A Summary of the proceedings at 2019 HITLAB: The Health Innovators Summit, New Delhi by Manish Sharma @msharmas

(source: HITLAB)
Impact of Frugal Innovations, AI, Remote Health Services, Vertically Integrated Technology Platforms and Care Delivery Platforms supported by technology, Blockchain based HealthTech solutions, Personal Digital Avatars, Diffusion of Digital HealthTech

The Health Innovators Summit, New Delhi by HITLAB in partnership with Department of Management Studies is a once a year conference held in February in India. 

Prof. M.P. Gupta, Dhananjaya Chair Professor & Head - Department of Management Studies, IIT, Delhi who is known for his pioneering work in eGovernance,  spoke about 

and how AI and Remote Medicine are two areas he sees gaining traction in the field in the coming years.

Dr. Sachin Malhotra, in his keynote presented the work being done by Tech care for all, India by deploying their platform that integrates the patient journey with the use of various technology solutions across the patient journey. The solution comprised of a Medical Learning Hub, Telemedicine solution powered by Remidi, Bangalore, a frugal EMR/EHR solution that can be deployed in low resource setups and a medical learning hub. 

He highlighted the work being done by Tech4All with the Catholic Health Association of India, by building a future ready organisation that can delivery healthcare for a billion plus people in the rural settings as well as their urban locations. Dr. Vivek Sahi added to the conversation with his talk about the role of Technology for Social Impact. 

Prof. Stan Kachnowski, Chair, HITLAB talked about the need for Digital Health Innovation for India’s 1.3+ Billion lives. He talked about the importance of innovating for the bottom billion that needs to be driven by a more efficient information symmetry and diagnostic symmetry. 

Prof. Kachnowski, talked about the Diffusion curve and spoke about how a collaboration across the world led to an eradication of smallpox. He spoke about the need to build research centers like how Stanford Biodesign has a collaboration going with AIIMS, Delhi. During the Q&A one of the professors of IIT, Ropar mentioned about a similar collaboration between IIT, ropar and PGI. All such active efforts will allow for the diffusion of technology to happen at a great pace, Prof. Stan Kachknowski said. Prof. Kachknowski referred to the work of Eric Topol at UCSD on Medical Informatics, Digital Medicine and Digital Human. 

Prof. Stan talked about Diffusion of Digital Healthcare for the billions is the focus of HITLABs globally to help eradicate diseases expeditiously, economically and efficiently. 

In the experts speak of the talk, Dr. Thierry Marchal, Global Industry Director - Healthcare, ANSYS Europe and Mr. Shitalkumar Joshi in their talk about Why computer modelling is the next evolution of Healthcare Sector talked about the use of simulation technologies to impact various aspects of product development for Molecules, Devices, Health Tech. Dr. Thierry Marchal while giving the example of simulation technologies being developed at ANSYS talked about how simulation technologies are being used to help orthopedic surgeons design the hip joints for the patients by giving insights that doctors can understand. He opined that the same technology is now being extended (early days still) to create “Personal Digital Avatars”

In their talk they mentioned about how various government agencies are speeding up the process to accept simulation results to speed up the regulatory acceptance process. E.g., European Parliament, FDA. 

The Innovation Insights section of the day started with Dr. Deepak Agrawal, Professor, Neurosurgery & Gamma-Knife, AIIMS, New Delhi talking about From Big Data to Big Impact. 

Dr. Agrawal talked about the Big Data in AIIMS, N. Delhi. From the time of rollout of the Digital Health solution at AIIMS, they have captured the demographic data of more than 3 million patients. All Lab investigations 1 million data points coming into the system from about 10 millions records. He mentioned how they are enabling simple processes to enable to generation of big data. Capturing of information from patients from 3000 beds, by asking the nurses to capture the vitals of the patients once every shift, across 3 shifts. 

Dr. Agrawal spoke about some of the case studies, these are: the appointments system of how they enabled the system and how they improved the system using big data analytics in partnership with Dr. Mudit from Indian Statistical Institute to determine the amount of overbooking being done, social demographic maps were used to determine which are the areas that are weak in healthcare infrastructure based on the places from where the patients were coming to AIIMS, Delhi because hospital facilities might be available but super-specialist facilities might not be available in those areas. 

