Healthcare 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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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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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.





nrips 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.


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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



nrips 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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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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Are you looking for an E-prescribing/EMR  solution for use in India. Contact @plus91 via twitter or via the Plus91 Website at

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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.

nrips insight:

All the best!

Bexci's curator insight, April 4, 2016 9:02 AM

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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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.


nrips 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.



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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


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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


nrips 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 10:09 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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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 7:40 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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nrips insight:

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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