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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Why is India Facing a 2nd Wave of the Corona Virus

Why is India Facing a 2nd Wave of the Corona Virus | Healthcare in India |

we as a country seem to have performed the hara-kiri that our cricket teams of the '80s and 90's were well known for. Before we had won the match, we started celebrating the victory, and seem to have lost the game. We didn't wait till Covid was completely under control. We started dismantling the specially created Covid Centers. We took our families to the malls and did not care about spraying sanitizers, before and after each interaction with something from outside our controlled environment. We started unmasking at will within our buildings and even at the Kirana stores. We started flying and driving around the country without masks and frolicking on the beaches of Goa. Our house parties were back on, and we destroyed the controlled zone that all India had worked so hard to become over a whole year. All, in less than a couple of months. And so it's back, worse than ever before, crippling our economy, our spirit, and making us feel bleak about the future. Except for this time, it doesn't look like everyone wants to tackle it together anymore.


The center and the states don't seem to get along. The media is pushing up the pitch and the amplitude of the hyperbole. Strangely, vaccines seem to be running out. People are still not masking up. Many are demonstrating utter and complete stupidity with regards to bending the rules. Construction sites are working in full sway as if there is no covid in this world. Watchmen in buildings aren't sure if they should let delivery in or collect them at the gate, so they do nothing. And the poor Kirana-wala is feeling weird about asking the people coming to his shop to mask up again. My neighboring Kirana-wala told me he is not done arguing with customers who are say "khaasi pehle nahin hui kya" (Translates to "Haven't you had a cold before?") Sounds like March 2020 again!


We both decided to formally put down our reasons for what has brought us to this stage. Policymakers must not let this happen again

1. The single biggest factor for the wave having arrived is how we have behaved in the recent past. 

2. Mutating Strains: Not under control

3. The Vaccine rollout: Lessons to learn

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India's Haryana state partners with Deloitte for COVID-19 virtual home care service

India's Haryana state partners with Deloitte for COVID-19 virtual home care service | Healthcare in India |

The state government of Haryana in northern India has kicked off a project with Deloitte to provide virtual home care services to patients with mild to moderate symptoms of COVID-19 amid the ongoing second wave of infections in the country.

Sanjeevani Pariyojana, or The Life Project, provides patients with support and resources to manage their care at home, including access to virtual triage, COVID-19 field hospitals and in-patient facilities.

It was piloted in the Karnal district before being expanded to other districts in Haryana.

more at


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A Case for Eliminating Medical Errors with Evidence-Based Decision Support

A Case for Eliminating Medical Errors with Evidence-Based Decision Support | Healthcare in India |

A report by the World Health Organisation (WHO) reveals that patients living in low-income countries experience as many disability-adjusted life years lost due to medication related harm than those in high-income countries.


For patients in hospital, the impact of clinical errors is greater, and this may be attributed to the complexity of certain diseases and the use of complicated medication regimes.


In children and elderly, medication errors often occur due to administration of wrong dosage, incorrect therapeutic route and a failure if the patient does not follow the prescribed treatment.

The Crucial Role of Digital Tools for Better Patient Outcomes
Today, with the increase in disease profiles and the influx of information available across online mediums, there is a dire need to have a platform that can provide filtered, precise and reliable medical information. Moreover, as the pandemic has posed unprecedented challenges for the healthcare industry, the need of the hour is a database with different treatment types used for both non-communicable and communicable diseases.


Considering this, digital healthcare technologies such as Clinical Decision Support (CDS) systems are providing healthcare professionals with innovative diagnostic and treatment solutions that enable them to deliver quality patient care.

CDS systems improve patient safety, discard unnecessary tests, reduce cost, and increase satisfaction of patients and clinicians.


The platforms use biomedical information, patient-specific data or a mechanism that integrates knowledge and data to present useful information to the doctor when healthcare is delivered, enabling quicker action.


All healthcare professionals and hospitals should use CDS systems that can provide them information that is verified by doctors who have years of experience.


It is imperative to understand that clinical errors do not occur due to medical negligence, in fact they include a range of honest errors and innocent mistakes which are beyond the healthcare provider’s control, despite enough caution. We experienced an onslaught and sudden surge in use of healthcare technologies owing to the pandemic. In the post pandemic, the trend of virtual care is anticipated to grow even more that will ensure smarter and quality care. And when we say digital healthcare technologies are here to stay, the rationale is to not get rid of paper record, but to adopt more patient-centric methods.



read the entire article at


nrip's insight:

Well besides that the author seems to have added all the goodies of enhanced EHR's and Clinical CRM's into CDSS's ,this post says it as it is. Hospitals and Doctors today need to adopt technology based informatics software/tools for improved productivity as well as safety.

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AI algorithm that can detect the presence of COVID-19 disease in Chest X Rays

AI algorithm that can detect the presence of COVID-19 disease in Chest X Rays | Healthcare in India |

“ATMAN AI”, an Artificial Intelligence algorithm that can detect the presence of COVID-19 disease in Chest X Rays, has been developed to combat COVID fatalities involving lung. ATMAN AI is used for chest X-ray screening as a triaging tool in Covid-19 diagnosis, a method for rapid identification and assessment of lung involvement. This is a joint effort of the DRDO Centre for Artificial Intelligence and Robotics (CAIR), 5C Network & HCG Academics. This will be utilized by online diagnostic startup 5C Network with support of HCG Academics across India.