Another case study involved the HAI. What was the cause of HAI on specific beds in a particular location of the hospital and to find the sources to enable corrective action. Dr. Agrawal mentioned that we need to have collaborations in place between clinicians and data analytics experts so that we can have meaningful data analytics from the data recorded.

Prof. Supten Sarbhadhikari, Former Director, Center for Health Informatics, National Health Portal in his talk on Active Assisted Living in Healthcare talked about the relate to the concepts, products, services, systems, Access to information by various stakeholders, social environments and type of users and how the interactions between these are important to deliver care are these helping the improvement in healthcare delivery. He talked about how Active Assisted living can help in Health and wellness. With the increasing life expectancy, but is the quality of life improving? Prof. Supten talked about various dimensions that are important to be considered for Active Assisted Living in Healthcare. Replace I to We so that Illness becomes Wellness, Prof. Supten said. Having knowledge is good, but application of the same with context and keeping the above dimensions in mind are important.

In her talk about Shaping care delivery for the next-gen patient experiences, Ms. Sylvana Sinha, Founder Managing Director and CEO, Praava Health shared her insights from setting up Praava Health in Dhaka Bangladesh and what aspects from social, location, systems led her to designing a collaborative care experience for the patients visiting the Praava Health facilities. She mentioned how they rolled out a service that for a fixed amount of subscription, they patient could avail an unlimited access to the Praava Health services throughout the year. 

Ms. Sinha, mentioned how at Praava Health Technology is seen as an enabler, technology she said will not replace the family doctor (a concept on which Praava Health is built-on: family doctors + diagnostics) rather technology will help the doctors do what they are best at. If they are in a room, they should observe the patient, listen to the patient, help patient to get better in how to manage their health. And this is done at Praava Health by the use of technology by making the patient and doctor a collaborator in the care process by providing relevant technology tools to each of the collaborators in the patient journey with the goal of enabling continuity of care across various doctors that see the patient. Ms. Sinha said the Praava Health model is the “brick and click” model of healthcare service delivery. Its brick and mortar enabled by technology. She believes that healthcare in Asia will move from being brick to click in the years to come, but it's never going to replace the family doctor. 

In his talk on New-age clinical trials for improved patient care, Dr. Rajesh Jain, Co-Founder & Chief Solution Architect of ConsilX Digital, ConsilX talked about the use of Blockchain in Clinical Trials industry and how their company is deploying blockchain based solutions. Dr. Jain talked about empowering the patient and keeping the patients at the center of every kind of innovation. And how they are moving these concepts to actual practice via their solutions. Dr. Jain talked about innovation being a collaboration and technology will always being an enabler. 

Dr. Jain spoke about how patients want to be participative in their healthcare than ever before and even in clinical trials. Patients want to get their healthcare administered to them much more effectively than having to go to the doctor’s clinic or multiple doctors clinics enabling a virtual and remote care delivery process. This is now true for the clinical trials patients too. Dr. Jain talked about how blockchain can be used for better data access management by maintaining security and privacy of the patients. Dr. Jain talked about how various stakeholders are collaborating to delivering technology from ConsilX. He mentioned that their solution covers, Patient Enrollment, eConsent, Engagement, Direct Data Collection, Supply chain management, collaborative research and analytics. 

Dr. Jain spoke about the feedback the solution has received from being a HITLAB collaborator and from the feedback received from the field that has helped them in their product development from the past two years.

There were two panel discussions: 


I was honored to attend the HITLAB Innovators Summit: India, 2019 on the 16th February 2019. I was going back to my timeline on twitter and saw that I had been following the conference from 2014 by sharing the insights being shared by the experts during all these years. And to get to listen to the experts sharing their insights in person is something that made me take the trip from Bengaluru to Delhi and back the same day. I made sure I would not miss the opportunity and the trip was all the effort. And should be a must attend conference series for those interested in Health Tech innovations and learn what has moved and what has remained the same or not moved at all.

I would like to Thank Devmalya Sarkar and Ms. Vandana from the HITLAB,  Delhi team. And a big thanks to the speakers and panelists whose thoughts I have been able to share above. I am sure more folks would like to reach out to them to learn about their work and continued innovations to push the boundaries. 

Presented below are some moments from the HITLAB, 2019, New Delhi

Source: Conference Brochure

Source: Conference Brochure

Please note the references of embedded twitter and linkedin posts are attributed to the author.

