The 10 Best Physical Rehabilitation Centers To Watch October2020

2020/Vol.10/Issue-03
Potential RealizedMore than a Vision at Gillette Children’s
Specialty Healthcare
The
1
Best
PHYSICAL
REHABILITATION
CENTERSTo Watch
Barbara Walczyk Joers
President & CEO

hat our environment impacts the well-being
Tof our body is a well-known fact. For those
who still doubt, research has established
that too. A natural or nature-like setting and
environment reduces our stress, uplifts our mood
and helps our nervous, immune and crucial body
functions to work smoothly.
Not only that but nature also helps us to deal with
physical pain and even heal quickly after a medical
procedure like surgery. In a classic test conducted
on patients who underwent gall bladder surgery
by Robert Ulrich, half were given a view that had
trees while the other half could see a wall. Those
with a view of nature healed better, quickly,
handled pain better and had a low negative impact
of surgery.
Even for general well-being, medical practitioners
advise a brisk walk in a natural surrounding as the
least rigorous form of exercise that can be done by
one and all. ‘Green Exercise’, the term coined in
2003, to describe the beneﬁt of exercising amidst
nature has proven effective for not just general
well-being but also physical rehabilitation. A
recent study conducted in 2019, suggests that
spending at least two hours a week in green
spaces was enough to promote good health and
psychological well-being.
While medical science has surely progressed
enough to help with rehabilitation in ways earlier
unheard of, the role of nature in the healing
process cannot be denied. In this edition of
Insights Care, we bring The 10 Best Physical
Rehabilitation Centers To Watch. Using advanced
science, these institutes are helping patients deal
with pain and disability, to live life at its fullest and
as naturally as possible.
Healing
with Nature
SNEHA SINHA

Potential Realized
More than a Vision at Gillette
Children’s Specialty Healthcare
CoverStoryCoverStoryCoverStory
08

Modern Healthcare
Physical Therapy in Pain
Management: Evolving
Roles of Extracorporeal
Shockwave Therapy in
Musculoskeletal Pain
Management
In-depth Analysis
Need to Strengthen
healthcare research
Watch out
Trends in Physical Therapy
that will rule 2021
Hands-on
Using Wearable Devices
to Our Advantage
in Everyday Life
ArticlesArticlesArticles
CXO
18 28
16 26
CONTENTS

Co-designer Paul Belin
Art & Picture Editor Deepanjali Jena
Art & Design Head
Editor-in-Chief Sumita Sarkar
Managing Editor Sneha Sinha
Senior Editor Anish Miller
Visualiser David King
Asha Bange
Circulation Manager Tanaji
Research Analyst Eric Smith
Sarah Wilson, John SmithBusiness Development Executive
Mark WilliamsBusiness Development Manager
Sales Executives Kelli, Bill, Amy
SME-SMO Executives Atul, Gemson
Digital Marketing Manager Alina Sege
Technical Consultants David, Robert
Technical Head Jacob Smile
Marketing Manager Mary D’Souza
Assistant Technical Head Pratiksha Patil
Assistant Digital Marketing Manager Amol Wadekar
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OCTOBER, 2020
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Corporate Ofﬁces:

