Download - Apollo Hospitals

117 Pages·2013·12.03 MB·English

A holistic approach to Staying Healthy physically and
chairman’s message 2 mentally underscores Apollo’s approach to healthcare
and patient well-being. In the face of rising disposable
performance highlights 4 statutory section incomes in the country and changing demographics and
disease profile, Apollo has committed to Staying Healthy in
financial highlights board of directors 36 all aspects of its operations in order to help keep people,
milestones corporate information 37
healthy. The group’s leadership in value based integrated
notice to the shareholders 38
healthcare delivery has earned Apollo a distinction
corporate review directors report to the
amongst peers in India, and a mark in the world as a
shareholders 49
preferred destination for affordable, quality medical care.
as leaders 7 corporate governance report 59
clinical excellence
centres of excellence business review Founded on four pillars of excellence-Clinical,
Technological, People and Value- Apollo’s mission is
as innovators 17 management discussion and to bring holistic healthcare of international standards
technology excellence analysis 85 within reach of every individual in India. Apollo provides
process excellence clinical governance 109 outstanding care to a patient in all facets of healthcare
research excellence
including preventive medicine. It effectively and efficiently
financial statements
aligns people and technology, ably supported by best
as care providers 20
practices, to facilitate superior patient experience and
people centric approach auditors’ report on standalone
outcomes. Its patient centric approach is led by effective
financial statements 111
and compelling medical management, resulting in
as strategists 21 standalone financial statements 117
cluster based approach auditors’ report on consolidated enhanced physician performance and clinical outcomes.
backward & forward integration financial statements 162 At Apollo teams of interdisciplinary professionals dedicate
consolidated financial themselves round the clock to providing excellent care and
in the country 25 statements 164 service to patients and communities in a compassionate
clinics and health centres statement pursuant to and respectful environment.
footprint, expansion & achievements section 212 of the
companies act, 1956 226
in the world 29
medical value travel
in recognition 30
in csr 31
The hand drawn illustrations used in this Annual Report reflect a child’s vision of Apollo Hospitals
and our core business of keeping people healthy. The drawings echo the optimism of the numerous
children Apollo has touched in one way or another through the Save A Child’s Heart Initiative
(SACHi) and the Society to Aid the Hearing Impaired (SAHI). These children are fighters. And they dedicated “Our mission is to bring healthcare of international standards within the reach
are winners. They have sunny dispositions and are poised on the threshold of a whole new life of every individual. We are committed to the achievement and maintenance of
experience thanks to the nurturing care of Apollo Hospitals, SACHi and SAHI. Apollo stands behind mission excellence in education, research, and healthcare for the benefit of humanity.”
that optimism and strives to make their dreams real.
Contents
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Dear Shareholders, the Proteus Plus technology by IBA, Belgium, Financially speaking, staying healthy to deliver o
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provides best-in-class treatment for cancer. the prescribed results translates to prudent p
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This centre, will be the first of its kind in the selection of the right opportunities, strategic r
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Just like the absence of sadness is not joy, the region covering Asia, Africa and Australia. capital infusion, forethought in allocation, and t
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absence of disease is not health. The WHO the capacity to balance growth with profitability. r
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states this, and all of us instinctively know it. For a growing country like India, staying healthy We have a long history of industry-leading v
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Health is our greatest gift. It is god given, but has to become a mantra. From the micro to performance and have again been able to w
the duty to nurture it is ours alone. the macro, every facet of our ecosystem needs deliver strong growth and improved profitability
to embrace the importance of staying healthy. in 2012-13. We recorded consolidated annual future-proofing our team, remain our top
Apollo Hospitals has spent the last thirty years Individuals, neighbourhoods, and organizations revenues of ` 37.7 billion, reflecting 19.7% agenda. Harnessing the power of information
enriching and several million lives with its have to embrace it. Thanks to the stresses of growth. Consolidated Net Profit grew by 38.8% technology in reaching out to the patient will
healing touch. Our commitment to advanced modern day living, India has today emerged as to ` 3,044 million and consolidated diluted EPS continue to be our talisman for enabling quality
patient care has helped us put in place the the diabetes capital of the world and a spate of for the year stood at ` 21.88 per share. I am health care to all.
