months before the high court, the MCI had argued in its affidavit that "...what is not allowed to be done directly cannot be permitted to be done indirectly".

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Rougher Passage to India’s Drug Market

Rougher Passage to India’s Drug Market | Healthcare in India |

FDA Commissioner Margaret A. Hamburg, M.D., contrasted the craftsmanship and beauty of India’s Taj Mahal with recent lapses in quality by “a handful” of the country’s drug manufacturers during a recent visit there. If the comparison was meant to flatter the domestic pharma executives and regulators with whom she met, they didn’t appear to think so.

Dr. Hamburg and officials from India’s Ministry of Health and Family Welfare pledged cooperation in data sharing and even “medical and cosmetic product and inspections conducted by the other Participant.” That’s no small promise since India is the world’s second largest exporter of prescription and over-the-counter drugs. Yet their formal Statement of Intent conditioned such cooperation “as time and resources allow” and didn’t set specific terms.

In a conference call with reporters today, Dr. Hamburg said implementing the statement was a five-year commitment “already under way” as both countries “have already embarked upon some cross-training activities and started to identify some critical areas for future activities together, so I think progress will be made.”

Indian drugmaker Ranbaxy has come under repeated FDA scrutiny. It agreed last year to pay a $500 million fine for safety and record-keeping violations. More recently, it urged Dr. Hamburg to lift the FDA’s consent decree. Extended as of January, this decree effectively bans four of Ranbaxy’s Indian plants from exporting active pharmaceutical ingredients to the United States. Although Ranbaxy contended that it needed the export activity to fund FDA-sought quality improvements, Dr. Hamburg declined the company’s request.

Domestic Generics

According to the All India Chemists and Druggists Association data reported by Indian newspaper The Economic Times, Mumbai-based Glenmark Pharmaceuticals impacted the Rs 3,000 crore ($483.7 million) Indian diabetes drug market long dominated by multinationals last year. Glenmark racked up Rs 16 crore ($2.58 million) in eight months for its Zitamed and Zita generic versions of sitagliptin

These generics sold 30% cheaper than the Januvia and Janumet branded drugs of market leader Merck & Co., which generated more than $5.8 billion in combined global 2013 sales for Merck and are the subject of a patent dispute between the companies.

Through court decisions and regulatory actions, Indian officials have pressed foreign-based multinationals for lower-cost drugs. These multinationals, however, have argued that Indian actions hinder their ability to do business selling innovative if costlier drugs.

Patent Questions

India’s Patent Office sent shivers through the biopharma industry in 2012 when it revoked the exclusive patent rights held by Bayer for cancer drug Nexavar, and awarded the nation’s first-ever compulsory license to a domestic maker of a much cheaper generic. Industry cringed again last year when India’s Supreme Court rejected patent protection for Novartis’ blockbuster cancer drug Glivec, as the drug faces a 2015 expiration of its first U.S. patent.

The patent decisions, Bagla explained, reflect Indian compliance with the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) of the World Trade Organization, of which India is a founding member.

“Western companies need to factor this situation among the risks of doing business in India,” Bagla emphasized. “Some of our clients are limiting their involvement in India due to this. Others are a taking a measured approach to what products and technologies they bring. Very few are walking away from India completely.”

Legal and Regulatory Moves

Last year, the Indian Supreme Court ordered a nationwide halt to clinical trials for 157 new chemical entities, citing the need for stricter ethical standards after seven girls died in a Phase IV trial of an HPV vaccine carried out on children unaware they were under study. The court also shifted responsibility for trials from the Central Drugs Standard Control Organization headed by Dr. Singh, ordering India’s Health Secretary personally responsible for new-drug clinical trials.

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Dabur Launches India's First Ayurvedic Medical Journal

As part of its plans to propagate the benefits of traditional Indian form of medicine, leading Ayurvedic healthcare company Dabur India Ltd today launched 'Ayurveda Samvad', India's first Ayurvedic Medical Journal. 

The quarterly journal was unveiled by Shailaja Chandra, General Secretary, AYUSH, Government of India. 

