Simple Steps for Living a Healthy Life

If you work a lot more than 40 hours each week it will sooner or later catch up with and you will burn out. You may feel that this is necessary given the present times, but you will have to try to find the balance that will give your employer what they require without infringing on your health. You have to find time to do things that are fun and that you feel you have earned as a result of your hard work.

Eating is another part of our lives that many people struggle with. Food is often used to provide comfort and many times not used for nourishment alone. It is important to pay attention to the signals sent by our bodies and eating when we are hungry and only until we are satisfied. Emotional eating has become a way of life for a great many people leading to being overweight and having to deal with the medical conditions brought on by these extra pounds. Keen shoes and a walk in the park are a great way to provide exercise as well as stress relief.

Fitness activities should be part of everyone’s weekly schedule. This should be something that is fun. Do not make it into a chore. There are many places that a person can take a walk or go for a bike ride. Many cities have weekend activities that make a great option for exercise. The parks department in my city hosts a three mile walk at one of the parks each week. Keen shoes on sale can get you headed down the right path.

In order to stay healthy; you have to have balance in your life. Spending too much time on one thing and not enough on another can lead to stress and the feeling of being overwhelmed. Being faced with this is never good and often leads to negative behaviors. Find a keen shoe sale and enjoy the beauty of the outdoors.

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Lokpal - Only Meeting, No Meeting Ground

As expected, discussions between the government and civil society representatives on the drafting of a Lokpal Bill are headed for a breakdown with both sides admitting there’s no agreement on any of the fundamental issues.

As a result, in what could be a first, two versions of the draft Bill could be sent to the Cabinet, leaving it to take a final call on the Bill.

Sources said the government has already decided that whether the two sides agree on a single draft Bill or not, it would go ahead and introduce a Lokpal Bill in the monsoon session of Parliament. After a two-hour meeting this afternoon, the two sides agreed only on the date of their next meeting, probably the last, on June 20 and, if needed, June 21.

The contentious issues like inclusion of the Prime Minister, the higher judiciary and the MPs under the Lokpal’s ambit, did not even come up for discussion today.

“It was not at all satisfactory,” was the prompt reply from Justice Santosh Hegde, speaking to The Indian Express, immediately after the meeting was over. There was disagreement even on the “basic issues,” he added.

Echoing this was Union Minister Kapil Sibal: “There was no consensus on basic issues with regard to the form of Lokpal Bill. Structurally there is no convergence of opinion over what the office of Lokpal should be like — both at the Centre and state-level.”

“We shall meet again and in case there is no consensus, both sides will go ahead with their version of Bill. A draft Lokpal Bill will be sent to Cabinet by June 30, which shall have version of the ministers of the government as well as the Jan Lokpal bill (drafted by the civil society),” the minister said.

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Major Factors Regulating Growth In A Healthy Child

Many factors contribute to a child’s overall growth. However, nutrition, hormones and the growth potential a child inherits from their parents are the major factors regulating growth in a healthy child. Chronic illnesses such as diseases of the kidneys, liver or heart, as well as chronic use of certain medications can delay a child’s growth.

GROWTH CHARTS

Doctors use growth charts to determine if a child is growing normally with respect to their height and weight. Since there is a range of normal heights at any particular age the growth charts are composed of curves which represent percentiles of growth.

HOW TALL SHOULD MY CHILD BE?

Which percentile a child should be growing at is primarily determined by their parent’s height. The first question to answer when evaluating a child for delayed growth is are they growing on a percentile curve that is appropriate or expected for their family. In general we expect short parents have short children and tall parents have tall parents.

The height potential a child receives from their parents can be estimated by calculating the midparental height (MPH). On average adult males are 5 inches taller than adult females. The formula for MPH adjusts the parent’s height either up or down by 5 inches depending on whether the child is a boy or girl. The MPH is calculated using the parent’s height in inches.