Management BriefCompany Name
Baton Rouge
Rehab Hospital
brrehab.com
Trisha Guidry
Director
Offers comprehensive neurology-based inpatient and
outpatient rehabilitation services.
Burke Rehabilitation
Hospital
burke.org
Jeffrey Menkes
CEO
Burke, a member of the Montefiore Health System, has been
a leader in rehabilitation medicine for over 100 years.
CHRISTUS Health
christushealth.org
Susan Landreaux
Executive Director
Craig Hospital
craighospital.org
Jandel Allen-Davis
CEO
A world-renowned rehabilitation hospital that exclusively
specializes in the neurorehabilitation and research of patients
with spinal cord injury (SCI) and brain injury (BI).
Post Acute Medical
postacutemedical.com
Anthony F. Misitano
CEO
Post Acute Medical is committed to providing high quality
patient care and outstanding customer service
Anthony Slonim
CEO
Renown is northern Nevada’s healthcare leader and Reno’s
only locally owned, not-for-profit health system.
Renown Rehabilitation
Hospital
renown.org
David Mork
CEO
A world-class health care network, offering the most
comprehensive primary, specialty and subspecialty care
in the region.
Spaulding Rehabilitation
Hospital
spauldingrehab.org
David Storto
President
University of Michigan
Hospitals-Michigan
Medicine
med.umich.edu
Marschall S. Runge
CEO
Michigan Medicine is home to one of the largest health care
complexes in Michigan.
Delivers a complete healing experience that respects the
individual
Spaulding Rehabilitation is a world leader in advanced
rehabilitation treatment and research – serving the greater
Boston region and beyond.
Gillette Children’s
Specialty Healthcare
gillettechildrens.org
President & CEO
Gillette provides comprehensive services, highlight trained
specialists, integrated team approach, family-centered care
and a lifetime of services.
Roosevelt Warm Springs
Rehabilitation Hospital
augustahealth.org
The
1Best
PHYSICAL
REHABILITATION
Centers To Watch

President & CEO

Potential Realized
More than a Vision at Gillette
Children’s Specialty Healthcare
An unwavering commitment to
ensuring the best care for all
children and a partnership between
patients and providers is the deeply rooted
legacy that drives the mission of Gillette
Children’s Specialty Healthcare. 123 years
ago Dr. Arthur Gillette and Jessie Haskins, a
student who had grown up with a complex
condition, successfully lobbied Minnesota
lawmakers to establish the nation’s ﬁrst
hospital dedicated to the care and treatment
of kids with disabilities. Today, this legacy
and care model continues to guide more than
1,400 people who work at Gillette as they
care for children with complex
We have a long history
of over 120 years in helping
patients improve their health,
achieve greater well-being,
and enjoy life
“ “ cOVERsTORY

onditions, rare disorders and
ctraumatic injuries.
Deﬁning a Unique Care Model
Based on her own experiences with
healthcare as a child, Gillette
President and CEO, Barbara
Walczyk Joers believes it’s
important that everyone on the care
team has a deep connection to the
hospital’s mission and focus. “Most
of our patients will require continued
care and therapy throughout their
life, so we built and organized our
resources around a care model that
treats the entire condition of a child
and looks at their life goals, versus
one episode of care. Such a plan
helps patients and families think
about what’s possible and how to
reach their full potential now and
throughout life.” Joers says.
This integrated practice model stands
out in the current environment of
consolidation in health care that can
often leave patients and families
feeling lost as they seek to navigate
care. “Our care model is why patients
choose Gillette” says Joers, “and
why we feel that giving patients and
families a choice in their care
provider remains a priority for
Gillette.” The Gillette Care Model is
built on three pillars leading to the
fulﬁllment of the vision—“Potential
Realized.” These pillars are: Focused
Expertise, Proactive Care Planning
and Trusting Relationships.
Barbara Joers explains: “At Gillette
we are fortunate to be organized
around a core of well-trained and
are
recognized
worldwide
for
excellence
in patient
care,
advocacy,
employment,
research and
education”
“We

