In this Expert’s Corner conversation, Dharampal Singh Rawat, Senior Director (Cardiovascular, Terumo Aortic and Medication Management, Terumo India), shares his perspective on the biggest shifts shaping advanced cardiovascular care in India. From expanding access to complex technologies and strengthening clinician training to building more integrated care ecosystems, his views underline why innovation must be paired with capability, collaboration and long-term clinical impact.
1. To begin, could you briefly describe your current role and the core mission that drives your work in healthcare today?
In my current role as Senior Director- Cardiovascular, Terumo Aortic, and Medication Management at Terumo India, I focus on expanding access to advanced cardiovascular and aortic care technologies across India. My work involves driving strategic initiatives that enable hospitals and clinicians to adopt innovative solutions that improve patient outcomes while strengthening clinical efficiency.
Beyond cardiovascular care, we are also deeply focused on medication management, where the goal is to create optimal drug-delivery environments that prioritise safety, accuracy, efficiency, and effectiveness. By enabling better systems and technologies, we aim to give healthcare professionals the confidence and time to focus on what matters most – delivering quality patient care with peace of mind.
This approach closely aligns with Terumo’s global mission of “Contributing to Society through Healthcare.” As part of a medical technology organisation with over a century of heritage, we remain committed to advancing patient care through innovation. This includes bringing cutting-edge endovascular solutions such as the Treo next-generation EVAR device and the RelayPro Thoracic Stent-Graft System, alongside precision-driven infusion and monitoring technologies that enhance safety in critical care environments.
What truly drives me is the ability to bridge innovation with impact, ensuring that cutting-edge technology not only reaches leading hospitals but also supports clinicians across diverse care settings in India. By championing enhanced access and adoption of advanced medical solutions, we aim to improve patients’ quality of life and support the sustainable development of India’s healthcare ecosystem.
2. Which specific problem in the healthcare ecosystem are you most focused on solving, and why does it matter now?
One of the most urgent challenges in India’s healthcare ecosystem today is improving access to advanced cardiac care. Cardiovascular disease continues to be the leading cause of death in the country, and with India’s elderly population steadily increasing, the demand for complex cardiac interventions is only going to rise.
We are seeing people live longer today, but with that longevity comes a higher incidence of structural heart disease, aortic conditions and other complex complications that require specialised care. Among these, aortic aneurysms remain a particularly under-recognised concern. Often referred to as a ‘silent condition’, they can progress without noticeable symptoms until they become life-threatening, which means many patients remain unaware until the disease is advanced.
At the same time, patient behaviour is gradually changing. Patients are becoming more curious and proactive about their treatment options. While awareness of minimally invasive procedures is growing, many are still in the process of understanding what is available and what is appropriate for them. The intent to seek better outcomes is there. However, access to specialised expertise and advanced interventions remains uneven across regions.
While primary and secondary care have expanded significantly, high-complexity cardiac procedures remain limited to select centres and are often financially out of reach for many patients. Our focus is on bridging this gap by not just introducing globally benchmarked cardiac technologies in India but also ensuring they are fully integrated. This means building clinical confidence, generating local data, and collaborating closely with hospitals and stakeholders. These steps help make advanced care more widely accessible.
As India’s population ages and disease patterns shift, the question is no longer whether we need advanced cardiac interventions. The real question is how quickly and equitably we can make them accessible
3. Can you share one initiative, product or programme from your organisation that you believe has made the most meaningful impact on patients, providers or the health system?
One initiative I am particularly proud of is the Terumo India Skill Lab, along with its digital extension, eTISL. Over time, we realized that infrastructure alone does not improve patient outcomes. A cath lab can be well equipped, and advanced devices can be available, but outcomes ultimately depend on the skill and confidence of the clinician.
In many Tier 2 and Tier 3 cities, the challenge is not intent or infrastructure, but access to specialised expertise. TISL was designed to address this gap. It offers structured, simulation-based hands-on training that allows physicians to practice complex cardiovascular and endovascular procedures in a safe environment before performing them on patients.
