Cancer Care Challenges and Solutions in Delhi Government
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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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
AGENDA 1.NEED AND REQUIREMENT OF CANCER TREATMENT/ OVERVIEW 2.INFRASTRUCTURE AVAILABILITY 3.CONSTRAINT AND PROBLEMS 4.POSSIBLE SOLUTIONS 5.DISCUSSION
NEED/REQUIREMENT & OVERVIEW
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
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.
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
CONSTRAINTS AND PROBLEMS
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
PROPOSAL/POSSIBLE SOLUTIONS
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
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
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
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
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
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
SUPPORT SERVICES AYURVEDIC SUPPLEMENTARY SUPPORT SERVICES HEAD WIG LIBRARY
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)
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
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.
KEY EQUIPMENT AT A GLANCE LINEAR ACCELERATOR HDR BRACHY THERAPY UNIT GAMMA CAMERA DIGITAL PET MAMMOGRAPHY MRI CT ULTRA SOUND MACHINE X-RAY MACHINE
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
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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