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Digital Healthcare: Saving lives in a time of crisis

The HP government’s flagship telemedicine programme with Apollo Telehealth successfully saves the lives of a mother and her newborn child at a 12,000 feet Himalayan village in the Spiti Valley. Apollo Telehealth rendered its services through emergency teleconsultation with specialists facilitated by their telemedicine staff on the ground

Telemedicine is said to be the next big thing in healthcare. It’s hot right now (and not over-hyped as sceptics term it) simply because digital health dramatically enhances traditional means of treatment and care delivery, as evidenced from this real-life example. In a distinct feat of emergency delivery at an altitude of more than 12,000 feet in Kaza, the Himachal Pradesh government’s telemedicine programme with Apollo Telehealth showcased its sheer dedication, commitment, humane approach, and capability to save two lives— a mother and a child in critical state. From providing detailed patient history to doctors thousands of miles away to diagnosing the condition of the patients to providing a line of treatment and round-the-clock monitoring, telemedicine eliminated the possibility of any sort of fatality.

The mother, a 27-year old female, was admitted to Community Health Centre (CHC), Kaza, diagnosed with Abruptio Placentae (premature separation of the placenta from the uterus). While a caesarean section was performed to deliver the baby, the mother developed complications of post-surgical bleeding. Alpha Khakhar, an obstetrician-gynecologist at Apollo Hospitals who was consulted to manage the complication said, “We obtained detailed patient history, performed thorough examination over telemedicine, and diagnosed the condition as post-partum haemorrhage. Following that, we advised the line of treatment for clinical management of the patient. Complications were also starting to show effects on the baby as the delivery was preterm and the baby was born with low body weight. In addition to that, the baby had bluish discolouration at birth. To stabilise the condition of the baby, cardio pulmonary resuscitation (CPR) was advised for two minutes followed by other emergency clinical management procedures. Following CPR and emergency care the baby was shifted to neonatal care unit. However, the baby continued to have intermittent low blood sugar levels.

As the condition of the baby continued to deteriorate, a teleconsultation with senior paediatrician Latha Vishwanathan, of Apollo Hospitals was organised. A detailed assessment of the baby was performed by the paediatrician and she advised the staff to administer IV fluid and NG (nasogastric) feeding; monitor oxygen saturation and random blood sugar (RBS) levels regularly and measure body weight daily. Round-the-clock monitoring was performed by Apollo and government staff to ensure oxygen administration based on saturation levels. However, the blood sugar levels of the baby continued to dip drastically and a teleconsultation with the paediatrician was again organised for clinical intervention. The government emergency duty doctor monitored the baby, under the guidance of a senior paediatrician from Apollo.

Vishwanathan said, “As both the mother’s and the baby’s condition were worsening, the block medical officer (BMO) at Kaza requested our telemedicine staff to accompany the mother and the baby. However, the roads were closed and it took time to organise transport to the higher centre. Till then, we maintained round-the-clock supervision on the baby. This was possible only because of tele-emergency that allowed access and support to the child or else, it could have been fatal.”

Evidence-based intervention in those crucial minutes improved long-term outcomes for these fragile patients. Using cameras and connective devices, healthcare staff at Kaza connected with attending physicians and child specialists to monitor vital signs, ask questions, validate diagnoses, examine x-rays together and have the doctors observe treatment progress. It was only after six days of round-the-clock monitoring via telemedicine services that the mother and the baby were shifted to Mission Hospital in Manali where they were admitted. The condition of the mother and baby stabilised a day after the initial treatment procedures.
“Apollo Hospitals Group is the pioneer of telemedicine in the country, and it is providing emergency healthcare services to people in remote parts of the country through Apollo Telehealth,” said Sangita Reddy, joint managing director, Apollo Hospitals Group. “It has saved lives in both urban and rural areas of the country amid the Covid-19 pandemic as well, and this incident in Kaza will be an inspirational story for the whole Apollo group for times to come.

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