In an interaction with Mamta Maity, indiainfoline.com, Mr. Shanay Shah, President, Shalby Ltd. said "Many people who had their surgery conducted at Shalby, some 20 to 25 years ago are still walking without pain today. We have innovated the Zero Technique, an approach to performing joint replacement surgeries that include, among other things, prior planning, implant selection, surgical technique planning, and patient counselling."
On the backdrop of the disruption due to the pandemic, how did Shalby cater to the treatment of chronic illness?
The Covid pandemic affected treatments of almost all diseases and impacted resource management for other diseases as medical assets were prioritized for the treatment of /o. During this crisis, we at Shalby recognized the need to prioritize our existing patients while also building capacity to cater to the growing surge of Covid positive patients that required immediate treatment. We had to restructure our treatment plans and surgeries to better manage our resources.
Some of the revamp led to postponing our joint replacement surgeries and others had to push dates for appointments as most of our staff had been assigned to prioritizing Covid patients. This led to diseases such as cardiovascular, cancer, and other chronic diseases being disrupted to a large extent. The travel restrictions added to the existing crisis and we eventually leveraged technology to serve our patients with telehealth facilities for treating their chronic diseases.
How do you see the Indian healthcare industry preparing itself to battle the threat of the fourth wave, even as other countries are reporting a rise in cases?
After nearly two years of the pandemic, with the first two waves creating the maximum disruption, India has ultimately achieved its mass vaccination goals across the country. By building herd immunity, the battle against Covid is eventually waning and infection spread has been contained to a large extent. With immediate response teams and a highly organized methodology, the spread of infection and isolation techniques have been developed to achieve maximum results. Extensive vaccination drive including the booster dose has contributed in this significantly. The Indian healthcare industry is prepping itself with all requisite measures to contain the spread of infections and treat existing Covid positive patients. Continuous transformation in enabling priority health development is helping the industry to successfully avert the threat of the fourth wave.
In spite of other countries reporting a surge in cases, the Indian healthcare sector is apt in building a strong and resilient infrastructure to face and overcome any future waves. Some of these include telehealth and virtual consultations where in-patient consultations are not possible due to travel or access restrictions to the healthcare facility.
What are your expectations from the government in providing healthcare facilities to tier 2 and tier 3 cities in a post-pandemic era?
The government should introduce healthcare policies that are business-friendly for the private sector and encourages investment in the healthcare sector. Such initiatives will have a big impact on both the growth of healthcare services and the creation of jobs, which is very important for the country. The government's goal of increasing public healthcare spending to 2.5 percent of GDP by 2025 along with continuous immunization efforts appropriately demonstrates its determination to make a difference in improving the country's current healthcare conditions. Isolation beds, medical staff, and equipment are all things that show how important it is to have a pro-health care government.
Technology is being utilized in Tier 2 and Tier 3 cities, and the government is granting more assistance by expanding the number of beds per thousand people. In the long run, this will help close the gap between urban and rural parts of the country. Substantial incentives for the establishment of hospitals in smaller areas would significantly improve healthcare services in tier 2 and tier 3 cities. To spread the word about its universal health cover "Health for All," the government has announced and started programs like Ayushman Bharat and National Digital Health Mission. These programs make healthcare more accessible and available to more people, as well. Various apps and tools have been made accessible to help even private businesses set up their own base so that more people can get the care they need.
Tell us about the developments and future projections of the orthopedic industry in the country.
The country's orthopedic industry is at a defining moment. In this industry, we have the ability to expand and produce cutting-edge medical equipment with a burgeoning R&D and collaborative ecosystem. There has been a rise in the amount of money being spent by the government on health and wellbeing. There has been an upsurge in public and private sector interest in health and wellbeing since the pandemic. Because of this, new initiatives and government-led plans have been based on a better healthcare delivery system. When it comes to promoting health care policies and program integrations, this movement is exactly what the market needs. As a consequence of the pandemic, there has been a strengthening of the relationship between public and private healthcare providers, which has culminated in a much more robust healthcare landscape. These measures are guaranteed to put the healthcare sector on the correct path and support the country's economic development.
The joint replacement implants industry which has been dominated by MNCs presently is likely to see significant contribution by Indian players in near future. Incidentally, Shalby acquired Consensus Orthopedics, a California based joint replacement manufacturing company last year through our subsidiary Shalby Advanced Technologies Inc. (SAT). Through SAT we will be foraying into implants business across India as well as in key international markets like South East Asia, South Asia and Japan. This development is fully in line with our strategy to grow our orthopedic implant business and establish Shalby’s footprint in the medical device market in the US, India as well as other key International markets.
