Category: Medical

A Chicago area healthcare system is spending $1 billion to re-invent healthcare on the city’s South Side in neighborhoods where there’s a 30-year life-expectancy gap when compared to the more affluent North Side.

Advocate Health Care’s investment will include $300 million in land purchases and related spending to build a new hospital that will replace a facility that is more than a century old. And another more than $500 million will be allocated to expand outpatient care executives say will be “embedded in the community.” Another more than $200 million will be invested in hospital and outpatient programs and services designed in part to address social determinants of health such as expanding access to healthy foods, housing, transportation and prescription drugs.

It’s one of the largest community-focused healthcare investments in the nation, industry analysts and those involved say, and comes at a time providers of medical care are investing in an array of services from food and nutrition to housing to make sure patients are getting the right care in the right place and at the right time. Health insurers, too, are increasingly paying to address social determinants of health beyond hospitalizations, physician services, prescription drugs and medical devices.

“We are so far ahead of where we were 50 years ago technologically and in terms of the potential to decentralized care that I think the timing of this new effort is good as long as the principles do not get overly enamored with gigantic facilities,” said Jim Unland, president of Health Capital Group and editor of the Journal of Health Care Finance.

In Advocate’s case, executives say they aren’t focused on big facilities but investing in a “wellness model” that executives involved say included several months of meetings with community leaders and South Side residents throughout 2024.

Far more will be spent on outpatient care and related programs than a replacement hospital for the aging Advocate Trinity Hospital building that is 115 years old. As one example, 10 new “Advocate Health Care Neighborhood Care” locations will be created to “serve the whole family” including the first one in the next year at the South Side YMCA.

“We have built a model that gets at the heart of chronic disease and wellness through much help South Side residents live their healthiest lives,” Michelle Blakely, president of Advocate Trinity Hospital said when the project was announced this month. “We need to provide the community with the necessary resources to stay well – where we live, work, play and worship – and that takes a comprehensive plan.”

Advocate Health Care is a part of the large multi-state Advocate Health, which is based in Charlotte, N.C. and was formed in 2022 as the result of the mega-merger of with Advocate Aurora Health and Atrium Health. Advocate Health Care remains the largest medical care provider in the Chicago area and Illinois with more than 250 sites of care that includes 11 hospitals.

“The health disparity gap the South Side communities face keeps me up at night,” said Dia Nichols, president of Advocate Health Care, who oversees operations in Illinois. “I am passionate about everyone getting the care they need – equitable care.”

Advocate Health Care has an agreement to purchase 23 acres of land on the South Side of Chicago near Lake Michigan where it plans to build a 52-bed hospital with 26 medical surgical beds, a four-bed dialysis unit and an emergency room with 16 bays, executives said. “This will enable Advocate to expand services and beds if community need warrants, but currently there is an excess of hospital beds on the South Side,” Advocate Health Care said in a statement, citing data from the Illinois Department of Public Health showing fewer than half of hospital beds on Chicago’s South Side are being used.

“For over 30 years, this vacant site has stood as a symbol of disinvestment and missed opportunities that have deeply impacted the entire Southeast Side,” Chicago alderman Greg Mitchell, who represents the area, said of the $300 million in spending on the former U.S. Steel South Works site near the lakefront.

The development process included more than 20 listening sessions and engaged hundreds of South Side residents, executives and community leaders said. “This visionary initiative, rooted in the voices and ideas of South Side residents, takes direct aim at the systemic inequities that have persisted for generations,” Chicago Mayor Brandon Johnson said.

Chicago’s South Side has been hit hard by the loss of medical care providers. In particular, more than 20 hospitals have closed since 2000 in the Chicago area and most have been on the South Side, according to a 2022 report in Chicago Policy Review.

The loss of medical care providers has led to disparities with “four times as many diabetes related deaths on the South Side than the North Side,” Advocate said in announcing its investment. More than 84% of hospitalized South Side residents also have one mor more chronic conditions including hypertension, diabetes, congestive heart failure, mental health needs, substance use issues and renal failure, Advocate executives said.

To be sure, there are notable differences in not only the quality of the care received between Chicago’s North and South sides that have been well documented by national studies and health experts but the number of healthcare professionals and physicians willing to practice on the low-income South Side.

