THE new sunday express Voices Anand Neelakantan Anuja Chandramouli Ravi Shankar Sheila Kumar Satya Mohanty Sadhguru Jaggi Vasudev Buffet MAGAZINE People Wellness Books Food Art & Culture Entertainment JUNE 20 2021 SUNDAY PAGES 12 India’s person to hospital bed ratio 9 per 10,000 500% in teleconsultations between March and May last year At Home with Covid The pandemic has provided a boost to the growing telemedicine and home healthcare services sector in India 200% rise in psychiatric teleconsultations during the same period 70-80% people prefer teleconsultation from a safety perspective, while the rest do it for convenience Source: Practo Report on Telehealth, and EY & IPA Report on Virtual Healthcare, released in 2020 DurgadAtt pandey increase By Noor Anand Chawla H ospitals are the frontline battlegrounds in the war on Covid-19. Doctors and nurses are saving lives at great cost to their mental and physical well-being. Never before has remote medical treatment been so relevant than now. Thousands of lives have been lost due to poor healthcare and overexposure to the virus. India’s health infrastructure remains tawdry with basic facilities not available in the , hinterland where Community Health Centres have a 76.1 percent shortage of doctors. Professional home care has become the large-scale alternative to hospitalisation for both Covid-19 and non-Covid patients—a sector that has grown exponentially over the last year. The India Home Healthcare Market Size and Share report by market research and consulting company Grand View Research estimates the segment at $6.2 billion in 2020, with a projected increase to $21.3 billion by 2027. Gyan Mehta (name changed) from Bengaluru, all of 26 years of age, has Duchenne muscular dystrophy a genetic disorder that , leads to progressive muscle degeneration. He was admitted to ICU after a fall last year, which caused multiple fractures. Unfortunately the , post-surgery complications put him on a ventilator, which led to more muscle weakness and ICU delirium. He needed long-term acute care at home, with skilled nursing and telemedical consultation. His family chose Cloudphysician, a medico-technical team dedicated to setting up home ICU facilities after hospital discharge. Their services include identifying software, hardware, open-source technologies, pan-tilt zoom cameras, a reliable internet service, and a real-time video conferencing platform. They also provide specially trained critical care nurses and a physiotherapist for round-theclock care. ICU intensivists with experience in remote care offered guidance throughout the treatment, motivating Mehta and putting him on the path to recovery In . 50 days, he was able to make monthly outpatient visits to his doctor. In six months, he took a holiday abroad with his family when air services resumed. Similarly Vishakha , Malhotra contracted the coronavirus in Delhi, which she suspects was the result of a visit to a mall. She went into home isolation; going to a hospital was risky and the bed , crunch accelerated the situation further. A friend suggested a home care package from a top hospital, which included medical equipment, a vitals monitoring tool with built-in alert mechanism in case her situation deteriorated, daily monitoring by a nurse on call and video consultations with a doctor. Medicines were home-delivered. It took 15 days, but Vishakha recovered. Why home care? The patient is not disoriented since he or she is in familiar surroundings, like their own room, bed, their favourite cups and plates, music and TV . Home care includes a customised care plan that considers lifestyle needs with extra support. Hospitalisation implies a loss of independence. Choosing the time to rise from bed, eat and sleep helps to retain confidence. Non-Covid patients can socialise and even have outings under supervision. Interaction with family and friends ensures mental health. It helps avoid hospitalisation during the pandemic. For non-Covid patients, the home healthcare team from a hospital has nurses, physical therapists, occupational therapists, speech therapists, social workers and aides working under a doctor’s care. Home care professionals help family members to avoid the burnout associated with caring for patients. Specialised services from the home healthcare provider are an important factor in choosing it. On top of the list are nurse care, palliative care, elderly care and post-surgery care. In focus are expert packages that offer advanced services for tracheostomy care, paediatric nursing and counselling. The Indian health industry is witnessing its biggest boost in medical home care, which involves teleconsultation, home lab testing and home delivery of pharmaceuticals. Home-based vaccinations, especially for paediatric purposes, are expected to grow in demand after the