devoted pediatric specialists and sub-specialists in areas
including Physical Medicine and Rehabilitation (PM
&R), Orthopedics, Neurology, Neurosurgery and
Complex Care Pediatrics. This depth and breadth of
expertise forms the foundation for our care - many of our
providers are truly the best of the best, leading research
and filling conference sessions around the world when
they speak.”
This amazing depth of expertise, combined with 120-
plus years of experience allows Gillette care teams to
develop innovative and sophisticated care plans with
families, says Joers. Proactive, individualized care
planning, along with focused expertise, help establish
and build trusting relationships with patients and
families. “Parents come to us in a moment when their
hopes and dreams for their child have been thrown into
doubt,” Joers continues. “Maybe this parent just heard a
diagnosis for their child or they witness their child
endure a trauma due to an accident. Whatever brings a
parent through our doors and to seek our help is often
due to something life changing and unexpected.”
Joers Inspiration
Joers speaks from experience. Her dedication to patient
care came at an early age. “When I was five I was found
to have a middle ear condition that impacted my hearing,
facial structure and speech. From there, several surgeries
were done. During one of those surgeries I had a bad
experience with a clinical staff member. While my
surgeon was tending to the result of the incident, which
was in the middle of the night, I asked how to make sure
this doesn’t happen again. Instead of giving me orders or
ideas for when I was hospitalized next – he leaned down
to me and said - run a hospital and do it right.
This experience drove Joers to pursue a career in hospital
administration and ultimately to Gillette where she
remains focused on the vison established by Dr. Gillette
and the patients Gillette continues to serve.
This clear focus on mission and vision can help clear the
fog of anxiety and help everyone surrounding and
supporting this child to find a path and plan. “Our first
goal is to let the family know that we’ll help them
discover and understand everything their child can do.
As we work to help children reach their full potential
strong bonds will develop.”
The Gillette care model has a broad impact: the hospital
sees patients from every Minnesota county each year,
and over the last three years has seen children from all
50 US states and over 30 foreign countries.
Pediatric Rehabilitation Expertise and Much More
While recognized nationally and internationally for their
rehabilitation program, Gillette Children’s Specialty
Healthcare is that and more. “We began as a surgical
hospital, offering interventions to correct
musculoskeletal deformities to improve function and
mobility” states Joers. “From the beginning our patients
needed rehabilitation and time to regain physical
function. Over time our teams saw the importance of
physical medicine and rehabilitation, physical,
occupational and speech therapies, as well as custom
orthotics, prosthetics and seating services in offering a
full system of care for the children we treat.”
Gillette’s Pediatric Rehabilitation Program is one of the
most comprehensive in the nation and is just one of eight
in the U. S. and only hospital in the Upper Midwest to
earn the Commission on Accreditation of Rehabilitation
Facilities (CARF) for pediatric specialty program and
brain injury. Gillette has the highest concentration of
pediatric rehabilitation medicine specialists in the nation
who work with children, adolescent and select adult
Gilletteis the right place for
you and
your family
‘‘
‘‘

patients with a wide variety of complex conditions. “Our
rehabilitation services, both inpatient and outpatient, are
among the best in the world and our outcomes show it”
states Joers.
A shining example of Gillette’s rehabilitation care model
in action is the Cerebral Palsy program. “We are one of
the top centers globally, really - for children with
Cerebral Palsy” explains Joers. “We take a long-term,
team focused approach to the proper diagnosis,
management and selection of interventions in the
treatment of Cerebral Palsy. The family will work with a
team of providers including PM&R physicians,
orthopedic surgeons, neurosurgeons, neurologists and
physical therapists to understand the type and severity of
Cerebral Palsy.” Gillette’s teams engage with physicians
and clinicians from multiple countries to share protocols
and to help advance care for children regardless of their
location.
Honored and Humbled to be Trusted
While Gillette remains focused on its core mission, Joers
also recognizes that “change is constant in healthcare”
and the hospital remains ready to adapt and move
forward to ensure the best continues care for its patients.
In 1890, Dr. Gillette addressed the Minnesota Academy
of Medicine and said “Overcoming deformity is the ﬁrst
thing; the next and very important too, is to keep it so.”
Barbara aﬃrms this legacy of commitment saying,
“Everyone who works at Gillette is driven by this
responsibility and are inspired by our patients and our
mission each day. At Gillette we want ALL children to
be given the opportunity to realize their potential.”
“Weare
committed
to providing
the
highest
standards
of care
throughout
our
organization”

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PHYSICAL THE
that will rule
Trends in
16 www.insightscare.com| OCTOBER 2020 |

