Doctors’ ‘Tele ICUs’ Take Life-Saving Critical Care to Hospitals, Help 40,000 Patients

Two doctor friends, Dr Dhruv Joshi and Dr Dileep Raman were in the United States doing their Pulmonary and Critical Care Fellowship at the Cleveland Clinic. With the medical cases they were seeing, they began chatting about the scope of critical care.

These conversations soon highlighted an important focal point — the majority of ICU patients do not get the critical care that they need. 

“This in turn leads to an increased number of fatalities,” says Dr Dhruv. The duo were intrigued and, specialising in critical care themselves, intended to come up with a solution.  

“We saw an opportunity to create an impact on a larger level back in India and so moved back home towards the end of 2015,” says Dr Dhruv, adding that he along with Dr Dileep began travelling through the country’s hospitals to get a sense of the ground reality. 

The time they spent in this endeavour brought to light some harsh facts.  

“Our travels made us realise that there was a need for more advanced technology that could meet the need for care that patients in ICUs needed,” says Dr Dileep. 

Dr Dileep Raman (L) and Dr Dhruv Joshi (R)
Dr Dileep Raman (L) and Dr Dhruv Joshi (R), Picture credits: Dr Dhruv Joshi

So the two decided to bring their plan to fruition by introducing tech into the medical scenario in a way that hadn’t been seen before. This solution would help patients get world-class care regardless of the location or status of the hospital.

In 2017, their platform Cloudphysician, born out of this thought and founded in Bengaluru, set a precedent for how healthcare, when combined with the right technology, could change the way critical care functioned. 

As the duo explains, Cloudphysician is a healthcare technology company to remotely provide ICU expertise to hospitals.  

Designing a smart ICU in a box 

As they say, introducing this revolutionary idea into the healthcare industry was no easy task. But the two friends knew if they wanted it to be the game-changer they envisioned, they needed to create a model that was easy to deploy, and accessible to everyone, no matter their background. 

Dr Dhruv who is the co-founder and CEO of the company says the platform is exactly this, as it combines state-of-the-art technology with the clinical expertise of doctors and specialists. 

The command centre at Cloudphysician
The command centre at Cloudphysician, Picture credits: Dr Dhruv Joshi

His counterpart Dr Dileep oversees the clinical operations of the platform and is chief of healthcare at the company, which has now grown from two individuals to 200 people. 

For anyone attempting to understand the ‘Smart ICU in a box’ concept, the duo explain that the aim is to simplify the work for bedside caregivers, especially in hospitals where there are no ICU specialists or where the inflow of patients is too many. 

How does Cloudphysician work? 

“The command centre at Cloudphysician is connected to the hospital ICU where we partner,” explains Dr Dhruv. “Patients who are in this hospital ICU are monitored 24/7 by a trained critical care team at Cloudphysician.” 

This monitoring includes keeping track of the patient’s vitals, detecting complications, and having doctors on site alerted in time if there is something amiss with the vitals.  

Thus, the ‘command centre system’, which is a Smart ICU solution termed RADAR helps Cloudphysician collaborate with partner hospitals. “Through this, it becomes possible to run clinical operations through audio-visual means, and essentially provide actionable alerts,” he says. This expert care given to the patient also means patients will not be required to be transferred such as in cases where the hospital does not have trained intensivists. 

The modus operandi can be broken down into four steps. 

Bedside caregivers are constantly in touch with the command centre
Bedside caregivers are constantly in touch with the command centre, Picture credits: Dr Dhruv Joshi

Once Cloudphysician partners with a hospital, Dr Dhruv says the first step is ‘Activation’ that lasts about two weeks. “The Cloudphysician team is introduced to the hospital and creates a structured plan along with the hospital of how ICU processes can be bettered.” 

Dr Dileep adds that in this step, the deployment team also installs hardware and software in the hospital that will function as the connection between them and the Cloudphysician setup.  

The next step is ‘Augmentation’ which lasts for six weeks, wherein the Cloudphysician team works in real-time with the hospital to suggest measures to help alleviate the patient’s distress.  

“In the third step, which is ‘Digitisation’, we try to bring transparency and automation into the process,” says Dr Dileep. The aim of this step is to reduce the workload of bedside caregivers, make the healthcare process more alert, and ensure that everything is being documented. This lasts for around 12 to 18 weeks. 

The ultimate goal, the duo say, is to empower the partner hospital through the fourth step, and through this to enable critical care patients to get the highest level of care. 

Doctors at partner hospitals are in awe of this technology, and confirm that it is a great solution. For instance, at the Cachar Cancer Hospital & Research Center, when a patient’s heart rate increased due to a condition known as supraventricular tachycardia, the Cloudphysician team was able to intervene on time. 

The Cloudphysician team giving hospital staff training in critical care
The Cloudphysician team giving hospital staff training in critical care, Picture credits: Dr Dhruv Joshi

Dr R Ravi Kannan, Director, testifies, “Cloudphysician’s teams’ timely identification and intervention were able to stabilise the patient.”

This is one instance where the virtual ICU has helped. To date, the virtual healthcare platform has helped over 40,000 patients across 70 hospitals in 17 states of India, says Dr Dhruv. 

Medical assistance for every patient

“When we started the company the aim was to get healthcare to adopt technology just like other industries,” says Dr Dileep, adding that this is a barrier they have succeeded in breaking. 

He adds that compared to other industries, this industry has been slow in adopting new tech and this is the notion they wanted to change. 

While the healthcare industry is based upon the belief that the doctor’s gut feeling does matter in medical cases, the duo say they agree. But what Cloudphysician aims to do is to integrate tech into the process and make it simpler for the doctor to have all the accurate information needed to take that call.  

Another focus point was making a one-stop solution that can help everyone no matter their background or financial status. 

“We wanted that these technology-enabled solutions shouldn’t be limited to expensive and large corporate hospitals but rather all,” says Dr Dhruv adding that through the platform, any hospital of any size and in any location of the world can provide excellent critical care to patients. 

This especially counts in cases where patients need intensive care as they do not have the luxury of time. This coupled with high costs of transport means that patients lose valuable time in being moved to other centres.

“Cloudphysician helps around 1,800 patients every month and is looking to expand the concept among the hospitals in India, especially government hospitals,” says Dr Dhruv. 

“Through our interventions, we aim to augment the bedside team, not replace them. We are looking to reduce the burnout of critical care staff.”

Edited by Yoshita Rao

Author: Aaron Ryan