Saturday May 26, 2018

ICU Care from far: How India is solving its problem of doctors shortage

1
//
175
Doctors remotely monitor live footages of patients inside an electronic intensive care unit (eICU) at Fortis hospital in New Delhi, India, January 20, 2016. REUTERS/Adnan Abidi
Republish
Reprint
A doctor remotely monitors live footage of patients inside an electronic intensive care unit (eICU) at Fortis hospital in New Delhi, India, January 20, 2016. Picture taken January 20, 2016. REUTERS/Adnan Abidi
A doctor remotely monitors live footage of patients inside an electronic intensive care unit (eICU) at Fortis hospital in New Delhi, India, January 20, 2016. Picture taken January 20, 2016. REUTERS/Adnan Abidi

By Aditya Kalra

NEW DELHI (Reuters) – A doctor at a hospital in India’s capital, New Delhi, was recently tracking a wall of monitors displaying the vital signs of intensive care patients admitted hundreds of miles away when red-and-yellow alerts rang out.

The oxygen flow to a 67-year-old patient had stopped when no critical care doctors were present in a hospital in the northern city of Amritsar.

But the doctor in the New Delhi centre run by Fortis Healthcare quickly issued a set of instructions and stopped the patient from suffering brain damage or death, the Indian hospital chain said in an account of the episode.

India’s top private hospitals, seizing on a shortage of critical-care doctors, are expanding into the remote management of intensive care units around the country and, starting this month, in neighbouring Bangladesh too.

India has seven doctors for every 10,000 people, half the global average, according to the World Health Organization. Data from the Indian Medical Association shows the country needs more than 50,000 critical care specialists but has just 8,350.

Such a shortage of doctors means small facilities in India’s $55 billion private hospital market are ill equipped to provide critical care even as numbers seeking private healthcare rise because the public health system is in even worse shape.

India’s largest healthcare chain, Apollo Hospitals Enterprise, and Fortis will this year expand their network of electronic intensive care units (eICUs), scaling up operations thanks to advances in communications technology.

“We want to leverage (doctors) using technology,” said K. Hari Prasad, head of hospitals business at Apollo that employs more than 700 critical care doctors.

Apollo, which monitors 200 patients in six states from its only eICU in Hyderabad city, will open three new centres to track 1,000 more patients. Prasad said he is also in talks to extend the service to government hospitals.

Fortis will start remote monitoring of intensive care patients in the Bangladeshi city of Khulna this week, its first such cross-border operation. The hospital chain tracks 350 patients from its New Delhi centre but will start two more eICUs by mid-2017.

Jayant Singh, director of healthcare at Frost & Sullivan India, a consultancy, estimates that eICUs are boosting industry revenues by $220 million a year by giving smaller hospitals the ability to treat critical patients at the hands of top-flight intensive-care specialists, even if they are in another city.

India’s eICU beds will expand by 15-20 percent each year from about 3,000 now, Singh said.

SAVING LIVES

With multiple computer screens inside these high-tech eICUs, doctors suggest treatment procedures after assessing medical history and real-time heart rate charts of patients fighting for their lives in distant facilities.

Doctors recently saved a 30-year-old pregnant woman in a hospital in the southern city of Warangal after her heart stopped beating, assisting a resident doctor not specialised in intensive care to carry out chest compressions through a video link.

“We save about 25 lives a month,” said Shamit Gupta, medical director at Fortis’ eICU unit.

Hospitals charge between $10 and $30 a day to virtually monitor a patient from their eICUs, with revenues shared between hospitals and companies such as General Electric and Philips that have developed the tracking software.

That comes on top of standard critical care costs of about $200 a day in a small city hospital.

At that price, eICUs do little to address concerns of millions of India’s poor patients who often share beds or wait for days to gain admission to a public hospital.

“This technology basically is not bridging the gap between the poor and the rich, but increasing access to specialized healthcare for those who can afford it,” Frost & Sullivan’s Singh said.

(Reporting by Aditya Kalra; Editing by Sanjeev Miglani, Robert Birsel)

Click here for reuse options!
Copyright 2016 NewsGram

  • Rakesh Manchanda

    Indian doctors in lobby with politicians have insulated themselves with conflict of interest.They need to be courageous to help break this deadlock and seek solutions while inviting health awareness groups to connect to humanity is spite of Rich-Poor patient divide.

