Telangana Diagnostics.ppt.pptx.ppt

Telangana diagnostic hub working

1. Telangana Diagnostics –
A cost effective, free
diagnostics delivery initiative
28-Dec-2020

2. Problem Statement
Diagnostics based patient care is the new normalin Healthcare Delivery.
Based on recent study on Cost of Health Care spent by individuals, major pie in
expenses is taken up by Diagnostics and Medicines. And their share is increasing day
by day in the overall delivery because:
 Diagnostics playingpivotal role in determining the issues without wasting precious time
available before starting the treatment.
 Because of Medico Legal Issues, Doctors are not able to proceed without first diagnosing the
issue through medical tests.
Also the study reveals middle class is becoming poorer day by day if they are facing
any medical issue.
Thus, Government of India provided a greater focus on creating a wholistic solution for
making diagnostics an affordable solution for public.
Free Diagnostics is made a mandatory program under NHMdesigned and executed
via State Health Departments in delivering it.

3. How we adopted?
Different states have different models of this program delivery like
Fully Outsourced (Ex: AP, Delhi)
Partly Outsourced (Ex: Gujarat, Rajasthan)
Telangana opted for Complete In-House model
While setting up in-house model, we designed as Hub & Spoke Modelwhere a Central Laboratory
(Hub)caters to all Health Facilities (Spokes)that are in the vicinity of below 60 KMs.

4. What have we done?
Launched our 1st Central Laboratory (Hub)in August 2018 in Hyderabad.
This Hub supports >300 Health Facilities (Spokes)
60Investigations are delivered at the central lab -40 Clinical Biochemistry Tests, 10
Microbiology Tests and 12 Pathological TestsS.NoClinical Biochemistry Tests 19S. HDL
1Blood Urea 20S. LDL
2Blood Urea Nitrogen 21S. Total Cholesterol
3Fasting Blood Glucose 22S. Total Protein
4Glucose Tolerance Test (GTT)23S. Triglycerides
5Gamma Glutamyl Transferase (GGT)24S. Uric Acid
6HbA1c 25SGOT/ AST
7Lipid Profile 26SGPT/ ALT
8Liver Function Test 27T3 - Total
9Post Lunch Blood Glucose 28T4 - Total
10Ramdom Blood Glucose 29Thyroid Profile
11Renal Function Test 30Thyroid Simulating Harmone (TSH)
12S. Bilrubin D 31Serum Sodium
13S. Bilrubin T 32Serum Potassium
14S. Calcium 33Serum Chloride
15S. Albumin 34Serum Electrolytes
16S. Alkaline Phosphatase 35Serum LDH
17S. Amylase 36Gestational Glucose Tolerance Test
18S. Creatinine 37Creatinine Clearance S.NoClinical Microbiology Tests6 Rheumatoid Factor (RA)
1 Anti Streptolysin O 7 S. Typhi lgM & lgG
2 C - Reactive Protein 8 Stool for Ova & Cyst
3 Chickengunya lgM 9 Dengue NS1 Antigen
4 Dengue lgG Antibodies 10Rapid Plasma Reagin Test
5 Dengue lgM Antibodies S.NoPathology Tests 7 Erythrocyte Sedimentation Rate
1 Absolute Eosinophil Count8 Packed Cell Volume
2 Complete Blood Picture 9 Platelet Count
3 Complete Unine Exam 10Stool for Occult Blood
4 Coombs Test Direct 11Total Leukocyte Count
5 Coombs Test Indirect 12Total Red Blood Cell Count
6 Differential Leukocyte Count
+ Vitamin D3, Serum Iron & UIBC

5. Delivery Excellence
Initially started with 800 samples per day. Currently > 5000
samples are tested daily with TAT of 24 Hours
In 1
st
year, the patient foot fall was 2 Lakhs and now with
present stats, 10 Lakhs patients are utilizing the service per
annum.
After setting up the Diagnostics Labs increased the patient footfall
at Government Facilities
Reports generated, validated and deliveredonlineto respective
Spoke facilities. Patients can directly download their reports from the
SMS sent from the system.
Quality Assurance practices have been implemented from the
beginning of the program.
 Daily IQCs are run in the laboratory.
 Central Lab is entered into EQAS program with CMC, Vellore and
AIIMS, New Delhi since inception of the program and is being
complied with the Standards.

6. Hub Setup Requirements
•2500 SFT of lab space
•Centralized Air Conditioning
•Restricted Entry to Sanitized
Environment
Space Requirements:
HR Requirements:
Infrastructure Requirements:
Clinical Chemistry AnalyzersImmunoChemistry AnalyzersHematologyAnalyzers
Urine Analyzers Elisa Reader & Washer Rotary Shaker
•Lab Supervisors (2)
•Bio Chemist
•Pathologist
•Microbiologist
•Quality Manager (1)
•Lab Technicians (8 B.ScMLTs & 16
DMLTs)
This man power to support 3 shifts of
work.

7. Financials & Outcomes of 1
st
YearMarket Worth of Tests Delivered
# of Tests Delivered (in 12 Mths):
32,30,792
Market Worth: 16 Crores
OOPE SAVINGS For Public
12.45 CRORES
Lab Establishment Costs
(One Time)
2 CRORES
Operational Costs for 12 Mths
(Monthly Recurring)
3.55 CRORES
(1.79Cr for Reagents & 1.76Cr for HR, Other
Consumables, Sample Transporation etc)
Rs. 10 Per
Test
Based on the study conducted in the initial year, program delivered 16 Cr. worth of testsbased on current
market value at a fraction of cost.
Each test costed Rs. 10/-Only on average.

8. Work in Progress
Confidential Document
In first 2 years, only Pathological/ Laboratory services were delivered. Now Imaging
Services also added in Hyderabad City with a concept of Mini Hubs @ UCHCs or major
UPHCs
Initially 8 Mini Hubs are operationalized.
Each Mini Hubs are equipped with Radiology and ECG Services
 Digital X-Ray with Tele-Radiology Reporting
 Ultra Sonography by the Radiologist for Anti-Natal and General Cases
 Tele-ECG with Artificial Intelligence Report & linked to STEMI HUBS for immediate and timely
intervention
8 More Mini Hubs would be started soon to saturate Hyderabad City with Imaging and ECG
Services.
Based on the current sample load, Central Lab is being further expanded by acquiring
additional space
 Histopathology services are being added
 Microbiology lab is being fully automated and also adding cultures etc.

9. Work in Progress
Confidential Document
36 additional Hubs are planned setup across the
state with
 Each district to have at least 1 Hub. Larger districts
may have 2 Hubs
 Hub to Spoke to be within 60 KMs reach / Sample
Transportation time will be less than 5 Hours
Already 20 District Diagnostic Hubs ready for
operations in 30 days time
Establishing 16 more would bring entire Telangana
State under the Hub and Spoke Model of
Diagnostics.
After stabilizing the pathological services, Imaging
Services would be added in due course.

10. Conclusion
Confidential Document
Delivered a successful model that exceeded the program objectives. More than 9 Lakhs
patients are served per year currently.
# of Tests can be tailor made based on the demand and necessity for a fraction of increase
in operational expenditure
Existing framework on Diagnostics and Quality Assurance can be utilized in setting up the
central labs.
Additional employment generated through lab technicians’ recruitment and vendor transport
team.
Equipment, test methodology knowledge and test data are completely owned by
Government; and these get helped in creating new policy for providing better healthcare via
preventive & predictive practices
Current electronic reporting framework would be integrated with Electronic Health Record
framework in future.

11. Thank You