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In an inspiring conversation with Dr. Dileep Raman, Co-Founder and Chief of Healthcare at Cloudphysician, we uncover the groundbreaking work of transforming regular ICU beds into Smart-ICU beds, technology-driven lifelines for Entrepreneurial Households and their Industrious Communities. Through their innovative tele-ICU platform, Cloudphysician is bridging the gap in critical care, ensuring every patient, across smaller towns and cities in India, receives expert attention, no matter where they are located.
Team Enmasse: Dileep, let’s start off by looking into the problem that Cloudphysician is seeking to solve for India.
Dileep Raman: In simple terms, there are around 300,000 ICU beds in the country but very few trained ICU specialists, less than 4,000. This creates a big problem, especially in smaller cities. What we do is upgrade regular ICU beds into Smart-ICU beds. These smart beds have the necessary skills, processes, and technology for proper care. Currently, most ICU patients don't have access to ICU specialists. Our solution ensures that every ICU patient gets the expert care they need and deserve.
Team Enmasse: And give us a sense of how this works. How do you turn a regular ICU into a Smart-ICU?
Dileep Raman: The Cloudphysician system integrates a comprehensive tele-ICU platform that enables our team of expert critical care doctors and specialists, from our control centre, to monitor and manage ICU patients remotely, in real-time. We use advanced technology, including cloud-based software, data analytics, and high-definition video conferencing, to extend our reach to hospitals, especially those in underserved areas.
Our system collects and analyses patient data continuously, allowing for immediate interventions when necessary. This includes monitoring vital signs, medications, lab results, and other critical patient information. Our specialists work alongside the bedside team providing them with support, guidance, and decision-making assistance around the clock. This approach not only enhances patient outcomes by ensuring timely and expert care but also helps address the shortage of critical care specialists. By leveraging technology, we can bridge the gap in critical care services, enabling even remote hospitals to offer advanced ICU care to their patients.
Team Enmasse: And how does Cloudphysician do this? Is this done through cameras?
Dileep Raman: Yes, that's a crucial part of our setup. Our system utilises high-definition cameras, microphones, and speakers installed in the ICU rooms, enabling our remote specialists to visually and audibly assess the patient's condition in real-time. These cameras allow us to conduct thorough examinations, closely observe patients' responses, and interact with on-site healthcare staff as if we were physically present in the room.
Moreover, our platform integrates seamlessly with the hospital's electronic health records (EHR) and other critical medical systems. This integration gives us a comprehensive view of the patient's health status, including real-time access to vital signs, medical history, laboratory test results, and imaging studies. This way, we ensure that our decision-making is informed and data-driven, enabling us to provide personalised and precise critical care interventions remotely.
Team Enmasse: Could you share a real-life example of how Cloudphysician has made a difference in someone's life?
Dileep Raman: Absolutely. There's a story that really stands out to me. In Bihar Sharif, a town near Nalanda, we encountered a 24-year-old man who had suffered a severe accident. He broke his thigh bone, which is the largest bone in the body. This injury led to a fat embolism, where fat from the broken bone entered his lungs, causing profound respiratory failure. This condition can be fatal without proper care, as the patient's oxygen levels can plummet dangerously.
Team Enmasse: That sounds critical. Is immediate transport to a major city the only option?
Dileep Raman: Typically, yes. But in cases like this, time is of the essence, and a long ambulance ride to a major city like Patna could be too risky. This is where our partnership with the local hospital in Bihar Sharif made a difference. They lacked an intensivist, but through our remote ICU support, we could provide the necessary care right there.
Team Enmasse: How does that work in practice?
Dileep Raman: The patient could access our team of doctors and nurses through our Smart-ICU setup. The hospital had a new ventilator, but they weren't familiar with it. We guided them through its operation and managed the patient's care remotely. After about 12 days in the ICU, the patient could come off the ventilator and eventually return home to his family, healthy and able to continue his role as the household’s primary income earner.
Team Enmasse: That's incredible. And the cost savings?
Dileep Raman: Significant. The cost of care in Bihar Sharif was a fraction of what it would have been in a metro city, without compromising the quality of care. This approach not only saved the patient's life but also protected the family from catastrophic health expenditures. It's a win-win for the patient, their family, and the local hospital. This case exemplifies our mission to bring world-class healthcare to underserved areas, ensuring patients receive the proper care in their own communities whenever possible.
Team Enmasse: So give us some statistics. How many hospitals, patients, beds? What does the Cloudphysician universe look like right now?
Dileep Raman: As of January 2024, we crossed 1,450 beds in our network, which spans approximately 100 cities and towns across India. We're currently partnered with around 193 hospitals and are adding about 10 to 15 new ones each month. While these numbers might sound impressive, we're just beginning. India has around 40,000 hospitals that could benefit from our services, so there's much more ground to cover. So far, we've cared for about 90,000+ ICU patients within our network. Each patient has a story, much like the ones I've shared, which drives us forward. Moreover, the vast amount of data we've gathered from these cases is invaluable. It helps us improve our service, making our care more efficient, accurate, and scalable.
