Amid all the challenges, technology-enabled solutions will be key to accessible healthcare for all as it offers opportunities to streamline processing and improving overall patient experience
By Kalyani Sharma
Healthcare industry: Overview
Healthcare has taken centerstage in the backdrop of the COVID-19 pandemic. It has placed an enormous strain not only on the domestic but also global healthcare sector’s workplace, infrastructure and supply chain. On the positive side, it is also accelerating change across the ecosystem and increase in acceptance as well adaptation of new innovations in a short period.
As per invest India, “Indian healthcare sector is expected to rise to $ 372 billion by 2022 at a CAGR of ~16 per cent. The healthcare sector has several growth drivers such as increased life expectancy (70 years by 2022), rising access to insurance coverage (20 per cent Indians are currently covered), better health awareness (particularly amongst the younger generations), growing lifestyle diseases (leading to more demand for healthcare services), several government initiatives, and a large medical infrastructure in pipeline (over $ 200 Bn to be spent by 2024). Moreover, there has been a steady growth in government and private expenditure on healthcare with government spending set to increase to 2.5 per cent of GDP by 2025, up from 1.6 per cent in 2020-21. The private sector has emerged as a vibrant force in India’s healthcare industry– accounting for almost 74 per cent of the country’s total healthcare expenditure.”
How Remote Patient Monitoring (RPM) is shaping the future of healthcare: Express Healthcare’s webinar series
The COVID-19 pandemic is turning out to be a long drawn out battle, against a foe that seems to be adept at outsmarting the human race. But the silver lining to the COVID cloud is that this has also been a time of accelerated innovation. Be it medicines, vaccines, adopting new technologies, adapting and updating healthcare practices. Indeed, the daily learnings of the past months will help us survive and thrive, not just against SARSCOV-2 but also other new emerging disease threats into the next few decades.
At the forefront of this battle, are our medical and paramedical staff, fighting a war, often racing against time, against an invisible foe, often without bullets, or adequate armor. To compound maters, most countries, including India, are running short of healthcare personnel. According to the Ministry of Health and Family Welfare, India has one medical doctor for every 1404 people and 1.7 nurses per 1,000 people. This is lower than the WHO benchmark of one doctor and three nurses per 1,000 people.
Amid all the challenges, technology-enabled solutions will be key to accessible healthcare for all as it offers opportunities to streamline processing and improving overall patient experience. There has been a greater proliferation of technology-enabled healthcare solutions in the country due to COVID, targeting various segments of the population. One such timely intervention has been Remote Patient Monitoring (RPM), a solution which is especially important considering the significant infrastructure and healthcare professionals’ shortage in the country.
As per the report by Mordor Intelligence, “India’s remote patient monitoring (RPM) market is expected to see a CAGR rate of 6.4% from 2020 to 2025 as per the latest report. Also, the global market size for RPM Devices is anticipated to hit the USD 1.8 Bn mark by 2026 from USD 920 Million in 2020, at a CAGR of 10.64% over the next five years, reveals data.”
Studies conducted by the National Center for Biotechnology Information (NCBI) have shown how RPM considerably helps in improving clinical outcomes in patients with cardiac failure, atrial fibrillation, ventricular arrhythmias, respiratory disorders. This, quite obviously, brings in a host of good news for the healthcare industry. Enhanced patient outcomes is one among them that will be observed as we start implementing Remote Patient Monitoring significantly across the country.
Express Healthcare, in association with Dozee, recently organised a webinar to understand the need of adopting new technologies and its positive impact on the currently burdened healthcare system.
Dozee is the pioneer in contactless, continuous remote patient monitoring in hospitals & at home, delivering unparalleled patient safety & maximizing utilization of ICU beds. The webinar focused on the Dozee Pro RPM solution, which is contactless vitals monitor for hospitals that features an AI-powered triage system. This enables the continuous and accurate monitoring of a patient’s heart rate, respiratory rate, and other clinical parameters like sleep apnea, myocardial performance metrics without coming in contact with the patient. The solution allows a hospital to quickly ramp up ICU facilities as per patient load, by converting a bed into a step-down ICU in 2 minutes flat, allowing doctors to remotely monitor patients outside the ICU. This has made a huge difference in ICUs and COVID care centres across the country.
Three healthcare experts namely Dr Vaishali Shelgaonkar, Associate Professor & HOD, Dept. of Anaesthesia Indira Gandhi Government Medical College, Nagpur; Dr Shailesh Jhawar, Director-HOPES, Sr. Consultant – Critical Care & Cardiothoracic Anaesthesia, Apex Hospitals and Dr Avinash H R, Asst. Professor, General Medicine, ESIC Hospital, who have already implemented solutions from Dozee participated in a panel discussion along with Mudit Dandwate, CEO & Co-founder, Dozee and Viveka Roychowdhury, Editor, Express Healthcare as a moderator. The panelists shared their experiences, the implementation journey, the challenges, as well as the lives saved, the impact on their hospital ecosystem and healthcare management practices.
