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Changing trends in health care sector in India

Introduction
Healthcare has become one of India’s largest sectors – both in terms of revenue and employment. The industry comprises hospitals, medical devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance and medical equipment. The Indian healthcare delivery system is categorised into two major components public and private. The Government i.e. public healthcare system comprises limited secondary and tertiary care institutions in key cities and focuses on providing basic healthcare facilities in the form of Primary Healthcare Centers (PHCs) in rural areas. The private sector provides majority of secondary, tertiary and quaternary care
institutions with a major concentration in metros, tier I and tier II cities. The Indian healthcare industry is projected to continue its rapid expansion, with an estimated market value of US$ 280 billion by 2020, primarily on account of increased population growth in India’s low income communities Large investments by private sector players are likely to contribute significantly to the development of India’s hospital industry and the sector is poised to grow to US$ 100 billion by the year 2015 and further to US$ 280 billion by 2020.
Sudden flourish in the healthcare sector is also driven by the growth of the diagnostics segment, both path-labs and radiology
The diagnostic market is the fastest growing segment of India’s healthcare industry, according to PricewaterhouseCoopers (PwC), with the segment forecasted to grow to US$ 17 billion by 2021.

Collateral Benefits
The high growth healthcare industry has been an area of interest since past few years, which has also lead to some significant opportunities in the sectors allied to healthcare industry To list a few the allied opportunities are in various segment like, Software and IT for medical services which we can call healthcare IT, Healthcare Analytics, High patient care services, e commerce and healthcare, medical equipment’s, R&D, hospital and clinic management systems etc. Specialization in various services like architectural design, accounting, construction, nurse trainings, etc. specific to healthcare industry are an obvious off-shoot we would like to ignore for this article

Medical Equipment Industry
The USD 3 billion worth Indian medical device sector is Asia’s fourth largest market, and presents an exciting business landscape and opportunities for both multi-national and domestic players. The technological advancement and expertise that the global market leaders offered has proved to be an advantage. Today, India’s medical device sector is dominated by multi-national companies, which is evident from the fact that about 75% of the sales are generated by imported medical devices. The domestic players, on the other hand, were quick to adapt the winds of change and started to focus on low cost devices. It will come as a surprise to many that the domestic players in India export more than 60 percent of their output as Indian markets are dominated by such imported medical devices. Over the years, many multi-nationals have set up operations in India. However, the nature of majority of the operations is to only distribute
imported devices and provide support function. Few multi-nationals have started domestic production too. Some multi-nationals have also entered India by acquiring domestic manufacturers. For example, in 2008, Netherland-based Royal Philips Electronics acquired Meditronics, a leading manufacturer of General X-Ray and Alpha XRay Technologies, a leading manufacturer of cardiovascular X-Ray systems. Some of the leading medical device and medical electronics companies operating in India are 3 M, India Medtronic, Johnson & Johnson, Becton Dickinson, Abbott Vascular, Bausch & Lomb, Trivitron Diagnostics, Accurex Biomedical, GE Healthcare, Philips
Medical, Wipro Technologies, HCL Technologies, etc

Opportunities & Development
India’s medical devices industry is now opened up to 100 percent foreign direct investment (FDI). India presents an attractive market opportunity for global medical device manufacturers, but the country has never been able to tap into its potential as a domestic manufacturing base. Despite having a medical device market that ranks in the world’s top 20, the industry has a long history of being under-resourced. With the focus on ‘Make in India’, the electronics industry is set to see a manufacturing revolution and this industry has a plethora of opportunities with healthcare. Everimproving nanotechnology and semiconductor designs are revolutionising the medical electronics industry and taking the healthcare industry to new heights of patient care quality. Portable, wearable, and implantable medical devices with foldable printed circuit boards (PCB) and embedded chips in a patient’s body are able to monitor
patient health outside of the clinical environment. This is helping doctors in providing prompt assistance to patients in medical emergencies with better clinical aid. Growing manufacturing emphasis, increasing technological adaption by Indian
companies, penetration of hospitals in rural and tier III towns, all provide an impetus for indigenous production, assembly or low cost equipment’s, thereby making this segment a space to stay with

Recent Transactions in the Industry
• Trivitron Healthcare has acquired Mumbai-based imaging accessories manufacturer Kiran Medical Systems, and Imaging Products (India) Pvt Ltd (IPI) for an undisclosed amount
• Other recent deals in this segment include Goldman Sachs making Rs 110 crore investment commitment in BPL Medical echnologies, Perfint Healthcare raising $11 million from Norwest Venture Partners

Healthcare IT Overview
Healthcare IT is a core component to achieving successful transformative shifts in healthcare. Growth in data, digitization trends in health information and electronic medical records, improvements in collaborative data exchange, workflows and mobility, and need for better financial management are changing the needs of the hospital enterprise. Additionally, patient demographic changes and chronic disease growth, cost control considerations, and the importance of patient safety, have all come together to heighten demand for Health Information Technology (HIT) in India. Healthcare IT market in India will continue to grow at a considerable pace in the next few years with addition of small hospitals in different regions in the country, thus easing the access to healthcare facilities and greater number of hospitals realizing the potential benefits of deploying IT. The market is predicted to grow at a CAGR of 12.9% from FY’2013-FY’2018 and is expected to cross INR 8,000 million by FY’2018. “The increase in adoption of electronic health records, mHealth, telemedicine, and web based services has made electronic patient data expand, necessitating the implementation of robust IT systems in Indian healthcare institutions. The technology’s benefits, which include enabling experts from any part of the world to advise patients on medical care, streamlining operations, and helping hospitals achieve performance targets, have popularized IT in healthcare.”