Triaging COVID suspect patients using X Ray is fast, cost effective and efficient. It can be a very useful tool especially in smaller towns in India owing to lack of easy access to CT scans there.


This will also reduce the existing burden on radiologists and make CT machines which are being used for COVID be used for other diseases and illness owing to overload for CT scans.


The novel feature namely “Believable AI” along with existing ResNet models have improved the accuracy of the software and being a machine learning tool, the accuracy will improve continually.


Chest X-Rays of RT-PCR positive hospitalized patients in various stages of disease involvement were retrospectively analysed using Deep Learning & Convolutional Neural Network models by an indigenously developed deep learning application by CAIR-DRDO for COVID -19 screening using digital chest X-Rays. The algorithm showed an accuracy of 96.73%.





nrip's insight:

Utilizing algorithms for chest X-ray is an effective triaging tool. Once perfected these can accessible by people in remote areas. Thus offering significant improvements in the care process as encountered in rural and remote areas.


Similar methods are being used/experimented on by a variety of labs and digital health companies, for predominant respiratory diseases.


Plus91 has developed similar technology for different Pneumonia and TB.

nrip's curator insight, May 12, 12:47 AM

Utilizing algorithms for chest X-ray is an effective triaging tool. Once perfected these can accessible by people in remote areas. Thus offering significant improvements in the care process as encountered in rural and remote areas.


Similar methods are being used/experimented on by a variety of labs and digital health companies, for predominant respiratory diseases.


Plus91 has developed similar technology for different Pneumonia and TB.


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Global Fund Approves US$75 million for India’s COVID-19 Response

Global Fund Approves US$75 million for India’s COVID-19 Response | Healthcare in India |

The Global Fund has approved US$75 million in fast-track funding to support India’s response to the COVID-19 crisis that is devastating the country. This new funding will support India in purchasing oxygen concentrators and Pressure Swing Adsorption (PSA) oxygen plants to help meet the medium-term needs for medical oxygen.


“What is happening in India can happen elsewhere,” says Peter Sands. “This is a warning that we cannot let our guard down. The emergence and rapid spread of more virulent variants highlights the importance of a global and comprehensive approach – including testing, treatments such as corticosteroids and medical oxygen, and vaccines – to fight this pandemic. No country is safe until we have COVID-19 under control everywhere.”


read the release at the Global Fund website at


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India’s vaccine diplomacy gets a boost from the Quad

India’s vaccine diplomacy gets a boost from the Quad | Healthcare in India |

The leaders of Quad countries (Australia, India, Japan, USA) have decided to launch a mega vaccine initiative under which coronavirus vaccines will be produced in India for the Indo-Pacific region with financial assistance from the United States and Japan while Australia will contribute in logistical aspects.


 As per a joint statement, the vaccination capacity of India will be increased to produce 1 billion doses by 2022,


Foreign Secretary Harsh Vardhan Shringla said it was decided that India's manufacturing capacity is something that is going to be leveraged to make US vaccines.


"In today's context, it is one of the most important initiatives. We are talking about huge investments in creating additional vaccine capacities in India for exports to countries in the Indo-Pacific region for their betterment.


This will undoubtedly boost India’s vaccine diplomacy efforts. India has been providing vaccines to developing countries around the world.

So far 71 countries have received vaccines manufactured in India.


A majority of these are developing countries which did not have adequate access to the vaccine. India’s vaccine diplomacy has won attention for its efforts to make vaccine availability more equitable.


On the other end, there has been criticism that India is working outside the WHO’s COVAX initiative in supplying vaccines. This hypocritical talk has been rejected by India’s External Affairs Minister Subrahmanyam Jaishankar who has asked “Which one of these countries have said that while I vaccinate my own people, I will inoculate other people who need it as much as we do?”


There is a lot the world should learn from India's initiatives against the pandemic and its holistic and altruistic approach against it. Even though many will claim it is doing good so as to enhance its presence in the region, those same people must learn that as per Indian culture, its good to do good and not be concerned about the fruits that the good work may bear. The benefits are not the effect but a side effect.

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Health policies to cover TeleMedicine costs - IRDAI

Health policies to cover TeleMedicine costs - IRDAI | Healthcare in India |

Via three separate circulars, the Insurance Regulatory and Development Authority of India (IRDAI) has directed all insurers to standardize the terms for all policies they underwrite. It has also directed them to include TeleMedicine as part of claim settlement of policy.


It has directed insurers not to bracket costs associated with pharmacy and consumables and implants. It has also directed companies to simplify the wordings of terms and clauses of policies.

