Indian Health Care Sector

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arshyam
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Re: Indian Health Care Sector

Post by arshyam »

^^ A more detailed article on The Hindu - same author, with my added emphasis:
Ebola risk high for India: Expert

An infectious diseases and public health systems expert at Harvard Medical School has warned that the risk of India seeing an Ebola patient is “very, very high,” and predicted that India may well have “at least a few cases before the calendar year is over”.

In an exclusive email interview with The Hindu Ashish Jha, Professor of International Health at Harvard’s School of Public Health and Director of Harvard Global Health Institute, said, “As long as the outbreak continues in West Africa, the chances that someone will end up in India and then, develop symptoms is very high.”

His remarks came even as India’s Health Ministry announced its plan to conduct mock drills simulating treatment for a potentially infected patient, and World Health Organisation Director-General Margaret Chan said, “The whole world is put at risk” by the deadly virus spiralling out of control. WHO’s India office, in a statement, underscored India’s “active screening of passengers at international airports and hospital preparedness in major cities for referral of potential suspected Ebola cases for investigation,” noting the Health Ministry’s screening of 21,799 passengers between August 1 and October 12, of whom 55 were deemed high risk but no positive cases had emerged so far.

{I can vouch for this. Arriving at MAA on Aug 15, I saw screening right at the gate. Also, the flight crew made repeated announcements before landing for passengers to proactively inform the gate staff if they had visited western Africa recently.}

Yet Professor Jha noted that in terms of preparedness to deal with a potential epidemic “The bottom line is that India is probably not as prepared as it should be.”

He said that when the first case crops up it would likely be at a public hospital in some mid-size or large city, where there may be serious questions about whether the institution had provided sufficient training to manage someone, even temporarily, until substantial expertise could be brought in.

In this regard a WHO spokesperson also said to The Hindu that it would “not be surprising to see sporadic cases emerge in other countries as we have seen in Senegal, Nigeria and the U.S.,” though she added that if precautions were put in place, these sporadic cases do not lead to outbreaks.

On the question of preparedness Prof. Jha said he would want to know about whether the hospitals had “proper protective equipment they need to care for [an] Ebola patient,” adding that he “worried” about whether hospitals across the country, even those designated as regional centres of excellence in each state were “really getting the training they need to be safe and effective.

The WHO echoed the concerns surrounding preparedness, with Isabelle Nuttall, the agency’s Director for Global Capacities, Alert and Response, explaining that there was a difference between an Ebola case arriving in a country and spreading in that country.Dr. Nuttall said, “It is possible that a case will arrive in a country and what WHO is doing is getting countries that may see some of these imported cases… prepared, [with the objective] to stop the transmission from occurring in these countries.”

More generally Prof. Jha argued that eradicating Ebola once cases emerge in a country will require meticulous case management and public health skills, and India has “way too few of these kinds of people for a nation of its size and complexity”.

He suggested that India may need to turn to agencies such as the U.S. Centre for Disease Control and the National Institutes of Health in helping it managing the condition.
{This last bit takes the cake! Having bungled screening and treatment in Texas, now this guy wants us to 'take their help'? I would appreciate this brof if he were to address problems in his country first - there was ZERO screening in Seattle when landing from an intl flight last week - not a single guy even remotely looking like a medical professional.}
Reading this article makes me feel either this 'prof' or The Hindu is pushing an agenda here. I mean, I can understand a Harvard 'desi' brof wanting to talk down to us natives once in a while - but why is this even being reported? What standing does this guy have, or achievements to show that he knows what he is talking about? Reminds me of that silly toothpaste ad in India, where some random 'practicing in the UK' dentists recommend using the said toothpaste. Also, the correspondent did not seem to bother asking GoI or the Ministry of Health about this. I didn't see any comments from the govt in this article. Article closed for comments, so cannot post any of the above :(

Our health care is not all that bad - how many SARS or Avian flu cases did we see in India? In fact, I recall one gratifying instance of the pot calling the kettle black - all passengers (incl me) inbound especially from the US were screened in a thermal scanner at MAA during the height of the bird flu epidemic. Suffice to say that bird flu wasn't much of an issue in India. But reading such articles makes the average guy dhoti shiver onlee.
arshyam
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Re: Indian Health Care Sector

Post by arshyam »

These are the guys most affected by the virus, and they are asking for our help. Enough said.

African Union seeks India’s help - IANS, The Hindu
In a bid to fight the rapid spread of the Ebola virus disease, the African Union Support to Ebola Outbreak in West Africa, a team formed for emergency response on Ebola that is under the African Union Commission Social Affairs, has urged the Indian government to lend support with medical human resources.

The Indian government has had disasters, including natural and human made in many aspects and is very good at emergency preparedness and emergency response, hence, working with them in that aspect could really be supportive to tackle the issues, according to Mustapha Sidiki Kaloko, the commissioner for social affairs at the AUC. — IANS
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Re: Indian Health Care Sector

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The next step towards keeping India polio-free - The Hindu
This year, India was certified polio-free, after completing three years without reporting any case of wild polio. Now however, experts say the need of the hour is to switch over to the injectable polio vaccine, which is likely to be introduced into the universal immunisation programme by the third quarter of 2015. Any delay in its introduction could have negative consequences for public health.

“The oral vaccine, which contains three types of weakened polio viruses, has been successful in combating the polio menace, but without the injectable vaccine, polio eradication cannot be concluded,” says T. Jacob John, member of the WHO committee on global polio eradication. He explains that although India is free of the wild polio virus, the oral vaccine continues to cause one case of vaccine-associated paralytic polio in every 1,50,000 babies. “Earlier, the benefits of this vaccine outweighed the risks. But now, it is unethical. A shift to the injectable vaccine will eliminate this risk,” he says.

This apart, the oral polio vaccine could also potentially lead to circulating vaccine-derived polio viruses, when the vaccine virus mutates to become like the wild polio virus. “To pre-empt or combat this, we need the injectable vaccine,” he says.

Once the injectable vaccine is introduced late next year, both forms of the vaccine will be given for some months and then, in 2016, the government plans to remove one component of the oral vaccine (making it bivalent from trivalent), synchronously with the rest of the world.

