TECHNOLOGY MANAGEMENT

PROJECT REPORT ON

Technology Portfolio in
Healthcare Industry

Under the guidance of

Prof. Rajesh Dhake

Submitted by -
Akshay Pohane - 15320
Harsh Kher – 15350
1. Healthcare industry

1.1 Industry:
The healthcare industry (also called the medical industry or health economy) is an aggregation
and integration of sectors within the economic system that provides goods and services to treat patients
with curative, preventive, rehabilitative, and palliative care. It includes the generation and
commercialization of goods and services lending themselves to maintaining and re-establishing health.
The modern healthcare industry is divided into many sectors and depends on interdisciplinary teams of
trained professionals and paraprofessionals to meet health needs of individuals and populations.

1.2 Healthcare industry in India:

The Indian healthcare sector is expected to register a compound annual growth rate (CAGR)
of 22.9 per cent during 2015-20 to US$ 280 billion. Rising income level, greater health awareness,
increased precedence of lifestyle diseases and improved access to insurance would be the key
contributors to growth.
The private sector has emerged as a vibrant force in India's healthcare industry, lending it both
national and international repute. It accounts for almost 74 per cent of the country’s total healthcare
expenditure. Telemedicine is a fast-emerging trend in India; major hospitals (Apollo, AIIMS, Narayana
Hrudayalaya) have adopted telemedicine services and entered into a number of public-private
partnerships (PPP).The telemedicine market in India is valued at US$ 7.5 million currently and is
expected to grow at a CAGR of 20 per cent to reach US$ 18.7 million by 2017.Further, presence of
world-class hospitals and skilled medical professionals has strengthened India’s position as a preferred
destination for medical tourism.
The Government of India aims to develop India as a global healthcare hub. It has created the
National Health Mission (NHM) for providing effective healthcare to both the urban and rural population.
The Government is also providing policy support in the form of reduced excise and customs duty, and
exemption in service tax, to support growth in healthcare.

2. Competitors in Industry

2.1 Wockhardt Hospitals:

Wockhardt Hospitals is a subsidiary of the Wockhardt Group, which was founded in early 1960s by Mr
Habil Khorakiwala. The company is headquartered in Mumbai, India, and has manufacturing plants in
India, UK, Ireland, France and US, and a few other countries.
Wockhardt Hospitals, a leading health service provider has a strong presence in the western parts of
the country including Mumbai, Nagpur, Rajkot, Nashik, Goa and Surat. Its group of nine hospitals
fulfils the need of the community in its chosen field of super specialty like Cardiology, Orthopedics,
Neurology, Gastroenterology, Urology, Aesthetics and Minimal Access Surgery.
Many of the Wockhardt Group hospitals are accredited by the NABH (National Accreditation Board of
Hospitals & Healthcare). Wockhardt hospitals also receive patients from Europe, USA, Africa, Middle
East and South Asia.

2.2 Apollo Hospitals:

Apollo Hospitals is one of the leading chain of hospitals, pharmacies and clinics in India.
Its presence encompasses over 10,000 beds across 64 hospitals, more than 2,200 pharmacies, over
100 primary care and diagnostic clinics, 115 telemedicine units across nine countries, health insurance
services, global projects consultancy, 15 academic institutions and a research foundation with a focus
on global clinical trials, epidemiological studies, stem-cell and genetic research.
The group has been adopting clinical excellence as an industry standard. It was the first to invest in the
prerequisites that led to international quality accreditation like the JCI and also developed centres of
excellence in cardiac sciences, orthopaedics, neurosciences, emergency care, and cancer and organ
transplantation.
Along with excellence the Apollo philosophy rests on the pillars of technological superiority, a warm
patent- centric approach, a clear and distinct cost advantage and an edge in forward-looking research.