Team HCITExperts
Your partner in Digital Health Transformation using innovative and insightful ideas
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How to #Innovate for Impact? by Devmalya Sarkar @DevmalyaS

With digital technology advancing at warp speed or at the speed of startups these days, there's probably little that health-tech and digital health innovations can't potentially transform.

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#EHR in India: Challenges and Opportunities vis-a’-vis’ Ayushman Bharat by Dr. Oommen John, @oommen_john

As India is embarking on a journey towards providing Universal Health Coverage through multi-pronged approaches of reducing catastrophic out of pocket expenditure and increasing access to essential health services , it is envisaged that Health Information Technologies (HIT) / Digital Health would create enabling environments for addressing some of the system level challenges in healthcare delivery.

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Algorithms in #EMR by Dr. Joyoti Goswami

Practicing physicians these days are barraged with a lot of technical jargon promoted by the Information technology professionals such as Big Data, Hadoop, Artificial Intelligence and Predictive analytics. For a physician not introduced to the these terms, the conversation is of little value unless there is a specified value in the clinical setting.

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#RPA in Healthcare: The Path Ahead for Health IT Leaders By Sreejith Madhavan

Historically, healthcare industry has shown a reluctance to invest in technologies that did not come under the purview of diagnostics and treatment, or demanded by insurance payors (such as electronic claims submission). Anything that required cognitive (human) intervention or intuition was kept aside from the technological takeover. The unprecedented growth of life expectancy, the discovery of new drugs and treatments, and the ability of modern medicine to combat chronic ailments and epidemics have spurred the need for technological inclusion in multiple areas of healthcare.

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What does it take to build real-world #AI enabled healthcare solution? By Vijayananda J, @vijayanandaj

Development of new technologies has undoubtedly enabled several breakthroughs in the healthcare industry. To put it simply, it has revolutionised the growth of healthcare from nascent patient-care to accomplishing treatment of life-threatening diseases. High-performance computing and the availability of digital data have extended these remarkable outcomes explaining why AI-based healthcare solutions are at top of the funding lists and are continuously gaining traction.

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NITI Aayog’s National Health Stack - a Healthy Stack?! by Divya Raj @divyaraj1

Extraordinary problems need extraordinary solutions. And creating a country level IT infrastructure addressing challenges in India's Healthcare management for its 1.3 billion population definitely falls very well into that category. 

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#Blockchain in Healthcare: Will it or won't it survive? By Tirupathi Karthik, @TirupathiKarthi

What is Blockchain

Blockchain offers a permanent record of online transactions. Transactions are deemed as a “Block” and a ledger binds them in a “chain” thus earning its moniker “Blockchain”. Each transaction is validated and stored by a network participant based on rules but sans a governing central authority. Information can neither be modified nor copied or deleted.

Every transaction has a time and date stamp, offering a trusted transaction history and allowing verification of such records. Since the information is encrypted, the only way to access the blockchain is with a passcode. This shared ledger system makes Blockchain rather secure. Given this, Blockchain is gaining new use cases for applications that require trusted and immutable data.

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Containing Health Care Cost, What is our role as a Physician? by Dr. Chandrika Kambam @Ckambam

Indian health care is at an inflection point. Today governments’ spending on healthcare needs is one of the lowest amongst the Developing countries [1]. India spends about 5% of the total expenditure on Health which is around 1.7% of the GDP. Public healthcare growth has slowed down over years. In 1998 about 43% of population was served by Public Hospitals and today only 30% use the Public health care system. [2] That means almost 70% of the health care needs are serviced by Private players, trust hospitals and non-profit institutions. This has led to the rapid growth of Private players who are growing at the rate of CAGR 16.5% year on year [3]. The costs of procedures or hospitalization has increased anywhere from 83% to 263% in 10 yrs. i.e. 2004 to 2014. There is also a wide variation of the cost for the same procedure in different hospitals [4]. It is also noted that 86% of rural Indian patients and 82% of urban Indian patients do not have access to any form of employer-provided or state-funded insurance.

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Software Product For Hospital Industry by Girish Koppar @KopparGirish

Before we talk about software product for hospital industry lets understand how the Hospitals are broadly classified

- Based on the legal entity ( Private , Trust or Corporate)
- Based on specialty ( Super specialty, Multi-specialty, Single specialty)
- Based on bed strength ( Larger hospitals and Nursing Homes)

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Electronic Health Record System from the Perspective of Data Privacy by Dr. SB Bhattacharyya @sbbhattacharyya

Electronic health record systems handle health-related ultra-sensitive data of a person throughout his life, along with all personal information that accurately identifies him. This makes it imperative to protect the data from cyber-threats and consequent untold damages. This article discusses the various issues involved and the different mitigation methods.

