Remote Healthcare : The CloudPhysician way

A conversation with the CloudPhysician team that is helping augment critical healthcare infrastructure in the country through remote ICU monitoring services.

The team includes; Dhruv Joshi, MD (US board certification: Internal medicine, Critical Care, Pulmonary medicine); Dileep Raman, MD (US board certification: Internal medicine, Critical Care, Pulmonary and Sleep medicine); Dhruv Sud, Head of Engineering, 8+ years at Epic Systems (development team)

How did you discover the problem surrounding shortage of critical healthcare capacity?

Having gone through medical schooling in India, it was clear to us that there was not only inadequate healthcare infrastructure but also a shortage of healthcare staff, especially in specialised fields such as critical care, nephrology and so on. After completing our fellowship in critical care and pulmonology at the Cleveland Clinic, where we met, and spending some time on evaluating the opportunities in India, we decided to return to India and reassess the situation.

Upon our return, we travelled extensively to different parts of the country, especially visiting hospitals in Tier-2 and Tier-3 cities. Between the two of us we personally visited about a 100 or so ICUs across the country and what we found was that the situation was far more dire than what we had expected. Most of the critical care expertise was concentrated in the metro cities which compromised the care of patients outside these major centers significantly. In addition, as intensivists, our training had taught us that high quality nursing was a cornerstone of ICU care. This too was found to be lacking in most centers. In our estimate the majority of ICU care in India suffered from these quality lacunae and likely had poor outcomes as a result. To us this presented a solvable problem that had to be addressed without delay.

What is the current traction on the ground?

Today Cloudphysician manages nearly 200 ICU and HDU beds across 18 hospitals in 7 states. The team consists of 10 intensivists. Since inception we have helped close to 10,000 patients that total more than 26,000 patient bed days. Cloudphysician has tracked over 2.5 million vital signs, 150,000 lab results and ~15,000 images, and instituted over 100,000 interventions. This data has been leveraged to develop a clinical decision support system to help further increase the ability of a single intensivist to see more patients.

What is the plan for the next few weeks? Where would you need support on scaling up?

The COVID-19 pandemic has strained India’s preexisting shortage of intensivists (<5,000). Hospitals are understaffed and underskilled to deal with the projected massive influx of critically ill patients. We are looking to build capacity to cater to 1,000 ICU beds in the next few weeks to meet a surge in demand. Towards this end, we are looking for support from grants to help fund deployments and increase our command center capacity.

In addition, our technology platform is a cloud based solution and we are seeking support in the form of AWS and GCP credits to further bolster our cloud infrastructure.

We are backing ideas that are capital efficient, scale ready and can create immediate impact to combat Covid-19.

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