67 year old Hari Prasad (name changed), was on life support system in Amritsar and the chances for his survival were low. He was immediately put on surveillance through an electronic intensive care unit (eICU), when the doctor at Delhi based hospital chain Fortis got an alert that Prasad’s oxygen levels are going down. The doctor immediately opened up the electronic record of the patient. “On assessing it was found that although the set oxygen on ventilator was 100%, just 21% of it was getting delivered,” said Sandeep Dewan, director at Fortis’s eICU initiative, Critinext.
eICU is run on a virtual connection between the command centre, usually a well built and reputed hospital in metro, and the patient’s bed, usually in a small hospital in a remote area. The technology allows 24 hour flow of vital facts such as pulse rate, temperature, heartbeat, breath flow apart from a connected monitor, ventilator and audio visual technology to raise alarm, conduct surgeries, medical treatments or emergency procedures.
Lack of expertise in handling intensive care cases and shortage of specialised doctors in smaller towns is opening up a new vista of expansion for the country’s top private hospitals. Fortis Hospitals and Apollo Hospitals, both are planning to increase the number of beds on eICUs considering the high demand in semi urban areas.
Apollo is currently monitoring around 100 beds across India and plans to scale it up to 1000 beds monitored by three to four command centres across various Apollo Hospitals in India in the next 3 years.
Both Fortis and Apollo claim an average occupancy of 85% on eICU beds.“There are about 70,000 ICU beds available across India which caters to 5 million patients requiring ICU admissions per year,” said Pankaj Gautam, head for eACCESS initiative at Apollo Hospitals, a program which includes e-ICUs initiative. Apollo employs more than 700 critical care doctors.
Fortis has also kicked off remote monitoring of patients in eICU in Bangladesh, its first such cross-border initiative.
Meanwhile, smaller hospitals in metros are also exploring options to enter into the eICU industry. Pinky Yadav, medical superintendent at Delhi based Sri Balaji Action Medical Institute, said “e-ICU is a state of the art technology for Tier 3 and Tier 4 towns since super specialist are not present to monitor critical cases due to road or airport inaccessibility. Since it is a new dimension for the healthcare industry, we are also looking forward to support this technology.”
Hospitals charge between Rs 700 and Rs 2000 a day to virtually monitor a patient from their eICUs, with revenues shared between hospitals and companies such as General Electric, Siemens and Philips that have developed the tracking technology. “However, it does not contribute to the revenues much as e-ICUs usually reduce the average length of stay in ICU which balances the cost of treatment,” said Dewan. As per Indian medical journals, eICUs have reduced the average length of stay in ICU by 1.02 days and has prevented 114 adverse clinical events in a year.