Last year, for example, a 31-page report by the American Medical Association and Chicago’s Sinai Urban Health Institute showed closures of OB-GYN facilities have created a “number of disparities” for maternal and infant health on Chicago’s South and West sides. The report was supported by the March of Dimes.

“The health of medically disenfranchised patients and the health of their babies suffer when pregnant patients don’t have access to care in their communities,” AMA President-elect Bobby Mukkamala, M.D. said when the report was released. “With closures of health care facilities compelling patients to travel for necessary care, patients experience worse health outcomes.”

Meanwhile, the lack of full-service obstetrics care in these areas makes it difficult to recruit medical care providers and physicians in particular that is unlikely to improve anytime soon.

“Accompanying ramifications include a decrease in recruiting new physicians into particular specialties such as emergency medicine, family medicine and obstetrics in these communities,” Mukkamala said. “This has created a cycle of disjointed, disconnected care for patients in these neighborhoods, a higher level of burnout for physicians and physicians leaving the profession altogether.”

But the Advocate effort has been hailed by elected officials across party lines and localities in a city and state known for its rough and tumble politics.

“The monumental investment Advocate Health Care is making on the South Side of Chicago will expand access to world-class health care and represents a critical step towards advancing equity – serving as a powerful reminder of what’s possible when we prioritize the health and well-being of our communities,” said Illinois Governor JB Pritzker. “In addition to expanding access to state-of-the-art health care facilities, this investment will also expand workforce opportunities in the region.” Forbes

The chief executive officer of Unique Identification Authority of India(UIDAI), Amit Agrawal has been appointed as the new pharmaceuticals secretary in place of the existing 1992 batch IAS officer Arunish Chawla.

While, senior bureaucrat Arunish Chawla has been appointed the revenue secretary as part of a top-level bureaucratic reshuffle effected by the Centre on Wednesday.

Chawla, a 1992 batch Indian Administrative Service (IAS) officer of the Bihar cadre, is currently the pharmaceuticals secretary. He has been appointed secretary, Department of Revenue, Ministry of Finance, according to a personnel ministry order.

Chawla will continue to hold the additional charge of secretary, Ministry of Culture till the appointment of a regular incumbent, it said.

The post of revenue secretary fell vacant after incumbent Sanjay Malhotra was appointed the governor of the Reserve Bank of India earlier this month. PTI

India’s medical technology (MedTech) industry is poised for rapid growth in the coming years, with several new players entering the segment to meet the rising global demand for a range of medical devices.

The Indian MedTech industry is relatively young and will take time to earn the confidence of local hospital chains that source most of their devices from established, foreign multinational corporations (MNCs). As such, Indian medical equipment manufacturers are eyeing regulated global markets like the US and Europe, as well as Asia Pacific and the Middle East regions for business and better revenue realization, industry executives and experts said.

According to the Association of Indian Medical Device Industry (AIMED), the domestic MedTech market was valued at approximately $12 billion in 2023-24, and is expected to more than quadruple to $50 billion by 2030.

India’s MedTech sector is expected to grow at a compound annual growth rate (CAGR) of 20-23% for the next five years, according to consulting firm EY. The industry has also seen a huge inflow of private funding this year. By August, it had attracted over $1.2 billion of private equity and venture capital investments, the highest in the past five years.

You will see that a large part of what is produced here will find its way to the global markets,” said Suresh Subramanian, national lifesciences leader, EY-Parthenon India.

India’s medical devices exports rose at a CAGR of 14% from FY20 to reach reach $3.8 billion in FY24, according to a report by EY released in November 2024.

However, the country continues to remain a net importer of medical devices, bringing in 80-85% of its domestic requirements from abroad. In FY23-24, India’s medical devices imports reached $8.2 billion, marking a 13% increase from the previous year, and more than twice the value of total exports.

“The surge in imports is attributed to the growth of top-tier hospital chains such as Max, Hinduja Group, Fortis, Manipal, Calcutta Medical Research Institute (CMRI) and Apollo, which are investing in advanced infrastructure,” the EY report stated.

Indian companies see potential for growth domestically, but inadequate R&D ecosystem, and lower cost realization have prompted them to focus on exports to boost revenue.