Girls:	MPH = (Dad’s height – 5") + Mom’s height 2
Boys:	MPH = (Mom’s height + 5") + Dad’s height 2
As an example if mom is 5'4" (64") and dad is 5'10" (70") their daughter’s MPH would be:
MPH =	(70"-5") + 64" = 2	65" + 64" = 2	129" 2	= 64½" (5'4½")
And their son’s MPH would be:
MPH =	(64" + 5") + 70" = 2	69" + 70" = 2	139" 2	= 69½" (5'9½")

The MPH is then plotted on the right hand of the growth chart.

In our example then a MPH of 5'4 ½” for a female is at the 50% percentile,
Likewise the MPH of 5'9½" for a male is the 50%. On average for this family their sons and daughters should be growing along the 50th percentile line. Just as there is range of normal heights for children at any age there is a range of heights amongst brothers and similarly amongst sisters.

If your child’s height is on a growth channel lower than the predicted ranges their growth is most likely not appropriate for your family.

In our example family they have a five year daughter (A) who is 42" and a 12 year old daughter (B) who is 54¼" The five year old’s height is at an appropriate percentile for the family. In contrast the 12 year old daughter is shorter than expected for the family even though her height is in the so called normal range of the growth chart.


HORMONE CAUSES OF DELAYED GROWTH

There are three groups of hormones which are necessary for a child to grow. Growth hormone and thyroid hormone are important growth factors from birth until a child reaches their adult height. The production of the sex steroids testosterone and estrogen during puberty, also influence growth. A deficiency of any of these hormones will result in a delay of growth. These deficiencies can be present at birth or develop throughout childhood and adolescence. Generally with growth hormone deficiency there are very few other signs in a child except for poor growth. Children with thyroid hormone deficiency aside for having poor growth may complain of being tired, weak, feeling colder than others, having constipation, dry skin and coarse hair. The possibility of a deficiency of sex steroid production should be raised if a boy has not shown any signs of puberty by age 14 or a girl by age 13.

THE GROWTH EVALUATION

The initial evaluation of child with poor growth includes reviewing their previous growth pattern, obtaining a history about their family’s heights and looking for signs of hormone deficiencies, chronic illness of genetic syndromes associated with delayed growth. Growth records form birth to the present can provide an enormous amount of information as to an underlying cause of the child’s poor growth. Many times a completed growth chart is more valuable than laboratory tests. Often multiple sources have to be tapped to find the complete growth history. This may include your child’s doctor’s office, baby books you may have kept and even the marks on the doorframe in your home where you have followed your child’s growth over the years. After reviewing this information, special tests may be recommended including blood tests to measure hormone levels, assess the function of your child’s kidneys, liver, intestines and assess their nutritional status. Usually we obtain an X-ray of the hand called a bone age to assess the rate at which your child’s bones are maturing.

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Govt Committed To Curb Black Money Menace

Competition among tax havens had created an unhealthy situation, helping individuals to park substantial undisclosed income outside their countries, denying government's legitimate revenues, finance minister Pranab Mukherjee said on Monday. The government was committed to vigorously pursue all necessary steps to curb the menace, he added.

The UPA government has been on the back foot over the issue of black money and has been criticised for its failure to bring back money stashed in foreign countries. The government has taken several steps to blunt the attacks which has seen civil society members taking to the streets. Mukherjee said there was a considered view that tax havens and low tax jurisdictions were important actors in the global financial crisis. The opaque system in these jurisdictions and restrictions on exchange of information in these tax havens and their non-compliant behaviour was a matter of serious concern, he said. "The concerns are not only on account of protecting revenue base but also linked to financing of activities which are detrimental to national security interest." He said the government was in the process of negotiating exchange of information agreements with tax, no tax or low tax countries.

The finance minister said India had also initiated process of re-negotiation with 65 countries to broaden the scope of provisions governing exchange of banking information and information without domestic interest. The government had finalized 14 Tax Exchange Information Agreements (TEIAs) and completed negotiations/renegotiations of Double Taxation Avoidance Agreements (DTAAs) with 36 countries in the last financial year.

