An extensive techno-medical study has been made in 1994 by the Society for Biomedical Technology (SBMT) to bench-mark the different types of stents available in the market, which is broadly classified as tubular and coil stents. Detailed experimental and clinical studies on three stents of the either types have provided the necessary benchmark. This has been made the basis for the development of indigenous stent patented as Kalam-Raju Stent.

 Kalam Raju Stent (K-R stent) led to the crash of prices of imported coronary stents in Indian market by more than 50%. For this historical effort, the CARE Foundation received of the Defense Technology Spin-off Award in 1998.

The Healthcare scenario of today requires multi-work centers as well as inter-disciplinary specialization. Co-operation in and healthcare units are mandatory due to:

• The increasing mobility of people
  
   
• The requirement for avoiding repetition of medical procedures, and
  
   
• The monetary constraints.
   

This co-operation between the units to enable benefits of cost-efficient medical advances reach the patients is possible only through communication. In other words, Telemedicine allows doctors reach to patients rather than patients reaching out to doctors. Telemedicine has been pioneered in tune with the “put the patient’s concerns above us” model of CARE. It has been evolved keeping the needs of the patients in mind and consequently:

• Decreases costs incurred by patients through increased efficiency and decreased time in travel.
  
   
• Increase access to CARE for the underserved populations.
  
   
• Put the patients at ease and facilitate hassle free follow-up.
  
   
• Enabling CARE to reach to new sections of patient population. 

CARE plans to make healthcare accessible by using latest communication technology for connecting population living in villages, towns, and small cities with the Hospitals in the big cities. The initiative will enable the rural population across the country to seek medical advice from experts sitting in large super specialty hospitals without having to bear the financial burden and stress of commuting to the cities.

In the first phase, CARE has launched Telemedicine at the district hospital at Mahaboobnagar, which enables transfer of textual data, images and video conferencing between the district hospital and CARE Banjara Hospital on a continuous basis, there by enabling patients to get the best of the opinions from their local site.

The greatest impact of telemedicine is on the patient, the family and the community. By using telemedicine technologies, it reduces travel time and related stresses to the patient. In many instances, patient would be accompanied by additional family members involving expenditure on day care costs, and time away from the job. This disruption in the local community can be avoided when advanced communication technology is used to bring the consulting specialist to the patient.

Surgical procedures today are commonly divided into three categories based on the technology used and their underlying efficiency.

The first generation of surgery, open surgery, remains the predominant form of surgery and is still used in almost every area of the body. However, the large incisions required for open surgery create significant trauma to the patient, resulting in long hospitalization and recovery times, as well as significant pain and suffering.
 
Over the past few decades the second generation of surgery, Minimally Invasive Surgery (MIS) has reduced the trauma to the patients by allowing some surgeries to be performed through small ports rather than large incisions, resulting in shorter recovery time, fewer complications and reduced hospitalization costs. MIS surgery has been widely adapted for certain surgical procedures. However in case of complex surgical procedures tissue manipulations such as dissecting and structuring require precise operations, which is difficult to perform using MIS surgery.
 
Robotic surgery is the third generation surgery and overcomes many of the shortfalls of both open surgery and MIS surgery. Robotic Surgery allows surgeons to operate while being seated comfortably at a console viewing a bright and sharp 3-D image of the surgical field. This immersive visualization results in surgeons no longer feeling disconnected from the surgical field and the instruments, as they do while performing an MIS surgery.
 
In India the prevalence of Robotic Surgery is limited to only a few cases. The Robotic surgery system is expensive. The procedures involved in this surgery are highly priced and their availability is restricted to two centers in New Delhi. CARE has undertaken development of indigenous technology for robotic surgery systems. It is envisaged that such systems would be required at large number of hospitals when minimum invasive surgeries will replace the current procedures in the next one decade.
 

A heart beat (muscle contraction) takes place through a series of electrical signals to pump blood through the body. Normally, the heartbeat begins in the top right section of the heart muscle. A special group of cells sends an electrical signal throughout the top half of the heart (the atria) and through a connection leading to the lower half. The electrical signal then spreads through the lower half of the heart (the ventricles).

 Traditionally, doctors locate areas of abnormal electrical conduction by feeding pacemaker-like wires through the circulatory system to the heart. Electrodes on the tips of the wires record electrical signals coming from specific positions within the heart. When an abnormal pathway is found, a small amount of radiofrequency energy is delivered to the site, creating a scar which interrupts the pathway, hopefully eliminating the cause of the arrhythmia.
 
With the advent of Electro-anatomical mapping systems it is now possible to precisely locate abnormal electrical impulses in the heart. Such mapping systems provide three-dimensional images of the heart. Color-coded pictures show information about the electrical impulses within the heart. The mapping technique uses technology similar to that used by satellite global positioning systems. Three magnets are located under the patient's table. Using the magnetic field for guidance, the mapping system tells doctors the location (within a few millimeters) of the catheter. With the three-dimensional images, doctors can pinpoint the location of abnormal electrical pathways and precisely deliver the radiofrequency energy.
 
CARE has imported and installed state-of-the-art CARTO Electrophysiological Mapping Systems. A technology development plan is on anvil to develop an indigenous prototype. The programme is headed by Dr C Narasimhan, Chief of electrophysiology.