Resource RSS Resource RSS Feed MedTech startup, Jiseki Health MedTech startup, Jiseki Health, is a concierge service that helps its clients take control of their health and improve their wellbeing. 12/24/2020 12:00:00 AM The Founding of a COVID Drugs Website A short background piece on what inspires me to create a website to combat misinformation in the pandemic via science and COVID stories. 12/9/2020 12:00:00 AM The Corona Page's Founding Story A short background piece on what inspires me to create a website to combat misinformation in the pandemic via science and COVID stories. 12/8/2020 12:00:00 AM 3 C’s — Cancer, Cure and COVID — The Aftermath What happens to cancer care post-COVID? The New Normal will be NOTHING like — the normal. BUT, this calamity could also provide an opportunity to innovate - eventually, for the greatergood. hashtag#cancercare hashtag#oncology hashtag#covid19 hashtag#macroeconomics 6/1/2020 12:00:00 AM FDA: A Must-to-Know for Healthcare Entrepreneurs In early 1900’s, the healthcare scenario in the US was chaotic with the new drugs coming into the market without proper clinical trials leading to many drug-related disasters. To control the situation, the U.S. Food and Drug Administration (FDA) agency was established. But with changing times accompanying the increased needs for new innovative and efficient treatment, the health and security concern has also increased. The control the increasing demand for drugs, and also the market pressure the FDA has implemented new quick approval methods. The bottom line of this piece is to highlight the fact that both the health entrepreneurs and FDA should work together for the betterment of the situation. 8/28/2019 12:00:00 AM Advancement in Patient-Focused Oncology Benefit Management Oncology Analytics Raises $21 Million Series B Financing Led by Oak HC/FT 11/6/2018 12:00:00 AM Funding Resources for Medical Device Startups This article is about technology startup accelerators focused on medical device innovation. It includes information about the following organizations: YCombinator, HealthBox, Matter, and Catalyst HTI, Doctors and Hackers, HealthWildcatters 9/3/2018 12:00:00 AM Harvard Business School - Advanced Management Program - My Experience A moment arrives in everyone's life when they feel a need to 're-explore' themselves and look for a 'purpose'. And what if one could achieve all of these while learning from some of the best HBS thought leaders and Global executives, while forming life-long relationships? If this value proposition sounds compelling, read on! 5/28/2018 12:00:00 AM Various Technologies Blending With Healthcare Industry Technology and Healthcare- sounds like poles apart, but are actually a powerful duo! The healthcare industry is becoming more dynamic after the involvement of technology. The technology is not only improving the efficiency and effectiveness of healthcare services but also backing the industry by acting as “Cost-Cutter” which is bliss. With the passing time, the technology has created an “alleyway” for ingenious healthcare startup ideas to pitch in and become the “Next high-profile development”. The writing piece is intended to offer a unique insight about the various adaptation in healthcare due to technology and how that can become an excellent opportunity for smart healthcare startups to bud. 12/25/2017 12:00:00 AM Mergers and Acquisitions Trends show that health care spends are approximately 18 percent of gross domestic product (GDP). The prediction is that by 2022, this figure will be in the range of 19.9 percent of total GDP. Most of this spending will be due to Medicaid enrollments as propagated by ACA, tech spending, an aging population etc. As the spends increase, competitive players will all be vying to get a piece of the pie and smaller and less profitable players will be ultimately forced to sell out. A survey reveals that 88% of health care executives are in pursuit of some M & A activity. In this article we bring you answers to a few burning questions: Are hospital consolidation transactions prevalent today? What is different about the M & A transactions today when compared to those of the healthcare reform era? How have transactions been regulated to ensure and maintain appropriate market competition and avoid antitrust violations? How can health care providers best position themselves in the M&A landscape? If alignment with another hospital/system is on the horizon, what process are organizations using to navigate the transaction successfully? These and several other questions including those about potential exits will find answers in this article. This article would help healthcare executives to be proactive and determine an appropriate strategy to increase chances of success in an era of consolidation. 11/30/2017 12:00:00 AM Medical Tourism: A Money-Spinner Strategic Combo Consider the reduced stress levels in a post-operative patient relaxing on the sunny beaches of Canada that are ranked top among medical tourist destination. Medical tourism is a rapidly growing business in healthcare that has the potential to change how the health care services are received and provided. It can serve as a low-cost, no-waiting, high quality health care alternative combined with the delight and excitement of holidaying in tourist destinations. Although the advantages of medical tourism are substantial, the challenges are also immediate. These hurdles, need to be taken care of, to make medical tourism more appealing and safe for the medical tourists. Medical tourism industry so far is receiving diligence from both public and private sectors as an emerging source of revenue. This tendency in healthcare is drawing the attention of entrepreneurs to invest in the healthcare sector and tourism industry. 5/24/2017 12:00:00 AM Align Clinical Champions to Your HIT Product Lifecycle A seasoned Dallas based attorney and advisor to health tech startups offers insights on how young companies can tap clinical champions to contribute to the various stages in their HIT product lifecycle. 5/23/2017 12:00:00 AM Hypertension – What You Need To Know With no obvious symptoms, hypertension can quietly cause a considerable amount of damage to cardiovascular health if left untreated. 3/31/2017 12:00:00 AM Health 3.0- The Smart Approach to Healthcare “Prevention is better than cure”! The proverb had never been more relevant than now, especially for US healthcare, as the emphasis is on preventive healthcare rather than curative. As the scene of healthcare is shifting towards a patient-focused approach, the development of improved and unique healthcare approach has become a challenge. The new “Third Generation Healthcare” also known as “Health 3.0” is now concentrating on finding unconventional ways and methods to increase the health consciousness in the patients through patient engagement strategies. The Health 3.0 is focusing on making healthcare more accessible, fast, and affordable. This piece is an attempt to provide insights about the Health 3.0 and how it can influence and change the present day healthcare scenario. 2/27/2017 12:00:00 AM HIT Marketing: Finding a Clinical Champion for Your Health Tech Solution Entrepreneur and physician Arlen Meyer discusses what it takes for health tech companies to build a successful clinical champion relationship 2/5/2017 12:00:00 AM Marketing to Physicians Starts with Speaking Their Language Dallas based doctor and entrepreneur Darshan Gandhi offers advice for building credibility and getting buy in when marketing to physicians. 1/16/2017 12:00:00 AM To the Moon in 42 Folds: Exponential Growth for Your Medtech Innovation Scaling your business through aligning payers, patients and physicians 1/9/2017 12:00:00 AM Buy sell pharmacy - what it takes to buy a pharmacy Abstract There is bound to be significant changes to the pharmacy profession and these will be significant. There has been significant health care reform, third party cost-cutting initiatives, enforcement to reduce fraud etc. which have been affecting the operations and profit margins of the pharmacies. There is the need now for large pharmacies to acquire competitors and for the smaller pharmacies to look for an exit strategy. Several entrepreneurs today are looking to establish start-up companies that they wish would grow into an attractive one which is worthy of acquisition. They would later sell the pharmacy at an attractive price and serve as an employee or consultant for the company that makes the purchase. There are several challenges for the purchaser who would be purchasing the company. There are challenges faced by the pharmacy segment that will not be seen in non-health care enterprises. There are aspects of finance that are not taught in the pharmacy undergraduate courses and many pharmacists are unaware of the earning potential as pharmacy owners. In this article we address most of these issues and bring clarity on what it takes to buy or sell a pharmacy. The challenges faced by purchasers in acquiring a pharmacy  Financial statements etc. that initially look attractive for pharmacy owners, may turn out to be less attractive – let us explain this - When the pharmacies are dependent on third party payers for revenue that can be seen as a blessing. Subsequently, third-party payers may recover the revenue they have previously paid based on a post-payment audit. This would become a problem area for the pharmacy. As a result from a purchaser’s point of view financial statements (balance sheet and profit / loss statements that look attractive at first may soon become less attractive. From the payers’ view, the pharmacy’s ability to collect and retain revenue will depend on the documentation maintained by the pharmacy. If the documentation is seen to be sloppy and not adhering to the reimbursement rules, even if the pharmacy has provided products, they may not be able to collect or retain revenue. Similarly, a non-compliant documentation can lead to a post-payment audit which is not favorable. If the pharmacy is known to have engaged in fraudulent practices in the past (eg. billing frauds or payment kickbacks) then it ends up owing a lot of money to the government. Therefore, when acquiring the pharmacy through a stock purchase, the acquired pharmacy will carry the liabilities that existed before the purchase. Whereas when acquiring the pharmacy through an asset purchase the purchasing body / unit will not be liable for prior acts of the selling unit / entity. On the other hand, if in an asset acquisition, the government concludes that the asset sale is actually a “de facto merger”, then the government will impose liability on the purchasing entity for the earlier acts of the selling unit. One may raise a defense to counter the aggressive action of the government in this regard, but the time and expense in posing a defense may be great.    What amounts to a de facto merger? a. What should a purchaser look for when wanting to acquire a pharmacy b. In order to avoid any potential risks the purchaser must conduct a thorough due diligence which will include the following: c. Product mix of the pharmacy  How much of the particular business is related to across the counter products or compounded prescriptions or narcotics or commercially available prescriptions or ‘DME’ – Durable Medical Equipment. As a purchaser you should be interested in recurring revenue and if the existing pharmacy has been spreading itself thin by providing all products to everyone then that can pose a problem. d. Supplier and Provider – Number issues  What are the number of physical locations that the pharmacy have? i.    Check if the pharmacy has a DMEPOS supplier number and / or a Medicare Provider number for each of these locations?  ii.    What are the pharmacy provider and supplier numbers? iii.    Has the pharmacy closed any locations in the last five years? iv.    The locations should have the appropriate pharmacy licensure e. Payer Mix:  The attractiveness of the payer mix is generally purchaser specific. Medicaid Issues – The pharmacy has to be a qualified provider to one or more state Medicaid Programmes.   f. What are the Medicaid Provider’s numbers? g. Employment and Independent Contractor Issues  What does the pharmacy use? Part-time employees, Independent contractors, marketing representatives or medical directors? 1.    Does the pharmacy have any personal service contracts or employment with any health care providers?  2.    Does the pharmacy have any written or vocal relationship with health-care referral sources like physicians, home health agencies, hospitals etc?  3.    There are safeharbours and starks that the pharmacies should comply with.  4.    The referral sources should refer to the purchaser and one should check if this is in place. If this is the case the value to the purchaser will be lessened.  5.    Is the seller primarily dependent on one referral source? In that case, you need to bear in mind that the value of the seller will be lessened since the impact on the seller will be increased if the referral source ceases to support the seller.  6.    Ensure that a single referral source is not responsible for more than 10% of the pharmacy’s business.  7.    Litigation,Audits and Reviews – if there is a potential or ongoing audit, litigation or dispute with any payer, government agency, health care provider, private health care agency which would create an adverse circumstance for the pharmacy? 12/30/2016 12:00:00 AM Pharmaceutical companies, restrictions and regulations The role played by pharmaceutical companies has become very important and prominent in the international healthcare agenda as health indicators have been linked with any nation’s successful development. Also, the economic and legal issues surrounding pharmaceuticals has become increasingly complex and politicized due to the increase in trade globally. Considering this there is an increased need for regulations in the pharmaceutical sector where effective laws and regulations are needed. In this article we elucidate on these regulations and restrictions imposed by the many government agencies like FDA etc. and what steps have been taken at the global level along with guidelines taken from several areas. 12/16/2016 12:00:00 AM Concepts in Managed Care Pharmacy Managed care is not a new concept and in fact, has its roots dating back to the 1930s. The government first became involved in managed care in the year 1973 with the passage of Health Maintenance Organization Act. Managed care is today defined as an organized health care delivery system which is meant to improve the quality and accessibility of healthcare which includes pharmaceutical care and ensure containment of costs. It is also hoped that managed care would improve outcomes and overall quality of life of the patient. In this article we look at the many aspects of managed care including the role in specialty pharmaceuticals. 12/16/2016 12:00:00 AM How do I start a Dental Practice? Part I If your dream is to build your own dental practice, you would have surely made it your priority to do the right thing. Opening a dental office and starting a practice can be overwhelming and we try to provide the necessary guidance and structure for you to break down the many areas and components of this job. Dentistry has become increasingly competitive over the years but yet remains an attractive industry and expenditures in this sector has gone up tremendously. The demand for a dentistry will only continue to increase as long as the patient’s incomes keeps increasing. Hence being in an industry with extreme levels of competition and expansion in growth one needs to have the necessary business skills and sound business sense as well as strategy to ensure success. A person trying to develop a dental practice may not have sound strategies and may even have problems with the day to day running of the practice. In this article we try to bring out the necessary elements of strategic planning and management. For many dentists the challenge can be in transitioning from a solo practice to a group practice. Dentists who try to enter into partnerships may also have a problem trying to find the right partner or in entering into a collaboration. In this article we hope to throw light on all these aspects of a good dental practice as well as establishing sound strategies for our readers. 12/15/2016 12:00:00 AM How do I start a Dental Practice? Part II If your dream is to build your own dental practice, you would have surely made it your priority to do the right thing. Opening a dental office and starting a practice can be overwhelming and we try to provide the necessary guidance and structure for you to break down the many areas and components of this job. Dentistry has become increasingly competitive over the years but yet remains an attractive industry and expenditures in this sector has gone up tremendously. The demand for a dentistry will only continue to increase as long as the patient’s incomes keeps increasing. Hence being in an industry with extreme levels of competition and expansion in growth one needs to have the necessary business skills and sound business sense as well as strategy to ensure success. A person trying to develop a dental practice may not have sound strategies and may even have problems with the day to day running of the practice. In this article we try to bring out the necessary elements of strategic planning and management. For many dentists the challenge can be in transitioning from a solo practice to a group practice. Dentists who try to enter into partnerships may also have a problem trying to find the right partner or in entering into a collaboration. In this article we hope to throw light on all these aspects of a good dental practice as well as establishing sound strategies for our readers. 12/15/2016 12:00:00 AM Valuation – A “Game Changer” for Startups According to market analytics, the investment in the startups of healthcare domain has escalated by 78% from the last year. The main reason for this escalation is the fact that the investors want to be “in the saddle” to take risks and venture into new healthcare business. For any startup to get funded, valuation plays a key role. The investors are interested to invest in companies with a promising picture. So, startups probing for funds or profitable exits should analyze each factor contributing to the high-rise of valuation. The prevailing essence of this think piece is to assist the healthcare startup entrepreneurs in assessing the valuation factors, work upon them and raise the company valuation. 12/15/2016 12:00:00 AM How to market your product in healthcare? Marketing healthcare and the many ways to market can often seem like a daunting task and its complexities are many. There are a few proven ways in which to market within the healthcare segment albeit the job being complex and sometime confusing. There may be many hundreds of strategies and thousands of tactics worth exploring, but there are few rudimentary principles that can provide a manageable starting point for bringing them all together and getting your healthcare marketing in order. These may be fundamental elements and the basics and can act as building blocks which help demystify healthcare marketing. While this may be true for a few marketing practices, there are a few tried and tested methods that healthcare professionals employ to connect with their patients. Many of these healthcare practices are finding it difficult to keep up with the changes in marketing technology. We find that advertising strategies that once were very effective are no not bringing in the new patients. The practices suffer from this and there are negative consequences when one does not adapt to change, when the healthcare practitioners continue using the same old strategies. In this article we bring to you an overview of those fundamental principles and then help you try a few new ideas and strategies helping you market in ways that can be more effective! If you are looking for ways by which you can market your healthcare services and improve your patient acquisition program, then this article will provide the necessary guidance. 12/13/2016 12:00:00 AM How do I start an Urgent Care Clinic? What is meant by Urgent Care? Urgent care is that segment of health care that allows patients to receive care for pressing medical concerns without the hassle of expensive trips to the emergency room. This type of care also takes away the burden from emergency room personnel and allows them to concentrate on more dire medical cases. We believe that opening one of these is a lucrative business opportunity more so since niche medical services are always on high demand. 12/12/2016 12:00:00 AM An attainable paradox - reduce cost and improve quality of care This article provides an overview on the following: Reducing Costs and Improving the Quality of Health Care How does decrease in health care costs affect quality of health? Factors that are to act as prime drivers leading to higher spends in healthcare in the coming years Disease avoidance and its effect on healthcare costs and quality of care Conclusion thereof: Inefficiencies in Health care Spending – What are the reasons and sources for the same As per their findings: Learning from these findings for U.S healthcare system Inefficiencies in the allocation of health care spends and their impact on quality of health care What is Data Watch and how can it benefit the reduction in cost and simultaneous improvement in quality of health care Organizations that can provide guidance on health spending and what can they do in this regard along with their limitations The Medical Expenditure Panel Survey (MEPS): This will provide the following: Government Initiatives to Increase Data availability and improving patient-centred outcome Other initiatives: Lack of co-ordinated care leading to duplication and over-treatment Lastly the failure of providers to adopt widely recognized best medical practices adds to the wasteful expenditure 12/12/2016 12:00:00 AM Healthcare technology, EMRs and data storage Hospitals and doctors have the task of having to choose from a variety of healthcare data storage options. The important thing to know is whether the data to be stored is in the form of patient data, images or any critical hospital information – this can dictate the storage method to be used as well as the ones that would best serve that particular organization. Since the storage comes in so many formats, finding the right method to store such data can be a huge challenge to hospitals. While there is not much federal regulation around medical records storage, most organizations prefer staying ahead of the HIPAA’s (The Health Insurance Portability and Accountability Act of 1996) storage contingency plan requirements. Cloud storage has been a very hot topic in the recent years and this seems to be seen by most medical practitioners and entrepreneurs as an incomplete solution till date. In this article we examine various methods of medical record storage as well as the safety precautions organizations need to undertake while safeguarding the medical records of their patients. Also, we delve into the many opportunities that are thrown open to new entrepreneurs because of this new and interesting area, within the medical field, that is now open to investors and medical enthusiasts. This article will help healthcare organizations and professionals to safely navigate the maze of data storage options. 12/9/2016 12:00:00 AM Starting a hospice agency - what does it entail? With the great increase in geriatric population and the need for improvement in Medicare reimbursement guidelines, there has never been a greater need for a hospice, and it promises an exciting time for entrepreneurs entering the space. Opening a Hospice Agency is not only a profitable business but also offers plenty of rich rewards. While examining the prospects of starting a Hospice agency or home care you will be experiencing the excitement and exhilaration of the new venture but you would seldom remember that you are building beyond the immediate future. You also need to remember that you are building for the time when you will retire and / or sell the agency and would therefore need a good succession plan so that you would pass it on to your children and grandchildren. Hence when starting a hospice business you not only need to understand the fundamentals – such as simple matters that need to be tended to, but also look at creating a suitable and sustainable business model within a positive organizational culture. In this article we delve into the many aspects of starting a Hospice company while bringing you step by step procedures for the same along with guidance regarding legislation. We help you arrive at your ultimate outcome that you would wish to achieve for your hospice company. There is the clinical care component of providing care for the patients and families and the aspect of providing psychological and spiritual care during end of life stage. A home hospice agency must provide the care that will enable improvement of quality of life for those with advanced, progressive and terminal illness. Let’s look at all these aspects and find the necessary guidance in this article. 12/9/2016 12:00:00 AM The Journey from Pay-for-service to Pay-for-performance The revenue that is generated from practice is the lifeline through which other services are made available. There is a need for a constant and solid revenue stream for physicians, hospitals and healthcare practices and providers. In such cases whereby the practices’ claims processing time gets slowed down, there arise many issues for the practices and hence a slowing down, making it difficult to manage expenses. The two prominent and current payment models in use are Pay-for-Service and Pay-for-Performance. While the first model has been in use for quite some time, the latter is a new idea and has come into existence with the primary purpose of reducing the medical costs but also to improve quality of care. In this article we try to bring out the differences between the two systems and also the advantages of the latter. We have discussed both the models in detail and tried to establish the major differentiating factors. 12/6/2016 12:00:00 AM Private Practice Vs Employed Practice– What Would You Choose? Healthcare reforms in the industry have transfigured the traditional model of practicing medicine. Ample scope awaits the physicians to choose between employed practice and private practice. Nevertheless, the benefits enjoyed by each of them are quite different, projecting the latest trend in the employed practice. A physician with entrepreneurial traits, a team player willing to take risks, a visionary on future and market values may take a step ahead to invest in private practice. Enterprising a private practice is a multi-dimensional approach involving expert individuals in each area headed by a physician. To build the private practice the physician is idealizing requires hand-picking of infrastructure, human resources, IT services, legal security measures, and marketing strategies. It doesn’t end with a successfully running private practice making profits, to accommodate for competition; the physician needs to be concerned with continuing professional development. 12/6/2016 12:00:00 AM Developing a dental practice, partnership in dentistry Abstract If your dream is to build your own dental practice, you would have surely made it your priority to do the right thing. Opening a dental office and starting a practice can be overwhelming and we try to provide the necessary guidance and structure for you to break down the many areas and components of this job. Dentistry has become increasingly competitive over the years but yet remains an attractive industry and expenditures in this sector has gone up tremendously. The demand for a dentistry will only continue to increase as long as the patient’s incomes keeps increasing. Hence being in an industry with extreme levels of competition and expansion in growth one needs to have the necessary business skills and sound business sense as well as strategy to ensure success. A person trying to develop a dental practice may not have sound strategies and may even have problems with the day to day running of the practice. In this article we try to bring out the necessary elements of strategic planning and management. For many dentists the challenge can be in transitioning from a solo practice to a group practice. Dentists who try to enter into partnerships may also have a problem trying to find the right partner or in entering into a collaboration. In this article we hope to throw light on all these aspects of a good dental practice as well as establishing sound strategies for our readers. Developing your own dental practice – let’s get started with the basics Shape your future as a dentist Dentists can and should exercise full control over what their practice is going to be in the future. Thinking this through in terms of sustainability and profitability is a very important aspect and key to success in the years to come. Using external consultants would be one way of managing your practice and you should be able to find experts. However, most consultants may only be able to offer simple advice and promises that may come at a very high price and may work for everyone.  Myths around the dentist’s practice Myth No.1: One can make it only by offering their services in the premium-priced wealthy upper –middle class segment.  Proof that this is a myth: In the dentist retailing segment, both Cartier and Wal-Mart have been successful although Wal-Mart is a lot bigger and worth much more. Myth No. 2: Dentists cannot analyse strategically to run their own dental practice. Proof that this is a myth: In the dentist retailing segment, both Cartier and Wal-Mart have been successful although Wal-Mart is a lot bigger and worth much more.  What we think in this regard: We believe that with the right inputs and support dentists can run their own dental practice implementing the right strategies and we provide just that help in this article. What we think in this regard: We believe that with the right inputs and support dentists can run their own dental practice implementing the right strategies and we provide just that help in this article. The five steps we envisage for you:  We believe that the key to better strategy is in understanding the services you provide, the customers you serve as well as the link between the two now and for the future. Let’s look at these five steps in some detail Understand and Categorize services Dentists perform several activities for their patients and each is a single activity or a group of activities. These are actions that can have logical separation or distinction from each other.  Eg. A service like doing a dental filling can have the following series of activities:  1.    Getting patient seated 2.    Numbing the patient 3.    Drilling out the old filling if there is one 4.    Putting in a new filling For purposes of strategy such services need to be categorized in a useful manner and there are many ways to that dental services can be classified: 1.    ADA Procedure code or groups of such codes eg. Preventive, hygiene, amalgam fillings, cosmetic procedures such as bleaching and veneers.  2.    Quality of Service eg. Auxiliary versus dentist delivery, periodontist versus dentist delivery, gold versus porcelain versus composite versus amalgam. 3.    Other features – eg. The time of day the service is provided (regular hours, early morning, lunch time, evenings or weekends. 4.    Location – eg. Urban versus rural or retail storefront versus professional building. These services may also be categorized with the aid of more than one of these areas. One can use a combination of personnel employed, production technique and time of service delivery. This may lead to situation where there may be too many narrow classifications and narrowly defined services which will create its own set of problems. One has to exercise caution and judgement in deciding which categories are more useful and focus on service characteristics that would be important to customers so that you can create a differentiation in the dentistry market with your unique offering. Understand and Categorizing Customers 1.    Do not underestimate the influence and importance of segmenting your customers. They can be segmented based on: o    Demographics – (age, gender, income, first language) in a few instances they can be grouped into “elite” customers. o    Insurance extensiveness or insurance model and further classification based on coverage categories like basic vs. C & B implants.  o    Purchase occasion or knowledge levels of the patients regarding the benefits of dental treatment i.e. patient dental IQs o    Patient status: new patients, regular recalls, or emergency patients o    Benefits required by the patient or lifestyle considerations of the patient o    Cosmetic benefits, pain relief, some balance of performance/price or “cachet” (wanting to use the services of the same dental practice as the community’s elite) o    Proximity of the practice 2.    While patients are the end-users of dental services they are not your only customers. Your customers would include:  ●    Other dentists who refer patients or contract specific services from the practice such as panoramic X-ray services. Especially of importance to specialists. ●    Health-related professionals and Physicians who refer patients ●    Physicians or health professionals who refer patients, including receptionists and hygienists and Auxiliary staff of other dentists  ●    Insurance companies ●    Government employees eg. People from the military, welfare, and recent migrants. Most of these can be categorized as “mediators” of patients or as “complementary elements”. It would be in your best interest to provide something of value to this group as they will impact your business, directly affecting your business sales and profits. Positioning Strategy  Positioning is another important aspect of strategy and understanding.  The important five classical positioning strategies o    These depend solely on the services provided and the customer (patient) section / division that is being served. o    Wealth, the criteria for segmenting patients will help decide whether patients are price sensitive or not.  o    We categorize those who are price sensitive as “non-elite” and those that are price sensitive as the “elite”.  For the Elite group:  o    Need not be segmented based on whether they have insurance since they are not price sensitive.  o    They need not be subdivided on the basis of age, gender since the group will have few people and practicing specialization on smaller sub groups would be infeasible.  For the Non –Elite group: o    Important to know whether they have indemnity insurance as these patients would demand more dentistry. o    They can be further segmented as Adults, children, and seniors.  o    If anyone in this group is without indemnity insurance, find out if they belong to a managed care plan. Specialize on a demographic sub-set o    When the market is large it would make sense to specialize on a demographic sub-set.  Hegemony is when the practice offers complete line of service to a full and complete spectrum of patients. Offering all services to all customer groups at all times of the day.  Every practice will have a positioning strategy and it’s important that you  1.    Determine the practice’s positioning strategy and construct a competitor SCM.  2.    The matrix should provide the set of services provided by your competitors and the set of customers served by your competitors.  3.    Next, indicate if your practice operates in each service-customer segment 4.    Indicate how important this segment is 5.    Enter the percentage of patients in each service-customer segment 6.    The totals of the columns and rows will indicate whether your practice has service-focussed, a customer-focussed or any other positioning strategically. 12/6/2016 12:00:00 AM Tax burden on employees and employers( paying for ACA) Abstract The Affordable Care Act – What’s in it for the employees and the employers in terms of tax burden?  In this article we bring you clarity on this aspect of the ACA which has been an important issue under consideration by experts, the common man, the hospitals as well as the physicians. What is the bottom line on the Obama Care Tax Plan and what do these tax related provisions under the act, mean to everyone and each individual sector.  The Affordable Care Act comes with limits to deductions, tax breaks, tax hikes, tax credits, and such other changes. While a few of these affect the average American, the tax increases affect the following brackets of earning members, in various ways: Why Does Obamacare create new taxes? What are the benefits, rights and protections under Obamacare ●    Obamacare includes several benefits, rights and protections which include a mandate that health insurers cover people with pre-existing conditions.  ●    Obamacare provides access to almost 50 million low-to-middle income men, women and children across the country at reduced premiums by way of tax credits and expansion of Medicaid and CHIP. ●    Nevertheless the ACA’s expansions of quality, availability and affordability of health insurance comes at a high cost.  ●    With all tax provisions remaining in place the revenue thus generated, by the new taxes, aid in covering the costs for the programs and reducing the deficit.  Let’s look into how the tax under Obama Care affects the common man, the hospitals and the enterprises at large. The Bottom Line on the Obama Care Tax Plan Here are some quick facts to help you understand how Obama Care affects taxes: In all this data we see one fact that’s becoming clear to us – The requirement for insurance cover, expansion of employer based cover, cost assistance, and the fee for not having cover, are all the main tax provisions that have been affecting the average American. Points to ponder: ●    Even if you see areas where there are no higher taxes associated with the ACA, it would not exempt you from those costs associated with the law – this means one has to buy health insurance, all the same, unless you come under Medicaid or any other exemption, and that will cost money.  ●    Under the ACA, for both health insurance costs as well as taxes – the thumb rule is that ‘those who make less pay less and those who make more pay more’.  ●    Combined with cuts to spending, the revenue generated from the new taxes will help in paying off the ACA’s requirements, lower the deficit / shortfall by 2023 and fund the tax credits as per the Congressional Budget Office.  12/6/2016 12:00:00 AM Starting a Hospice Company Abstract  With the great increase in geriatric population and the need for improvement in Medicare reimbursement guidelines, there has never been a greater need for a hospice, and it promises an exciting time for entrepreneurs entering the space. Opening a Hospice Agency is not only a profitable business but also offers plenty of rich rewards. While examining the prospects of starting a Hospice agency or home care you will be experiencing the excitement and exhilaration of the new venture but you would seldom remember that you are building beyond the immediate future. You also need to remember that you are building for the time when you will retire and / or sell the agency and would therefore need a good succession plan so that you would pass it on to your children and grandchildren. Hence when starting a hospice business you not only need to understand the fundamentals – such as simple matters that need to be tended to, but also look at creating a suitable and sustainable business model within a positive organizational culture. In this article we delve into the many aspects of starting a Hospice company while bringing you step by step procedures for the same along with guidance regarding legislation. We help you arrive at your ultimate outcome that you would wish to achieve for your hospice company. There is the clinical care component of providing care for the patients and families and the aspect of providing psychological and spiritual care during end of life stage. A home hospice agency must provide the care that will enable improvement of quality of life for those with advanced, progressive and terminal illness. Let’s look at all these aspects and find the necessary guidance in this article. What are the crucial aspects that entrepreneurs should consider before starting a hospice? Firstly what is palliative care? How does World Health Organisation (WHO) define palliative care? Can we have a clear and detailed definition of palliative / hospice care which will help new entrepreneurs in the field to negotiate with local and national health departments who may not otherwise be familiar with the essential features of such care provision?  One definition states that “Palliative care is the care of patients with active, progressive, far advanced disease with a limited life expectancy, for whom the focus of care is - quality of life."  From this definition it is clear that palliative care is not disease-specific, is not about the defined number of weeks or months of survival, but is about the quality of life the patient gets. Hence from this definition it is clear that the relatives should also be taken into consideration since it would be impossible to care for a critically ill person until and unless the needs of the relatives are also taken into account. Principles of Palliative Care All good palliative care begins with good principles – like all good clinical care, whatever may be the illness, whatever the stage of it, whatever the age, gender, class, race, creed of the patient and whatever the nature of the illness, or whether or not it is life threatening. Let’s arrive at an understanding of palliative care: ●    Palliative procedures are invaluable constituents of modern palliative care but not in themselves comprehensive care.  ●    They may include all the normal procedures such as radiotherapy, insertion of stents, drainage of effusions, chemotherapy, and stabilization of bones as well as procedures as simple as catheterisation.  ●    Specialized palliative care would be provided by a service (where-in there may not be a provision for having in-patient beds)  but the care will be provided where the principal clinicians ( nurses, doctors, social workers and team members) would have had advanced training in the principles of modern palliative care.  Are “Hospice” and “Palliative” care one and the same? ●    In most aspects they are the same although the word hospice is better known to members of the public than the term “palliative care”.  ●    Palliative care is the preferred term for health care professionals, more so since it has become a nursing speciality in many countries and palliative medicine became a medical speciality in UK in 1987.  ●    There is a misconception that hospice means care for the dying which is made possible by the well-intentioned volunteers or some ultra-religious groups. Especially in North America, the term “hospice” is often used to describe a care philosophy rather than a care programme.  With ever so many misconceptions about palliative care it’s important to understand “What Palliative care is not”.  ●    Care of the elderly also known as Geriatrics. ●    General Practice ( Family Medicine) ●    Care of the Chronically ill  ●    Care of Cancer ( Oncology) ●    Care of the incurable ●    Pain Relief Service ●    Euthanasia or physician assisted suicide ( both of these emphasise on death and not on quality of life What are the many models of palliative care?   What are the key features that distinguish palliative care from other treatment methods? Is there so much suffering to justify the needs for so much palliative care? ●    The answer is a “YES” and there are several reports that have been published that show poor relief given to people suffering who are in the final years and months of life.  ●    These patients were all suffering with various conditions with pain, breathlessness, loss of appetite, nausea, vomiting insomnia, sores etc.  ●    The psychosocial implications of these illnesses were fear, anxiety, depression, loss of dignity, a sense of being a burden to people and often a feeling that their suffering was not taken seriously by care givers etc.  ●    At an existential level their worry and discomfort included questions about life, death, religion, faith and their relevance to them, as well as a need for forgiveness.  If health authorities are not impressed with the wealth of evidence from other countries demonstrating the need for palliative care, then research into the unmet suffering and needs of your country / district will need to be done and the evidence shown to the authorities.  Does palliative care have world-wide relevance? Yes! No matter where people live, whatever their age, gender, education, class, race, language, culture, creed or disease - they describe the same suffering and the same needs, and respond equally well to appropriate palliative care, which takes into account their culture and their belief system.  What are the most important aspects that you need to consider before investing in a Hospice company 1.    Deciding on the geographical area that you wish to serve ●    The first detail that one needs to pay attention to is, deciding on the geographical area that one wishes to serve.  ●    Targeting too small an area can seriously limit your growth while making an investment in too large an area can make it unmanageable.  ●    Doing a due diligence in your demographic search of the target area to check if there is potential population and wealth to make your business a success will be useful ●    There are several demographic searches that can come in useful in determining whether your choice of location is appropriate.  ●    Zipskinny is a good one but county and state demographics can provide good information too. ●    Getting a clear picture of what the area looks like in terms of age group of residents in the area, average income of people living in the area, and a knowledge of the professions that the people are employed in, will provide you with the necessary inputs to gauge the potential for your hospice company in that area. 2.    Deciding on the nature of the enterprise that you are planning to create ●    The next area one needs to consider is whether you would be creating a C Corporation, S Corporation, Partnership or LLC. How your business will be structured should be considered in great detail since this would have long term implications.  ●    Also, you need to ensure that the agency is sound in terms of structure, operational efficiency, cash flows and incomes to meet your retirement plans. If you would wish to sell the enterprise at retirement and hope to have a tidy sum at that time you surely need to build an agency that is solid in every manner possible.  ●    For several people how to structure the corporation can be a difficult decision and can be confusing too. The best way to go about this would be to take the guidance of an attorney who deals in corporate law and who will know what corporate structure would be best suited for your particular requirement going forward. Learn the pros and cons of each type of structure before you take a step forward. It can be very expensive and complicated to change structure once it is established, and hence it makes sense to choose judiciously.  3.    Stick to the rules of your structure as well as any structure built into any external systems ●    Once the structure for the organization has been decided, following all the rules as applied to that structure is crucial for the success of the business. Attending board meetings and maintaining minutes of the meetings etc. is important.  ●    Make sure all taxes are paid as per corporate structure and that accounts of business expenses are maintained and not mixed with personal expenses. Why does one need to do this? When you plan at a later date, to sell the enterprise it will come under scrutiny and a failure in any one area can affect the price that you can get for your company as well as get unnecessary exposure to government interventions.  4.    Next Big Decision to be made – where would I have my office? ●    Initially as you are starting your enterprise your home can double as your office as well, but with growth will come the need for additional space and a formal atmosphere from which you can run your enterprise.  Location also has a big implication on the business. You will need a commercial space as the business grows, to accommodate the internal staff, for meetings of the entire group of employees, and for caregiving as well as internal needs.  ●    Finding the right space can be sometimes more challenging and the more attractive the location the better it will be for your business. Appearances will play a major role in influencing the people who will look at using your hospice service.  5.    Licensing Requirements: There are several licenses that need to be obtained primary among them that need to be completed being: ●    State licensing applications and federal Medicare applications  ●    Customized policies and procedures and all operational materials in written format ●    Development of quality assurance procedures, bereavement and volunteer programs ●    Operational setup and survey readiness  6.    Before you get started planning a palliative care service there are a few steps to be taken: ●    A well conducted needs assessment is a must. ●    A discussion with local, regional and health care planners  ●    Detailed assessment and consideration of costs (capital and  revenue) both short and long-term. ●    Detailed assessment of recruitment and staffing challenges ●    The educational role played by any planned service. ●    Relations with local hospitals and clinics to be considered in detail with due consideration to sharing of facilities, procurement of pharmaceuticals etc. ●    Needs assessment has to be done nearing in mind a certain warning – It may be a tempting to see the unnecessary suffering of patients in the last stages of life in particular areas and one may have the knowledge that palliative care will ease the suffering of these people, although they may be a small number. Without doing a thorough needs assessment one should not rush into setting up a palliative care service in that area. Not taking the points mentioned above into consideration can be disastrous and time spent in looking into these questions in detail is always time well spent. 12/5/2016 12:00:00 AM Starting Home health Franchise Company Abstract Home health care seems to be growing in popularity due to an ageing population and the personal preference of several older Americans who prefer being cared for in the comfort of their homes. This being the situation, starting a home care business which will meet all the demands of home care will prove to be a rewarding enterprise and within this segment there is the skilled home health care agency as well as the non-medical in-home care agency. Starting a home health agency or enterprise can have its own set of challenges and in this article we try to provide guidance on areas that may require greater attention and detailing. We tell you what the basic requirements will be as well as the necessary advice to execute the same. Starting your own home health care business can help you engage your entrepreneurial spirit while building your future while helping in improving the lives of countless seniors and such others in your community.  Very basic and rudimentary steps to be followed for setting up a home care business  The basic requirements are by and large very similar to that of any other business and these include: 1.    Setting up the business entity  You would have to look into what kind of business entity you wish to have, say, Sole Partnership, S Corporation, Partnership, Limited Liability Company or C Corporation. Make sure you consult an attorney and or a CPA to ensure that you have the proper legal framework in place along with right business structure, sales tax numbers etc. allocated, information regarding payroll etc. properly formulated, workers’ compensation etc. all in place.  2.    Registration with secretary of state Register your enterprise with the Secretary of State in your particular state. In order to do this you need to decide a business name for your enterprise and check if that name is available in your state including consideration for a domain name for a website. This is crucial and when the approval is obtained from the state, you should have a letter head, brochures and business cards printed. 3.    Check on licence requirements Depending on the city or country there will be a specific business licenses that needs to be obtained. The person desirous of starting a home health company has to apply for this in the place where he intends starting the enterprise. 4.    Employer ID needs to be obtained Federal Employer Identification Number (EIN) has to be obtained from the IRS which is similar to your personal social security number which provides identification to your business as regards tax liabilities. 5.    Ensure you have sufficient finances before you begin Ensure you have sufficient finances to take care of any emergencies and have a business checking account and apply for business loans that will be required to meet start-up costs. Make sure you have computerized accounting systems in place.  6.    A Policy and Procedures manual is a must  Keep a procedures and policy manual handy or write one if one is not available in the market. This should be able to advice you on issues such as planning of care, employee and payroll records, client admissions, orientation, in-service training, scheduling, client billing etc.  7.    Be connected with referral sources Connect with long-term care providers and agencies as well as hospital discharge social workers, for referrals in the area in which your enterprise is going to be located. Local physicians can also act as good referral source for your enterprise.  8.    Find and Hire Caregivers The reputation of your business will depend quite hugely on the quality of care that you are able to provide and hence you should be prepared to hire the best people and this would require that you spend time recruiting the right people after conducting a thorough interviewing process. Check the references of those of those you wish to hire and ascertain that they are compassionate, resourceful and competent. To in the aid you in the process you may post appropriate advertisements in the local papers as well as the internet. Local community colleges that offer CNA, nursing programs etc. may also help as your advertisement and employee sourcing places.  9.    Finding the right space for the center Find a place that will provide a locality suited to your clients in terms of affordability and without excess population or increased competition. Inexpensive and accessible should be your mantra when looking for space to begin with. 10.    Build a Website Hiring a web designer who can give you a good website with the right content can be a good way of making your enterprise known to adult children of the older citizens who would be interested in securing a home care service for their parents. You could also post ads in established elder care websites with strong internet presence for giving your business great exposure. 11.  Your attitude can be all important  Being smart and resourceful in managing the everyday affairs of your business and being respectful, thoughtful of your employees is a good practice. One should be understanding and accommodating of your of clients’ needs. Reflecting upon the reasons for which you started the enterprise at times when the going gets tough will help you to enjoy and reminisce upon the small accomplishments along the way.  Costs of starting a home care business What are the costs involved in starting a home care business, is probably a question that is often repeated and in this article we discuss this in brief throwing light on a few aspects of the business. It is quite apparent that the elder care and home health care businesses and enterprise are at the beginning of a 20+ years of continual growth with the “Baby Boom” populations beginning to hit the magical age of 65, way back in 2011.  This number alone will show you that the industry and business opportunity is very attractive. Also, the new home care business owners have lesser obstacles to face because:  ●    These services are offered in the homes of clients ●    You can run this business from the comfort of your home or office ●    This is a service industry and comes with many benefits and no major investment in products ●    The regulations for home health care business  is mostly limited in many states ●    The formal training needed  to be given to your employees is comparatively less ●    There is no inventory to be maintained in order to run a home health care agency ●    As we have seen this is one of the fastest growing industries for new businesses ●    Requires less capital investment as compared to other businesses. 12/5/2016 12:00:00 AM Target Audience in Healthcare Abstract When we look at branding in the medical sector what strikes us as important is the understanding of many facets, chief among them being your target audience. The most important agenda is to first identify your target market and hence finding out who you want your message to reach. We find that the greatest mistake that marketers make is in failing to define the target clearly and the marketing message becoming too generic and wide. For example, if your audience is the older segment but your advertisement primarily includes children and their healthcare, then your campaign is going to be wasted due to a lack of focus. In this article we highlight the importance of your target audience in the healthcare segment and help you visualize your reality and that of your patients. We believe that with the first step, which happens to be, “defining your target audience” everything else will fall into place and you will then be able to have a wonderful patient doctor relationship, with who so ever comes to you, since you would then be able to relate to the person better. When you discover and understand the group of people you plan to serve, everything else becomes easy and multiple marketing strategies can then be implemented with focus on the different criteria at any given point in time.  How do you go about defining your target audience - a critical health care marketing success factor?   When your marketing efforts are focused to reach everyone, everywhere and anywhere then you are destined to have a frivolous and worthless budget. Focusing and defining with great precision to get the best results with your precious resources is an important and crucial aspect of healthcare marketing. Carefully and precisely identifying your target audience will lead to successes in your branding and provide you with a branding strategy that will be par excellence. With this kind of focus you clearly know who you wish to reach, where they are located, what would be their wishes and desires for good healthcare and how to speak to them directly.  What are the many parts to health care marketing and what are the factors that go into defining your target audience? Elements for successful branding: Visualizing your target audience as someone who is a real person in flesh and blood with their set of ideas and wishes is critical to the success of your branding. How does one clearly define his target audience in the healthcare sector to bring in focus? What are the criteria which he would find pertinent? ●    Demographics - Factors such as age, occupation and gender play vital roles in establishing what your target audience should be. Educational levels, family structure, household incomes, should also be taken into account before planning your marketing strategy with any group of people.  ●    Psychographic – Examining the personality of your target group could be an important aspect of your strategy. Their lifestyle and behavioral patterns can tell you a lot about how to reach them and entice them into associating themselves with you.  A study of their personality will tell you whether they would be willing to visit your office frequently or not. This will also help you understand if they will be open to innovation and technology.  ●    Location / geography – Narrowing your target area to a certain number of zip codes in and around your clinic or hospital would be a good idea. Patients who happen to hear about a good doctor may be willing to drive a few extra kilometers or even a few hours to see him / her. One should also take into consideration all potential road and climate issues. This will define the territory that you wish to own and provide service to. This will define ZIP codes with a realistic distance between them as well as your location or locations. The geography can also be defined bearing in mind the physical and psychological barriers. ●    Behavior – What lifestyle patterns does your target audience adhere to and which of these can you take advantage of when planning your marketing strategy? Answers to these questions can help you with your marketing and reaching your target in the best manner possible.  Understanding your target audience in all these areas and facets of their life will help you create an appealing and fascinating marketing strategy around their needs and lifestyle. You will thus be able to build your brand and your patient base in a much more effective manner since you would now have a much more in depth knowledge of their likes and dislikes and behavior etc. Once this target has been defined and shortlisted based on these criteria we can give you 4 useful tips to manage your marketing in the targeted groups.  12/5/2016 12:00:00 AM Profit Vs Not for profit companies in healthcare – A comparative study The United States is now faced by several formidable and overwhelming economic challenges least of which appears to be the fragmented healthcare system. Spending twice as much per capita on healthcare as compared to other developed countries, U.S still ends up with worse care and poorer health conditions. American enterprises are also spending way too much on healthcare than their adversaries internationally, making them less competitive in an economic world. Unless a superior healthcare system is evolved, the nation would face bankruptcy. At the bottom of this inefficient and expensive U.S healthcare structure is the “for-profit” system, where the healthcare conglomerates have the freedom and incentive to charge higher premiums at their will, while simultaneously exploiting the system. They also do not provide as many patient services as required by them, nor do they provide the services to those found to be needy (nonprofit patients) in the community. “Spend less and Charge more” – this seems to be the order of the day for these commercial establishments. This does nothing for the “Obamacare” goal of providing uniform healthcare to all Americans. 12/5/2016 12:00:00 AM FDA in Healthcare Abstract The medical field is by far the most exciting in America for entrepreneurs and most health care practitioners are in a unique position to take advantage of the many opportunities that present themselves. Invention and creation of new products and services in this field has been on an upswing while most of the important revolutionary changes have occurred in the health entrepreneurship field in the last 100 years. In spite of this many health care entrepreneurs have found it a daunting task to act on their entrepreneurial ideas due to several reasons, chief among them being FDA regulations. This article addresses a few of the key concerns and issues as well as the many challenges that FDA poses to healthcare entrepreneurship. Healthcare innovation when challenged by the FDA raises many questions which entrepreneurs need to address before jumping in. The common pitfalls that await the entrepreneur who does not address these questions, can make or break the entrepreneurial venture. What are the chances of beating the odds and succeeding in spite of the many challenges that FDA has brought in. Why FDA Regulation? Regulation is meant for a good reason.   •        Regulation is meant for a good reason. •        Regulation is meant to protect the safety of the customers. •        Companies also welcome regulation but there are times when the FDA clearance / approval process can seem a critical challenge and capital intensive. •        The healthcare entrepreneur needs to be introduced to FDA regulations around many a medical devices and mobile applications. •        We know regulation is for good reason—to protect the safety of consumers, and companies want the same. However, the FDA clearance/approval process can seem murky, challenging, and capital intensive. Development of any pioneering healthcare product, be it a biologic, drug or a medical device, from the conceptual stage to the marketing and sales stage is seen to be a very expensive and complex process. Years of research and development go into the making of such a product. This necessitates that all product development activities should be done in accordance with the regulatory requirements. •        Creating a product that meets regulatory standards for your targeted jurisdiction, which means developing a product that is of quality and following safety standards, while being effective for use, is of utmost importance.   •        Although all the information regarding guidance, laws, as well as international standards for healthcare product development is available, steering and navigating through the regulatory system is not simple especially since there are multiple jurisdictions. •        Health care entrepreneurs find FDA and other regulation to be a critical challenge. •        The regulatory landscape is not intuitive or easily understood by people who do not belong in the industry. •        There are several healthcare technology developers who come from outside the space for whom these frameworks and regulations can be utterly confusing. •        There are key principles and best practices that need to be followed while navigating through the maze of FDA regulations and other regulatory issues that may be encountered during health care product development. •        In order to save money and time, bringing these healthcare products to the market should be done in accordance with the regulatory framework (FDA and others). In thisarticle we look at a few healthcare segments that have embraced FDA and the reasons for their doing so, while a few others think that FDA is killing healthcare entrepreneurship and innovation. Here we also provide a definitive guide to the FDA for the digital health entrepreneur as well as a comprehensive step by step procedure enabling the healthcare entrepreneur to navigate the regulatory landscape.   Few healthcare start-ups embrace FDA – Find out why ·        There is enormous wisdom in the decision to embrace FDA feels Bryan Haardt, the CEO of Decisio Health which provides software which helps in adherence to clinical protocols. ·        Being one of the few software-specific companies making a foray into the FDA-regulated space, Haardt tells us that his company had to make a new path in digital health. ·        The FDA he says has not released any guidelines for this space as yet and is infact testing out the thesis on companies like Decisio. ·        While dealing with government regulations is a necessary evil, Haardt feels strongly that “entrepreneurs should not shy away from the FDA”. ·        He says “You cannot outrun the regulatory bodies and so you need to embrace them”. ·        Haardt further emphasises “run towards the FDA, not away from it”. ·        By deciding to work closely with the FDA and other regulatory bodies you ensure that your product will comply with regulations while creating the much needed internal discipline within the company. ·        FDA should be embraced as an opportunity to create a great company, says Haardt. Haardt provides us with invaluable insights into healthcare entrepreneurship and his ideas are illustrated in this diagram Is FDA killing medical innovation? If so how?  Against the backdrop of a healthcare reform and a medical device tax which has been leading to controversies, there are the medical tech companies which have been steadily focussing on the products that deliver faster, cheaper and more efficient patient care. These health care entrepreneurs are also making inroads within the US Food and Drug Administration regulatory authorities to re-design the complex review and approval processes for new medical devices. The FDA made an attempt last year to help change that perception and announced a medical device innovation consortium which was made responsible for simplifying the process of designing and testing the new innovative medical product. With this and inputs received from the government, industry and other non-government organisations, the MDIC ( Medical Device Innovation Consortium) will prioritize the regulatory needs of the medical device industry and fund these innovations in an attempt to streamline the process. With this effort the MDIC may be able to help the industry to become better equipped to bring safe and effective medical devices to the market at much lower costs. Every year there are medical device trade press and the Cleveland Clinic that look for their favourite technology trends among the many that the industry engineers and scientists push for improving and managing human health. The politicians, regulators, politicians and corporate executives are busy hashing out these very details and the thought leaders agree that the ideal technology in the healthcare segment should strike a balance between reduction in overall costs and increasing safety and survival rates. A company by name Novobionics, a subsidiary of Duggirala’s company, developed a non-invasive technology that would imitate and mimic the effects of gastric bypass surgery and raised a small amount for the its funding. The advantage of this device – it tricks the gastro-intestinal tract into thinking that its full thereby slowing down the rate of the nutrient absorption which in turn will ease the suffering of patients with diabetes. This innovation showed great promise but the entrepreneur and physician at San Mateo Medical Center tried hard and struggled to bring the medical innovation to market. But the issue he faced was that when it came to medical innovation, investors had to pay the government huge sums to invest in technology which scared off the prospective investors! This story is not unique – “Uncertainty” is not a word that Silicon Valley investors like to hear. This is just one of the many issues raised by FDA which is killing medical innovation. There has been a huge outcry from the medical device entrepreneurs who have been pointing out that funding is drying up. A convergence of such factors has only worsened the situation.   The other causes for concern are a 2.3 percent excise tax on medical devices which has been brought in as part of the Affordable Care Act which further raises the cost of taking a medical device to market! The lack of any clarity on the regulatory guidelines from the Food and Drug Administration (FDA) is another important cause for concern. Although the tax may not seem like much, its on the revenue and not the profits and since we know that most medical device companies are far from a profit margin, the tax takes a toll on the company. It is still unclear as to which entrepreneurs will be required to pay the tax. For example will this tax be levied on mobile medical devices, smartphone apps., which are used in clinical settings, such as diabetes analysis app.   The other major issue comes from the fact that the patent office is slow to approve applications and investors having to work secretly in order to protect their ideas and sometimes this has to be done for years. Thereby, one entrepreneur may have one great innovative idea that he has been working on unaware that there are many others who are simultaneously working on the same or similar model. What does the FDA say to this? The FDA avers that they are aware of these concerns and that they are reaching out to entrepreneurs and other venture capitalists and have included their feedback to implement a few changes in the regulations of the FDA. The FDA says that they are trying to create a balance between patient safety and innovation. While the FDA feels that they are putting in all efforts to bring greater advantages to the entrepreneurs that also feel that entrepreneurs would have to contend with institutional review boards and also front the cost for clinical trials. 12/3/2016 12:00:00 AM How to practice effective healthcare leadership At a Glance Leading with care The healthcare leader of today is Versatile and Decisive Practices for Effective Healthcare Leadership  Leading with care What does this entail for the new generation leader? ●    Understanding the unique qualities and needs of his team ●    Providing a safe and caring environment to every member of the team enabling them to do their jobs effectively ●    Having the essential qualities a leader in the health and social care segment should possess Why is this important?           Leaders are meant to understand the underlying emotions that affect their team members while caring for team members as individuals, while helping them to manage their feelings. This would help the members of the team focus all their energy in the care and service of the patients. What it is not? ●    It does not allow anyone to make excuses for poor performance ●    Does not encourage the possibility of the leader not taking responsibility for the poor performance of members of your team ●    Failure to comprehend the impact of your emotions or conduct with colleagues. ●    Taking responsibility away from the others in the team Other important attributes to be seen: ●    Caring for the team ●    Providing opportunities for mutual support ●    Recognition of underlying reasons for behavior ●    Spreading a caring environment beyond one’s zone of influence The healthcare leader of today is Versatile and Decisive Research has proven that 30% of senior healthcare leaders are responsible for manifold executive roles. Healthcare leaders who have an education which covers many disciplines often have an advantage since they are expected to take on diverse responsibilities. Studies show that most successful CEOs with a medical or clinical degree also hold a master’s degree in administration.  The new environment needs leaders to encourage a collaborative spirit and thereby improve the skills of the workforce. The ability to mentor and inspire the workforce is a trait that is a must in the health care professional of today. Those executives who are able to create a new list of traits that the fast-moving healthcare marketplace requires will be better equipped to manage and handle the challenges and the competition for future career opportunities.   Thus the transformation of the healthcare industry has in turn seen the evolution of the healthcare executive. Practices for Effective Healthcare Leadership While we may list several personality traits that are desirable in the healthcare professional and those that define a successful healthcare leader, there is no one single trait that defines success. There are on the other hand practices and tendencies that these leaders share. Firstly, they should have a vision and strategy for the future. They have to inspire performance in others in the pursuit of their individual goals. The primary focus and mandate of any healthcare industry is to improve the quality of healthcare in the societies and communities where they serve. These leaders may vary in their individual vision and goals but by and large they have striking similarities in terms of essential, fundamental skills that they possess in order to build success. These are elucidated here: Building Strong Teams:  As healthcare evolves it will continue to require greater collaboration and with patient focussed medical homes becoming the custom model, the need for alliances, partnerships and teamwork becomes intensified. Hence the need to understand the effective allocation of talent to build effective teams, while having the confidence to let the teams work together. The more effective the teams, the greater the variety of skills and experiences they exhibit. For leaders to be successful they should begin with recruiting the right team with the right skill sets bringing together the many varying experiences of people from different backgrounds, perspectives and ideas. These leaders would then have to ensure that the carefully chosen team is provided with the right collaborative environment to bring out the best in themselves and the rest of their team members. These leaders then provide their folks the freedom to explore new possibilities. 12/3/2016 12:00:00 AM Legal start up lawyers Abstract The legal facets of the healthcare industry, be it a start-up or an existing hospital or entity, would have to be an integrated team of lawyers that would be able to draw from a diverse number of legal specialities. The healthcare sector is a highly regulated one with several regulatory and legal procedures to be followed in order to address the complex and dynamic issues which are present in healthcare for all service providers. These lead to challenges for the healthcare industry and the lawyers / attorneys need to adopt a proactive approach to dealing with healthcare legal issues. Practical and Cost-effective solutions in the legal arena is the need of the hour for healthcare industry which will enable them to deal with operational as well as strategic issues. In this article we outline the legal challenges that a healthcare industry would face due to factors of regulation, procedures and dynamic changes seen. We provide you with guidance on deciding the exact nature of your legal requirements that will arise when running a healthcare enterprise, while outlining the many legal issues that would need to be tackled. Segments of the healthcare industry that would require legal expertise would include: ●    Residential treatment centers, ambulatory surgical treatment centers, subacute care facilities, rehabilitation agencies. ●    Ambulatory care centers, home health agencies, diagnostic imaging centers, rehabilitation agencies. ●    Cancer center, dialysis centers, eHealth companies providing IT solutions and disease management companies  ●    Medical education payors and providers, group purchasing organizations, physicians who are lone practitioners, multi-speciality and single-speciality physician and groups ●    Physician practice management enterprises, nursing care providers and organizations ●    Enterprises providing long-term care and assisted living facilities. ●    Businesses involved in the manufacture, design and distribution of medical equipments and pharmaceuticals ●    Joint ventures both in for-profit and not-for-profit sectors ●    Investment banking firms that provide finance to healthcare companies, equity investors and lenders. The range is extensive and beginning with the acquiring of a practice (start-up stage) right upto rolling out an internet based healthcare business, or healthcare roll-up company, a lawyer and legal expertise is required. The issues can be common as well as critical, and the need of any healthcare enterprise is cost-effective and practical solutions to the operational, strategic and legal complications that come along the way. There will be challenges that are unique to the healthcare industry and the legal entity ( preferably with multi-disciplinary approach) would have to focus all its attention on employment laws, asset protection, taxation laws, intellectual property rights, financial restructuring, pension and benefit plans, mergers and acquisitions and many other related areas. There has to be expertise that goes beyond traditional healthcare laws and these would be in relationships between physicians, healthcare providers and related businesses. A lot can be achieved by the use of a 360 degree perspective and we try and bring you some of those aspects in this article. At the very outset – when you are about to start the healthcare practice or business When a healthcare provider or business person is at the juncture where he intends starting a healthcare practice, the task and detailing for the same can be an overwhelming process. Unravelling and understanding every aspect and the legal processes which would include details such as:   1.Choosing the forms 2.Applying for the loans 3.Deciding whether the legal entity is going to be a professional corporation or not and whether that is required for your kind of business 4.Getting start-up assistance wherever possible 5.Maximising tax benefits 6.Entering into negotiations with hospitals and health maintenance organizations 7.Reserving a name for the business and protecting the same 8.Hiring employees and entering into Employer- Employee Agreements 9.Ensuring that there are concrete structures with partners. Entering into Employer –Employee Agreements This is one area that would need careful scrutiny and understanding of the needs and desires of both parties involved. Negotiating and preparing the agreements would be an important role for the legal department who would be able to scrutinise every part of the agreement before arriving at the right one with all legal terms and terminology being correct without compromising the interests of the employer or employee. This way the enterprise can cut down on time-consuming and ineffective negotiations. Employers also have a need to protect their goodwill and other intangible assets which can be made possible by the proper use of the right terms and covenants that would make this possible. Inclusion of stock-option plans, bonus plans and other benefit arrangements for employees can also be done by competent lawyers which will enable the organizations to get the right people into their company. Estate and Trust Planning In a healthcare practice the owners and the business entity are to be considered as a whole where the interests of the owners is as important as that of the business. Wealth preservation as well as estate and trust planning, therefore become an important aspect of the legal mechanism that requires careful consideration and detailed planning. Agreements of ownership One major issue that can arise in any enterprise with partners and owners, in healthcare in particular, would be with disagreements that can arise due to the close involvement and personal interactions that would be needed from all parties concerned. This can lead to discord and the legal manager of team would have to recognize these areas of conflict and points of disagreement ahead of time and provide safe guards or offer solutions when issues arise. At the outset, when the agreements are drafted, it would be a good idea for the legal departments to come up with innovative and time-tested solutions to enable optimization of the partnership agreements and work relationships. Mergers, Acquisitions and Sales There are mergers, acquisitions and sales in the healthcare sector on a regular basis and everyday there are one or more of these happening. Be it due to retirement, industry consolidation or any other reason there are 998healthcare practices that are being sold, bought or merged every day. These require a different kind of legal acumen and there is a full range of laws and practices that the legal departments has to be acquainted with. The legal department has to be equipped to handle and provide thorough due diligence especially in the case of entities entering into joint ventures right from the start of the negotiations till the closing. The transfer of ownership or partnership will entail much more than a simple transfer or sharing of assets. Several important legal aspects will have to be considered and this would be laws around sale or merger of practice, include corporate laws, federal and sales tax laws, ERISA, anti-trust issues, third party reimbursement laws, and laws around abuse and fraud. The structure of the M & A transaction for the healthcare business taking into consideration corporate tax, regulatory issues and estate planning, apart from liability and antitrust will have to come within the expertise of the legal cell in the healthcare practice especially when the business is a closely held one. The knowledge base of the lawyer in this case has to be extensive and whether he or she is representing the buyer or the seller he should be thorough during the process and during the negotiations and documentation process. The attorneys should preferably have had exposure to such work and have a good experience in dealing with these aspects and the regulatory frameworks of Mergers and Acquisitions and the business requirements of healthcare registrations, licenses, permits etc. 12/3/2016 12:00:00 AM Pay-for-service Vs. Pay-for-performance in Health care industry   Abstract The revenue that is generated from practice is the lifeline through which other services are made available. There is a need for a constant and solid revenue stream for physicians, hospitals and healthcare practices and providers. In such cases whereby the practices’ claims processing time gets slowed down, there arise many issues for the practices and hence a slowing down, making it difficult to manage expenses. The two prominent and current payment models in use are Pay-for-Service and Pay-for-Performance. While the first model has been in use for quite  some time, the latter is a new idea and has come into existence with the primary purpose of reducing the medical costs but also to improve quality of care. In this article we try to bring out the differences between the two systems and also the advantages of the latter. We have discussed both the models in detail and tried to establish the major differentiating factors. Difference between pay-for-service and pay-for-performance payment models Pay-for-Service Model  ·        Payment model where the services are unbundled and paid for individually ·        Could inadvertently give physicians an incentive to increase the number of treatments they provide since payment is dependent on quantity rather than quality. ·        As patients are safe-guarded by the cost-sharing provided by insurance coverage, they also tend to welcome blindly any medical service that might be of any value. ·        All this has led to rising medical costs, reduces the efficiency of integrated care there is a broad agreement that reforms are needed to the Pay-per-service model that is commonly used today. ·        This model provides financial incentives for doctors to increase the services they provide to the patients while penalizing them for providing better services and improving health. ·        Model whereby the physicians charge individually for each of the services rendered to the patient. ·        This is one model which is beneficial to the physicians since they can get the maximum revenue by providing a plethora of services to their patients. Nevertheless the quality of healthcare            being provided has been suffering and is considered to be poor in this model. ·        The physicians also do not seem to care about this trend nor are they seen to be concerned about providing the right care. ·        The main focus of the physicians in this model is to render as many services as possible so that they can receive more by way of payments for each service rendered. ·        This model has been in existence for some time and the government is trying its best to curtail the increase in medical costs brought in by the pay-per-service model and to abolish this                     trend. ·        Several changes have been instituted in the regulatory frameworks in order to remove this system and model in a phased out manner. ·        The system of bundled payments and capitation are methods that have been discouraging physicians from performing unwanted and unnecessary procedures as they do not get paid more              for these extra procedures.  