Recently, I read an interesting article in the Times of India about the 10BedICU, which shows great promise in how modern healthcare can be brought to rural India using advanced technologies.
The poor quality of health systems in much of the world was laid bare by the COVID-19 pandemic, particularly in rural areas, where access to critical care has remained very low. This gap was very pronounced in India, where rural hospitals were not equipped to handle a sudden surge of critically ill patients in the second wave. It was in this crisis that an innovation took place: the 10BedICU initiative, which continues to be a lifesaver and is changing the critical care arena in underserved parts of India.
A Rural Revolution in Critical Care
The best human embodiment of the story of 10BedICU comes in the form of Pratima Barman, a 70-year-old resident of Nalbari village in Assam. But come 2023, when Pratima became critical, her family had to transport her to a far-off hospital at Guwahati for specialized treatment. But the newly developed 10BedICU at the local hospital meant that they can treat their case and possibly save the lady’s life.
It saved Pratima’s family from the huge expenditure and emotional turmoil of traveling long distances for expensive treatments, thus stressing the need for critical care units locally.
The scenario is more and more common in India, where more than 200 intensive care units have been rolled out to taluka and district hospitals under the 10BedICU initiative, impacting more than 65,000 patients.
In fact, under the leadership of Srikanth Nadhamuni, CEO of Khosla Labs, this public health crisis is being used for lasting health care reform. Each unit costs around Rs 50-60 lakh, has an efficient model with a state-of-the-art facility and was installed in those rural areas where basic critical care services were missing.
The Public-Private Partnership Model
10BedICU is a success model due to the innovation of using a public-private partnership model in this initiative. The PPP model has harnessed state governments, private funding sources, and community support to come up with sustainable, locally-owned ICU units. This realizes long-term sustainability, as the stakeholders at the local level are involved and take charge of these facilities. “We provide the infrastructure and tools, but it is the maintenance that is crucial in operation of these 10BedICUs. We involve the government in a well-designed plan with which to keep everything running right.” Such collaborative effort ensures that once the set-up work is completed, the running and maintenance responsibility shifts to the local government and community, thereby generating a sense of ownership and accountability.
Technology at the Core of 10BedICU
Indeed, underlying the 10BedICU project is new technology to improve patient care and operational efficiency. Among other central technologies, the development of cloud-based software called ‘CARE’ makes patient records and doctor records more customized in their management. It ensures flow without hitches and data-driven decision-making is possible, given the high-stakes ICU environment.
Another technological innovation is the Telehub concept, whereby rural hospitals are connected to district-level hubs for remote consultations and expert oversight to ensure improvement in patient outcomes for areas with low access to specialist care. Moreover, the implementation of Generative AI into the system has changed the whole diagnostic process. It highly reduces the burden on the doctor as the AI tool eases the task of preparing diagnosis reports and discharge summaries, and thus allows the health providers more time for direct patient care.
These advances are not merely technical but rather practical tools that have been quite effective in demonstrating marked significance with respect to improving the quality of care that can be offered by the respective rural hospitals.
As Nadhamuni described, “During the Delta wave [the devastating second wave of the pandemic], my phone never stopped ringing from Bengaluru, all of them crying for ICU beds.” Such a moment of truth of the dearth of ICU infrastructure in the rural hinterlands spurred him and his team to build a model that employs technology to plug the gap.
Five Pillars of Success
Key components under the 10BedICU model include five pillars of ICU equipment, cloud-based software set-up, establishment of Telehubs, training medical personnel, and community support. Taken individually, each pillar addresses a very critical component of the health delivery system that ensures sustainability and scalability of the initiative. Such training is very essential since many rural hospitals are not having enough personnel with skills in critical care. The initiative empowers healthcare workers to effectively manage ICU patients through the delivery of targeted training programs. More importantly, the local communities support the ICU units, which means they will be maintained properly and integrated into the health system of a particular locality.
Impact on Rural Healthcare
Maximum impact can be felt in remote and underserved places, where traveling for specialty care remains a challenge because of difficult terrains and financial constraints. The outcome has been profoundly meaningful for the region: Dr. Rakesh Nongthombam, Associate Professor at Jawaharlal Nehru Institute of Medical Sciences, Manipur, noted that the work has “brought critical care within reach for those to whom it was once inaccessible.” This initiative has also very effectively brought down the number of patient transfers from taluka hospitals to bigger district hospitals, reducing the burden on families and the health system in general. The success of bringing up quality care closer to home is reflected in a reported 70% reduction in patient transfers in areas where the 10BedICU model has been put into place.
The Road Ahead
Going forward, 10BedICU is hopeful that it will be able to replicate this model across the country by setting up more units in Karnataka and other states. One of the key reasons behind the success of this initiative has been its ability to customize its approach depending on the needs of the region concerned. In Karnataka, it was a systematic government approach; in Nagaland, it was the commitment of the medical community to serve their people.
“I want to set up a 10BedICU in every part of the country,” says Nadhamuni. Now, the model sets to tell the world how a blend of public-private partnership, technological innovation, and people’s participation combine together to take on the challenge of critical health care delivery.
In conclusion, 10BedICU has transformed a healthcare crisis into an innovation and sustainable change platform. It has brought life-saving care to rural areas, meeting the immediate needs of people while establishing a more equitable foundation for healthcare in India.
Dr. Prahlada N.B
MBBS (JJMMC), MS (PGIMER, Chandigarh).
MBA (BITS, Pilani), MHA,
Executive Programme in Strategic Management (IIM, Lucknow)
Senior Management Programme in Healthcare Management (IIM, Kozhikode)
Postgraduate Certificate in Technology Leadership and Innovation (MIT, USA)
Advanced Certificate in AI for Digital Health and Imaging Program (IISc, Bengaluru).
Senior Professor and former Head,
Department of ENT-Head & Neck Surgery, Skull Base Surgery, Cochlear Implant Surgery.
Basaveshwara Medical College & Hospital, Chitradurga, Karnataka, India.
My Vision: I don’t want to be a genius. I want to be a person with a bundle of experience.
My Mission: Help others achieve their life’s objectives in my presence or absence!
My Values: Creating value for others.
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Very true Prahlada Sir,
"In the heart of rural India, a small 10-bedded ICU shines like a beacon of hope, saving countless lives that would have otherwise slipped away. It's like a tiny seedling that has sprouted in the desert, providing shade and sustenance to those who thought they were doomed to wither away.
Just as a single matchstick can ignite a fire that lights up an entire room, this small ICU has sparked a revolution in rural healthcare. It's a drop of water that has created ripples in the ocean, reaching far and wide to touch the lives of many.
Imagine a mother cradling her newborn, who was on the brink of death but was saved by the ICU's timely intervention. She's like a bird that has found its nest, safe and secure, thanks to the care of the dedicated medical team.
Or picture a young farmer, who was rushed to the ICU after a tragic accident, and is now back on his feet, tending to his fields. He's like a sapling that has been nurtured back to health, strong and resilient.
This ICU is a lifeline, a bridge that connects remote villages to the world of modern medicine. It's a ray of sunshine that has pierced the darkness of despair, illuminating the path to recovery.
And the beauty of it all? This model can be replicated, like a fractal that repeats itself, in countless remote areas across India. It's a blueprint for hope, a testament to the power of human compassion and medical expertise.
Let us spread this spark, this beacon of hope, to every corner of our great nation. Let us create a network of ICUs that will cradle the lives of our people, like a mother cradles her child. Together, we can make a difference, one life at a time."
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