2.3 Fortis Healthcare Ltd

Fortis Healthcare Ltd is an integrated healthcare delivery service provider in Asia. The
healthcare verticals of the company span primary care, diagnostics, day care speciality and hospitals,
with an asset base in seven countries.
The company operates its healthcare delivery network in Dubai, Hong Kong, India, Mauritius,
Singapore, Sri Lanka, and Nepal with 76 hospitals, over 600 primary care centres, 191 day care
specialty centres, over 230 diagnostic centres and a talent pool of over 23,000 people.
Fortis Healthcare is driven by the vision of becoming a global leader in the integrated healthcare delivery
space and the larger purpose of saving and enriching lives through clinical excellence. The net profit of
the company stood at around Rs 500 crore (US$ 80.06 million) in FY13.

2.4 Reliance Life Sciences (RLS):

Reliance Life Science is part of the Reliance Group of companies. RLS was established to
develop business opportunities in medical biotechnology with key initiatives in biopharmaceuticals,
pharmaceuticals, regenerative medicine, clinical research and molecular diagnostics.
From an integration perspective, these opportunities encompass repositories, research, process
development, pre-clinical studies, human clinical trials, commercial-scale manufacture and marketing,
all of which are carried out in-house.
Reliance GeneMedix plc, a UK-based subsidiary of RLS with a manufacturing facility in Ireland, is
developing biosimilars for the European market.
Reliance Institute of Life Sciences is a not-for-profit organisation, focusing on competency development
in Biotechnology, not only for Reliance Life Sciences but also for the industry. The institute offers a wide
range of competency development programs and diploma programs in biotherapeutics and clinical
research.
RLS initiative is one of the most diverse and integrated biotechnology initiatives being developed
anywhere in the world.

2.5 Max Healthcare

Max Healthcare commenced operations in 2001. Today, it is India's first provider of
comprehensive, seamlessly integrated, world-class healthcare services. The organisation has 12
facilities in North India, offering services in over 32 medical disciplines. Of these, nine facilities are
located in Delhi & NCR and the others in Mohali, Bathinda and Dehradun. These include state-of-the-
art tertiary care hospitals at Saket, Patparganj, Shalimar Bagh, Mohali, Bathinda and Dehradun;
secondary care hospitals at Gurgaon, Pitampura and Noida; and an out-patient facility and speciality
centre at Panchsheel Park. The 12 hospitals together have over 1900 beds.
With the most advanced technology and state-of-the-art infrastructure, Max Healthcare is one of the
leading chains of hospitals in India. It is committed to the highest standards of medical and service
excellence, patient care, scientific and medical education.

2.6 Opto Circuits:

Opto Circuits started operations in 1992 as an Original Equipment Manufacturer (OEM) of
optical sensors, medical electronics, security systems and chip-on-board assemblies for known
companies around the world.
Opto Circuits is headquartered out of Bengaluru, India, from where the company designs, develops,
manufactures, markets and distributes a range of medical products that are used by healthcare
establishments in over 150 countries, predominant in North America, Europe and BRIC nations. The
company specialises in vital signs monitoring, emergency cardiac care, vascular treatments and
sensing technologies. Its products are U S Food and Drug Administration (FDA) listed and CE marked.
Some of the well-known brands marketed by the company are Criticare Systems, Mediaid, Unetixs
Vascular, Eurocor and Cardiac Science.

2.7 Narayana Health:

Narayana Health is one of India's largest and the world's most economical healthcare service
providers. It started off as a hospital with 300 beds in 2001. Presently, Narayana Health has grown to
a 6,594 beds healthcare conglomerate with 31 hospitals present in 19 locations within the country. The
group has already established its presence in Bangalore, Ahmedabad, Berhampore, Davangere,
Dharwad, Durgapur, Guwahati, Hyderabad, Jaipur, Jamshedpur, Kolar, Kolkata, Mahuva, Mysore,
Raipur and Shimoga. The chain is expanding, with projects in Lucknow, Mumbai, Siliguri, Bhubaneswar
and internationally at Kuala Lumpur and Malaysia. The chain has 1,500 full-time doctors and 15,000
employees spread across all these locations.
With an average of 150 major surgeries performed every day and average of around 80,000 Out Patient
Department (OPD) patients per month, Narayana Health offers super-specialty tertiary care facilities
across areas of specialisation, including cardiac surgery, cardiology, gastroenterology, vascular,
endovascular services, nephrology, urology, neurology, neurosurgery, paediatrics, obstetrics and
gynaecology, psychiatry, diabetes, endocrinology, cosmetic surgery and rehabilitation, solid organ
transplants for kidney, liver, heart and bone marrow transplant as well as general medicine.