ERAPY
2021
As an important part of the healthcare system,
physical therapists have provided quality care to
the patients even during the current pandemic.
Given the importance and magnitude of physical disability
after accidents, many survivors, including those from Covid
could beneﬁt from physical therapy services. However, the
lack of awareness leads to challenges to work. Physical
therapy eﬀectively helps treatments and improvements in a
patient’s physical functioning.
Switching to Telehealth
For patients who cannot risk entering any healthcare
facility, Physical Therapies will be provided by telehealth
services. Because so many people are working from home,
the situation will arise in the future for telehealth setups. It
will help people who live in areas where access to physical
therapy is lacking. During a private telehealth session, one
can also involve the family members. Having this feature
will prove valuable for the future.
Aquatic Therapy
It uses physical properties of water which is useful for a
variety of medical conditions. Obesity is a big issue
nowadays; this therapy is extremely useful for such people.
It also strengthens muscles and decreases joint stress.
Super-Suits and Robotics
There is no cure for cerebral palsy. Moreover, many of the
symptoms of cerebral palsy can be improved with physical
therapy. Physical Therapy for cerebral palsy will take on a
futuristic look with the introduction of exoskeletons or
wearable robotic devices. It is a wearable device that
combines robotics and electronics to help improve walking.
It also strengthens wearer’s muscles and brain coordination.
As healthcare continues to evolve rapidly, so will the
physical therapy. The focus will be on physical therapy,
with all these trends coming our way, it will certainly
improve the way of living. Experts agree that the demand
for physical therapy will continue to increase. It will be able
to deliver the right care at the right time in the right place
thanks to technologies of course. The employment as well
is projected to grow 34 per cent, according to the Bureau of
Labor Statistics. Physical therapy is the next big thing and a
key to healthy living in many more ways.
Watch out
17|OCTOBER 2020 |www.insightscare.com

As the Founder and Managing
Director of V2U Healthcare,
Dinesh Verma has established
the company’s vision and
mission and worked on crafting
strategies to fulﬁl desired
outcomes. He pursued part-
time studies in Business
Administration and later
completed an MBA from Henley
Management College in 1999.
Dinesh has always wanted to
create a diﬀerence by being a
Solution Provider and not
merely a distributor of
physiotherapy products. Hence,
he, along with his team,
emphasized on careful
technology selection, invested
in employee learning, and
educating the customer.
To remain relevant, he
established V2U’s clinical
services in Physiotherapy in
2006 – Physio Asia Therapy
Centre. This also provided as a
test-bed for the company’s
technologies and concepts.
ABOUT THE AUTHOR
Dinesh Verma
Founder & MD
Modern Healthcare

Physical Therapy or Physiotherapy plays a
particularly important role as the first line of
treatment in pain management - for acute, subacute,
or chronic pain. For decades, several modalities such as
technologies in Electrical Currents, Ultrasonic, Lights and
radiations (Lights & lasers) have been used. However, in
the last decade, one modality that has really caught the
attention of professionals in Pain Management is
Shockwave Therapy Units.
Shockwave can be defined as a strong pressure wave in any
elastic medium such as solid, Liquid, or Gas. Such waves
can be produced & felt when you stand close to a
supersonic aircraft, explosions, lightning, or other
phenomena that create violent changes in pressure.
Characteristic Properties and Parameters of Shock Waves
The energy of a shockwave is released as pressure on the
environment. This pressure is remarkably high, builds up
extremely fast and with a classical shock wave the
pressure amplitude is mainly positive pressure. The
negative part is much weaker and longer and corresponds
to the tension wave, hence, the key characteristics of
Shockwave are: Extremely fast rise of the curve, extremely
high pressure, Low negative wave compared to very high
peak pressure
Extracorporeal Shock Wave Therapy (ESWT) is a
conservative treatment modality with ever-growing interest
in musculoskeletal disorders. Modern musculoskeletal
ESWT is divided into focused and radial technology and
most musculoskeletal lesions to be treated are easy to reach
with either of them.
PHYSICAL THERAPY
IN PAIN MANAGEMENT
Evolving Roles of Extracorporeal Shockwave Therapy in Musculoskeletal Pain Management
In Late 70s & early 80s, Focused shockwaves were
introduced as Lithotripter technology for damaging and
destructive effects on Tissue (like Kidney Stones), while
these effected were desired, it was also noticed that there
were regenerative physiological effects as well in the areas
that received lower energies.
This led to development of a focused shockwave with
positive lower energies delivered at non-destructive levels.
These Focused shockwaves started to produce incredibly
positive results of specific musculoskeletal conditions such
as tendinopathies and in Bone healing. These devices focus
the shockwaves to a point which is approximately 4–6 cm
apart from the application to the skin.
FOCUSED Shockwaves (f-ESWT) are generated extra-
corporeally (electrohydraulic, piezoelectric, or
electromagnetic). Such energy is focused by concentrating
reflectors and is transmitted inside the body to induce
therapeutic effects at a target area via external applicators.
In the early 2000s, there was a further development to offer
lower cost and less energy devices hence devices with
ballistic pressure waves were developed – they were able to
produce RADIAL Pressure waves - mechanically by a
compressed air driven projectile which hits the applicator.
This technology is since named radial ESWT (rESWT).
Such ballistic Radial shockwaves were generated either via
Pressure generated Chamber Or electromagnetic Chamber -
that controlled the movement of Projectile in a tube that
Hits the end Plate with a force – that ultimately transmits to
the Subcutaneous tissue. As the Energy.

