2. DR DEV TANEJA
MBBS , M.S.(GEN.SURGERY)
DIP. IN BUSINESS MANAGEMENT
TANEJA CLINIC
UNION BLDG., KOTNAKA
URAN. NAVI MUMBAI.
drttanejahospital@yahoo.com
3. FUTURE OF HEALTHCARE
HOW YOU PRACTICE TODAY ?
HEALTHCARE DELIVERY SYSTEM
ADVANCES IN MEDICINE
BUSINESS OPPURTUNITIES IN HEALTHCARE
ARE YOU AWARE ?
THINK OVER
4. HOW YOU PRACTICE ?
BEFORE 1980 - Dr’s KNEW THE PATIENTS
1980-
1980-2005 - NETWORK PRACTICE
FUTURE ?
5. FUTURE OF PRACTICE
DENSITY OF Dr’s INCREASING
PAYING CAPACITY IS INCREASING
Pt. WELL INFORMED / EDUCATED / HEALTH CONSCIOUS
Pt. WILL DEMAND QUALITY TIME
Pt. WILL NOT HESITATE TO USE CPA
Pt. WILL NOT BE LOYALTO A DOCTOR / CHOOSY
Pt. WILL BECOME MORE DEMANDING
6. PATIENT
PATIENT – IN LATIN IT MEANS
“SUFFEROR” OR “PASSIVE VICTIM”
PATIENT DEFINATION OF DOCTOR
OLD DOCTOR GOD
NEW DOCTOR PROFESSIONAL
SERVICE PROVIDER
7. PATIENT CONSUMER
AWARENESS – LIT. / T.V. / EDU. / INTERNET
AESTHETICS OF CLINIC
BEHAVIOUR OF SUPPORT STAFF
HEALTH INSURANCE COVER
WILL LIKE TO DISCUSS - THAN SIMPLY GET DIAGNOSED
PATIENT EDUCATION WILL BECOME IMPORTANT
DISEASE PATTERN - FROM INFECTIOUS DIS. TO LIFE STYLE
9. HEALTHCARE DELIVERY
1) EMERGENCY CARE – ACCIDENT, HEART ATTACK ETC.
2) ROUTINE CARE - URI, LOOSE MOTION, HT, DM ETC.
3) ELECTIVE TREATMENT
(A) LIFE STAGE – DELIVERY,CATARACT,DENTURES
FAMILLY PLANNING OP. ETC.
(B) LIFE STYLE - COSMETIC SURGERY,
LASER EYE SURGERY
TKR / THR
10. MAJOR IMPACT ON
HOSPITAL PRACTICE
MEDICAL INSURANCE
HOSPITAL ACCREDIATION – NABH , JCI
TELEMEDICINE
HEALTH MANAGEMENT ORGANISATION (HMO)
THIRD PARTY ADMINISTRATOR (TPA)
CPA / REGULATORY CHANGES
11. HOSPITAL PRACTICE
PRESENT SCENARIO
MOSTLY SMALL NURSING HOMES – MOSTLY DOCTOR COUPLE
THEY LACK
1) QUALIFIED SUPPORT STAFF
2) GOOD LIFE SUPPORT SYSTEMS
3) ADVANCED INVESTIGATION FACILITY BACK UP
4) QUALITY FOR MEDICAL INSURANCE STANDARDS
5) POOR RECORD KEEPING
6) POOR HYGIENE
12. FUTURE OF HOSPITAL PRACTICE
MOSTLY GROUP PRACTICE
PROFESSIONALLY MANAGED
MOSTLY TIED TO HMO / TPA / HOSPITAL CHAINS
HUB & SPOKE MODEL- CORPORATES
MODEL-
MARKETING OF SERVICES
NOT ONLY CURE BUT CARE ALSO – HOSPIPOTELS
TELEMEDICINE CONNECTIVITY
13. HOSPITAL PRACTICE
IMPACT OF MEDICAL INSURANCE
HAVE TO MAINTAIN MEDICAL RECORDS
PROPER BILLING SYSTEMS
FOLLOW PROTOCOLS OF TREATMENT / MEDICINES
PRESCRIBED
COMPUTERISATION
HEALTH INFORMATION SYSTEMS
TPA – THIRD PARTY ADMINISTRATOR
14. HOSPITAL PRACTICE
IMPACT OF HOSPITAL ACCREDIATION
DIAGNOSTIC SERVICES - NABL
INTENSIVE CARE FACILITIES / OPER. THEATRE STANDARDS
SPACE ALLOCATION
QUALIFIED MEDICOS / NURSING / PARA MED STAFF
MEDICAL RECORDS / BILLING SYSTEM
SUPPORT FACILITIES - KITCHEN / HOUSE KEEPING
15. ADVANCES IN MEDICINE
NANOTECHNOLOGY
STEM CELL THERAPY
GENETIC MAPPING / GENOME
ROBOTIC / VIRTUAL SURGERY
BIO-
BIO-TECHNOLOGY
NEW-
NEW-DRUGS / VACCINES / MACHINES
TELEMEDICINE
APPLIANCES WORN BY PATIENT-REHABILATATION / MONITORING CHR. DIS.