The quarterly publication will cover detailed information on various clinical trials being conducted on Ayurvedic medicines.

Announcing the launch, Dabur India Ltd Ayurveda R&D Head Dr J L N Sastry said the journal would cover the holistic approach on Ayurveda. It would popularise Ayurveda and reach out to the doctor fraternity to propagate messages on the Ayurvedic way of life to manage health and diseases. 

The journal will feature articles covering original scientific studies in the field of Ayurvedic medicines with direct clinical significance, addressing health care issues and public health policy. 

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India has to indicate its position on certain aspects of IPR

India has to indicate its position on certain aspects of IPR | Healthcare in India |

US lobby groups such as the US Trade Representative and the International Trade Commission are demanding trade sanctions against India if it does not take a tough stand on intellectual property rights, or IPR, after receiving several complaints from US pharmaceutical companies and government representatives against India's trade policies, particularly concerning the Indian Patents Act (2005).

Local drug makers say the Indian government should not be bullied into taking decisions based on demands by such lobby groups. Kiran Mazumdar-Shaw, chairman and managing director, Biocon Ltd, in an interview said the US should not take action based on a trade body's request, while also explaining that India will have to find a middle path of working with big pharma.

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The UPA regime: A Decade of massive healthcare reform

The UPA regime: A Decade of massive healthcare reform | Healthcare in India |

Winston Churchill once said, "Healthy citizens are the greatest asset any country could ever have." The UPA's effort to invest in citizen's health deserves better coverage and notice than it has attracted so far.

As we inch towards the end of United Progressive Alliance's (UPA's) second term, it is important to look back and reflect on what was accomplished and what is still to be achieved. If health indicators are any yardstick, then the UPA's thrust on social healthcare has led to improved health of citizens and set the stage for future reforms.

In 2004, when UPA came to power, expenditure on public health was around Rs 7,500 crore. This has now almost quadrupled to Rs 27,000 crore. In the beginning of UPA's regime, the National Rural Health Mission (NRHM), known to be "the most ambitious rural health initiative ever", was initiated.

The NRHM was formed to provide effective healthcare delivery to our rural population, especially women and children. The latest data shows that in the last 10 years, infant mortality rate (IMR) has come down from 58 per 1,000 to 44. This is further set to decline sharply.

During the National Democratic Alliance's regime, the IMR declined at a snail's pace of 1.3% annually, whereas now this deceleration is happening at 6.4% per annum.

With government focusing on early and periodic health screening of children through its Rashtriya Bal Swasthya Karyakram, children's health indicators could improve further.

With the Janani Suraksha schemes, institutional deliveries through skilled birth attendants have increased rapidly. Approximately 12 million deliveries per year are taking place at no expense to the beneficiaries. This is followed by cash incentives and other benefits.

As a result of such initiatives, the maternal mortality ratio of India has been reduced by 50% from 390 in 2000 to 200 in 2010.

Providing government-run health insurance to below poverty line (BPL) workers and their families through Rashtriya Swasthya Bima Yojana (RSBY) is yet another milestone achieved by the UPA government.

The objective of RSBY is to protect BPL households from major health expenses that could wipe out their life's savings.

This scheme allows inpatient treatment up to Rs 30,000 per year, and since its inception in 2008, around 35 million families have enrolled in the programme. This scheme has been praised by global leaders for its unique, innovative and inclusive business model.

Making India free from the blot of polio is another achievement of the UPA. This was only possible due to massive immunisation and awareness efforts of the government. Nevertheless, the government should be in surveillance mode as we are surrounded by nations that are still afflicted by polio.

Due to improved life expectancy, the average Indian would live five years longer than he would have had a decade ago. An increase in life expectancy will be a driver of economic growth, as it happened in Japan, which saw an increase in life expectancy by 13 years after World War II, followed by rapid economic growth.

This is a battle half-won. We have people falling into the trap of poverty and indebtedness due to escalating healthcare cost. The government should speed up its intention to provide free medicine to all through public hospitals and health facilities.

