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Early adoption of cutting edge tech helps Medanta deal with Covid crisis

IT infrastructure created in the last five years at Medanta has proved significant for the hospital during the Covid crisis, with anytime anywhere and secured access made possible for functions across the board, says Rajiv Sikka, CIO, Medanta – The Medicity Hospital

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By Salvi Mittal

How did you prepare your hospital to manage the outbreak of Covid-19?
As a part of our routine management and clinical practices, we ensure the following: embracing and co-opting technology in everything we do (this has proved invaluable), rigour of discipline in interpersonal interactions with regards to hygiene, a strict set of SOPs to eliminate hospital acquitted/transmitted infections. These coupled with Covid specific terms of conduct and engagement, heightened awareness and audits, along with reinforced protocols made us the best and the safest with regards to keeping the infection at bay and also in patient care. IT infrastructure created in the last five years has proved significant for the hospital when anytime anywhere and secured access has been made possible for functions across the board. Our staff is entirely equipped to work from home (WFH) and conduct their duties virtually to ensure complete business continuity.

Mobility first was the inherited part of five-year digital roadmap we drafted for ourselves. Laptop in place of desktops was one of the derivative of that roadmap. During the Covid challenge, there was adequate spare laptop inventory and dongles for a smooth transition.

The only extra procurement has been done in the form of enhancing teleconferencing ports and channels, so as to enable more concurrent users to come on a common VC session or a conference call. This usually applies to the care team of doctors, who might want to congregate on a VC session to discuss emergency scenarios or where multi-speciality and highly specialised inputs are required.

Telemedicine will be essential in the epidemic of new epidemics, please describe your work/journey with telemedicine?Among the pioneers of telemedicine in India, Medanta invested in an Integrated Telemedicine Solution app about three years ago. This solution is available on multiple platforms including iOS, android desktops, tablets and mobile. It’s not a typical Zoom, WhatsApp or a video call system but a well-designed human-machine interface catering to patient, doctors and hospital administration. The patient can use this app for booking an appointment (four possible modes: video, in-person, telephony or e-mail based chat) and will receive a link which will take him on the session for consult. Post the session, patients receive the prescription and the resultant records are automatically saved in the employee health records (EHR) system. It’s a comprehensive telemedicine platform – in turn integrated with appointment, tariff, medical records and video-conference platforms where doctor and patient are just a click away from each other. The payment gateways work seamlessly for multiple options like net-banking debit, credit cards or digital wallets.

Medanta being an early adapter of cutting edge technologies has started to see our investments in action which is evident by the fact that our telemedicine consults have seen 700 per cent growth from pre-Covid era and our downloads have crossed 100,000. A deeper analysis of the data shows contrast to typical beliefs in usage of telemedicine. Here is a review of some misconceptions

Myth 1: Elders are not conversant with digital platforms
Our observation: Our 50 per cent of the patients are 50 years or older.

Myth 2: Patients with serious and chronic diseases have to visit hospitals
Our observation: Neuroscience and oncology are among the top four specialties covering more than 42 per cent of the telemedicine patients.

Myth 3: Telemedicine is a metro or big city behaviour
Our observation: 40 per cent of the telemedicine patients are coming from UP and Bihar.

Myth 4: Only existing patients will use telemedicine platform to reach out to their treating doctors
Our observation: Over 45 per cent of patients are newly registered, which means in Covid times, more and more patients will have trust on super specialities like Medanta.

Were there any challenges faced by your institution in handling Covid-19 cases in the country? What were some of the key lessons learnt?
One of the major challenges was to ensure business continuity amid the pandemic.  As a vanguard healthcare provider, Medanta has been engaged seamlessly. For a hospital, there are two important stakeholders to accommodate in the business continuity situation – patients and employees and doctors. Medanta has ramped up resources to serve patients through WhatsApp based chats, websites, a dedicated call centre, etc. This is active 24×7 so that patients can reach out to us by any means.