In the United States it is seen that the health care system means high cost and high volume, but it surely does not mean high value. The nation is seen to spend more than twice on healthcare when compared to other countries. Spending more on healthcare does not necessarily mean a healthier nation! Once again, it is seen that even within United States there are different areas that are spending different amounts on healthcare which also has no connection with better outcomes. The pay-per-service model which awards more for quantity rather than quality, especially for the high-value and high-cost services, is seen to be the key reason for these increased healthcare spends. This model encourages wasteful use, more so, of high-cost treatment and it does nothing to bring in financial incentives between the different providers. This results in healthcare providers not being fully aware or concerned of the exact care that their patients should receive, and the patients receiving care that they may not need and may not want. Not only are the insurance companies liable to extra costs, this model also raised the premiums, deductibles and cost-sharing for healthcare consumers. The pay-per-service model does nothing to bring in low-cost, high-value services which include preventive care or patient education while these could surely improve the patient’s health care lower costs throughout the cycle and system. For example, there are many instances of patients with heart failure or poorly controlled diabetes who come to the hospitals needing acute care while in actuality the disease could have been managed with preventive disease management thereby eliminating the need for expensive hospital stays. Where we are today and what are the opportunities to entrepreneurs? There are clear signs that the trends are changing. The Affordable Care Act provides a plethora of payment and delivery systems which are meant to control costs while improving the care and treatment provided. The provisions of the Affordable Care Act under the Medicare program enables a variety of options that complement existing private-sector innovations and ensures the adoption of alternatives to the existing pay-per-service model of healthcare. These alternates encourage preventive care and better care co-ordination making these incentive based and more so for patients with chronic ailments. Instead of making payments based solely on services provided patients can now have the luxury of paying based on the care outcomes and extent of treatment given leading to results based treatment. There is the trust that moving the physicians away from linking payments to provision of quality care will improve standards of healthcare delivery while enabling quality care. This new method will surely serve as a method to reduce costs. 12/3/2016 12:00:00 AM Pharmaeutical Companies Restrictions and Regulations Pharmaceutical companies, restrictions and regulations Abstract The role played by pharmaceutical companies has become very important and prominent in the international healthcare agenda as health indicators have been linked with any nation’s successful development. Also, the economic and legal issues surrounding pharmaceuticals has become increasingly complex and politicized due to the increase in trade globally. Considering this there is an increased need for regulations in the pharmaceutical sector where effective laws and regulations are needed. In this article we elucidate on these regulations and restrictions imposed by the many government agencies like FDA etc. and what steps have been taken at the global level along with guidelines taken from several areas. Why the need for restrictions and regulations in pharmaceutical companies The FDA (Food and Drug Administration) is the government agency whose function is to ensure the safety and efficacy of medicines made available to Americans. The government enforcing major control over medicines has made pharmaceuticals the most regulated product in the country. There have been two major incidents (tragedies) that have been the source and the reason for two of the FDA’s legislative acts. These are interesting case studies in themselves and we report the incidents here. The Massengill Company, in 1937, in an attempt to make a liquid variety of the antibiotic drug Sulphanilamide, made use of the solvent diethylene glycol, which is otherwise also used as an antifreeze. This medicine thus created, Elixir Sulphanilamide, killed 107 people, most of who were children and the drug was quickly recalled from the market. Massengill was sued and the chemist responsible committed suicide. This led to the Food, Drug and Cosmetic Act of 1938, which brought in the legislation that drugs be tried and proven safe before they are marketed. What one needs to note about this particular amendment, is that, although thalidomide’s issue was clearly one of safety for which the FDA had already had regulations, the laws had been altered to add proof of efficacy. What we also need to be aware of is that most drugs, herbs, food and dietary supplements that Americans and the populations of other countries consume on a regular basis, have neither been assessed nor approved by the FDA. While a few may be beyond the scope of FDA’s regulatory authority, some are perhaps approved drugs that are being used in ways that the FDA has not approved. These are called “OFF-LABEL” drugs being used by physicians and its usage is widespread. While the FDA may tolerate this usage, it does not allow pharmaceutical companies to promote these products.  Realistic and effective laws and regulations are required for the pharma sector because  ●    Pharmaceuticals concerns the entire population  ●    There can be many serious consequences due to usage of the wrong drugs and medication  leading to injury and sometimes even death ●    The product quality cannot be determined by the consumer ●    Many people are involved such as patients, manufacturers, sales force and healthcare providers ●    Any controls which are informal, are insufficient as means of restrictions ●    The use of poor quality, ineffective or harmful medicines would give rise to therapeutic fiascos or disasters, resistance to medication and sometimes even death ●    The wrong medication can also undermine the confidence that people hold in health systems, pharmaceutical manufacturers, health professionals and distributors. ●    To protect the interests of the public in providing the best health care, governments have to provide comprehensive laws and regulations, and restrictions along with the appropriate regulation. ●    This should ensure that the manufacture, trade and use of medication is regulated properly and that the public has access to the required information and medication.  What would be required as part of the effort for regulations and legislation  ●    If countries are starting afresh then it is good to have a general law / legislation in place.  ●    Countries may choose to form new laws and regulations or to revise existing ones. ●    There is expert assistance to aid in this process and there are also many models that countries could easily follow. ●    Once the laws are passed, the regulations made can be brought into operation slowly, one at a time, as there will be the requirement for resources and experience to implement the laws.  ●    While drafting or revising existing regulations the country should  o    Find out the type of legislative instrument required o    Bring in legal and healthcare experts and create frameworks using their guidance o    Keep all parties, with any interest in the proceedings, involved in the procedures and processes o    A list of all rules and regulations which are already in effect should be made o    A regulatory authority also needs to be established for the control mechanism to be in place o    Nationwide drug legislation requires provisions related to importing, distribution, manufacturing, marketing, labelling, prescribing, pricing, dispensing, licensing, control of personnel and facilities and inspection. o    Medicines have to be formally registered so that they meet the standards of individual products of criteria such as safety, efficacy and quality.  o    Countries that need comprehensive guidance can seek the assistance and help of WHO or others with similar experience.  What you need to understand about pharmaceutical companies and the regulations and restrictions they face Pharmaceutical companies are indeed distinctive for the government control and extreme economics, with high fixed costs of development with low costs of production. 12/3/2016 12:00:00 AM Ways to Market in the Healthcare segment Abstract Marketing healthcare and the many ways to market can often seem like a daunting task and its complexities are many. There are a few proven ways in which to market within the healthcare segment albeit the job being complex and sometime confusing. There may be many hundreds of strategies and thousands of tactics worth exploring, but there are few rudimentary principles that can provide a manageable starting point for bringing them all together and getting your healthcare marketing in order. These may be fundamental elements and the basics and can act as building blocks which help demystify healthcare marketing. While this may be true for a few marketing practices, there are a few tried and tested methods that healthcare professionals employ to connect with their patients. Many of these healthcare practices are finding it difficult to keep up with the changes in marketing technology. We find that advertising strategies that once were very effective are no not bringing in the new patients. The practices suffer from this and there are negative consequences when one does not adapt to change, when the healthcare practitioners continue using the same old strategies. In this article we bring to you an overview of those fundamental principles and then help you try a few new ideas and strategies helping you market in ways that can be more effective! If you are looking for ways by which you can market your healthcare services and improve your patient acquisition program, then this article will provide the necessary guidance. Healthcare marketing today Not very long ago, there were not many physicians who needed to market their medical practice, but this has undergone tremendous change. With the advent of advanced technologies such as the internet as well as increased awareness, patients are now more demanding and discerning than they were say, 20 years ago. It is therefore becoming necessary for the medical practitioner and entrepreneur to help improve the knowledge and understanding of the products and services you provide, among your patients. Healthcare Marketing today is about making use of the data available and using it to make a personal connection with each patient instead of promulgating and publicizing your enterprise using general advertisements en masse to the public at large. Automation is a solution to many of the healthcare marketing issues and can make the process more efficient while you spend less time on marketing. There are six fundamental ways of healthcare marketing and these include Professional Referral Marketing, Branding, Internal Marketing, Internet Marketing, External Marketing and Public Relations. Professional Referral Marketing promises the medical speciality providers, a reliable and continuous supply of patients sent by other medical, dental or professional sources. These referral sources are not to be taken for granted and is the lifeblood of many speciality medical practitioners. Whether the referral source is a secondary or primary source should not matter and one should also remember that this referral does not happen magically or simply because you are known to be a good doctor / provider. To succeed in getting a regular stream of referrals one has to have a well-defined plan of action and an unfailing system in order to preserve the sources and grow the professional referrals. Branding is all about standing out in a crowd and appearing successful with a positive frame of mind. Your reputation needs a differentiator by way of a powerful presence for your health care business. Providing and projecting the right image will have to be done by deliberate effort and by expressing the right message at the right time to the right audience. Effective and Meaningful branding means all this and much more. Internal Marketing This would primarily mean all those who you come into contact with on a regular basis such as patients and clients who are currently being treated by you as well as those others who you may be in communication with. Patients who had been seeing you professionally in the past could also be treated as an influential audience and can also act as a dynamic and good source of referrals, additional services, testimonials and word of mouth advertising.  Internet Marketing This can offer you a wide range of tools to market your healthcare practice. Whether your practice is that of a physician, ophthalmologist, dentist or any other, it is under constant competition with other healthcare professionals in your area when it comes to enticing and drawing patients online. How you ensure that your practice stands out in the crowd is the challenge. Patients who do not have a recommendation from a close friend or family on what health care facility or professional to use, would normally run to doing their own research – online. This would mean using anything from search engines to social media, provided they know that the information they are receiving is authentic extensive and trustworthy. For you as a practitioner it is important that you get listed prominently in all these places where your potential clients would be looking. This would ensure that you drive more traffic to all those entities where your service is listed thereby increasing more foot traffic to your practice. Ensure that the listing provides the most compelling information about your service. Creating a strategic website, focussing on search engine optimization, conducting a healthcare survey through social media and using it in cross-promotion marketing strategies can be a few useful ways to use technology to your benefit. Many healthcare professionals refer their patients to other businesses by word-of-mouth, but with the use of social media one can automate this process whereby one can promote another’s business and in turn get referrals using social media, making the process simpler and easier. This will help keep the business within the community while increasing exposure for the healthcare professionals and hospitals.    Public relations: This would primarily mean generating publicity and press exposure for your healthcare enterprise or practice and planning this meticulously. Broadcast interviews and newspaper articles would be part of the agenda while trying to improve your public relations. Becoming a powerful influencer in your area will go a long way in improving your business / practice and this kind of free press does not come easily. It requires careful preparation, perfect timing and well intentioned, clear messages reaching the right people with deliberate effort. External Marketing Where there are prospective patients who are not aware of the service you provide, you have to depend on “external marketing”. These would be the advertisements in television, newspapers, radio, billboards etc. which would target an audience that would now have to be educated on the services that you can provide to take care of their health care issues. The ROI on these external marketing efforts is quiet significant and there is little margin for error in these. 12/3/2016 12:00:00 AM Healthcare IT Healthcare IT - data cloud (patient information storage, opportunities for entrepreneurs) Healthcare data storage – What’s in it for the entrepreneur! Abstract Hospitals and doctors have the task of having to choose from a variety of healthcare data storage options. The important thing to know is whether the data to be stored is in the form of patient data, images or any critical hospital information – this can dictate the storage method to be used as well as the ones that would best serve that particular organization. Since the storage comes in so many formats, finding the right method to store such data can be a huge challenge to hospitals. While there is not much federal regulation around medical records storage, most organizations prefer staying ahead of the HIPAA’s (The Health Insurance Portability and Accountability Act of 1996) storage contingency plan requirements. Cloud storage has been a very hot topic in the recent years and this seems to be seen by most medical practitioners and entrepreneurs as an incomplete solution till date. In this article we examine various methods of medical record storage as well as the safety precautions organizations need to undertake while safeguarding the medical records of their patients. Also, we delve into the many opportunities that are thrown open to new entrepreneurs because of this new and interesting area, within the medical field, that is now open to investors and medical enthusiasts. This article will help healthcare organizations and professionals to safely navigate the maze of data storage options.  Big Data Explosion in Healthcare: An accelerator of value and innovation We are seeing an era of open information in healthcare segment today. With pharma companies and other organizations collecting years of information and data in the form of electronic database, we have experienced almost a decade of digitizing medical records. The public stakeholders as well as the Federal Government have also made the shift to greater transparency by enabling decades of stored data to become searchable, actionable, and usable by the entire healthcare sector. This access to data has brought the industry to the tipping point.  How can you see opportunities in this for the healthcare entrepreneur? With the advent of big data healthcare entrepreneurs and stakeholders are able to access new areas of knowledge which were hitherto unavailable to them. The “big data”, so called, not only for its absolute volume but also for its timeliness, complexity and diversity has become indispensable for pharmaceuticals, industry experts, providers as well as payors who need to analyse this big data to get insights into the many aspects of a patient’s health. This “big data” revolution, although still in a very nascent stage, can address major issues such as: Healthcare quality variability as well as the rising healthcare spends. For instance, any entrepreneur entering into this arena of healthcare can contribute enormously by: ●    Helping the physicians with data that will help them mine information to show which would be the most effective treatment for particular medical conditions ●    Be able to gain information that can help patients reduce their medical expense ●    Be able to identify patterns that are seen as related to drug side effects or hospital readmissions.  ●  Innovative companies and entrepreneurs are able to create applications and build them from scratch along with analytical tools that would help patients, healthcare professionals and physicians to find value and opportunities. ●    Some of these are helping in the substantial reduction of the rising medical costs in the US and other countries. Examples of enterprises that have moved to replacing their electronic health records and revenue cycle technology with EPIC or CERNER with great success rate and improvements To improve the quality of healthcare while bringing down the cost, it would be necessary to convert all American medical records into computerized format. To site a few examples of healthcare enterprises that have taken these steps into innovation –    ●    In one of its biggest steps into venturing into IT, Mayo Clinic selected Epic to switch its existing electronic health record – Mayo has developed a strategy for ensuring that this multi-year project stays on time and within budget.  ●    Mayo had been taking the necessary steps to move towards this change and convergence of its practice for many years and has implemented the same in many of its locations – Florida, Arizona, Midwest etc.  ●    Mayo felt that an integrated EHR such as EPIC would help the organization keep focus on patient’s needs first. ●    Their aim was also to get better results and advancements with revenue cycle management, in order to make bills easier to process and to be understood easily and in a better manner by patients.  There have been other successful implementations of EHR namely – Primary Care of the Treasure Coast (PCTC) – a ten member physician practice which set up an aggressive EMR training schedule and PCTC launched eClinicalWorks EMR in August of 2005. They thought electronic records were the future of healthcare and these EMR systems helped them manage their patients’ chronic diseases. Records that are very difficult to pull out with paper charts were made available with these electronic systems. One other implementation was in the practice of Pedro Ballester, MD. Pedro’s wife, Kathy Ballester, who was the office coordinator at the time of considering an EMR, was “anti-EMR” and did not see a need to fix something if it was not broken. However the three member team of Dr.Pedro went electronic in 2004 using SOAPware EMR system and the practice’s EMR system soon became indispensable even to Kathy Ballester! She vowed that there was no way she would ever go back to the paper based system. Dr.Pedro’s office also felt that SOAPware, its interface and functions, worked well for a small office. Developing Universal Electronic Medical Records – Need of the hour Reform in the healthcare segment has been a priority in the legislative and medical communities, as well as the general public. Antiquated administrative systems have been a major cause for overinflated burden on healthcare costs. These do not allow for maintenance of efficient and functional records in healthcare which has led to the damage and loss of individual patient care and systems of health management. There is universal agreement that a technologically sound and updated system with access provided throughout the nation would bring a leap in healthcare reforms. Nevertheless there have been many stumbling blocks that have come in the way of this progress and these have to be addressed. One must take into consideration implementation of a robust, successful and universal EMR. The agenda of the healthcare reform as far as the EMR is concerned should be allowing access to patient information at all probable venue of care while still affording security, privacy and autonomy of patient information. The primary tenets of a sound, robust and universal EMR would have to be control, security, funding, accessibility, compatibility, integration, portability, integration from many sources as well as home-data procurement with medical oversight needed to maintain the system’s integrity. The potential for this system is endless but care must be taken to avoid drawbacks. What are the advantages for new entrants into this field? With the recent technological advantages the new entrants to this field of “big data”: within the healthcare industry can consider themselves fortunate since it has become easier for them to work with the data, even when the files are large and having different database structures and technical characteristics. While all this is at an early stage, most of the potential for value creation is yet to be claimed. This is one of the plusses for new entrants into this segment who are waiting to grab the opportunity and make a mark. With the industry poised for rapid change and new discoveries the ones committed to innovation will be the ones to reap rich benefits and rewards. They require proactive strategies to take them forward and win in the new environment. With the advancement of technological capabilities and as the understanding of Big Data increases and improves, we will find that there will be a greater ability to work with big data and there is an expectation that there will be innovative new ideas for working with such data. There is a rising demand for insights and hence a greater demand for big data now in the clinical space. A series of converging positive changes has brought the healthcare segment to a tipping point, in which big data can play a major role. 12/3/2016 12:00:00 AM How to start an Urgent care, investing in one, franchising, partnering Abstract What is meant by Urgent Care? Urgent care is that segment of health care that allows patients to receive care for pressing medical concerns without the hassle of expensive trips to the emergency room. This type of care also takes away the burden from emergency room personnel and allows them to concentrate on more dire medical cases. We believe that opening one of these is a lucrative business opportunity more so since niche medical services are always on high demand. Those who have in the past started urgent care centers have made several mistakes and learn from them. We believe we can also learn from the mistakes of those ahead of us while appreciating the correct initiatives they have undertaken. We look into the mistakes and arrived at solutions that will help us avoid these problems in future. The new ventures in this segment can learn something more about how to start an urgent care business and avoid costly mistakes that can harm development in the future. In this article we bring to you all the expertise from those who have invested in urgent care and points you need to bear in mind before venturing into one. We bring to you the steps that you need to follow while after investing in the urgent care business and how to go about establishing franchises as well as partnering with others.  Let’s start with the mistakes While many of these thoughts on how to start an urgent care center are given from the perspective of entrepreneur physicians, they surely apply to urgent care centers as well and those that are started by business conglomerates and hospital systems. Please be aware that these are not given as a set of rules to be followed but guidelines to follow in the avoidance of mistakes. 1.    Avoid wasting money on expenses that you deem unnecessary ●    Have a good idea which need not be earth shattering – when looking at this advice and taking into consideration that an urgent care has become an absolute necessity, it will surely prosper in any community of any reasonable size. ●    Your urgent care never be better than the people you employ – so ensure you have good people on your team ●    Don’t waste hard earned money and remember that the enterprise is not immune to failure and one sure way to fail is to run out of money. Avoid unnecessarily expensive items.  ●    The internet can offer you a host of places where you could find computers, office supplies, medical equipment and other items for your urgent care center. 2.    Do not confuse a good doctor with a good entrepreneur ●    Your being a good doctor need not necessarily mean that you would be a good entrepreneur.  ●    You may not be as good at strategizing and may not have the skills needed to lead a team and enable your staff run an urgent care center. ●    You should endeavour to become a student of urgent care entrepreneurship. ●    Attending seminars, reading books on starting businesses, immersing yourself with the idea of entrepreneurship and connecting and networking with other urgent care entrepreneurs are all important. ●    Developing the inner entrepreneur will take you a long way in your journey. This is not taught in medical school. ●    Remember that this should not be treated as a primary healthcare center but should be seen as a business requiring a vision for the future and drive from the investor. ●    Networking with other entrepreneurs and professions in your field can take you a long way in your venture – National Urgent Care Conference is one such place to network which can add value. 3.    Not having a business plan ●    Action without a plan will be futile and so will it be futile to plan without putting the plan into action. ●    Putting pen to paper helps you look into issues in a detailed fashion and many obstacles can be foreseen.  ●    Your business plan will give you a framework from which to operate and succeed. ●    Your detailed business plan can include areas of importance such as  o    How to get your finance? Create a financial plan o    Efficient marketing of the urgent care center o    How much do you plan to invest? o    Where will your urgent care center be? How to choose the state, town or area? o    How to market your center? o    Determine whether to build or lease your facility.  o    Develop an efficient staffing model o    Learn and implement strategies to grow and expand the urgent care center. o    Ascertain that you have a blueprint for planning, building, and operation of a successful freestanding ED or urgent care center.  Even if there is no requirement for a bank loan or a need to convince investors, writing a detailed urgent care business plan will take you a long way in the business. Take the business plan to many others who are known to you and see if they think the plan will hold water. It is better to have your plan shot to pieces rather than have your finances depleted after trying out a poor plan or not having one to begin with.  4.    Sticking to Your Business Plan Blindly It’s a big mistake to follow your business plan blindly. Let’s look at the reasons why you should avoid this.  o    You will never be able to plan for every contingency that can arise in your start-up urgent care center ▪    There can be delays in construction ▪    Your partner may back out at the last minute ▪    A vendor may not deliver your material or furniture Likewise there may be hundreds of such issues and contingencies which may be foreseen or unforeseen. How will you be able to respond to these issues? You would need to be nimble and not get bogged down by these or because of your wishing to stick to your original business plan. While making a business plan and planning for the future are necessary there can never be a 100% fail proof plan and hence sticking to one can be disastrous. Taking a positive approach even if your entire plan goes haywire will ensure that you save your enterprise from a complete crash. Be willing to make changes when required. 5.    Referring Basic Procedures to Specialists ●    While there is a great revenue crunch for most urgent care centers, many of them literally send thousands of dollars in revenue to specialists.  ●    Whatever level of training they may have, most of the doctors in urgent care can perform simple lacerations, minor procedures and treat fractures etc.  ●    The National Convention of the Urgent Care Center Association of America provides a day’s training and workshop that can benefit any urgent care physician. Let your physicians take advantage of this.   Procedures that can be easily performed at the Urgent care center:         12/3/2016 12:00:00 AM Importance of a Team and Team Building  Abstract What should health care organizations focus on? While it’s an interesting time to be in the health care sector everything is also changing. Right from how providers are getting reimbursed to how care is provided, there are phenomenal changes seen. Every procedure must be scrutinized in order to ensure quality care and that the care provided is top notch. The future of many entrepreneurs and their enterprises depends on these factors. What are the commitments that healthcare organizations give to their patients and the community they serve? Increased patient safety, employee retention, improved patient satisfaction and delivery of collaborative care. These are a few of the watch words in the industry today and one needs to look into how organizations are able to tap into the right talent to ensure success in these four critical areas? In this article we address issues related to talent management and its impact on healthcare, finding the right people for the right roles, evaluating your healthcare force, new skills required to meet the challenges in healthcare, perspectives of heterogeneity in healthcare and how leaders are preparing themselves for the transformation and change. What does the new entrepreneur have to gain from these trends and what should he look out for?    Talent Management and its impact on healthcare – finding and retaining scarce talent Post global recession the demand for quality healthcare has continued to outweigh the quantum of resources available. Talent management challenges today are different from those faced by providers in the last few years. While there has been a great increase in the retirement numbers especially in key areas such as nursing, the demand for these specialized workers has been on a rapid incline. Research shows that HIT (Health IT) companies, drug and device companies, insurers, and providers alike, have the same needs and this will lead to severe competition for the same restricted number of skilled and trained workers. Healthcare organizations are today compelled to position themselves in the best possible manner in order to obtain, manage and retain critically valuable technology workers.  Employee retention With the shortage seen and with the expected increase in the shortage gap – the dearth for qualified doctors, nurses and clinical staff increases the pressure on hospitals to somehow retain the existing people and continue to attract top talent. It is becoming increasingly important not only to find the best candidates but also to ensure they will remain with the organization and the jobs. These have to be people who wish to remain in their organizations long-term. If the employees are satisfied with the organization with which they work then there is less of a likelihood that they will leave. It is the duty of the organization therefore to ensure that they keep the co-worker’s satisfactions levels enhanced and ensure that they are motivated to excel. Entrepreneurs and Dream Teams in healthcare We all are aware that without a the right people, organizations are not going to sustain their core mission – that of providing quality healthcare One very young CEO shares his story of how he created a winning team and also ended up bringing in former CEOs of Mucinex and Emergen- C on his board. Unless you have been in the Ivy League college or have no family connections in the big league, you are not going to attract name board advisors. Jordan Eisenberg was one young entrepreneur who attracted the former CEOs of big brands such as Emergen-C and Mucinex to come onto this board and was lucky to find a major celebrity investor to join the board as well! The founder and CEO of UrgentRx, Eisenberg, was an active member of Young President’s Organization ( YPO). UrgentRx is ranked 168 in this year’s fortune 5000 list and his company is creating waves in the over-the-counter pharmaceutical space offering pocket-friendly packets of fast acting, powerful medication for headaches, allergies, upset stomach etc. Eisenberg’s winning creative streak led Goldman Sachs to selecting him as “one of the 100 most intriguing entrepreneurs of 2014 and 2015. His story is indeed worthy of mention and at 33 what he has achieved is indeed phenomenal. Eisenberg has also been following up on social responsibility with aggression and the donations from the company has run to $ 1.5 million worth of products to the needy. What does Eisenberg attribute to his success in attracting big names and creating a winning team? Intentional networking and relationship building he says are the hallmarks for his success.  Eisenberg’s secret sauce:   12/3/2016 12:00:00 AM Profit Vs Not for profit company Abstract  The United States is now faced by several formidable and overwhelming economic challenges least of which appears to be the fragmented healthcare system. Spending twice as much per capita on healthcare as compared to other developed countries, U.S still ends up with worse care and poorer health conditions. American enterprises are also spending way too much on healthcare than their adversaries internationally, making them less competitive in an economic world. Unless a superior healthcare system is evolved, the nation would face bankruptcy.  At the bottom of this inefficient and expensive U.S healthcare structure is the “for-profit” system, where the healthcare conglomerates have the freedom and incentive to charge higher premiums at their will, while simultaneously exploiting the system. They also do not provide as many patient services as required by them, nor do they provide the services to those found to be needy (nonprofit patients) in the community. “Spend less and Charge more” – this seems to be the order of the day for these commercial establishments. This does nothing for the “Obamacare” goal of providing uniform healthcare to all Americans.  Hospitals Ownership Hospitals are owned by three entities – for-profit, nonprofit and government. We are not apprised of the specialization of each of these different medical services or how their profitability would affect their specialization. Services are categorized as unprofitable, profitable and variable. It would be right to assume that “for-profits” are most likely to offer profitable services while the government run hospitals would most likely offer unprofitable services. Nonprofits form the intermediate and fall somewhere in the middle. In this article we bring you an overview of the characteristics of each one and how they differ from one another in terms of their adaptations to changing environments and the requirements thereof, the positive aspects of each as well as the shifts in corporate structure and arrangements that will ensure their survival. What are the many advantages and disadvantages of each of these? We debunk a few myths while bringing awareness on the need of the hour.  Prominent and noteworthy differences between a for-profit and non-profit healthcare organizations We have seen that hospital entities can come in various types and we also know that for profits may be privately held or traded publicly. Regardless of whether the entity is a non-profit or for-profit, the providers can consist of a single site or be part of a national chain or anything and everything between the two.  In spite of these differences the entities share several commonalities whereby they follow rules, regulations etc. which they are subjected to in equal measure regardless of the fact that they are for-profit or not for profit entities. Let’s take a look at these: ●    Every provider licensed by the state to provide a kind of service will be subject to regulations, laws and supervision that is mandated by the state in which the entity holds a license. ●    Whether you are a non-profit or a for-profit enterprise, the officers and other senior managers running the place would come under scrutiny by the board, investors, donors and trustees and will owe ultimate accountability to them.  ●    The entities that are certified by Medicare or Medicaid (if they are able to take payment from either of these for services) will be subject to regulations, federal laws, and other requirements and will receive payment at a certain rate prescribed. This will not wary among providers and will continue remaining the same either ways. There may be minor variations based on geography but that will be the only difference.  On the whole it is difficult to come to any general conclusion about the quality of services that will be provided by a non-profit and a for-profit and to make a comparison between the two. It is also not easy to predict which of these is a more viable proposition, financially, but we can draw out the differences between the two in terms of their reach, viability to providers and consumers and reliability of services thus rendered. Some of the most successful healthcare systems in America are non-profits that are focused locally while there are others that belong to the national for-profit enterprises. A brief understanding into the structure, financial viability and leadership of these providers with the aim of helping consumers in assessing the reliability and quality of services they will receive before making important decisions regarding long-term care or any healthcare issue Information available publicly that will provide insights into the organizational structure and fiscal stability of any healthcare practice.  ●    Many of the providers post information about their senior management on their websites and if the said enterprise is publicly traded then the site may even have copies of financials that they have filed with the SEC, as well as comprehensive information about the Board’s configuration and oversight.  ●    All non-profit healthcare providers are expected to file Form 990s annually, which are considered as informational tax returns. This will provide information about the provider’s management, vision, mission, and budgets for the year, and contributions from donors etc. This is a provision that non-profits strictly fulfill and hence 990s are available free of charge on all their websites.  ●    You can look up a provider’s business filings at http://www.sec.state.ma.us/cor/coridx.htm which can provide you with information about how long the company has been in business, who are the directors and officers on board, and whether it owes any state taxes. Criticism levelled against the FP healthcare sector o    These FP enterprises are seen in a critical light by advocates, labor unions and patients alike.  o    They feel that with these enterprises the patient’s interests become dependent on the shareholders.  o    There is an opinion that “for-profit” hospitals would most probably turn away Medicaid patients or those who are not covered by health insurance while favoring those with private insurance.  o    The “for-profit” hospitals are also likely to discourage and stop offering services that would lose money.  Points in favor of FPs o    On the other hand there are supporters of FP hospitals that proclaim that their status enables them to invest in innovative technology, and provide better care overall while being able to raise funds.  o    Those hospitals that transitioned from “not-for-profit” to “for-profit” status say that they have not seen any decline in care quality. On the other hand they felt that there was an improvement in complete financial health.  12/3/2016 12:00:00 AM Seasonal Aller-geez not again! Simple measures to fight allergies. 12/1/2016 12:00:00 AM Concepts in Managed Care Pharmacy Abstract Managed care is not a new concept and in fact, has its roots dating back to the 1930s. The government first became involved in managed care in the year 1973 with the passage of Health Maintenance Organization Act. Managed care is today defined as an organized health care delivery system which is meant to improve the quality and accessibility of healthcare which includes pharmaceutical care and ensure containment of costs. It is also hoped that managed care would improve outcomes and overall quality of life of the patient. In this article we look at the many aspects of managed care including the role in specialty pharmaceuticals. Role of Managed Care in: Disease Management: Concept of reduction of health care costs and improvement in quality of life for individuals with chronic illness by prevention and minimization of disease through integration of care. Electronic Prescribing: E-Prescribing as it’s otherwise called, uses health care technology which can improve prescription accuracy, reduce costs, improve patient safety and secure, real-time, bi-directional, electronic connectivity between clinicians and pharmacies. Drug Utilization Review (DUR): DUR is an authorized, structured and ongoing review of prescribing, dispensing and usage of medication. Medication Errors: Medication errors are among the most common medical errors, causing harm to at least 1.5 million people yearly (and one of the leading causes of death in the United States) Medication Stockpiling (polypharmacy) Polypharmacy can have major harmful effect on individual patients as well as entire populations. One of the areas covered under Managed care pharmacy would be medication stockpiling by streamlining medication refills and checking drug-drug interactions. Maintaining Affordability By securing drugs at lower prices from pharmaceutical manufacturers. Patient Confidentiality The US Congress passed the Health Insurance Portability and Accountability Act (HIPAA) in the year 1996. Managed care pharmacy plays a significant role in ensuring confidentiality. Prior Authorization A well-designed prior authorization program has to be implemented which will optimize patient outcomes by ensuring that patients get the most appropriate medications. This is sure to ensure reduction in waste, unnecessary prescription drugs and errors.  Outcomes Research This is a facet of research that will measure results of medical treatment and other intervention in patients to evaluate improvement in clinical outcomes Specialty Pharmaceuticals Over the last several years, cost and utilization of pharmacy products have risen exponentially creating an unsustainable system from the financial standpoint. This is how managed care could help…... Managed care pharmacies and the role they would play in medication management over the next decade: ●    Speciality pharma will likely have a great impact on the practice of pharmacy in the next 10 years.  ●    This will affect all pharmacy practice settings and increase the need for medication management to ensure the appropriate use of important therapeutic agents. ●    In the treatment of chronic diseases such as diabetes, hypertension, asthma and others, the prevalent medication dispensing methods (retail pharmacy) would be replaced by mail order pharmacies. ●    Speciality pharmaceuticals which are meant for a smaller patient population (but higher utilization) would a different model for distribution, suggesting an ongoing evolution. ●    This model would require specified storage and handling, complex clinical management and close patient monitoring. ●    Today (as of 2016), 55% of the medicine distribution occurs in the setting of physician office while outpatient hospital and home infusion account for the rest. This would likely change with more of the dispensing moving to centralized pharmacies.     ●    Managed care pharmacy practice will push the speciality drug volume to specific providers who have a proven positive impact on the health outcomes, in an economical fashion. ●    In the next 10 years there will be the emergence of pharmacists who are based directly out of physician’s office and will provide the specialty medication to the patients. ●    Many of these medications would be dispensed right at patient bedside in the comfort of their homes. 11/30/2016 12:00:00 AM Drug trials and clinical research Abstract  With the recent emphasis and focus by federal agencies in funding clinical research we come to understand its importance in establishing evidence based medicine and healthcare reform. Clinical research and drug trials aid in establishing a wide-ranging and extensive array of therapies which add value to healthcare, to the individual and society at large. In spite of the enormous benefits of conducting clinical trials they can also have potential for causing risks to the participants of the clinical trials. There can be harm caused to participants because of the flaws due to biased information obtained during these clinical trials. A well designed clinical trial may appear pretty simple and straightforward but it has also to be established on sound and rigorous methods and should be governed by ethical principles. In this article we provide an overview of what drug trials and clinical research means, the types of clinical trials available, why these clinical trials are important to healthcare, how they work, how these trials are organized, who can participate in these trials and such other issues that are critical for our understanding and for the entrepreneur who may wish to make a foray into clinical research and drug trials.  What do we understand by the term “Clinical Research?” This is a branch of healthcare science that enables determination of the safety as well as effectiveness of devices, medication, treatments, diagnostic products which are all necessary for human use. These can be useful in prevention, diagnosis, treatment or even in relieving symptoms of any disease. “Clinical research” refers to the study or trials that are conducted on people and as the developers design the study and its outcome they take into account the various clinical research phases and what they plan to accomplish for each of the different research phases. They will later begin the Investigational New Drug Process (IND) a process that is required before they can start the clinical research.   Drug Trials or Clinical Trials can be explained as research studies that explore the possibility of a certain medical strategy or treatment and its effectiveness and safety on human beings. These drug trials can also predict which of the many medical approaches will work best for illness of a certain kind for certain groups of people.  While preclinical research generally serves as an answer to many basic questions regarding a drug’s safety etc., it does not become a substitute for studying ways and manner in which the drug interacts with the human body.  What are the many areas of clinical research and trials that one should be aware of and how is this achieved ●    Clinical trials are separated into the following types: Treatment, prevention, supportive care, screening, and health services research, diagnostic, as well as basic science.  ●    In order to ensure participant safety, clinical trials are first initiated with smaller groups to ensure that the new method does not affect the participant in any manner and does not cause any unnecessary side effects.  ●    Clinical trials are most needed when one wishes to find out if a certain treatment will benefit people suffering from a particular illness and if that is the best course of action i.e. if the new approach works effectively in humans and if it is safe. ●    The designs of the clinical trials could be either “experimental” or “observational” in nature and can include study types such as case cohort, control, systematic review and randomized controlled trials.  ●    The research team that is involved in the clinical trials may be a team of doctors, social workers, healthcare professionals, data managers, scientists, nurses and clinical trial coordinators.  ●    The participants of a clinical trial would have to meet certain eligibility criteria and ensure they are suitable for the same. ●    There are both risk factors as well as benefits to the participants of a clinical trial. There is an “informed consent”  document that the participant is asked to sign before he is ready and included in the clinical trial.  Risks to participants are both monitored and controlled. There may be rare instances where the risks are unavoidable due to medical research studies.  ●    The clinical drug trials are divided into 4 phases in order to examine the safety of a new drug and compare the same with treatments that are already in practice and use.  What’s in it for entrepreneurs and providers? What should they bear in mind before entering this field? ●    The implementation of clinical trials requires an approach founded on rigor and scientific methods with statistical, ethical and legal deliberations and reflections. Hence it is essential that health care providers understand the principles and guidelines on which well-performed clinical tests depend. This will help the providers in retaining a good partnership with the industry and patients in quest of the most competent, safe, resourceful and effective treatments and remedies.  ●    Providers need to be aware of the key areas and concepts along with the issues that they may encounter in the fruitful design and execution of a clinical trial. The health care providers may also partner with regulatory bodies and pharma industries in order to compare the treatment methods and therapies. This will enable everyone concerned in meeting the common goals of health care reform. ●    While these clinical studies and trials are most needed in the development of new treatment methods for serious illnesses like cancer, they are also vital in studying all aspects of medicine. All new treatment methods and drugs as well as medical devices would have to go through these clinical trials and have to seek and obtain the approval of FDA. Who can take part in these clinical trials and what age group should the participants be? While people of all ages can take part in the clinical trials, there are steps that one needs to take in order to be part of any study. 1.    For instance for a child to be enrolled in a clinical study the parents or guardians should first decide if they wish to involve the child in the study.  2.    Once the parents give their permission the older children should be asked if they are willingly taking part in the study and they have to provide their individual consent to take part in the clinical study. This process is termed as consent.  3.    The child has a right to refuse taking part in the trial even if the parents are willing to permit it.  4.    One may ask what the uncertainty in the trail can be. Doctors who are in charge of the clinical trial are themselves not sure of the results of the trial ahead of time. If they did have any idea of what the result would be, then there would be no need for the trial in the first place.  5.    One has to bear in mind that there is bound to be an element of uncertainty in any clinical study and hence the need to be well informed of all consequences before entering the trial.  6.    There is no simple answer to the query “should I take part in a clinical trial”. The common man does not usually pay much attention to a clinical trial until he has a serious illness.  7.    We don’t hear about clinical trials in every day conversation and these get reported in the news only when something goes wrong with the clinical trials themselves and someone is seriously affected by a drug trial.  8.    Medical breakthroughs which are the result of clinical trials on the other hand get reported in the news. What we do not hear about is the millions who are benefitted by taking part in the clinical trials and the several others who are benefitted by others participating in the clinical trials. What are the definable and actual benefits of clinical trials? 1.    Clinical trials show us what works and what does not in healthcare and medicine. They are the best means of knowing what works in treating diseases like cancer. 2.    They can answer two important questions – does the new treatment work on humans and if it does, are the doctors looking at how well the treatment works. Also, is it better than the current treatment for that particular disease? If the new treatment is not better than the existing one, then does it atleast have lesser side effects or does it work on certain people for whom other drugs have proved ineffective in treatment?  3.    The clinical trials can also tell us if the new treatment is safe and if it is entirely without risk. Or atleast does the new treatment balance the possible risks? 4.    Clinical Studies are all not just meant to study treatments. They are also useful in studying new ways to diagnose, detect, or learn the extent of disease.  What are the safeguards that are employed in order to make these clinical trials and drug trials safe for the participants? Why does the process of approvals take long? 1.    The first step is to answer the questions listed above and exposing lesser people to the unknown treatment. 2.    This would require several different clinical trials which are normally grouped into phases and in each phase they are meant to test every new treatment method before it can be considered safe and effective. Thus every new treatment has to pass several tests before being deemed fit for public usage.  3.    Clinical Trials are only a small part of the research that go into the development of the new treatment. New drugs that are discovered or created have to undergo a process of purification and then have to be tested in laboratories ( in cell as well as animal studies) before even reaching the human clinical trial stage. Among those drugs that are tested in the early stages, very few are seen to be worthy of clinical trials on humans. For example, in the case of a new cancer drug entering the clinical trial stage, there are major bottlenecks before the drug is made available for human consumption. It takes on an average around 8 years from the time a cancer drug enters the clinical trial stage to get approval from FDA.  4.    Why does it take such a long time for approvals? This is to ensure that the drug is absolutely safe and effective. Also, only a certain people are deemed eligible to take part in each clinical trial. It takes months if not years to see if a certain drug works on any one person.  5.    Next, finding out if the drug increases the chances of survival is another long process and the greatest barrier to this is finding enough people to take part in every stage of the drug trial. Among those of the adult population, affected by cancer, less than 5% would be willing to take part in the clinical trials. In fact clinical trials are used more in the treatment of children with cancer. 60% of children under the age of 15 participate in clinical trials, this being the reason for survival rates of children with cancer being higher in the last few decades. 11/30/2016 12:00:00 AM Genesis and Future of Obama Care or Affordable Care Act Abstract President Obama’s significant effort and legislative policy, the ‘Patient Protection and Affordable Care Act’ of 2010, brings in control over the whole of U.S health care system. This act was signed into law by President Obama in March of 2010 and its major provisions went into effect on the 1st of January 2014. There have been significant changes that went into this policy before it was brought into effect and there will be many more changes in the years to come.  In this article we look into the genesis and the future of Obamacare Act and what goes into the core principles of the act.  Core Principles of the Act: “Everyone should have some security when it comes to their health care”, Obama at the time of signing.  Commonly named Obamacare, the Affordable Care Act will be providing insurance to more than 30 million of uninsured people, by providing Medicaid as well as federal subsidies to the lower and middle income Americans who can buy private coverage. Obama’s part and role in the advent of the Affordable Care Act The concept which was proposed by President Obama was not new and had been tried by several democratic presidents before him, but unsuccessfully. They had all tried to create a nationwide insurance system for almost 75 years. President Obama pointed out at the time of signing in 2010, that there had been ‘generations of Americans’ who had put up a valiant struggle to ensure something similar was implemented’. As a presidential candidate Obama proposed what was seen as the ‘largest middle-class tax cut for healthcare in history’. This turned out to be a foundation of his presidential campaign. Essence of Obamacare in a nutshell ●    Essence of Obamacare can be seen as a three-legged stool of regulation and subsidies. ●    It can be said to be a community rating that ensures that insurers make the same policy available to every citizen irrespective of health status as well as a mandate which insists that everyone purchase insurance. By this regulation and subsidy, healthy people are not allowed to keep from getting insured and subsidies are provided to those with lower incomes.  Origin or Genesis of Obamacare Obamacare is said to have had its roots in the original “Heritage Plan of 1989” which is said to have had all these features. Today, Heritage tries very hard to deny the obvious i.e. picking at the differences between what was in its tenets and ideals and what it used to advocate, as against what the democrats passed – making the differences seem like a big deal – while in reality it is not. It was all disinformation and importantly the features of the ACA and its mandate are all ideas the Republicans used to support.   We take a closer look at the history of the Individual Health Insurance Mandate of 1989 – 2010  The Republican Origins of Democratic Health Care Provision Considered to have had its origin in 1989, the individual health insurance mandate took shape at the conservative Heritage Foundation. The Republicans had earlier introduced health care bills twice in succession which also had an individual health insurance mandate but paradoxically the very same advocates of those bills are seen to oppose the current mandate of Obamacare. These republicans include Orrin Hatch, Christopher Bond, and Robert Bennet etc. Democrats and republicans also introduced a bi-partisan bill.  Chronological Order of Events  In the past - Obama Opposing a mandate in 2008  ●    Strangely, Barack Obama opposed a similar mandate in Feb of 2008 and said that his views on the subject were divergent from those of Hillary Clinton.  ●    He, at that time, stated that both he and Hillary Clinton had the aspiration to care for the health of all Americans, but that there was a small difference in their approach to the mandate.  ●    He said, that Hillary Clinton’s directive, that every citizen buy healthcare and insurance was not in his framework. He thought that such a mandate would be difficult since people were not averse to buying healthcare but could not afford to buy it.  ●    So Barack Obama then ascertained that he was focussing on lowering healthcare costs and he stated then that, that was the ‘modest difference’.   ●    This was his argument and stance way back in 2008, when he was contesting the elections.  Constitution of the PPACA in 2010 ●   By the year 2010, the Patient Protection and Affordable Care Act (PPACA) as it is known today aka “Obamacare”, was passed in both the House and the Senate without any Republican votes. ●   On March 23rd 2010, President Obama signed the act with the individual mandate and brought it into law. ●   On January 5th 2011 the Republicans in the US House of Representatives brought in an act (The Repealing – the Job-Killing Health Care Law Act (HR 2) to repeal the PPACA. ●   Their argument was that the health insurance mandate was unconstitutional. ●   The hurdle in implementing the PPACA was cleared when the Supreme Court upheld the provisions of the health care law in June of 2012. ●   The National Federation of Independent Business and Twenty-six states had filed suit in the federal court challenging the healthcare mandate opposing the law that individuals carry insurance or pay penalties and also the expansion of Medicaid. ●   The Supreme Court finally ruled that states could not be forced into co-operating with the Medicaid expansion, leaving all other provisions intact. ●   During the first year of President Obama’s tenure in office, came the political action, in the year 2009. ●   On July 14th 2009, the House of Democrats brought in a 1000 page plan for revamping the health care system. The debate around this raged through the summer and beyond. ●   There were those like John Boehner, who was a House leader, who charged that the PPACA would force millions of Americans out of their private health insurance into a government-run plan. ●   On the 9th of September 2009, when President Obama addressed critics in a joint session of Congress, he mentioned the words of Sen. Ted Kennedy, who has died a few weeks prior and had battled for healthcare reform throughout his career. According to Sen. Ted Kennedy Healthcare reform was a ‘moral issue’ which addressed the ‘Fundamental principles of social justice’. ●   President Barack Obama mentioned in the house that the law would not apply to illegal immigrants and this was implemented when the reform plan, introduced a week later, prohibited participation by those residing ‘unlawfully’ in the U.S. ●   When the Senate Bill was amended and approved by the House in March of 2010, the republicans voted against it. ●   Addressing all the concerns expressed nationwide, the Act pointed out that “the act or the bill does not force anyone to change their existing insurance”. It was stated clearly that the act avowed a ‘new, transparent and competitive insurance marketplace’. ●   When Obama was re-elected in November of 2016, it ensured the Act becoming a reality. What does the Affordable Care Act entail? ●    The Patient Protection and Affordable Care Act of 2010 consists of Affordable Health Care for America Act, the Patient Protection Act, the health care sections of Health Care and Education Reconciliation Act and the Student Aid and Fiscal Responsibility Act.  ●    It includes amendments to other laws such as Food, Drug and Cosmetics Act and the Health and Public Services Act.  ●    Since implementation of the law there have been a few additions and deletions which we shall try to update.  Future of Obamacare and how it will affect Doctor’s incomes ●    As Obamacare moved towards making key implementations a reality the massive law is creating change by affective physician incomes in many ways. ●    In Jan of 2014, the Affordable Care Act (ACA) carried out the greatest insurance coverage expansion since 1965 and brought in historic change in the way insurers operate. This change affected doctors and the manner in which they earned and there were many such changes implemented. More Covered Services:  ●    With the new law coming into force a few major impediments to insurance coverage have been removed and will also ensure a few extra services that your payers may not have covered for you earlier.  ●    Jeffrey Cain MD, President of the American Academy of Family Physicians (AAFP) says that these reforms will help physicians because those of the patients having insurance and access to primary care have better health outcomes. ●    In 2011 and 2012 the ACA mandated that insurers covered 63 different preventive services without the need for out-of-pocket payment to be made by the patients.  ●    These included treatment of blood pressure and mammography screenings, immunizations of many varieties, screening for autism, child hood behaviour screening and a few controversial areas such as access to contraception.  ●    The physician practices will be reimbursed for these services without the hassle of having to collect money from the patients. ●    Since January of 2014, individual and group plans have had to cover services such as ‘essential health benefits’ which include mental health services, maternity care, medications, rehabilitation, and chronic disease management. ●    In this case also the insurers will have to pay the physicians and other providers for the services rendered. 11/30/2016 12:00:00 AM Growing role of payers and PBMs in patient care  Abstract There has been such a huge increase in demand for containing healthcare costs which has led to the evolution of pharmacy benefit management (PBMs). The PBMs are responsible for implementing drug formularies, negotiating rebates from manufacturers and these formularies have been relatively inclusive but are seen to have become more restrictive over time. We have tried to bring to you in this article the evolution of PBMs, key roles played by PBMs in drug benefit management, how they apply innovative strategies in order to reduce costs, emerging trends in drug business management, challenges faced by the segment, the role of PBMs in the changing health care environment and other such crucial and critical areas. US healthcare system and its management of prescription drugs One of the interesting aspects of US health care system is its expertise in terms of delivery of multi various lines of healthcare. Since the late 70s there has been a great evolution in the management of prescription drugs which has been seen as a separate entity and a line of business. There has been great focus on the drug costs and respective insurance coverage with regards to the understanding of the functioning of the PBMs. Prescription drug costs have accounted for 10% ($2.6 trillion) of US Healthcare spending in 2010, which is a substantial amount with an increase in growth with every passing year. Evolution of PBM  PBMs as we have mentioned, date back to the 70s, when the idea of drug cards became common and an add-on to the then existing union medical benefit program. PBMs have its roots in claims administration and as there has been an increase in the prescription drugs coverage in the private sector, insurance companies have been facing the difficult and daunting task of managing a large volume of relatively small value claims efficiently and economically. With more and more employers getting into the drug benefit scheme, PBMS began to construct information technology competencies and know-how in order to enable the automation of the drug claims. In the 1980s full-service PBMs became independent and began to function on their own, seeing a growth in revenue in the next 10 years. In the US alone, there are around 70-100 full-service PBMs operating with the number in variance depending on the acquisitions and mergers. The PBMs come in all shapes, structures and sizes and they can be private, publicly traded or even not-for-profit organizations. The well-known PBMs are UHG, Aetna, Cigna and a few subsidiaries of major drug outlets and retail stores (eg. Walmart, Walgreens). There are a few systems companies like SXC Health Solutions and claims adjudicators like Argus Health Systems which have PBM divisions too. Consolidation of the PBM Industry – how has this happened? ●    As of 2013 72% percent of market was controlled by TOP 3 PBMS ●    Record profits shown by leading industry PBMs with stocks trading at all-time highs ●    There is $284 billion market and many PBMs are anxious to capture a piece of this ●    The arena of independent Rx advisors is reducing and leads to employer Rx spend being excessive. Scope of PBM’s in Obamacare In light of what has happened to PBMs in 2013, what can Rx manufacturers expect from Obamacare? PBMs in Obamacare for insurers will be responsible for accumulating the buying power of millions of fresh enrolments. Result would be that Obamacare patients will receive lower prices for drugs as the PBMs are known to drive the Rx manufacturer discounts – how do they achieve this – fee reductions from retail pharmacies; step-up in utilization of mail-order pharmacy; rebates on pharma manufacturers.   What about the competition among PBMs? Competition among PBMs will become very high. The so called “BIG Five” PBMs in Obamacare (Express Scripts, CVS Caremark, Prime Therapeutics, Optum Rx, and Catamaran) will wage a battle in their desire for PBM dominance just as we see happening in all private and public insurance markets. Each of the Big Fives is dedicated to a different insurance provider: CVS Caremark works exclusively with CVS retail chain pharmacies Optum Rx is linked directly to United Health Care Thus each of them having varying approaches to the way they deal with Rx manufacturers, as each has a different objective. Whatever may be the individual objective of each PBM, the collective goal is only that of driving down cost of Rx services.  How is each PBM to be differentiated? The Big 3 – Express Scripts, Medco Health Solutions and CVS / Caremark – are not just sitting back and simply enjoying their dominance. They are constantly looking at different business strategies and pursuing them with rigour to ensure that they remain ahead of the rest of the competition and industry. They remain the dominant factor in terms of deciding prices and hence every prescription continues to depend on them. “There are hence many models emerging” says Steve Miller, MD of Express Scripts. Steve Miller says that his company is taking a behaviour-centric approach and thereby they are developing a unique forte for themselves. They are becoming experts in consumer behaviour as regards medication. Their goal therefore is to influence consumer behaviour to promote optimal use of medicines from the point of quality and cost. Providing Face Time – CVS / Caremark CVS / Caremark – the other one among the Big 3 – they have put their bet on the retail segment. “Driving business from the front doors of their pharmacies” – that’s the goal of Caremark. The one missing factor in pharmacy services is the face-to-face interaction between the pharmacist and patient. Encashing on this lacunae, CVS promotes this – how does CVS achieve this - by providing face time. Steps taken towards this - Implementing a “Maintenance Choice” as a program CVS allows patients to pick up their 90-day prescriptions at any CVS store instead of receiving them by post. Speciality medication can also be bought at the pharmacy, where the pharmacist will be available to answer questions and show you how the drug is administered.  ●    CVS now has 520 stores after it boosted its store strength strategy with the acquisition of Long’s Drug Stores along with Rx America, a PBM with 8 million members. ●    The PBM now also has 4, 50,000 Part D members in its CVS Medicare membership.   Model PBM Markets under Obamacare While the details of the operation of Obamacare PBM is not known, one should also look to other insurance markets for understanding and insights into the market. In particular, the PBMs in the Medicare Part D marketplace and Rx services that are an offering by PBMs in new private health platforms will provide an insight into the PBM offerings from Obamacare. “What is the impact of PBMs on Private Health Exchanges” ●    Private Health Exchanges resemble insurance concept of Obamacare to a very large extent. ●    There are several large entities such as (IBM, Walgreens, GE and others) which plan to migrate their employees out of the health insurance plans to “defined contribution” programs. This can be achieved by private health exchanges. What are these private health exchanges? ●    Some are the “self-insured” model which provide healthcare to individuals while most others offer group health insurance to employers within a “fully insured” model.  ●    The common objective of both models is to reduce the cost of healthcare to the employers. 11/30/2016 12:00:00 AM How to get the ‘Best’ or find ‘value’ out of networking events Abstract Wherever you are in your healthcare career or business, whether you are about to start a business, searching for a co-founder, moving to be new job or any other status – networking can be your life support. It can propel you to the next opportunity, and aid you in your professional growth. It would enhance you at a personal level as well. Networking for the healthcare professional is all important and one needs to network diligently and get connected with peers and groups in order to succeed. In this article we bring you the details of how to get the best out of networking events and what’s needed from you to make use of these for a successful career or to run a healthcare enterprise. What are the pre requisites for successful networking in any sector? Crucial for success in networking and in developing lasting relationships is being genuine in all your actions. One has to be patient and must listen carefully while understanding the needs of others. True networking happens when you spend your valuable time with people who are able to communicate and discuss with you matters that are close to your heart – namely your business and area of expertise. For good networking one has to work in tandem with other active professionals, which enables you to increase your network and to learn something new every time. Networking is not an activity done to get the next job. We network to get smarter, to build value around ourselves and our areas of expertise, to make new friends, and to increase our credibility in our professional community. It also enables us to be useful to others and to enjoy work outside our job.  Expanding your network – how do networking events help healthcare professional in achieving this and how to go about this How to expand your network? There are a number of ways, chief among them being attending networking events where you can meet people. While networking events around healthcare are the best, one need not avoid other industry events. For instance, your local Chamber of Commerce may be having an event for people from all sectors to be able to connect and network. This, while not being directly related to healthcare can still give you an opportunity to network with peers and people who may need your services and vice versa. How would one know if the people who are at the event are related to healthcare in the particular area that interests them? The answer to that question is – one does not know. But on the other hand you do not also know who these people will be connected to. People you meet at the event may be known to the people in your area of expertise who may be interested in getting in touch with you. Also, no matter how small the area is, you never know who is involved in what. For instance, someone in your area may be: ●    A lawyer who represents a doctor or a local hospital ●    An investor in a medical group ●    Someone on the board of directors of the hospital ●    A member of the hospital auxiliary ●    A chiropractor, a physician, or other health care professional  ●    The public relations or advertising agency for the hospital There are other civic bodies and not-for-profit groups that offer a great networking platform as well. Several of these events have media coverage which allows you to add these media people to your network. Those who utilise every opportunity to meet more people regularly will have a larger network very soon. The purpose of building a network is to come out of your comfort zone. If you remain with people you are already acquainted with, you will never get the opportunity to meet new people from varied backgrounds and other fields. By meeting new people continuously you will surely meet people with the right connections. After all you never know who would be connected to whom. 11/30/2016 12:00:00 AM An attainable paradox - reduce cost and improve quality of care Reducing Costs and Improving the Quality of Health Care  With the signing into law, the Affordable Care Act in March 2010, the President helped usher in an act that helped millions of young adults take insurance coverage and thus made preventive services more affordable for Americans. When this is fully implemented, the law will be able to expand the coverage to an estimated 27 million uninsured Americans and will also ensure availability of affordable comprehensive coverage through additional employer-sponsored insurance along with the latest health insurance marketplaces or exchanges. There are inevitable signs that indicate that Affordable Care Act has begun to slow down the growth of costs and improve quality of care by the use of pay-for-performance programs, better and improved primary care and care coordination, and pioneering Medicare payment reforms. The provisions of the Affordable Care Act, and other such provisions will help in bending the cost curve and bringing it down while laying the foundation for moving health care to higher quality and efficient care. But we are still left with the question as to whether the reduction in cost will happen alongside the improvement in quality of care. In this article we examine the many factors that lead to increased health care costs and the many ways in which this can be brought to control. Can a decrease in cost lead to an increase in quality of health. What are the factors that act as prime drivers leading to higher spends in health care in the coming years. What are the reasons and sources for increase in health care spends and what are the many government initiatives that provide us with data around these many factors. These and a few connected issues are dealt with in this article.   How does decrease in health care costs affect quality of health? The impact that the decrease in health care costs has on the quality of health care is a paradoxical situation and one is given to wonder if these two can really go hand in hand. On the other hand we take a look at the healthcare spending in the last few years and its impact on the GDP. Spends on healthcare have been on the increase and has been dramatic over the past several decades, in terms of the GDP as well as in absolute terms. What is the increase in spending attributed to – could it be demographic changes making an impact, is it the indiscriminate spending on prescription drugs that’s causing increase in healthcare spends, is it the increase in office-based visits, hospitalizations, and other personal care areas since 1996 that is causing this unprecedented increase in medical care costs? On the other hand we see that disease prevention reduces healthcare costs. Reduction in disease in turn increases life expectancy thereby increasing the demand for healthcare. Hence we are to once again examine if reduction in costs and improvement in quality of health care can go hand in hand. Earlier studies have been of the argument that preventing diseases that reduce longevity increases healthcare costs and preventing non-fatal diseases lead to health care savings. The question we have to address is whether disease prevention could lead to both increased longevity and lower lifetime health care costs.  Factors that are to act as prime drivers leading to higher spends in healthcare in the coming years 1.Ageing population – by 2030 there will be one in every 5 Americans who will be over the age of 65, as compared to one in every eight today. This will lead to per capita medical costs in any given year increasing to 3 times higher for those above 65 and over, when compared to the younger population. 2.The increase in use of medical services due to the development of new technologies and increase in unit costs that far exceed the rate of inflation. 3.The long-term growth of healthcare wages which has not been followed by an equivalent labour saving technological improvement and progress. 4.There has been wage growth in many important parts of the economy while this has not been the case for workers and labour intensive sectors such as healthcare, performing arts and the education sector. These sectors should also raise the wages failing which there will be a relative cost of output in these labour intensive segments. 5.Intensive sectors and higher costs will be passed onto the consumers as increased prices. Disease avoidance and its effect on healthcare costs and quality of care Belief: Prevention of disease is seen as a way to reduce healthcare costs but this is not seen in practice. Prevention of mortal and fatal diseases increases life expectancy, thereby increasing the demand for health care. Studies also show that most health care expenditures are intense and maximised in the last years of life. Conclusion thereof: 1.Disease elimination in the case of those that reduce life expectancy, to some extent, leads to increased healthcare costs. 2.Important cases as in the instance of neoplasms, which when eliminated increase both life expectancy as well as lifetime healthcare spending with a rough estimate of 5% for men and women. 