While state-of-the-art technology and global brands in healthcare make Bengaluru a destination for medical tourism, a large section of Indians themselves cannot access this level of medical treatment as it is well beyond their means. One of the reasons for the high cost of treatment is the expensive medical infrastructure. This necessitates higher charges for patients as the hospitals have to recover their infrastructure investments and overheads. The high charges have often led to disputes and mistrust between patients and doctors. In many procedures, there is no documentary evidence for the patients to go by.
Bengaluru-based ENT surgeon, Dr Kumaresh Krishnamoorthy, embarked on a mission to bring down the cost of medical equipment to make healthcare easily affordable for all.
One of his first developments is a video laryngoscope that costs just Rs 22,000 (including GST). An internationally-known brand costs around Rs 5 lakh, excluding taxes. This huge difference in cost brings down the charges for patients needing any surgical procedure.
A laryngoscope is used not only in operation theatres but also in ICUs, emergency departments, post-surgical documentations and even in ambulances. It is critical equipment used to look at the voice box and insert a tube that enables breathing when a patient cannot breathe on their own. Many hospitals have just one, used in the operation theatre. Smaller hospitals donâ€™t even have one, and anesthetists being their own flexible one that also costs around Rs 5 lakh. Only one laryngoscope in the operation theatre means it cannot be moved around to areas in the hospital where needed.
The laryngoscope developed by Dr Krishnamoorthy circumvents these limitations. It is a video laryngoscope that uses an android mobile phone for light and as a camera. It is a miniature model and can be carried around in the doctorâ€™s pocket. The camera in the laryngoscope can be changed based on the needs of the procedure. This laryngoscope has a unique attribute in that it can document the entire procedure on the phone. This can be sent through email or as a message to whoever needs it. This facility also makes it possible for real time guidance from a remote location by a specialist in case of emergencies. This can be life-saving as a patient in an ambulance gets help even before reaching the hospital.
â€śFor example, in a knee replacement surgery, some times, a patientâ€™s voice gets affected temporarily. This could be due to some viral inflammation of the nerve. The documentation possible through this laryngoscope makes it possible for the doctor to prove to the patient and attenders that the voice box was not affected during the surgery. The entire procedure of inserting and removing the laryngoscope will be recorded on video on the phone. An ENT surgeon often does procedures such as removing a foreign body such as fish bone from the throat. Biopsies are done often. All these procedures can be recorded and documented. At times, in an ICU, a patient cannot be maintained on a tube inserted through the throat to facilitate breathing. In such cases, an insertion is made at the throat (tracheotomy) and alternative breathing tube inserted. The patient and attenders can now be shown videos of the changes in the voice box because of prolonged tube insertion and therefore the need for this procedure. This documentary evidence convinces patients and avoids the mistrust they nurtureâ€ť, says Dr Krishnamoorthy.
(UV Bot and laryngoscope)
A critical aspect of healthcare is hygiene and sanitation. A UV Bot is a disinfecting equipment that has been made mandatory in western countries. It is used in hospitals in operation theatres, post-surgical units, ICUs, labs and wards. Incidentally, it is also being used in hotels and public places in the West. It is not in use in India due to its high cost including import duties and taxes. The cheapest one would cost around Rs 50 lakh while the top-end one would be around Rs 1 crore.
This equipment emits UV light much like a water purifier and kills all germs in its range. A ward purified using this technology after a patient is discharged will ensure the next patient is not infected by germs still present in the ward. Significantly, it also prevents the formation of superbugs.
Dr Krishnamoorthy has developed a UV Bot that is more powerful than the existing ones in the market and costs only around Rs 7-10 lakh. It is portable and can be used in multiple locations in a building. It completely sanitizes the environment in its range in 15 minutes.
â€śThings such as remote controls, door knobs, hand rails or ceiling are not manually cleaned adequately after a patient is discharged. People can get infected. This is proven by existing international studies. Now, this affordable UV Bot will prevent such infections in hospitals and public places as it is affordable,â€ť says Dr Krishnamoorthy. The UV Bot developed by Dr Krishnamoorthy emits 1,500 Watt of UV energy, significantly higher than the existing models. Both the inventions are in the process of being patented by him.
Indigenous, affordable solutions
â€śI wanted to create indigenous solutions that are affordable so that the quality of life improves for patients. Also, we need a healthy relationship between patients and doctors. The lower cost and documentary evidence makes a huge difference. Often people believe that things have gone wrong because of mistakes made by the doctors or procedures have been carried out unnecessarily when truly that was not the case. Now, with documentary evidence, the patient is certain, aware of all facts and therefore will have no doubts,â€ť says Dr Krishnamoorthy.
On hygiene, Dr Krishnamoorthy says, â€śIn the West, it is mandated that hospitals have to use UV Bots. If a patient is admitted due to secondary infections acquired after discharge, the insurance company fines the hospital if it does not have a UV Bot. Now, Indian hospitals can be as safe for patients as their western counterparts.
More products on the anvil
Both the productsâ€” the laryngoscope and the UV Botâ€” have been validated by a third party and are available for use in India. Dr Krishnamoorthy is in the process of developing more affordable equipment and solutions to bring down healthcare costs in India. His mission on affordable healthcare and healthy patient-doctor relationship bodes well for the Health for all Mission in its own way.