Doctor in the Cloud: As Covid-19 rages on, hospitals embrace technology

The platform runs on a software called Power BI, a data visualisation tool that evaluates the vitals of all patients in ICUs in over 15 districts of Karntaka

In July, when Covid-19 cases were rising sharply in Karnataka, a septuagenarian patient was admitted to a hospital in the district of Kalaburagi. The patient was critical — he had Covid-19 and pneumonia, and multiple organs in his body had been affected. The doctors at the hospital immediately got on to the Critical Care Support Unit of the state to consult senior doctors in Bengaluru. On their advice, the patient remained in ICU for a week and was treated for other complications along with the Covid-specific treatment. After three weeks, the patient recovered and was discharged. 

“The fatality rate in Karnataka is much lower than the national average as we have been able to provide critical care to Covid patients through this service. It has been a significant contributor in saving the lives of patients during the pandemic,” says Anoop Amarnath, a member of Critical Care Support Unit in Bengaluru.

Karnataka was the first state to link ICUs of Covid hospitals on a single platform and monitor the progress of patients from a command centre. The platform runs on a software called Power BI, a data visualisation tool that evaluates the vitals of all patients in ICUs in over 15 districts of the state.

“While the e-rounds happen on the Microsoft Teams platform, Power BI data gives us an idea about which district has how many cases, the mortality rate and the number of critical patients. This provides a clearer picture of how to go about with the virtual rounds,” says Amarnath, who is also chairman, geriatric medicine, HoD Internal Medicine at Manipal Hospitals. Karnataka has managed more than a 100,000 cases through this platform so far.

Many hospitals have switched to technological platforms to manage patients remotely, with physical intervention as and when required. “In any ICU, up to 70 per cent of decisions can be cognisant and only 30 per cent require a procedure that will need a health care professional to be physically present at the patient’s side,” says N Ramakrishnan, managing director of Chennai Critical Care Consultants, which was one of the earliest providers of tele-ICU support to hospitals located in the US.

Fortis Hospitals have deployed a technology called ‘Stasis’ that helps provide precision, round-the-clock care and treatment to patients. The technology has upgraded the hospitals’ patient monitoring system by helping doctors to be clued into their patients’ vital parameters at all times. “The beauty of Stasis is that patients can be monitored from any part of the hospital,” says Manish Mattoo, zonal director at Fortis Hospital in Bengaluru.

Stasis provides a sensor attached to the patient and a small portable device that is kept next to the person. All vitals of the patient are recorded on the device and this is relayed to doctors or the nurses over the cloud (internet). The live data is reflected on their mobile phones and alerts are sent out in case of abnormal variations.

“In the case of Covid-19 patients, these monitors are installed and alerts come to the doctors or nurses’ phones. So they can intervene as and when required,” explains Mattoo. The monitor records four vital parameters — temperature, pulse rate, oxygen saturation and ECG. The technology came in handy during the peak of the pandemic, when ICU beds were scarce, to ‘bridge’ the patient till a bed became available. Fortis Hospital in Bengaluru has so far treated over 1,000 patients using this remote monitoring technology.

This technology can also be utilised to treat patients who have other complications. For example, patients who have undergone angioplasty may experience stoppage of the heart. With this, the intervention to revive the patient can happen as soon as the alert comes in.

That’s not all. The hospital chain is working on predictive analytics by analysing data of patients in ICUs and figuring out how to predict outcomes based on clinical parameters, especially for chronic diseases.

Fortis has also deployed a first-of-its-kind, comprehensive ‘safe check-in kiosk’ outside hospitals, which ensures adherence to all the essential protocols to be followed during the pandemic. Using AI-driven face detection technology, it ascertains whether the user is wearing a mask and if it’s being worn properly.

The team of doctors at Chennai Critical Care Consultants has been offering tele-ICU rounds to an accredited Covid-19 hospital in Tamil Nadu and giving specialised inputs. The team provides support whenever required, using a software called Omnicure which facilitates two-way video calls. The company is also working with a Bengaluru-based start-up called CohereMed, which has been incorporating AI in clinical care to identify chronic issues in patients for speedier treatment.

Rise of remote monitoring

• Manipal Hospital is part of Critical Care Support Unit monitoring patients across Karnataka with the help of Microsoft software Power BI
• Fortis Hospitals have deployed a technology called ‘Stasis’ to provide precision, round-the-clock care and treatment to patients
• Doctors at Chennai Critical Care Consultants has been offering tele-ICU rounds to a Covid-19 hospital in Tamil Nadu via Omnicure
• Apollo Hospitals has so far carried out 150,000 consultations via its app Apollo 24x7 from over 129 cities
• Home health care provider Portea Medical has seen 12x spike in digital consultation services as compared to pre-Covid levels

“There is definitely a shift in the way health care services are accessed today, beyond just telemedicine. It’s important that people walk hand-in-hand with information and technological innovations. Whether it’s our Covid Risk Scanner, where users harnessed the power of AI or Apollo 24/7 Vaccine Tracker, even the delivery of information has changed for us,” says Shobana Kamineni, executive vice–chairperson, Apollo Hospitals Group.

In the area of home care, home health care provider Portea Medical has worked with six states to manage Covid-19 patients at home. These patients were either asymptomatic or mildly symptomatic and, hence, were isolated at home. “We put together a solution using our technology platform and with our medical expertise and created a protocol. Overall, about 200,000 patients have been managed by us in the past six months,” said Meena Ganesh, CEO and managing director of Portea Medical.

The platform captures specific parameters of patients such as temperature, pulse rate, oxygen level saturation. “The system tells us whether somebody needs to be referred to a doctor for a tele-consultation or if they need to be referred to a hospital,” says Ganesh.

Portea Medical has seen a 12 times growth in their digital consultation services as compared to pre-Covid levels, with a peak of 3,000-4,000 consultations per day on some days.