Sharing her Dozee implementation journey, Dr Shelgaonkar said, “The entire healthcare system is under pressure since March 2020. The country has 2 million hospital beds and only 100,000 ICU beds. Coupled with the shortage of trained nursing staff, it was impossible to keep an active watch on the health of all the patients continuously, especially outside the ICU during these challenging times. We adopted Dozee RPM in July 2020 to help us manage patients who require continuous monitoring while safeguarding our staff. Dozee is playing a crucial role in monitoring over 150 patients at a time and has helped the timely transfer of over 200 patients to the ICU.”
Explaining about the training of staff, she added, “Initially, we pulled all four branches who were already accustomed to handling some kind of critical patients. We started with them. The nursing staff which was working in various ICUs were simultaneously asked to train other nurses. Doctors were training doctors and we were training around almost other 600 medical officers from district health administration as well as non-core branch doctors so that they can help us in managing COVID pandemic. We did not have any break to arrange for training plus manage the patients. It was on job training.”
Dr Jhawar while sharing his experience with Dozee mentioned, “Issue with our healthcare setup is that we are volume-based country and still with that volume, the value preposition is not lost. The problem with critical care is difference in trajectory to every patients journey of illness which at the right point of time you need the right intervention. At the right points, if the trajectory is aligned with improving outcomes patients get better. And, to pick up those right points is very important. And that’s why, remote patient monitoring is the way forward. In our case, we had to triage our hospital into different levels. So multiple ICUs had to be created (some ventilated, some with high flow oxygen patients and some with recovering patients). In a corporate setup, there is a limit on expansion. So, when we were in the process of expansion, Dozee team, who was already in touch helped us with the execution process within three days.”
Highlighting the important parameters of a valuable technology, he added, “In my point of view, there are 3 things that are very important: Firstly, technology should not be additive in nature, Secondly, it should not be very expensive in terms of infrastructure, Thirdly, it should be readily deployable. Any technology with all these parameters is a valuable technology.”
Sharing his experience with Dozee, Dr Avinash, mentioned, “Since December, 2019, patients were pouring in and we faced multiple challenges of manpower, exposure to healthcare workers and others. When we met dozee team, we converted 50 out of our 200-bed hospital into Dozee HDU that helped in monitoring moderate patients. Moderate patients need to be monitored continuously so that we can pick them early change the treatment regimen. This helped us in saving lot of patients in our hospital. Dozee monitored HDUs reduces human errors and also exposure and also will help in monitoring of post-covid symptoms.”
Highlighting the challenges faced by Dozee as a start-up, Dandwate said, “For timely delivery, installation, training and transfer, our operations and customer success team worked really hard and went from city to city for smooth running of the system.”
Sharing his views on technology adoption in hospitals, Dandwate added, “Technology is worthless if nobody is going to look at it. We try to work with people who are forward looking and understand that it is not a competitor but a force multiplier.”
Talking about company’s future plans, he said, “Currently, we have about 220 hospitals across the country who use this technology and in about 12 months we are planning to partner with close to 1000 hospitals across India. In terms of future, we will continue to build up and improve the product offerings that we have. Currently, we have heart rate, respiration, blood pressure, oxygen saturation, myocardial performance & sleep apnea. These are the set of parameters that you can monitor on Dozee. Our R&D team is working to also test ECG which will be integrated on the same set of platform along with temperature sensor. We work very closely with the clinicians to improve patient outcome, nursing efficiencies and as engineers our job is to find solutions that can augment their practice even more and we can improve this entire ecosystem. That’s the idea going ahead as well.”
Talking about the way forward, Dr Avinash said, “Remote care monitoring is the future in the management of all infectious disease especially COVID waves to come.”
“Our dream of 5 trillion economy and universal health coverage can only be achieved by appropriate resource utilization, empowering more n more people at local level and enable them with whatever available”, added Dr Jhawar.
Sharing her views on the future of remote monitoring system, Dr Vaishali mentioned, “I think such kind of technology has a bright future. We have volumes of patients and as compared to them doctors and nurses are definitely less. Also, we need humans to monitor these monitors and hence to tackle such a huge no of patients such type of monitoring technology is mandatory. The pandemic has taught us about how to go for changes in healthcare management.”
Post the panel discussion, the panelists and speakers answered questions from the audience.
A recording of the webinar can be viewed at https://www.expresshealthcare.in/healthcare-videos/webinar-videos/how-remote-patient-monitoring-is-shaping-the-future-of-healthcare/430443/