2.8 Lotus Eye Hospital and Institute

Lotus Eye Hospital and Institute has been catering its valued added super specialty services to
the society since 1993. Lotus always imports peer approved technologies from across the world. Lotus
is a listed corporate eye hospital in India with seven state-of-the-art Centers in Tamil Nadu and Kerala.
Dr S K Sundramoorthy and his team of ophthalmic experts, who are highly qualified with vast
experience, offer comprehensive eye care to hundreds of patients daily at our state-of-the-art hospitals
in Coimbatore, Tirupur, Salem, Mettupalayam and Cochin in South India. LOTUS is known for its
excellence in ophthalmic services with personalized care and is committed to pioneering in the
technological revolution in eye care and rendering service to thousands of patients from across the
globe to see the world better than ever before.

It serves with super specialty comprehensive eye care consisting of modern cataract surgery,
advanced LASIK procedures including bladeless lasik, ICL procedures, all varieties of corneal
transplants, medical and surgical retinal services, state-of-the-art contact lens clinic, orbital and
oculoplasty department, glaucoma care, neuro ophthalmology and uvea clinics.

2.9 Dr Lal PathLabs

Late Dr. (Major) S.K. Lal, a pioneer in the field of pathology who had been trained in the army
and later at the Cook County Hospital, Chicago, USA, laid the foundation stone of Dr Lal PathLabs in
1949. Blessed with immense knowledge and expertise in this field, Dr. S. K. Lal established an
organization that was destined to become the first pathology laboratory of repute in Delhi and Northern
India. Today Dr Lal PathLabs is recognized as a centre of innovation and a premier clinical pathology
laboratory. Dr Lal PathLabs has become synonymous with trust and reliance in the field of pathology
services. Treasuring this trust, Dr Lal PathLabs has emerged as one of the highest accredited
laboratories in the country, delighting over 12 million customers per year. Banking on state-of-the-art
technology and highly skilled personnel, Dr Lal PathLabs shall continue to provide supreme quality of
service and earn the trust of millions of people in the times to come.

3. Product/Services:

Health care services and facilities subsector is comprised of many subsectors. The broad classification
includes

3.1 Hospitals: Hospitals provide medical, diagnostic, and treatment services to inpatients and some
outpatient services. This category includes General medical and surgical hospitals, Psychiatric and
substance abuse hospitals, Specialty hospitals (not including psychiatric and substance abuse
facilities), Family Planning & Abortion Clinics, Hospices & Palliative Care Centers, Emergency & Other
Outpatient Care Centers, Sleep Disorder Clinics, Dental Laboratories and Blood & Organ Banks.

3.2 Nursing and residential care facilities: They provide residential care combined with either
nursing, supervisory, or other types of care as needed. This category includes Home health care
services, Nursing Care Facilities, Urgent Care Centers, Mental health and residential developmental
handicap facilities, In-Home Senior Care, Community care facilities for the elderly and other residential
care facilities.

3.3 Ambulatory health care services: Players provide direct and indirect health care services to
ambulatory patients. This category includes Outpatient care centers, Medical and diagnostic
laboratories, Ambulance Services and other ambulatory health care services.
3.3 Medical Practitioners & Healthcare Professionals: This category includes Medical Practitioners,
Chiropractors, Homeopaths, Psychologists, Social Workers & Marriage Counselors, Dermatologists,
Nutritionists & Dietitians, Optometrists, Physical Therapists and other alternative Healthcare Providers.

3.4 Medical devices, equipment, and hospital supplies manufacturers: These are medical
companies in the forefront of the latest medical technology offering their products across the whole
spectrum of medical equipment, hospital supplies, products and services, including specialist
applications.