  • Rakesh Manchanda

    Indian doctors in lobby with politicians have insulated themselves with conflict of interest.They need to be courageous to help break this deadlock and seek solutions while inviting health awareness groups to connect to humanity is spite of Rich-Poor patient divide.

Next Story

Diesel Exhaust Converted Into Ink by Indian Innovators To Battle Air Pollution

Supervised by young engineers, workers at the start-up company Chakr Innovation in New Delhi cut and weld sheets of metal to make devices that will capture black plumes of smoke from diesel generators and convert it into ink.

0
//
12
representational image. VOA

Supervised by young engineers, workers at the start-up company Chakr Innovation in New Delhi cut and weld sheets of metal to make devices that will capture black plumes of smoke from diesel generators and convert it into ink.

In a cabin, young engineers pore over drawings and hunch over computers as they explore more applications of the technology that they hope will aid progress in cleaning up the Indian capital’s toxic air – among the world’s dirtiest.

While the millions of cars that ply Delhi’s streets are usually blamed for the city’s deadly air pollution, another big culprit is the massive diesel generators used by industries and buildings to light up homes and offices during outages when power from the grid switches off – a frequent occurrence in summer. Installed in backyards and basements, they stay away from the public eye.

“Although vehicular emissions are the show stoppers, they are the ones which get the media attention, the silent polluters are the diesel generators,” says Arpit Dhupar, one of the three engineers who co-founded the start up.

The idea that this polluting smoke needs attention struck Dhupar three years ago as he sipped a glass of sugarcane juice at a roadside vendor and saw a wall blackened with the fumes of a diesel generator he was using.

It jolted him into joining with two others who co-founded the start-up to find a solution. Dhupar had experienced first hand the deadly impact of this pollution as he developed respiratory problems growing up in Delhi.

An Indian girls holds a banner during a protest against air pollution in New Delhi, India, Nov. 6, 2016.
An Indian girls holds a banner during a protest against air pollution in New Delhi, India, Nov. 6, 2016.

A new business

As the city’s dirty air becomes a serious health hazard for many citizens, it has turned into both a calling and a business opportunity for entrepreneurs looking at ways to improve air quality.

According to estimates, vehicles contribute 22 percent of the deadly PM 2.5 emissions in Delhi, while the share of diesel generators is about 15 percent. These emissions settle deep into the lungs, causing a host of respiratory problems.

After over two years of research and development, Chakr has begun selling devices to tap the diesel exhaust. They have been installed in 50 places, include public sector and private companies.

The technology involves cooling the exhaust in a “heat exchanger” where the tiny soot particles come together. These are then funneled into another chamber that captures 70 to 90 percent of the particulate matter. The carbon is isolated and converted into ink.

Among their first clients was one of the city’s top law firms, Jyoti Sagar Associates, which is housed in a building in Delhi’s business hub Gurgaon.

Making a contribution to minimizing the carbon footprint is a subject that is close to Sagar’s heart – his 32-year-old daughter has long suffered from the harmful effects of Delhi’s toxic air.

Motorists drive surrounded by smog, in New Delhi, India, Nov. 8, 2017.
Motorists drive surrounded by smog, in New Delhi, India, Nov. 8, 2017.

“This appealed to us straightaway, the technology is very impactful but is beautifully simple,” says Sagar. Since it could be retrofitted, it did not disrupt the day-to-day activities at the buzzing office. “Let’s be responsible. Let’s at least not leave behind a larger footprint of carbon. And if we can afford to control it, why not, it’s good for all,” he says.

At Chakr Innovation, cups, diaries and paper bags printed with the ink made from the exhaust serve as constant reminders of the amount of carbon emissions that would have escaped into the atmosphere.

There has been a lot of focus on improving Delhi’s air by reducing vehicular pollution and making more stringent norms for manufacturers, but the same has not happened for diesel generators. Although there are efforts to penalize businesses that dirty the atmosphere, this often prompts them to find ways to get around the norms.

Also Read: Exposure to Traffic-Related Pollution Poses Threat of Asthma in Kids

Tushar Mathur who joined the start up after working for ten years in the corporate sector feels converting smoke into ink is a viable solution. “Here is a technology which is completely sustainable, a win-win between businesses and environment,” says Mathur. (VOA)