In a statement, Poonam Khetrapal Singh, regional director, WHO, says that countries must remain mindful of the risk of polio and remain vigilant to detect any case of importation of the virus. “As long as there is polio anywhere, unprotected children in all countries are at risk of getting polio,” the statement says, adding that WHO was working towards implementing the Polio End Game Strategy, which includes introducing at least one dose of injectable polio vaccine into routine immunisation and withdrawal of the oral polio vaccine in a phased manner.
Vriksh
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Re: Indian Health Care Sector

Post by Vriksh »

Seeing chatter on my whatsapp regards Ebola in Delhi Area. Some cases found in Apollo Hospital, Delhi Metro Hospital and Faridabad as per some unverified source. Any confirmation from official sources??
SSridhar
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Re: Indian Health Care Sector

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Iraqi child gets stem cell treatment in Chennai hospital - The Hindu
Nourl Al Zahara

A seven-year-old girl from Iraq underwent stem cell treatment for a heart ailment at Frontier Lifeline Hospital, recently.

The child, Nourl Al Zahara from Baghdad, is the only child of Salem, a botany teacher, and Raza, a lawyer. She was diagnosed with dilated cardiomyopathy, a condition in which the heart muscles get enlarged and weak.

When she was six months old, she had trouble breathing, and when she began walking would get tired easily.

Her skeletal muscles were also weak.

Stem cell treatment was chosen, a release from the hospital said, as doctors wanted to give Nourl’s heart a chance to regenerate and ensure her quality of her life was not compromised.

Healthy

“As the heart does not have the capacity to heal by itself, stem cell therapy helps in the process.

“The treatment was successful and the child is now healthy and looking forward to going to school,” said the chief executive officer and chairman of the hospital K.M. Cherian, according to the release.

The hospital has permission and approval from the Indian Council of Medical Research for stem cell treatment for heart diseases.

Over 100 children have benefited from such stem cell implantations at the hospital, the release said.
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Re: Indian Health Care Sector

Post by panduranghari »

Gawande, who has written a book called The Checklist Manifesto, argues that what we face now in our health systems around the world is not a cashflow crisis, or a lack of knowledge, but a crisis of complexity. We have too much knowledge, and not enough intellectual capability to process it effectively. His solutions sound so easy; not to say too easy — except that he also gave us vivid stories to show just how effective such solutions can be.
Atul Gawande: Why Do Doctors Fail? 25 Nov 14 New York
Atul Gawande: The Century of the System 02 Dec 14 London
Atul Gawande: The Problem of Hubris 09 Dec 14 Edinburgh

The last one is next week from Delhi.

http://www.bbc.co.uk/podcasts/series/reith < can download to listen

Highly recommended for those interested in healthcare in general and economics related to healthcare too.
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Re: Indian Health Care Sector

Post by dsreedhar »

Regenerative medicine (cell therapy, gene therapy) and Immunotherapy are the latest and advancing technologies in the world today.
Where does India stand in research in these areas? So far I see most scientists are from US, Europe, Japan and China but hardly any from India. India need to catch up and contribute to this growing field. Otherwise we end up just importing and paying hefty royalties for these medicines in future.
If it makes sense we need to have a separate thread for Health science research.
Rahul M
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Re: Indian Health Care Sector

Post by Rahul M »

anyone cares to opine on the reported 20% cut in govt spending on health ? why now and how will it impact us ?
TIA.
arshyam
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Re: Indian Health Care Sector

Post by arshyam »

Rahul saar, apparently it is only a reallocation based on the spending pattern for the first half of the spending pattern, fuelled by (what else) mischievous reporting. Please see this article:

Did The Modi Government Cut Health Spend? - Arunabh Saikia, Newslaundry
Ever since we carried this story by India Spend (our content partners), we have received multiple mails and tweets, questioning the authenticity of the story. The story headlined “Facing Health Crises, India Slashes Spend”, quoted a Reuters report, “India slashes health budget, already one of the world’s lowest”.

In light of the many concerns and queries, we figured it is only fair that we put out a story that puts thing in perspective and clarifies the issue.

The India Spend report – and the Reuters report – states that the government has ordered a cut of nearly 20 per cent in its 2014/15 healthcare budget owing to fiscal strains. However, several people have refuted the contention. On Twitter too, where the Reuters story had gone viral with almost a 1,000 shares – there have been several heated arguments. Detractors of the government have questioned its intent to tackle the issue of public health.

The first is the “budget estimate”. The budget estimate for any ministry is the amount allocated to it in the budget papers for the following year. For instance, in this case, Arun Jaitley made a budget estimate of Rs 30,645 crore, while releasing the 2014-15 budget in July, 2014.

This amount, for the record, is five per cent more than what was allocated by the previous government for the 2013-14.

The budget estimate, now, may not be enough for a particular ministry. Or, for that matter, may be more than what a ministry has the wherewithal to deploy. That leads to a “revised estimate” in around December (which is financial mid-year) that quotes an updated figure (according to the situation). Unfortunately, as Mint has pointed out, as many as 10 ministries haven’t even spent 30 per cent of the initial budget estimate.

According to a Lok Sabha document, only about 25 per cent of the allocation on health has been used till October 2014. No, that’s not because public health is hunky-dory in India. The reason is absorption of funds. Which essentially means that there is a serious scarcity of structures to utilise funds. As this Planning Commission document reveals, reasons for this includes weak development of partnerships with non-governmental agencies and the private sector. In fact, increased absorption trends are often a result of higher salaries and not necessarily because of better structures that facilitate better usage of funds.

So, it is perhaps unfair to claim that the reported slash in the revised estimates means a lack of intent on the government’s part to improve public health in India.

To further reiterate, the 2012-13 revised estimate, under the United Progressive Alliance – 2, also saw a cut of more than 18 per cent compared to the initial budget estimate. However, the next budget (2013-14) saw an increased estimate of more than three per cent than the previous year. Which means that cuts in revised estimates are more practical than sinister. Of course, it is beyond calamitous that we don’t have the required structure to utilise our funds efficiently and that we spend only one per cent of our gross domestic product on public health. That, though, is another story.

Notably, Reuters based its story on two anonymous quotes of two health ministry officials. There was no mention in the copy about revised estimates.


