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    Role of Diagnostic Centres in Achieving Universal Healthcare Coverage (UHC) - (Hony) Brig. Dr. Arvind Lal

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    India Health Progress
    Presentation from India Health Progress' event: Access to Healthcare: Multi stakeholder approach in ensuring the continuum of healthcare

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    Role of Diagnostic Centres in Achieving Universal Healthcare Coverage (UHC) - (Hony) Brig. Dr. Arvind Lal

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    India Health Progress
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    Presentation from India Health Progress' event: Access to Healthcare: Multi stakeholder approach in ensuring the continuum of healthcare

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    Role of Diagnostic Centres in achieving Universal Healthcare Coverage (UHC) - (Hony) Brig. Dr. Arvind Lal

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    Presentation from India Health Progress' event: Access to Healthcare: Multi stakeholder approach in ensuring the continuum of healthcare

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    709 views38 pages

    Role of Diagnostic Centres in Achieving Universal Healthcare Coverage (UHC) - (Hony) Brig. Dr. Arvind Lal

    Uploaded by

    India Health Progress
    Presentation from India Health Progress' event: Access to Healthcare: Multi stakeholder approach in ensuring the continuum of healthcare

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 38

    Role of Diagnostic Centres in achieving Universal Healthcare Coverage (UHC)

    (Hony) Brig. Dr. Arvind Lal Padma Shri Chairman & Managing Director Hony. Physician to the President of India

    Health Ecosystem

    Health Ecosystem is defined by the interaction between organisms and their environment in specific, limited spaces.

    Concept of Ecosystem & importance of Health


    For any interaction to happen in ecosystem, health is the foremost requirement. Humans are the most evolved species on planet earth Jaan hai; Jahan Hai Pehla Sukh Nirogi Kaya The greatest wealth is Health

    Indian Healthcare Industry


    Current industry size ~ US $ 40-55 bn (Rs 200,000 - 275,000 cr); expected to touch US $ 100 (500,000 cr) by 2015 ~ 1.5 mn beds - Projected addition in beds to the extent of 750,000 over the next 5 years Private players account for almost 80% of the healthcare delivery market Entry of Corporates with large growth plans increase in M&A based consolidation activities
    Growth Drivers Changing Lifestyles incidence of NCDs Growing per capita incomes/ literacy levels Healthcare awareness demand for quality / reliable services Increase in Government Spending Penetration of Life and Health Insurance

    The Indian Healthcare industry is projected to grow by 13% pa till 2012CII-Mckinsey

    Indian Healthcare Industry


    No. of beds in India only 0.9 per 1,000 pop Only 25% Indoor/Patient Admission facilities available Communicable diseases take heavy toll (Malaria, Dengue, Typhoid etc) Incidence of Non Communicable Diseases increasing at alarming rate!
    v India has 61.3 million people living with diabetes (only next to China) The Asian Age, 2nd Nov 2012 v India being referred to as Diabetic Capital of the world

    NCD - Coronary Artery Disease (CAD)


    Coronary Artery Disease (CAD) is the most common noninfectious disease in India Likely to affect over 6.5 crore Indians by 2015- Dr. Thomas Alexander, British Heart Journal Dramatic rise in incidence, 3-4% in Rural areas, 8-10% in Urban areas 1.8 crores productive years of life expected to be lost due to CAD in working age group (35-65 yrs) by 2030, seriously affecting Indias growing work-force & economy

    NCD - Cancer worldwide & in India


    Of the 10 million new cancer cases seen each year worldwide, nearly 5.5 million are in 3rd world countries Cancer is 2nd most common cause of death in the developed & developing world Cancer prevalence in India: App 28 lakh cases with 10 lakh new cases & 5.5 lakh deaths occurring each year More than 70% of the cases report for diagnostic & treatment services in the advanced stages of the disease, which has lead to a poor survival and high mortality rate

    Indian Pathology Industry


    The Indian pathology market is estimated at app. 1.5 Bn USD (Rs. 6,300 cr) Over the last 5 years, the domestic pathology market has grown at an estimated CAGR 20 % Pathology services are offered by Government and private hospitals, independent pathology laboratories and blood banks Highly fragmented industry with 50,000 100,00 path labs in the country; ~ 2,000 in Delhi / NCR Increase in activities of the organized sector consolidation and inorganic growth on the upswing
    Independent Labs 52%

    Market share by service providers


    Blood Banks 5%

    Hospitals 43%

    Role of Labs/Diagnostic Centres


    70% of Clinical decisions are based on lab tests
    e.g: Causes of fever, Indications for surgery, Patient admission/discharge etc.

