Foreword

Healthcare in India

A picture of contradictions

"...whatever you can rightly say about India, the opposite is also true". - Professor Joan Robinson as quoted by Dr Amartya Sen.

State of Indian Healthcare

Unfolding opportunities

Private Sector now provides more than 70 per cent of the healthcare in India. The growth of private healthcare has had many positive impacts on the healthcare scenario in India.

State of Indian Healthcare

A need for uniformity

The major challenge for Indian healthcare today is to provide a modicum of uniformity in healthcare services throughout the country.

Healthcare Management

21^st Century Healthcare

New paradigms

The 21st century is the century of the patient, or the citizen who might become a patient. Many health services are now based on a paradigm which assumes that the patient or citizen is competent and should be fully involved.

Effective Leadership for Patient Safety

Lessons from the 'Safer Patient Initiative'

Achieving success in the area of patient safety requires leaders to adopt a new approach.

Decision-Based Evidence Making

Developing tools and strategies for comparative effectiveness

Despite the publication of over 18,000 Randomised Clinical Trials (RCTs) each year, available clinical evidence is often of limited quality. Generating the evidence needed to support an evidencebased healthcare system will require collective effort, and needs to be driven by decision makers in the healthcare community such as patients, physicians, policymakers and payers.

Healthcare Disparities

Closing the gap

Eliminating healthcare disparities is the need of hour. The author discusses various options-increasing self-awareness among physicians, increasing minority representation in the workforce and collecting data and evidence based medicine to increase the quality-of-care for all individuals.

Direct Practice Medicine

Better outcomes, lower Costs

Direct Practice Medicine (DPM) is a new model for healthcare that emphasises a deepening of the doctor-patient relationship. It eliminates the disruptive impact of set pricing of healthcare services, and the control of reimbursements by thirdparty payers. DPM aligns the medical and fiscal interests of doctor and patient, fostering a trusted relationship that increases the opportunities for improving health outcomes.

The Electronic Health Record

Delivering healthcare for the 21^st century

An enhanced Appreciation of the connection between quality and coast has made the question of mass-market penetration of the EHR an issue of broad importance.

Ensuring Patient Safety

Role of regulation

Rules and regulations can only be truly effective in contributing towards patient safety if individual healthcare practitioners take on accountability for their own actions and omissions.

Cultural,Social & Linguistic Barriers

Can they be overcome?

Cultural, social and linguistic barriers are a great challenge for healthcare providers. In order to overcome these barriers, clinicians must rethink their daily clinical work. The data compared in this article show that immigrants in Europe differ from natives but also from their countrymen at home. The investigation of this population should help us to provide better healthcare.

Palliative Care

Reaching out to patients with heart failure

Patients with end stage heart failure and their carers carry a prolonged and heavy symptom burden that affects all domains of life. Moreover, access to supportive and palliative care is patchy, and recognition of the dying stage remains poor. Extending palliative care to this group of patients is now an important priority.

The 'vital signs' of Performance Improvement in Cardiac Outcomes

Reaching out to patients with heart failure

Every healthcare executive, administrator and clinical staff member has heard and understands the phrase 'vital signs'. The vital signs play an important role in monitoring the well-being of the patient. Using the analogy of 'vital signs', author explains the importance of identifying Key Performance Indicators (KPI) to improve the healthcare services offered by the hospitals.

Medical Sciences

Bariatric and Metabolic Surgery

Anaesthesia concerns

As it has been realised that western diagnosis criteria for obese and metabolic syndrome do not hold true for Asian patients, anaesthesia care providers should be completely aware of the pathphysiology, risks and difficulties encountered by obese patients during the bariatric surgeries.

Stroke Assessment

A medical emergency

Early recognition of stroke signs and symptoms by the public and professionals, rapid transfer of the stroke patient to hospital, early stroke specialist assessment and treatment including thrombolysis and transfer to a specialist acute stroke unit are all evidence-based interventions leading to improved outcome with lower disability and mortality from stroke.

Transcriptional Control of Heart Failure

Recent developments

Heart failure is a major health problem worldwide. Current therapies manage the symptoms of heart failure. New experimental findings suggest possible future therapies that arrest the development of heart failure.

Surgical Speciality

Assessing surgical outcomes

New techniques

Methods that assess individual patient variables would appear to offer the best methodology for assessing surgeon and anaesthetist performance.

Diagnostics

Predictive, Preventive & Personalised Medicine

A novel strategy for healthcare

Predictive medicine is a new philosophy in the healthcare and novel strategic activity aimed at a potential application of innovative biotechnologies in the prediction of human pathologies, a development of well-timed prevention and individual therapy-planning. Essential components of this approach include well-organised population screening protocols using novel diagnostic biomarkers of disease states, targeted prevention of common human pathologies such as Diabetes mellitus Type 2 and breast cancer, optimal treatment planning and personalised medicine, thereby resulting in substantial improvement of the quality-of-life.

Lab-on-chip

Innovative approach towards telemedicine in primary care

The project POCEMON uses telemedicine to enable point-of-care monitoring of diseases such as multiple sclerosis and rheumatoid arthritis.

PET-CT

A step towards personalised radiation medicine

The introduction of functional data into the radiotherapy treatment planning is currently the focus of commercial, technical, scientific and clinical development. The integrated Positron Emission Tomography / Computer Tomography (PET / CT) offers a lot of advantages in terms of tumour delineation and the description of biological processes. To define the real impact of the PET / CT on the radiotherapy planning, experimental and clinical analyses are required.

PACS

Role of the end-users

To fully achieve the benefits of PACS, the end-users (both radiologists and referring physicians) need to make some necessary efforts.

Technology, Equipment & Devices

RFID for Medical Devices

An exciting future

Imagine an RFID tag travelling through the human body such as in Sci-Fi movie Fantastic Voyage. In biotechnology, bioengineering and healthcare, RFID has a lot of interesting research opportunities.

Artificial Intelligence

Applications in healthcare

For improving the efficiency of treatments and avoiding costs by minimising the risks of false diagnosis, it is important to integrate Artificial Intelligence tools in everyday medical applications. This facilitates more targeted pre-operative planning and reduces the risk of intra-operative complications.

Facilities & Operations Management

Reducing ICU Mortality

Strategies for the 21st century

Over the years, Intensive Care Units have become the hot corner of hospitals. In the near future, new automated systems will ease ICU patient monitoring and secure delivery of sophisticated treatments.

Surgical Workflow

Methods and applications

Given a great demand for a rigorous analysis of surgical interventions, Surgical Workflow Analysis proves to be a powerful methodology to understand and describe surgical procedures.

Information Technology

Home Telehealth

Understanding the outcomes

The use of telemedicine to embrace the home as a health venue recognises the possibility to maintain patient independence for rehabilitation and disease management.

Telehealth

Strategies for successful, cost-effective implementation

Telehealth is best used in patients with illnesses that respond to monitoring and rapid intervention. It is ideal for patients with heart failure because the weight monitoring provides information that is responsive to health interventions.