With changed behaviour of patients and doctors, the key take away is that telemedicine would continue as new norm of working in the healthcare world. In a country like India where accessibility to a doctor is a still a distant reality, it will certainly reap the greatest benefits in the long term.

How has the use of digital health helped in dealing with the Covid-19 situation in the context of your organisation?
The guiding principle during COVID-19 was to ensure consistently contactless (read digital) experience in all interactions so as to avoid unnecessary exposure to healthcare staff without compromising the quality of healthcare to patients.

After successful rollout and adoption of telemedicine, senior lab doctors started accessing various lab machines remotely for review of results before releasing it. Similarly, radiologists started accessing modalities scan on the PACS (picture archiving and communication system) running on the VPN. Remotely, radiologists were able to prepare, review and discuss the reports with physicians before publishing.  In all cases, patients can access the final approved report from the portal without coming to the hospital.

Next was deployment of solutions for remote scanning assistance to the expert technicians on CT and MRI. This has helped them from undesirable exposure.

How has the use of digital health helped in dealing with the Covid-19 situation at Medanta?
When state governments in Delhi-NCR came out with a policy for home isolation to reduce the burden on hospitals, Medanta was one of the earliest private hospitals to begin care packages for coronavirus disease. The digital platforms developed by us were able to help caregivers in remote delivery of services – be it triaging by clinician, video consults by Covid-19 specialist or offering remote monitoring by nurses. All critical alerts on patient conditions were reported on real time basis back to Covid-19 care team for immediate corrective actions.

As part of its outreach program for OPD, Medanta clinical teams leveraged our digital platforms to provide high-end clinical diagnosis and consultation by specialist doctors in different areas of the country.

How has your hospital worked with health authorities in managing the Covid-19 situation in the country? Did you also work together with other partners such as healthcare startups/medtech companies in tackling Covid-19?
As coronavirus outbreaks surge worldwide and as it continues to evolve unpredictably, everyone was expecting healthcare to come out with a riposte. Medanta has a dedicated Institute (called MIER) to carry out research, in the quest of quality healthcare. MIER undertakes and promotes med-tech research programs that have a bearing on the health related needs of patients. This research is carried out on a universe of India specific/India relevant demographic, psychographic and physiological samples across varied SEC groups.

Startups provide the agility when time is an essence to find a pragmatic solution and has more relevance in Covid-19 situation. As the most admired healthcare brand Medanta has a proven track record of working successfully with and fostering start-ups in the past. We leveraged that experience to work with many startups in last four months – some of the work was in economical and effective diagnosis kit for anti-body / antigen. We also worked with a young company focused on clinical grade smartphone for diagnosing asymptomatic coronavirus infection detection and post intervention monitoring. It has non-invasive technique for obtaining body organ-system wide biomarkers which can analyse the changes in the body organ systems such as respiratory, nervous system, functional blood biochemistry, endocrine system, etc.

How do you think digital health in Medanta will look like post Covid-19?
Fortunately Medanta leadership is fully cognizant on harnessing IT in delivering better healthcare. Some of the technologies pertaining to digital health were available for ages but embracing was a challenge. What most CXO were not able to achieve, (faster and all-encompassing adoption of technology) Covid-19 forced them to.  Post Covid-19, I anticipate the same kinetic embrace of technology.

Mobility would continue to be the norm. For Medanta, it would just an enablement for larger section of the staff like enabling BYOD policy or providing secured VPN.

The video conferencing facility, like in any other enterprise, would now be more frequently used. Hopefully, this would be the new norm with need for only essential travels in future.

Information security during WFH is critical, especially when the patient’s health related information is concerned. All the applications accessed on internet are now compliant with the Health Insurance Portability and Accountability Act (HIPPA). Access to information would be protected at two levels – first at firewall level and second at user authentication level. Additionally, all apps have zero footprint, which means nothing is stored on local mobile device and information is always pulled from the server in line with information security norms of the hospital.

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