    Faster diagnosis resulting in reduced hospital stay esp. with acute bed shortage in India Scientific management of disease Huge cost saving 3% of Indians slip BPL yearly because of health problems

    Role of Diagnostic Centres


    Prevention of diseases and Complications Early changes can be detected with diagnostic tests Mainstream medicine would be way different if they focused on prevention even half as much as they focused on intervention~Edward Stanley

    Role of Diagnostic Centres


    Clinical Trials are not possible without Diagnostics India has immense opportunity boosting R&D; playing major role in drug development Lesser healthcare expenses with early and pin-pointed diagnosis thus reducing expense on drugs & health management

    Challenges

    Accessibility

    Affordability

    Quality

    Challenges
    Accessibility
    600,000 villages have practically no health infrastructure i.e. PHCs, Labs or collection centres Almost nil infrastructural support in form of roads, electricity, water, schools

    Challenges
    Affordability
    Diagnostic Tests are expensive 77% or 83 cr Indians earning below Rs 20 per day Vicious Cycle starts with nonaffordability; causing more disease that causes loss of man hours and productivity

    Challenges Quality
    Lack of skilled medical personnel Lack of Governmental regulations & quality enforcement Causes unrestricted proliferation of substandard diagnostic centres

    Current Model
    Hub and spoke model Samples collected, transported using cold chain & tests performed at larger Quality Centres Goverment Model Private Players Model

    Govt- Hub & Spoke Model


    CHC PHC CHC DH DH PHC

    CENTRAL LABORATORY

    PHC CHC

    DH

    DH CHC

    PHC

    Government Model Challenges


    Eternal demand & supply problem Restricted test menu, equipments, trained manpower etc. Unmonitored quality Lack of cold chain maintenance

    Private Players Model


    CC1

    CC2

    Lab

    CC3

    CC4

    How LPL is Helping Ecosystem ?

    Accessibility:
    High-tech Hub & Spoke Model Satellite - VSAT, Fiber optic cable Regional Centers Reference Centers Largest test Menu 3,000+ tests

    LPL Hub & Spoke Business Model


    Types of Units -Reference Lab -Metro Lab -Satellite Lab -Collection Centers Delhi Product Portfolio - > 3,000 Tests - 600 Tests - 400 Tests -App. ALL Activity - High End Testing - High End & Routine Testing - Routine Testing

    Metro Mini Metro Other towns

    Sample Collection

    ICT NATIONAL PATHOLOGY GRID


    Collection Center

    Dr Lal PathLabs

    Doctors PC

    Hospital with Lab


    prop. interface

    INSAT-3C enabled bi-directional interface

    REMOTE LAB

    REMOTE LAB

    REMOTE LAB

    2800 km ISDN AGARTALA Doctors PC

    2 X 128K

    REMOTE LAB

    REMOTE LAB

    NEW DELHI Location of Server

    REMOTE LAB

    Frankston

    Collection Center Collection Center


    REMOTE LAB

    Collection Center

    Hospital with HL7 Interface

    Collection Center

    Hospital with Lab

    Remote Lab

    Collection Centre

    Dr.'s PC

    Current National Pathology Grid


    cc1

    Mumbai

    CENTRAL LAB

    Delhi

    cc2

    LAB 1

    cc3

    cc4

    Bangalore
    cc1

    Kolkata
    cc1

    cc2

    LAB 2

    cc3

    cc2

    LAB 3

    cc3

    cc4

    cc4

    Hub: Reference Lab, Rohini


    Largest lab. in Asia ~ 85,000 sq. ft. State-of-the art design and implementation of best-practices Consolidation of operations with Clinical Trials labs Central Hub Pathology education (Fellowship / Diploma National Board; MLTs) Outsourcing (Global Accreditations) Location in Sector 18, Rohini, North West Delhi

    Rohini Lab

    How LPL is Helping Ecosystem?


    2. Affordability

    Reasonably priced CGHS ECHS Govt PSUs Camps CSR activities

    How LPL is Helping Ecosystem?

    Quality & Laboratory Accreditations

    Dr Lal PathLabs Introduction


    Highest No. of patients tested (~ 30,000 per day) Widest test menu 3,000+ tests & panels 125 labs, 2,000 collection centers, being run presently largest in the country Rohini Reference Lab biggest lab in Asia, 85,000 sq. ft.

    Dr Lal PathLabs Introduction


    135 Pathologists i.e. largest pool of pathologists with any Pathology provider 25 Ph.D & M.Sc - senior research scientists 500 Medical Laboratory Technologists 6 full time Chartered Accountants 250 well qualified sales & marketing personnel with 30 MBAs 200 Couriers & Pick-up boys

    QUALITY

    Accreditation in India
    q Accreditation in India is under the aegis of NABL (National Accreditation Board for Testing and Calibration Laboratories), Department of Science and Technology, Govt. of India qNearly 400 labs currently accredited in India

    INTERNATIONAL ACCREDITATION College of American Pathologists (CAP)


    qConsidered an international stamp of Quality (equivalent to JCI, USA) q40 CAP accredited labs in India qPractically, all US labs are CAP accredited; should not all Indian labs be NABL accredited?

    Suggestions

    Tighter Governmental regulation & accreditation of Diagnostics Industry Increased scaling-up and training of medical/paramedical lab personnel Hub and Spoke model to be strengthened by technical & infrastructural support

    Suggestions Public Private Partnerships (PPP) both in operating labs and training personnel Greater adoption of IT: Tele-Pathology and Tele-Radiology More R&D in academia & industry Greater Health insurance diagnostics to be included

    Thank You

    [email protected]

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