3.When the prevention has a miniscule or small effect on the longevity as is the case with behavioural illnesses, diseases and mental illnesses, then cost savings will be seen. 4.Diseases related to circulatory system will be an exception and the elimination of these can show increase in life expectancy albeit with a reduction in healthcare spending. 5.Thus we can see that the stronger the negative impact of a disease on longevity, the higher the healthcare costs after elimination. 6. Treatment of lethal and fatal diseases leaves less room for longevity gains due to the effectiveness of prevention but will give more room for health care savings. Inefficiencies in Health care Spending – What are the reasons and sources for the same Not all medical spending and increases in spends are seen to be fruitful or productive. David M. Cutler and Mark McClellan have proven that improved treatment of heart attacks gave rise to significant increase in patient longevity between 1984 and 1998. In contrast we have known that Jonathan S. Skinner, Douglas O. Staiger, and Elliott S. Fisher have also examined Medicare Costs and survival gains in the case of acute myocardial infarction (AMI) in the years 1986 – 2002 and they have published in a series of papers [Health Affairs 25 (2006): w34–w47 (published online 7 February 2006; 10.1377/hlthaff.25.w34)] their findings. They believe that the overall gains and achievements in post AMI more than justified the increase in costs during the period. As per their findings:  1.Since 1996, there has been a steady decline in survival gains while health care spending has been on the rise. 2.When examining these gains region wise they had discovered that those regions experiencing the largest spending gains were not those realizing greatest improvements in survival. 3.Those aspects that yielded greater benefits to health care were not those that increased costs and vice versa. 4. David Cutler and Mark McClellan argued that benefits from technological innovations more than justify the increase in costs of health care.  Learning from these findings for U.S healthcare system 1.Do not kill the golden goose in terms of medical advancements brought in by technology, for the sake of short term monetary savings. 2.From the research conducted by David Cutler and Mark Mc Clellan, there was evidence pointing to rapid decline in mortality following heart attacks between the years 1984 and 1998 and the costs for treatment of heart attacks rose by $10,000. 3.Regions with the greatest increase in healthcare spends experienced the smallest gains in survival. 4.More than 20 percent of Medicare spends on heart attack treatment gives little health value. 11/30/2016 12:00:00 AM Medicine 4.0 – “Advantage digitization” Digital healthcare strategies and beyond.... Medicine 4.0 and digitization are becoming just buzz words! The reason – inaction and inertia in implementation of an all-inclusive IT infrastructure. The possibilities with digitization of healthcare are immense, but merely talking about them is not going to enable the change. Communications and operations in the healthcare system are crucial to superior and improved healthcare. Innovative digital technology has the capability of bringing in change and improvements in medical care to patients and the quality of healthcare in general. Several opportunities of modern medicine are being underutilized much to the detriment of the public and healthcare participants as well. Yet, digitization cannot be seen as an end in itself but is only a means to an end. How do health care organizations completely and comprehensively integrate digital in their healthcare systems? How are healthcare organizations to implement digital technology in their scope in order to efficiently process and achieve additional benefits for all the people involved? What requirements need to be met in order to digitize healthcare and which ones can be genuinely fulfilled? In this article we bring you answers to many of these questions and help you understand how to implement the change and integration which requires that the systems use state-of-the-art technology. 11/15/2016 12:00:00 AM Health 3.0 - The Smart Approach to Healthcare “Prevention is better than cure”! The proverb had never been more relevant than now, especially for US healthcare, as the emphasis is on preventive healthcare rather than curative. As the scene of healthcare is shifting towards a patient-focused approach, the development of improved and unique healthcare approach has become a challenge. The new “Third Generation Healthcare” also known as “Health 3.0” is now concentrating on finding unconventional ways and methods to increase the health consciousness in the patients through patient engagement strategies. The Health 3.0 is focusing on making healthcare more accessible, fast, and affordable. This piece is an attempt to provide insights about the Health 3.0 and how it can influence and change the present day healthcare scenario. 11/8/2016 12:00:00 AM What's stress got to do with it? [part 2] In part 1, we discussed about the relationship of stress with different parts of our lives. Now we will explore about the second step which is 'SIMPLIFY.' Simplify is a abroad term that has to be specialized to each individual’s situation.For example, many times we convince ourselves that multiple things have to be accomplished before the end of the day. But stress arises when time constraints make it humanly impossible to achieve them all. To simplify this situation might mean to make a list (before the stress climaxes) of the tasks that actually have to be done that day.  Confronting stress In Part 1, we explored the relationship of stress with many different parts of our lives. In the end, we concluded: Don’t ignore it, confront it! Luckily, confronting stress is a much more peaceful and reflective process than implied. The first step, again is to RECOGNIZE that it impacts me on a regular basis even if it is subconscious. Awareness opens the door to coping. The second step is to SIMPLIFY. Simplify is a broad term that has to be specialized to each individual’s situation. For example, many times we convince ourselves that multiple things have to be accomplished before the end of the day. But stress arises when time constraints make it humanly impossible to achieve them all. To simplify in this situation might mean to make a list (before the stress climaxes) of the tasks that actually have to be done that day. Eliminating cleaning the bathroom and dropping off the dry cleaning that day might just make the difference between a rushed end to the day and one that allows you to appreciate the people and privileges that enrich your life.   10/12/2016 12:00:00 AM Physician Education Debt and Potential Salary in the United States Studying medicine is challenging in US considering the length of the program and the amount it costs. To become a doctor, one has to have great passion for the profession and love to be challenged. Doctors are among the highly paid professional in US but there are constraints such as expensiveness of the course, burden of education debts and improper planning for potentiating the salary which can be earned. These issues may demotivate the individuals from pursuing their interests; however, focused approach and proper planning may help solve the problem. 10/4/2016 12:00:00 AM Overview of the Affordable Care Act (aka Obamacare) President Obama’s significant effort and legislative policy, the ‘Patient Protection and Affordable Care Act’ of 2010, brings in control over the whole of U.S health care system. This act was signed into law by President Obama in March of 2010 and its major provisions went into effect on the 1st of January 2014. There have been significant changes that went into this policy before it was brought into effect and there will be many more changes in the years to come. In this article we look into the genesis and the future of Obamacare Act and what goes into the core principles of the act. 10/3/2016 12:00:00 AM What's stress got to do with it? [part 1] Everyone reacts differently when they hear the word ‘stress.’ Stress is the chameleon of causes that manifests in so many different ways at different times of our lives.However, in the medical community, we refer stress as the physical and mental toll where an individual suffers due to poor coping.Think of stress as a wild weed in your pretty little garden and ignoring it will only empower it more over time. We experience it all the time. A cold that just doesn’t seem to go away. A pulled muscle that’s taking a long time to recover. Small amounts of memory loss. Sometimes more serious conditions underlie these symptoms. But the majority of the time, for the majority of people, it’s one thing: stress! Stress is the chameleon of causes – it manifests in so many different ways at different times of our lives. Everyone reacts differently when they hear the word ‘stress.’ The majority of society attaches a negative connotation to the word. Subconsciously, they associate weakness or inability or even craziness to ‘stress.’ 10/1/2016 12:00:00 AM Shortage In Nursing: The Problem and the Solution Nursing is the largest workforce in health care profession and is one among the highest paying occupation in U.S.A. The nursing industry is estimated to experience the highest job growth in coming years. Ironically, there is a global shortage of nurses, in terms of, both the quantity and quality. It is mandatory to address the issue and bridge the shortage before the situation could worsen to a point affecting the patient care.   At a Glance   Introduction Nursing Shortage: How did it start? Mapping: Which places have the most shortage? Projected Score: How much shortage? Ingredients - Factors causing shortage Conquering: Steps to Overcome Shortage Career prospects in nursing Nurse Entrepreneurs: A New Trend in Nursing Every Cloud Has a Silver Lining Introduction   What is nursing? The first thought that comes to our mind is- a woman in a clean white skirt, wearing a passive smile, holding a tray full of bottles and medicine and walking behind a physician. Cut to the present era…nursing is now no longer limited to the patient’s bedside. The industry experienced a breakthrough from a traditional practice of bedside care to the nurse being a clinical researcher, information analyst, designer of medical equipment or a nurse entrepreneur.   Nursing is the largest workforce in health care profession and is one among the highest paying occupation in U.S.A. The nursing industry is estimated to experience the highest job growth in coming years. Ironically, there is a global shortage of nurses, in terms of, both the quantity and quality. It is mandatory to address the issue and bridge the shortage before the situation could worsen to a point affecting the patient care.   Nursing Shortage: How did it start?   Shortage in the nursing industry was rampant, since World War-II. The profession was meant for females, with few men interested to pursue it as a career. Later, with women moving on to other professional options, there was a deficit created in the nursing industry.   The number of students enrolling for nursing courses have gown down, largely due to lack of nursing staff for education. As a result, the number of graduating nurses has also decreased. In addition, many nurses choose non-clinical occupations, leaving a few trained professionals for bed-side nursing.   Implementation of the Affordable Care Act has extended the health care to underprivileged people, adding up to the numbers who must receive care, with no increase in the numbers of nurses who must provide care. Also, the large number baby boomers are now in the health state, where they need long-term and end-of-life care. All these factors together, have created a huge demand for trained professionals and are exerting pressure on the already over-worked nursing fraternity. 6/23/2016 12:00:00 AM Valuation – A “Game Changer” for Startups According to market analytics, the investment in the startups of healthcare domain has escalated by 78% from the last year. The main reason for this escalation is the fact that the investors want to be “in the saddle” to take risks and venture into new healthcare business. For any startup to get funded, valuation plays a key role. The investors are interested to invest in companies with a promising picture. So, startups probing for funds or profitable exits should analyze each factor contributing to the high-rise of valuation. The prevailing essence of this think piece is to assist the healthcare startup entrepreneurs in assessing the valuation factors, work upon them and raise the company valuation.   Introduction   Thinking of becoming the “Next big thing”?  You need to know what it takes to grow big. Let us take an example. Two healthcare startups are seeking funds- one with mind-boggling ideas; and the other mind-boggling ideas and a promising market value! Which startup has more likelihood of receiving the investment? Well, the chances of the second startup getting the funding are more than the first one, as the promising market value assures an investor of future profits on the investment made.   For any startup, the journey from a zero-sized company to a “Billion Dollar Club Member” requires a lot of strategies and funds. Seeking funds is a complicated process; however, proper business homework makes it less complicated. Company valuation fills in an important place in the homework as the investors hunt for companies with a promising valuation.   Valuation is a process for estimation of the net worth of any company. For a new startup, a clear understanding about certain points related to startup valuation is worthy. The complete understanding of valuation includes    1)Significance of valuation    2)Variety of valuation  3)Vital plug-ins for startup valuation  4)Marketexits   Significance of Valuation   Valuation, in early stages of a startup, means the growth potential, and not the value of the company. The valuation aids the startups to:   Variety of valuation methods   The valuation of any startup helps them to seek investment. Most of the investors will ask about the company valuation in the first place. So, it is very important for the startups to choose and exercise the correct valuation method to acquire precise values.   There are four main methods of valuation: 1) Score card method 2) Check-list method 3) Venture capital method 4) Discounted Cash Flow (DCF) method The startup valuation not only helps in attracting investors, but it gives the complete picture about the market valuation of the company i.e. price the market is ready to pay.  6/20/2016 12:00:00 AM Basics of concierge medicine The “American Academy of Private Physicians” stated that the concierge system was being practiced by only about 5,000 doctors, and the figure has risen gradually.On the contrary, physicians feel that they have lost power and that the payment system is mostly not within their control. They consider the system unfair and find this to be the case in most matters. Young doctors are therefore more liable to embrace these conversions. Nearly 17% of doctors below 45 years of age expressed their willingness to switch over to a new concierge/direct income system. Younger minds are open to these changes but the older ones are not too enthusiastic about the transition. Concierge medicine services for diligent physician care: The Concierge healthcare system evolved in Seattle in Washington during the 1990s. In this patient care system, the patients pay several hundreds of dollars for enhanced services. The typical services offered are extended physical examinations, instant appointments, home distribution of medicine, health care referrals, 24/7 physician access to telephone, pager and e-mail. The concierge care system is proposed to bestow “supreme value and maximum accessibility” of services to a niche clientele and selected set of patients. Although concierge care has an outstanding business prospect, it has fascinated only around 200 doctors countrywide. The approximate number of osteopathic doctors in concierge care is quite unpredictable.   The “American Academy of Private Physicians” stated that the concierge system was being practiced by only about 5,000 doctors, and the figure has risen gradually. The Physicians Foundation expressed that, in a survey of greater than 20,000 doctors, 20 percent or more claimed that they are at present practicing concierge medicine or have planned to practice it in future.   On the contrary, physicians feel that they have lost power and that the payment system is mostly not within their control. They consider the system unfair and find this to be the case in most matters. Young doctors are therefore more liable to embrace these conversions. Nearly 17% of doctors below 45 years of age expressed their willingness to switch over to a new concierge/direct income system. Younger minds are open to these changes but the older ones are not too enthusiastic about the transition.  6/19/2016 12:00:00 AM Accountable Care Organizations (ACOs) - How do they function? The basic premise of an Accountable Care Organization is a good co-ordination among healthcare providers in order to improve access to care while reducing costs. ACOs follow an organized system of healthcare, which includes good co-ordination among the healthcare providers, improved access to acute medical care, continuity of care, and many other implementations that support for the successful application of population health management. To Learn about the Background on Accountable Care Organizations, Click Here! Functioning of an ACO   ACOs follow an organized system of healthcare, which includes good co-ordination among the healthcare providers, improved access to acute medical care, continuity of care, patient counseling involving medication adherence and lifestyle modifications, use of electronic health records and many other implementations that support successful application of PHM. Irrespective of the type of financial incentives received from the payers, ACOs strive to prevent a disease. ACOs treat and mitigate the patient’s suffering, which ultimately reduces the duration of hospital stay of the patients, number of emergency room visits and cost of hospitalization.   Role of Information Technology (IT) ACO comprises of multiple healthcare professionals from different departments, and works on the principle of PHM. It is necessary to maintain clinical integration, which is highly impossible without a proper IT infrastructure. Earlier communication of clinical information between physicians and other healthcare providers was very difficult, as the information was stacked up in paper files. But, in this modern era, where the use of computer technology is widespread, it is easy to manage patient’s health effectively. For example, electronic health records (EHRs) can be easily exchanged with other providers if the patient requires interoperable care. The federal government has already spent half a billion dollars to help the states develop health information exchanges (HIE). Due to limited grants/ expiry of the grants, the local HIEs are looking for new-business model. Moreover, the physicians have started direct physician-to-physician messaging, which is on its verge. 3/21/2016 12:00:00 AM Different Models of Concierge Medicine and the Future The concierge medicine model maintains a good physician-patient bonding. A patient can avail physician services round the clock. The physician meets not more than 15 patients each day. The physician also earns a satisfactory income without toiling like the traditional doctors. The concierge model demands a fair amount of entrepreneurial and marketing skills. The situation is challenging because the physicians are not trained businessmen. To learn more about the "Basics of Concierge Medicine", click here!   The Choice of healthcare models:   Health care markets’ response to primary care providers The scarcity of primary care givers will fetch a decision-making situation for the physician and the patient. This would force their practices into two entirely diverse models. Each model is different and offers valid response to the patient surplus. The two models create noticeably dissimilar experiences for both the physician and patient. And each model depicts wide split in the doctor’s medical education.   Model 1: Physician as the leader of the healthcare structure – heads a team supervising the Nurse Practitioners and Assistant Physicians In general, the physician is considered the Chief of the service team. The Physician’s Assistants and Nurse Practitioners initially treat the patients under the supervision of the Chief physician. The expertise and knowledge of the Chief physician will be retained for highly complex cases during the day. The major job of the new age physician will be in his commitment to directing and correlating the care pyramid of their subordinates. Issues with this model of practice:   The lack of leadership skills education in medical colleges and residency training is the most challenging issue for physicians. Nearly 30-50% of their time is used up in management and leadership tasks for which they are not trained by medical schools. Organizational leadership should be regarded as a major topic for Continuing Medical Education (CME) in the future. Model 2: Having service as the main motive – Direct care model The demand for concierge services: Today, the popularity of concierge medicine is greater than before. Patients soon realise that they are allowed to see the main physician only on special and rare occasions. The patients are ready to pay an extra amount for the special privilege of being treated by the chief physician. The deficit in the number of physicians demands a huge extra remuneration to meet the patients’ needs. As there is seen a substantial move towards concierge medicine service and with that a fall in premiums more avenues within the concierge practice is now becoming available. The immense acceptance of the concierge model will indeed have another element which will be a driving force – the doctors themselves.    In this model the physician’s role is exactly the opposite of that of the physician in Model 1. In the concierge model the physician sees less than 15 patients a day, thereby enabling direct patient care and meaningful relationships with the patients. With the extremely low overhead of the concierge medicine model these physicians are able to make the same income as the doctors who are driven by volume without them having to see all these patients or having to supervise providers at various levels. As a physician you would have to deal with the challenge of not having the necessary business acumen and training as well as lack of any grounding in marketing. As a patient, you will be able to see your doctor at any time you are ill or in for a regular check-up or care. The doctor will be mostly practicing solo in a small office and will also provide you with more of his concentrated time and attention.   In general: The concierge medicine model maintains a good physician-patient bonding. A patient can avail physician services round the clock. The physician meets not more than 15 patients each day. The physician also earns a satisfactory income without toiling like the traditional doctors. The concierge model demands a fair amount of entrepreneurial and marketing skills. The situation is challenging because the physicians are not trained businessmen. 3/9/2016 12:00:00 AM A Primer on Trademarks You might have an idea to start a new company and have selected a name, logo for your company. You need to register this name and logo as a trademark as it is a distinctive sign or logo that helps to identify certain products or services of a particular individual or a company. But before filing an application make sure that the name and logo are unclaimined becuase trademark infringement may cost you millions. This article discusses the trademarks and its registrations process. Make a mark with TRADEMARKS   You might be planning for a new business and might have selected a name and logo for your company. Protect your company's name and logo by registering as a trademark. Before filing an application, find out if the name and logo are unclaimed because trademark infringement may cost you millions. 3/3/2016 12:00:00 AM Healthcare Transparency - The Problem As there is increased exposure to healthcare costs there is even greater and meaningfull need as well as transparent price information. This would necessitate all the stakeholders commit to enable access to the right information about price, quality as well as safety to patients to help them make informed healthcare decisions. This article will bring into focus these issues.   To learn more about “Healthcare Transparency - The Solution”, click here!   With increased exposure to healthcare costs there is even greater and more urgent need for meaningful as well as transparent price information. This would necessitate that all stakeholders commit to enable access to the right information about price, quality as well as safety to patients to help them make informed healthcare decisions. This article will bring into focus these issues, while presenting other information in similar context.    What is healthcare transparency and what defines healthcare transparency?  Transparency and better public information on quality and cost are needed for a few important reasons.  1. Helping providers improve their quality by benchmark standards created which tests their performance against that of others.  2. To help patients make informed choices about their health care and  3. To ensure and encourage public sector and private insurers to reward efficiency and quality.  The information asymmetry that is the experience of many consumers, payers and providers is currently seen to shield the critical shareholders and stakeholders from information that is much needed by them to make the necessary decisions regarding what works best for them.  Transparency is seen as a tool to help level the playing field. The potential for transparency to address a variety of areas of the healthcare delivery system – which includes cost, quality and outcomes – which means highlighting vital information to consumers, payers, providers and stimulating savings and quality improvements.  What are the developments so far?   With great efforts from the National Committee on Quality Assurance (NCQA) which has focussed on health plan’s transparency and Aetna’s Excel Initiative on transparency of clinical quality and cost efficiency, there has been a greater attempt to bridge the gaps in information asymmetry. Transparency of prices, costs, effectiveness and quality of medical services is seen is as a key tool to improve performance and outcomes while lowering costs. 3/1/2016 12:00:00 AM Healthcare Transparency - The Solution Investments in health information technology is necessary to ensure the right information at the right time to patients, payers and providers. Changes in the current methods of payment can increse transparency. It can be solved by publicising the patients condition by using the assistance of medicare. To learn more about “Healthcare transparency - The Problem”, click here!   What can be done to achieve transparency in health system?   Investments in health information technology, which is seen as necessary to ensure the right information is made available at the right time to patients, payers and providers. Making fundamental changes to current methods of payment can help increase transparency. Making patient’s condition publicly available can be made possible using the assistance of Medicare which can assume a leadership role in making provider’s quality and cost information available. Medicare can forge public-private partnerships by which they can create uniform quality metrics, multi-payer database, and transparent methodologies for adjusting the cost and quality. There should be a modification in the HAS legislation to reduce the potential harmful effects on a vulnerable population. With high-deductible health plans there is an increased risk that patients will fail to get the early care that could detect the serious condition in an early stage. This could further lead to patients not getting the right medication that could control the risk factors as well as other chronic conditions. The legislative modifications to minimize these risks could be: Where there are lower age workers the HAS deductibles allowed for them should be lower. For those employers covered under employer’s plans there should be a guaranteed choice of comprehensive health plans. The areas of primary care and preventive services should be made exempt from deductible. Prescription drugs should also be given an exemption since these may be used in the management of chronic diseases. There should be great flexibility in benefit design. There should be a ceiling on the income on eligibility for HAS so that there can be a reduction in tax subsidy for high-income individuals. There has to be fundamental change in the payment methods. There has to be gains in efficiency and quality which needs to be achieved simultaneously. Key Elements of a Fully Transparent Health Care Marketplace   How can entrepreneurs leverage this market and take advantage of the lacunae? Under the circumstances healthcare providers are fighting hard to provide transparent and understandable pricing, and they all have a long way to go. They are all lacking in skill sets and business models should be able to clearly define service bundles that need to be priced thereby making the pricing understandable to buyers. Manageable pricing is important too. One price fits all, or different prices in different cases? Who are all stepping in to fill the gap? Software technology entrepreneurs are one of the many who are utilising this opportunity and this started health insurance shopping sites such as ehealthinsurance.com and information sites such as WebMD.   Online health insurance purchasing got into mainstream sometime last year and led to launch of public exchanges. There is an array of start-ups which are in the health care transparency market and famous among them are: CastLight (provides healthcare price information for employees of self-insured companies. Care.com: helps you find in-home care givers 23andMe: Aids in accessing personal genetic information BestDoctors: Helps you find doctors for second opinions ZocDoc: Helps you find doctor and schedule appointment on-line TruVeris: Helps in bringing in transparency in pharmacy benefit manager pricing for payors Pokitdok: Helps you find a doctor and obtain price quote GoodRx: Helps you find discount coupons for prescription drugs 3/1/2016 12:00:00 AM Accountable Care Organizations (ACOs) - Background Despite the fact that U.S. provides its citizens the world-class care, with a contribution of 17.2% of its GDP into the healthcare (as per 2014), the outcome of the services provided is not effective. Moreover, the U.S. healthcare expenditure is more than that spent by any country. In an attempt to reduce the cost burden of the patients, and make it more patient-centric, the health-policy experts have recommended the establishment of Accountable care organizations (ACOs). These organizations work on the principle of population health management (PHM), which gives incentives to the providers for keeping them healthy. What is an ACO? Accountable care organizations (ACO) are healthcare organizations comprise  a set of healthcare providers such as physicians, specialists, and hospitals that aim to provide quality and cost effective care to the patient. The approach of Accountable Care Organization (ACOs) came into existence with an intent to decrease the healthcare costs and improve the quality of care, thereby, decreasing the cost burden of the patients. ACOs are liable to render justification for the cost and quality of the healthcare services provided to the patients. According to the Affordable Care Act, they can be established with the support of any type of provider organization; either with the private payers such as private insurances/ employer-purchased insurance or the government organizations such as Centers for Medicare and Medicaid Services (CMS). The providers offer financial support to the ACOs, and encourage them to mitigate the patients’ concerns while giving them the freedom to select the medical services required. Despite of the differences in the type of provider organizations, the ACOs are eligible to avail incentives from the providers. 2/22/2016 12:00:00 AM A Beginner's Guide to Health Entrepreneurship - Part One The healthcare professional is quite innovative, and yet we find that most ground breaking ideas fail to leave the ideation board. Healthcare industry is evolving day by day, not just due to government intervention but also due to health care being taught as a way of life rather than as a crisis to be dealt with. Changes in this industry offer tremendous business opportunities for entrepreneurs and they have responded by finding and providing newer,better solutions to old problems.But it’s a little crazy to be an entrepreneur to launch an entrepreneurial venture alone to meet the needs of an aging and moreover it could be a daunting task.Let alone sustain it, by creating a new idea for the beginners. What to expect This guide is all about concepts and insights. This as a guide to “How to think” rather than “How to do”. While, as we know, ideation is difficult we are also aware that the implementation part is even more difficult. Here we provide you with information that will propel you to “think” and help you invest in the “right idea”. Reality check The “idea” can make or break a startup and picking the right idea can help you get a good start. With these insights from us you will gain a big-picture view and in-depth insight into what will make the best start-up idea for you. This guide will introduce you to the fundamental, vital and crucial concepts about ideation for startups that you should essentially understand before embarking on your journey. What we have for you here is a clear and extensive guide with in-depth knowledge regarding the deficiencies and gaps currently seen in the healthcare segment. Armed with this background, you will now be fully equipped to create an idea around this which resonates with you. Thus, this guide will help you come up with the right idea, which could improve your odds of successful execution. 2/21/2016 12:00:00 AM A Beginner's Guide to Health Entrepreneurship - Part Two This article is dedicated to encourage and promote a culture of creativity and innovation in the ideation stage of the entrepreneurial journey. The specific function of ideation and innovation is seen as the discipline whereby the entrepreneur develops new approaches or makes improvements to existing ones - thereby offering sustainable value to customers. Any and all healthcare professionals as well as others desiring to make a mark as entrepreneurs in this segment can benefit from this article which provides a broad guideline to the budding healthcare entrepreneur. Missed Part One of this article? Click here! Why you should read this before embarking on your journey a)Choosing the right startup idea will speed up your learning curve and save time, effort and heartache along the process b)There is a huge opportunity cost involved in picking a startup idea which involves a great amount of energy, money, focus, time and dedication to execute the idea. We believe you do not wish to invest in an idea less worthy of your time. c)By fully assimilating these concepts you will know which the best startup idea is for you, and where you will find it too! Gaps and issues in the healthcare sector, seen today and the opportunities It’s no mystery that healthcare is fragmented. The system wastes billions of dollars annually and yet fails to deliver the right care. It is indeed clear that the system needs to be fixed! Many of these issues are being attended to by the government – people are forced to take an insurance policy or pay a fine, there are preventive services that citizens are entitled to with no extra costs, and when you get sick health plans cannot cancel your coverage etc. In spite of all this there are the more subtle problems in the healthcare industry which are today being solved by entrepreneurs. Entrepreneurs are changing the way in which you can manage your health thereby enhancing the manner in which you address lifestyle choices. Healthcare 21st Century – a glimpse While headlines are raging with news about health care reform and there is always a debate over public vs private system, there are innumerable opportunities for business within this segment. Whichever way the political debates are going, the truth is that there are plenty of opportunities for new entrepreneurial pursuits in the healthcare segment. What’s in it for the entrepreneur? The industry has varied areas of expertise with a complex set of interconnected providers, all working in coordination to ensure our health.   A way to classify: a)Pharmaceuticals, Life Sciences, and Biotechnology​ b)Health Care Equipment and Services   But this hardly covers all the areas. The manufacturer of the x-ray machine, the technicians, and the physician – all play a vital role in patient care. This leads us to arrive at a broader classification:   a)Hospitals, physicians, nursing homes, diagnostic laboratories, pharmaceuticals, chemicals, medical equipment, manufacturers and suppliers   b)Ancillary services medical equipment and supplies, healthcare services, biotechnology, and alternative medicine. Let’s look at a few innovative ways in which companies have taken ideas and converted them into healthcare start-ups. Let’s hope these will spur you to come up with ideas for your own “health care industry start-up”.   Gym Pact an innovative healthcare solutions company. This is one platform where you connect with wannabe exercisers and the system holds you accountable with cash; if you do not exercise you pay cash to the folks that do!   Wellness FX a company that uses a tri-monthly blood sample to gauge your inner health while charting progress.   Fitbit provides gadgets and instruments that let you track your distances, calories burned and your sleep cycles.     Rock Health an innovative healthcare accelerator program which is dedicated to support startups through mentorship, funding and any other required support. Founded by an enterprising team global professionals this platform is meant to kindle the healthcare entrepreneur. Providing two different models of funding, this startup provides incubation program as well as angel investment.   Andreessen Horowitz is an investment fund that has created a fund specifically looking at early stage companies using machine-learning in healthcare (technology)   There are many more such innovative solutions made available due to the lacunae and shortages in the existing health care system. 2/19/2016 12:00:00 AM Global Healthcare Milieu - Part One The main drivers for the growth in the healthcare sector are aging population (mainly baby-boomers), increasing access to care, emerging market growth, etc. The responsibility of the healthcare entrepreneurs is to look into the major issues and to naviagate them. This article briefs the current state of global health care and the activities in a few geographic markets. As they address the issues of funding, cost and other global concernst they provide areas of consideration to stakeholders and promising entrepreneurs for the growth of their revenue and market share in 2016 and beyond. Health care enterprises should look into major issues such as navigating the influence of health care reforms in many countries: quality issues, rising costs, lack of infrastructure in most parts of the world, safety and privacy concerns, workforce related issues etc. In this article we would bring out the challenges and opportunities that will be seen originating from these areas, global and market-specific. This article examines the current state of global health care, the activities in a few geographic markets and also provides areas of consideration to stakeholders and promising entrepreneurs as they address issues of funding, cost and other global concerns while seeking to grow their revenue and market share in 2016 and beyond.   A quarter of the world’s population sees global health care as one of the top three most worrisome areas threatening the world today.   In the coming years we are going to see a most challenging time for global healthcare sector whereby operating processes as well as historic models of businesses will not be enough to manage the problems caused by the rising demands of cost pressures, rapidly evolving markets and inadequate care providers.   The main drivers for growth in this sector are   a)aging population (mainly baby-boomers) b)increasing access to care c)emerging market growth d)technological advancements e)innovative products f)many acute conditions transforming to chronic diseases​ 2/15/2016 12:00:00 AM Global Healthcare - Challenges (Part Two) Here we continue to analyze the primary challenges faced by populations all over the world to deliver high quality care at a reasonable cost. Although some challenges are unique to some nations, issues related to access continue to reverberate across the world. Understanding these challenges could provide a motivated individual the necessary background how to tackle a problem by adding value using his entrepreneurial tool kit.   Missed Part One? CLICK HERE! Second Major Issue affecting Global Health – Cost and Quality of Healthcare   Whether it is the recession riddled Europe or the US which spends 18 percent GDP on healthcare, both private and public fund systems are stressed economically, while costs have become unsustainable and unaffordable. Unfortunately higher medical expenditure does not mean better treatment nor does it correlate with better results or quality medical care even in the developed countries. Increase in health care costs can be primarily attributed to factors like prolonged hospital stays, expensive diagnostics, inefficient processes and overuse/misuse of medications. Does greater spend translate to better health? As history has shown, the answer is a disappointing no!   All countries should be doing ‘something’ to improve their health care systems. This would ensure that the resources thus released / freed could be used to cover more costs, people and services. Some thoughts to achieve this:   Adopting a more strategic approach to providing and health services, eg. buying services based on health requirements of the population, payments made to providers based on performance   Private-sector health facilities are not seen to be more or less efficient than government facilities and this seems to largely depend on the setting, so privatization would solely not solve the problem   There can be assistance from donors who contribute effectively by aiding in the development of domestic financing institutions and reducing fragmentation in the way funds are delivered (for instance the Gates Foundation) Reducing fragmentation at the global level could be another effective method to ensure that money spent is well utilized for healthcare!  