3.5 Medical insurance, medical services and managed care: This segment deals with the players
that provide medical insurance or different types of services to either patients or other medical sector
players. The term managed care or managed health care is used to describe a variety of techniques
intended to reduce the cost of providing health benefits and improve the quality of care for organizations
that use those techniques or provide them as services to other organizations. This sector further
consists of many players including Health maintenance organizations (HMOs), Preferred provider
organizations, Exclusive provider organizations, Medicare, Medicaid, Healthcare Consultants, Medical
Patient Financing, Healthcare Staff Recruitment Agencies, Health & Medical Insurance, Surgical
Apparel Manufacturing, Medical Supplies Wholesaling, Medical Waste Disposal Services, Dental
Insurance, Medical Couriers, Medical Device Cleaning & Recycling, Medical Claims Processing
Services, Pharmacy Benefit Management, Corporate Wellness Services, Home Medical Equipment
Rentals and Medical Case Management Services etc.

3.6 Pharmaceuticals & Related Segments: The pharmaceutical industry develops, produces, and
markets drugs or pharmaceuticals licensed for use as medications. Pharmaceuticals eliminate the need
for inpatient and invasive care services. They are subject to a variety of laws and regulations regarding
the patenting, testing and ensuring safety and efficacy and marketing of drugs. This sector further
consists of many players including Over-the-counter (OTC) drugs & Drug Stores, Prescription drugs,
Biopharmaceutical drugs, Generic drugs, Pharmaceuticals Packing & Labeling Services, Dietary Fiber
Supplement Manufacturing, Vitamin & Supplement Manufacturing, Cough & Cold Medicine
Manufacturing, Health Stores and Eye Glasses & Contact Lens Stores etc.

4. Type of Technology: Product / Process

4.1 Information Technology and Medicine – Process technology

Information technology has made significant contributions to our world, namely in the medical
industry. With the increased use of electronic medical records (EMR), telehealth services, and mobile
technologies like tablets and smart phones, physicians and patients are both seeing the benefits that
these new medical technologies are bringing.

Medical technology has evolved from introducing doctors to new equipment to use inside
private practices and hospitals to connecting patients and doctors thousands of miles away through
telecommunications. It is not uncommon in today’s world for patients to hold video conferences with
physicians to save time and money normally spent on traveling to another geographic location or send
health information instantaneously to any specialist or doctor in the world.

With more and more hospitals and practices using medical technology like mobile devices on
the job, physicians can now have access to any type of information they need – from drug information,
research and studies, patient history or records, and more – within mere seconds. And, with the ability
to effortlessly carry these mobile devices around with them throughout the day, they are never far from
the information they need.

4.2 Medical Equipment Technology – Product technology

Improving quality of life is one of the main benefits of integrating new innovations into medicine.
Medical technologies like minimally-invasive surgeries, better monitoring systems, and more
comfortable scanning equipment are allowing patients to spend less time in recovery and more time
enjoying a healthy life.

The integration of medical equipment technology and telehealth has also created robotic
surgeries, where in some cases, physicians do not even need to be in the operating room with a patient
when the surgery is performed. Instead, surgeons can operate out of their “home base”, and patients
can have the procedure done in a hospital or clinic close their own hometown, eliminating the hassles
and stress of health-related travel. With other robotic surgeries, the surgeon is still in the room, operating
the robotic devices, but the technology allows for a minimally-invasive procedure that leaves patients
with less scarring and significantly less recovery time.

4.3 Technology and Medical Research –Product technology

Medical scientists and physicians are constantly conducting research and testing new
procedures to help prevent, diagnose, and cure diseases as well as developing new drugs and
medicines that can lessen symptoms or treat ailments.

Through the use of technology in medical research, scientists have been able to examine
diseases on a cellular level and produce antibodies against them. These vaccines against life-
threatening diseases like malaria, polio, MMR, and more prevent the spread of disease and save
thousands of lives all around the globe. In fact, the World Health Organization estimates that vaccines
save about 3 million lives per year, and prevent millions of others from contracting deadly viruses and
diseases.