PATIENT-
SURGERY INTERVENTIONAL MED NON- INTERVENTIONAL MED
NON-
ALTERNATIVE THERAPIES
16. NANOTECHNOLOGY
1 MICRON = 0.001mm 1 NANOMETER = 0.000001 mm ( 0.1 MICRON )
NANOTECH IS DEVELOPMENT OF ENGG DEVICES SO SMALL THAT THEY ARE
MEASURED ON MOLECULAR SCALE
NANOTECH DEVICES 100-1000 TIMES SMALLER THAN HUMAN CELLS
100-
NANOSCALE DEVICES SMALLER THAN 50 NM CAN ENTER CELLS
NANOSCALE DEVICES MORE THAN 20 NM CAN MOVE OUT OF BLOOD VESSEL
NANOSCALE DEVICES CAN INTERACT WITH MOLECULES ON BOTH SURFACE
& INSIDE THE CELL
FIRST PREDICTED BY NOBEL LAURETE DR RICHARD FREYMEN IN 1959
17.
18. NANOTECHNOLOGY
NANOSHELLS – 20 TIMES SMALLER THAN RBC
NANOPROBES – ATTACHED TO ANTIBODIES. EMIT MAGNETIC
FIELD
QUANTUM DOTS – EMIT LIHGT OF DIFF. WAVELENGTH
DEPENDING ON SIZE . SUPERIOR TO DYES
NANO COMPLEX – HORMONE / PEPTIDES / LIPOSOMES
ORGANIC DENDRIMERS
HOLLOW POLYMER CAPSULES
19. USES OF NANOTECH’Y
1) CANCER THERAPY - NANO SHELL BOMBS / SMART BOMBS
– INTERRUPT CELL DIVISION PROCESS
- CHEMO TH DRUG + CELL KILLING PEPTIDE
2) PROVIDING OXYGEN – ARTIFICIAL RBC 0.1 Micron
3) ARTIFICIAL MITOCHONDRIA – FUNCTION FOR DAMAGED MITOCH.
EXCHANGE OF COMPLEX METABOLITES
4) AUTONOMUS MOLECULAR MACHINES – MONITOR LEVEL OF DIFF.
COMPOUNDS
5) BIOSENSORS – TAKING SNAPSHOT AT MOLECULAR LEVEL
6) CONTRAST IMAGING – NANO PARTICLES
23. STEM CELL
PRIMAL UNDIFFRENCIATED CELLS
WHICH RETAIN THE ABILITY TO DIFFRENCIATE INTO OTHER CELL TYPES
THAT ALLOW THEIR USE IN REPAIR & REPLENISHMENT
SOURCES
1) ADULT STEM CELLS - BONE MARROW
2) FOETUS STEM CELLS - (ABORTED)
3) EMBYONIC STEM CELLS
4) UMBLICAL CORD BLOOD STEM CELLS ( UCSC )
24. ADVANTAGES OF
UMBILICAL CORD STEM CELLS
DERIVED FROM WHARTON’S JELLY
NO ETHICAL ISSUE
UNDEVELOPED ABO & HLA ANTIGENS - LESS CHANCES OF
HOST/GRAFT REACTION
BLOOD FROM UMB.VEIN - STEM CELLS HARVESTED - STORED IN
CRYO VIALS AT MINUS 196 DEGREES
SC THERAPY - LEUKEMIA , STROKE , SPINAL CORD DAMAGE ,
DAMAGED RETINA , DIABETES , CIRRHOSIS ,
OSTEOPOROSIS , BERGER’S DIS .,HEART ATTACK
.