In contrast to f-ESWT, the maximum rESWT energy in
Radial Shockwave is delivered at the applicator Tip to skin
interface. Focused shockwaves peak pressure is about 100
times higher while the pulse duration is 1000 times shorter.
The clinical effect of rESWT are now growing with
emerging research and now being demonstrated as a widely
accepted method with comparable results specifically for
superficial musculoskeletal disorders.
Different tissues possess different acoustic impedance. At
the interface between these tissues, acoustic energy is
released and transformed into mechanical energy.
In contrast – RADIAL shockwaves have different physical
characteristics. They are pressure waves and not real
shockwaves.
Bio-physiological Effects of ESWT
Ÿ Mechano-transduction
Mechanical energy is transferred to the cell by altering
the cytoskeleton and extracellular molecules connected
to the cytoskeleton. It is probable that stimulus
transmission occurs particularly in the cell nucleus, but
also in other cellular structures (endoplasmic reticulum,
mitochondria, etc.).
Ÿ Healing
Neovascularisation plays a central role in the
healing of ESWT-treated areas (formation of new
blood vessels). This has been demonstrated with
several clinical findings. In addition, changes in the
nerve cells can also be detected, which would
explain a change in pain perception after ESWT.
Ÿ Other key physiological effects include
new functional proteins induced by ESWT
promoting a chondro-protective effect, anti-
inflammation, anti-apoptosis, and tissue and nerve
regeneration and as well as improves the treatment
of ischemic muscle.
Clinical Applications for specific conditions
Following are the list of approved clinical indications that
are based on the strength of the supporting clinical
evidence:
Ÿ Calcifying & Non-Calcifying tendinopathy of the
shoulder
Ÿ Lateral epicondylopathy of the elbow
Ÿ Greater trochanter pain syndrome
Ÿ Patellar & Achilles tendinopathy
Ÿ Plantar fasciitis
Among recently emerging applications with available
research evidence includes – Erectile Dysfunction & Bone
Healing (Focused Shockwave); Knee Osteoarthritis /
Myofascial dysfunction and Trigger Point therapy and back
pain management (Radial Shockwave)
Contraindications and adverse effects of ESWT
While Shockwave therapy is providing great outcomes in
pain management, care has to be taken to exclude certain
conditions such as - Epiphyseal plate in focus Shockwave,
Coagulopathy (high-energy ESWT is associated with a risk
of bleeding ), Acute infection, Lung, Brain and nerve (in
focus Shockwave), Pregnancy, Malignant tumor in focus.
Conclusion -
Both Focused and Radial Shockwave techniques are being
used by the professionals for Pain Management.
A systematic review - confirms that “there is no scientific
evidence in favour of either rESWT or fESWT with
respect to treatment outcome” (ref - C. Schmitz, N. B. M.
Csaszár, S. Milz et al., British Medical Bulletin, vol. 116,
no. 1, 2015)
However, due to the smaller sizes and lower costs of the
devices, Radial ESWT has increasingly been used all over
the world. Even if the applied energy diminishes by square
relative to the penetration depth, this method has
demonstrated its effectiveness for soft tissue injuries and
applied to treat more complex musculoskeletal symptoms
associated with trigger points.