Recently, we further strengthened this initiative with the introduction of a state-of-the-art cath lab within the Terumo India Skill Lab, designed to replicate real clinical environments and support training in minimally invasive procedures. The facility enables physicians to experience realistic procedure simulations and peer-to-peer learning, helping them transition more confidently from open surgical approaches to advanced catheter-based interventions.
The lab is supported by advanced audio-visual capabilities that enable live case streaming and virtual proctoring. This means experienced specialists from leading centres can guide doctors remotely, helping decentralise expertise beyond metro cities.
eTISL extends this learning digitally through webinars, recorded case demonstrations and academic discussions, ensuring that education is continuous and not limited by geography.
Since 2018, we have trained over 1,500 healthcare professionals every year, with the larger goal of decentralizing expertise and expanding access to quality cardiovascular care across India.
4. What is one innovation or strategic decision that significantly changed the trajectory of your organisation or portfolio in the last 2–3 years?
Over the past few years, one of the most important strategic decisions for us has been to accelerate the introduction of advanced cardiovascular technologies in India while also strengthening the clinical ecosystem needed to support them. Historically, there has often been a time lag before global innovations in cardiac and vascular care became widely available in India. Our focus has been on narrowing that gap so clinicians here can access globally benchmarked technologies sooner and deliver better outcomes for patients.
A good example of this approach is the introduction of Endoscopic Vessel Harvesting (EVH) technology in India. The system enables surgeons to harvest veins used in coronary artery bypass grafting through a minimally invasive approach, which can support improved recovery while maintaining surgical precision. However, the real shift has not just been about bringing in the technology itself, but also about working closely with surgical teams to build familiarity and confidence around these newer approaches.
Alongside surgical innovation, we have also been strengthening the monitoring and perfusion ecosystem in cardiac operating rooms. Technologies such as the CDI OneView System, which we are preparing to introduce in India, aim to provide clinicians with integrated visibility into key perfusion parameters during surgery. This helps clinical teams make more informed decisions in real time.
At the same time, we continue to expand our focus on aortic care, where complex conditions such as aneurysms require highly specialised interventions. The introduction of advanced EVAR and TEVAR solutions has helped physicians address challenging patient anatomies with greater precision while also encouraging closer collaboration between clinicians and device specialists.
Taken together, these developments reflect a broader shift in how we approach growth. The focus is not only on introducing new products but also on building a more integrated ecosystem of technologies, clinical partnerships, and digital capabilities that ultimately support better patient care.
5. From a business perspective, what do you see as the biggest operational or financial challenge in Indian healthcare today, and how are you addressing it?
Our focus is on bridging this gap by not just introducing globally benchmarked cardiac technologies in India but also ensuring they are fully integrated. This means building clinical confidence, generating local data and collaborating closely with hospitals and stakeholders to make advanced care more widely accessible
Hospitals face high capital expenditure. Advanced medical devices, cath labs, hybrid OTs and critical care infrastructure require significant investment. At the same time, patients are highly price sensitive and reimbursement frameworks are still evolving, putting pressure on margins while maintaining quality outcomes
Workforce capacity is another critical concern. Shortages of skilled personnel, particularly nurses and trained technicians, directly impact efficiency and patient throughput. A World Health Organization report projects a global shortage of 11 million health workers, including nurses, by 2030 and India is not immune to this trend
Adoption cycles for advanced technologies can also be slow due to skill gaps and operational readiness. This further delays the return on investment for hospitals, highlighting the need for integrated solutions that address both training and operational challenges
At Terumo India, we focus on enabling solutions that reduce hospital stay and complications, improving both outcomes and cost efficiency. Our approach is to support hospitals not just with products, but with long-term capability building that optimises turnaround time, and makes advanced cardiovascular care more viable and scalable.