Team Enmasse: In our discussions, we're challenging the notion that Entrepreneurial Households in smaller towns and cities lack the capacity or willingness to spend on quality services. We hear stories indicating that, despite their remote locations, their aspirations and needs are the same as those in larger cities. These Industrious Communities have the willingness to spend; what they lack is access to high-quality services. Is this consistent with your experience?
Dileep Raman: Absolutely. The healthcare iron triangle of access, quality, and cost has always been challenging to balance. With advancements in technology, we can now address these challenges more effectively. Our partners in smaller towns want to provide the best care possible within their EPIC communities but often face constraints like staffing or perception as a mediocre facility. They reach out to us with the drive to change this.
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Team Enmasse: Give us a specific example of this demand for better healthcare services from EHs and their communities.
Dileep Raman: One recent example is our partnership with a hospital in Bilaspur, led by a highly regarded orthopaedic surgeon. This region, like many others, has been underserved for a long time. The surgeon sought to bring the best possible medical technology and services to his hometown, not just to save money but to provide top-notch care. This desire for excellence is a common theme among our partner hospitals. They strive to offer comprehensive care beyond their speciality, moving towards a virtual hospital model that provides access to a wide range of specialists. This approach enables local hospitals to become centres of excellence, reducing the need for patients to travel long distances for quality care.
Team Enmasse: It's ironic that smaller towns like Bilaspur might soon offer better ICU care than larger cities.
Dileep Raman: Absolutely. We're seeing a shift in expectations and demands for healthcare services, even in the most remote parts of India. Patients and their families, EHs effectively, are increasingly knowledgeable and aspirational, comparing local healthcare services to international standards. They recognise and appreciate the added layer of care and expertise provided by remote medical teams, signalling a significant change in how healthcare is perceived and delivered across the country.
Team Enmasse: Dileep, could you share examples that illustrate the healthcare challenges and opportunities in tier 2 and tier 3 cities?
Dileep Raman: Certainly. Kerala is a prime example, where healthcare costs have almost doubled in a decade, signalling an urgent need for India's healthcare system to evolve. This evolution must ensure quality care remains affordable. Conversely, in cities like Mathura, we encounter a different scenario. There's a pronounced demand for quality healthcare that the local infrastructure and talent pool need help to satisfy. Addressing this gap is precisely where our focus lies.
Team Enmasse: How do these insights shape strategies for healthcare providers?
Dileep Raman: The key challenge, such as attracting skilled healthcare professionals to places like Mathura, stems from the economic disparity. Patients' willingness to pay in metropolitan areas versus smaller cities for identical services guides our strategy. We aim to enhance healthcare infrastructure and services, crafting a compelling proposition that balances quality and accessibility, ensuring excellence is recognised and rewarded everywhere.
Team Enmasse: Can you discuss the impact of branding and competition on improving services in these areas?
Dileep Raman: Branding and competition are crucial. In tier 2 and tier 3 cities, home to millions of Entrepreneurial Households with economic means and high aspirations for healthcare, overcoming the perception that quality care is exclusive to larger cities is a significant branding challenge. Effective communication of value propositions, showcasing the capability to provide metropolitan-level care locally, is essential.
Competition fosters a culture of continuous improvement and innovation among healthcare providers. It's about creating a healthcare ecosystem that prioritises excellence, encouraging specialisation, and enhancing healthcare outcomes. This competitive spirit not only improves services but also drives providers to focus on areas where they can genuinely excel.
Team Enmasse: How should providers in these cities leverage branding and competition?
Dileep Raman: Providers must view these challenges as opportunities. For branding, engaging with the community to understand and align with their health aspirations is critical. This involves using digital platforms for outreach and education, building a brand that reflects local values and needs.
Regarding competition, focusing on unique strengths allows providers to distinguish themselves, even in crowded markets. Collaboration can also enhance service offerings, improving patient outcomes and solidifying market positions. Ultimately, success in navigating these challenges hinges on understanding local market dynamics, clear communication, and a steadfast commitment to healthcare excellence and innovation.
Team Enmasse: Many thanks for these insights into EHs and the opportunity to deliver high-quality healthcare to these Industrious Communities. Finally, what is your vision? Where do you want to take Cloudphysician?
Dileep Raman: It's exciting to share our vision. At Cloudphysician, we believe our model of delivering cost-effective, high-quality care is crucial and replicable. The challenge of global health is vast, and it calls for a collective effort. India, with its unique combination of talent, technological prowess, and social capital can be the epicentre of a global IT service revolution that extends to healthcare.
Unlike China, which lacks the soft capital, or the US, where the cost structure is prohibitive, India can bridge this gap, offering equitable healthcare solutions worldwide. Our goal is to develop a model in-house that's scalable globally. If our solutions work in places like Motihari, they can work anywhere, making us a virtual hospital not just for India but for the world. This is about more than an IT revolution; it's laying the groundwork for a healthcare revolution, ensuring care for all. That's our dream and our vision for Cloudphysician.