"While countries have accepted to end bank secrecy in general, some countries have agreed to do so only from prospective date and are not willing to exchange past banking information," Mukherjee said, while addressing a tax conference organised by the Paris-based OECD — a group of 34 industrialised nations. "India is... suffering from the fact that some of its citizens are using some countries to put their money to avoid paying tax," OECD secretary general Angel Gurria said at the conference.

The OECD and India announced plans to strengthen ongoing cooperation on tax related issues through the development of a three-year partnership that will provide greater opportunities for dialogue and sharing of information. The finance minister said the Global Plan for Recovery and Reform, the statement of G20 leaders in London issued in April 2009, had called for action against non-cooperative jurisdictions, including tax havens.

"However, the spirit of this statement has not been respected. We cannot say with certainty that bank secrecy is over in all cases. While the countries have accepted to end bank secrecy in general, some countries have agreed to do so only from prospective date and are not willing to exchange past banking information. This puts a question mark on the efficacy of present legal provisions for exchange of banking information. There is an urgent need to revisit existing legal framework developed by OECD in this regard," the minister said.

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Congress Calls Anna Hazare 'Unelected Tyrant'

A day after finance minister Pranab Mukherjee took on civil society activists for trying to supplant Parliament, Congress joined the act, dismissing Anna Hazare's complaint to Sonia Gandhi about being tagged a saffron agent by not only repeating the charge but virtually labeling him a tyrant.

Congress pushed back hard at civil society after being at the receiving end of anti-corruption campaigns, saying Hazare is "reading from a script written by forces behind him" - a clear reference to RSS -- and accusing him of being consistently soft on corruption in BJP-ruled states like Gujarat and Karnataka.

Congress spokesperson Manish Tiwari also hit out at the Hazare group for being "unelectable" and said, "If this democracy faces its greatest peril from someone, it is from the tyranny of the unelected and the unelectable".

Tiwari questioned the civil society's claim to represent public opinion and said its hectoring attitude showed a contempt for democracy. "I can only say that Hazare should consider his languagea¦ given his age I feel some sympathy for him," the Congress spokesperson said.

Congress has clearly decided that Hazare's reference to UPA-II as "a bunch of cheats and frauds" on Sunday - a charge repeated by his associates like Arvind Kejriwal - won't be tolerated. It has clearly riled the party and Tiwari admitted Congress had changed its attitude. "Accommodation has been mistaken for weakness," he said.

Congress sources, however, denied the government was looking to snap its dialogue with the Hazare group, but said the Centre was running out of patience with "irrational expectations and attitudes". This was articulated by Tiwari, who said, "This 'my way or highway' will not worka¦ restraint is called for by both sides, it cannot be a one-way street."

Hazare's complaint to Sonia about Congress leaders calling him a RSS mask not only failed to deter such criticism but resulted in sharper attacks as his letter is seen as a proof of the saffron barb having struck home. "Without doubt Hazare is playing to an RSS agenda," said sources.

With no let up in the diatribe between Congress and Hazare, the fragile negotiations between the government and the Hazare group do not seem likely to succeed. While the civil activists are stepping up their demands, government is equally determined to stymie them on issues like inclusion of the prime minister, higher judiciary and actions of MPs in Parliament in the Lokpal bill.

By more or less terming Hazare as anti-democratic and a tyrant in his stubborn advocacy of his version of transparency laws, Congress directly questioned the civil society's credentials. "He calls himself Gandhian but his statements are increasingly aggressive and violent," said Tiwari adding that Hazare's instances of good governance were BJP or NDA chief ministers of Gujarat and Bihar while there was not a word on Karnataka's B S Yeddyurappa.

Hazare's style of bargaining over Lokpal bill, said Congress, showed his contempt for democracy and was evident from the Gandhian's sweeping belief that "voters could be purchased with liquor and money". Seen along with Mukherjee dismissing Hazare's August 15 deadline for enacting a Lokpal law the forced cohabitation with civil society seems to be nearing its end.