Insurers to cover TeleMedicine

The regulator has directed insurers to include TeleMedicine as part of medical consultation cover in health policies. This was done as the Medical Council of India has issued TeleMedicine practice guidelines in March 2020 enabling doctors to provide healthcare using TeleMedicine. The provision of allowing TeleMedicine shall be part of claim settlement of policy of the insurers and need not be filed separately with the authority for any modification. However, the norms of sub limits, monthly/ annual limits, etc., of the product shall apply without any relaxation.


nrip's insight:

TeleHealth has always been a promising healthcare technology and now is its time to shine. This was expected. Covid-19 has brought digital health into the mainstream like never before. Its no more about aggregators and food delivery like apps masquerading as health technology. Talk to Plus91 to know more about how to adopt TeleHealth/TeleMedicine , Clinical Analytics or Mobile Health at your hospital/clinic/research group


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What ails India's healthcare sector: Abhijit Banerjee

What ails India's healthcare sector: Abhijit Banerjee | Healthcare in India |

Here is where we have a huge problem. Ayushman Bharat does very little for primary healthcare.


It has been announced that 1.5 lakh health and wellness centers will be set up, partly to deal with primary healthcare issues including NCDs – but, given the budgetary allocation of less than Rs 1 lakh percenter, this looks more like a very minor upgrading of the existing sub-centers and/or primary healthcare centers (PHCs).


Similar and sometimes more ambitious upgrading, including the provision of some free medicines, has been attempted by a number of states in the past; but, for the most part, there has been no reversal of the trend towards a wholesale exit from public healthcare, especially in North India.


There is now a substantial body of work that documents that, in many states, more than three-quarters of visits to primary care centers are to private providers – even though most of these providers have no medical qualification whatsoever.


This is in part because the sub-centers are open intermittently and unpredictably, and doctors and nurses are often missing from the PHCs.


It seems unlikely that small investments in these sub-centers and PHCs will change all that; the patients will probably continue to stay away, and therefore using these as the basis of outreach for NCDs and other public health interventions probably have limited potential.


The obvious alternative is to make use of informal providers who do have access to the patient population. It should certainly be recognized that they have the potential to be a public health hazard, especially because they abuse antibiotics and steroids – which contributes to rising resistance.


However, the policy response to this phenomenon has been mostly to declare these informal providers illegal and then to ignore their existence. This essentially deprives us of the primary tool for dealing with the very serious health problems that we are facing.


We need to think of ways to integrate them better into the overall healthcare project and give them better incentives, which would be easier if they had something to lose. Based on this we suggest the following steps.


Recognize and train informal healthcare providers.


A randomized control trial that was carried out in West Bengal (published in Science, 2016) shows that training private sector informal healthcare providers to improve their performance (measured by sending them ‘fake’ patients) by a very significant amount. Based on that, West Bengal has already begun training many thousands of informal health providers.


Develop a set of cell-phone-based checklists 


For treatment protocols for these practitioners to use, to react to the common symptoms they face. This is similar to what Atul Gawande has proposed for the United States (but much more basic).


Develop a simple test that allows the government to certify these practitioners as health extension workers.


Passing this test will allow them to deliver various public health interventions and perhaps be paid for participating in them. Moreover, evidence suggests that the patients are aware of the value of such certification and trust those certified more.


Recognize those who are certified


As the front line of defense against NCDs and malnutrition. Think of ways to reward those whose referral leads to the detection of a serious ailment.


Enforce existing laws


That makes it impossible for these practitioners to dispense high-potency antibiotics and steroids. This includes shutting down stores that violate the existing laws about who can prescribe what. At the same time, make it legal for informal providers to prescribe a range of less critical medicines, much like the nurses.


Expand the number of MBBS doctors and trained nurses


Coming out of the system and consider introducing some other intermediate degrees for practicing a limited range of healthcare. This is the model we had before Independence and the one that many other countries have adopted.


In addition, it is not clear that the government should rely entirely on the private sector to deliver tertiary care within PMJAY. There are already complaints from the healthcare sector about the prices the Indian government is proposing, which might result in many hospitals opting out and others selectively refusing to deliver certain treatments (even if that is against the rules). 


PMJAY will probably relieve some of this pressure on these public hospitals. However, it still makes sense for the government to try to simultaneously improve the delivery of secondary and tertiary care in the public sector.


Given that public hospitals will be able to bill their patients to PMJAY, which gives the public hospitals stronger reasons to compete with the private sector, it is a natural moment to expand this part of the government system. Therefore, we recommend, for secondary and tertiary care:


• Build a second district hospital in every district headquarters outside the state capital. Once it is built and is operational, refurbish and modernize the existing district hospital and bring it to acceptable standards.


Finally, it is very difficult to improve healthcare substantially unless we get the customers to demand better care (to fear antibiotics, seek out tests, and so on). This has to be a priority for any government. This is our final recommendation:


• Carry out public health campaigns to raise the awareness of NCDs, immunization and the dangers of overmedication. Recent evidence suggests that entertainment-education may be a very powerful device in this regard.


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The promise of eHealth for rural India

The promise of eHealth for rural India | Healthcare in India |

As a scientist at the New Delhi-based Institute of Genomics and Integrative Biology (IGIB), Dr. Anurag Agrawal often ponders the links between genes and lung disease. Could there be a connection between height, weight and a propensity to develop asthma? How might diet affect chronic obstructive pulmonary disease?


In the winter of 2013, he started thinking: What if there was a way to use shipping containers to collect and mine people’s health records, thereby gaining insights into disease to provide treatment?


