Cloud Physician: The smart ICU designed by a Malayali doctor

Meet Dileep Raman, a young doctor who passed out from Trissur Medical college with a gold medal and went to America for his higher studies. But to everyone’s surprise, he discontinued his practice to begin a startup in India. There were a lot of skeptics who laughed at the idea. But the young doctor had a definitive plan when he decided to throw away such a prestigious job profile to begin a startup in India. It wasn’t just enough that he should put his degree to simply cure patients, it was equally important to “bring them back to life.” He took help from technology for that mission. Cloud Physician is the startup he created in partnership with friends Dhruv Joshi and Dhruv Sood, who is an engineer.

To put it in simpler terms, this startup transforms Internal Care Units into Smart ICUs. The network of hospitals under the Cloud Physician receives 24/7 virtual attention from Doctors and Nurses who are specialized in Internal Care Units. A person admitted to the ICU will be closely monitored and given intensive care treatment appropriately. Considering India is a country where specialists Health care workers are less in numbers, this startup promises to produce groundbreaking innovations in the health care sector. This Bangalore-based startup is currently offering medical care to Intensive care units from Ladakh to Kerala. Dr Raman who combined medical science with technology talks to Manorama online about his startup.

The idea came up in America

After finishing MBBS from Trissur Medical college he shifted to America for his higher education and specialized in Internal medicine, Palmary, and critical care. From 2008 to 2015 he was in the US.

He worked at the Cleveland Clinic which was a big hospital network. They had various branches and everywhere they had ICUs. But it is also true that these intensive care units needed specialized doctors. They would have main doctors working at a Central unit and these doctors would offer medical aid to other ICUs through a tele ICU facility.

Considering the US itself lacked enough ICU specialists one can imagine the plight of India. India as a whole had only 4000 ICU specialists. It would take 10-12 years to train an ICU specialist. And in India, it would easily take at least 25 years to train the required number of ICU specialists. It was this thought that drove him to India. Dr Dhruv Joshi who worked with him at Cleveland Clinic also joined Dr Raman in this endeavour.

How it all began

In 2015 they returned to India. For two years they travelled extensively in India to learn about the situation. They also knew that it was not practical to incorporate American technology in India without any modifications. Also, it required a huge amount of money. A technology that was feasible to the Indian conditions were what was the need of the hour. They wanted a technology that could connect them to the interiors of India, and for this purpose, they travelled from Ladakh to Kerala to research the requirements. In 2017, they did a pilot project in Mysore, which turned out to be successful. So in 2017, along with Dr Dhruv Joshi and Dhruv Sood they started Cloud Physician.

A technology to suit India

It was Dhruv Sood who helped them with technological assistance. He was there in America for 9 years and was a specialist in the health care facility. Under Sood’s supervision, they developed a software that was viable to the Indian conditions.   If one were to rely on Western technology, 50 ICU beds will cost at least 5 crores. Under their technology, it required only a quarter of that money. At their main command centre in Bangalore, there are 15 ICU Specialists and 35 ICU nurses. Currently, they have serviced around 450 ICU beds. They are active at 32 hospitals in 13 states. Among these most of them are government hospitals. Their service is also available at Ladakh hospitals. There is no way such specialists will be accessible in remote villages in India. And that’s where the tele-ICU facilities come in handy for such places.

The workings of Cloud Physician

If a hospital needs the services of Cloud Physician, then it also requires high-quality internet service and electricity. Someone from their team will visit these hospitals and study their facilities or the lack of it. Soon after they will install this software in their ICU equipment. They don’t need to buy new equipment for this facility. It’s only when some hospitals wouldn’t have enough ICU gear that they suggest buying new ones. A high-definition camera will be installed at the ICU. Through this high-quality camera, one can even see the pupil of the patient's eyes.

The camera will be clear enough to see the switches and buttons of the ventilators as well as the ICU Monitors. These can be viewed live at Bangalore’s command centre. This is how the specialist doctors diagnose the condition of the ICU Patients and offer medical care. A patient’s complete medical report will only be handed over only after getting his/her permission. Through the software’s assistance, every detail of the patient's condition will be noted down. If the duty doctor or nurse isn’t around a patient whose condition suddenly worsened, the message will be instantly conveyed to those on duty from the command centre. That will help immensely in giving intensive care treatment to the patient without much delay. It is through the 24/7 teleconferencing service that this facility is possible.

Service during Covid times

An ICU specialist in a hospital can offer aid to around 8-12 patients in a day. Through their technological assistance, it can come to 60 to 80 patients. The healthcare workers will provide all assistance to ICU patients. The required inputs will be provided by them. They started before Covid. But things changed drastically post Covid. Though the number of Intensive Care units went up, there weren’t enough specialists around. During the covid time they were able to provide specialist treatment to nearly 4000 ICU admitted patients.

Decisions that changed our lives

In Kerala, the services of Cloud Physician are available at Manjeri Medical College and Kozhikode Beach Hospital. This was started in partnership with Maitra Hospital. Through this, they are able to assist Junior doctors and nurses. For example, the condition of a patient in ICU is worsening and there are no specialists in the hospital. Each minute is precious. Through the ICU’s teleconferencing facility they can consult with the specialists at the Command centre. With Covid, many hospitals started stocking ventilators. But unfortunately, it is not necessary that medical practitioners should know how to operate it. Through teleconferencing facility, they can get training for that.

Less stress

The ICU doctors are always in a rush. It is also not possible for them to work 24/7. After their rounds, they would discuss the patient's health reports with their specialists. And they also decide the kind of treatment required. This provision will help in getting a second opinion as well as in clearing doubts. And not just that, this will also take away the stress of the ICU specialists. Afterall they always had to pay a heavy price whenever the technology got delayed. Through Cloud Physician more and more people will get access to specialist doctors.

The future lies in the technology

Former Kerala Health Minister Shylaja has always maintained that the future of the health care sector depends on technological assistance. It was the Minister who inaugurated Cloud Physician at Kozhikode Beach Hospital. And it continues to run efficiently. It is important to train medical practitioners to work along with new technology as the human machinery has its limitations. Considering India’s population there aren’t enough medical practitioners or healthcare workers in this country. That’s where one should take the assistance of technology. There are no trained ICU specialists in the Kerala govt service. Therefore with the aid of public-private partnership, one should make sure to incorporate such technological assistance in hospitals. The more specialists you can gather with the aid of such technology for medical care, the better. This can really save a lot of lives.