Cancer Care Challenges and Solutions in Delhi Government

 
ONCOLOGY SERVICES
IN DELHI GOVT.
 
Dr B L Chaudhary
Vivek Agarwal (DANICS)
Dr Sumit Arora
Dr Kamal Baghotia
Dr Parmod Mittal
Dr Shaam Bodeliwala
 
Training Programme for Officers of
Govt. of NCT of Delhi (Group 1), IIMA
A
G
E
N
D
A
 
1.
NEED AND REQUIREMENT OF CANCER
TREATMENT/ OVERVIEW
2.
INFRASTRUCTURE AVAILABILITY
3.
CONSTRAINT AND PROBLEMS
4.
POSSIBLE SOLUTIONS
5.
DISCUSSION
 
NEED/REQUIREMENT
& OVERVIEW
 
Increasing Cancer Burden
High Mortality Rates
Early Detection: higher chance of survival
High Treatment Cost
Economic Impact
Quality of Life: physically and emotionally taxing
Research and Innovation
 
“Delhi being the catchment area for surrounding states bears the
additional responsibility”
NEEDS & REQUIREMENT
 
Krishan et al. Indian J Med Res. 2022;156(4-5):598-607.
2040
CANCER CARE INFRASTRUCTURE-DELHI
 
CONSTRAINTS
AND PROBLEMS
 
Shortage of Skilled Personnel-Super specialist doctors (Medical
/Surgical Oncologist and Radiation/Nuclear Medicine), Physicist,
Technicians
Diagnostic Challenges-Lab & Technical resources
Data Management: patient records and treatment plans (PACS).
Medicine and Equipment Procurement
8
CONSTRAINTS AND PROBLEMS
 
PROPOSAL/POSSIBLE
SOLUTIONS
 
 
PPP model
Already operational successfully in
Diagnostics and Dialysis services in IGH,
Dwarka
 
 
 
 
10
Proposal #1
TENURE 
10 YEARS
 + ANOTHER RENEWABLE TERM
PRICING – 
CGHS
 RATES
GOVERNMENT TO FACILITATE STATUTORY LEGAL
REQUIREMENTS AND ANY FURTHER APPROVALS REQ
Pros and Cons of Proposal #1
 
12
Proposal #2
 
New recruitments on Regular/Ad-hoc basis.
Conduct of interviews on a fixed date of  every
month.
Outsourcing of Technical Staff.
Deputation of an Administrator to oversee till
the organization reaches its operational
efficiency.
DNB/DrNB course proposal
Internship for FMGs
Digitalization of Patient Management services
Pros and Cons of Proposal #2
 
THANK YOU
 
A report from International Atomic Energy Agency (IAEA) states that approximately 
50%-60% 
of
the new patients should receive radiation therapy, alone or as an alternative or adjuvant treatment to
surgery
 
Expert doctors like Psychiatrists, Dermatologists, Dentists, Nutritionists, Physiotherapists etc. shall be available for
providing support services to patients
SUPPORT SERVICES
SUPPORT SERVICES
CANCER INFORMATION AND RESOURCES
 
VIDEO CONSULTATION AND TELE
MEDICINE FOR SUPPORT SERVICES
 
PAPER LESS REPORTING  AND
ADMINISTRATION
 
PATIENT AND DOCTORS APP TO
MANAGE DAILY OPERATIONS
CANCER CARE ON FINGER TIPS
 
We shall provide tele-medicine
We shall provide tele-medicine
services including Tele Radiology /
services including Tele Radiology /
Tele Pathology services and Cancer
Tele Pathology services and Cancer
Treatment Planning. It would enable
Treatment Planning. It would enable
us to provide healthcare services
us to provide healthcare services
remotely even when doctors are not
remotely even when doctors are not
physically available.
physically available.
 