USING WEARABLE DEVICES
TO OUR ADVANTAGE IN
EVERYDAY LIFE

ife is about uncertainty, and in most cases, the
Lonly reason one loses one’s life. Despite the best
of health, there are aspects to life and health
which ought never to be taken for granted. For example,
a cardiac arrest, a brain hemorrhage or even certain
forms of virulent cancers that take just days to spread.
What is taken to be uncertainties, in reality, are
conditions ignored for the longest periods of time in the
absence of knowing them well in time. Our bodies do
give signals when things start to go wrong. Some are
subtle, others fairly obvious. Most get the latter but never
the former, and in that become prone to the so-called
“death by uncertainties”.
With advances in medical sciences, uncertainty and
subtle hints of bad health can be caught fairly early so
that one can live a healthy life for a fairly long time.
Some of these advances include the following wearable
devices.
Google Smart Contact Lenses
Google is omnipresent! It’s everywhere, sees everything,
and these days even hear everything that everyone says.
Short of being God, Google is now also into the field of
eye-care with smart wearable contact lenses which
besides being the best in eye-care also help those who
progressively lose vision to diabetes and as a last resort,
have to use normal spectacles. In partnership with
Novartis of Switzerland, Google is bringing out these
smart contacts which besides restoring sight, also
informs its users of the status of their blood sugar which
directly affects diabetes. How this takes place is by
measuring glucose levels from the user’s tears which are
the specialty of this nifty piece of technology. It is said
'to restore the eye’s natural autofocus’. In the coming
days, this is one fine piece of technology that shall find
increasing use for fairly obvious reasons.
Embrace, the smartwatch!
Yes, this indeed is the ultimate watch that manages to
keep a watch over all your essential bodily activities like
pulse, heart-rate, blood flows and the likes using sensors
that are anything but mundane. Yes, the sensors they use
on this piece of wearable device uses medical-grade
equipment for output which people can believe without a
doubt. Besides, it has other features including an
accelerometer which senses movement or vibrations, and
measures changes in velocity and speed of one’s
movements, a gyroscope which identifies one’s bearings
in relation to the earth’s surface to know if one is
standing, sitting or lying prone on the ground, a
companion app called Empatica Mate which ‘works with
Alert to visualize Embrace data, enabling you to view
your day at a glance. Quickly get a holistic view of your
daily routine including how much you’re moving and
resting, and any seizures that may have occurred’. The
wearable device also has Bluetooth connectivity, USD
accesses and decent battery life.
Essentially what the smart device does is that it sends
data to the Empatica Mate app on one’s mobile phone
which depending upon the status of the readings,
processes it further as also alerts all those who need to
know of the wearer’s condition in real-time. Elders with
health issues, those with epilepsy and abnormal heart
conditions are the kinds who would find this app of most
use.
HealthPatch MD from Vital Connect!
This is one patch of health everyone everywhere ought to
have, to give accesses to the best of healthcare
professionals anywhere on the planet! Vital Connect’s
HealthPatch MD has re-usable biosensors embedded
onto wearable patches that stick to the skin of the wearer.
While the patch itself can be disposed of, the embedded
Hands-on