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'New law to regulate clinics should focus on rights of patients'

'New law to regulate clinics should focus on rights of patients' | Healthcare in India |
As a 19-member high-powered committee drafts the clinical establishment law for the state before the forthcoming budget session, citizen groups have demanded that it should be focused on patients instead of on doctors.
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Docs use WhatsApp to save heart patients

Docs use WhatsApp to save heart patients | Healthcare in India |

Doctors at KEM Hospital have turned to the most ubiquitous personal technology - the smartphone - to speed up diagnosis of patients with suspected heart complications. 

They have started using the popular smartphone messenger 'WhatsApp' to send pictures of patients' electrocardiograms (ECG) to each other for a quick review, saving time spent on reaching the emergency ward and checking the actual report. 

The approach enables them to begin the treatment of a person who has suffered a heart attack within the crucial golden hour, the period when emergency care is most likely to be successful. Delay in proper diagnosis and treatment during this period results in amajority of cardiac fatalities. 

In fact, over 60 per cent of patients who have suffered a heart attack reach the hospital way beyond the golden hour, the average being about five hours. So every moment they spend waiting for the doctor to arrive and study their ECG increases the risks. 

"The moment a patient walks in here complaining of chest pain or any other related problem, a specialist takes out an ECG and sends the image to the doctors on hand," said Dr Prafulla Kerkar, head of KEM's cardiology department. "We, in fact, have a WhatsApp group where the experts in our department are signed in." 

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NPPA asks sellers to Upload knee implant prices on their websites

NPPA asks sellers to Upload knee implant prices on their websites | Healthcare in India |

Two crore people in India develop knee problems that may require an implant. However, only around one lakh patients undergo implants while the rest cannot afford the expensive treatment.


The National Pharmaceutical Pricing Authority (NPPA) has asked the sellers to upload the prices of the implants on their websites. NPPA has issued the order for ensuring that the sellers comply with the price fixation. The authority had also fixed the price of the implants on August 16.


"All manufacturers, importers, distributors, stockists, hospitals, nursing homes and clinics must display on 'home page' of their website, the MRP or the price of the knee implant system at which they are charging or billing the patients, along with the brand name, specifications, and names of the manufacturing and marketing company, within three working days from issuing this office memorandum," stated Kalyan Nag, Adviser, NPPA in the order.


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Centre to Promote Medical Tourism

Centre to Promote Medical Tourism | Healthcare in India |

"We have finalised fresh guidelines to promote and market medical tourism by sufficiently incentivising tour operators and market facilitators to cash in on its hidden potential that hitherto stays untapped and unexplored," tourism secretary Parvez Dewan said.


He was speaking at the inauguration of "Medical and Wellness Tourism Summit -2014" here that was organised by PHD Chamber of Commerce and Industry.


According to Dewan, these incentives would also be extended to NGOs for the promotion of eco-tourism.


Without elaborating much, he said these incentives would comprise "part reimbursement of expenses, undertaken by tour operators and market facilitators to propagate medical tourism in India and overseas".

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Harsh Vardhan promises better healthcare under NaMo government

Harsh Vardhan promises better healthcare under NaMo government | Healthcare in India |

Promising ‘extraordinary’ steps in the health sector by the Modi government, Union Minister Harsh Vardhan today said a mass movement will be built for implementing various policies and programmes in the coming months. ‘I can say with confidence that our government under the leadership of Narendra Modi is committed to health sector in the country and intends to do extraordinary work in this field,’ the Health Minister said. 

In this regard, he called for building a ‘mass-movement’ involving everyone in the policies and programmes so as to make India a healthy society. The Minister said everyone should take pride in the fact that India today is a polio-free country.

The government has earmarked Rs 39,237.82 crore for the health sector in this year’s general budget. Finance Minister Arun Jaitley had also promised that the government would take up on priority basis initiatives such as providing free drugs and diagnostic services while aiming to ensure ‘Health for All’.