One such container eventually made its way to a village in Uttar Pradesh. Here, villagers could gain access to a paramedic, deposit blood samples and have a qualified doctor advise them by monitor. They could submit a cardiogram, have a doctor look at it within days and, if necessary, sound an alert.


The IGIB is one of 39 state-funded Council for Scientific and Industrial Research laboratories. As a government establishment, it had limited scope to expand. But five years ago, IGIB partnered with Narayana Health (NH), a renowned Indian multi-specialty hospital chain, and the American IT giant Hewlett-Packard, to install more than 40 such ‘eHealth’ centres in various parts of the country.


The NH network now uses these shipping containers as part of its rural healthoutreach, which includes electronic medical records (EMR), biometric patient identification and integrated diagnostic devices. The HP cloud-enabled technology allows for the monitoring of clinical and administrative data.



more at


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Indian Air Force launches MedWatch, a #mHealth app

Indian Air Force launches MedWatch, a #mHealth app | Healthcare in India |

The Indian Air Force  has launched a mobile health (mhealth) app to provide health information to the users, including first-aid and other health and nutritional topics


The 'MedWatch' was launched on 8 October on the occasion of IAF's 85th anniversary and was conceived by the doctors of IAF and developed in-house by Directorate of Information Technology (DIT)


"'MedWatch' will provide correct, Scientific and authentic health information to air warriors and all citizens of India.


The app comprises a host of features like information on basic First Aid, health topics and nutritional facts; reminders for timely Medical Review, vaccination and utility tools like Health Record Card, BMI calculator, helpline numbers and web links


The 'MedWatch' is first such health app to be built by any of the three armed forces.


check out the press release :


check out the original unedited article :



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World Bank to assist Andhra Pradesh in transforming health sub-centres

World Bank to assist Andhra Pradesh in transforming health sub-centres | Healthcare in India |

The World Bank came forward to fund for the development of 7,500 health sub-centres as electronic sub-centres (e-sub-centres). As part of the programme, e-health records would be maintained in all the e-sub-centres apart from extending telemedicine facility.


The e-health centres include 1,147 Primary Health Centres (PHCs), 192 Community Health Centres (CHCs), 31 area hospitals, 13 district hospitals and 23 teaching hospitals.


The World Bank (WB) team comprising Programme Leader (Human Development) Jorge Coarasa, Senior Operations Officer Kari Hurt and health specialist Mohini Kak met Chief Minister N. Chandrababu Naidu on Tuesday.


Explaining the government’s efforts in improving health services in the State, Mr. Naidu suggested the visiting team to provide expertise to fill the gaps in medical and health services. The government has introduced IT-enabled health services. However, introduction of some more global practices was required to further improve the services.


The government has been releasing health bulletin every month and sufficient data was available, he said, adding, the WB can extend its cooperation in research and innovation.


Electronic records to be maintained apart from extending telemedicine facility


Read the whole story at


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InnoHEALTH 2018 | Medical Events Guide

InnoHEALTH 2018 | Medical Events Guide | Healthcare in India |

InnoHEALTH is a movement to create a mutually beneficial knowledge platform for all, that would also provides a unique opportunity to young innovators to showcase their products and services to the global community.


The event brings everyone interested in healthcare innovations in a common platform from across the globe. The idea is to create an inclusive ecosystem of healthcare experts, technologists, policy makers, young innovators and all stakeholders, that would assist in the faster adoption of innovations for the betterment of the community.


InnoHEALTH 2018 will be held at Gurgaon, Delhi on  5th and 6th of  October 2018


nrip's insight:

Sign up at for exclusive information as well as offers & discounts for Health and Wellness conferences and events

nrip's curator insight, October 2, 2018 11:09 PM

Sign up at for exclusive information as well as offers & discounts for Health and Wellness conferences and events

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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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Harsh Vardhan launches 'revamped' health schemes - From 'paper-based to paper-less'

Harsh Vardhan launches 'revamped' health schemes - From 'paper-based to paper-less' | Healthcare in India |

Union Health Minister Harsh Vardhan has launched "revamped" health schemes for providing cashless, paperless and citizen-centric services.


These include the revamped Central Government Health Scheme (CGHS) and the umbrella schemes of Rashtriya Arogya Nidhi (RAN) and Health Minister's Discretionary Grant (HMDG) on NHA's IT platform


He said that due to lack of timely intervention, delayed response and various hurdles, the poor and the needy were not able to avail the benefits of these health schemes.


read the original story at



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Digital technology: The next frontier in healthcare delivery in post-Covid India

Digital technology: The next frontier in healthcare delivery in post-Covid India | Healthcare in India |

The pandemic accelerated the humanizing of digital technology – it brought people together at a time when physical distancing was legally mandated in many parts of the world.


One year on, digital solutions – in every sector – have truly come of age. The pandemic has ushered in a new era and meaning for digital tech, as organizations, businesses, and institutions began to function through virtual mediums almost exclusively.


Perhaps most crucially, it demonstrated just how powerful digital interventions can be in last-mile delivery of essential services, particularly in hard-to-reach, underserviced areas, and how they should be leveraged even in times of normalcy without such severe supply chain disruptions.