In a nutshell, effective governance is the key to improving equity. Third Major Issue – Technological transformation and digital innovation   Through out the world, healthcare systems are recognizing the need for technological innovation and advancement. Data management and health technology would be necessary to facilitate treatment options and new diagnostic methods.   This in turn could lead to huge increase in costs whereby private and public health care providers/insurers can find opportunities to restructure care delivery models promoting efficient use of resources.   In an era of cost reductions and reforms, acquiring and leveraging technology innovations would require financial investments that health care professions and providers will find a challenge, even in developed countries.   How technology-enabled health care systems are producing an immense volume of information and data and how these can be interpreted is important. Availability, integrity and confidentiality of such information becomes important and much depends on this. Fourth Major issue – Adapting to market forces   There is an urgent need and requirement for health care providers and health plans to rethink the existing business models in order to face the challenges posed by emerging trends and simultaneously embrace the opportunities they present. Scaling to prosper    Rapid consolidation among healthcare providers has been the norm lately and the stage has been set to enable convergence of market forces. In spite of the intensified regulations and scrutiny, horizontal and vertical consolidation is on the increase. With the shift to an ecosystem of service providers and products, cross-sector convergence will also increase. Increasing role played by the Government Regulator, Payer, Market – shaper: these are the many roles played by the Government in the global healthcare sector. One could find it difficult to grasp the relevance and the need for this.   Talent and skills gap   With both developed and developing countries finding their health care needs growing, they are in a constant struggle to find adequate trained, qualified health care professionals as well as physicians and nurses. Consumerism There is seen a major shift with patients being faced with large deductibles and cost-sharing for services and treatments – these include medical devices and pharma products of special nature. 2/14/2016 12:00:00 AM Dawn of the new Healthcare Model - Kaiser Permanente taking the lead Health care systems involve multi-disciplinary groups of practitioners who form “teams”, each of them with an approach of tolerance and awareness for other disciplines as we find patients sent from one practitioner to another. There has been an evolution with other entities like pharmacies as well, with advancement from clinical pharmacy through pharmaceutical care to medical therapy management services. Pharmacies have now become more focussed on direct patient care. Thus healthcare is in a dynamic state with several cost concerns, legislative reform and quality concerns driving transformation. Payors are looking at everything the providers do and every dollar they spend. Providers are hence challenged to do more with less. In this article we examine the fundamental principles of healthcare, looking at why we are here and what we hope to accomplish for patients and communities. We also examine Kaiser Permanente and the Cleveland Clinic Models that had evolved over the centuries.x1   Over the last decade we have seen several different models: Wellness and healthcare services being at the entry point in the system. Model in which healthcare professionals share common knowledge base, an instinct to help patients, where professional boundaries become blurred or overlap, where professionals share a common knowledge base and a common professional interest. A model that encourages an interdisciplinary approach with the providers having shared borders. Medical Management and disease management provided by “Physician Extenders” with the use of evidence based medicine. With models and systems in place that are outcomes driven and outcomes justified. Use of complementary and alternative medicine within the scope of the delivery model.   There are challenges faced by every sector of the healthcare industry in identifying, embracing and driving their many roles within this new healthcare model.   The direction we take today would affect health care scenario in the years to come. If we do not take the trouble to create change – change will (re) create us! 2/11/2016 12:00:00 AM The Kaiser Permanente experience - Part Two Being a pioneer in implementing a new model of healthcare, Kaiser had their own share of challenges. Here we examine and learn from their experience as they successfully implement a functional Electronic Health Record system and bring in George Halvorson as the CEO who had the Vision to 'transform' how healthcare was delivered. We also cast light on the growth of High-Deductible Health Plans and how physician engagement was key to this viability of this model. Issues the Kaiser Permanente model was experiencing at the time ·         Model was struggling to implement a functional electronic health record and carried a reputation for inconsistent and poor customer service. ·         There were seen deep divisions within the powerful Permanente Federation which represented Kaiser’s 17,000 physicians and there was a struggle about operations and strategic direction. ·         The surprise element came in March of 2002, when Kaiser federation brought in a new non-physician CEO, George Halvorson. ·         George had spent most of his work years as CEO of Health Partners which was a successful mixed model health plan. ·         He had the reputation of being a product innovator and had developed the prototype in the mid 1990’s for the consumer-directed health plan. Things we could learn from George Halvorson’s initiatives and the many changes he brought about in the Kaiser System. ·         Halvorson brought in population health improvement objectives for its members along with the prototype developed, both of which were firsts in the industry. ·         During his tenure Halvorson led the Kaiser plan to stable and solid profitability while adding several members in California in spite of a devastating recession and the membership base reducing. ·         Investments made - $6 million in computerized patient care systems and population health management infrastructure ·         Other accomplishments – helped healing the breach in trust with Kaiser Physicians and improved the customer satisfaction score to an extent that the model earned a 5 star rating under the Medicare Advantage system. ·         Achievements by Year 2013 – over $53 billion in revenue and over $ 19 billion in reserves and investments! Halvorson’s time at Kaiser, his views on health reform, his public health crusading and unfinished agenda with reforms at Kaiser ·    He touches upon the evolution of Managed Care and he believed that Kaiser was not a HMO in the classical sense of the word. He maintains that while it was strange that the HMO membership count went down from 29 percent of the total employed populace in the country to 13 percent, it was an achievement of sorts that Kaiser managed to add a million lives in California alone! Halvorson maintained that Kaiser was a vertically integrated care system using a health plan as its financing model. The Kaiser model was one that enabled them to do things that they could not do under other settings.   ·  The major achievements through the incorporation of this model were: o   Focus on the patient, prevention, population health, changing care delivery, information flow on the patient – while many other care systems focussed on information creation to generate bills! Kaiser Permanente distinguished itself on creating information in support of care. o   The secondary function of that information flow is creating cash flow. This is the primary reason that distinguished the Kaiser model from others and created a path very different from other HMOs. 2/10/2016 12:00:00 AM Hospital Trends from an Investor's Perspective The U.S. Healthcare is becoming complex with its ever-growing expenditure on healthcare, need for performance improvement, and the goal for achieving universal health care. Affordable Care Act, a legitimate trial to reform healthcare, imposed ban on establishing and expanding physician-owned hospitals, a niche popular for arranging luxury care and forging profits. Before starting a healthcare company to acquire vulnerable physician-owned hospitals or investing in a new hospital in competition with rural non-profit hospitals, it is beneficial for an entrepreneur to dig into the market strategy of hospital care. The information shared in this article is a picture of hospital structure, billing for services, flow of money in a value chain, valuation, factors affecting investment, fate of the physician-owned hospitals to favor entrepreneur, and scope in making profits.   Introduction Out of every $6 Americans spend, 1 $ is spent on healthcare.  Investors admit that industries other than energy and manufacturing are far more productive, especially the healthcare industry. Healthcare sectors, specifically, hospitals can be an excellent investment opportunity for an entrepreneur inclined towards healthcare. U.S. economists point out 0.6% surge in the currency spent on hospital care in 2014. This bit of information hooked us on the road to figure out the model of hospital funding, administration, market strategy, and the impact of Affordable Care Act on the hospitals, particularly, physician-owned hospitals.   Healthcare trends in the USA The United States has the most expensive health care system as compared to other countries across the globe. A sum of $2.9 trillion accounts for nearly 17.4% of GDP of a nation. Any clue why these figures ring the bell? It was the total national health expenditure of U.S. in 2013! Though, 20 cents of every $1 spent on healthcare is used in marketing, underwriting, administration and making a profit.  Figure 1: Expenditure based on specific services Source: www.healthcare-economist.com   By all means, the U.S. healthcare system has got the edge, notably in precautionary cancer screening, with its advanced research and equipments. Going by records, the US has the highest survival rate of cancer patients. On the other hand, the U.S. healthcare system exhibited low performance in specific areas, such as access, equity, quality, and efficiency, in comparison with low revenue Asian and European countries. An article Mirror, Mirror on the Wall, published by Commonwealth Fund, 2014, focused on below normal standards in access, equity, quality, and efficiency of health care in the U.S.         2/9/2016 12:00:00 AM Investment Opportunities in Physician-Owned Hospitals   Value-based care is a one-stop solution to limit the expenses and add to the quality of healthcare. With the strict imposition of law, it is highly impossible to get physician investment before starting a new physician-owned hospital but the task is simplified for already existing hospitals. While the physician-owned hospitals without Medicare certification can go with other options of merging with healthcare organizations as it has an adverse impact on pricing of the other set of for-profit hospitals. For an overview of Hospital Trends from an Investor's Perspective, CLICK HERE The Affordable Care Act and POH Value-based care is a one-stop solution to limit the expenses and add to the quality of healthcare.                                                                       The trend of physicians being a part of hospital management progressed until the implementation of Affordable Care Act. Section 6001 of the Affordable Care Act of 2010 amended section 1877 of the Social Security Act has imposed additional requirements for physician-owned hospitals to qualify among the other hospitals. However, exceptions are given to rural providers. This Act imposed severe restrictions on the already existing hospitals from expanding and also from starting up new ones. What would happen to physician-owned hospitals? With the strict imposition of law, it is highly impossible to get physician investment before starting a new physician-owned hospital. However, the task is simplified for already existing hospitals. The inherent quality to deliver cost-effective high-quality services contributed to patient satisfaction, positioning them strong in the race. While the physician-owned hospitals without Medicare certification can go with other options of merging with healthcare organizations, it has an adverse impact on pricing of the other set of for-profit hospitals. Healthy competition among peers would enhance the quality of care provided at minimal prices. The merging or termination of physician-owned hospitals eliminated competition for the community and other for-profit hospitals to dispense high-quality care at minimum prices on par with physician-owned hospitals.   The possible modifications in the ownership template can be considered to meet the requirements of a “whole hospital” mentioned in Starks Law. Merge with a hospital but maintaining ownership of a physician. Merge with a hospital or organization but sell the ownership of a physician. Completely dissolve the hospital from a business.                                           Figure 5: Changing pattern of physician ownership                               The physician-owned hospitals came up with other options to continue in practice. Public equity market share is merging the hospital into a corporation whose shares can be sold in share market. In other words, converting the physician shares to public shares. Affiliate with physicians by employment without a direct equity. Real estate or equipment leasing service is an indirect ownership arrangement 2/5/2016 12:00:00 AM A Primer on Copyrights Copyright is an assignable legal right for a fixed number of years for a new business. So, when you start a new business it should be claimed under the law of copyrights. Lets understand how we can copyright your work.     Claim Your Right to COPYRIGHT Let's understand how you can copyright your work ….. Firstly, perform copyright registerability assessment and if the results are positive proceed with the application process for copyright registration. Then get your copyrights registered with U.S Copyrights office by filing an online application along with correct fee and copies of your work.   Copyright Registration and Maintenance Process   Legal discourse Patent lawyers or attorneys have specialized qualifications and knowledge on matters related to patent law and practice. They stand for you in procuring the patent and thereby protect the rights of your invention. As applying for a patent is a cumbersome process, it is always recommended to hire a patent attorney to file the patent on your behalf. A patent attorney makes a preliminary evaluation of patentability, which includes determining if the invention qualifies for patent and whether the patent granted is broad enough in its coverage. 2/3/2016 12:00:00 AM A Primer on Patents You may have a great idea or a dream to start a business and want to file a patent before any other person coming with the similar idea. Filing a patent helps to protect an invention, a product, or a new technical solution. Without these laws of copyrights, patents, and trademarks, businesses would be in the chaotic state and ever-defensive mode. Let's learn more about the patents, its application and maintenace.   Protect Your Intellectual Property With Copyrights, Patents and Trademarks   "How Opal Mehta Got Kissed, Got Wild, and Got a Life" changed the life of Kavya Vishwanathan from being a young Indian American novelist who got $500,000 contract from Little, Brown and Company while she was in high school, to be referred among the top cases of plagiarism today. This is one example of a breach of copyrights- a right that protects the ownership of any work in original. In the same way, patents and trademarks are also ways to claim ownership of innovations and designs.   Any creation of human intellect, which can be an invention, a trademark, design or the practical application of an idea, is called intellectual property (IP).  Intellectual property needs laws to prevent its misuse by others for their interests, mostly financial.   How do entrepreneurs protect their ideas? Patents, trademarks and copyrights are the frontrunners in protecting your ideas and business interest. Many of you might be into developing new mobile apps and software applications.  Patents and trademarks help to prevent other parties from attempting to profit from your creations. You can protect your original work related to computer software, literary, drama, pictures, photographs, music, sculptural works, choreography, architecture, or audiovisuals by claiming copyrights. Copyright is a legal right that grants the creator with exclusive rights to its use and distribution. However, copyright protection is not applicable to ideas or concepts because it protects the expression of an idea but not the idea itself. Do you have something original or created by you in a tangible form! Bingo. Use a copyright symbol ©and it is copyrighted now. Here are few exceptions to copyrights protection: a)Titles, names, short phrases, slogans, which are covered under trademark protection b)Mere listings such as ingredients and phone numbers c)Works that contain no original authorship such as calendars or rulers If someone uses, reproduces, distributes, displays or performs your copyrighted work without seeking permission, it is a case of copyright infringement.   2/3/2016 12:00:00 AM HIPAA - What do I need to know as a Health Entrepreneur? The enactment of “The Health Insurance Portability and Accountability Act” (HIPAA) Act was aimed at making health care affordable to all and also ensuring health insurance coverage to everyone. It didn’t take too much time for the lawmakers to realize that, in doing so, the privacy and confidentiality of patient health information would be jeopardized. But the result was an integral and indispensible part of HIPAA. Although, the health care organizations had to put in additional funds, resources, and efforts to comply with HIPAA, it opened vistas of business opportunities. Along with the security and privacy responsibilities, HIPAA has also created a “Peachy Leeway” for the new innovative business startups. Being an entrepreneur you just have to spot the scope and go for it!   Introduction   HIPAA- A “Double- Edged Sword”   HIPAA was implemented to provide increased healthcare security and privacy for the people, however, it is a “double-edged sword”.  For example, a leading health insurance company like Anthem Inc. had to pay a penalty of $1.7 million for a computer security breach in healthcare data. On the contrary, it also played the role of business “ladder” for many successful new healthcare technology startups like Aptible, Flatiron, Misfit, and CardLogix. Along with the security and privacy responsibilities, HIPAA has also created a “Peachy Leeway” for the new innovative business startups. Being an entrepreneur you just have to spot the scope and go for it!   Genesis of HIPAA   Have you ever asked this question, why on earth an Act like HIPAA came into existence? Well, the answer revolves around the fact that till the 1990’s there was deficiency of a convenient system for storage of health records and protection of the health information. To rectify the situation, in the year 1996, Congress passed an act named as “The Health Insurance Portability and Accountability Act” (HIPAA). The Act was an amalgam of five set of titles or rules.   The HIPAA act mainly dealt with three main purposes:   To provide healthcare coverage to the maximum population To reduce fraud and abuse cases in the health insurance To digitalize health records and promote its confidentiality and security     Figure 1- Important Components of HIPAA   Although, HIPAA Act was implemented, but there were some existing gaps in the Health Information Privacy Rule. So, in the need to strengthen the HIPAA Act, the Congress passed the Health Information Technology for Economic and Clinical Health Act (HITECH) in the year 2009. The enactment of HITECH Act was aimed at strengthening of the electronic healthcare documentation system and Health Information Privacy rule. However, implementation of the HITECH Act required several amendments under the HIPAA Act. So, in order to modify certain terms and rules of the HIPAA Act, the Department of Health and Human Services (HHS) and the Office for Civil Rights)  issued the Final Omnibus Rule, in 2013.   The Omnibus Rule officially entitled as “Modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notification Rules Under the Health Information Technology for Economic and Clinical Health Act and the Genetic Information Nondiscrimination Act,” was anticipated to augment the privacy rights of patient’s health records.   Amalgamation of the four revised rules led to the birth of the “The Final Omnibus Rule”: Revision of HIPAA Privacy, Security, and Enforcement Rules Revision of Privacy Rule, contemplated in 2010 Revision of Breach Notification Rule under the HITECH Act Revision of Privacy rule required for implementation of Genetic Information Nondiscrimination Act (GINA)   The Omnibus Rule brought about certain vital changes in terms of interaction between covered entities and their business associates, and redefinition of terms like electronic storage material to electronic media and maximizing the non compliance penalty to $1.5 million. The origin of Omnibus Rule leads to the enactment of HIPAA amending to the HITECH rule. The Final Omnibus Rule worked as connecting “Puzzle piece” for the HIPAA and HITECH Act.     HIPAA compliance   The HIPAA Act implies certain strict norms of privacy and protection for the companies handling protected health information. The companies dealing with Personal Health Information (PHI) must safeguard it by auditing the status, storage location, network security and visibility. So, if a company complies with all the privacy and security norms, the company can be referred as HIPAA-compliant; a little deviation or breach may lead to noncompliance.   Penalty for Noncompliance   Non-compliance to HIPAA may have significant consequences, in terms of finance as well as reputation. The Office for Civil Rights (OCR) can impose both civil and criminal charges depending upon the extent of noncompliance. The civil penalties for HIPAA noncompliance vary depending upon the intention and level of breach.   Table 1: Civil penalties     Table 2: Criminal penalties   2/3/2016 12:00:00 AM HIPAA - Business Opportunities Every problem gives a cope for developing an idea for starting a new business or a new technologies or devices. This new technology and devices has increased tremendously, with the implementation of the Final Omnibus Rule. With this increase in technologies HIPAA has opened a opportunity galore for health entrepreneurs.   To learn about "HIPAA - What do I need to know as a Health Entrepreneur", CLICK HERE!   HIPAA- Opportunities Galore   “Necessity is the mother of all invention”, but in the business world, it says “With every problem comes scope for new business”. The scope of new technology and devices has increased tremendously, with the implementation of the Final Omnibus Rule.   1. Electronic Health Records (EHR)   The EHRs are becoming more and more a standard in health care organizations. These are the electronic forms that help to capture patient-related health data. The integral process of an EHR requires encipherment of the sensitive health records to chaperon it from unauthorized access. Apart from ciphering of at least 128 bit, the usage of other data security setups like firewall and log management systems also may be helpful to restrict the unauthorized access. Auditing of the systems for risk analysis can also be implemented. After the implementation of the HITECH Act, the protocols for the EHR developers have been upgraded, and the focus is more on the development of new stark encryption technologies.   2. Smart Cards Smart Cards are amongst the unique and whiz innovations of the modern world. They are considered as the utmost trusted tools for safekeeping of the sensitive health records. Nowadays, with the rising urgency for heightened data security the smart cards are becoming “in vogue”. The smart cards are rated according to their level of intricacy and data immunity provided by it. The smart cards are helpful for providing absolutely controlled authorized data accession and authenticated access to the network.   The HIPAA Act has unlocked a vast scope for the new IT companies to provide efficient smart cards for the healthcare organizations for secure data storage.   3. Healthcare Analytics   With time, the healthcare sector in not limited to the healthcare providers, but it has extended to many innovative businesses. The healthcare analytics is one such new field which can provide an improved assistance to the healthcare provider for handling the diverse patients more efficiently.     Accompanying the implementation of “Affordable Care Act” in 2010, the predicament of the healthcare providers has increased. So, to reduce the burden of the healthcare providers, the healthcare predictive analytics can play a vital role. They can help the hospitals to recognize the group patients requiring medical follow up to reduce the amount of readmissions.   The new HITECH Act includes provisions for the healthcare provider to acquire compound authorization of patients to use the patient health data for future studies. The analytics experts can use the same data for preparing models but only after removing all the personal identifiable data. But reassurance of the HIPAA compliance should be checked strictly when usage of PHI is concerned.   4. Cloud Technology   The storage of the Protected Health Information by the cloud technology is gaining popularity amongst the healthcare organization. However, for the organization involved in Cloud servicing, HIPAA compliance is a serious headache and all the service providers should be aware of all aspects of HIPAA compliance. The healthcare organizations should check for certain points about the Cloud Service providers which include standard encryption system, risk analysis audits, and high level data accession security.   5. e-Health   The advancement of healthcare technology is acting as a boon for both the healthcare industry and the patients. The increasing availability of smartphones and notepads has started a unique trend in the healthcare, termed as e-Health or Mobile Health or Telemedicine.   The online medical consultancies are helping in transit of the healthcare services to the patients residing in outlying areas. The e-Health is also playing a key role in making the healthcare facilities more convenient for the patients and also providing assistance to the healthcare providers to amplify their scope of pursuit. But the main query is how to avoid noncompliance. Well, the most appropriate solution to this is – Finding the right guy.   According to the Final HIPAA Omnibus Rule both the business associates and healthcare providers are responsible for the secure transfer and recording of the data. Being the e-Health partner, there are certain protocols needed to be followed for a proper business odyssey:   Acquisition of clean chit for HIPAA compliance Signing Business Associate Agreement (BAA) with the healthcare associate Guaranteeing high level of data cipher system and security measures   e-Health can be very useful for the healthcare providers, but a little attention to HIPAA compliance will work wonders for the business.   6. Mobile Apps   If an entrepreneur is starting a company related to healthcare-based mobile apps or softwares, they should be aware of all the rules and regulation regarding PHI and HIPAA compliance. However, the HIPAA rules are not applicable to all healthcare apps rather to the apps which gather, compile and transmit PHI with covered entities. But there are certain contemplating specks about risks factors associated with healthcare mobile apps developer should keep in mind.   All the gadgets like notepad, tablets and smartphones can be misplaced or lost which will generate a risk of data copout. The security of data saved in these devices is a big question as it is easily accessible to any person coming in contact with the device. The user might knowingly or unknowingly post data in the social media which will cause HIPAA noncompliance.   It is true that all the above mentioned risk factors are out of the application developer’s control, but they should be given attention to for HIPAA compliance.   7. Wearable Technology and other Innovative Devices   The key rule for any business is “Demand and Supply”. With the increasing demand for brisk healthcare delivery, the innovative healthcare technology devices are helping in the speedy delivery of the health information. The devices like wearable devices, stretchable devices and microchips are contributing to the supply of personalized health data like blood pressure, heart rate, pulse rate and body temperature. But all the device manufacturers should enquire about the applicability of HIPAA compliance as storage and transmission of personal health data are involved and take appropriate measures accordingly to avoid penalty.   8. Medical Devices   The medical devices are the backbone for the healthcare industry and as the scope in healthcare is “Souping Up”, the new upgraded medical devices are introduced. But, one of the major problems faced by medical device manufacturers is the confusion regarding the applicability of HIPAA. The HIPAA compliance is mainly applicable only to companies manufacturing medical devices involved in storing PHI like unique identifying points and health data.   Any company involved in procuring health information and transmission of the data to healthcare entities should be HIPAA compliant. On contrary to this, the medical device companies involved in manufacturing devices for sale only does not require HIPAA compliance. So the most crucial step for any medical device developers to decide – Whether HIPAA compliance is applicable or not?   9.  HIPAA compliant Data center   The HIPAA compliant Data center can be helpful for removing the non compliance risks but it is important for the healthcare organization to audit risk analysis regularly and try to eliminate the potential noncompliance risks.   2/3/2016 12:00:00 AM Introduction to Social Entrepreneurship ‘Social entrepreneurship’ is an endeavor to draw up new business ventures in solving community or social problems. It creates innovative solutions to pressing social issues and mobilizes the ideas, capabilities, resources and social arrangements essential for sustainable social transformation. A ‘social entrepreneur’ combines the passion of a social mission with a business perspective, innovation, and determination and strives for solving the social issues. The concept of social entrepreneurship has been in existence for few decades and came into limelight with the rise of community and social problems. Social entrepreneurs are promoted by the government through support in the form of funds and finances. Many social enterprises present around the world collaborate and support the seeding social entrepreneurs. Introduction: ‘Social entrepreneur’ is a person who takes an initiative in implementing an ingenious or path breaking idea that has the potential to solve social problems and create positive modifications in the society or community. This attempt to draw upon business techniques to find solutions to the social problems or issues is termed as ‘social entrepreneurship’. Franklin Delano Roosevelt was an American statesman and political leader who served as the 32nd President of the United States. In the 20th century, Franklin Delano Roosevelt passed as a social entrepreneur for his role in the establishment of Tennessee Valley Authority to overcome the effects of the Great Depression. The Tennessee Valley Authority revitalized local economy by harnessing the power of the local rivers to create cheaper energy.   Origin of social entrepreneurship The concept of social entrepreneurship is not new. This concept has been in existence for many decades. There were entrepreneurs during nineteenth and twentieth centuries who strived extensively for the eradication of social evils. Many organizations were established that worked towards protecting the child rights, women empowerment, and saving the environment and treatment of waste products. The social entrepreneurs also involved themselves in addressing environmental problems and fiscal issues for rural and urban poverty stricken communities as well, apart from addressing the social problems.   Eminent entrepreneurs who contributed their efforts to eliminating the social problems: a)Robert Owen, the founder of cooperative movement   b)Florence Nightingale founder of first nursing school and developer of modern nursing practices   c)Susan B. Anthony (US): Fought for Women’s Rights In United States, including the right to control property and helped spearhead the adoption of the 19th amendment. The concept of social entrepreneurship became popular among the society and academic research, following the publication of “The Rise of the Social Entrepreneur” by Charles Leadbeater. Many activities related to the development of community and higher social purpose comes under the modern definition of the social entrepreneurship. As social entrepreneurship is manifested in multiple forms despite the established definition, it remains a difficult concept to define. Usage of the terms “Social Entrepreneur” and “Social Entrepreneurship” a)1960s-1970s- The terms were used first in literature for social change.   b)1980s-1990s- The terms came into widespread usage, which was promoted by social entrepreneurs Bill Drayton, Charles Leadbeater, and others.   c)1950s-1990s- Michael Young was a leading promoter of social entrepreneurship.   Social Enterprises Around The World 1. Gates Foundation Bill and Melinda Gates are the founders of the Gates Foundation. The Gates Foundation helps to improve the quality of the lives for billions of people. It collaborates with the partner organizations that brings resources, expertise, and vision to help tackle censorious problems that include four program areas. a)Global Development Division works to help the world’s poorest people lift themselves out of poverty and hunger.   b)The Global Health Division accomplishes to harness advances in science and technology that would be helpful in saving the lives in the developing countries.   c)The United States Division functions to improve the education and support to the vulnerable children and families especially in the Washington State.   d)The Global Policy & Advocacy Division solicits to escalate the relationships and promote policies that will help improve the work.   2. The Skoll Foundation Jeff Skoll, the President of eBay, founded the Skoll Foundation, a social enterprise, in 1999. Till date, the foundation has invested about $500 million in activities related to social entrepreneurship. The Foundation also gives away, Skoll Awards to the deserving social entrepreneurs and organization.  In addition, the foundation also funds a $25 million portfolio of program-related investments (PRIs). The Skoll Centre for Social Entrepreneurship, is an academic center dedicated to social entrepreneurship, and is run by The Skoll Foundation, in partnership with the Saïd Business School at the University of Oxford. The foundation also supports other social enterprises such as Ashoka, Acumen Fund and Duke University’s Center for the Advancement of Social Entrepreneurship. The Skoll World Forum is an online platform that facilitates collaboration between the executives and the big brains behind social entrepreneurship. The Skoll Foundation promotes social entrepreneurship through creating public awareness of the social causes through their partnership with organizations such as PBS NewsHour and the Sundance Institute.   3. The Omidyar Network   The Omidyar Network is established by Pierre Omidyar and his wife, Pam. It is a philanthrocapitalist investment firm that enriches the economic advancement. The network of the firm with other for-profit companies fosters the participation in the areas such as Consumer Internet and Mobile, Education, Financial Inclusion, Governance & Citizen Engagement, and Property Rights.   4. Echoing Green Echoing Green is a global non-profit organization that provides seed funding and also technical assistance to emerging social entrepreneurs. It organizes a fellowship program for social entrepreneurs. Out of 3,500 applications, only about 0.85% applicants are pulled each year and are trained effectively. Echoing Green Fellows include the founders of Teach For America, City Year, College Summit, Citizen Schools, One AcreFund. It has invested over $40 million in seed-stage funding and provided strategic assistance to nearly 700 world-class leaders driving positive social change around the globe. 2/2/2016 12:00:00 AM How to start a Social Enterprise? A social enterprise stands on a belief to change the society in a good way. Social entrepreneurs take the initiation to implement the ideas to solve the problems. Different steps are involved in starting a social enterprise. This article describes the different steps in social enterprise.   Introduction: ‘Social entrepreneur’ is a person who takes an initiative in implementing an ingenious or path breaking idea that has the potential to solve social problems and create positive modifications in the society or community. This attempt to draw upon business techniques to find solutions to the social problems or issues is termed as ‘social entrepreneurship’. For an Introduction to Social Entrepreneurship, CLICK HERE Strategies of Social Entrepreneurship 1. Non-Profit with earned income strategies This kind of social enterprises performs social and commercial entrepreneurial activity to achieve self-sufficiency. In this context, a social entrepreneur operates an organization that would aim for a combination of social and commercial benefits; and the revenue thus generated would only be utilized for further improvement of social values. The examples include Ashoka, Goodwill, Canadian Cancer Society, The Salvation Army, SickKids Foundation etc. 2. For-Profit with goal- driven strategies These social entrepreneurs operate organizations that are both social and commercial, and the organizations are financially independent.  This is also a social purpose business that performs social and commercial entrepreneurial activities simultaneously for achieving sustainability. The examples include Microsoft, Grameen Bank, DripTech, Revolution Foods etc. 2/2/2016 12:00:00 AM Funding Basics - Angel Investing The journey of a new business starts with great idea and it passes through several phases of the business cycle. But transition from one phase to another is facilitated by funding generated through various means. There are many ways for generating funds and one among them is Angel Investors.   Abstract: According to market analytics, the number of healthcare startups has increased by 68% in 2015. This time is regarded as the “Golden Era” of Healthcare startups with Venture capitalists interested to venture in the healthcare sector and reduced initial investment requirement due to cutting edge technology. However, out of 1000 startups only 8 of them can grow big. The main reason for this observation is that the entrepreneur does not have proper guidance and knowledge about the funding processes. The main catchphrase of this article is to provide useful information about the Angel funding process and illustrate the various facts associated with this funding process. This information can help the entrepreneurs seek the right kind of funds, to help their business grow and flourish!   At a Glance Angel Funding The Process of Angel Investing Legal Constraints Linked With Funding Process Summary   Introduction Show me the money! Well if you are an entrepreneur undergoing business metamorphosis, funds will be the first thing you would seek. According to Gavin Newsom, "Accessing capital to start a business can be a daunting process, especially for entrepreneurs who start out with a great idea but have no real familiarity with the business world." Funds are the lifeline of any business. The journey of any new business starts with a great idea and radically passes through several phases of the business cycle. Transition from one phase to another is facilitated by funding generated through various means. These include bootstrapping, equity crowdfunding, angel investors, micro VC’s and Venture capitalists.   Figure 1: Stages of funding in business lifecycle   In a typical business lifecycle, the founder bootstraps the idea with prototype and rolls out the product by generating revenues through angel funding and seeks venture capitalists for future expansion and growth.   Angel Group Angel investors are upscale individuals who invest their money in startup companies or small businesses in exchange for profit shares or ownership equity. Originated from the Broadway Theater, the term “Angel” has become popular in the capital funding markets. The angel investors sometimes organize themselves into networks and form angel groups that invest the collective capital in to new ventures. Angel investors are much more tolerant and encouraging to the startups. The prime focus of angel investors is a brisk growth of the company’s business rather than procuring higher profits. In the United States, the Silicon Valley monopolizes the angel investing market. An angel investor invests somewhere around $25K to $100 million. Traits of the companies that the angel investors look into before investing are: Novel technology or product The quality and liability of the founders Chances of the company becoming the next big thing Well stratified business plan with some evident profit Angel investors are classified into two broad groups: Affiliated Angel: An affiliated angel can be someone with some association with the entrepreneur or the business in which he they are investing but may not be related or a close acquaintance. Non-affiliated Angel: A non-affiliated angel is someone without any connection to the entrepreneur or the business. 