Following up on the Reuters report, many news organisations – including Newslaundry – carried reports, which seem to suggest, as pointed out by many people, that Prime Minister Narendra Modi’s government will cut India’s health budget by 20 per cent. That, we admit, is not the truth and premature to say the least.
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Re: Indian Health Care Sector

Post by Varoon Shekhar »

Heartening, particularly in light of some recent negative news about Indian medicines, in the Canadian et al press.

ACCRA: A vaccine against meningitis prepared by an Indian company has been approved by the World Health Organisation (WHO), paving the way for its use to eradicate the disease in sub-Saharan Africa.

The MenAfriVac vaccine was developed by the Indian company, Serum Institute of India Limited (SIIL), under a project of the global non-profit health organisation PATH and the WHO.

"Developing the MenAfriVac vaccine fits exactly (with) Serum's ..

Read more at:
http://economictimes.indiatimes.com/art ... aign=cppst
Suraj
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Re: Indian Health Care Sector

Post by Suraj »

I came across the following document on immunization rate from the erstwhile Planning Commission:
12-23 month immunization coverage data (XLS)

Code: Select all

States/UTs	BCG	Measels	All vaccination
Andhra Pradesh	95.3	74.9	49.6
Assam	73	66.6	37
Bihar	73.9	53.1	39.8
Chhattisgarh	88.3	70.7	54
Gujarat	91.6	74	55.2
Haryana	82.3	80.7	74.8
Himachal Pradesh	100	88.6	73
Jammu and Kashmir	97	86.7	78
Jharkhand	83.7	65.9	51.1
Karnataka	88.6	75.4	63.4
Kerala	100	88.4	79.7
Madhya Pradesh	86.1	65.5	48.9
Maharashtra	100	88.3	65.1
Orissa	83.2	73.7	59.1
Punjab	88.4	79.7	67.9
Rajasthan	70.5	58.4	31.9
Tamil Nadu	99.1	90.9	86.7
Uttar Pradesh	71	41.5	29.9
Uttrakhand	91.4	75.6	63.6
West Bengal	94	82.2	67.4
Delhi	89.6	89.6	63.6
Chandigarh	100	100	100
Arunachal Pradesh	65.1	34.6	19.1
Manipur	100	100	100
Meghalaya	82.8	100	82.8
Mizoram	75.4	100	75.4
Nagaland	96.8	81.2	78
Tripura	80.1	72.8	69.4
Sikkim	100	100	100
Dadar& Nagar Haveli	100	100	100
Daman & Diu	100	100	100
Goa	100	59.3	59.3
Puducherry	100	100	100
Andaman & Nicobar Islands	100	95	95
All India	84.4	67.2	51.2
The overall numbers are not very good at all. Even though polio has now been fully eradicated, its dangerous to depend just on herd immunity, and basic universal care should include the full set of vaccinations for every child.
Vriksh
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Re: Indian Health Care Sector

Post by Vriksh »

Recently I have been working on applications development for a solid phase non toxic, reusable (but expensive) industrial absorbent that is extremely good at picking up hydrophobic/ non polar / oleophillic molecules as compared to polar, hydrophillic compounds. It can potentially absorb molecules like Pharma APIs quite effectively ~concentrating APIs by about 100-300 times in the solid phase. Initial focus was on using this for waste water remediation however now we are looking to develop green separation technology for Pharmaceutical manufacturing. Any gurus/ resources who I can tap to understand the market potential / physics/chemistry/engineering/process design in the Pharma sectors using this material? It is similar to Tenax TA used in GCMS SPE cartridges in term of properties.
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Re: Indian Health Care Sector

Post by A_Gupta »

http://timesofindia.indiatimes.com/city ... 830048.cms
NAGPUR: An average increase of 8.6 years in the lifespan of Indians between 1990 and 2013 is a surely a huge positive for the country. Still, the country has a long way to go as many smaller and developing nations have done far better.

The latest study on life expectancy and causes of deaths in 188 countries published in journal Lancet on December 18, 2014, has shown that though India has done good, Nepal, Bangladesh and Bhutan did better with achieving increase in life expectancy ranging from nine to 11 years. The only exception among South Asian neighbours is Pakistan where the average rise in men's age has been just two years while that of women five years.

Sri Lanka too saw an increase of just five years each for both men and women but that is because it was already doing much better than anyone else in 1990 with average life expectancy higher than India by ten years for men and 17 years for women. India did close in a bit during the period with difference now remaining eight years for men and 12 years for women. Despite the improvement, India ranks 133rd for women and 132nd for men among 188 countries under study showing India's performance relative to the world has been less than impressive.
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Re: Indian Health Care Sector

Post by vina »

Sad to see the news of Dr Suniti Solomon's passing away. She of course was the person who first identified cases of Aids infection in India and played a large large part in setting up the advocacy, support, screening and treatment centres and AIDS control strategy along with the Govt of India and prevented the dooms day prediction of India becoming the global AIDS capital of the world and having sub saharan levels of AIDS infection coming about.

I wish the she was honoured with a Padma award for her contribution , even posthumously. She was a Professor of Microbiology at Madras Medical College Hospital. A wonderful human being and a brilliant doctor and researcher.

Her husband, Solomon Victor was an brilliant cardiologist as well and again a great human being with tremendous values. Tamil Nadu was blessed to have such brilliant people with sterling values at the helm in many fields including public health and medicine .Now of course a lot of that has been flushed down the toilet and diluted with the casteist poison and commercialisation of the entire healthcare sector, especially in TN. A person of the calibre of Dr Solomon Victor and Dr Suniti Solomon probably won't even make it to a medical college in TN , unless they were of the right "caste" or their parents shelled out nearly a crore in capitation fees and a few more crores their post graduations and if are were trained by the pioneers/ world leaders in their fields like they were, probably wouldn't come back to India at all and even if they did, most probably not serve in Madras Medical College Hospital.
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Re: Indian Health Care Sector

Post by manju »

I help set up the first (in India) University accredited HIV Fellowship in 2005 which is housed in SVYM, Sargur Village, Mysuru dt. This one year HIV Fellowship is accredited by Rajiv Gandhi Health Sciences Univ.

http://timesofindia.indiatimes.com/city ... 650539.cms

Article on Swami Vivekananda Youth Movement in paper. http://www.svym.org/


MYSURU: Self-confidence and moral support can beat all odds in life. A classic example is that of Keshava (name changed). The 42-year-old has been an HIV positive since 2004 and initially he was in a bad condition. Doctors too had given up on him. But today, Keshava is leading a dignified life. He could walk over 3km a day without any support.