Nowhere is this more apparent than in health care services. In the early months of lockdown in India, several essential health services were disrupted, and one of the hardest hit was maternal health care.


Childbirth stops for nothing and no one – the ecosystem had to adapt almost overnight to meet the new challenges of maternal health care delivery. For instance, a quality improvement and assurance program called Manyata, which trains health care staff in private maternal care facilities on a set of 16 evidence-based clinical standards for quality and safe care, moved its entire training and certification architecture online to continue providing this crucial capacity-building to under-resourced nursing homes.


And thus, digital interventions came to the rescue.


With the immediate challenges of the pandemic addressed by a plethora of digital innovations, we must retain this momentum to chart a path for realizing India’s Universal Coverage Health goals.


The digital ecosystem offers path-breaking and efficient solutions for accelerating the three pillars of UHC – availability, affordability, and quality – by advancing transformations in health care on both the demand and supply side. 


Digital tech can be a game-changer. In terms of supply, it is enabling reach and scale at levels that were previously unimaginable.


Digital solutions can increase the penetration of quality care mechanisms to remote parts of the country through telemedicine and remote training sessions for health care staff.


On the demand side, tech has tremendous potential to amplify grassroots voices from beneficiaries and patients, both as a means to incorporate their feedback in designing healthcare solutions (or improving existing ones), and encouraging demand for affordable, high-quality care.


However, while leveraging digital interventions for improving healthcare and service delivery is crucial, it cannot be done in silos.


The pandemic has exposed fragilities in the very foundations of our healthcare ecosystem. We must therefore create strong structural support that can enable availability, affordability, and quality to become all-pervasive, by rallying the health ecosystem and incentivizing the participation of both private and public sector. 


Perhaps most crucially, the private sector needs to be integrated into the total health system in order to complement and augment government efforts in strengthening the health care ecosystem. The important role of the private sector was amply reinforced in the aftermath of the Covid-19 pandemic, as the government turned to private sector facilities to help in its frontline response to the virus. So, too, with building a digitally-enabled health ecosystem. 


The visionary National Digital Health Mission (NDHM) is poised to revolutionize Indians’ experience of health care access and delivery. However, for the NDHM to achieve scale and speed of impact, extensive private sector involvement is crucial. 


A strengthened and integrated health system must put its weight behind digital interventions if we hope to facilitate a transformation in the months and years ahead. 


read the original , unedited version at


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Digital Healthcare In India – A Need For Standardisation - Food, Drugs, Healthcare, Life Sciences

Digital Healthcare In India – A Need For Standardisation - Food, Drugs, Healthcare, Life Sciences | Healthcare in India |

India, being a huge country, has always suffered from lack of universal access to quality healthcare. As a result, a huge chunk of healthcare needs end up being unmet.


However, with the increased proliferation of information technology in the healthcare industry, access to healthcare has been positively influenced.


Healthcare is now accessible at our fingertips in the form of online appointments, online consultations, online delivery of medicines, etc.


However, this digital avenue also requires the government to lay down the appropriate legal framework to prevent misuse of technology and exploitation of the end customer/user.


Even though there has been an honest attempt at regulating the online healthcare industry by the authorities, the current regulatory regime is a hit and miss.


The regulatory clarity around the e-healthcare industry does not extend to the e-pharmacy industry, because of which the last mile connectivity of the e-healthcare industry is severely affected.


E-pharmacies have been caught in a regulatory quagmire ever since they first started operating in the country.


The need of the hour is to put in place a comprehensive framework for digital healthcare in India which takes into its fold all its key components. Online delivery of medicines cannot be divorced from online consultations and therefore, a standardised regulatory regime needs to be set up to provide clarity to all the stakeholders in this industry.


The regulatory initiatives relating to online consultations such as the Telemedicine Guidelines, EHR Guidelines, etc. also need to be extended to online pharmacies to instil confidence in major market players.


read the entire article at


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ASHAs need a ray of hope in their lives

ASHAs need a ray of hope in their lives | Healthcare in India |



India features close to the bottom in international rankings in most health indices. The Covid-19 pandemic has exposed the fundamental problems plaguing the healthcare system, be it physical infrastructure, manpower or health management.


At least two-thirds of India’s 1.3 billion people depend on the public healthcare system, but the country has only 8.5 hospital beds and eight physicians per 10,000 people.


On account of the burgeoning costs of private healthcare and the inability of public healthcare to respond to the needs of the huge population, India’s remote villages have been traditionally relying on indigenous health systems of basic care supported by community agents.


Community health workers are greatly improving the life of millions of people where doctors and nurses don’t go. Community healthcare providers, like paramedics, are taught essential services such as maternal and child healthcare. The strategy is to move beyond doctors and nurses and shift down to lay people, peers and family.


An Accredited Social Health Activist — or ASHA, an acronym that translates as “hope” in Hindi — is the Government’s recognised health worker who is usually the first port of call for any health-related demands in rural India, where healthcare facilities are scant and medical professionals can be hard to find.


As a result, many Indian communities, especially women and children, rely on ASHAs for primary healthcare.


In many villages there are 1,000 to 1,500 people in each ASHA’s care.