During the course of any clinical encounter a person discloses ultra-sensitive health related information to his provider to enable the latter to address his health-related problems better, faster, and hopefully, cheaper. Information that he would otherwise rather keep well under wraps. Ethics demands all providers treat all information that their patients disclose to them with the greatest of care and keep them secreted away from everyone, even the spouse, unless explicitly released from this obligation by the patient. The confidentiality of the private information needs to be maintained at the highest possible levels of security by medical professionals at all times—unless there are extenuating circumstances to disclose them, like for the public good, compliance to the law, etc.

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A Data Scientist’s Experience in Decoding Chest Imaging by Vidya MS

The Chest Imaging Update 2018 held by the Narayana Health group, brought together over 150 radiologists, pulmonologists and doctors gathered to update and improve their knowledge in the reporting of Chest Imaging, both X-ray and CT. As a data scientist with keen interest in medical imaging, my aim was to get an inside look into the daily practice of medical professionals in detection and diagnosis of pulmonary diseases.
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PregBuddy’s year with Google Launchpad by Sivareena S. L. @SarikaSivareena

We’re all aware about the Google Launchpad accelerator which selects pre-series A startups across the globe every year to assist them scale their business. Along with this, Google Launchpad has few more offerings where they have extremely well structured programs for various stages of startups. Pregbuddy has benefited from couple of these programs as we grew our product.

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Mea Culpa, I am one of those who is guilty of getting on and staying on the Big Data wagon for the wrong reasons. “Data is the new oil” is an oft-repeated phrase. I am about to commit a “virtual” suicide by proclaiming that it is not so. Data has its place and it is not at the top of the digital food chain. I feel that we have crowned the half-naked prince, Emperor in haste.

For the sake of clarity, when I say data, I will be referring to digital data throughout this piece. Data is a by-product of any activity. Therefore, creating data is as natural as breathing. So we have data. A lot of data. So what? Accumulating data, structuring it, storing it, analyzing it are a natural progression from that point onwards. How and what we do with the data is more important. Software. 

The magic that is software, to me, is more transfixing. Consider the prospect of a language written in a semantic that is alien to our natural human language. A cryptic command, logic, condition, trigger – anything at all – that is magically read, understood and acted upon by silicon. Hardware that contains baked-in code that can parse and carry out complex instructions at blazing speeds. Pieces of such chips soldered on a board and communicating through ‘roadways’ of circuits laid out on a board. The miracle of hardware coupled with the magic that is software is what gets my adrenalin pumping. How can such a marvel not be exciting?

Even the awesomeness of hardware pales in comparison to software. Hardware is more or less static. It is confined to physical and functional dimensions. Software, however, is supreme. It can use the same hardware (with some limitations of course) and carry out simple tasks, entertain with games, or perform wildly complex calculations at very very high rates of speed, accurately all the time. And it can do this million million times with alacrity. This is just the beginning of what software can do. But wait, there’s more!

Consider intelligence in software. It suddenly becomes a living, breathing, dynamic being. Almost. Software can learn and teach itself. Crunching data and spitting out patterns and actionable analysis suddenly becomes mundane, banal almost pedestrian. No. I am not against data or big data. By itself, big data is just that. A monstrosity. Sometimes, big data actually gets in the way. Misleads us in making decisions quickly. Software breathes life into data. 

Take any software language or tool. Examine it. Study its flow, the eloquence, the nuance and its brilliance. Brevity in software coding is revered by programming perfectionists. There is elegance in a well-written piece of code that executes beautifully, perfectly, every time. Anyone that can find literary melody in Shakespeare or Milton can certainly begin to enjoy the harmony in a beautifully crafted software application code. So, my appeal goes out to all those who are worshipping big data to take a moment to reflect upon the joy that software brings to our daily lives. After all, the future is software!