Export boost
“The opportunity exists to create a business that focuses on the Indian ecosystem and participates in the India growth story. Having said that, the market will still take time to evolve, so one has to get into the international space simultaneously,” said Anish Bafna, CEO and managing director of Healthium Medtech.

Healthium, which was acquired by private equity firm KKR in May this year in a $839-million deal, currently has a 50-50 split in its domestic and international business. Bafna expects this to continue for the next few years. The company, which also works as a contract manufacturer for other companies in addition to selling under its own brand, expects to bag more orders.

“The exports are only going to be [growing],” Subramanian of EY-Parthenon said. A key reason for this is that there is better revenue realisation for products manufactured in India being exported, he pointed out. There is also a growing engineering, software and technology talent pool in India that can be leveraged.

There are also geopolitical tailwinds, as countries look to move supply chains away from China. Unlike in pharmaceuticals, regulatory pathways for medical devices are better defined and have shorter time periods, Subramanian pointed out. “Within a year, they are able to do what is necessary to get into global markets,” he said.

A lot of Indian startups initially make products that are import substitutes and gradually realise that there is a lot of potential globally, Subramanian said.

HRS Navigation, a five-year-old startup making minimally invasive surgical navigation systems, is looking to go global in the next two years. The series-A funded startup has already captured a 30% market share in India, its director Arpit Paliwal claimed.

“Right now, 10% of our installation is international,” Paliwal said. The company is present in neighbouring countries like Nepal, as well as in some countries in Africa, and the Middle East. The company plans to crack into the European markets in the next two to three years, Paliwal said.

Established vs newcomers
Indian healthcare providers have a long-standing relationship with multinational companies, and Indian players find it hard to enter the space.

The Indian MedTech industry is still in an evolutionary stage. We are still very, very young, Bafna said. “These [import] practices have been built over the last 50-60 years where the multinationals were the first to the market,” he said.

Plus, there is still a trust deficit when it comes to Indian companies. “Our industry was never regulated. Only by October 2023, the whole industry got regulated,” said Himanshu Baid, MD, Poly Medicure. “Earlier, anybody and everybody could bring or manufacture anything without any standards or regulation,” he said.

With the National Medical Device Policy 2023, the government has brought in more regulations, which might help build confidence, but it’s a slow process, Baid said.

Import substitution
According to EY’s report, electronic medical equipment made up a bulk of India’s imports, at 64% in FY24. This was followed by ‘disposables and consumables’, which accounted for 16.7% of imports. Both these segments grew 14.5% and 11.5%, respectively.

However, industry experts see the share of consumables, as well as other low- and medium-tech equipment imports reducing in the near future. “A large part of the imports that are consumables and therapeutic devices and point-of-care devices will be manufactured in India,” Subramanian said.

In the low-to-medium technology space, Indian companies have started doing much better in the last four to five years, Baid said. “We will develop self-sufficiency in the next four-to-five years maybe,” he added. LiveMint

Chief Minister Hemant Soren said that a health circuit of all the medical colleges and hospitals and district hospitals of the state should be created so that patients can be shifted from one hospital to another as per the need. This will not put much pressure on patients in any one hospital. For this, it is necessary that better treatment facilities should be available in all hospitals.

The CM was holding a high-level review meeting with the officials of the Health, Medical Education and Family Welfare Department today. He said that the government is committed to providing better health facilities to the people in the state itself. The CM also held an important meeting with the concerned officials regarding the re-development plan and traffic system of the capital Ranchi.

The CM directed the officials of the Health Department that all government hospitals in the state should be functional 24 × 7. In this direction, doctors and paramedical personnel should always be available in the hospitals so that whenever the patients come, their treatment can be ensured. He also directed the Community Health Center and District Hospitals to take initiative towards providing better and state-of-the-art facilities.

The CM directed the officials to provide the services of specialist doctors in all the district hospitals. He said that steps should be taken to ensure such arrangements in community health centres as well. He said that having specialist doctors in district hospitals will also help in relieving patients from being unnecessarily referred to medical college hospitals.

The CM said that complaints of mismanagement in hospitals are often received through various mediums. Patients coming to hospitals for treatment have to face many kinds of problems. Some patients are not able to get beds in hospitals, while others face inconvenience in getting tests done. There is a crowd of patients in OPD. To avoid such mismanagement in the hospital, strengthen and improve the hospital management, so that patients can get all the information related to treatment easily. Take the services of professionals for better management of hospitals.