The offensive, despite the risk that Team Hazare could cite it as provocation to pull out of the joint drafting panel, showed a change of heart in Congress since the Ramlila Maidan crackdown. A section of the party has blamed the government for being "over accommodative" of civil society leaders like airport diplomacy for Baba Ramdev and, in turn, ceding space to BJP which was riding on these protests.

An AICC leader, agreeing that there was a hardening of stance on civil society, said, "You can call it course correction but the events of last two months have shown that we cannot anymore give the benefit of doubt to these leaders. And we have lost patience with irrationality."

Congress appeared attempting to retrieve the lost authority in the face of kowtowing to civil society since Anna's fast in early April forced it to take the unprecedented step of a joint drafting panel with non-government entities in it. Tiwari said, "If someone has confused our sensitivity for weakness, then he should disabuse himself of that notion. Governments run on authority and UPA is not ready to compromise on that."

[Source]

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Gujarat Gets 500 Medical Seats In A Week

Those who wish to pursue MBBS, here is some good news. The state has got approval for 500 medical seats in a week's time from the Medical Council of India (MCI).

The state had received approval for 150 seats each in the Medical College in Sola and Adani Medical College in Bhuj last Thursday.MCI on Saturday approved 150 medical seats in the new medical college in Ahmedabad, which will be run by Gujarat Cancer Research Society. In addition, 50 seats have been increased in the Medical College in Bhavnagar.

State health minister Jay Narayan Vyas on Sunday said, “Gujarat would probably be the first state in the country to get approval for 500 new medical seats in a year. We are also expecting MCI's approval for the new medical college at Gotri in Vadodara. Next year, 500 more seats will be added to the state's medical education as medical colleges at Patan, Valsad and couple of other institutes will be set up in the state.” “I guarantee that no deserving students will be left out from pursuing medical education because of weak financial condition,” Vyas added.

“In fact, we are receiving offers from banks to open their counters at admission centres to provide education loans to deserving candidates. The state has taken up the mission to ensure that not a single deserving student from Gujarat has to go to other state for medical education,”

Health Insurance

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5 Retirement Mistakes That Will Haunt You

"You'll regret it. Maybe not today, maybe not tomorrow, but soon and for the rest of your life."

Those words, spoken on a tarmac at the finale of the classic film "Casablanca," could be stretched from the intended affairs of the heart to how we plan for retirement.

There are financial decisions we make that seem a good idea at the time and retirement moves we make half-heartedly. When it comes to ensuring a lifetime of retirement income, bad decisions may not hurt immediately, but once the pain arrives it can last for decades.

Here are five retirement mistakes that will haunt you, and ways to avoid the haunting entirely:

1. Guesswork, Not Legwork

How much will you need to retire?

That straightforward question should be a starting point for people of all ages, at all stages of planning. A great number of people, however, do no more than guess at what they should save.

According to the Transamerica Center for Retirement Studies, a nonprofit organization funded by Transamerica Life Insurance, half of workers continue to guess at the amount of money they need to save to feel financially secure when they retire and a large number (44%) of American workers do not have a strategy to reach their retirement goals.

Of those who do have a strategy, only half have factored in health care costs and one-fifth have factored in long-term care insurance, making their estimates inadequate. A reduction or loss of Social Security benefits ranks third in greatest retirement fears.

As part of its research, Allianz Life asked a segment of baby boomers how much money they thought they would need to live on.

"The average number they came up with was $60,000," says Katie Libbe, vice president of Consumer Insights for Allianz Life. "Then we asked them to try to calculate what that means in terms of a portfolio that's going to deliver that for as long as they think they are going to be in retirement. They were at a loss in terms of what they would need. They said $500,000 when, if you just apply a 4% withdrawal to that portfolio, they would really need $1.5 million. They don't know how to do even this basic calculation. You can teach them about some of these individual tactical mistakes, but they can be off even in the strategic sense of how much money needs to be socked away."

Not only is there the danger of not ensuring the longevity of your savings; there is the temptation of being unreasonably aggressive with your portfolio to make up for maybe not saving as much as they should have.