What according to you would drive Indo US collaboration and improve the development of research and education in musculoskeletal care.
In recent years, there has been a tremendous improvement in the development and advancement between the Indian and US orthopedic corridors. Through the exchange of orthopedic research and technology, this collaboration will result in replicating high-quality, and improved results in our joint replacement patient populations in the United States and India. The rise in collective and collaborative initiatives between the two countries comprises educational seminars for medical and engineering professionals to advance knowledge transfer between India and the United States. The development of short-term traveling fellowships between the two countries will help build direct exposure opportunities in the healthcare delivery systems.
Developing these new learnings and training tools to improve the technical aspects of advanced orthopedic surgery will help raise the availability and affordability of these facilities. Our partnership with Gardner Orthopedics, Florida, USA is established on similar lines, to build high-quality and reproducible outcomes for the benefit of joint replacement patients in both countries. Furthermore, integrating valuable patient data from high-volume surgery centers in both countries will invariably accelerate and augment the development of the musculoskeletal care segment.
What are the evolving trends that will influence the healthcare market and specifically help in the expansion of the joint replacement sector?
Total Hip Replacement (THR), Total Knee Replacement (TKR), partial knee replacement, partial hip replacement, shoulder joint replacement, and other small joint replacement treatments are all part of the joint replacement market. Joint replacement surgery is becoming more common in India with the increase in trained joint replacement surgeons, changing demographics, reduced physical activity, more money spent on health care, better healthcare infrastructural facilities, and medical tourism. Better implant designs and a lot of options have also made it easier for surgeons to choose the implant that best fits the requirements of patients. Implant design and development has mostly focused on lowering mechanical depreciation and enhancing implant retention in the hip and knee replacement markets. This method has proven to be quite effective, with current bearing surfaces and implant coatings offering alternatives that are significantly more durable than those that were previously accessible. With a substantial increase in joint replacement and reconstruction surgeries, the overall demand for orthopedic implants has also increased. Technological advances to manufacture customized joint replacements will help expand this segment.
What are the necessary steps India needs to undertake in becoming self-reliant and be recognized as a major in the global orthopedic market?
India is a country where most persons over 60 have some kind of bone and joint disease, and most of them need joint replacement surgery right away. Prevalence of conditions such as arthritis and osteoporosis are becoming more common among the country’s population. The rise in the sedentary lifestyle among the urban and emerging townships has all contributed to the growth of the joint replacement market. The rise in trained orthopedic surgeons with better facilities in hospitals is encouraging more people to opt for having joint replacement surgery. The market for customized implants is expanding due to these demographic and developmental factors. India is the second-fastest-growing healthcare market after China and the orthopedic market is expected to grow as medical devices that are meant to prevent or treat disorders in the musculoskeletal system are witnessing a systematic rise. Their availability in hospitals, orthopedic clinics, and ambulatory surgery centers signals how the market is already on a growth trajectory. In being self-reliant, devices that are used in the field of orthopedics are being manufactured and are being utilized for a large number of surgeries. These primarily include joint reconstruction tools, orthopedic braces and supports, trauma systems, spinal devices, orthopedic prostheses, and orthopedic accessories, among other things. Additionally, the increasing prevalence of disorders such as diabetes, obesity, osteoarthritis, and osteoporosis is fueling the expansion of this market segment throughout the nation.
How has Shalby contributed to fostering innovation in the healthcare landscape on a global scale?
There are many people who have had their quality of life improved by having joint replacements at Shalby. Many people who had their surgery conducted at Shalby, some 20 to 25 years ago are still walking without pain today. We have innovated the Zero Technique, an approach to performing joint replacement surgeries that include, among other things, prior planning, implant selection, surgical technique planning, and patient counseling. This technique eliminates all unnecessary instruments, resulting in a very simple and effective surgery. The zero technique gets its name from the fact that all of the usual surgery requirements, such as surgery time, method, recovery time, hospital stay, medicines, blood loss, patient and relative mental stress, and so on, are reduced to nearly zero levels. Even the need for a blood transfusion is reduced and the patient’s recovery time is significantly improved. All of the surgery's requirements are planned and organized in advance so that the surgery and patient’s recovery go as smoothly as possible. Another innovation that Shalby has provided to the healthcare segment is the OS needle, which is also called an orthopedic surgeon's needle. It can go through both bone and soft tissue very quickly. With the OS needle, patients undergoing surgery are able to recover much faster.
Until the early 1990s, these surgeries could only be performed by drilling into the bones, which led to excruciating pain and agony post the surgery. However, with the OS needle, patients have little discomfort, and the procedure is completed much faster.
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