The CM took information from the officials about the progress of construction work of five new medical colleges and hospitals in the state. He said that all these hospitals should be made fully functional as soon as possible so that the system of referring patients to RIMS or other big hospitals remains under control. He directed to take concrete steps for better functioning of community health centers located in remote and far-flung rural areas, so that rural patients do not have to go here and there for treatment of common diseases.

The CM gave instructions to improve the system of RIMS – The Regional Eye Institute under construction in the RIMS campus should start by February next year at any cost. OPD and investigation facilities of all departments should be made available in the same building. New and modern medical investigation equipment should be installed in the hospital. Scrap old and outdated equipment.

The appointment process of specialist doctors should be completed as soon as possible as per the need. Patients who have been successfully treated in RIMS and only need proper nursing and care, should be shifted to Sadar Hospital. This will provide relief to a great extent from the problems of beds and other problems for patients in the hospital. The departments in RIMS which have a heavy burden of patients should be shifted to Sadar Hospital. For this, Sadar Hospital should have all the facilities and arrangements for treatment.

Appropriate steps should be taken to remove encroachment in RIMS. Entry of unwanted elements should be stopped in RIMS campus. Improve the security system here.

The CM also held an important meeting with the officials of the Road Construction Department and Ranchi Municipal Corporation regarding the re-development plan of the capital Ranchi and the increasing traffic pressure and the steps being taken to get rid of it. He gave many important instructions to the officials towards making Ranchi beautiful and smart. He said that we all have to make joint efforts for a clean and green Ranchi. Initiatives should also be taken to ensure the participation of common people in this. On this occasion, the Road Construction Department gave information about the construction of new flyovers and roads in Ranchi along with the plan of inner and outer ring road through a powerpoint presentation. The Commissioner of Ranchi Municipal Corporation was instructed to visit the city regularly so that information about cleanliness and the reality of encroachment can be obtained and concrete steps can be taken to solve it.

The CM instructed that the work of repair, strengthening and widening of the roads of the capital Ranchi should be completed expeditiously. Encroachment should be removed by running a campaign in the capital Ranchi. There should be a strong arrangement of street lights on the roads and streets. Municipal corporations should provide the best possible service to the people of Ranchi. Pay special attention to the cleanliness of Ranchi city, there should not be heaps of garbage and dirt on the sides of the roads.

The CM asked to plant trees on the dividers of the roads. Do not make the dividers a concrete wall. Implement any arrangement while assessing the utilities. In view of the cold, ensure the arrangement of bonfires at the squares and intersections and distribution of blankets among the poor.

Chief Secretary Alka Tiwari, Additional Chief Secretary to the Chief Minister Avinash Kumar, Principal Secretary of Health Department Ajay Kumar Singh, Principal Secretary of Urban Development Department Sunil Kumar, Secretary K. Srinivas, Mission Director, NHM Abu Imran, MGNREGA Commissioner Mrityunjay Kumar, Municipal Commissioner of Ranchi Municipal Corporation Sandeep Singh, Director- Urban Administration Satyendra Kumar, Director of RIMS Dr. Rajkumar, Director- Health Services Dr. C.K. Shahi and other officers were present. Daily Pioneer

Royal Health Inc announced the successful close of a minority investment, led by HealthQuest Capital, a leading growth capital firm focused on investing in transformative healthcare companies. Although the funding amount remains undisclosed, this recapitalization resulted in a near eightfold increase in enterprise valuation since the entry of Royal Health’s 2019 investors.

This strategic investment will enable Royal Health to scale its operations. It will also enhance the company’s technology offerings. Additionally, it will support expansion in both US and international markets.

Royal Health is renowned for pioneering solutions that optimize radiology workflows and elevate patient care. The company is well-positioned to lead innovation in an industry experiencing rapid transformation.