He had also announced earmarking of Rs 500 crore to set up four more AIIMS-like institutes. Both Vardhan and Lok Sabha Speaker Sumitra Mahajan were attending the foundation day celebration of International Vaish Federation which was inaugurated by Tamil Nadu Governor K Rosaiah. The Speaker called upon the Vaish community to work for the welfare of the citizens. Men and women should commit themselves to the betterment of society, she said.

Improve healthcare services in rural areas

The former minister Ghulam Nabi Azad tried hard to convince docs to spend some time in rural areas without much success and Dr Harsh Vardhan is walking down the same road, perhaps convinced that it’ll improve healthcare services. Replying in Question Hour in the Rajya Sabha, he said the central government would create a mechanism to ensure docs are available in rural dispensaries and centres.  ‘One way to do it, which will be feasible and acceptable to all, is that during the PG courses, medical students can be asked to spend a fixed duration in rural health centres,’ Harsh Vardhan said.

Malaria and dengue prevention

The minister asked all states to take malaria and dengue prevention measures on a war footing and hoped to make a new beginning in battling these ailments.  ‘Dengue and malaria strikes with sickening regularity every year resulting in many deaths. Prevention of this tragedy is easy only if the prevention protocol is implemented with commitment,’ he said. ‘Let us make a new beginning. Let us not be complacent if the number of victims this year is less than last year’s. We must aim for zero incidences within two to three years,’ he said. He believes that 80% success rate is feasible if well-known preventive measures are implemented. 

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Patient Education DVDs now available at an online store

Patient Education DVDs now available at an online store | Healthcare in India |

Diabetes Patient Education Simplified!


P.E.A.S™  - India's first exhaustive patient education DVD library now available at our online store. 


Medically Accurate, High Definition Animated Videos related to Diabetes available in Indian regional languages viz. Hindi, Gujarati, Marathi, Tamil, Telugu, Kannada, Malayalam, Bengali.


Via Parag Vora, nrip
nrip's curator insight, July 10, 2014 8:40 AM

Excellent use of technology (eCommerce) to bring Patient Education and Awareness into the limelight. I checked out this link and found something for each specialization.  Hope to see more and more of such examples in the coming months.

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Top 5 Cardiac Care Hospitals in India

Top 5 Cardiac Care Hospitals in India | Healthcare in India |

Heart diseases are one of the leading causes of death in India. 80 per cent of the Indian population succumbs to a heart problem. If you are running helter-skelter for the best heart hospitals in India, ‘check-in’ either of these top cardiac care hospitals in India.

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Do you still have a family physician?

Do you still have a family physician? | Healthcare in India |

Do you still have a family physician? - In the time of super-specialisation in medicine and healthcare, patients seem to bemoan the scarcity of the family doctor who cured their sniffles without making them undergo a battery of tests. Where is the general physician now?

Sorry situation

India produces nearly 42,000 MBBS doctors every year. But of these, only 8,000 to 10,000 take up general medical practice as a profession

India does not offer an MD in family medicine. Of close to 8,000 seats that are reserved for a 3-year PG course offered by the Diplomate of National Board, only 5–6% of seats are allotted to family medicine

Another reason general practice is on the decline is that fresh MBBS graduates avoid practicing family medicine as a career because it pays less

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MCI tells doctors: Use block letters when you write prescriptions

MCI tells doctors: Use block letters when you write prescriptions | Healthcare in India |

The days of doctors’ prescriptions being parallel lines of illegible scrawls punctuated by the odd circle to indicate dosage, may soon be a thing of the past.

The executive committee of the Medical Council of India has decided that doctors should only write prescriptions in capital letters.

If the prescription also includes other remarks such as dietary advice or recommended tests, then at least the drug names and dosages should be written clearly in capitals, the committee has ruled.

Letters to this effect will soon be sent to all medical colleges, MCI chairperson Dr Jayshreeben Mehta told The Indian Express Monday.

“The executive committee has just passed this proposal. The committee unanimously felt that drug names and dosages are at times not clearly written in prescriptions causing a lot of confusion among both chemists and patients. That is why we have decided that all prescriptions should be in capital letters. Once the order comes out, it will be sent to all medical colleges,” Mehta said.