sensors within which can be removed contain ECG sensors that help read pulse rate, heartbeat rate,
breathing and even body temperatures. Besides, the bunch of sensors also have accelerometers that
detect body position and speed of movement.
With its Bluetooth connection, the HealthPatch MD can connect to any mobile phone and pass on
information received from the biosensors in real-time. It is one vital piece of a wearable device that
everyone, everywhere on the planet ought to have on their shelves all the time. Problems never
arrive with prior warnings and it thus makes sense to have something which gives signals at just the
right time.
Quell Relief
They call themselves 'Advanced, personalized pain relief technology' which surprisingly is
available without a prescription! It's one nifty piece of wearable that lives with you day and night.
With zero drugs and no surgery, it involves stimulating sensory nerves with safe and precise
electrical pulses from attached electrodes that trigger a natural pain relief response which works 24
x 7 even during sleep and which in addition self-compensates for weather changes. A single charge
lasts for as long as 40 hours. While providing for chronic knee pains, it notifies the wearer about
changes in the ambient weather that may affect pains, tracks one's activity, movements and gait, and
also coaches on how one can achieve optimal results – all this with extreme personalization to one's
body type and levels of activity while remaining discreet enough to be worn throughout the day!
Intelligent Asthma Monitoring with ADAMM
An asthmatic knows the worth of each breath what with the body itself creating problems in
ingesting it. With labored breathing, life becomes tough to say the least. But like always, when a
problem refuses to be cured, one ought to look for solutions that raise the red flag even before the
symptoms of the problem starts to arise.
For Asthama, this comes in the form of a complete solution for monitoring asthma with Intelligent
Asthma Monitoring with ADAMM.
A three-part solution, the first part consists of wearable and a flexible patch-type device that can be
worn anywhere on the upper torso, front or back and can be moved around as one may choose. The
device has very sensitive monitors that detect every aspect of breathing including cough counting,
respiration, wheezing and heart rate and provides notifications, inhaler detection and voice
nd
journaling. The 2 part consists of a smartphone app that gathers all the information and manages
all the medication and remedial issues, including sending reminders, displaying on the mobile
phone likely symptoms and giving out a treatment plan. In the 3rd part, a web-portal constantly
monitors and reports the treatment's efficacy to both the user and any attached medical authority. As
per the product's website, 'over 3,000 devices already committed for clinical trials thus making
ADAMM-RSM a leading digital health revolution for respiratory monitoring in clinical trials which
remains a complete package featuring a unique searchable database that allows very flexible query’

The world today is confronted with a
dangerous virus that has brought
economies, travel and life to a complete
standstill. Healthcare systems are trying their
level best to keep afloat and discover a cure as
soon as possible. This urgency to save lives has
once again highlighted the need and importance
of high quality scientific evidence and
knowledge, stable research infrastructure as
well as funds available for medical research, to
ensure better response and resilience.
Healthcare research also known as medical
research is the driving force for improving the
performance of healthcare systems and the
quality of life of individuals by finding better
preventive and proactive treatments and drugs.
This can involve testing new medicines,
vaccines, medical devices, new medical
procedures as well as examining the whole
genome sequence to find out the cause and
treatments for various diseases.
While India today is well known for its
excellent medical facilities and clinical
expertise, it really lacks behind in the field of
medical research. A study published by Ray et
al (2016) revealed that between 2005-14 out of
the 579 medical institutes and hospitals, that
were evaluated, only 25 produced more than
100 papers in a year and alarmingly 57.3% of
the medical colleges did not have a single
publication in a decade as compared to the
research output of Mayo clinic, which was
approximately 3700 studies in a year. The
reason for such a disappointing output can be
insufficient funds, poor research infrastructure,
the notion that research is done only for the
benefit of the pharmaceutical industry as well as
overburdened physicians having little time and
energy left to think about any serious research.
Apart from this the government and authorities
have also failed to integrate medical education
and research with basic sciences as well as
technology as prevalent in the United States and
most European countries. This proves to be a
major roadblock to “Make in India” based
innovations. In addition to this there is also a
strong presence of an authoritative and
hierarchal set up that discourages capable start-
ups and faculty to go beyond the routine
healthcare practices particularly in the field of
genetics.
Genomic research defined as the study of the
whole genome to identify genetic mutations, the
impact of these mutations on gene functions as
well as the interaction of the genes with each
Need to
Strengthen
Healthcare
Research
In-depth Analysis