Peter Nassif, CEO and Founder of Royal Health Inc, commented, “This partnership with HealthQuest Capital represents a significant milestone for Royal. Their expertise and shared commitment to advancing healthcare align perfectly with our mission to revolutionize radiology with smarter, more efficient solutions. This investment will allow us to accelerate delivering exceptional value to imaging centers, healthcare providers and patients”

HealthQuest Capital’s investment reflects its confidence in Royal Health’s ability to address critical challenges in radiology, including operational efficiency, staffing shortages, and improving the patient’s experience.

Sharath Reddy, Partner at HealthQuest Capital, stated, “Royal Health Inc is at the forefront of transforming radiology with cutting-edge technology that enhances workflows and delivers better outcomes for both patients and providers. We’re proud to support their continued growth and innovation as they redefine the future of radiology.”

The investment will drive advancements in Royal Health’s product portfolio. It will also accelerate research and development efforts. Additionally, it will enhance the company’s ability to support healthcare providers navigating complex radiology landscapes.
NewsBit Bureau

The FDA is aware that Olympus has issued a letter to affected health care providers recommending the forceps/irrigation plug accessory to certain endoscopes be removed from use related to a potentially high-risk device issue:

• MAJ-891 Forceps/Irrigation Plug (Isolated Type)
• All lots
• UDI: 04953170063114

Patient infection as a result of exposure to a contaminated device can occur when reprocessing of the MAJ-891 Forceps/Irrigation Plug is improper and/or incomplete, such as not disconnecting the MAJ-891 from the endoscope and disassembling it before reprocessing. This exposure could result in patient injury including infection, urinary tract infection, or sepsis, and, in some cases, could result in death. These harms may require inpatient hospitalization/monitoring, and treatment with oral or intravenous antibiotics.

Olympus has reported 120 injuries and 1 report of death due to infection following procedures in which the MAJ-891 was used with a cystoscope (CYF scope).

Device use
The MAJ-891 is endoscope accessory attached to the instrument channel port of certain Olympus endoscopes, including cystoscopes (CYF series), ureteroscopes (URF series), choledochoscopes (CHF series), and hysteroscopes (HYF series) to allow both irrigation and the use of endo-therapy accessories. The MAJ-891 was discontinued in 2022 from the US market. U.S. Food and Drug Administration

The National Consumer Disputes Redressal Commission, presided by Mr. Subhash Chandra in an appeal by Fortis Hospital held that expert evidence in medical negligence cases should be judged on a case by case basis, placing the onus on the hospital to dispute allegations of negligence.

Brief facts of the case
The complainant’s son suffered from a spinal condition, AAD, caused by a childhood injury. This left him wheelchair-bound and progressively deteriorating neurologically. The patient was admitted to SMS Hospital for surgery but left without permission, later consulting a doctor from the hospital and getting admitted to Fortis Hospital for surgery. Surgeries were performed, but complications arose, including a collapsed lung and quadriplegia. He remained on a ventilator and eventually died. The complainant argued the hospital was negligent, as post-surgery scans showed bone fragments compressing the spinal cord, which were not present in earlier scans. The hospital did not deny these findings. It was also alleged that the patient’s lung collapse and high steroid use without consent contributed to his death. The complainant filed a complaint before the State Commission of Rajasthan, which allowed the complaint. It directed the hospital and the doctor to pay Rs. 50,00,000 as compensation with 9% interest rate. Consequently, the hospital filed an appeal before the National Commission.

Contentions of the opposite party
The hospital claimed the disease, Mobile Atlanto Axial Dislocation (AAD), was caused by a neck fracture from a fall. They argued that informed consent was obtained, surgeries were performed as per protocols, and the patient’s condition post-surgery was expected in such complex cases. They stated that proper treatment was provided, and the complainant failed to prove negligence. Medical literature was cited to support that risks in medical procedures do not imply negligence if conducted with reasonable skill.

