Thursday May 23, 2019

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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Sony Mobile Exit India Market Owing to Hyper- Competition

Sony Mobile would continue to monitor the market situations and business feasibility in the country

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Sony Mobile, India
the pressure from Chinese brands and Samsung in the major price segment resulted in continuous decline of sales for Sony. Pixabay

Facing stiff competition from Chinese and South Korean players, Japanese conglomerate Sony Corporation has announced to quit the Indian smartphone market.

Sony had less that 0.01 per cent of the total Indian smartphone market share in the first quarter of 2019, according to Counterpoint Research.

Sony Mobile, however, said that it would continue to monitor the market situations and business feasibility in the country.

“Our focus markets are Japan, Europe, Hong Kong and Taiwan to drive profitability and future prospects in the 5G era,” Sony Mobile said in a statement on Wednesday.

Sony Mobile, India, Market
Sony Corporation has announced to quit the Indian smartphone market. Pixabay

“We have ceased sales in Central and South America, the Middle East, South Asia, Oceania, etc. in FY 18,” it added.

The company assured that it would continue its customer support operations including after sales support and software updates for existing customers in India.

The India smartphone market is currently dominated by Chinese players like Xiaomi, OPPO, Vivo and OnePlus among others, besides South Korean tech giant Samsung.

According to Shobhit Srivastava, Research Analyst, Mobile Devices and Ecosystems, Counterpoint Research, the pressure from Chinese brands and Samsung in the major price segment resulted in continuous decline of sales for Sony.

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“With declining sales in India and other markets, Sony took the right decision to focus on the high ASP (average selling price) markets such as Japan,” Srivastava told IANS.

Sony India in July last year brought its flagship “Xperia XZ2” smartphone for Rs 72,990 to India that turned out to be its last launch.

“In a cut-throat market like India where Chinese smartphone brands rule the roost with industry-leading specs and having over 60 per cent market share, it’s tough for other brands to garner a meaningful revenue share. Sony has had a very miniscule market share in India,” Prabhu Ram, Head, Industry Intelligence Group (IIG), CMR, told IANS.

For Sony, the performance of its mobile business has lacked the sheen, and has been a clear outlier compared to its other divisions.

Sony Mobile, India, Market
Sony had less that 0.01 per cent of the total Indian smartphone market share in the first quarter of 2019. Wikimedia Commons

“It makes sense for it to cut its losses and refocus on other verticals,” Ram added. (IANS)