Any visitor to a village where these community healthcare models are the primary drivers of awareness will marvel at the ability of the ASHAs to connect with and explain things to women. Their lack of a degree is not a handicap, it is an advantage. They understand how to reach the people who most need reaching out to: The illiterate, vulnerable and poor village women. They know how they think and live, because they are one of them.


The efficacy of the ASHAs can be seen in the impact they have made on India’s healthcare indicators. Their efforts have contributed to a 59.9 per cent decline in maternal mortality and a 49.2 per cent decline in infant mortality. Under their aegis, immunisation rates for the country increased from 44 per cent to 62 per cent and institutional deliveries doubled from 39 per cent to 78 per cent.


While ASHA workers have the potential to play a wider role in rural healthcare, their service conditions are pathetic and need to be improved


read the original unedited article at


nrip's insight:

Community workers are the most effective mechanism to improve Rural Healthcare. They should be constantly trained and cared for. The success of Community Health programs in a number of countries such as Nigeria, Ghana, India  have all been due to the effectiveness of empowering people from local communities and training them on specific programs like Maternal Health, Child Care, Malaria, TB, Vaccination programs to ensure they become the go to person for those programs within the local community.

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An overview of NDHM's Technology

An overview of NDHM's Technology | Healthcare in India |

NDHM Architecture

NDHM is employing a federated architecture for its ecosystem. That means that management and data access occurs in a federated manner where different entities or systems will manage the health data.
There is no central data storage controlling and storing data.

Using the Federated Health Records Framework (FHR), patients can access and view their health records, and provide consent to any HIPs and HIUs to access their data.

To ensure smooth consented data sharing and time-bound data access, it is necessary to make the data traceable and auditable. Therefore the FHR Framework architecture leverages MeitY's Data Empowerment and Protection Architecture (DEPA) electronic consent framework, which is already being used in the financial sector.

Here are some interesting technical features of the NDHM ecosystem

FHIR for all Medical Data

Asynchronous APIs

Patient Privacy & Security Features of NDHM

- HIPs can only create data if authorized by the Patient:

- An HIU(Health Information User) can only get past health records of other HIPs if consented by Patient

- Peer to Peer Data Transfer Between HIP & HIU


Final Thoughts

It is one thing to have a concept and another thing to implement and execute it. So far NDHM seems to be going in the right direction. And there is hope that it will continue to do so.

Technology is being given equal importance to gain the trust of all players involved in this industry.


Privacy and Security have been a prime priority in the project as you can see from the above article, this is an oft-ignored aspect in old projects. Hope it continues to stay this way.


read the whole article at




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How did UP's health system prepare itself to introduce COVID vaccines to its people?

How did UP's health system prepare itself to introduce COVID vaccines to its people? | Healthcare in India |

In India, two simulation exercises were conducted in Uttar Pradesh to

  • identify bottlenecks
  • address possible challenges
  • ensure a smooth #COVID19 vaccine roll-out in the largest state of the country


Vaccinating a large group of people is not easy, but the largest state of the country – Uttar Pradesh – prepared well for this task.


With more than 200 million people residing in it, having conducted numerous vaccination campaigns in the past, preparing the health system to vaccinate its people was not new to the state government.


However, to ensure smooth running of the much anticipated COVID vaccination introduction involving adult populations when the disease is still spreading, two dry runs were conducted in all 75 districts: one on January 5, 2020 in 853 sites and the other on January 11, 2020 at 3081 sites. Among these sites, half were in urban and the other half in rural areas in first dry run.


This is the kind of planning and execution strategy which is part of the success of India's COVID Vaccination program. Well done India


Read the mid-planning phase post about this on the WHO Website


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Indian Healthcare Sector is witnessing a huge transformation

Indian Healthcare Sector is witnessing a huge transformation | Healthcare in India |

India is one of the world’s largest democracies and the way it makes a mark on the global map being a powerful and emerging economy, it gives positive insight about the future prospect of the country.


Healthcare, being India’s one of the largest sectors both in terms of revenue and employment, has witnessed a huge transformation in the last decade.


The latest technology and innovative digital tools have led the Indian healthcare delivery system to get evolved in terms of providing enriched healthcare experience to masses especially in the front of clinical outcomes.


With the Government undertaking many measures to bolster patient care and private players playing equally pivotal roles, the sector is making giant leaps to enable people at large to avail accessible and affordable healthcare.


The healthcare sector is projected to become 8.6 trillion by 2022. The unprecedented growth of the healthcare sector is due to a range of factors including spike in non- communicable diseases, a considerable increase in income of the middle class, more awareness, quest for quality care, and easy access to service providers.


The government also seems to be determined to provide quality health for all. With this objective, the spending is set to be increased to 2.5% of the gross domestic product by 2025.


Even though the healthcare sector is growing, there is low accessibility and affordability for most of the population as the insurance coverage is less plus the costs of healthcare are also rising.


Some of the biggest factors for limiting healthcare accessibility include:- 


1. We have 7 beds for 10,000 population whereas globally it is 26 beds.


2. There are more medical professionals in the urban area than in the rural areas/villages where a large strata of our population lives with low accessibility to healthcare.