New technology in healthcare:

1. Mobile stroke units. MSUs use specially-outfitted ambulances and staff members, in conjunction with
telemedicine to perform blood tests, CT scans and TPA tests before the patient arrives at the hospital.

2. Medical device cyber security. Most healthcare IT leaders integrate stringent security features for
network infrastructures and EHRs - but not for their mobile devices. As many devices are attached to
patients' EHRs, C-suite members must perform threat assessments and know the devices and software
connected to crucial patient data.

3. Wireless wearable sensors. As an increasing number of consumers turn to wellness apps, devices
and wearable sensors, healthcare officials must learn how to utilize this data to reduce hospital stays
and readmissions for those with serious and chronic conditions.

4. Miniature leadless pacemakers. Next-generation pacemakers are 10 percent of the size of

conventional pacemakers and are designed for only one heart chamber. It's more effective than
traditional models, but only ideal for 15 percent pacemaker patients.

5. Blue-violet LED light fixtures. These lights provide continuous environmental disinfection technology
to kill harmful healthcare-related bacteria – a major cause of morbidity, mortality and increased
healthcare costs in the U.S.

6. New high-cost cardiovascular drugs. Three newly-approved homecare cardiovascular drugs are
expensive compared to standard-of-care medications, but short-term data has lauded efficacy.

7. Changing landscape of robotic surgery. The robotic surgery landscape is rapidly changing; vendor
competition is set to explode in early 2016 with a switch from mainframe to tablet-type programs.

8. Spectral computed tomography. Spectral computed tomography will reenter the health tech
conversation due to new tools and increased marketing. The tool builds on traditional CT scans by
adding depth to the physiologic function of soft tissue with a dual-layer detector.
9. Injected bioabsorbable hydrogel (SpaceOAR). Approved for prostate cancer patients, SpaceOAR is
designed to protect tissue and healthy organs from radiation treatment. Currently there is limited
reimbursement for this product's use, but studies have shown the barrier to be highly effective.

10. Warm donor organ perfusion systems. New technology provides warm perfusion of lungs and hearts
to eliminate the issue that two-thirds of organs are never used by hospitals, as viability deteriorates
harvesting, preserving and transporting.

5. Technology Transfer

Technology transfer, also called transfer of technology (TOT), is the process of transferring
(disseminating) technology from the places and in groups of its origination to wider distribution among
more people and places. It occurs along various axes: among universities, from universities to
businesses, from large businesses to smaller ones, from governments to businesses, across borders,
both formally and informally, and both openly and surreptitiously. (Wikipedia)

Technology plays an important role in health care market. Advances in health care in the
second half of the 20th centuries raised expectations about attainable levels of health and therefore
increased the demand for technologically sophisticated health care.

Improving access to medicines in developing countries through technology transfer related to

medical products and local production. There are two main streams of activity.

Technology transfer policy

This includes:

 Commissioned research, workshops, analysis and reports

 Policy development identifying political, economic, social, technological, legal and
environmental conditions that are conducive to successful technology transfer

Facilitating technology transfer

This includes:

 Mapping of appropriate technologies and assessment of freedom-to-operate

 License negotiation on behalf of developing country manufacturers
 Establishment of centers of excellence to provide training and documentation on manufacturing
processing
 Provision of technical support to developing country manufacturers
 Coordination of network of experts
 Training and capacity building

1. Method and Image Processing Software for Detection of Pharmacogenomics variation of

Genes

Value Proposition
A method and image processing software for detecting pharmacogenomic variations in clinical
settings where detection instruments are not feasible

Summary
The detection and genotyping of polymorphisms has become one of the most challenging and often
expensive and time-consuming obstacles to many molecular genetic applications including clinical
diagnosis, pharmacogenomics and forensic analysis. Traditional methods are able to survey only a
relatively small number of variations at a time.
The researchers have developed a simple, cost-effective, robust yet reliable method amenable for
evaluation for pharmacogenomics purposes. The method includes development of array for
genotyping a panel of single nucleotide polymorphisms (SNPs) of folate pathway genes with detection
system based on visual chromogenic end product. Computerized analysis is reproducible and avoids
various forms of human errors.