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world’s busiest solid organ transplant program. cardiac and other lifestyle diseases confronts pleased to announce a 110% dividend of ` 5.5 t
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During FY13 we completed 500 bone marrow our society. per share for fiscal year 2013. And finally as a responsible corporate, we tu
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transplants with outstanding outcomes. continue to stay focused on running our o
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After successfully rolling out Robotic surgery At Apollo we believe staying healthy requires Continuous value addition and innovation in business in an sustainable and socially y

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capabilities in Chennai and Hyderabad, we a 360 degree approach; our framework each of our activities, the hallmark of the Apollo responsible manner. e
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introduced the same this year in our hospitals encompasses employees, the local communities, culture, underpins our corporate story. This has t
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in Delhi and Kolkata. The group has completed the under privileged, the corporate world, resulted in several accolades nationally and Over the past three decades, you, our n
over 130,000 heart surgeries, by far the largest underserved communities and even globally, testifying to our pioneering leadership shareholders, the Board of directors, our
cardiac programme across the globe, with a neighbouring nations. And to all of them, our in healthcare delivery. The responsibility of doctors, our employees, our bankers &
success rate of 99.6%. We are also the first message is the same—follow an active lifestyle being at the helm inspires us to go the extra financial institutions and the Central and
healthcare organization in the Asia Pacific marked by systematic exercise, balanced meals, mile to surpass the highest expectations State Governments have stood by us providing
region to offer the Renaissance TM Robotic and stress-free living. Alongside, regular health patients and their relatives have of us. unwavering support through every step and
system for spine surgeries. checks are a must as early detection is closely initiative undertaken by us. I thank each one of
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aligned to staying healthy. We live in a borderless world and healthcare you and look forward to your continued support, u
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The last year saw us crossing the milestone of is indeed truly so. When Apollo was conceived belief and trust. i
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` 10 billion in standalone pharmacies sales. As a health services provider, we are committed thirty years ago, very few believed us when we e
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We now have over 1500 stores and are focused to staying healthy in all aspects of our said that one day Apollo would reverse the trend With warm personal regards to you and your s

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on continuing to grow this segment profitably. functioning and continuously endeavour to of Indians going abroad for treatment, to one families. God bless. e
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We also have a scientific expansion strategy of sharpen our clinical excellence. Apollo Hospitals where India would be treating the world. Patients ie
commissioning over 1,000 beds across seven Group is today one of the largest provider from across the globe now look up to the Apollo w
locations in the coming year. The expansion groups globally, having equalled or surpassed Hospitals Group to provide solutions to their
Dr. Prathap C. Reddy
plans as envisaged also includes 500 beds as notable institutions across the world in several health concerns, be it in cardiology, oncology,
Chairman
13 part of our “Reach” Hospitals initiative. The important criteria, including patient volumes, orthopaedics, neurology, gastroenterology, or Apollo Hospitals Group.
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2 “Reach” Hospitals initiative was recognized solid organ transplant volumes, and clinical transplants. Our approach is early detection and
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0 for “Inclusive Business Innovation” at the outcomes. Even though the Apollo Group has timely treatment, which we believe lead to better
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t prestigious G20 summit in Mexico. Apollo continuously redefined itself over the past three outcomes for the patients. in
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ep organization in the world to be declared winner. patient, remains unchanged and is our raison We are now embarking on a set of ci
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al d’être. This defines and drives all our activities, transformational initiatives keeping the l s
u We plan to establish a Proton Therapy centre be it clinical or operational, and ultimately future in mind. Building competencies t
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n in India. This advanced radiation therapy under determines our financial health as well. and capabilities, infusing fresh talent, and te
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five years at a glance h
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financial highlights a
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consolidated financial performance e
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Rupees million, except for share data FY 2013 FY 2012 Growth
Revenue from operations 37687 31475 20%
Operating EBITDA 6082 5131 19%
(Earnings before Interest, Tax & Depreciation)
Operating EBIT (Earnings before Interest & Tax) 4659 3892 20%
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Profit Before Tax 3991 3260 22% ta
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Profit After Tax 3044 2194 39% t
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Earnings per Share (EPS)-Basic 22.08 16.83 31%
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Earnings per Share (EPS)-Diluted 21.88 16.30 34% c
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consolidated financial position
Rupees million FY 2013 FY 2012
Application of Funds 41,050 32,807
Fixed Assets 25,987 20,855 b
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Goodwill 1,453 1,350 s
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Non-Current Investments 1,480 4,422 s
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Net Current Assets & Long term Advances * # 11,879 5,935 re
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Deferred Tax Asset 251 245 e
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Bed Growth
Sources of Funds 41,050 32,807
Shareholders Funds 27,313 24,913
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– Capital Reserve on Consolidation 155 155
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2 Minority Interest 173 126 f
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or Loan funds and Long term provisions/liabilities 10,863 5,818 an
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re Deferred Tax Liability 2,546 1,795 ia
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n * Includes cash and investment in liquid mutual funds of ` 6,822 million in FY13 and ` 3,364 million in FY12. a
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# Previous year numbers have been regrouped and reclassified wherever necessary to conform with current year classification. e
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8 JCI Clinical excellence is Apollo’s pioneering o
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concept and the hallmark of its healthcare a
accredited practice. A combination of highly skilled and te

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hospitals experienced doctors and detailed protocols, e
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has effected superior patient outcomes and ie
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clinical practices. A standing proof to this
11 NABH
excellence is the number of JCI accredited
accredited hospitals under the Apollo flagship.
