Thursday April 2, 2020

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

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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
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)

  • 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.

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  • 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.

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Virus of Hatred and Insanity Wreaking Havoc With the Preventive Measures in India

All you need to know about the Tablighi congregation at Nizamuddin

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India Tablighi
The Tablighi Jamaat congregation has created a havoc in India.

By SALIL GEWALI

Why is the WORLD on lockdown now? It is exclusively intended to keep away from any XYZ who might have infected with COVID-19 and thus contain the deadly pandemic as soon as possible. To combat the outbreak how much “monetary loss” each nation has been incurring each day is unprecedented and unimaginable. Here the main concern being to “save” the lives of the citizens at any rate. Yes, each nation-state considers each life of a citizen as “precious” as anything.

But look at the situation arising out of the Tablighi congregation at Nizamuddin, New Delhi,India and its immediately aftermath. It has raised many questions than answers. What is very disgusting is some of the members of the organization caught “repeatedly spitting” from the windows of the bus as reported by “Hindustan Times” and other news media. Some members directly spat on a “woman” calling her ‘coronavirus’. The members did not even heed to the requests from the elderly people and doctors. Finally, police had to forcefully close the windows of the bus.

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Well, everyone knows that COVID-19 spreads through droplets that come out from our mouths. So, to prevent the possible infection from the fluid droplets we strictly ensure that we cover our mouths with masks. The whole world is doing that. But why this godless act by “certain” members of the religious attendees of Tablighi in New Delhi thereby putting other public potentially at risk. Why such an evil motive, who all are encouraging such things?

India Tablighi
Well, a very learned scholar and also the Governor of Kerala,India, Arif Mohammad Khan described the non-cooperation of the certain Muslim community as a “crime against the nation and humanity.”

Was that elaborate religious congregation not mean to teach us how to be more conscious as a human being and to be compassionate towards other “fellow beings”? What is appalling at this hour of crisis is that there are many Mosques in India which are deliberately “defying” the lockdown order and observing the regular namazs and mindlessly encouraging mass gathering. Some have attacked police while in some states the medical doctors or their assistants associated with the quarantine care have been disrespected, abused and manhandled. Mindless stone-pelting upon the doctors and police have been reported from several states in the country. Why are such disgustingly inhumane behaviors arising from the community of a particular faith only? Why are certain people so uncouth and so uncooperative? Can the pandemic catastrophe be put down by such inhumane behaviors? Will it not be “irreligious” itself when the people, be it from any faiths, recklessly contribute to the suffering of others?

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Further, will GOD “saves ones” who have not taken the preventive measures? Absolutely not. God has given a human being the “brain” in order to decide judiciously what to do and what not to do. God will never descend from heaven to save if we abuse ourselves. About 10 members from the Tablighi Jamaat have already died from Coronavirus. Is it not the loss of precious lives for which we should “mourn”? Is it not a loss for the nation as a whole?

India Tablighi
Due to the religious congregation, many new COVID-19 cases have been reported in India.

Many infected persons from the Jamaat are potentially likely to infect others healthy which might multiply progressively, some of them have already dispersed to their respective states started causing problems as already been reported from the states like Bihar and Gujarat. Some are attacking police personals by violating the lockdown. Is the fundamental teaching of all religions not for the well-being and wellness of each human being on the planet? One wonders why such godless acts are being encouraged, or tolerated! Is tolerating the forces with sinister motives not sin in itself?  Well, a very learned scholar and also the Governor of Kerala Arif Mohammad Khan described the non-cooperation of the certain Muslim community as a “crime against the nation and humanity.”

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Here is another “shocker” published by Indian Today about a week back. An Infosys software engineer from Bangalore Mujeeb Mohammad appealed through his facebook by writing – “Let’s join hands, go out and sneeze with open mouth in public.

Also Read- Munish Raizada Films’ Debut Political Documentary- Transparency: Pardarshita, The Untold Series of IAC & AAP Released

Spread the virus.” How shall we describe this motive? What is in store for us in this 21st Century? Mind out, if such “insanity of hatred” is let to rear its ugly head, the sanity will certainly die a death. The virus of insanity could be more dangerous than Coronavirus. It will directly attack the very LUNGS and HEART of the Nation, and humanity at large.

An India-based writer and researcher, Salil Gewali is best known for his research-based work entitled Great minds on India which has earned worldwide appreciations. Translated into twelve languages, his book has been prefaced by a world-acclaimed NASA Chief scientist – Dr. Kamlesh Lulla of Houston, USA.

[ Disclaimer: The pictures used in the article are supplied by the author, NewsGram has no intention of infringing copyrights. ]