Observations by the national commission
The National Commission observed that the definition of “service” under Section 2(1)(d) of the Act must be understood broadly and includes services rendered by medical practitioners. The principles of medical negligence, as established in Jacob Mathew (based on the Bolam Test), highlight that negligence is determined by deviations from standard medical practice. Negligence must involve failure to meet the expected standard of care, resulting in harm to the complainant. Key elements are duty, breach, and damage.The Hon’ble Supreme Court in V. Kishan Rao vs. Nikhil Super Speciality Hospital applied the doctrine of res ipsa loquitur in medical negligence cases. This principle shifts the burden of proof to the hospital to show they were not negligent when negligence is evident. Expert evidence must be judged case by case, as ruled in Dr. J.J. Merchant and Indian Medical Association vs. V.P. Shantha. In the present case, the hospital performed surgeries on the complainant’s son without adequate pre-operative tests or proper informed consent. The patient’s condition worsened post-surgery, leading to his transfer in critical condition. Evidence showed that the hospital did not meet the required standard of care. The complainant established negligence, as per the principles in Jacob Mathew. The Commission observed that the State Commission correctly held the hospital liable for medical negligence under res ipsa loquitur. However, the specific liability of the hospital (appellant no. 1) and another doctor (appellant no. 2) was not sufficiently proven. The findings regarding other doctors (appellants 3 and 4) were upheld, as they failed to justify their actions. The order of the State Commission was upheld in part. Appellants 3 and 4 were jointly and severally liable for compensation to the complainant. However, the appeal of appellants 1 and 2 was allowed due to lack of sufficient evidence of negligence against them. Live Law

India’s private hospital sector in 2024 clocked single digit growth in average revenue per occupied bed (ARPOB), helped by improved operations and advanced medical treatment. Apollo Hospitals and Fortis Healthcare reported strong revenue growth, showcasing the impact of strategic measures and enhanced patient care.

Apollo, a leading health care provider, reported a 3 per cent increase in hospital occupancy in 2024, alongside a modest 2 per cent price hike for services. The growth was attributed to higher patient volume, fewer invasive surgeries, and shorter hospital stays.

The chain said 30-35 per cent of cases it treats are daycare procedures: A shift that has reduced the average length of hospital stays to 3.2 days and helped saving costs without compromising revenue.

Krishnan Akhileswaran, group chief financial officer at Apollo Hospitals Enterprise, highlighted that revenue per occupied bed (RPOP) is not just a pricing metric but reflects case complexity, technology use, and average length of stay. “As many as 70 per cent of Apollo’s patients paid less than Rs 2 lakh per admission, emphasising affordability despite rising costs from wages, medical technology imports, and GST input costs,” he said.

Apollo said its focus on minimally invasive and robotic surgeries ensured sustained RPOP growth of 6-7 per cent annually. Of this, 4 per cent is attributed to pricing adjustments and 2-3 per cent to improved case mix and technology adoption.

Fortis Healthcare said ARPOB grew in 2024 due to a favourable case mix and growth in high-revenue specialties such as oncology and neurosciences. Ashutosh Raghuvanshi, the hospital’s managing director and chief executive officer, said strong patient volumes were supported by expanded bed capacity, advanced medical infrastructure and international medical tourism reviving after Covid-19.

Fortis benefited by integrating technologies and skilled clinical teams, enabling specialised treatments and better patient outcomes. These factors collectively enhanced ARPOB while maintaining accessibility through strategic pay or mix optimisation, it said.

Mythri Macherla, vice-president and sector head, corporate ratings, at ICRA Limited, said the sector’s ARPOB growth was supported by annual tariff revisions, demand for elective surgeries, and the recovery of medical tourism. “Market share gains for organised players have also played a crucial role,” she added.

Bed occupancy at private hospitals improved in 2024 due to higher surgery volumes, especially in oncology and neurosciences, and the increasing contribution of digital channels in patient acquisition.

Despite positive trends, hospitals grapple with rising costs. Apollo faces annual wage inflation of 10 per cent and import duties of 27-37 per cent for advanced medical technologies. By focusing on volume-driven growth, Apollo has managed to offset such costs while maintaining affordability for patients.

The outlook for the sector remains strong, with ARPOB expected to grow further as hospitals invest in advanced treatments and expand their reach in underserved regions. The recovery in medical tourism and increased insurance penetration will help growth too, according to analysts.

Booster shot

• Apollo Hospitals reported a 3% increase in hospital occupancy and a 2% price hike for services in 2024
• Fortis Healthcare’s Average revenue per occupied bed (ARPOB) grew in 2024 due to a favourable case mix and growth in high-revenue specialties
• Recovery in medical tourism and increased investment in advanced treatments is likely to help ARPOB growth
• Despite positive trends, hospitals grapple with rising costs

Business Standard