3. The insurance coverage is also very low as compared to other countries leading to an increase in out-of-pocket expenditure taking a toll on the patients.


4. There is a shift in disease patterns from communicable to non- communicable diseases like diabetes and cardiovascular disorders. The cardiovascular diseases are the highest known cause of death especially in the younger age group in India.


The way technology is making an impact, the time has come when just doctor-patient engagement is not enough. With continuous technological growth, the healthcare industry is going to be more based on “Value-based care “ outcomes in the coming days.


New trends as per Vision2024 would be–


1. Healthcare will go mobile.
2. New strategies to deliver low-cost healthcare will be on the rise.
3. New drug pricing models will be unveiled.
4. Behavioral healthcare will see more acceptance.

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Cancer Cure: Breakthrough 

Cancer Cure: Breakthrough  | Healthcare in India |

In a breakthrough in research, IIT-Bombay scientists have developed technology to leverage a patient’s immune system to cure cancer.


Researchers made use of gene and cell therapies to reengineer immune cells to attack and kill cancer cells in the body.


Such immunotherapy using CAR T-cells, a treatment for cancer, which costs Rs 3-4 crore in the US, can be made available for Rs 15 lakh if the technology is developed in the country. 



Purwar's team has been working on CAR T-cell technology for six years. ''It is an autologous cell therapy for personalized medicine, where cells are taken from patients, re-engineered and re-infused in the patient. We got immune cells from volunteers and clinical patients with help from TMH and re-engineered them using the technique. The modified cells were positively tested in laboratories on artificially grown cancer cells.'' said Purwar. 


T-cells (a type of white blood cell or WBC), an integral part of the human immune system, can identify tumors and destroy them. But in advanced stages, the cancer cells adapt to the presence of T-cells and remain undetected. In the new approach in immunotherapy, called CAR (chimeric antigen receptors) T-cell therapy, the T-cells ability to detect and kill cancer cells is restored. CARs are the protein that assists T-cells to recognize and attach to protein or antigen, present on cancer cells. These proteins help to destroy cancer cells.         


''Our team has delved into strategies that would improve the efficacy of the technique and demonstrated that a single injected dose can lead to multiplication of modified T-cells that can destroy cancer cells,'' said Punwar.   


Globally, over 600 clinical trials are in progress for CAR T-cell therapy, many of which are on in China said, Dr. Narula from TMH. 


''It has got huge potential. With the cancer burden, we have, the therapy will be considered a success, even if it is applicable to only a fraction of patients currently. Technologies are being developed globally, but are exorbitant. There are high expectations from this technology as it can create pathways for developing newer technologies, for newer therapies, for more forms of cancer. Thousands of Asians can benefit,'' said Narula. 


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Funds crunch may hit e-health project

Funds crunch may hit e-health project | Healthcare in India |

Kerela Health Department’s ambitious e-health project has managed to complete a tumultuous pilot phase with “significant achievements” on one side and much valuable lessons learnt on the other.


However, scaling up of the project across the State could remain a far-fetched dream, as the financial investment it entails is huge and the technical challenges immense, it is feared.


The ₹96-crore project envisages the development of an electronic demographic data base, electronic health records (EHRs) of a population and end-to-end automation of all government hospitals.


With less than ₹30 crore Central funds remaining to be secured, finding funds to sustain the project in the long term is a challenge that the Health Department will have to face head on.





nrip's insight:

This pilot has finally reached a point of success after over 5 years of turmoil. Its critical that this project is funded to scale.

Pilotitis should not get another victim, and one where the claim of success is made, something which is not the case with ober 90% of pilots globally.

How to source missing funds: They may find it prudent to look at additional value benefits which can be obtained with additional modules or applications. These are in addition to the features that were part of the pilot. The additional benefits to different departments and/or different ministries may open the doors to get the additional funds

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How the Thiruvananthapuram Medical College is killing the queue with technology

How the Thiruvananthapuram Medical College is killing the queue with technology | Healthcare in India |

The Medical College hospital (MCH) in Thiruvananthapuram, is a prominent healthcare institution in Kerela and attracts thousands of patients every day.


MCH has undergone a series of changes in a bid to present itself as patient-friendly with special emphasis on technology.


1. The process to improve facilities at MCH kickstarted under the government’s ‘Aardram’ mission which aims to introduce a variety of technologies that will strengthen patient infrastructure at hospitals and make them easier to consult doctors.


2. An advanced virtual queue management system has been established through which patients at Akshaya centres, through computers at taluk hospitals can take appointments of doctors at a specific time and date.


3. Instead of waiting for hours at the hospital, patients can now get virtual tokens and just arrive at the hospital at the time of their appointment. This is aimed at eliminating extra crowds at the hospital during those hours.


4. SMS messages will be sent to the patient reminding them of their doctor appointments.


5. Through the e-health system, doctors at MCH can also avail a patient’s medical information via Aadhaar. This will help multiple doctors seeing the same patient access his/her medical history resulting in a fruitful exchange of information.


6. Doctors will soon be able to record their prescriptions digitally on their computer systems which will help them better treat their patients when the latter come for the next appointment. Officials at the pharmacy can also access these records helping in better delivery of medicines.


