Pan Caribbean Digital Healthcare Network Dr. Devi Shetty. MS, FRCS(England) Chairman Narayana Health Health City Cayman Islands

More money than food, 80% can’t afford Tertiary Healthcare (Source: Deloitte Outlook 2017 - forecast to grow up to $ 8.7 trillion by 2020) US $ 8.2trillion Food & Agriculture (Source: Plunkett Research 2016) US $ 8 trillion Information Technology (Source: Gartner Report 2016) US $ 3.4 trillion Oil & Natural Gas (Source: IBIS World Report 2017) US $ 2 trillion Automobile (Source: Auto Industry 101) Media (Source: Advanced Energy Economy 2016) US $ 1.7 trillion Energy US $ 1.4 trillion Apparel Part of $8.7 trillion industry.

Challenges for Future Healthcare Life expectancy will reach 100 years Most of the deadly diseases like cancer, HIV will become chronic diseases requiring constant monitoring Average American undergoes 9.2 surgeries in life time (American College of Surgeons) Less children will be born to take care of the old 90% of hospitals beds will be Critical care Beds Families and countries budgetary allocation for healthcare will surpass all the other expenses

United we Survive, Pan Caribbean Digital Health Network 40 million people,29 island nations, 7000 islands Carribean countries must get together for collective strategy and bargaining for supplies & self paying health insurance Share skilled manpower, software and training Doctors, Nurses,Techs Visiting team of experts from HCCI to train local Doctors to perform procedure in public hospitals of every country Complex surgeries to be referred to Health City to be performed at less than the current cost. Post surgery follow up locally. Gradually build local expertise for complex procedure

Caribbean Medical, Nursing & Paramedical school WHO Region 2013 2030 Africa 1.1 2.4 Americas 8.8 15.3 Eastern Mediterranean 3.1 6.2 Europe 14.2 18.2 South-East Asia 6.0 12.2 Western Pacific 15.1 25.9 World 48.3 80.2 Source : World Bank. *numbers in millions

Caribbean Medical, Nursing & Paramedical School Between George Town hospital,Health City modern medical school Every member country to sponsor students, credential the degree One year internship in Health City Bangalore Mentor the students for USMLE,PLAB Nursing, paramedic students rotation between india & Cayman

School – National Public School, HSR LayoutClass – MontessoriStudent Name – Ms Ayura OletiYear – 2019-2020Application No. – NPSHSR/2019/MONT/00354

“If healthcare was an airline” “If healthcare was an airline, only dedicated risk takers, thrill seekers and those tired of living would fly in it.” Patient Safety (2005) By Professor Charles Vincent, Professor of Clinical Safety Research Imperial College UK

Joint Commission, 65%of sentinel events due to communication failure

EMR - one of the 4 causes of physician burnout in USA Lloyd Minor, Dean Stanford medical school “Doctors are burning out because EMRs are broken” American Medical Association “Every hour spent with the patient, doctors spend two hours on updating EMR” STAT news survey “Improving EMRs was the top of the list of ideas to transform health care”

Online Healthcare 65% of diseases are degenerative diseases, emergencies like heart attack, brain stroke can be managed online More than half Of Kaiser consultation done on line Diagnosis is dependent on history, images and medical data Most of the islands cannot accommodate a Cardiologist, Neurologist or Diabetologist Kaizala can store medical records on phone, Skype Every patient to have medical records in phone - Kaizala.

Quality of Care Delivered Better (observed 20% reduction in blood sugar levels HbA1C) 7th visit Difference 20.80 % 95% CI 16.6926 to 24.6513 Chi-squared 87.524 DF  1 Significance level P < 0.0001 1st visit