Committee members, sources said, made a strong pitch for all-caps prescriptions on the ground that misreading even a single letter can alter the name of a drug dramatically and lead to disastrous consequences for the patient. 

Doctors have welcomed the move but health ministry sources said they had no information about the decision.

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Very intelligent, and pretty much common sense. 

However, such techniques while they seem like common-sense, are typical of the jugaad mentality prevalent in India which result in postponing the impact of problems rather than working towards fixing them.

Its high time Indian Doctors start using e-prescriptions. There are a wide variety of ways to do that, on a variety of devices, and available at prices from almost nothing upwards.

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Amendments to Drug Act Simplify Access to Pain Medicines

Amendments to Drug Act Simplify Access to Pain Medicines | Healthcare in India |

Millions of Indians suffering chronic pain will get better access to pain medicines following changes in India’s drug law, Human Rights Watch said today. On February 21, 2014, the Rajya Sabha, the upper house of parliament, approved amendments to the Narcotic Drugs and Psychotropic Substances Act (the Drug Act) that  the lower house had approved a day earlier.

The amendments eliminate archaic rules that obligated hospitals and pharmacies to obtain four or five licenses, each from a different government agency, every time they wanted to purchase strong pain medicines. As Human Rights Watch documented in a 2009 report, “Unbearable Pain: India's Obligation to Ensure Palliative Care,” this resulted in the virtual disappearance of morphine, an essential medicine for strong pain, from Indian hospitals, including from most specialized cancer centers.

“The revised Drug Act is very good news for people with pain in India,” said Diederik Lohman, senior health researcher at Human Rights Watch. “These changes will help spare millions of people the indignity of suffering needlessly from severe pain.”

Patients who experience severe pain without access to adequate treatment face enormous suffering. Like victims of torture, these patients have often told Human Rights Watch that the pain was intolerable and that they would do anything to make it stop. Many said that they saw death as the only way out and some said they had become suicidal.

The amendments to the Drug Act give the central government authority to regulate so-called “narcotic drugs,” require a single license to procure morphine and other strong opioid medications, and charge one government agency, the state drug controller, with enforcement. The government introduced the amendments to the Drug Act in 2012.

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Hospital warned against deal with stem cell banks

The couple, unaware that Hiranandani did not allow any other service provider to collect stem cells, had made an arrangement with LifeCell International. They had paid an advance of Rs 60,000 for the banking, that lasts up to 21 years. A complaint was lodged in June 2012, after which a probe was ordered by the Competition Commission of India (CCI). 

Hiranandani's refusal came when the couple went to seek permission to allow the LifeCell representative to collect the stem cell on the day the baby was born. Stem cells must be collected shortly after a baby is born. Hiranandani cited its tie-up with Cryobank for denying entry to another company representative on its premises. The couple tried to reason with the hospital and then decided to shift to SevenHills Hospital, Marol, for the delivery. 

The body, while penalizing the company 4% of its annual turnover of the last three years, said the hospital should behave ethically towards patients. It said the hospital's arrangement was based more on a commission model rather than competition and that was "against the spirit of health services". CCI found that Cryobank was paying the hospital Rs 20,000 for every patient who opted for stem cell banking. This practice is common in the industry. 

The industry hailed CCI's decision. "Patients deserve to be given a fair choice. The industry is new and such pacts can hamper its growth," said Meghnath Roy Chowdhry, secretary, Association ofStem Cell Banks of India (ASBI). Gynecologists said most city hospitals affiliate more than one player though the practice may be different for nursing homes. "Each company may have something better to offer. As doctors we only explain the benefits and disadvantages of storing stem cells, but beyond that the choice is with the patients," said Dr Suchitra Pandit, president, Federation of Obstetric and Gynecological Societies of India. 

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Indian drug that breaks down blood clots approved for human clinical trials in India

Indian drug that breaks down blood clots approved for human clinical trials in India | Healthcare in India |

Clot-specific Streptokinase (CSSK), a drug that breaks down blood clots, developed by an arm of the Council for Scientific and Industrial Research (CSIR), has been cleared by the office of the Drug Controller General of India (DCGI) for phase two human clinical trials.