2/1/2016 12:00:00 AM Funding Basics - micro VCs and VCs In the previous article we have discussed about the basics of angel investing and now we move on to understand how micro VCs and VCs work for funding. Lets get into the details. Abstract: After understanding the basics of 'angel investing', we move on to understand how micro VCs and VCs work. We also look into the processes involved and some of the prominent firms in the US recently. According to market analytics, the number of healthcare startups has increased by 68% in 2015. This time is regarded as the “Golden Era” of Healthcare startups with Venture capitalists interested to venture in the healthcare sector and reduced initial investment requirement due to cutting edge technology. However, out of 1000 startups only 8 of them can grow big.   At a Glance Micro venture capital Venture capital Venture Capital Firms- The Top Players VC Investment in Health-care in the year 2015 The Process of VC Funding   Introduction Funds are the lifeline of any business. The journey of any new business starts with a great idea and radically passes through several phases of the business cycle. Transition from one phase to another is facilitated by funding generated through various means. These include bootstrapping, equity crowdfunding, angel investors, micro VC’s and Venture capitalists. In this article, we focus on micro VC’s and Venture Capitalists   Figure: Stages of funding in business lifecycle   In a typical business lifecycle, the founder bootstraps the idea with prototype and rolls out the product by generating revenues through angel funding and seeks venture capitalists for future expansion and growth.   Micro Venture Capital Micro VCs are the minor venture firms that principally invest in the seed stage of startup companies that are unable to magnetize the traditional venture capitalist investment. The most common problem faced by any startup is entering into a new market or creating the new market, and the Micro-VCs are much more lenient to these companies and are ready to bear the risks.  General characteristics of Micro VC firms: Predominantly invest at the seed stage Investment on behalf of 3rd party partners Fund limit $50million Nowadays, due to modern technological inventions like Cloud and SaaS, the offsetting a new startup is getting straight forward, and micro venture capitalists are playing an important role in providing the much-needed capital. As a result, the Micro-VC’s are gaining much more profit by investing in the next great idea.   Venture Capital Venture capital is a smart investment which financially backs startup firms and small business which are anticipated to have potential for growth but do not have passage to the capital markets. Venture capital according to business language also termed as the “risk capital” may lead to a share of equity, profits, and even some management role. Some facts about venture capitalists Venture capitalists take the high risk but have the chance to reap greater returns. Venture capitalists are private funders like an affluent independent capitalist or even investment banks. Venture capitalists not only invest in startups, but they also help companies in expansion or even recovery of bankrupt companies. Venture capitalists provide wholesome money as well as help to acquire prestige, because if you can get backing from a venture capitalist that means your business or idea has a great amount of potential for breakneck growth. Venture capitalists invest in the companies that they expect to go big either by going public or merge with larger firms. 2/1/2016 12:00:00 AM Funding Basics - Bootstrapping and Crowdfunding As the number of healthcare startups increase, entrepreneurs face growing challenge for raising the necessary capital. Here we focus on the most common fundraising 'bootstrapping' and a growing modality 'crowdfunding' which is beneficial for the entrepreneurs. 2/1/2016 12:00:00 AM Biomedical Engineering - An Introduction Advancement in healthcare, including quicker diagnostics, newer treatments, and better equipment can be indisputably attributed to biomedical engineering. It designs and constructs innovative devices such as prosthetic limbs and organs, machinery required for imaging techniques, and upgrade the processes involved in genomic testing, in the manufacturing  or administration of drugs etc., thereby enhancing the medical care to the patients.   Introduction   Tailoring treatments aka “personalized medicine” is the holy grail of medical science delivered using Biomedical Engineering. The concept of design and application of engineering sciences to healthcare  has revolutionized the way we perceive science and has led to the discovery of a new branch of science called "Biomedical Engineering." This branch aims at improving the human health care through integration of engineering principles with biomedical sciences and clinical practice.   What do Biomedical Engineers (BME) do?   BMEs design and construct innovative devices such as prosthetic limbs and organs, machinery required for imaging techniques, and upgrade the processes involved in genomic testing, in the manufacturing  or administration of drugs etc., thereby enhancing the medical care to the patients.   Specialties in Biomedical Engineering   The BMEs focus on the following fields:   a) Biomedical electronics: This branch involves association of BMEs with the physicians and other paramedical staff who use electronic devices in modern medical practice. BMEs advise and assist the hospital staff with the safe operation of the technical equipment, because devices such as CT and MRI imaging systems, ICU and CCU monitoring and telemetry systems, heart lung bypass machines, dialysis machines may be complex to operate. However, their assistance is not required while using simple equipments such as electronic thermometers, infusion pumps, and nerve stimulators.   b) Biomechatronics: This branch of science involves the integration of mechanical, electrical, and biological sciences. It also includes the fields of robotics and neurosciences. The main intent of this branch  is to manufacture devices that interact with muscle, skeleton, and nervous system of the body hoping that it may help the individuals who have lost their motor control due to trauma, disease or congenital defects.   c) Bioinstrumentation: It is the application of electronics and measurement principles used to develop medical devices, which aid in the diagnosis and treatment of the disease. Computers play a crucial role in bioinstrumentation, wherein a microprocessor performs a variety of small tasks and a microcomputer processes large amounts of information in the medical imaging system.   d) Biomaterials: These are living or artificial substances used for implantation into the human body.  However, making the right choice of the material for a right individual is very difficult and the biggest trial for an BME. Biomaterials must be non-toxic, non-carcinogenic, chemically inert, stable, and mechanically strong enough to withstand the repeated forces of a lifetime.  So far, metal alloys ceramics, polymers, and composites have been used as implantable materials. New biomaterials include incorporation of living cells, which act as a perfect biological and mechanical match for the living tissue.   e) Biomechanics: The application of the conventional principles of mechanics such as statics, dynamics, fluids, solids, thermodynamics, and continuum mechanics etc. to clinical problems is called biomechanics. The study of movement and deformation of the materials, its flow within the body and in devices, and transport of chemical constituents across biological and synthetic media and membranes can be performed using this branch of science. Advancements in the field of biomechanics has led to the evolution of artificial heart and heart valves, artificial joint replacements and has also offered a better insight of the functioning of components like heart, lung, blood vessels and capillaries, bone, cartilage, intervertebral discs, ligaments and tendons of the musculoskeletal system.   f) Bionics: The application of natural biological principles and systems in studying and designing the engineering systems and the latest technology is called bionics.   g) Cellular, Tissue, and Genetic Engineering: This area of science believes in the treatment of an ailment by targeting the disease at its cellular or molecular level. This requires application of anatomy, biochemistry and mechanics of cellular and sub-cellular structures in order to understand the disease process and to facilitate intervention at specific sites. With these capabilities, miniature devices deliver compounds that can stimulate or inhibit cellular processes at required target sites to promote healing or inhibit disease initiation and progression.   h) Clinical Engineering: The application of technology to health care is called clinical engineering. The clinical engineer is an integral part of the health care team and is accountable for the development and maintenance of computer databases of medical instrumentation and equipment records, and for the purchase and use of sophisticated medical instruments. Some physicians seek their help to adapt instrumentation to their specific needs or for the hospital.   i) Medical Imaging: Integration of physical phenomena such as sound, radiation, magnetism etc. with high speed electronic data processing, analysis and display to generate an image is called medical imaging. This invention produces images with minimal or no invasion, making them less painful and more readily repeatable than invasive techniques.   k) Orthopedic bioengineering: Exercising engineering and computational mechanics to understand the functioning of bones, joints and muscles, and for the design of artificial joint replacements is called orthopedic bioengineering. Orthopedic bioengineers have the following functions: Pursue fundamental studies on cellular function, and mechanosignal transduction. Perform stress analysis of the musculoskeletal system. Develop artificial biomaterials (biologic and synthetic) for replacement of bones, cartilages, ligaments, tendons, meniscus and intervertebral discs. Perform gait and motion analyses for sports performance and patient outcome following surgical procedures.   l) Rehabilitation engineering: The only objective of rehabilitation engineers is to improve the quality of life of patients with physical and cognitive disabilities. They construct prosthetics. Provide assistive technology that enhances seating, positioning, mobility, and communication. Provide cognitive aids for those with cognitive dysfunction.   m) Systems physiology: The use of engineering strategies, techniques and tools to gain understand the functioning of living organisms ranging from bacteria to humans is called systems physiology. It may include computer modeling that deals with description of the physiological events using mathematical descriptions.   n) Bionanotechnology: This area uses nanotechnology in biomedical research. The developments of nanobiotechnology include Nanoscale Nanodevices Nanoparticles This technical approach to biology enables the scientists to imagine and create systems used for biological research.   o) Neural engineering: This discipline uses engineering techniques to understand, mend, substitute, improve, or exploit the properties of neural systems. Neural engineers are competent enough to solve design problems at the interface of living neural tissue and non-living constructs. 1/15/2016 12:00:00 AM How to start a Biomedical engineering company and the future After understanding the basics of Biomedical Engineering, we proceed to learn more about the nuances involved in 'starting' a BME company and its future.   Starting a bioengineering company   The passion and commitment to convert an idea into a creation is where the biomedical startups originate from. But, to survive in this competitive field a cutting-edge idea is the prerequisite. Most of the biomedical companies fails drawing any profits due to lack of business acumen , go-to-market strategy and improper team management.   It is relatively easy to access grant funding for a worthy scientific idea to support continued research and development. But, when the time comes to go-to- market from the lab , the founder needs further external investment to fuel the next phase of growth. Later , there comes a time when business require a good mix of management team to take business forward and seek access to new funding routes for further scalability and profitability.   Following are some tips for setting up successful enterprise:   You  should be master in your domain. You need to build network of professionals who can do things, which you are not good at. They may help you in handling regulatory issues, quality assurance, finance, logistics and commerce. You need to find investors who may fund your bioengineering ideas. Once you  receive funding  from an external investor it is no longer proprietary. You would have to incorporate operation-related suggestions from investors. Once you have an investor, you are obliged to share your ideas on how you plan to make the product a commercial success. Remember at some stage you need investors for scaling-up business so that you can focus on product development and innovations.     Risks associated with starting a bioengineering company   1. Cost pressures: The increase in world population and shift in prevalence and distribution of chronic diseases, combined with escalating research costs, rising global competition, and the increasing complexity of distribution systems, are placing unprecedented cost pressures on the biomedical industry. These cost pressures are paired with increasing pressures from governments, employers, and consumers to reduce pricing and augment global distribution of drugs and devices.   2. Dependency: Biomedical firms are more dependent than most business on the relationship between government and industry. The ability of biomedical firms to promote and sell product hinges upon legislation and the protection of intellectual property.   3. Cross-border mobility: The U.S. is irrefutably the world’s leader in biomedical innovation. However, it is unsafe, because most of the students involved in research aren't from the host country. Therefore, they would return after finishing their doctoral studies and would serve their respective homelands, thereby hindering innovative ideas.   Reputed Universities Offering Biomedical Courses   Johns Hopkins University in Baltimore, MD Georgia Institute of Technology in Atlanta, GA University of California - San Diego Duke University (Pratt) - Durham, NC Massachusetts Institute of Technology - Cambridge, MA Stanford University - Stanford, CA University of Pennsylvania - Philadelphia, PA University of Washington - Seattle, WA Rice University (Brown) - Houston, TX University of California - Berkeley, CA 1/15/2016 12:00:00 AM Biomedical Engineering - market opportunities and innovations With the average life span increasing, people are expected to live longer. As a result, the demand for biomedical devices is growing exponentially. Lets get into the details about the opportunities and innoviations in biomedical engineering.       1/15/2016 12:00:00 AM I am a Startup CEO: how do I "value" my company? According to market analytics, the investment in the startups of healthcare domain has escalated by 78% from the last year. The main reason for this escalation is the fact that the investors want to be “in the saddle” to take risks and venture into new healthcare business. For any startup to get funded, valuation plays a key role. The investors are interested to invest in companies with a promising picture. So, startups probing for funds or profitable exits should analyze each factor contributing to the high-rise of valuation. The prevailing essence of this think piece is to assist the healthcare startup entrepreneurs in assessing the valuation factors, work upon them and raise the company valuation.     1/6/2016 12:00:00 AM Types of market "exits" and a "check-list" After understanding the basics of how to value a company, we need to know about the different types of market exits and to create a DIY self-evaluation checklist. This exciting article explains about the types of market exits and a check list which helps the entrepreneurs to increase the company’s market value for a big hit.   1/5/2016 12:00:00 AM Shortage in Nursing: The Problem Nursing is the largest workforce in health care profession and is one among the highest paying occupation in U.S.A. The nursing industry is estimated to experience the highest job growth in coming years. But there is a global shortage of nurses, in terms of, both the quantity and quality. Now it is important to address the issue and bridge the shortage before the situation gets worsen.     1/4/2016 12:00:00 AM Shortage in Nursing: The Solution   In the prevoius article we discussed about the Problem of shortage in nursing. Now we will continue it by discussing few steps to overcome the lucrative career prospects that arise from the shortage.   1/4/2016 12:00:00 AM Aging population and opportunities for entrepreneurs The world faces a critical situation without precedent. We are moving to an environment where we would have a greater number of older people than children and more people at extreme old age than there have ever been in the past. With the proportion of older people increasing and with life expectancy being on the increase throughout the world – there are several questions that the world is faced with under the circumstance.   Click here to learn more about "Impact of Aging population on healthcare" What can Nations, States and Countries do to establish better healthcare for the aging population?   Here we have to try and examine these issues in detail and make an attempt to address these questions. The emphasis is on the central role that health will play in the coming years. There has to be a better understanding of the changing relationship between health with aging and the global healthcare segment should be able to take full advantage of the powerful resource which is seen in the elderly. Nations, States and Countries have to be willing to develop necessary data systems and research capacity in order to monitor and understand the patterns and relationships for well-being. Research is also to be better coordinated if costs have to be monitored and kept under control. There should be special emphasis on maintaining healthful lifestyles with everyday functioning in countries not affected, whatever stage of economic development the country may be in. Whatever the resources available to the various countries, there has to be awareness and knowledge based approaches to prevention and treatment of heart disease, stroke, diabetes, cancer etc. Needs that will arise from a growth in an aging population percentage Most countries are affected by an aging society and this will place a substantial burden and additional pressure on long-term and income support programs for the older people as well as on publicly-funded health. The demographic changes affecting countries will add to the economic burden and this will also lead to the need for other areas getting strengthened. Additional requirement for infrastructure and institutions needed to help and manage the aging population This investment in additional requirements to meet the growing needs of an aging population is a very important aspect that would need immediate attention and the longer that we find nations delaying this, the costlier and less effective will be the solutions. An aging population is a powerful and transforming force the world needs to contend with. At the national and global levels we are yet to comprehend its full impact. With a new demographic reality projected, we hope to create awareness about this critical link between global health and aging, while emphasising on the significance of synchronised research and rigor in closing the gaps in our knowledge.   All-inclusive public health action is required to address population aging issues. This would mean fundamental shifts in the ways we think about aging itself, and not just in the things we do. The World Report on aging and health provides a framework for fostering healthy aging built around concepts of an efficient, well-structured functional ability. Regardless of their declining physical and mental capacity, older people do wish for respect and well-being and have a desire for holding a fulfilling role in society.   The key points to be noted are: 1. There are several opportunities available for investors in innovative technology which can address the many challenges of aging. 2. The advancements in robotics and telemedicine are bringing in a level of ease and less pressure on medical professionals 3.  The other factor to be borne in mind is that investment in technology alone will not be able to meet all medical enterprise challenges. There has to be full-fledged investment in infrastructure as well along with support services. 4.  There would be the need for big shifts not just on the infrastructure front but also culturally and in most cases it would require the training of older people to facilitate their use of new technological advances in healthcare. 5. An aging population presents many challenges to ensure that our infrastructure can support the needs of the older people to live independent, healthy and productive lives. Changes in demographic structure of the United States and other countries 1.    Estimated 22 % of population will be over the age of 65 by 2030 and the fastest growth of cohorts in this subgroup will be in over 75. 2.   Currently 44.5 million are over the age of 75; by 2050 this number would have increased to 50 million; 3.    Such changes are occurring worldwide. By 2030 percentage of people over 65+ will be about 24 percent in Europe and 12 percent in Asia and Latin America. 1/4/2016 12:00:00 AM Impact of Aging population on healthcare Aging leads to decrease in mental and physical capacity, risk of disease and eventually death. Older people are sometimes seen as a burden to society and the onus rests on the public health systems and society as a whole to look into these issues which have led to discrimination. This article describes about the impact of aging on healthcare.   Click here to learn about "Aging population and entrepreneurial opportunities" How do countries prepare for an aging population and improve upon chronic disease management With long term trends of an aging population and with an increase in people perpetrated with chronic diseases, we see a greater need for health care services in developed and emerging economies in 2016 and beyond. The aging population is expected to triple in the next half-century and this increase in life expectancy will place a huge burden on the health care system in all countries. The other shared demographic among countries is the trend wherein the spread of these chronic diseases like heart disease, stroke, cancer, respiratory disease, diabetes and mental illness, among others, have been seen as the leading cause of mortality in the world which may be attributed to an aging population, diet changes, increased obesity levels and improved diagnostics. Biology of Aging Aging occurs due to the wide range of cellular and molecular damage happening over time. This leads to decrease in mental and physical capacity, risk of disease and eventually death. While this is neither linear nor consistent, these changes are loosely associated with a person’s age. This relates to the discrepancy we see in the fact that a few 70 year-olds seem to enjoy good health, while there are others in the same age who seem to have become frail and require significant help from others for sustenance.   Other than biological causes, there are other life transitions which are also causes for aging, such as retirement, relocation, better housing requirements and death of partners or friends. Therefore while looking at developing a public health system it is important that we look into reinforcing recovery, psychological growth as well as adaptation of the individuals rather than just ameliorating the losses associated with old age. Health conditions associated with aging Hearing loss, refractive errors, back and neck pain, cataracts, neck pain, osteoarthritis, chronic pulmonary disease, diabetes, dementia and depression are some of the common ailments afflicting people as they age. As people age they also experience several of these conditions simultaneously. There are the complications brought on by the geriatric syndrome which leads to the emergence of several complex health states which do not fall into any specific disease category. These arise due to underlying issues such as urinary incontinence, frailty, falls and pressure ulcers. Geriatric syndromes are better predictors of death than the number of specific diseases present. In spite of these, traditional structured health services often overlook geriatric medicine as a speciality. What are the challenges faced by nations trying to deal with an aging population Diversity in older age There is no specific “older age” that one can benchmark and there are a few “80 year-olds having the physical as well as mental capacity of 20 year-olds, where as there are others who experience significant lowering of mental and physical capabilities at a much lesser age. If there is to be an all-inclusive public health response, all these wide ranging experiences of the aging population have to be taken into consideration. Inequalities in Health With the inequalities in health being due to several factors such as the family we were born into, our ethnicity, sex etc. these also have a cumulative effect on the impact across our life course. Therefore there is a greater need for public health policies to be created to reduce these inequalities rather than reinforce them. Changing world and its impact on healthcare Older people, being old and frail are sometimes seen as a burden to society and the onus rests on the public health systems and society as a whole to look into these issues which have led to discrimination, the way policies are being created and the many difficulties older people have to experience. With technological advancements, globalization, changing gender norms and migration the lives of older people is being affected in indirect and direct ways. The public health systems should take stock of these changing trends and frame policies accordingly. Health care expenses associated with aging In the year immediately before death is when a large proportion of health care costs attendant with advanced aging is incurred. With people surviving to increasingly older ages, there is a high cost of prolonging life which is shifted to older ages. The extent and nature of medical treatment at very old ages has become a contentious issue. Statistics and data from the United States suggest that there is great increase in healthcare spending at the end of life as compared to spending in general. International organizations as well as governments are emphasising on the need for cost-of-illness studies particularly relevant to age-related diseases which will aid in the assessment of the burden expensive chronic conditions – Alzheimer’s disease for instance.   1/4/2016 12:00:00 AM Basics of Rehabilitation/Physical Therapy services With the rising population affected by chronic diseases, the number of physically-challenged people is also increasing. So, rehabilitation services are required to provide functional independence, prevent further loss of function, and improve the quality of life of patients with physical illnesses or other chronic disease conditions.   Why the Business of Rehabilitation and Physical Therapy Looks Promising? A large number of people around the globe are either physically, mentally, emotionally, or developmentally impaired. Nearly 15% of the world’s population has some form of disability. With the rise in the population affected by chronic diseases, the number of physically-challenged people is also increasing. Moreover, age is also a contributor to this impairment. Disability hampers the reach of the population to health care facilities, thereby resulting in the severity of the suffering. Rehabilitation services aim to provide functional independence, prevent further loss of function, and improve the quality of life of patients with physical illnesses or other chronic disease conditions. Rehabilitation therapy emphasizes on – Physical therapy that helps improve strength, mobility, and fitness Occupational therapy that aids in daily activities Speech-language therapy  that helps with speaking, understanding, reading, writing and swallowing Treatment of pain   Types of rehabilitation therapies The type of rehabilitation therapy depends on the patient’s suffering. Medicine and physical health – This can be categorized into: 1. “Physical medicine and rehabilitation” (PM&R), also known as physiatry, is a branch of medicine that intends to improve and restore the functional ability and quality of life of the patient’s having physical impairment. 2. “Physical therapy”, also known as physical rehabilitation or physiotherapy, deals with the treatment options and exercises required for alleviating physical disability by promoting mobility, which results in enhanced functional ability and improved quality of life. 3. “Aquatic therapy” uses water during the treatment and also during exercises. This type of therapy is used for relaxation, fitness, physical rehabilitation, and other therapeutic benefits. 4. “Medical nutrition therapy” (MNT) involves restricting the patient to a specific diet program to achieve the desired outcomes. 5. “Physical activity” aims to enhance or maintain physical conditioning and boosts the overall health and wellness of the individual. 6. “Sports medicine” focuses on physical fitness, treatment, and prevention of injuries related to sports and exercise. 7. Athletic training, exercises and regimes to uplift the performance and ability of the individual to participate in athletic activities. 8. “Vision rehabilitation” is a form of rehabilitation service to the visually impaired, aiming to impart facilities that assist in restoring functional ability and improving the quality of life and independence. Mental health   Rehabilitation services for the mentally challenged include -   1. Drug Rehabilitation/Medical/Psycho-therapeutic treatment: This form of rehabilitation service is offered to an individual who is dependent on alcohol, prescription drugs, and street drugs.   2. Rehabilitation for an individual with charges of a criminal offence (Penology).   3. Rehabilitation services for individuals with alterations in neurocognitive function caused due to a disease or an injury (Neuropsychology).   4.  Psychiatric rehabilitation intends to restore mental health in individuals with mental illness.   *Rehabilitation facilities use robots to enhance rehabilitation. Another revolution in this segment is the introduction of “telerehabilitation”, which uses telecommunication or/and internet to render rehabilitation services.   Classification of Rehabilitation Services   1. Inpatient Rehabilitation Services: These services refer to those that are offered to an individual during his/her stay in the hospital or a rehabilitation center. The inpatient rehabilitation may last for weeks to months. Once the patient is out of the inpatient rehabilitation, he/she is discharged from the hospital with adequate training on self-management for the present as well as in the future.     2. Outpatient Rehabilitation Services: This type of rehabilitation service is associated with performing all the daily activities by staying at home and offering frequent visits to the rehabilitation center for treatment, as and when required.   3. Residential Rehabilitation Services: This type of rehabilitation program requires housing of the individual during the entire course of treatment and lasts for 28 days. The participation of the individuals in this type of program is voluntary, and obligatory, unless and until ordered by a court. Residential rehabilitation programs differ in the extent of restraining the patient to the house. Like, locked-door programs require complete restraint of the individual to the house/facility, whereas others do not require restraint and also prohibit the return of the individual.   4. Executive/Luxury Rehabilitation Services: In today's world, everyone is too occupied to look after anyone. So, when one wants to look after someone, but cannot, centers like executive rehabilitation centers can be a great option. These centers provide the individual with all the luxuries that one would get to staying in a multi-star hotel, ranging from the gym, massage, to appetizing food. So, if one couldn't afford the time to care for a patient with substance abuse or behavioral addiction, executive rehabilitation services could be a significant alternative.      A large population of the U.S. needs rehabilitation services. The top 10 rehabilitation centers in the USA are:   Rehabilitation Institute of Chicago in Chicago, IL Kessler Institute for Rehabilitation in West Orange, NJ TIRR Memorial Hermann in Houston, TX Mayo Clinic in Rochester, MN University of Washington Medical Center in Seattle, WA Spaulding Rehabilitation Hospital-Massachusetts General Hospital in Boston, MA Craig Hospital in Englewood, CO MossRehab in Elkins Park, PA Rusk Rehabilitation at NYU Langone Medical Center in New York, NY Shepherd Center in Atlanta, GA 10/28/2015 12:00:00 AM How to identify business opportunities in Rehabilitation/Physical Therapy? After understanding the basics of Rehabilitation/Physical Therapy, here we continue our discussion on how to identify business opportunities that is useful for further expansion. At a Glance Translating health care opportunities into business Six steps for setting up rehabilitation business The take away For Basics of Rehabilitation/Physical Therapy, CLICK HERE! Translating health care opportunities into business Many private equity firms and healthcare companies are keen in evolving the market of addiction into a business world. According to a report, the addition rehabilitation services has grown to $35 billion in 2014 from $21 billion in 2003. These numbers show promising growth in this sector. Market trends The rehabilitation therapy industry of the U.S. is greatly shattered. The top 50 companies in the health care resort to less than 25% of the revenue. Not even a single participant shares 5% of the total market revenue. Small scale health care centers contribute to approximately 45% of the physical therapy clinics. However, their growth is limited due to- Underdeveloped referral sources and infrastructure Well-established organizations with  happening alliances Figure 1- Reimbursement for Rehabilitation and Physical Therapy The outpatient rehabilitation centers contribute $29.6 billion, that is presumed to grow by 7% every year till 2018. Physical therapy alone accounts for $26.6 billion, i.e. approximately 90% of the outpatient rehabilitation expenditure. Figure 2- Competitive Analysis Factors suggesting long-term growth Aging U.S. population Growth in employment Unhealthy lifestyle among youth Increasing penetration of physical therapy services New government regulations (e.g., the PPACA) increasing patient access to physical therapy Outpatient rehabilitation is significantly less costly than surgery or hospitalization, but with similar clinical effectiveness Figure 3- U.S. Outpatient Rehabilitation Expenditures Figure 4- Outpatient Rehabilitation Spending by Segment Physician-owned physical therapy practices (POPT) from 10-15% of all physical therapy clinics and represent an ultimate market opportunity. They provide an excellent opportunity to the physicians to serve their patients better with greater convenience, enhanced results, and continuity of care by serving them in the office setting. 10/28/2015 12:00:00 AM What is Population Health Management? Population health management is about organizing system in place to manage population proactively and deliver the highest quality care while reducing the cost of engaging patients. This article explains about the basics of Population Health Managementand its success.   Population Health Management (PHM)   With the most advanced and sophisticated healthcare system in the world, the USA might be the most expensive medical care destination. But their expenditure is healthcare is skyrocketing due to lack of access to healthcare for many and gaps in the care provided. Experts in healthcare economy express the need for an organized healthcare reform focusing on making health care more affordable, accessible and delivering high-quality care for all the citizens in the USA. Healthcare reform- The need for PHM The first step towards the reform was HITECH Act of 2009 which authorized $19 billion in federal subsidies to physician and hospitals for the Meaningful Use of electronic health records. The Patient Protection and Affordable Care Act of 2010 encouraged providers to responsibility for the cost and quality of care. The Centers for Medicare and Medicaid Services (CMS) were instructed to create a shared savings program for accountable care organizations (ACOs).  ACOs are groups of physicians and hospitals dedicated to reducing the heath care cost and to improve the quality of care. As per this program, which began on Jan. 1, 2012, federal government will penalize hospitals for avoidable readmissions and base a portion of their reimbursement on quality measures. The entire objective of the reform is to move to pay-for-performance from fee-for-service, which is considered as a major reason for cost in U.S.Healthcare system.  With the initial success of Patient-Centered Medical Homes (PCMHs) and Accountable Care Organizations (ACOs) models, the reimbursement system is likely to replace fee-for-service.  The current shift in healthcare systems will involve increased financial and clinical accountability.  Thus, the healthcare system in the US is opting for “population health management" - An approach to providing affordable, quality healthcare and reduce the healthcare cost. The aim of population health management (PHM) is to keep the patient population healthy, minimizing their encounter with emergency department, hospitalizations, and procedures. It helps to redefine care delivery paradigm from a disease-specific approach to patient-centric approach. To meet its objective, PHM requires automation across the continuum of care to access population needs and stratifying risk  based on patient risk arrived by analyzing clinical and non-clinical data.   Successful Implementation of PHM Program   A PHM program, implemented successfully, can work wonders in cutting down the healthcare expenditure and improving your patient’s health outcomes. The following five steps will help providers in planning for successful implementation of PHM program.   DATA is the ‘IT’ thing   Data is the heart and soul of PHM. The healthcare system yields a huge volume of data, at every touch point, from a patient-physician visit to discharge, from medication to health message alerts, from billing to insurance department.  These data sets, generated at different levels of care, are just dots. The first step towards implementing PHM begins with connecting these dots by acquiring, aggregating, and leveraging clinical data across the care network.  The PHM system demands an efficient data collection, storage, and 360° automation. This implies that we think beyond EHR and its interoperability with other systems. Efforts to make the EHR more sophisticated for data capturing at all levels may be worth exploring.   Analyze the population data:   Data without actionable insight is a waste. Analytics helps in giving insights into the population health status which is the core of any successful PHM program. Algorithms, designed using risk scores using clinical data from electronic medical records and claims, may help to predict vulnerable population.   Supported by non-clinical scores such as compliance, access-to-care and socio-economic, these analytics may help to identify the patients who have a high risk of being hospitalized or likely to have an expensive intervention. The data analysis may facilitate complex tasks such as tracking of the health status of patients, reminding them about medications, and warning them about the risks associated.  These interventions may ultimately result in improved patient outcomes, contributing to treatment success.   Bridging the care gaps   There could be many differences or gaps in care, when utilization of health care is compared to the distribution of healthcare, when the treatments provided are compared to the treatment outcomes, when the treatment ordered is compared to the treatment instituted. Care gaps can occur at any level of healthcare, due to numerous reasons. These gaps in care may adversely affect the healthcare costs and the patient health outcomes.     The patient clinical data and utilization pattern, captured through a PHM program, is used to determine whether the patient has a gap in care. Based on this analysis, the care manager designs personalized a care management program to engage at-risk patients in receiving necessary services, alerts, and reminders at the point of care. Engage your patients for better health outcomes:   Population health solution strives to engage patients at various touch point along with physicians and other clinicians. To optimize the patient engagement, the physicians and care coordinators must be in constant touch with their patients, even if they are out-of-the-hospital. Contact can be established and maintained by sending reminders to the patient's mobile phones, delivering e-mails, or placing a call. However, new technologies like telehealth devices seem to be a great promise. Using these devices, the physician can analyze the telemonitoring data and prescribe preventive and curative measures. Empower and support the primary care physicians Primary care physicians (PCPs) are the first point of care for most patients. Therefore, it is important to empower the PCP to ensure that patients receive appropriate and timely care. However, due to shortage of PCPs, formation of a care team, consisting of physicians, nurse practitioners, medical assistants, dietitians, physical therapists, care managers, health coaches, or other professionals, may be needed. The objective is to manage more patients and address their needs timely and efficiently.   The health care system in U.S. is a one-to-one effort, that is, the patient consults the provider even for an insignificant query. But, in the near future, the workflow might change to include phone visits, e-mail consultations, group visits, and encounters with a variety of care team members. This would then reduce the number of hospital visits, thereby benefitting both the PCPs and the patients.     