25. UMBILCAL CORD STEM CELLS
1980 - UMB. CORD BLOOD APPROVED FOR USE BY FDA
1988 - FIRST UMB. CORD BLOOD TRANSFUSION FOR BLOOD CANCER
1998 - FIRST UCSC T/T BY DR E GLUCKMEN IN PARIS FOR FANCONI’S
ANAEMIA
IN INDIA - KOREAN COMPANY HISTOSTEM
TO SET UP BIGGEST UCSC BANK IN WORLD
DAILY 72,000 BIRTHS IN INDIA
HISTOSTEM CELL THERAPY CENTRE WITH APOLLO HOSPITAL
UCSC BANK - Rs 35,000/- FOR 21 YRS
35,000/-
MOST FAMOUS PT. - MR AJIT JOGI
26. GENETIC MEDICINE
HUMAN GENOME PROJECT -HUMAN GENETIC
MAPPING COMPLETED TWO YEARS AGO
HOW GENES ARE ARRANGED IN 23 PAIRS
OF CHROMOSOMES
PROTEOME -HOW VARIOUS PROTEINS / NUCLEIC
ACIDS ARRANGED ON GENES
HAPMAP – ANALYTICAL TECHNIQUE CALLED
PASSIEVLY PARALLEL DNA SEQUENCING
27. GENE THERAPY
1) SCREENING OF GENETIC MARKERS
2) TO IDENTIFY GENES RESPONSIBLE FOR DISEASES
3) GENETIC VACCINES –SPECIFIC ANTIGENS THAT WILL
CAUSE IMMUNE RESPONSE
4) CANCER VACCINES
5) GENETIC ENGINEERED CYTOKINES-IMMUNO
CYTOKINES-
SUPPRESANTS
6) GENE TRANSFER THERAPY
7) REPAIR OF MUTATED GENES
8) PREVENTIVE MED - PREDICT DIS. BY G MAP’G
9) CUSTOMOSED MEDICINES - BY GENETIC MAPPING
31. BIOTECHTEHNOLOGY
USE OF BIOLOGY , TECHNOLOGY , COMPUTERS & OTHER
SCIENCES
USES – HUMAN , PLANT , INDUSTRY
“50 % OF ALL MEDICINES IN FUTURE”
FUTURE”
WORKS ON – IMMUNE RESPONSE
- METABOLIC PATHWAYS
- NEW DRUG DELIVERY SYSTEMS
- PRODUCES PROTEINS & PEPTIDES FOR HUMAN TH.
EXAMPLES - HEP B VACCINE , AIDS VACCINE , MALARIA VAC.