The CSSK is the first so-called biotherapeutic drug developed in India -- meaning it entailed the use of antibodies, proteins and enzymes, unlike conventional chemical drugs. If and when the drug reaches the market, it could offer an affordable alternative to expensive thrombolytic drugs used to treat patients of myocardial infarction or heart attacks, and other severe heart conditions like deep vein thrombosis.

Work on the Indian drug began seven years ago under a partnership between the CSIR's Institute of Microbial Technology (IMTECH), Chandigarh, and Nostrum Pharmaceuticals LLC of the US.

"Streptokinase has been modified by IMTECH through protein engineering and then made clot-specific, so that the basic risk of hemorrhage or bleeding, which is the problem with clot-busters in general, is much reduced," said Girish Sahni, director of IMTECH and inventor of the molecule.

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Indian pharma firms can't be judged by U.S. standards

Indian pharma firms can't be judged by U.S. standards | Healthcare in India |

Hours after the US drug regulator banned imports from a fourth factory of Ranbaxy Laboratories Ltd, the drug controller general of India G.N. Singh chose to back the Indian company, saying the current situation may not require withdrawal of its medicines from the local market.

On Friday, the US Food and Drug Administration (FDA) barred Ranbaxy, a subsidiary of Japan's Daiichi Sankyo, from producing or distributing drug ingredients manufactured at its Toansa facility in Punjab for the US market.

The FDA has already banned imports from Ranbaxy's plants in Mohali in Punjab, Dewas in Madhya Pradesh and Paonta Sahib in Himachal Pradesh. At the Toansa facility, the regulator found the company's staff found that workers retested drug products to produce acceptable findings after the items originally failed analytical testing. While the US has banned imports from these facilities, the Indian pharma market continues to use raw materials from these plants. Singh in an interview said, "Indian pharmaceutical companies cannot be judged by American standards." Edited excerpts:

Were the other three plants of the company found to be in violation of India's Drugs and Cosmetics Act?

We had approached them last year after US FDA flagged certain issues. Some of those were found to be true and my office had told Ranbaxy to take corrective measures. Similar procedures will be followed in this case as well. But I do not think this is a situation which will warrant withdrawal of drugs from the domestic market. Our biggest objective is to maintain good quality of medicines and we are doing that. There are no drugs in the Indian market that are not up to the standards stated under the Drugs and Cosmetics Act. We will shortly be in touch with Ranbaxy's management to find out what went wrong at the Toansa plant.

Will such decisions adversely affect India's image as a manufacturer of safe, affordable drugs?

As of today, India supplies low-cost drugs to over 200 countries. Our pharmaceutical sector is a huge success. We cannot be doing well if our drugs were of substandard quality. Many multinational pharmaceutical companies stand to gain if India loses its image as a supplier of quality drugs. However, we will take appropriate action. We are in the process of streamlining the drug regulation in India and fundamental changes will be taking place soon. I am not worried about issues of quality

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Oh doctor, you're in trouble

Oh doctor, you're in trouble | Healthcare in India |

It is not in the interest of patients or doctors to remain on a collision course forever. While growing awareness among patients about their rights is a welcome trend, medical councils have to step up to the plate.

Aam aadmi (and aurat) at the high table in Delhi has buoyed the hopes of citizens’ groups across the country. As 2014 kicks in, be prepared to hear a lot more from one group whose interests have been long-neglected — the harried aam patient.

Over the past year, a series of developments suggests that patient activism is on the surge, and could be shaping the practice of medicine in this country.

People for Better Treatment (PBT), a citizens’ group which started on December 30, 2001, in Kolkata, is fanning out across the country. Last month new PBT branches sprung up in Delhi, Chennai and Hyderabad. Next on the list is Ahmedabad and possibly Lucknow. PBT’s goal is to raise public awareness about medical negligence. It is the brainchild of US-based

Dr Kunal Saha, whose wife Anuradha died due to negligence of doctors in a Kolkata hospital. Dr Saha fought a long, protracted battle for justice for nearly 15 years, boning up on toxic epidermal necrolysis in the process, and mobilising an international panel of experts to bolster his arguments.

