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Exclusive: Healthcare experts deliberate different aspects of care delivery system amid COVID-19 crisis

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In an endeavour to deliberate on various facets of the Indian healthcare system vis a vis ongoing COVID-19 pandemic, the Healthcare Innovation Virtual summit was recently organised. A spectrum of healthcare experts including policymaker, industry veterans, and hospital decision makers participated in the Summit. It was inaugurated by Special Guest A L Hek, Cabinet Minister of Meghalaya, Department of Health & Family Welfare, Department of Home and Art & Culture, Government of Meghalaya. On this occasion a special issue of eHealth magazine was launched. A serious of panel discussion comprising different components of healthcare delivery system was also organized. Experts highlighted challenges of the hospital where occupancy rate has gone down. In addition, huge operational costs with added burden of precautionary measures amidst Corona crisis exacerbated their cup of woes. Maintaining revenue and living up to expectations of the demanding patients would be major challenge post COVID. They also underlined the importance of technology including telemedicine to augment and streamline key processes.

Talking about COVID situation in the State, A L Hek said, “The Coronavirus has presented us very unprecedented crisis in all the sectors including healthcare. The sector would emerge stronger and vibrant once COVID crisis goes over. We have utilized the lockdown period to strengthen healthcare delivery system and training personnel at every level. Crisis also brings a new opportunity.”

“We have already tested 12, 153 people for COVID-19 in Meghalaya. 11,859 were found negative while 44 found positive. Out of the total positive, 18 have already recovered. That mean only 25 active cases are in the State currently. Being a hill state, we have lots of challenges especially accessibility. We face infrastructural issue and manpower shortage as well. In this pandemic, we have realized to bolster infrastructure at district level. ICU care, ventilators, beds should be available in all districts,” he said.

 

Participating during a panel discussion on ‘Redefining Health Sector in the Post Pandemic World, Dr Tarang Gianchandani, CEO, Sir HN Reliance Foundation Hospital, Mumbai, said: “There is no immediate respite in sight, at least not for five to six months. By that time, we will learn to live with covid and find ways & means to manage healthcare. We need to protect our staff and patients. But we have realised that most of the positive corona patients are found to be asymptomatic. Infection rate is very high but virulence or severance is not very high as comparison to some other viruses like SARS.Best way is to make it a friend and learn to deal with it. There will be impact on healthcare and all other industry, but only way is that humans are by nature has resilient. They know to move ahead in all circumstances. Impact will be there in care delivery, foot falls, morale of the people. But we need to change our point of view. We need to come out regular way of looking at hospitals. We need to change our mindsets.”

Dr Alok Roy, Chairman & Managing Director, Medica Superspecialty Hospital, Kolkata, said: “When the pandemic came, none of us were ready. We had no idea on how to handle it. When unknown things suddenly props to you, one gets scared.Healthcare workers including doctors, nurses and para medical staff have played a pivotal part to contain the disease.Despite facing huge loss and challenges at multiple fronts, private healthcare community is working out of its way to protect people from corona pandemic.We have made lots of infrastructural changes in the hospital.We completely change the way air conditioning work in the system.We change the way we work in the system.The biggest issue with this disease unlike other diseases which only affect patients, it also proves baneful for healthcare staff.Precautions have to be both ways. We have realised that this battle will last longer than we expected. But we are preparaed for it. We are trying to adapt to tackle virus and save lives.”

Also read: Exclusive: How COVID-19 will transform healthcare paradigm, experts reveal

Dr Hari Prasad, President- Hospital Division, Apollo Hospitals, said: “Ever since, we have started counting covid case and death due to the pandemic, more number of patients have died due to heart attack, stroke, and cancer in the country. Somehow, covid seems to occupied everybody’s mind.Entire foundation of healthcare in this country has collapsed, it seems.The private sector provides 80-85 percent healthcare services. Many of the small hospitals have shut their shop. They are scared and worried to open up. Unless we help them to regain their confidence, get over their fears and start practicing with precautions to keep themselves safe, colleagues and patients, things won’t be like it was before covid”

“In all the tertiary care hospitals, occupancy has gone down to 20-30 percent. This is because the scare created among public due to corona. I suggest healthcare providers–doctors, nurses and para medical staff should know little more about precautions.Hospitals are safer environment than any other environment in the city and village. People should not hesitate to come to hospitals out of scare and fear.Five factors which matter to public are–looking at technology and virtual care, no rescheduling or if it happens fine being paid by hospital, covid-19 testing of patients after treatment, no waiting time, wants infection control protocol improved, and strict social distancing at care sites.We have to work on multiple fronts to get private healthcare back on track–to ally fear among people, living up to latest addition of expectations of patients, and strict safety guidelines. Tertiary care can’t survive with the solid foundation of primary and secondary care,” he said.

Yateesh Wahal, Executive Director, Nayati Healthcare & Research Pvt. Ltd, said : “While unlock 1.0 is on, still confidence is missing among healthcare fraternity.The volume in the OPD and elective, coming is low. In Delhi, the government has directed to share beds for Corona patients. We have allocated more beds to covid contrary to non covid patients. Though mortality is low, the virus is highly contagious.We have to co-exist both patients–covid and non covid. At the same time we need to undertake measures to let non covid patients get infected. There such be post treatment covid test to safeguard against the infection.Recently we discharged 97-year covid patient at our facility in Agra. It is dedicated covid hospital. At Mathura, we are providing treatment for both–covid and non covid. Initially we have least idea on how to manage things, but today we have evolved to keep ourselves afloat. Additional safeguard have been put in place. Nobody is completely insulated against the spread of contagious virus. Primary and secondary players are suffering significantly because there is no support system in comparison to tertiary care which can leverage.”