ABOUT THE AUTHOR
Chandni Luthra is the
Co-founder and Director of
FutureMed a molecular genetic
company that specializes in
genetic testing for wellness,
precision medicine as well as
clinical genomics. FICCI Ladies
Organization (FLO) in association
with Ministry of Micro, Small &
Medium Enterprises Government
of India recently selected her
amongst 100 successful women
entrepreneurs in MSME.
Chandni Luthra
Co-founder & Director

other and with the environment in
general has gained popularity over the
last two decades. Researchers world
over have analyzed enormous amounts
of DNA sequenced data to assess
genetic predisposition to diseases, to
improve diagnostics and therapeutic
treatments for cancer, diabetes,
neurological and cardiovascular issues
and for the development of tests to
improve efficacy of drugs to prevent
adverse drug reactions.
Even though genetic research and
testing has the power to transform
healthcare it is still grossly under
utilized for disease management in
India. Being home to different cultures
and genetic diversity in addition to
endogamous practices rare diseases
such as blood disorders, primary
immunodeficiency, neurodegenerative
and musculoskeletal diseases amongst
many others contribute significantly to
the medical and economic burden of
the country. According to the Council
of Scientific and Industrial Research
(CSIR) nearly 7 crore Indian’s suffer
from rare disorders of which at least
40% are genetic in nature.
Unfortunately quite a few of these
genetic disorders are either
undiagnosed or misdiagnosed due to
insufficient clinical and diagnostic
resources and even if these are known
the treatment is not always available
resulting in huge physical and
monetary costs to patients who very
often have to suffer all their lives. Rare
diseases are also more common in
children and are responsible for 30% of
the deaths during infancy. There is a
need to address these challenging
issues by investing more funds into
biomedical and genetic research to
identify the main causes of diseases
and discover novel therapeutic targets
and strategies to improve healthcare in
the country.
It has also been observed that the
genetic data of the Indian population is
grossly under represented in worldwide
genomic studies and thus clinicians
need to rely on the gene data banks
from UK, USA or the Caucasian
population. This does not serve us well
as this data is not reliable. Given the
unique diversity in the Indian
population, which is absent elsewhere,
genomic research only seems to be the
way forward to reduce the impact of
diseases. Practicing precision medicine
utilizing this indigenous data will also
help to reduce inequities in how
healthcare is financed. It is estimated
that the government expenditure was
about 1.4% of the GDP in 2017-18
while the private expenditure was three
times this number. Given this pattern
correct and early diagnosis and
removal of trial and error through
pharamacogenomics will greatly help
to reduce this cost.
The department of Biotechnology has
made a considerable breakthrough to
solve the struggle for genetic data in
the last one year by mapping the
genomes of 1008 people across
different ethnicities. While this is a step
in the right direction it is still a drop in
the ocean given the sheer diversity and
sub population of people in India. In
China and the US almost a million
people are included in research studies
therefore it is essential for the
government to scale up the sample size
and include more people as well as
reduce the cost of collecting such data.
Attention also needs to be given to
carry out newborn screening pilot
projects on a national scale to lower
the burden of rare diseases and also
train more clinicians, researchers and
councilors to correctly interpret the
results for the benefit of the common
people. The government also needs to
initiate researches on gut micro biomes
and gene editing – a group of
technologies that give the scientists the
ability to change a person’s DNA by
adding, removing or altering genetic
material at particular locations in the
genome- to help treat cancer, metabolic
and cardiovascular disease as well as
neurodegenerative conditions like
Huntington disease, Alzheimer and
Parkinson that have no specific
diagnostic approaches or treatments.
Our country is definitely active in the
field of medical research but it is still
not doing as much as it can. The
discoveries that are being made are
only a fraction as there is so much that
can be learnt from our diverse
population. India can truly become one
of the models to study genetic
variations and how these relate to
disease and drug responses. It is now
time for the government to increase
funding and formulate polices to create
a national genomic platform, which
will improve the healthcare system so
that our future generations can lead
healthier lives without having to suffer
tremendous financial burdens.

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