"I did not think I could live. It's only because of self-confidence and moral support that I could survive," says Keshava. Initially, he did not take treatment due to financial constraints. He owned a petty shop to sustain his family. In 2011, his health deteriorated and he was bedridden, unable to even move his hands. Doctors sent him back home losing all hope, he added.

His mother Sathyavathi says she owes it all to the Swami Vivekananda Youth Movement (SVYM). "If my son is alive, it's only because of SVYM and its volunteers' moral support," she says.

Despite his failing health, he did small jobs like starting a mobile recharge shop to support his family.

Thanks to the palliative care facility of SVYM, the bedridden patients and their families get support. The facility, apart from taking care of patients, also helps their family members to avail governmental benefits. "Now, I am receiving widow pension and my son is getting pension from the government. Palliative care volunteers helped me get these benefits," said Sathyavathi.
......................

Like him, more than 300 bedridden needy patients have availed palliative care. Today, some of them are leading a dignified life. "The goal is to improve the quality of life for patients and their families. The need of palliative care is essential in terminal and chronic diseases as they are incurable and result in physical, psychological, socio-economic strain to individuals and their families," says palliative care volunteer Dr Deepak Murthy.

The palliative care facility has served 345 bedridden patients suffering from cancer, paralysis, spinal cord injury, severe neurological disorders, hypertension, gangrene, kidney failure, cerebral palsy and other illnesses since 2011. Initially, 88 patients were inducted into the programme. Palliative care operates with a team approach consisting of doctors, nurses, counsellors, social workers and volunteers visiting each patient's home and providing a holistic care for patients to improve the quality of life by using an array of skills at their doorstep.
Theo_Fidel

Re: Indian Health Care Sector

Post by Theo_Fidel »

Interesting data on Alcohol and Tobacco consumption from around the country, though a bit dated. When country liquor is added in looks like TN is actually on of the moderate states in per capita consumption! The worst appears to be broad band of of central states, WB and Andhra/Telegana in a category of its own. The North/Western states also needs to gets it bidi consumption under control, in fact whole of India has a bidi problem. NE also seems to have a alcohol problem.

I guess we should stop making snide comments about TASMAC now, of which I'm as guilty as anyone else. TN has found a way to monetize Alcohol consumption but the problem areas seem to be other states. So all the advice freely given to TN should also be directed elsewhere... :evil:

http://www.thehindu.com/opinion/blogs/b ... 344654.ece

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panduranghari
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Re: Indian Health Care Sector

Post by panduranghari »

manju wrote:I help set up the first (in India) University accredited HIV Fellowship in 2005 which is housed in SVYM, Sargur Village, Mysuru dt. This one year HIV Fellowship is accredited by Rajiv Gandhi Health Sciences Univ.
Manju ji, any volunteering opportunities available in SVYM?
panduranghari
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Re: Indian Health Care Sector

Post by panduranghari »

Ripe for Disruption
Healthcare is so massively broken, that its disruption will come easy and happen fast. Hundreds of startups are working to make you the ‘CEO of your own health’ – to augment (or replace) doctors and hospitals.

I expect new AI-enabled healthcare options to be free or near-free, and so much better, that people will forgo traditional medical care in favor of these superior options. This will cause today’s healthcare system to crater.

Think libraries in an age of Google… Think traditional wired landlines in an age of mobile telephony… Think taxis in an age of Uber… Think long-distance in an age of Skype… the list goes on.

So what’s coming?

The $10M Qualcomm Tricorder XPRIZE will give birth to devices (i.e. the Star Trek Tricorder) that allow you, the consumer, to self-diagnose, anytime, anywhere.

Sick of going to the hospital? Companies like Walgreens and CVS are working to become your healthcare center.

My company Human Longevity Inc. (HLI) will sequence all 3.2 billion letters in your genome, plus your microbiome and compare your data to a massive database of millions of consumers.

Such data mining will allow you (your AI or your physician) to know in advance which diseases threaten you, and make your healthcare proactive and preventive.

HLI’s goal is to enable “n of 1” care, where the medicine prescribed for you is the perfect medicine just for you. HLI’s goal is also to add 30+ healthy years onto your life, making “100 years old the new 60.”

Beyond genomics, there’s a revolution in Stem Cell science unfolding, which to quote my friend and HLI co-Founder Dr. Bob Hariri, “will allow us to rejuvenate the regenerative engine of our body.” Rather than treating chronic organ disease, we are not far off from growing a replacement lung, liver, heart or kidney.

As powerful as genomics and stem cells are, there is an equally important revolution in biometric sensors under development. If you can’t measure it, you can’t effect it, and companies like Google, Apple, Samsung and dozens of other companies are investing billions to lead the way.

These sensors will constantly monitor your health… heart rate, blood pressure, blood glucose, and even small molecules released from cancers or cardiac trauma.

Coupled to your genomics, this sensor data will be uploaded seamlessly to your health app, giving you the needed warning to stop disease or damage before it happens. To quote SU professor and friend Dr. Daniel Kraft, think of this as “OnStar for your Body.”

Who will pay for it? Probably not you. Probably your insurance company, which makes a lot more money when you stay out of the hospital and live longer (they collect more fees and pay out far less).
Finance

Finance is another trillion-dollar industry that is in for a lot of interesting times ahead.

The days of a middleman financial advisor or broker will diminish this decade.

Big data-enabled AI is going to make everything cheaper, faster and better for you, the consumer.

As just one example, my friends at IBM Watson have been developing finance applications for the Watson ecosystem which, in my opinion, are excellent.

Imagine a service that can read through your social media posts from the past couple of years and determine from sentiment analysis which industries and values you like and which you don’t. You love tech and fashion, but hate alcohol and violence. You love Europe, but are not a fan of Russia, etc.