Delivering speech on this occasion, Amrita Dhupelia, Associate Franchise Director, Advanced Sterilization Products, Johnson & Johnson, said, “Hospital acquired infection (HAI) is a burning issue among healthcare professionals and providers need to be extra precautious while delivering care. Patients fear about HAI while visiting hospitals or getting discharged. The risk that a patient will develop a HAI is high. One in four in developing countries such as India is likely to acquire infection. It is 1 in 20 in the United States and 1 in 10 in European Union. These days due to fear of covid transmission, behavioral changes like hand hygiene, donning of face mask, cough and sneezing etiquettes and social distancing have been witnessed.”

“Patients expect safe and quality treatment at hospital. But they are vulnerable of infection at every second occasion—at OT, while dealing with equipment or handling by nurses and other staff. Plasma Sterilization with ASP Sterrad have several features including reduceing workflow interruptions, enhancing compliance with automated communication of information, among others,” she said.panel 2

Participating during panel discussion on How Virtual Care & Telehealth, Tele Radiology are redefining the Healthcare System?, Prashant Singh, Director-IT & CIO, Max Healthcare, said: “COVID has drawn a line between pre and post Corona times. We have been talking about telemedicine from a long time but COVID has increased value of proposition and realization as far as usage and perception of telemedicine is concerned. Lots of organizations including Max Healthcare are already using tele consults through third party aggregators like doc prime and practo. Some organizations are using it for follow ups. We had a government project where we were doing more than 3,000 tele consults per month. Because of fear factor and social distancing amid corona, people have started seeking tele consults. There is a typical workflow of tele consultations where patients tell doctors about ailments and get experts’ advice on the same. We have recently launched home healthcare isolation packages, where we provide multiple kits and other services.”

Dr Naresh Yallapragada, CIO, KIMS Hospital, Hyderabad, said: “Role of technology has come to the fore during COVID. Telemedicine was not being paid much attention before covid, but these day every hospitals and care providers give extra importance to enable better services to patients.”

Nandkishor Dhomne, VP-IT & CIO, Manipal Health, said: “COVID has led to whole financial chain crashed not only in healthcare but other sectors as well. The pandemic will remain for another some months. The pandemic led lockdown forced patients to be at home which affect revenue. Except emergency services, all other services have been affected. Operational costs exacerbate our cup of woes. Challenge is to how to deal with these cost when patient occupancy has gone down to minimum in recent times. We have launched apps to help patients to avail services at the comfort of their home.”

Abdullah Saleem, Group CIO, OMNI Hospitals, Hyderabad, said: “One among the many advantages of Telemedicine is patient engagement. It is an important tool for every hospital and providers to engage patients. After guidelines being released by the government, 70 percent experts from healthcare fraternity believe that it will be very beneficial for both patients and hospitals. It is gaining traction now due to several reasons like doesn’t require transportation, no waiting time, comfortable environment at home, easy access to experts, and lesser chances of catching new disease.”

Dr Bharat Gadhavi, CEO and Regional Director, HealthCare Global Enterprises Ltd, Gujarat, said: “COVID-19 has changed thing across the word in drastic manner. As physical distancing has to be maintained, it will change the way we live, practice and deliver care. It won’t go away very soon. Such pandemics keep coming as we are making changes in the environment. Due to COVID-19, we can’t be in close contact with patients for longer time. Clinical distancing has to be maintained. Devices could help us to monitor patients from distance. Thermal scanner has to be kept at distance of 5 to 15 cm. We should have thermal screener which needs not to be hand hold.”panel 3

Participating during a panel discussion on ‘How Covid 19 is igniting a redesigning of Healthcare?’, Dr Sanjeev Kanoria, Founder, Suasth Multispecialty Hospital, Navi Mumbai, said: “There is extreme overreaction and exaggeration of COVID in India. If one look at data and relate it with population statics, things will be pretty clear. We have a population of 1.2 billion and let’s assume the infection is maximum 1 million. That is still o.o4 percent of total population. Death rate is also o.ooo7 percent around. As per a WHO report, everyday around 6,000 people die due to poverty and starvation in India. Out of this, 3,000 are children. We have reduced our GDP by 40 billion/month. It’s overreaction. People have got scared. It is impossible to implement community infection transfer. Even well-equipped hospitals struggle to stop infection despite sanitation and other measures. We need to have balance approach.”

Dilip Patil, Co-Founder, Director, Trivector Group & Baby Quest Cryobank, said: “Today COVID has hijacked other underlying issues of existing patients—like TB. Almost 4,000 people die every day in India due to TB. Hospital acquired infection has been there, but it has been getting serious attention now. In fact, we need to focus on HAI as it gives birth to many diseases. We are harping on hand hygiene, surface cleaning, and social distancing. These are important. But we need to be cautious about air borne infection. Air disinfection and purification is need of the hour. We have to augment our existing processes to control air infection. “

Ekta Modi, COO, Parul Sevashram Hospital, Vadodara, said: “Initially it was very tough to manage doctors, beds, inventory, nurses and staff in the wake of Corona outbreak. Most of the staff was facing discrimination as they worked in covid areas. Theere was fear that they may cause infection. Today staffs are ready to work when management ensures their safety in terms of kits and all. It has been paradigm shift—Thinking process changed, training process and clinical process changed.”

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