Health care costs also need to be considered. According to research by Allianz Life, the average couple retiring at age 65 will spend approximately $285,000 in health care costs in retirement. As life expectancies continue to increase, baby boomers need to have a plan for covering some portion of managed care for an elderly parent as well as for themselves.

Health care costs, Libbe says, could "eat into a good chunk of their nondiscretionary dollars, which means fewer dollars available for all the fun things they want to do in retirement."

2. 'I'll Just Keep Working'

Most people assume they will retire at a certain age, and many look to salvage inadequate savings by working later into life.

But according to Limra, a global association of insurance and financial services companies, two in five people retire earlier than planned due to a number of factors, including layoffs or illness. For those assuming they will work part time in retirement, many can't due to circumstances beyond their control.

"We did some research recently where we found out that a lot more baby boomers are planning to work longer," Libbe says. "That's basically their backup plan for not having saved enough for retirement. The Limra statistic about two in five people retiring earlier than they expected just shows you can't count on working longer being your plan."

Making the prospect of retiring ahead of schedule all the more precarious is that 70% of respondents to the Transamerica Center survey agreed they could work until age 65 and still not have enough money saved to meet their retirement needs.

"Planning not to retire is simply not a viable retirement strategy," says Catherine Collinson, president of the center. "Planning to work past age 65 is an important opportunity to continue earning income, save more and help to alleviate a retirement savings shortfall; however, it's important that workers be proactive in setting a retirement savings goal, saving and investing for retirement, and having a backup plan if they are forced to retire sooner than expected."

3. Taking a Loan Against Your 401(k)

Close to one in 10 workers with qualified retirement plans from their employees took a loan out in the past 12 months, according to the Transamerica Center.

The center's 12th Annual Transamerica Retirement Survey, conducted among 4,080 American workers, found that the majority of those taking loans (42%) did so to pay off debt; 14% did so to buy a primary residence. Only 6% did so in response to medical bills and even fewer (3%) found it necessary for tuition expenses.

Though commonly viewed as "borrowing from yourself," those who fail to repay can be saddled with taxes and penalties. Borrowing against a retirement plan also reduces the ability of those funds to garner interest, a loss that will compound in perpetuity.

4. Not Taking Full Advantage of Benefits

Leaving money on the table will hurt you later in life.

According to the independent investment adviser Financial Engines, the recession hurt participant savings rates, with 39% of participants not saving enough to get their full employer match, up from 33% in 2008. Of participants under age 40, 47% failed to save enough to get the full employer match.

In tight economic times, it is understandable that households need to cut costs in many ways. But every dollar not added to your portfolio will miss out on the matching company funds and compound interest both will accrue for years to come.

5. Not Having a Tax Strategy

Many fail to consider the tax impact when withdrawing from their nest egg, Libbe says.

When in retirement, the objective changes from accumulation to converting investments into "tax-smart" income. A tax-efficient withdrawal plan can make a significant difference in how long your portfolio lasts. Retirees need to optimize taxable and tax-advantaged accounts to minimize tax-bracket impact and other income such as Social Security.

"You can actually make your retirement assets last longer if you know how to take distributions from them in retirement so that you are efficient with your taxes," Libbe says. "It is not easy for the average consumer to do, but there are financial advisers and software programs who can do exactly that. They can make sure you don't bump up into a new tax bracket and you are paying attention to required minimum distributions. It can be as simple or complex as you want to make it."

Avoiding the Pitfalls

The Transamerica Center for Retirement Studies recommends seven steps to help avoid these and other retirement mistakes that can have a life-long impact:

• Get the conversation going with friends and family. Just 9% of workers frequently discuss saving, investing and planning for retirement with family and friends.

• Formulate a plan and write it down. Only 10% of workers have written out their retirement strategy.

• Get educated. The majority of workers (71%) say they do not know as much as they should about retirement investing.

• Consider retirement benefits as part of your total compensation. Fifty-three percent of workers would select a job offer with a higher than expected salary but poor retirement benefits over one with excellent retirement benefits and minimum salary requirements.