8/5/2015 12:00:00 AM Learning from successful Population Health Initiatives In a previous article, we learned about the basics of Population Health Management. Here, we delve into accountability measures for PHM - does it work? We also review some successful initiatives and learn from them.   To learn about Population Health Management, CLICK HERE!   Measuring the outcomes of PHM- The Litmus test The effectiveness of any program is measured through its outcomes. An outcome measurement in the form of a dashboard view of risk stratification, prevalent health conditions by population area or the evaluating provider, and practice performance may point towards weak areas that need strengthening and ineffective programs that need further modification. These adaptations would require a trained clinical analyst on board to filter the results by payer, activity center, provider, health condition, and care gaps to measure the outcomes specific care management programs. The consequences of the PHM program can be measured in 3 ways. They are as follows - Financial outcomes: A successful PHM program attenuates the cost of the health care incurred by a patient. Edging off the cost burden of the patients can be achieved by focusing on prevention and reducing the risk of further complications, through measures as simple as promoting medication adherence. Clinical outcomes: The measurement of clinical outcomes should include both process metrics and outcome metrics. An example of low-cost intervention is medication-reconciliation program.    Engagement outcomes: As prevention of a disease or reduction of its likelihood depends on the selection of choices of the daily activities a patient performs, the participation of patients' in various activities affects the results of PHM. Therefore, their engagement should also be monitored. If the indicators reveal improved patient outcomes or reduced healthcare expenditure, it means that your PHM program is implemented successfully!   8/5/2015 12:00:00 AM Traits of a "healthcare leader" Leadership is essentially an ongoing job and always remains one journey - a never ending journey with elements and facets that add up to a broad and complex scenario. Entrenched in the leadership role are a multitude of behavioral, interactional, relational and structural considerations that provide meaning to the role. This article describes about the skills required as well as the challenges faced by the leaders in order to succeed in today's business world.   What does leadership mean to healthcare professionals?   As the world changes, there are newer and better ways of organizations and people with new patterns of behavior being seen and these demand certain levels of illumination and understanding. Infact, like any other industry the healthcare segment is also undergoing a huge shift and is reconceptualising its agenda, work and priorities to take into account global realities and technological advances. This has led to greater need for healthcare leaders to push their organizations into the fray. These leaders have to bear in mind that they cannot just push people into a future solely envisaged by them. They also need to bring everyone to the table so that the future can be shaped by mutual, co-operative dialogue and rigorous, concerted action.   This article looks into the skills required as well as the challenges leaders have to face in order to succeed in today’s business climate. What makes for the new leader and what goes into the making of this new leadership talent With a group of professionals coming together as an interdisciplinary team, delivery of health care today has changed. There are many factors and forces that are shaping this industry and these changes are driven by markets, changes in health concepts, and well-being, research, technology and discovery. It is only through dynamism in leadership that leaders can consider themselves equipped to position themselves to guide these transformations. These leaders have to learn the management skills required by healthcare leaders to succeed in today’s business climate, to solve business challenges to enable the enterprise’s bottom line. The changing face of leadership in the healthcare segment The four areas that require industry convergence can be classified under the broad heads and four key trends as well as progression drivers.   Strategic market access Patient centricity Innovation Health Management   All these areas have significant implications for tomorrow’s healthcare leader. Starting from functional leadership to managers to CEOs to the Chairman each one should bring unparalleled tactical and strategic vision along with a greater appreciation for newer ideas and business models. The older ways of doing business will not be sufficient anymore and leaders need to prepare themselves to find people with cross-functional skills and individuals desirous of expansive careers. For securing the right talent organizations would now have to look outside and for the right skills for the sector which is changing rapidly and constantly. The market place is indeed competitive for leaders with digital experience and will remain so for years to come.   7/4/2015 12:00:00 AM How to practice effective healthcare leadership? A leader should have a few effective leadership qualities to lead a team. They need to build a vision and strategy for the future. This would help the members of the team to focus all their energy in the care and service to the patients.This article descibes about the best practices for effective leadership.  To learn more about "Traits of healthcare leader" click here! Leading with care What does this entail for the new generation leader? Understanding the unique qualities and needs of his team Providing a safe and caring environment to every member of the team enabling them to do their jobs effectively Having the essential qualities a leader in the health and social care segment should possess Why is this important?             Leaders are meant to understand the underlying emotions that affect their team members while caring for team members as individuals, while helping them to manage their feelings. This would help the members of the team focus all their energy in the care and service of the patients. What it is not? It does not allow anyone to make excuses for poor performance Does not encourage the possibility of the leader not taking responsibility for the poor performance of members of your team Failure to comprehend the impact of your emotions or conduct with colleagues. Taking responsibility away from the others in the team   Other important attributes to be seen: Caring for the team Providing opportunities for mutual support Recognition of underlying reasons for behavior Spreading a caring environment beyond one’s zone of influence The healthcare leader of today is Versatile and Decisive   Research has proven that 30% of senior healthcare leaders are responsible for manifold executive roles. Healthcare leaders who have an education which covers many disciplines often have an advantage since they are expected to take on diverse responsibilities. Studies show that most successful CEOs with a medical or clinical degree also hold a master’s degree in administration.   The new environment needs leaders to encourage a collaborative spirit and thereby improve the skills of the workforce. The ability to mentor and inspire the workforce is a trait that is a must in the health care professional of today. Those executives who are able to create a new list of traits that the fast-moving healthcare marketplace requires will be better equipped to manage and handle the challenges and the competition for future career opportunities.   Thus the transformation of the healthcare industry has in turn seen the evolution of the healthcare executive. Practices for Effective Healthcare Leadership While we may list several personality traits that are desirable in the healthcare professional and those that define a successful healthcare leader, there is no one single trait that defines success. There are on the other hand practices and tendencies that these leaders share. Firstly, they should have a vision and strategy for the future. They have to inspire performance in others in the pursuit of their individual goals. The primary focus and mandate of any healthcare industry is to improve the quality of healthcare in the societies and communities where they serve. These leaders may vary in their individual vision and goals but by and large they have striking similarities in terms of essential, fundamental skills that they possess in order to build success. These are elucidated here: Building Strong Teams:   As healthcare evolves it will continue to require greater collaboration and with patient focussed medical homes becoming the custom model, the need for alliances, partnerships and teamwork becomes intensified. Hence the need to understand the effective allocation of talent to build effective teams, while having the confidence to let the teams work together. The more effective the teams, the greater the variety of skills and experiences they exhibit. For leaders to be successful they should begin with recruiting the right team with the right skill sets bringing together the many varying experiences of people from different backgrounds, perspectives and ideas. These leaders would then have to ensure that the carefully chosen team is provided with the right collaborative environment to bring out the best in themselves and the rest of their team members. These leaders then provide their folks the freedom to explore new possibilities.   7/4/2015 12:00:00 AM Physician Innovators The first requirement of a physician leader is humility. Physician innovators are aware that innovation is a team sport and a multi-disciplinary approach that ensure the professionals to the top of their license.Physicians who are willing to take on the challenge of leadership roles in healthcare organizations have to be willing to lead, redesign care and build outstanding teams from the outset. They should have the certain characteristics to lead a team .   The new breed of physicians needed today are Physician Innovators This is the conclusion from all experiences and the findings of a few medical practitioners, chief among them being Donald M Berwick, MD, President Emeritus and Senior Fellow, Institute of Healthcare Improvement.   He has written a book “How physicians can fix healthcare, and here we bring you a few valid theories, hypothesis and findings from his research.” He says that physicians need not lead the charge alone. There are physicians who have co-led innovation with non-physicians. In this case the physician is the medical director whereas the non-physician is the operations director. There is the other scenario wherein the non-physician with a tremendous amount of resource can lead the change and take different initiatives where by the physician may not be involved but will stand to benefit in terms of his work life becoming easier. Such work that’s see represents less than 10% of the total work that needs to be done. This brings us to the question – What does a physician innovator look like? What is to be expected of a physician innovator? According to Dr. Donald M Berwick the first requirement of a physician leader is humility. Physician innovators are also aware that innovation is a team sport and a multi-disciplinary approach should also ensure that the professionals are elevated to the top of their license. Physicians who are out there who are willing to take on the challenge of leadership roles in healthcare organizations have to be willing to lead, redesign care and build outstanding teams from the outset.   The initiatives should have the following characteristics:   1.      There should be steadfast support and engagement from senior leaders. 2.    These initiatives have a substantial impact on the work lives of the physicians involved 3.    There has to be a resource commitment – least of all a few people, full time on each initiative 4.    For a particular patient population this initiative should involve redesign of care right from scratch.   He also says that in his experience, the odds of success is a lot higher in those instances where physicians lead.   The American Association for Physician Leadership has been very supportive of innovation in healthcare delivery and believes that physician leadership is at the forefront of such innovation.   7/2/2015 12:00:00 AM Why do we need Physician Leaders today The multitude of challenges that healthcare organizations are facing today with the rising rate of chronic illnesses, an aging population, changing laws and regulations, health care reform and implementation of ACA. The forum also sees that there is a well-defined connection between physician leadership and high performance. There has been extensive reviews of material available and dozens of interviews conducted with healthcare leaders which all go to affirm that matured physician leadership will be needed for healthcare to make a definitive move towards higher quality, consistent safety, efficiency and value. What makes physicians best suited for the role? Physicians with their complete and deep clinical understanding, along with the unswerving desire to provide the best care to their patients, are best suited to be able to bring about change and betterment in health care which is the bedrock of success and health care reform. ACPE (now AAPL) has also seen that there is a rise in enterprises willing and seeking to engage physicians and to educate physician leaders in their new role. As per a survey conducted by the Medical Group Management Association, there is a 75-per cent increase to the number of physicians being engaged and employed by hospitals since 2000.   What are the disruptions in the healthcare industry and what is the outcome of such disruption? What role do physicians play in the current scenario?   The healthcare industry has entered an era of such distinct change and disruption along with an industry with great demands and growth, that physician leadership has become the need of the hour. “The healthcare segment has slowly and steadily moved towards “value-based care” and this is going to lead to the greatest change experienced for the last hundred years in healthcare”, says Dean Gruner, MD, president and CEO of Theda Care Inc., and a board member of the Theda Care Center for Healthcare Value in Appleton.   All this points to the enormous responsibility that falls on physicians and the current environment presents most outstanding opportunities for physicians to grow and develop permanent, life-long improvements in healthcare.   A collection of elements and forces place physicians at the crux of the matter and center stage: There has been a very fundamental redesign of care models in the clinical arena in several settings. The changes in financial payment models which have been rewarding health care organizations for clinical excellence while enabling provision of coordinated care at reduced costs. There has been a major shift from a volume-based to a value-based system in healthcare. The focus on managing public-health and moving populations towards wellness. The evolution of capitation, bundled and payment strategies. 5% of hospital leaders are physicians today, and given the tremendous change seen in this segment and considering the need for greater focus and diligence in healthcare this number is expected to increase rapidly. According to Maureen Bisognano, president and CEO of the Institute for Healthcare Improvement in Cambridge, MA, “It’s a wonderful sign that physicians are expanding from clinical care to include learning what it takes to be a good leader” and he says that this bodes well for healthcare. 6/5/2015 12:00:00 AM Global healthcare evolution over the past 30 years Globally, the healthcare sector has been undergoing drastic change in the last 30 years and most countries have been focussing on healthcare costs with worldwide financial crisis and climate of austerity bringing in drastic change. Socio economic, structural and clinical changes have ushered in a period of unrest and disruption with most countries grappling with the changes.With these changes the existing business models and healthcare processes will not suffice. In this article we look into the changes that have affected the healthcare segment in the last 30 years, the impact on costs and what are the many ways in which the segment and the entrepreneurs have thrived during this period. ​   To read more about “Global healthcare challenges - an eye on South Africa”, click here! Declarations for global health – What was the Alma Ata?   In the last 30 years we have seen a greater global response to the health problems. In the year 1978 there were 134 health ministers who signed the Alma Ata Declaration which had set a deadline for the achievement of global health at a certain level by 2000, which would ensure that people around the globe would lead a communally and economically productive life. Strategy to achieve this goal: Primary healthcare with community participation while tackling the root cause of disease such as poor sanitation, illiteracy and poverty. Globalization is now seen as an additional hazard to achieving this health status which was contained in the declaration.   The estimated 800 million are still lacking access to the most basic of healthcare services. However, there are a few who see globalization as a boon that can enable easier accomplishment of the “health for all” status.   The year 1998 saw the emergence of a new global health policy “Health for all in the 21st Century” which brought in additional elements not seen in the original Alma Ata. In this new version the importance of seeing health as a precursor to sustainable human development and the importance of seeing it from a gender perspective were both emphasised. Health for all in this policy meant the following: Health security for all Increasing life expectancy Achievement of global health equity Access for all to essential healthcare of quality   The first international health conference held in Ottawa in November 1986, had a charter which supported the health for all initiative which was to be implemented by the year 2000. This conference was in response to a growing expectation for a new public health movement around the world. While the focus of this conference was on healthcare needs in industrialized countries, this took into account concerns in all other regions as well.   These charters made a set of recommendations based on an analysis of world health problems and existing policies and programmes. These charters made recommendations to government organizations, international and non-governmental organizations and the business sector. The assertion made by this agreement and charter was that “Health and human rights should prevail over economic and political concerns”. The charter also called for “world-wide and all-inclusive, comprehensive primary healthcare regardless of people’s capacity to pay”. The Task force for Global Health – 30 year history   This task force was guided by the edicts of social justice, stewardship and compassion for the 30 year period.   Beginning with the early efforts to increase childhood immunization rates, the task force engaged partners from diverse backgrounds including Ministers of Health, foundations, Industry partners and pharmaceuticals, and international health organizations.   Their motive - to provide millions of people in the developing countries access to good health. These values continue to work till date. Achievement – More and more people had access to vaccines for influenza, polio, cholera etc. as a result of their work for Center for Vaccine Equity (CVE)   Worked with the support provided by Bill and Melinda Gates Foundation, CVE worked with partners from diverse fields such as WHO and Rotary International etc. to ensure the success of the “last mile” of polio eradication.   The center for Vaccine Equity (CVE) helped many countries by introducing poliovirus vaccine and made all coordinated efforts to develop antiviral drug therapies to help in the treatment of people who are immunecompromised, in reducing threats to themselves and in the eradication effort. This year also saw efforts by CVE to increase access to seasonal influenza vaccine for high risk people in four developing countries. Pharma companies were seen to participate in good measure in this effort by donating nearly 980,000 doses of vaccine for this effort. The final effort was made by Rotary and CVE as partners in the prevention and control of cholera. 5/5/2015 12:00:00 AM Global healthcare challenges - an eye on South Africa The National Healthcare Insurance (NHI) is directed and controlled by the department of health. The primary aim of this system is to give all South Africans access to quality health care to change the face of the healthcare sector. In this article we look into the global healthcare challenges in the south africa. To read more about “Global healthcare evolution over the past 30 years”, click here! Challenges faced by the public and private sector in dealing with the issues in global healthcare   a)The dialogue between the public and private sector is seen to be changing, as the global population ages and the prevalence of chronic disease rises in mature and growing countries alike. b)Both the public and private sectors realize they can’t address these challenges alone. c)There is hence a rebalancing of the delivery of care in the financing models, both in the public and private sectors. d)The situation calls for clear government policies and strategy to ensure how healthcare services are delivered, particularly with respect to the relationships between public and private providers is an important aspect of the challenges faced. e)The public sector is seen to be beleaguered by a number of weaknesses in terms of the inefficiency of service provided, poor staff motivation, poor working conditions along with geographical imbalances. f)The private sector with poor regulation operates in isolation with profits being the primary motive. g)This increases the burden on the government to abandon its passive role and direct the private sector to realise its potential to drive growth. 5/5/2015 12:00:00 AM US Healthcare system - The Origin The United States healthcare system originated in the 17th century from a simple method of home medication and itinerant doctors with minimal practice, to a more complex, technological, scientific, and authoritative system called the "medical industrial complex". This institute was based on medicinal science and technology,and was under the influence of medical professionals. This system evolved due to the recognition of the "germ theory" as the origin of the disease, professionalism of doctors, technological developments, emergence of medical schools and medical insurances, and the expansion of profit making medical healthcare units. This article explains more about its origin.and modern technologies.    To continue reading and learn more about “Filling gaps in the US healthcare system”, click here! Early Medicines: Before the eighteenth century, women in the household took care of the sick within the family and in case of very severe and aggressive illness the doctor was called. “Domestic medicine” was a mixture of scientific medicines and home remedies, developed by itinerant doctors. Practicing midwifery and taking care of women in labor and during delivery was a prevalent profession among women, as deliveries took place within their houses.   Western medicine was grounded on the Greek notion of “four humors”- blood, phlegm, black bile, and yellow bile. A balance between the humours led to good health and an imbalance caused several diseases. The medicinal properties of hot, dry, wet and cold compositions, and a range of plants and herbs, were also considered.   Surgeons and “bone-setters” were occasionally summoned. In the late colonial period, well qualified and trained physicians manifested in America.   The Massachusetts Medical Society formed in 1781 and the first college of medicine established by The University of Pennsylvania in 1765, licensed the physicians. Physicians who sought after progress in American medicine and medical profession established new medical schools. Well-equipped doctors became more authentic and practiced as entrepreneurs, accepting service charges. Origin of germ theory: The 18th century physicians emphasized that diseases originated and spread through germs and social environment. City governments formed health departments and the municipal dispensaries offered free consultation in cities, when worries about hygiene and sanitation arose, due to the outbreak of tuberculosis, diphtheria, cholera and yellow fever. Eventually, the government-financed public health and healthcare, and the private health centres declined. 3/6/2015 12:00:00 AM How do I "create" that billion-dollar healthcare idea? The healthcare professional is quite innovative, and yet we find that most ground breaking ideas fail to leave the ideation board. Healthcare industry is evolving day by day, not just due to government intervention but also due to healthcare being taught as a way of life rather than as a crisis to be dealt with. Healthcare industry trends also offer tremendous business opportunities for entrepreneurs no matter what. Entrepreneurs have responded by finding and providing newer and better solutions to old problems and launching new businesses to meet the needs of an aging but health conscious people.   To learn more about “Gaps and Opportunities in Healthcare”, click here!   Reality check The “idea” can make or break a startup, whereas picking the right idea can help you get a good start. With these insights from us you will gain a big-picture view and in-depth insight into what will make the best startup idea for you. This guide will introduce you to the fundamental, vital and crucial concepts about ideation for startups that you should essentially understand before embarking on your journey.   There are three principal paths to new entrepreneurial ideas 1. The “spur-of-the-moment” idea   This one hits you when you are driving, talking, with friends, in the shower or squiggling when in a meeting. The dots have connected and you are left with a great idea, a sudden inspiration making you excited!   You are not able to believe that until now no one else had thought about it. The value of this new idea seems pretty obvious to you. You now go online and start looking up the idea and you find that someone had already thought about it. That’s disappointing, but you continue thinking of that particular entrepreneurial idea and speak to friends and colleagues about it.   You slowly start seeing problems in the execution of that idea. You get feedback from valued sources that talk about that segment being a low paying one or a tiny market etc. The idea may turn out to be a great one, but you are not sure.   You have a good job and you don’t know if you wish to step into unchartered territory. Your dream of medical entrepreneurship slowly dies. Giving up could have been the right decision at that time! So cheer up! 2. The insider idea You may be the one who spent many years, say the last 10 years of your life, working in the medical field in the capacity of a doctor, and have been noticing several voids in the industry or issues relating to the kind of medical facilities made available as well as the quality of treatment available.   You may have been the one who has pointed out these deficiencies time and again, but, the hospital, as well as the medical fraternity has had other priorities. Therefore, there has been no significant change. There may be the situation where you have seen your company employing several vendors who are paid huge sums to do some work, but you find that the results are always insufficient and lacking in many ways. You probably see a better way to do it.   Or you may have seen your hospital kill a great new product or feature due to political or organizational reasons. In all this you see an opportunity to do these things on your own and have been gathering information, and have been talking to trusted co-workers as well as industry experts in your contacts, looking at the viability of solving the current problems, bridging the gap and thereby adding value to the system.   The interesting thing, in this case is that you are already well-positioned, networked and knowledgeable in the medical field and in this particular business space. This will add enormous value to the new venture you are looking at.       2/2/2015 12:00:00 AM Gaps and Opportunities in Healthcare Healthcare system is everywhere broken and we are all aware of it.This gaps and issues made the entrepreneurs immense the opportunitues to look into and to start their own venture. In this article we will discuss about the issues which are solved by the entrepreneurs.  To learn more about “How do I create that billion-dollar healthcare Idea”, click here! Gaps and issues with healthcare sector, seen today and the opportunities thereof   Healthcare system everywhere is broken and we are all aware of that. The system wastes billions of dollars annually and yet fails to deliver the right care. It is indeed clear that the system needs to be fixed! Many of these issues are being attended to by the government – people are forced to take an insurance policy or pay a fine, there are preventive services that citizens are entitled to with no extra costs, and when you get sick health plans cannot cancel your coverage.   In spite of all this there are the more subtle problems in the healthcare industry which are today being solved by entrepreneurs. Entrepreneurs are changing the way in which you can manage your health thereby enhancing the manner in which you address lifestyle choices. Healthcare 2016 – a glimpse   While the headlines are raging with news about healthcare reform and there is always a debate over public vs private system, there are innumerable opportunities for business within this segment. Whichever way the political debates are going, the truth is that there are plenty of opportunities for new entrepreneurial pursuits in the healthcare segment. What’s in it for the entrepreneur?   The industry has varied areas of expertise with a complex set of interconnected providers, all working in coordination to ensure our health. These can come under the broader heads – medical products, services and equipment to extend, protect and increase the life of a patient.   The two classifications can be defined as: Pharmaceuticals, Life Sciences, and Biotechnology Healthcare Equipment and Services   But this hardly covers all the areas. The manufacturer of the x-ray machine, the technicians, and the physician – all play a vital role as well!   This leads us to arrive at a broader classification: Hospitals, physicians, nursing homes, diagnostic laboratories, pharmacies and sustained by drugs, pharmaceuticals, chemicals, medical equipment, manufacturers and suppliers Ancillary divisions namely medical equipment and supplies, pharmaceutical, healthcare services, biotechnology, and alternative medicines Innovative ways in which companies have taken ideas and converted them into healthcare startups   Let’s look at a few innovative ways in which companies have taken ideas and converted them into healthcare startups. Let’s hope these will spur you to come up with ideas for your own “healthcare industry startup”.   Gym Pact has been very innovative in offering healthcare solutions. This is one platform where you connect with wannabe exercisers and the system holds you accountable with cash; if you do not exercise you pay cash to the ones that do!   Wellness FX is a company that uses a tri-monthly blood sample to gauge your inner health while charting progress.   Fit Bit provides gadgets and instruments that let you track your distances, calories burned and your sleep cycles.     HealthStart is one such innovative healthcare accelerator program, in India, which is dedicated to support startups through mentorship, funding and any other required support. Founded by an enterprising team global professionals this platform is meant to kindle the healthcare entrepreneur. Providing two different models of funding, this startup provides incubation program as well as angel investment.   In India some of the best healthcare in the world is provided by the private sector. With close to 600 million poor in the urban and rural areas with no access to affordable quality healthcare the per capita healthcare expenditure in India is a fraction of that developing countries like China and Brazil. This low dissemination shows that there is a huge need for private and public investment. Therefore we see that healthcare is the leading focus for investors in India and approximately 70% of social enterprises are concentrated in this sector.   Aavishkaar based in Mumbai, is an investment fund that makes equity investment during early stages of social enterprise, focussing on the base of the pyramid population which includes a variety of sectors like healthcare, agriculture, water and sanitation.   Acumen a non-profit organization in India, raises charitable donations to help the low income sector and their highest priority is the healthcare segment. Founded in 2001 this non-profit has been impacting the lives of millions by providing affordable ambulance services, affordable eye care, healthcare education.   There are many more such innovative solutions made available due to the lacunae and shortages in the existing healthcare system. 2/2/2015 12:00:00 AM How to get an idea to the clinic? We are fully aware of the challenges faced by individuals in the health entrepreneurship sector in developing a product or a service in the tightly regulated healthcare market, known to be notoriously difficult. You have the health entrepreneurship startup idea!But getting an idea to a patient is not a simple process it is notoriously difficult to develop the idea and then market the health technology. In this article we will discuss about how to get an idea to the clinic. To Learn more about "The Journey from Idea-to-Fruition", click here   Getting the idea to the patient - Not a simple process Getting an idea to a patient is not a simple process – it is notoriously difficult to develop the idea and then market the health technology. healthcare is a regulated area and approvals for products as well as services are tough to attain. These approvals are much more difficult to obtain than in any regular consumer technologies. These requirements for stringent regulatory approvals and clinical trials mean that health entrepreneurs can face years without substantial incomes and major hurdles for small businesses entrepreneurs. The truth is also that, developing on the idea and growing your business successfully needs strong execution and strategic capabilities which can be learned from successful entrepreneurs who have been there before you. The other challenge is the disconnect we see between local and national organizations, long decision making processes and budget silos. Developing a product in the closely and securely regulated healthcare market is indeed cumbersome and time consuming. Once the ideation stage is over the new entrepreneur has to be able to test the idea and refine the idea, while assumptions made have to be tested in the real world. The focus has to be on building a tested and viable business model from the initial idea. Then is the commercialization of the vetted business idea. There are different areas that need attention and these include selling, product development, and financial modelling among others. Challenges faced by healthcare providers in bringing the idea to fruition and execution We find that most healthcare providers are faced with prospects and occasions to innovate and yet they do not know what to do with these “ideas”. While caring for patients they envision ways and methods of doing the same thing in a better fashion and these present themselves as opportunities for healthcare providers.   The value of the idea is not the idea itself, says Dr.Pereras, the author of the book “Innovations and Entrepreneurship in the Healthcare sector”. He avers that many can benefit from innovations and that the value comes from transforming the idea into a product, company or improved process. This transformational stage is the area that that all new entrepreneurs need to be educated about and this is where the expertise is lacking.     1/6/2015 12:00:00 AM The Journey from Idea-to-Fruition There are several services and tools as well as innovative methodologies that may support your venture and these are all designed to help the new entrepreneur along the way. Growing the new health business from the seed of an idea is indeed a challenge. With several exciting transformations in the health entrepreneurship segment happening around us with and with technological innovation, business pathway creation, skill set development and rapid learning curve between entities, the new idea that you have, has to be developed and allowed to mature and take shape. In spite of these challenges we believe that being a health entrepreneur is well worth it. While it is one thing to create something useful that people buy, it is quite another to create something that can bring improvement in people’s lives and health. In this article we endeavour to provide foundational building blocks of entrepreneurship which involves developing on the idea so envisioned. To learn more about "Howto get an idea to the clinic?", click here!   Steps propounded by experts to develop an idea and bring it to fruition If you are an ambitious and budding health entrepreneur you may find an edge in the industry just by listening and learning from the experiences of those who have been there before you and succeeded. One such success story is that of device entrepreneur and investor Rudy Mazzocchi who is the CEO of Elenza. Starting his career in the early 1980s when as he recalls “One could sketch an idea on a napkin, have your engineer prototype it, get FDA approval in 90 days and commercially launch a product within 6 months” Rudy Mazzochi made a remarkable mark in the industry.   Today the environment in the health entrepreneur sector is very different. The average time taken from conceptualization to bringing a product to market is 4 to 5 years and slower processes and extra capital required can make a huge impact on the company’s success. Yet, clinical validation happens to be the cornerstone and the prime driver for any health device company. With solid clinical data a company can get to the next modulation point and raise more funds for his venture. 1.     If you are looking to validate a new concept, ask simple questions that will enable you to uncover unmet needs By asking the right questions and getting the responses you will find your unmet need. The questions you may want to ask: How can this process be done differently? How can the product efficiency be optimized?   Rudy  says that he has found these questions to be great ways to arrive at unmet needs and by witnessing surgical procedures and asking these questions he has many a times discovered an unmet need and hence a new revolutionary product. 2.   By critiquing the components of an idea one can assess the feasibility of the idea     Rudy describes his approach to this as “jumping from rabbit holes to chase opportunities”. Rudy says “You need to come up for air from time to time to test the feasibility of the idea for your proposed health device”.   This example is very useful to prove this point to the readers here. He speaks about an electroactive implantable intraocular lens which was being developed by Elenza for cataract patients. In bringing down the components of the lens – right upto the minute detailing – from liquid crystal chemistry to power cell and chip needed to run the algorithm – They were able to conclude that all requirements were feasible and indeed available for fabrication. In this specific instance that even the FDA came forward to provide specific consultative advice for the approval process! 1/6/2015 12:00:00 AM Filling the gaps in US Healthcare industry Every year billions of Dollars are invested on the US healthcare system but still it fails to deliver quality medical care. Entrepreneurs took the opportunity to minimize the gaps in the US healthcare system to maintain good health. To Learn more about "US Healthcare system - The Origin", Click here.  Emerging medical schemes: Health Maintenance Organizations (HMOs) controlled the division of healthcare and reimbursement to physicians. The expansion of HMO went unnoticed until it revolutionized the healthcare organizations and triggered disagreement between the patients and the doctors.   The doctors started losing authority and began working for organizations that earned from pre-paid medical services. The scheme “fee-for-service” gradually began to decline and was substituted by "capitation," where the doctors were paid a fee in one go, to treat all the patients. “Managed care” a system that emphasized on consumer choice, preventive medicine and personal care was introduced.   Consumers accessed health information through the Internet and the World Wide Web. They were fascinated by vitamin therapies, herbal preparations and acupuncture also called as “alternative medicine". Computer technology and communications opened doors for "telemedicine," a scheme that utilizes the internet, for diagnosing and treating by physicians at a distance. These schemes were considered as a response against the medical industrial complex.   Filling the gaps in US Health Industry Currently the healthcare system in the US, as we all know is not in a good state. The entire healthcare system in the United States wastes approximately $750 billion a year and fails to deliver above average care.   This is an equivalent to the annual cost of health cover for 150 million workers or the Defence Department’s budget!!   When all this is considered, and one looks at the 48 million uninsured Americans, we see that the US healthcare system needs a fix. Obamacare has helped address some of these issues. By end of 2015 people who did not have have insurance had to pay a fine. Also, there were several millions who were be eligible for Federal subsidies or Medicaid. There is the additional benefit today whereby you become entitled to pre-emptive services, with no out-of-pocket costs incurred. Additionally, in case you fall sick your health insurance and plan cannot get cancel your coverage. Obamacare is not enough – What can health entrepreneurs do? How can they contribute meaningfully? In spite of all that the government and Obamacare are providing, some of the subtle problems in our health care industry are being solved by entrepreneurs. How are these entrepreneurs contributing to the maintenance of good health? 1/6/2015 12:00:00 AM