In an age of millennials where what you stand for is as important as the profits you make. This gives the upper hand to an AI that can sort through 10,000 possible companies and recommend to you those investments which are most aligned with your values on a risk-adjusted basis.

Plus, it can monitor your social media and the global marketplace and adjust your portfolio as often as you wish.

Another revolution upon us are AI firms (Sentient Technologies is just one example) that are using advanced machine learning and data mining techniques to perform algorithmic trades on the stock market that no human will ever match.

Even better is AI trading based on massive bid data. We’re heading towards a world of a trillion sensors, riding on top of a world filled with 100 billion connected devices.

This will give your AI a 'god-like knowledge,’ allowing you (or your AI) to know anything, anytime, anywhere…

What do you I mean? Today there are companies that are using satellites to image and count cars in the Toys-R-Us or Home Depot parking lots every day, and based on that knowledge project the company’s revenues ahead of quarterly earnings reports.

Now extend this concept of ubiquitous knowledge to everything (and I mean everything) and you can see how finance might change.
Insurance

Insurance is an old business that deals with probabilities and imperfect knowledge. But in an era of 'perfect knowledge’, a lot is going to change. Here are just a few examples.

Health and Life Insurance…

Today Progressive Automotive Insurance will offer you a rate discount (Snapshot) if you allow them to install a sensor in your car that reports speed and acceleration – basically the data to show if you’re a good or bad driver.

Now imagine the same for your body… Want cheap insurance? Allow the insurance company to monitor your health and sequence your genome.

Again, this is not about denying you insurance or giving you a higher rate if you have bad genes (there’s actually a law against that called the Genetic Information Nondiscrimination Act of 2008, the GINA law, which prohibits prejudice again a single individual on behalf of their genome). This innovation is about giving you a discount if you’ll allow the insurance company to assist you in living healthier and longer. A total Win-Win.

Here’s another BIG scenario that could see the collapse of today’s insurance industry.

Let’s say that I have a genome relatively free of major disease, I don’t smoke, I eat healthy and I work out every day.

Let’s also say that I publish this information (validated by my sensors) to my social graph and say, “Hey, anyone else with good genes, healthy eating and workout habits who wants to self-insure along with me, let’s do it… We’re a low-risk partnership!”

If this was to happen, and the top 10% of the insurance pool pulled themselves out of the marketplace, this would crush the economics of the industry.

Up until now, this kind of knowledge and “peer-to-peer insurance” would never have been possible. It is now.

“Hold it,” you say… “There’s regulation that will stop you.” Yes, sure, there is, for the moment. But just like Uber versus the taxi industry, regulation can only be a stumbling block for so long.

Eventually the buggy-whip manufacturers die off as the automobile comes on the scene.

Automotive Insurance…

Above I already mentioned Progressive Snapshot Sensor Program, but imagine the next step…

In an era of autonomous cars, there may be no more need for auto insurance.

Autonomous cars don’t (rarely?) crash, so why insure?

Even worse for the insurance industry, people will stop buying cars altogether.

You won’t own a car any more, but instead you’ll have access to a 24x7 autonomous car service. Just like companies today that don’t own their servers anymore; instead, they use the cloud from Amazon or Google.

If you don’t own a car, there’s nothing to insure.

Farming/Crop Insurance…

Lastly, let’s focus on farming and crop insurance. The following also applies to many other types of insurance that I haven’t mentioned.

Today, when crops are insured for hail damage (for example), the process of assessing damage is expensive and inaccurate. It involves farmers or insurance assessors walking out into the fields and taking photographs.

But in an age of ubiquitous imaging (i.e. low-Earth orbit satellites and drones) and ubiquitous sensing (in-field sensors), this assessment is global, instant and effectively free.

An explosion of startups accurately and cheaply gathering massive amounts of data will reinvent every aspect of this particular niche, and in fact, every aspect of the insurance industry as a whole.
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Re: Indian Health Care Sector

Post by Amber G. »

x-post .. please see in US/India dhaga..
Raja Bose wrote: er...that's not the Google Glass AmberG is referring to. Anyhow those glucose measuring contact lens are not Google Glass.
..
Sorry, misspoke, and indeed I meant google's contact lesses ("glucose glasses?"), which I am told NaMo and the team is more interested.. ..OTOH effect of glucose which rotates polarization of light could indeed lead to actual google glass type devices to indeed work even without contacting the tears in the eye. ...(I have been talking about this idea to some for many years.. and there are patents .. but now this is perhaps practical technically)

This, specially technical details may/ought to go in its appropriate dhaga but NaMo's trip may inspire, push ahead many such health-care related products, and that will be good.

(VT, is right - BITS (Pilani), IIT's, MIT.. just to name a few, also have cool products, fairly near the final stages... simple monitoring (plus blood tests like measuring A1C - which Theranos can now - in California it is being done - do it with fraction (1/50 th of the cost of regular lab test)) can make a very BIG impact.

Anyway I hope lot of good things get pushed...

Let me end this by putting a small youtube interview of Elizabeth Holmes (CEO of Theranos) done by IIT alum in IIT leadership conference just a month or so ago...Homes got a standing ovation after his keynote address to the crowd (attended by IIT crowd, Indian ambassador to US, many CEO's of silicon valley, and even some brfites :). I did ask her about India (and other parts of US) and she was very enthusiastic and hoping that it will be soon. (At present only California, Arizona and Pennsylvania has these centers).

Here is the interview.. Note the background (IIT logos..) and her hope that bright youths(including IITians :) ) will help such projects..
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Re: Indian Health Care Sector

Post by Amber G. »

saip wrote:
vayu tuvan wrote:AmberG: All are Indian sources so they don't count. As Ulan Batori says it is zero coverage (in US media, i.e.).
Google glasses for Blood Glucose levels? Really? cheaper mass manufactured single use chemical measuring strips can be made for far fewer dollars (or INR) than the failed google glasses. Sorry no cigar saar.
The problem with single use strips is the need for poking your fingers to check the glucose level and that does not give you continuous reading. Something that continuously measures and sounds an alarm BEFORE your glucose level drops dangerously low is the need. That is the reason I keep a supply of hard candy in my vehicles. Even though the medications i take are not supposed to cause hypoglycemia, they do. Google contact glasses may be good but I think they are yet too expensive and difficult to use.
Saip - A few comments and alternatives which may be of help..