We shall develop this model
across the network of all such
similar centres that we set up.
CENTRALIZED HUB FOR REPORTING
KEY EQUIPMENT AT A GLANCE
 
 
BREAST
LIP, ORAL CAVITY
CERVIX UTERUS
LUNG
OVARY
PROSTATE
ESOPHAGUS
STOMACH
LEUKEMIA
LIVER
 
BRAIN, CNS
GALL BLADDER
KIDNEY
THYROID
PANCREAS
MELANOMA OF SKIN
TESTIS
MULTIPLE MYELOMA
COLON
RECTUM
SAMPLE DASHBOARDS
 
AGE WISE DATA
 
GENDERWISE DATA
 
DISEASE WISE DATA
 
TEST REPORT WISE DATA
 
HISTORY WISE DATA
 
DEATH RATE WISE DATA
 
ADMISSION / DISCHARGE DATA
 
CUSTOMISABLE FILTERS TO SORT DATA
AUTHORISED ACCESS
COMPLETELY SECURED NETWORK
MULTI-LAYERED APPROVAL SYSTEM
REALTIME DASHBOARDS
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The training programme for officers of the Government of NCT of Delhi focused on the need, infrastructure, constraints, and possible solutions related to cancer care. With increasing cancer burden and high mortality rates, Delhi faces challenges in early detection, high treatment costs, and maintaining quality of life. The infrastructure in Delhi includes specialized hospitals, machines, and skilled personnel, but constraints like shortage of skilled personnel pose significant problems. The discussions revolved around addressing these challenges to improve cancer care services in Delhi.


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  1. Training Programme for Officers of Govt. of NCT of Delhi (Group 1), IIMA ONCOLOGY SERVICES IN DELHI GOVT. Dr B L Chaudhary Vivek Agarwal (DANICS) Dr Sumit Arora Dr Kamal Baghotia Dr Parmod Mittal Dr Shaam Bodeliwala

  2. AGENDA 1.NEED AND REQUIREMENT OF CANCER TREATMENT/ OVERVIEW 2.INFRASTRUCTURE AVAILABILITY 3.CONSTRAINT AND PROBLEMS 4.POSSIBLE SOLUTIONS 5.DISCUSSION

  3. NEED/REQUIREMENT & OVERVIEW

  4. NEEDS & REQUIREMENT Increasing Cancer Burden High Mortality Rates Early Detection: higher chance of survival High Treatment Cost Economic Impact Quality of Life: physically and emotionally taxing Research and Innovation Delhi being the catchment area for surrounding states bears the additional responsibility

  5. PARTICULARS WORLD INDIA CANCER STATISTICS 400 New Cancer Patients in 2020 193 lakhs 14 lakhs 350 Cancer deaths in 2020 100 lakhs 8.50 lakhs 300 Death rate 51.82 % 60.71 % 250 Prevalent cases > 5 years 505 lakhs 27 lakhs 200 150 PROJECTIONS WORLD INDIA 100 New Cancer Patients in 2040 302 lakhs 21 lakhs 50 Cancer deaths in 2040 163 lakhs 13.8 lakhs 0 2040 New (2020) Death (2020) New (2040) Death (2020) Death rate 53.97 % 66.02 % India World Krishan et al. Indian J Med Res. 2022;156(4-5):598-607.

  6. CANCER CARE INFRASTRUCTURE-DELHI Hospitals name Machines (Linac+ Gamma camera with PET-CT and Cyclotron+ Brachytherapy+ CT+ Mammography) Specialized doctors (sanctioned strength) Bed strength Daily OPD attendance DSCI East (functional since 2007) 3+1+1+1+1 6 (combined strength of east and west wings 106) 236 Around 200 DSCI West (JPSSH) (nonfunctional since inception 10 years ago) 1 0 (combined strength of east and west wings 106) 50 0 IGH (functional since 2021) 0 (State of the art 5 Bunkers are available for radiation purpose) 0 (12 for oncology services) 60 (for oncology services) 0

  7. CONSTRAINTS AND PROBLEMS

  8. CONSTRAINTS AND PROBLEMS Shortage of Skilled Personnel-Super specialist doctors (Medical /Surgical Oncologist and Radiation/Nuclear Medicine), Physicist, Technicians Diagnostic Challenges-Lab & Technical resources Data Management: patient records and treatment plans (PACS). Medicine and Equipment Procurement 8

  9. PROPOSAL/POSSIBLE SOLUTIONS

  10. Proposal #1 PPP model Already operational successfully in Diagnostics and Dialysis services in IGH, Dwarka TENURE 10 YEARS + ANOTHER RENEWABLE TERM PRICING CGHS RATES GOVERNMENT TO FACILITATE REQUIREMENTS AND ANY FURTHER APPROVALS REQ STATUTORY LEGAL 10