hospitals
The Joint Commission International (JCI) is
a U.S based accreditation body dedicated
to improving healthcare quality and safety s
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around the world. The accreditation is an a
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international gold standard for hospitals. The u
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National Accreditation Board for Hospitals & r
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Healthcare Providers (NABH) is a constituent s
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board of the Quality Council of India, set c
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up to establish and operate accreditation i
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programmes for healthcare organizations. n
At Apollo, we constantly assess our process
efficiency and make critical changes as
needed to improve patient health.
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Sustained clinical excellence is made
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possible only by effective medical g
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management. At Apollo, quality is a li
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practice, a way of life that we have t
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imbibed in our processes. Healthcare
quality metrics which can influence
measurable changes in process,
protocols, and behaviours, help us
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provide the best medical treatment o
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possible. Over 30 million patients from o
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over 120 countries that we have treated a
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stand testimony to this all important r
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pillar of success. v
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patients from
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apollo clinical excellence@25 (ACE@25) t
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countries e
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Apollo Clinical Excellence@25, the ti
the apollo standards of clinical care (TASCC) o
revolutionary clinical balanced scorecard n
incorporates 25 clinical quality parameters
involving complication rates, mortality
rates, average length of stay after a major
The Apollo Standards of Clinical Care (TASCC)
procedure, hospital acquired infection rates,
comprises sets of process requirements and
pain management and medication errors
outcome measures which underpin the Apollo
in a dashboard called Rocket ACE (RACE).
Hospitals’ approach to clinical care. TASCC b
The numerators and denominators, inclusions u
focuses on delivering uniform high quality
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and exclusions are defined clearly and the i
clinical care to all patients alike, across all n
data collection methodology is standardized e
group hospitals irrespective of location and s
across all participating hospitals in the s
size. r
group—currently 31 in number. The data e
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Apollo Clinical Excellence@25 (ACE@25), collected is validated by a 20 member Clinical ie
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Audit Team. We analyze the trends on a
Apollo Quality Program (AQP), Apollo Incident
paediatric cardiac
quarterly, half yearly and annual basis, and
Reporting System (AIRS), Apollo Mortality
Review (AMR), and Apollo Critical Policies surgeries benchmark our performance with some of the
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1 Plans and Procedures (ACPPP) together Ç world’s best hospitals.
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1 form TASCC. 300%
0 ACE@25 embodies our commitment to
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ep 98% stimulates us to keep raising the bar in our ci
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the apollo quality program (AQP) c
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successful l
The Apollo Quality Program focuses on ig
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patient safety practices in all Apollo hospitals bilateral knee t
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regardless of accreditation status and covers
replacement for
four broad areas: Safety during clinical
handovers, Surgical safety, Medication safety 93
and the Six International Patient Safety the centre for cardiology
year old man
Goals of JCI. Trends have shown a positive
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trajectory over the last year and compliance o
rates have improved steadily in all areas. 130,000+ rp
The heart institutes at Apollo is one of the o
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world’s largest groups of Cardiology and t
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the apollo mortality review (AMR) heart surgeries Cardio-Thoracic Surgery. The institute is staffed
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with some of the world’s best cardiologists and v
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99.6% cardiothoracic surgeons whose commitment e
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to the prevention and treatment of heart
Another important review launched in
disease has led to better patient outcomes
2012 is the Apollo Mortality Review (AMR). success rate and improved quality of life, for the thousands
Using important trigger criteria, all deaths
who have walked into the hospital for a cure.
in the hospital are identified, categorised,
The expertise of the unit has been enhanced
systematically reviewed and analyzed
successful through continuous training, education and
to identify ways of improving outcomes clinical practice, leading to innovative solutions s
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and follow up actions and protocols are a
towards treating heart disease. With the t
devised to minimize such occurrances. AMR heart surgery u
Ç completion of over 130,000 heart surgeries, t
is now standard operating procedure across on 2 day old baby including key hole and complicated coronary ory
31 hospitals in the group.
by-pass surgeries, surgeries for valvular s
Ç pacemaker implant heart disease, and infant and neonatal heart ec
apollo critical policies, plans & procedures (ACPPP) on 97 year old man surgeries, the performance score card for the tio
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unit compares with the best cardiology centres
in the world.