- Trouble with many strips and meters (current available in US/Canada) is that they are VERY inaccurate. .(FDA requires something like 15% accuracy for 95% sample).. expensive..and uses old technology..

There are alternative good methods in various stages (but red-tape etc is in the way).. For example BITS (Pilani)-- along with some other institutes and companies - has developed a method costing about $.03 c per test.. MIT a has a product which requires no pin-prick.. (uses laser light and spectrum analysis).. There is a Israeli co which has prick-less meter (still expensive) in the market..Apple iWatch has a continues monitoring system..(using a patch under the skin) etc..

There are dogs who can alert for hypoglycemia, using just their nose ..they are getting into wider use..(So perhaps one can make chemical-sniffing meters)

There may be new methods, specially when we have good mobile computing power.. like measuring impedance of the skin, using tears in the eye, or polarization etc..

Then Theranos has long term - A1C type testing, costing less than price of a lunch, so that you can take it every 3 months..instead of every year (or much less often for 99% of the people in India due to cost) so that one can catch it much earlier..(I used their wellness center to test my blood, and I, was extremely happy to see the efficiency - the results were delivered to my iPhone (as well as to my Doctor) within hours..)


I heard some knowledgeable people say that diabetes (type 2) is in practice "reversible" if caught early ..
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Re: Indian Health Care Sector

Post by sanjaykumar »

Yes, glucose is a chiral molecule but so are the vast majority of biologically active molecules. A circular dichroism spectrum of glucose in solution may be somewhat specific but would be swamped by spurious signal from unrelated compounds, unless purified. It is an interesting idea to use tears, as a partially purified solution of glucose.

It would be unlikely for dogs to sniff out hypoglycemia-perhaps they can be trained to alert for behavioural changes attended upon hypoglycemia. Alert for diabetic ketoacidosis is of course more likely, but trivial. (Many humans are quite sensitive to the odour of ketones).

HgA1c is widely available in the west, it makes little clinical impact-for that needs motivated, compliant patients and compulsive physicians.
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Re: Indian Health Care Sector

Post by saip »

There is also a watch which uses disposable strips and does continuous monitoring. It is prescription only and the strips seem to be expensive. Having been dealing with type II diabetes for the past 15 years (that is the reason of my marathons), I am aware of the recent developments, but they have a long way to go. At the moment it is under control with medicines, but it is the random nature of hypoglycemia that I experience is a concern to me. The Presidential candidate Hukkabee touts a voodoo medicine for reversing diabetes. To think I used to like this guy because he ran a marathon after losing weight !!
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Post by arshyam »

There is an implant based system that is uses bluetooth to alert hypo and hyper glycemia on the phone. But the implant is still new tech and needs to be replaced periodically. And yes, expensive.
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Re: Indian Health Care Sector

Post by Amber G. »

Hi Sanjay. Nice post. To add..
sanjaykumar wrote:Yes, glucose is a chiral molecule but so are the vast majority of biologically active molecules. A circular dichroism spectrum of glucose in solution may be somewhat specific but would be swamped by spurious signal from unrelated compounds, unless purified. It is an interesting idea to use tears, as a partially purified solution of glucose.
The key point, IMO, is if you have good CPU/computing power etc one can look through those "spurious signals" and get very meaningful data..This not theory anymore. There are products which are giving accurate results (passing clinical trials etc). Tears (which google is using) is one good idea and the product may be in market sooner than many think,

Also in news, for quite some time, MIT type nano-sensors for skin-based glucose sensing..(these can be injected under skin like a tattoo dye)..and measuring fluoresce under infrared light... I think some prick-less glucose monitoring products are FDA approved and are in market (though quite expensive at present).

I was also thinking other properties..(will need work to look through all the noise signals etc) like impedance of skin varies as glucose level changes.
It would be unlikely for dogs to sniff out hypoglycemia-perhaps they can be trained to alert for behavioural changes attended upon hypoglycemia. Alert for diabetic ketoacidosis is of course more likely, but trivial. (Many humans are quite sensitive to the odour of ketones)
.

I recently visited Guide Dogs for the Blind, and they told me that they are donating good dogs for this kind of training. There are schools which are doing the training like Diabetic Alert Dogs..
Dogs can smell sweat and IF TRAINED can detect hypoglycemia, I am told..These service dogs are trained to smell chemical changes the human body produces when blood glucose is dropping or is low..Alert dogs have become more and more popular over the past few years, especially with people who have hypoglycemia unawareness.

More needs to be studied (strict clinical-trials) to study how (or how good) this works and certification of the the dogs etc..at present these animals provide a signal to alert their owner to check blood glucose and treat hypoglycemia, if necessary... I have heard anecdotal stories but would like to see clinical trials (Dogs are fairly expensive to train etc..>$50,000 per dog)
HgA1c is widely available in the west, it makes little clinical impact-for that needs motivated, compliant patients and compulsive physicians.
Yes it is widely available but most people don't do it (or do it once a year - or if there are other indications). Point is, (and that is what Theranos is driving at), if the price is low, why not do this (or other diagnostic tests) routinely for everyone so that one can catch and prevent diseases before they become serious.
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Post by saip »

The dog being so expensive is no solution except perhaps in a senior home where many of them could be diabetic and experience episodes of hypoglycemia. But for individual usage i do not see them to be of much use unless to help an individual who is senile/suffering from alzeimers.
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Post by sanjaykumar »

Yes it is widely available but most people don't do it (or do it once a year - or if there are other indications). Point is, (and that is what Theranos is driving at), if the price is low, why not do this (or other diagnostic tests) routinely for everyone so that one can catch and prevent diseases before they become serious.