• If your employer offers a plan, participate. And if your employer doesn't offer you a plan, ask for one. Just 71% of workers report being offered an employee-funded plan at work, while 92% say a plan is an important benefit. However, almost one-quarter of workers (22%) who are offered a plan at work do not participate.

• Make catch-up contributions. Just over half of workers (56 percent) are aware that people age 50 and older may be allowed to make catch-up contributions to their retirement plan.

• Have a backup plan in the event you are unable to work before your planned retirement. Only 19% of workers have a backup plan.

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Yoga And Back Pain

Back pain, one of the common problems of present day, is caused due to stress and tension in the muscles that support the spine. Sedentary lifestyle, stress, overuse or under use of the back, postural mistakes are unconscious triggers to the widespread problem of back pain. Regular exercise is a redeeming feature that brings relief to back pain.

Backache strikes when the muscles are under fatigue, commonly at the neck or lumbar region (where most twisting, turning or bending occurs). Frequent backaches occur due to overstrained or over stretched muscles, improper sitting positions, stress, lumbar scoliosis and earlier injuries. Many conditions cause back pain and they can be treated with conscious and gentle yoga practice. It has proven to be a safe and effective way to alleviate many forms of back pain and prevent its recurring bouts. However, all cases of back pain need to be evaluated by a medical expert for diagnosis and treatment.

Healing Benefits of Yoga

• Yoga strengthens muscle groups. Many postures in yoga strengthen the back and abdominal muscles and help the body maintain a proper upright posture and movement. Stretching and relaxation reduces tension in stress carrying muscles. When these muscles are well conditioned, it helps to offset back pain.

• Yoga eases lower back pain, by stretching and strengthening the muscles of the lower back. It increases blood circulation, which brings healing nutrients to the injured tissues. Yoga also helps maintain a natural curvature of the spine that is crucial in avoiding lower back pain.

• Thus, Yoga is an excellent therapy for healing injured and sore back muscles, speeding time to recover from an injury and preventing re injury. It also reduces the risk of disability due to back pain. In short, Yoga increases awareness of the body and keeps the body healthy and supple.

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Teleradiology - Bringing Round-the-clock Patient Care To Your Doorste

We live in a highly connected global village where the Internet has made remote healthcare widely available round-the-clock. Teleradiology, an important part of telemedicine, involves remote diagnosis through digitized images and remote advice. The process has been beneficial to a majority of the world’s population, as it balances out the maldistribution of radiologists the world over. Used in war-torn areas, outer space, on board ships, and in Antarctica, teleradiology, however, leaves some questions unanswered in the milieu of its operations in India and elsewhere.

Lakshmi Gopal of Medindia spoke to Dr Sumer Sethi, MD, Sr Consultant Radiologist at VIMHANS, Delhi and Director of Teleradiology Providers, a unit of Prime Telerad Providers Pvt Ltd. An author of many academic papers and books on radiology, Dr Sethi specializes in musculoskeletal and neuroradiology.

Q. What is telemedicine and teleradiology all about and why are they important?

A. Teleradiology is the process of transmitting and receiving digital radiology images comprising of X-ray, ultrasound, MRI, etc., from one location to another through a secure digital network. The images are transmitted using advanced computer systems, typically over the Internet. Through teleradiology, images can be sent to another part of a hospital, or anywhere in the world. It is a means of electronically transmitting radiographic patient images and consultative text from one location to another.

Q. How is teleradiology important from the consumer’s point of view? Does it bring down costs and improve diagnosis?

A. Teleradiology brings the best medical opinion available to the consumer’s doorstep. The consumer does not have to travel long distances to big cities with medical infrastructure. He can avail of expert opinion and quality reports in his remote hometown, saving on the costs of travel and accommodation. Teleradiology also helps the patient secure diagnostic reports in 30 minutes’ time nowadays, enabling faster treatment.

Q. What is the Medical Council of India’s stand on teleradiology as a form of practice in India?

A. The Medical Council of India currently does not have any specific guidelines for telemedicine. Therefore, the standards applicable to radiologists are also used for teleradiologists.