Apollo has standardized various clinical and
non-clinical processes from clinical care to
nursing care, managerial processes, utility
systems, and infrastructural requirements b
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by implementing the Apollo Critical Policies, s
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Plans and Procedures (ACPPP)—25 policies n
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in all—across all hospitals in the group. This s
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assures that patients receive optimal clinical r
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care under any circumstance. v
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the centre for orthopedics the apollo neuro institutes n
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FY13
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99% i
10,000+ g
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Equipped with the latest medical and success rate for World class neurologists, neuro surgeons, ig
imaging equipment, and incorporating the neurosurgical critical care specialists, nurses and researchers h
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latest trends and techniques, the centre hip resurfacing comprise the highly skilled neuro team at the
operations
offers a full range of orthopedic services Neuro Institute at Apollo Hospitals. Adept at
procedure
to patients. Highly experienced surgeons each year delicate surgical maneuvers, and with a track
perform advanced surgical procedures record of enviable patient outcomes, the team
like joint replacements, hip resurfacing, treats diseases that affect the brain, the spinal
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arthroscopies, advanced spine surgeries, and cord, muscles, and nerves, like brain tumors, o
FY13 r
complex trauma surgeries to help relieve 4400+ head injuries, stroke, headaches, and seizures. po
pain and restore an active life style. Apollo ra
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is one of the earliest hospitals to use the The Neurophysiological lab is equipped with e
minimally invasive
Chrondocyte replacement technique and the state of the art machinery capable of advanced re
iPod Navigation technique. knee replacement diagnostics. vi
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surgeries
Over 10,000 neurosurgical operations are
carried out every year in our hospitals where we
also provide integrated rehabilitation services.
Stereotaxy and Frameless Stereotaxy which help
pinpoint (accuracy within 1mm) the localization
FY13
of structures within the brain, Operative
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1000+ Electrophysiology, Micro Neurosurgery, and ta
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Minimally Invasive brain and spinal surgery, are u
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hip replacements all in a day’s work at the centres. o
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the apollo cancer institutes s
3100+ e
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spine surgeries n
The Apollo Cancer Institutes is one of the
cancer is curable
nations leading centres for cancer cure.
The cancer institutes carried out the first
successful cord blood transplant in the country
for leukemia. The institute offers services of
international standards for oncology care and
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has completed more than 500 successful bone u
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marrow transplants thus far (89 in 2012). The in
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centre is equipped with the latest equipments
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and avant-garde technology for quick and
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accurate screening, evaluation, diagnosis, e
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treatment, palliative care and rehabilitation—all ie
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under one roof.
Apollo’s team of experienced consultants
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1 (medical, surgical, and radiation oncologists,
– FY13
2 + radiologists, histopathologists, and physicians
1 5000
20 from relevant specialties), is highly skilled f
t surgeries and adopts a multi-disciplinary approach to in
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o providing oncology care. The Breast Clinic, the n
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re 89 Brain Tumour Clinic, and the Thyroid Clinic ia
al are specialty clinics within the Apollo Cancer l s
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n BMTs Institutes. The dedicated Paediatric Oncology a
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the transplant centre n
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Division manages childhood disorders like Apollo’s hemato-oncology services include 1200+ h
blood and lymph node cancers. diagnosis and management of the entire ig
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spectrum of acute and chronic leukemia,
Apollo offers the Cyberknife Robotic Radio lymphomas, and myelomas. solid organ Apollo Transplant Institutes provide a fresh lig
transplants lease of life for patients through liver, kidney h
surgery, the world’s first and only radio ts
and multi organ transplants. The Institutes
surgery system designed to treat tumours To mark World Cancer Day in February this in a single
offer transplant services, paediatric and adult
anywhere in the body with sub-millimeter year, Apollo launched a unique initiative to calendar year
hepatology, gastroenterology, nephrology,
accuracy. The Novalis Tx, the latest create awareness about the advantages of
and urology services, supported by superior
technology in radiation therapy is known to Robotic Surgery which is a better treatment
diagnostic facilities in radiology, interventional
maximize tumor destruction while minimizing option for cancer, as it is more precise, c
radiology, immunology, transplant o
damage to normal tissues, and is used in minimally invasive, heals faster, and has FY13 r
histopathology, and microbiology. The Apollo p
radiation oncology. better clinical outcomes. o
360+ Transplant Institutes holds the record for best ra
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in class outcomes, and have earned a badge as e
Apollo Cancer Institutes conducted over 5000
surgeries across 6 locations (Ahmedabad, liver the busiest transplant centre in the world. re
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Bangalore, Chennai, Delhi, Hyderabad and transplants ie
FY13 Using immune adsorption columns to reduce w
Kolkata) in 2012. These included the da Vinci
Robotic Surgeries for treatment of Urology, 8000+ blood group antibodies, the first ABO-
incompatible kidney transplant in the country
Gynaecology, Thoracic, Abdominal and
was done at Chennai in 2012.