Inder Davalur
Inderjith Davalur is a healthcare technology specialist, speaker, writer and utopian dreamer.
Inder works with hospitals committed to transforming the healthcare paradigm with the aid of new innovative technologies. His primary area of interest lies in using data analytics and technologies such as Deep Learning to shift the current physician-driven healthcare model to a patient-driven market dynamic.
Inder focuses on the manifold ways in which data crunching and machine learning can lead to better diagnoses that can not only be made at the time of illness, but predicted way before any symptoms surface. The path ahead in the sector, he believes, lies in the deployment of evolving technologies that immensely influence both diagnostic and therapeutic aspects of healthcare, delivering real patient-driven, data-enabled, informed healthcare.
Inder currently works as the Group CIO at KIMS Hospitals Private Limited, Hyderabad and has previously assumed leadership roles at leading hospitals and companies, in India and the United States of America.
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Simplifying Health Economics by Dr. Karan Sharma

After hearing about India's New Health Insurance Program, I thought it is good idea to share about Health Economics, so here I am

Health economics is a branch of economics concerned with issues related to efficiency, effectiveness, value and behavior in the production and consumption of health and healthcare. 
Alan William Plumbing Diagram about Health Economics
I am using Alan Williams “Plumbing Diagram” to comprehensively understand Healthcare Economics. He has divided scope of healthcare economics into eight distinct topics (explained in the documents) which are:
·        What is health and what is its value?
·        What influences health? (other than healthcare)
·        The demand for healthcare
·        The supply of healthcare
·        Micro-economic evaluation at treatment level
·        Market equilibrium
·        Evaluation at whole system level
·        Planning, budgeting and monitoring mechanisms.
There are interlinkages between each topic, which make it possible to see Health Economics as an integrated whole – more than an Ad-hoc assemblage of topics. According to understanding – The first five boxes
(A) Health and its values,
(B) Influencers to health,
(C) Demand for healthcare,
(D) Supply of healthcare and
(E) Market equilibrium factors are the analytical “Engine” of health economics.