HgA1C levels report the blood glucose over previous three months hence, more frequent measurements are of no further value. HgA1C is not quite yet a standard diabetes mellitus diagnostic test (variablity secondary to ethnicity, assay type, hempglobin allele variants, thallasemia trait etc). Most patients have poor control as assessed by HgA1C but unfortunately the HgA1C is not the limiting factor in improved diabetic compliance.
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Re: Indian Health Care Sector

Post by Vayutuvan »

arshyam wrote:There is an implant based system that is uses bluetooth to alert hypo and hyper glycemia on the phone. But the implant is still new tech and needs to be replaced periodically. And yes, expensive.
replacement because it runs out of power? There is some research into using the natural interactions and ionic channels in the body to power low power implants. Also is it possible to implant an optical fiber one end of which is outside and the other end is on a solar cell in the implant? Then all one needs to do to recharge the implant is to place the exposed end of the optical fiber under a sunlight/artificial light source for a a few minutes.
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Re: Indian Health Care Sector

Post by Amber G. »

saip wrote:The dog being so expensive is no solution except perhaps in a senior home where many of them could be diabetic and experience episodes of hypoglycemia. But for individual usage i do not see them to be of much use unless to help an individual who is senile/suffering from alzeimers.
Saip - The dogs I know have been VERY successful for small children, young adults, and regular folks hi. Their accuracy/reliability specially for hypoglycemia is very good. I know some guide dogs who have learnt this and are quite good at this.

(I know one person who has been using guide dogs for last 25+ years and one/two dogs (out of a few he handled over the life time) have been extremely good - virtually alerting him every time, and when he measured it was low.. If you are interested, I think the person who started this training has written a very good book-- check out the diabetes dogs school in California. (I gave the link earlier)..

Guide dogs (for blind) is another area where India is far behind. The quality of life, a dog changes is simply amazing. US, Canada, or even Japan and Singapore have these schools but India has NO guide dog schools or even laws or education about this...
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Re: Indian Health Care Sector

Post by arshyam »

vayu tuvan wrote:
arshyam wrote:There is an implant based system that is uses bluetooth to alert hypo and hyper glycemia on the phone. But the implant is still new tech and needs to be replaced periodically. And yes, expensive.
replacement because it runs out of power? There is some research into using the natural interactions and ionic channels in the body to power low power implants. Also is it possible to implant an optical fiber one end of which is outside and the other end is on a solar cell in the implant? Then all one needs to do to recharge the implant is to place the exposed end of the optical fiber under a sunlight/artificial light source for a a few minutes.
I am not sure. Apparently, the actual sensor is very thin (it's like a very thin hair) , and a device is attached to it on top of of the skin. This device has the power, I think, so it should be rechargeable. Will try to find the name of it, can't recollect now.
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Re: Indian Health Care Sector

Post by chaitanya »

National War Memorial, new AIIMS & bonus for railway employees: 7 things Cabinet cleared today
4) Three new All India Institutes of Medical Sciences (AIIMS) at Nagpur in Maharashtra, Manglagiri in Andhra Pradesh and at Kalyani in West Bengal under Pradhan Mantri Swasthya Suraksha Yojna, this will cost Rs 4,949 crore.

The institutes to be set up will be on par with the one in Delhi, complete with attached hospitals with capacity of 960 beds, teaching blocks, hostel and residential facilities.

Of the Rs 4,949 crore, the cost of the new AIIMS at Manglagiri in Andhra Pradesh will be around Rs 1,618 crore, at Nagpur in Maharashtra of Rs 1,577 crore and at Kalyani in West Bengal of Rs 1,754 crore.
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Re: Indian Health Care Sector

Post by panduranghari »

The future of blood tests

Image
Holmes, now 30, dropped out of Stanford and founded a company called Theranos with her tuition money. Last fall it finally introduced its radical blood-testing service in a Walgreens pharmacy near company head­quarters in Palo Alto, California. (The plan is to roll out testing centers nation­wide.) Instead of vials of blood—one for every test needed—Theranos requires only a pinprick and a drop of blood. With that they can perform hundreds of tests, from standard cholesterol checks to sophisticated genetic analyses. The results are faster, more accurate, and far cheaper than conventional methods.

The implications are mind-blowing. With inexpensive and easy access to the infor­mation running through their veins, people will have an unprecedented window on their own health. And a new generation of diagnostic tests could allow them to head off serious afflictions from cancer to diabetes to heart disease.

None of this would work if Theranos hadn’t figured out how to make testing trans­parent and inexpensive.
The key is minimizing the variability that traditionally contributes to error in the lab process. Ninety-three percent of error is associated with what’s called pre-analytic processing — generally the part of the process where humans do things.

Such as?

Manually centrifuging a sample or how much time elapses before you test the sample, which brings its decay rate into play.

So how do you avoid these potential errors?

There’s no manual handling of the sample, no one is trying to pipette into a Nanotainer, no one is manually processing it. The blood is collected and put into a box that keeps it cold. The very next thing that happens is lab processing, and that’s done with automated devices at our centralized facility with no manual intervention or operation.

How can improved processes actually save lives?

We’ve created a tool for physicians to look at lab-test data over time and see trends. We don’t usually think about lab data this way today. It’s “Are you in range, or are you out of range?” Instead, we like to think, “Where are you going?” If you showed me a single frame from a movie and asked me to tell you the story, I wouldn’t be able to do it. But with many frames, you can start to see the movie unfold.
In India local primary health centres could do this easily. No advanced medical training needed. If we had high tech facilities in many if not all cities, this would revolutionise access to healthcare. I wonder if Narayana hrudayala would be interested in this?
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Post by shiv »

Folks - in addition to my usual hobby of making aviation videos - there is just one medical video I have been wanting to make for a long time. Done it now. An explanation of Laparoscopic Gall Bladder surgery in 3 minutes - using an animation first and then parts of a live op. Comes with a disclaimer :D

https://www.youtube.com/watch?v=r-W953mlmbA
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Re: Indian Health Care Sector

Post by member_29089 »

shiv wrote:Folks - in addition to my usual hobby of making aviation videos - there is just one medical video I have been wanting to make for a long time. Done it now. An explanation of Laparoscopic Gall Bladder surgery in 3 minutes - using an animation first and then parts of a live op. Comes with a disclaimer :D

https://www.youtube.com/watch?v=r-W953mlmbA

ShivJi Pranaam.