- INSULIN SPRAY FOR INHALATION
- MEDICINES IN FRUITS / POTATO
32. 21st CENTURY
GOLDEN AGE OF BIOLOGICAL
SCIENCE
BEFORE 17th CENTURY
MOSTLY EMPIRICAL
18-20tH CENTURY
18-
MOSTLY SCIENTIFIC
33. ADVANTAGES OF
ROBOTIC SURGERY
ELIMINATES
1) HUMAN ERRORS
2) HAND TRMORS
3) KEY HOLE SURGERY
4) AVOID HEART LUNG MACHINES
5) PRECISION / ACCURACY
6)CAN MOVE IN EIGHT DIRECTIONS
AGAINST SIX OF HUMAN
34. ROBOTIC / VIRTUAL SURGERY
(A) DaVINCI ROBOT - FOR PROSTRATE SURGERY
(B) AESOP ROBOT - FOR CARDIAC SURGERY
(C) HUMANOID ROBOTS
LINDBERG OPERATION
FIRST TRANSATLANTIC SURGERY FROM NEW
YORK, USA TO STRASBOROUGH IN FRANCE
APPLICATIONS
1) ANY PART OF WORLD CONNECTED BY INTERNET
2) WAR / DISASTERS – TELEMENTORING HELMETS
3) IN SPACE MEDICINE
36. The surgical robot has 2-3 working arms and a single arm
2-
for assembly to the laparoscope (telescopic lens)
37. The surgeon is seated at a remote console, where he has
complete control over camera and robotic instrument
movement using hand manipulators and foot pedal controls
38. Tiny robotic instruments are inserted through key-hole (0.5-1 cm)
key- (0.5-
incisions made in the abdomen. The magnified three-dimensional view
three-
offered by this robotic system allows the surgeon to appreciate the
anatomic structures and organs being dissected with greater detail
39. By manipulating master controls using the surgeons’ thumb and index
finger, the surgeon is able to control tiny wristed instrumentation with great
precision and accomplish complex surgical tasks such as suturing and
dissection all with the facility of a human wrist
40. TELEMEDICINE
NASA - REMOTE ACT OF MEDICINE
USING INFORMATION & COMMUNICATION MEANS
(A) PATIENT CARE
1) CONSULTATION
2) TRANSMISSION OF PATIENT DATA
3) VIRTUAL / ROBOTIC SURGERY
4) HEALTHCARD / CHIP
(B) PATIENT EDUCATION
1) MED EDU. LEAFLETS / REFRENCES
2) ONLINE SECOND OPINION
41. TELEMEDICINE
FOR DOCTORS
1) CME
2) SECOND OPINION
3) ONLINE CONSULTATION / WEBSITE
4) ONLINE OPINION - RADIOLOGY / LAB
5) VIRTUAL / ROBOTIC SURGERY
6) WEB CONFERENCES
7) MEDICAL REFRENCES
45. ALTERNATIVE THERAPY
DEFINITION :
COMPLIMENTARY & ALTERNATIVE MEDICINE IS
“A GROUP OF DIVERSE MEDICAL & HEALTHCARE
SYSTEMS”.
COMPLEMENTARY - WITH CONVENTIONAL MEDICINE
ALTERNATIVE - IN PLACE OF CONVEN. MEDICINE
36% OF AMERICAN USED ALT. TH. IN LAST 12 MTHS.
20% OF BRITONS USED ALT. TH. IN LAST 12 MTHS
46. BUSINESS OPPURTUNITIES IN
HEALTHCARE
CII-
CII-McKINSEY REPORT
1) MEDICAL TOURISM - TIE UPS WITH HOSPITALS
HOTELS / AIRLINES / NHS
2 ) HEALTH SPA RESORT - ANANDA / NUSI
3) HOME FOR AGED
4) MEDICAL TRANSCRIPTION / BILLING
5) MED PROCESS OUTSOURCING
RADIOLOGY - WIPRO GE
LABORATORY - RANBAXY SPECIALITY LAB
47. BUSINESS OPPURTUNITIES IN
HEALTHCARE
6) TRAINING - DOCTORS / NURSES / PARA MEDICAL STAFF
7) LIFESTYLE CLINICS - OBESITY
- WELLNESS / ANTI AGEING / CHRONIC DIS.
8) REHABILATATION CENTRES
9) ALTERNATIVE THERAPY CLINICS
10) DRUG CLINICAL TRIALS
11) MEDICINAL PLANTS CULTIVATION
48. ARE YOU AWARE ?
25% DRUGS SOLD ARE SPURIOUS
ABOUT BANNED DRUGS
UNETHICAL DRUG COMBINATIONS
PHYTOSANITARY STANDARDS
WE MOSTLY BLINDLY FOLLOW MEDICAL
REPRESENTATIVES
49. THINK OVER
PLAN GRACEFUL RETIREMENT FROM PRACTICE
NON MEDICAL CAREERS FOR YOUR CHILDREN
DO YOU HAVE – LIFE / MEDICAL / INDEMNITY INSURANCE COVER
ARE YOU WORKING ON SELF DEVELOPMENT
DO YOU FOLLOW A HEALTHY LIFESTYLE ?
ARE YOU UPGRADING –MEDICAL / NON MED
ARE YOU A BETTER HUMAN BEING
YOU ARE STILL YOUNG TO LEARN COMPUTERS