The remaining three (F) Microeconomic evaluations, (G) Planning, budgeting and monitoring and (H) Evaluation of system are main area of Applied Economics. 
Let us understand each topic and its relationships:
A.    Health 
Health can be defined as physical, mental, and social wellbeing, and as a resource for living a full life. It refers not only to the absence of disease, but the ability to recover and bounce back from illness and other problems.
Health generally evaluated through its value and perceived attributes, which are like:
1.     Productivity of individual healthy days
2.     Value of life
3.     Expenses caused by diseases and etc.
Health can be treated both as consumption and an investment good, Consumption: health makes people feel better, Investment: it increases the number of healthy days to work and to earn income.
Health does have characteristics that more conventional goods have; it can be manufactured; it is wanted and people are willing to pay for improvements in it; and it is scarce relative to people’s wants for it. It is less tangible than most other goods, cannot be traded and cannot be passed from one person to another, although obviously some diseases can.
B.     Influencers
According to WHO, many factors combine together to affect the health of individuals and communities. The few factors which affect health include:
1.     Income and social status - higher income and social status are linked to better health. The greater the gap between the richest and poorest people, the greater the differences in health.
2.     Education – low education levels are linked with poor health, more stress and lower self-confidence.
3.     Physical environment – safe water and clean air, healthy workplaces, safe houses, communities and roads all contribute to good health. Employment and working conditions – people in employment are healthier, particularly those who have more control over their working conditions
4.   Social support networks – greater support from families, friends and communities is linked to better health. Culture - customs and traditions, and the beliefs of the family and community all affect health.
5.     Genetics - inheritance plays a part in determining lifespan, healthiness and the likelihood of developing certain illnesses. Personal behavior and coping skills – balanced eating, keeping active, smoking, drinking, and how we deal with life’s stresses and challenges all affect health.
6.     Health services - access and use of services that prevent and treat disease influences health
7.     Gender - men and women suffer from different types of diseases at different ages.
There are evidences available of other examples which has been documented which are like: Transport, Food and Agriculture, Housing, Waste, Energy, Industry, Urbanization, Water, Radiation, Nutrition etc.
C.     Demand
Health demand is to achieve larger stock of Health Capital (healthy days). It is not passively purchased from market; it is produce in combining time with purchased medical inputs. Both value of Health and its influencers affect the demand. 
The demand for health is unlike most other goods because individuals allocate resources in order to both consume and produce health. There are four roles of person in health economics:
1.    Contributors
2.    Citizens
3.    Provider
4.    Consumers
 In the context of ordinary goods and services, economics distinguishes between a want, which is the desire to consume something, and effective demand, which is a want backed up by the willingness and ability to pay for it. It is effective demand that is the determinant of resource allocation in a market, rather than wants. But in the context of health care, the issue is more complicated than this, because many people believe that what matters in health care is neither wants nor demands, but needs. Health economists generally interpret a health care need as the capacity to benefit from it, thereby relating needs for health care to a need for health improvements. 
Not all wants are needs and vice versa. For example, a person may want nutrition supplements, even though these will not produce any health improvements for them; or they may not want a visit to the dentist even if it would improve their oral health.
Healthcare has its peculiarity that may mean, it is not considered as any good or service where demand can be analyzed, however that the usual assumptions about the resource allocation effects of markets do not hold meaning for healthcare. Moreover, it may well be that people wish resource allocation to be based on the demand for health or the need for health care, neither of which can be provided in a conventional market. 
D.    Supply
Supply is to achieve and fulfill the demand of health. The supply side of the market is analyzed in economics in two separate but related ways. One is related to the Resource input and Goods output model, looking at how resource use, costs and outputs are related to each other within a system.
Important influencing factors to supply are as follows:
1.     Cost of production of service
2.     Alternatives of services
3.     Substitutes of inputs
4.     Remuneration and incentives
5.     Medical equipment and pharmaceutical markets
Other way in which supply is analyzed is Market structure – how many firms are there supplying to a market and how do they behave with respect to setting prices and output and making profits. These generally managed through market equilibrium
E.     Market equilibrium 
State where economic forces like demand and supply balanced. For healthcare many believes, it is imperfectly competitive market (Nash Equilibrium) where there is strategic interdependence between two firms. The Nash equilibrium occurs when both firms are producing the outputs which maximize their own profit given the output of the other firm. The other side believes it is competitive market. Market equilibrium factors are as follows:
1.     Money (payer), investment etc.
2.     Price mechanism
3.     Time price factors
4.     Waiting list
F.      Micro-economics evaluation
In simple words it is decision making related to allocation of resources. Major goal of microeconomics is to analyze the market mechanisms that establish relative prices among goods and services and allocate limited resources among alternative uses. It also analyzes market failure, where markets fail to produce efficient results. Few topics which would play important role in micro economics evaluation are:
1.     Cost effectiveness and cost benefit analysis of alternative treatment
2.     Cost utility analysis
3.     Opportunity costing
4.     Allocation based on phases of disease (Detection, diagnosing, treatment and after care)
5.     Market structure
Healthcare market typically which are analyzed are:
1.     Healthcare financing market
2.     Physician and Nurse services market
3.     Institutional service market
4.     Input factors market
5.     Professional education market
G.    Planning, Budgeting and Monitoring
Optimizing the system through effective instruments and tools, few are as follow:
1.     Budgeting
2.     Manpower allocation
3.     Regulation and norms
4.     Incentives structure
H.    Evaluation of system
It is to bring efficiency and equity to the system to bear on (E) Market equilibrium and (F) Micro economic factors through inter regional comparison, international comparison and benchmarking.
Efficiency - the allocation of scarce resources that maximizes the achievement of aims by Knapp.
Equity is always an important criterion for allocation of resources. However, it is observable that people attach more importance to equity in health and health care than they do to many other goods and services. It is important to distinguish equity from equality. Equity means fairness; in the health care context this means a fair distribution of health and health care between people and fairness in the burden of financing health care. Equality means an equal distribution, but it may not always be fair to be equal. 
Health economics has number of methodological limitations but it can offer us useful concepts and principles which help us think more clearly about the implications of resource decisions. An understanding of some basic economic principles is essential for all practitioners not only to understand the useful concepts the discipline can offer but to appreciate its limitations and shortcomings.
Wish to hear more from my connections on this...
The article was first published on Dr. Karan Sharma's LinkedIn pulse page here, its been re-published here with the Author's permission. 
Karan Sharma
Healthcare Strategy and Customer Experience Manager, Technology Enthusiast, Innovator and Healthcare Business Leader.

Highly experienced and focused senior Executive with strong background in Healthcare strategies and business problem solving. Have managed multiple projects in different disciplines and geographies with strong track record of building great teams with exceptional results. Provide and Execute vision, strategies or idea.

He is a clinician and healthcare management professional, worked in India, Middle East and Maldives.
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