current age restrictions are removed. Rise in Remote Treatment A 2020 RedSeer Analysis report indicates the many reasons for the growth of this sector. India currently has nine beds per 10,000 patients— far below the WHO-mandated standard of 40 beds per 10,000 patients—and a single nurse for every 1,000 patients. This has resulted in a severe lack of personalised attention for patients, whose needs are specific. The report highlights that going to a hospital invites a higher likelihood of catching infectious diseases, since 25 percent of patients in India have been found to be vulnerable to ‘hospital-acquired infection’. Intensive care averages between `35,000 and `50,000 a day These . factors make home-based care an attractive alternative to hospitalisation, except in critical cases. The growing demand for quality post-operative care, advancement in remotely operated technology , growing geriatric population, higher disposable income, and expanding chronic and lifestyle diseases are responsible for the meteoric growth of this sector in India. Cloudphysician’s closely monitored protocol is a prime example of the feats being achieved by the Indian healthcare industry to , provide an economically viable solution for long-term acute care at home. According to Dr Ruchir Mehra, CEO and co-founder of DISHA by Remedo app, technology , startups and PPPs are driving novel solutions to the country’s healthcare needs. The Remedo app connects patients to doctors by understanding their conditions and suggesting lifestyle changes, outside the fixed 10-15 minute consultation. Remedo acts as a digital extension of medical practice, helping doctors provide better care to patients outside the clinic. Dr Dileep Raman, Intensivist, Pulmonologist, Sleep Specialist and Co-founder of Bengaluru-based Cloudphysician, highlights their proprietary software technology called RADAR, which provides analytical insights into patient health, disease state, treatment line, and medication effectiveness. It also helps with telerounds and allows seamless communication among all healthcare providers. The ability to offer tele-ICU services is a step further in democratising healthcare in India and in increasing its reach. Awareness and the acceptance of technology-based medical advice, coupled with the penetration of smartphones and the internet, have triggered a shift in behaviour towards home care. The proliferation of devices on the market, from BP monitor to pulse oximeters, has helped people make better use of remote care. The Covid-19 Equation When 34-year-old Uma Maheswari in Chennai was diagnosed with mild Covid-19, she decided to return home after a few days at a Covid Care Centre. “I’ve two children and my husband works full time. I couldn’t afford to stay away from home for long,” she says. She immediately booked Apollo’s home care plan. It cost her `700 a day and offered , telecounselling and a home care kit. “I had top infectious disease specialists from the hospital checking on me via video conference,” says Maheswari. Turn to page 2 What to look for when choosing home healthcare services Dr Gaurav Thukral EVP & COO, HealthCare atHome India ● Whether the home healthcare provider has a team of trained, experienced, background-verified and clinically trained staff equipped to handle medical emergencies that can be trusted ● The decision-maker—family member /patient/ caregiver—should search for someone who suits their needs best. The home care partner should be trustworthy, credible, and experienced. Ask the following questions to check it is not a sham ● Are the home care partner and their team rightfully qualified and trained? ● Are they quality-driven in terms of safety, time efficiency, etc? ● Can they handle medical emergencies? ● Do they have medical backups in place? Dr Dileep Raman Intensivist, Pulmonologist, Sleep Specialist and Co-founder, Cloudphysician People must consider the appropriate expertise and the qualifications of the caregivers. They must be evaluated and vetted by trustworthy entities to ensure that the caregivers are adequately trained and skilled at what they do. Jagadish Ramamoorthy Co-founder & Director, Alserv The healthcare service provider must have hired only trained staff from verified institutes. Each member of staff must go through a background check before being deployed. Archana Sharma Founder, Samvedna Senior Care Dr Jayashree Dasgupta Co-Founder The team must be a mix of experienced and young professionals, including doctors, clinical psychologists, social workers, nurses and caregivers. For eldercare services, the staff should have been hired from reputed institutes specialising in geriatric care and elderly issues. The staff must also go through a specialised in-house training in geriatric care.
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