Advantages

 Simple, cost-effective method for SNP detection

 Reproducible results
 Human error minimized

Technology Readiness:

2. Signature microRNAs as Biomarkers for early detection of Cervical Cancer

Value Proposition
A non-invasive method using biomarkers in the diagnosis and prognosis of cervical cancer

Summary
For the early detection of cervical cancer, researchers have developed biomarkers based on
microRNAs (miRNAs). They have identified miRNAs that are differentially expressed in
malignant, pre-malignant and normal cervical tissues. In addition, they have also identified
miRNAs that are derived from human papilloma virus as well as cellular miRNAs directed against
human papilloma virus. Apart from these miRNAs targeting mitochondrial RNAs have also been
identified. These and other distinct miRNAs can be used for diagnosis and prognosis of cervical
cancer.

Advantages

 Non-invasive method
 Specificity and sensitivity
 Classification of tumours possible
 Less turn-around-time
6. Collaborating Industries:

While collaboration has been utilized in many industries and contributed to cost reduction and
performance improvement, healthcare industry has rarely utilized the advantages of collaboration. Very
few literatures have addressed the collaboration issues among healthcare service providers and
recently medical knowledge collaboration in cloud computing has been investigated.

Collaboration in healthcare services is defined as collective activities among healthcare service

providers to provide high quality services for service users and to increase revenue. The limited studies
consider pricing behaviours or implications of medical outsourcing. For example, if a patient exhibiting
symptoms of liver cancer is recommended by a hospital specialist to undergo a series of diagnostic
tests that might take several months to administer due to the hospital’s limited staff or equipment
availability, such a lengthy period of diagnosis may not be appropriate for treating the patient, or other
patients with acute illnesses that require more immediate medical attention. If the hospital can outsource
some of the required tests to other hospitals that have the available resources to perform the tests more
quickly, not only would the patient benefit from more expeditious service, it might even encourage price
competition among these hospitals, resulting in cost savings for the outsourcing hospital as well as the
patient. This liver cancer diagnosis example illustrates the advantages of healthcare service
collaboration for both patients and hospitals. Increased utilization of resources in hospitals can also
help reduce medical costs.

6.1 Application if Information and communication technology:

As an effect of the ageing of the population in general, the number of citizens with chronic
diseases is increasing, especially among elderly people throughout the Baltic Sea Region. This is a
great challenge for both the well-being of the citizens and the public health care systems. Health care
solutions provided by information and communication technology (ICT), also known as eHealth, offer
one solution to this problem. The tools and services which contribute to eHealth provide better and
more efficient health care services for all. eHealth technologies empower patients to take more
responsibility for their own health and quality of life, and they lead to better cost-efficiency in the health
sector. The use of eHealth technologies allows a mutually beneficial collaboration and involvement of
patients and medical professionals in the prevention and treatment of chronic diseases. Overall, ICT
can be used to ensure the top-quality health care of citizens.

6.2 Emergence of telemedicine

Telemedicine is a fast-emerging sector in India; many major hospitals (Apollo, AIIMS, Narayana
Hrudayalaya) have adopted telemedicine services and entered into a number of PPPs. As of FY16,
telemedicine market in India was valued at USD15 million, and is expected to rise at a CAGR of 20 per
cent during FY16-20, reaching to USD32 million by 2020. Telemedicine can bridge the rural-urban
divide in terms of medical facilities, extending low-cost consultation and diagnosis facilities to the
remotest of areas via high-speed internet and telecommunication. In 2015, Maharashtra government is
set to launch telemedicine projects in rural areas. Projects will be initiated in at five sites on pilot basis.

6.3 Mobile-based health delivery

Strong mobile technology infrastructure and launch of 4G is expected to drive mobile health
initiatives in the country. Cycle tel Humsafar is a SMS based mobile service designed for women, it
enables women to plan their family in a better way. Currently, there are over 20 mobile health service
initiatives in the country for spreading awareness about family planning and other ailments. Mobile
health industry in India is expected to reach USD0.6 billion by 2017.