6. Collaboration is critical in healthcare- who do you see as your most important partners (hospitals, payers, startups, government, etc.), and how do these partnerships create value?
Collaboration in healthcare is not optional; it is foundational. No single stakeholder can drive impact alone. Hospitals, clinicians, government bodies, payers and industry each play a distinct but interconnected role in improving patient outcomes.
Hospitals and clinicians are where innovation is ultimately tested and refined. Our own collaborations with institutions across the country, including structured partnerships and formal MoUs, are focused on strengthening clinical capability, training and responsible technology adoption. These engagements go beyond product introduction; they are designed to build long-term expertise and ensure that innovation is meaningfully integrated into practice.
Government institutions and public health systems help create the broader access and policy environment required for scale. Payers influence affordability and sustainability. Industry contributes research, technology and global best practices.
The real value is created when these roles align. Introducing a new technology is only one part of the equation. It must be supported by clinical training, appropriate reimbursement pathways, infrastructure readiness and policy support. When these elements move together, adoption becomes meaningful and sustainable.
In India, where disease burden is high and access gaps remain, this co-dependent model is especially critical. Each partner strengthens the other. When collaboration works well, innovation reaches patients faster, clinicians practise with greater confidence, and health systems become more resilient.
Ultimately, healthcare progress is not driven by one hero. It is built on shared responsibility and collective commitment to improving patient care.
7. Looking ahead to the next 3–5 years, what one trend in healthcare, pharma or digital health do you think leaders cannot afford to ignore?
Over the next three to five years, the trend healthcare leaders cannot afford to ignore is the convergence of advanced medical technology, digital intelligence and data-driven care.
We are moving from standalone devices to connected ecosystems. In cardiovascular and critical care, technologies are increasingly integrated with imaging, AI-enabled diagnostics, remote monitoring and real-time data analytics. This shift will fundamentally change how clinicians make decisions, how procedures are performed and how outcomes are tracked.
The real transformation, however, lies in how effectively health systems adapt to this convergence. As devices become more precise and digitally enabled, expectations around safety, efficiency and measurable outcomes will grow. Leaders will need to think beyond product adoption and focus on system readiness, digital infrastructure, interoperability and quality standards.
For India, this is a defining moment. The country is strengthening its manufacturing capabilities and expanding digital health frameworks. At the same time, patient expectations are rising, and providers are seeking globally benchmarked solutions. The opportunity lies in aligning innovation with scalability and affordability.
Those who will lead the next phase of healthcare growth are organisations that understand technology not as an isolated upgrade, but as part of a broader, connected ecosystem. The future will belong to those who can combine innovation, digital integration and clinical excellence sustainably and inclusively.
8. What is one lesson or piece of advice you would offer to emerging healthcare leaders and founders who want to build sustainable, impact-driven businesses?
One lesson I strongly believe in is this: solve a real problem, not just an impressive one.
In healthcare, it is easy to get excited about cutting-edge technology. But innovation that does not address a clearly defined clinical need rarely sustains itself. The first question leaders and founders should ask is not “Is this advanced?” but “Who does this meaningfully help, and how?”
Impact-driven businesses are built by spending time with clinicians, understanding workflow realities and recognising system constraints. A solution that fits seamlessly into practice, improves procedural confidence or reduces complications will always have more value than one that looks sophisticated but adds complexity.
Equally important is designing for scale from the beginning. In a country as diverse as India, a product cannot succeed if it works only in a handful of top-tier institutions. Sustainable healthcare innovation must account for affordability, training requirements, infrastructure variability and long-term outcomes. If adoption is difficult, growth will be limited.
Finally, patience matters. Healthcare is not a fast-turn industry. Building trust with clinicians, institutions and regulators takes time. Long-term credibility is far more powerful than short-term visibility.
In my experience, businesses that stay close to real clinical challenges, remain disciplined in execution and focus on measurable outcomes are the ones that grow responsibly and endure.