Last October, the Supreme Court gave its judgment. The apex court’s ruling found three doctors of the private hospital, Advanced Medical Research Institute (AMRI), negligent in the civil case but dismissed the criminal complaint. The judgment grabbed headlines because of the unprecedented compensation amount in a medical negligence case in India — `5.96 crore plus interest for each of the 15 years — awarded to Dr Saha.

The landmark judgment of the apex court has unleashed a fierce debate on fair compensation for patients who suffer due to medical negligence. The medical fraternity led by the Indian Medical Association (IMA) and the Association of Healthcare Providers India (AHPI) is seeking a limit on the maximum amount that hospitals should be asked to shell out in such cases. Their argument: without a cap, hospitals will go bankrupt.

Patients’ groups such as PBT led by Dr Saha say that is not true.
Dr Saha says AMRI has not yet coughed up the compensation money. Instead, the hospital authorities have asked for an extension of the deadline to pay the sum. The Kolkata hospital has also partially resumed operations.

Dr Saha has responded by petitioning the Supreme Court against what he terms “deliberate violation” of its order. The case is listed for hearing early January.

The debate over a compensation cap is taking place in the backdrop of a Parliamentary Standing Committee on health’s report on the Indian Medical Council (Amendment) Bill 2013, introduced in the Rajya Sabha last March. The committee recommended that teams probing cases of medical negligence include external experts instead of just Medical Council of India (MCI) members.

“All of the members of the Medical Council of India are medical professionals and whenever any complaint of medical negligence or violation of code of ethics is brought before the council, such cases are decided by the medical professional themselves,” the committee noted.

The MPs recommended that all cases of medical negligence should be inquired into by a committee of experts drawn from various fields and experience, including social activists, patients’ representative and so on.

Although MCI is the regulatory body governing medical practice, there is growing concern that the few cases brought before it are not impartially decided as council members are very lenient towards their colleagues and hardly anyone is willing to testify that another doctor has been negligent. The fact that the MCI has been embroiled in various corruption scandals in the past adds to the concern.

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The rise of internet use and telehealth in India

The rise of internet use and telehealth in India | Healthcare in India |

“Making geography history,” “making distance meaningless,” “a hospital in your pocket,” “cost effective, need based healthcare for everyone, anytime, anywhere,” are all hyperbole—fertile imagination working overtime and hype. But is it possible that in my lifetime I may actually see this happen? Improbable, yes. Impossible, no.

According to the Internet and Mobile Association of India, by June 2014 243 million people in India will have internet access, with 75 million of those living in rural India. India will be second only to China in terms internet use. 130 million people in India now access the internet via smart phones. 50% of urban internet users access the internet daily. So is healthcare via a phone possible in an “emerging economy?” Can this be the equivalent of buying a pizza or booking a ticket online?

Encounters between doctors and patients have always been face to face. I had serious concerns about whether India was ready to receive healthcare via a phone. From October 2012 to April 2013, 1866 individuals from five states were interviewed, 31% from rural areas. 22% from rural areas had smart phones (46% in urban). Surprisingly 48% in rural India and 72% in urban areas had heard of mobile health (mHealth). I would love to do a similar study in the UK or the US.

Perhaps it will clearly show that we are no longer following the West, not even piggy backing, but just leap frogging. In 2011, when I carried out a smaller study at a world renowned temple of technology in Chennai, the awareness of mHealth was dismally low.

The most reassuring finding now was that 55% of respondents (urban and rural) showed a very strong intent to use mobile phones for healthcare, if available. Mobile network operators in India should wake up to this. Their role in this will be much more than offering mobile TV—Tendulkar not withstanding.

Kenzie and Courtney's curator insight, October 29, 2014 4:21 PM


This article shows how India is developing by using a more modern type of communicating. By having over 243 million people introduced to the internet by this year. They're becoming more social within themselves and with the world around them because they're now opened up to the world of technology.

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