Friday, May 22, 2020

COVID-19: A Blessing in Disguise for the Healthcare System?


Problems Faced By The Healthcare Industry in India
COVID-19 has been a blessing in disguise in several ways. The outbreak of the pandemic has proven to be an eye-opener in many respects. Suddenly we observe the air quality index (AQI) improving significantly in various cities. Drastic reduction in the pollution levels in major rivers such as Ganga and Yamuna can also be observed. In addition to this, the pandemic has also made us realize that some of the perennial problems associated with healthcare, can be solved, provided, the right intention exists.

A significant portion of the medical bills for a patient admitted in an Intensive Care Unit (ICU) also includes charges imposed on the usage of critical medical equipment such as Ventilators, Infusion Pumps, and Monitors. The shortage of these types of equipment results in compromised and sub-optimal care.  Equipment such as ventilators is exorbitantly costly, and thus, the patients are indirectly made to pay for these facilities. This makes ICU care, out of reach for the teeming majority. To make situations worse, eighty percent of the healthcare expenditure in India is Out-of-Pocket (OOP), which drives a family into poverty in case of a serious healthcare event, requiring hospitalization.

India seriously needs jugaad innovation in healthcare to come up with affordable medical goods, without compromising the quality of care. One of the approaches may be to identify and remove the features which are rarely employed but play a significant role in increasing the cost of the development. One apt example being the successful employment of the Continuous Positive Airway Pressure (CPAP) machine as an alternative to a ventilator for providing breathing assistance to patients infected with COVID-19. This machine is already available and is presently being utilized for treating patients suffering from obstructive sleep apnea (OSA). Another approach could be the better utilization of the available ventilators, to support multiple patients at once, using Air Tube Splitters.

On similar lines, we can think about patient monitors as a combination of sensors and display devices. The modular nature of this device makes it convenient to use only those sensors which are required. The shared use of sensors will reduce the inventory of sensors, eventually reducing the lifetime cost of a patient monitor. The output of the different monitors can be displayed on a single screen. This will not only reduce the cost but also improve the monitoring, as a single healthcare professional can monitor the vitals of six to eight patients. In my observation, the price of Patient monitors, Dialysis machines, ECG machines, Ultrasound machines, and the Echo machine is unreasonably high. Shouldn’t we strive to develop medical facilities that are innovative, affordable, and adept at providing quality care to our teeming millions, or should we wait, for the next pandemic to strike to wake us up from our slumber?

The healthcare infrastructure in our country is inadequate. India faces capacity constraints in terms of hospital beds and qualified healthcare professionals. Recent experiences have shown that the problem of hospital capacity can be overcome if the intentions are right. Delhi government ramped up its capacity in a couple of weeks and is ready to face a situation where 1000 new COVID-19 cases are detected per day. Indian Railways (IR) has also come forward in support and has dedicated more than 6,500 hospital beds, which is half the number of beds from its 125 railway hospitals, dedicated to COVID-19 infected patients across the country. Out of these, one-third of the beds numbering up to 2000 will be fitted with ventilators. IR continuing with its support has decided, to convert as many as 20,000 old train carriages into isolation wards for patients if the cases multiply.

Another realization that has occurred, is the potential of Telemedicine in delivering ambulatory care. In ninety percent of the cases, a doctor is not even required to remain in direct contact with the patient. A registered medical practitioner (RMP) can run OPD without physically being present at the location. The vitals of the patients can be recorded by trained paramedical professionals. During the COVID-19 outbreak, the health ministry issued the guidelines for using telemedicine in a hurry. If implemented properly, telemedicine can solve the perennial problems of availability and affordability in the medical field. Using telemedicine, quality care can be provided in remote parts of the country as well. This will result in less travel to cities and hence will, decrease the cost of care.

This crisis has taught us many lessons. The healthcare system in India can be revamped and healthcare can be made more inclusive, provided we work in the right direction. No one has ever doubted the capability of India if only the right intent is cultivated. Needless to say, COVID-19 has been a blessing in disguise and it will bring a paradigm shift in the way healthcare service is delivered in India and many parts of the world.

(The author is Assistant Professor at FORE School of Management, New Delhi, India.)   

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