Opportunities and Development
IT solutions to become an integral part of process management, patient care and the management information system (MIS) in ospitals. With the health insurance sector poised for major growth in the coming decade, increasing demand from this sector for more efficient systems for storage and retrieval of information will put pressure on hospitals and other healthcare providers to imbibe technology to modernize existing infrastructure. Advanced patient history, cloud-ready, and customizable consultation are some of the new product offerings by EMR vendors. In the coming years, these vendors foresee a major change in adoption levels; where there would be wider adoption of newer platforms such as cloud, which they say will help them cut down costs and be easier to manage. Spurring investments, new hospitals, insurance penetration, and regulatory push and manpower shortages will drive the growth of the industry in the future. Many indigenous IT based companies have enriched their portfolio by providing client based healthcare solutions. Some of the noteworthy names are Tata Consultancy Services, Infosys, Wipro and HCL Technologies. It is well known that almost all leading IT MNCs are present today in the country driven by India’s vast talent pool and abundance of expertise in the IT and IteS sector.

Recent Transactions in the Industry
• Practo, a Bangalore based healthcare startup has raised $30 million from Sequoia Capital and Matrix Partners in its Series B funding. Practo is currently the largest doctor search engine in Asia.
• Secunderabad-based Virinchi Technologies acquired a majority stake in the Asclepius Consulting & Technologies, a software solutions provider for mid -size hospitals and nursing homes in India

Healthcare Data Analytics
Harnessing health data allows doctors and researchers to improve collaboration, better understand illnesses, and more effectively allocate resources to get the right treatments to the right patients at the right time. It can be helpful in preventing or minimizing the impact of outbreaks and diseases. To be truly useful, it must also be easily accessible, which is where the cloud comes in. The healthcare analytics market is expanding at a brisk pace and is expected to reach $21.3 billion by 2020, growing at a CAGR of 25.2% from 2013 to 2020. This segment has seen a flurry of activity lately, with vendors bringing out solutions in financial analytics, clinical control and administration and in managing R&D. This has put pressure on large as well as small-sized companies to increase their product portfolio. In order to maintain their competitive edge, healthcare data companies are inching towards advanced technology-supported solutions and solutions to improve patient experience.

Opportunities and Development
Healthcare analytics is poised for take off in India As governments across the globe are also adopting strict regulations and undertaking
initiatives to reduce healthcare costs, analytics is a tool that allows healthcare systems achieve this aim along with remaining ompetitive in today’s market. As of 2013, descriptive analytics holds a major market share. However, predictive analytics and prescriptive analytics are the highest growing areas during the forecast period. Some of the top players in this segment are IBM, OptumHealth, Oracle, Verisk
Analytics, MEDai’s Health, MedeAnalytics, Mckesson, Truven Health Analytics, Allscriipt Healthcare Solutions. Cerner

Recent Transactions in the Industry
CitiusTech , a specialised healthcare technology platform for business intelligence and analytic raised $100 million from General tlantic in March 2014

Diagnostics
The Indian diagnostic and pathology services market has seen a boom in the last five years. A strong driver for this segment is an increase in spending power, which has made sophisticated tests more affordable. Diabetes, orthopaedic and cardiovascular problems need the services of this segment very often. The segment generated revenues of USD 2.2 billion 2012 and is expected to grow at a CAGR of 12 percent to reach USD 4.3 billion by 2018. This crucial segment is subdivided into two broad categories -in- vitro  diagnostics and imaging diagnostics. The principal areas of growth include hematology, biochemistry, haematology, molecular diagnostics and specialty diagnostics. The increase in the number of hospitals and healthcare facilities, development of healthcare infrastructure and the advancement of medical equipment propelled the growth of this industry. The imaging diagnosis segment generated revenues of USD645.10 million in 2012, projected to reach USD1,000 million by 2018. Increased awareness and investments in advanced technology pouring into the segment, the sector has developed considerably over the past five years. SRL Ltd stands as the largest player in the $1.8 billion Indian diagnostics industry In 2010, the company acquired Piramal Diagnostics, making it the biggest acquisition in the sector. Piramal Diagnostics also brought in the largest radiology network in India Other well known players such as Apollo Hospitals, Metropolis Healthcare and Fortis Healthcare are entering the market with new diagnostic centres, equipped with the latest technologies.

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