Head & Neck cancers. In FY13, over 42,000 patients treated
chemotherapies were done and over 8000 FY13
with radiotherapy There is a rising need for transplants across
patients were treated with radiotherapy.
840+ the country. The Transplant Centre completed
42,000+ 1200 transplants in 2012. We have launched sta
kidney an awareness campaign called ‘Gift a Life’ to tu
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chemotherapies transplants persuade organ donation from the community. or
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20,000 pledges were garnered over a month
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long drive in Chennai and 3000 pledges over e
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two days in New Delhi. ti
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apollo emergency n
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The National Network of
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Apollo Hospitals is a pioneer of modern day Emergency Services ig
emergency care in India. It has set up the h
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‘National Network of Emergency Services’ An easy to remember
and strenghthened the five clinical pathways emergency access number -
on stroke, acute coronary syndrome, trauma, 1066
sepsis, and seizures, to provide emergency care Ambulances that are well
of uniform quality standards across the country. equipped and manned by trained
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personnel – a veritable ‘Hospital
Increasing population and inadequate has enabled us to offer teleconsultations r
Apollo Emergency Care is a scientifically on Wheels’ medical infrastructure in remote rural even overseas. In December, we launched this po
developed protocol-driven emergency system Air Ambulance Services geographies in India have galvanized service in Yangon, Myanmar in colloboration ra
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with several unique and innovative features. for remote areas and life- e
Apollo into amalgamating technological with KC Healthcare, facilitating quality
Community awareness programs and training threatening emergencies superiority with clinical leadership to launch treatment through telemedicine for people re
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for ‘Life Savers’ are conducted regularly. Effective communication system telemedicine services. in  Myanmar. ie
Its 24-hour emergency and trauma care between the central control w
is geared to meet all medical and surgical room, ambulances and the
Our TeleHealth Services, TeleHealth Network Apollo offers the most advanced platform
emergencies, including polytrauma. emergency facilities in the
and Apollo TeleClinics, aim to transcend for minimally invasive surgery available
National Network of Emergency Services hospitals
geographical barriers and touch a big populace in the world today—the da Vinci Robotics
Standardised emergency rooms
which has poor access to quality healthcare. program using cutting edge equipment
in the hospitals that are a part of
The National Network of Emergency Services is like the CyberKnife, at a fraction of the
operational across 9 cities in the country. The the network mHealth is a platform that utilizes India’s cost overseas. s
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Common functional and medical a
system comprises 22 emergency rooms and incredible cellular penetration to deliver t
protocols across the system u
over 500 personnel. The network is expanding cutting edge remote health care. It envisions We plan to establish the first ever Proton t
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rapidly and is expected to progressively cover Training of doctors and other Healthcare Hubs for countrywide delivery of Therapy Centre in the region, at Chennai r
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more towns and cities. personnel required for pre- healthcare solutions. to offer patients across Asia, Africa, and s
Air Ambulance hospital and in-hospital care e
Australia, the most advanced Radiation c
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‘Dost’- an accident insurance Such proactive investment in technology Therapy in cancer treatment. This is a io
card to increase affordability n
Saving time is the first step in saving lives. and the synergy of our clinical, pioneering effort in technology led medical
Life Savers’- a community
Air Ambulance Services are generally used administrative, and technical capabilities treatments in India.
involvement programme for
when ground transportation could potentially
rescuing emergency victims and
endanger a patient’s life. The services are
mobilising emergency response
also indispensable when the patient is in a
remote area and time is of essence.
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Apollo is equipping each of its major s
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hospitals with emergency air ambulance n
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services. At Kolkata and Colombo, our s
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hospitals have roof helipads; and our Delhi r
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and Hyderabad hospitals have landing v
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facilities. We operate both fixed wing aircrafts w
and helicopters. While the responsibility
for logistics is given to aviation companies,
3 we manage all medical aspects like trained
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