  11. Pros and Cons of Proposal #1 Pros Cons Needy patients coming to the hospital will be benefitted. Possible anticipated operational difficulties owing to low financial benefits. The available Infrastructure will be put to use Lack of right risk allocation between the parties Readily available pool of the experts available with the private parties can be utilized Difficult interdepartmental coordination between government and private sectors No precedence available to predict its success

  12. Proposal #2 New recruitments on Regular/Ad-hoc basis. Conduct of interviews on a fixed date of every month. Outsourcing of Technical Staff. Deputation of an Administrator to oversee till the organization reaches its operational efficiency. DNB/DrNB course proposal Internship for FMGs Digitalization of Patient Management services 12

  13. Pros and Cons of Proposal #2 Pros Cons Capability building in Government set up May have the long incubation period before optimum utilization of resources can begin It is a long term solution as manpower and infrastructure is building up Probability of Ad-hoc recruitment on consolidated pay of 95K is not attractive Attached teaching program will increase no. of specialist in future Government bears full risk and responsibility of the project

  14. THANK YOU

  15. A report from International Atomic Energy Agency (IAEA) states that approximately 50%-60% of the new patients should receive radiation therapy, alone or as an alternative or adjuvant treatment to surgery

  16. SUPPORT SERVICES TEAM OF EXPERT PROFESSIONALS NUTRITION AND WELLBEING DISABILITY SUPPORT SERVICES PALLIATIVE CARE Expert doctors like Psychiatrists, Dermatologists, Dentists, Nutritionists, Physiotherapists etc. shall be available for providing support services to patients

  17. SUPPORT SERVICES AYURVEDIC SUPPLEMENTARY SUPPORT SERVICES HEAD WIG LIBRARY

  18. CANCER INFORMATION AND RESOURCES COLLABORATION WITH NGOs, TRUSTS, & OTHER ORGANIZATION FOR HELPING WITH FINANCIAL AID TO THE PATIENTS COLLABORATION WITH CAREER DEVELOPMENT AGENCIES FOR CANCER SURVIVORS (PIC : 27 YR OLD CANCER SURVIVOR WHO IS A SUCCESSFUL CLASSICAL DANCER TODAY)

  19. CANCER CARE ON FINGER TIPS VIDEO CONSULTATION AND TELE MEDICINE FOR SUPPORT SERVICES PAPER LESS REPORTING AND ADMINISTRATION PATIENT AND DOCTORS APP TO MANAGE DAILY OPERATIONS

  20. CENTRALIZED HUB FOR REPORTING We shall provide tele-medicine services including Tele Radiology / Tele Pathology services and Cancer Treatment Planning. It would enable us to provide healthcare services remotely even when doctors are not physically available. We shall develop this model across the network of all such similar centres that we set up.

  21. KEY EQUIPMENT AT A GLANCE LINEAR ACCELERATOR HDR BRACHY THERAPY UNIT GAMMA CAMERA DIGITAL PET MAMMOGRAPHY MRI CT ULTRA SOUND MACHINE X-RAY MACHINE

  22. BREAST LIP, ORAL CAVITY CERVIX UTERUS LUNG OVARY PROSTATE ESOPHAGUS STOMACH LEUKEMIA LIVER BRAIN, CNS GALL BLADDER KIDNEY THYROID PANCREAS MELANOMA OF SKIN TESTIS MULTIPLE MYELOMA COLON RECTUM

  23. REALTIME DASHBOARDS AGE WISE DATA AGE WISE DATA GENDERWISE DATA GENDER WISE DATA SAMPLE DASHBOARDS DISEASE WISE DATA CANCER TYPE WISE DATA TEST REPORT WISE DATA DEATH RATE WISE DATA HISTORY WISE DATA HISTORY WISE DATA CUSTOMISABLE FILTERS TO SORT DATA AUTHORISED ACCESS COMPLETELY SECURED NETWORK MULTI-LAYERED APPROVAL SYSTEM DEATH RATE WISE DATA ADMISSION / DISCHARGE DATA ADMISSION / DISCHARGE DATA TEST REPORT WISE DATA

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