7. For the past one month, the entire OP block of the MCH barring a floor has been colour-coded for the benefit of patients. “The OP at MCH is vast and many a time, patients find it difficult to find the right OP and the doctor they wish to consult. We have set up LED systems on each floor guiding patients to the right blocks,” Dr Jose said.


8. LED lights in blue, orange, green and red have been set up for each department of the OP.


9. There are wall paintings along with normal signboards as part of patient-friendly measures to identify key departments.



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UP court fines doctors Rs 5,000 for poor handwriting  - suggests that medical reports be computer typed 

UP court fines doctors Rs 5,000 for poor handwriting  - suggests that medical reports be computer typed  | Healthcare in India |

The doctors writing prescriptions in illegible handwritings are under the scrutiny of law in Uttar Pradesh now. The Lucknow bench of Allahabad court set an example by imposing fine of Rs 5,000 each on doctors writing in “poor handwriting”.


Three different cases of doctors writing in running handwriting were reported from Unnao, Sitapur and Gonda district hospitals. The injury reports of the patients were said to be “not readable”

However, the doctors defended themselves, saying the illegible handwriting was due to the extensive workload.

The court further directed principal secretary home, principal secretary medical and health and director general medical health to ensure that in the future medico reports are prepared in easy language and readable writing. The court also suggested that such reports should be computer typed instead of being handwritten.

The medico-legal report, if given clearly, can either endorse the incident as given by the eyewitnesses or can disprove the incident to a great extent. This is possible only if a detailed and clear medico-legal report is furnished by the doctors, with complete responsibility," the bench observed.


curated from




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State-of-the-art-technologies are making their parenthood dream of many come true

State-of-the-art-technologies are making their parenthood dream of many come true | Healthcare in India |

On October 3, 1978, due to the pioneering effort of Dr Subhash Mukhopadhyay and his team in Calcutta, a girl—Durga—was born through IVF. It was the second such attempt in the world, a repeat of what his English counterparts Robert G Edwards and Patrick Steptoe had achieved barely days ago, on July 25. The news boded well for thousands of infertile couples, but there was no noise around the achievement. Perhaps because the couple chose to keep mum and didn’t want themselves or the child’s image to be shaped by the manner of conception. Battling ignominy and failure to be recognised for his monumental work led him to take his life on June 19, 1981. But recognition did come his way, posthumously, and 25 years after the birth of Durga, the physician was “officially” regarded as the first doctor to perform IVF in India. Later on August 6, 1986, Dr Indira Hinduja and Dr Kusum Zaveri helped deliver—Harsha—India’s first test tube baby.


Now, State-of-the-art-technologies are making their parenthood dream of many come true


A latest Ernst & Young (E&Y) report records high prevalence of infertility affecting nearly 10-15 percent of married couples in India, of which women account for 40-50 percent. Infertility attributable to male factors is on the rise and constitutes 30-40 percent of the segment.


Only 1 percent of infertile couples in India seek treatment, says the E&Y report. It highlights the rise in the population of women in reproductive age (20-44). This proportion could go up by 14 percent between 2010 and 2020. The climb is skewed towards women aged between 30 and 44 (20 percent increase estimated between 2010 and 2020), who typically display lower fertility rates. This shifting demographic trend coupled with rising contraceptive use is likely to scale up infertility rates in India.
Age has an important part to play in conception.


Tech to Rescue

The fertility treatment landscape has drastically improved over the years. The services at a fertility centre range from the simplest that involves IUI to the most advanced ones such as IVF,
IMSI (intracytoplasmic morphologically selected sperm injection), ICSI (intra-cytoplasmic sperm injection) and PICSI (a new method of sperm selection for ICSI).Today any IVF specialist is lucky to possess the latest techniques to combat the disadvantage of advanced maternal age, prevent unnecessary transfer of embryos, prevent and reduce implantation failure and give quick results. 


Performing genetic diagnosis prior to embryo implantation could prevent abnormal pregnancies. Various categories of hopeful mothers are advised this screening method. They are:

1. Women who suffered repeated implantation failure or recurrent pregnancy loss while undergoing IVF
2. Patients aged 35 years
3. Women with recurrent miscarriages after IVF
4. Women with a positive history of chromosomal aneuploidies in the family or are diagnosed carriers of chromosomal abnormalities
5. Or have a combination of some of the above factors



nrip's insight:

This is an excellent piece by Shillpi A Singh which came out in the New Indian Express which serves as a written documentary on how the field of IVF has evolved in India and where it will go from here. It touches upon several advances in the field today and has expert views contributed by 

 Dr Narmada Katakam, Medical Director, Genesis Fertility & Laparoscopy Centre, Hyderabad

Dr Aniruddha Malpani of Malpani Infertility Clinic in Mumbai

Dr Keshav Malhotra of Rainbow IVF, Agra

Dr Jayesh Amin, Director, Wings Hospital, Ahmedabad 

Dr Kokila Sreenivas, Director, Sukrutha IVF and Hospital, Tumkur

Dr Rit Shukla, Scientific Director, Pravi IVF & Fertility Centre, Kanpur

Dr Archana Agarwal, Medical Director, Mannat Fertility, Bengaluru



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