Q. What do you foresee for the future of teleradiology in India in terms of demand and supply within the country and outside?

A. The demand for radiologists is great in India and abroad - they are, however, in short supply. Teleradiology helps adjust this imbalance. India has a lot of talent and our doctors have emerged as one of the major providers of teleradiology services in the Indian subcontinent, the US, Africa, and the Middle East. Here, I must mention my company - Teleradiology Providers. Its key strength is that we have extensive experience working across both public and private hospital facilities. We have sub-specialist abilities and experience in the areas of neuroradiology, breast and cardiac imaging.

We also provide our own customized teleradiology software along with a dedicated web-based server platform and have the ability to link up with any centre in the world irrespective of the Internet speeds available.

Q. Teleradiology raises interesting ethical and practical issues. These include patient confidentiality, data security and image authenticity. How should these issues be tackled?

A. Teleradiology is a globally well-accepted method of radiology report delivery, and its systems and processes are usually governed by standards like the Digital Images in Communications and Imaging (DICOM) version 3.0, 1993 and the US Health Insurance Portability and Accountability Act (HIPAA) 1996.

All healthcare organizations must make sure that their teleradiologists are sensitized to the issues of patient confidentiality and data security. Teleradiologists, even when they work from remote locations, are basically responsible doctors and must keep their patients’ records confidential.

There is a chance of data security being compromised when teleradiologists use an email facility to support reporting - this should be avoided.

Image authenticity becomes an issue when a teleradiologist uses a jpeg image for reporting, instead of a DICOM image. The DICOM format for images gives clearer pictures and is ideally suited to radiology.

Q. How can accuracy of reporting be increased?

A. For accuracy of reporting, it is better if the same chest X-ray or mammogram is shown to two radiologists. The practice followed in medical colleges is that radiology reports are usually double or triple read - first the junior resident reads it, then the registrar, followed by the faculty member, who has the final say.

It would definitely make sense to follow such best practices and have standard double reads of reports to increase accuracy and cut down on ambiguity.

The computer may play a significant role in this area in future - recognizing patterns that could be later super-read by radiologists. This will increase efficiency and reduce the margin of error in spotting a significant issue.

Q. There are many teleradiology companies making the same claims of quality and efficiency today. Who do you think will survive the rat-race?

A. In the long term, only players with competent and quality systems in this field who follow all standard Internet security protocols like DICOM and HIPAA will survive.

Q. If there is an error in diagnosis, who shares the responsibility in a court of law?

A. Here, the same law applies, as onsite reporting. Teleradiologists take full responsibility for error in diagnosis in a court of law. In our company, teleradiologists take full responsibility of their work - they carry their own indemnity insurance. Further, our performance improvement program continuously monitors quality and performance parameters, ensuring an ongoing analysis of workflow and turnaround times, random quarterly audits of reports, and statistical reviews of important events with our chief radiologist.

Q. What is super cloud computing technology? Will it be able to afford low-cost diagnosis? What are the new techniques prevalent in teleradiology in the west? Have they reached India?

A. Super cloud computing can help store and share data, and connect more easily without large capital expenditures. It offers a platform for better scalability and flexibility. In our industry, the ability to work with large volumes of data with greater ease provides benefits beyond better scalability and cost savings - it makes a difference in patient care. With a cloud-based solution, images can be shared digitally at different locations.

Benefits for the patient in super cloud computing are that turnaround time is shortened and there are fewer interruptions and breakdowns.

The new technique prevalent in the west has to do with image pattern recognition by computers that the teleradiologist super-reads. This is not available in India yet.

Q. How can teleradiology help patients in remote rural areas in India? How can the cost of treatment come down for the poor in urban and rural areas?

A. It is very unfortunate that while 70 percent of India’s population lives in villages, the healthcare available there is meager. Also, the quality of rural healthcare can hardly be defined as state-of-the-art. As part of its Corporate Social Responsibility drive, Teleradiology Providers have taken the initiative to bring state-of-the-art diagnostics to a rural centre located in Mirpur, Haryana, where we do reporting free of charge.

[Source]

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