In your audio it seems that there is some clipping and squeaking. It is possible to condition the audio (even if it's not recorded with professional equipment) with a free software called audacity. The software is easy and fun to use. It has a million signal processing features but I think this audio only needs some peaking taken care of. Audacity also allows one to mix background music etc to the existing track. Then you can save it in one of popular formats and then encode it with your video (generally MP3 or AAC works well)

Also it seems that whichever mic you are using (collar-mic or headphone/mic) is too close to you. It can be improved with simple plastic cover with a few holes so that it does not pick up noise from other directions, and then placed about 1 foot away. Then use audacity to amplify it to desired levels

Chances are you already know all this, in that case apologies.

PS. Can you make one showing paki brain surgery I mean hemorrhoid removal? TIA. :mrgreen:
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Re: Indian Health Care Sector

Post by shiv »

GunterH wrote:
In your audio it seems that there is some clipping and squeaking. It is possible to condition the audio (even if it's not recorded with professional equipment) with a free software called audacity. The software is easy and fun to use. It has a million signal processing features but I think this audio only needs some peaking taken care of. Audacity also allows one to mix background music etc to the existing track. Then you can save it in one of popular formats and then encode it with your video (generally MP3 or AAC works well)

Also it seems that whichever mic you are using (collar-mic or headphone/mic) is too close to you. It can be improved with simple plastic cover with a few holes so that it does not pick up noise from other directions, and then placed about 1 foot away. Then use audacity to amplify it to desired levels

Chances are you already know all this, in that case apologies.

PS. Can you make one showing paki brain surgery I mean hemorrhoid removal? TIA. :mrgreen:
:D

That audio was recorded on Audacity using a standard headphone/mic combo in the presence of continuous background noise of birds and squirrels outside my window apart from the odd human voice and cow mooing, believe it or not. The clicks you hear are what is left after removing background noise using Audacity. Speaking of haemorrhoids and constipation - the noise removal has given my voice a constipated quality as in "Fust read da disclaima"
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Re: Indian Health Care Sector

Post by Vipul »

Indian medical tourism to touch Rs 52,200 crore by 2020.

As healthcare turns costlier in developed countries, India's medical tourism market is expected to more than double in size from $3 billion at present to around $8 billion by 2020, a report says.

According to a CII Grant Thornton white paper, cost is a major driver for nearly 80% of medical tourists across the globe. The cost-consciousness factor and availability of accredited facilities have led to emergence of several global medical tourism corridors Singapore, Thailand, India, Malaysia, Taiwan, Mexico and Costa Rica.

"Amongst these corridors of health, India has the second largest number of accredited facilities (after Thailand). The Indian Medical Tourism market is expected to grow from its current size of $3 billion to $7-8 billion by 2020," Grant Thornton India's National Managing Partner Vishesh C Chandiok said.

Bangladesh and Afghanistan dominate the Indian Medical Value Travel (MVT) with 34% share.

Africa, GCC and CIS regions (whose current share is just 30%), present the maximum possible opportunity for the Indian healthcare sector. Medical tourists from these sectors currently favour the South East Asian medical corridors.

Chennai, Mumbai, AP and NCR are the most favoured medical tourism destinations for the floating medical population who avail treatments in India.

"While the number of MVTs itself is poised to grow at over 20% CAGR, Kerala needs to focus on its visibility as a healthcare destination amongst other states," said the report.

Kerala attracts only 5% of such medical tourists currently and has the potential to increase its share to a 10-12% with a focused marketing strategy.

As per the study, the key factor to drive medical value tourism in Kerala will be availability of national as well as globally accredited facilities across the entire state, an area where Kerala lags behind in comparison to Tamil Nadu, Maharashtra, NCR and Andhra Pradesh.
"... Kerala is already one of the most preferred tourist destination in the country. For medical value tourism, however, there is a clear need to build and upgrade infrastructure," Grant Thornton India Partner Vrinda Mathur said.

The white paper suggests tapping a larger share of the health wallet of the African, Asian, Middle East patients as well as welcoming tourists from other regions and countries, as also a marketing campaign with active support of the government and private sector.
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Post by member_28705 »

http://www.sanofipasteur.com/en/article ... exico.aspx

Lets hope this comes to India too ASAP :)
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Re: Indian Health Care Sector

Post by panduranghari »

panduranghari wrote:The future of blood tests

It turns out that Theranos is a big scam.
Theranos, a company that makes low-cost blood tests, has been celebrated as the inventor of the next major medical breakthrough, and its founder, Elizabeth Holmes, has been hailed as the next Steve Jobs. But in an expose published today, The Wall Street Journal portrays Theranos as a company that is not only grossly under-delivering on its promise, but is also working hard to hide its problems.

A months-long investigation by the Journal found that, for the bulk of its blood tests, Theranos has not actually been using its own technology, which the company has claimed are capable of running tests with only a few drops of blood. Instead, it’s been relying on traditional machines from companies like Siemens. What’s more, the article alleges that in proficiency tests, Theranos’s own Edison machines have produced radically different results than traditional machines have, and internal emails reveal the company may have tried to prevent those inconsistencies from seeing the light of day.
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Re: Indian Health Care Sector

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Re: Indian Health Care Sector

Post by A_Gupta »

http://blogs.cfr.org/asia/2015/12/16/in ... your-sick/
India Says: Bring Us Your Sick
With a global market valued at approximately $10.5 billion in 2012 and expected to reach $32 billion by 2019, the economic lens is the most practical one to view Indian MVT {Medical Value Travel}. India is one of the three main Asian medical tourism destinations, along with Singapore and Thailand. And India’s network of corporate hospitals and travel facilitators boasts a current MVT market valued at $3 billion a year and expected to reach $8 billion annually by 2020.
But in order to optimize its use of medical tourism as a growing contributor to economic growth, like in many other areas of its economy, the Indian government would have to exercise much greater strategic coordination, streamline regulations, and improve data collection, which already occur in other countries known for MVT, such as Thailand and Singapore.
By the end of my month at Apollo, I noticed a similar interesting paradox in India’s medical tourism market as a whole: it has the potential to be part of India’s greater narrative of growth and technological success, while at the same time highlighting the very symptoms which describe why that overarching success may continue to stay just outside of the country’s reach.
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