Smart ICUs hold the potential to bridge accessibility gaps and enhance efficiency in critical care. However, aligning it with robust regulations is critical
India’s healthcare sector is evolving rapidly, with the Intensive Care Unit (ICUs) at the forefront of this transformation.
Dr Sunil Karanth, Chairman, HOD & Consultant-Critical Care Medicine, Manipal Hospitals, Old Airport Road, “The demand for ICU beds has surged, driven by the growing healthcare market, projected to expand at a double-digit CAGR of 22 per cent. This increase reflects the increasing need for acute care due to increasing lifespan, advancements in complex surgeries with the addition of technology like robotics, and post-treatment critical care for conditions like cancer and transplants. Another factor behind it is the increasing population in places where there is better access to healthcare. The migration from rural to urban areas has also improved access to healthcare for many. This is supported by enhanced infrastructure in public and private hospitals. Increased affordability, particularly among the middle class, has also contributed to this rising demand.”
Smart ICUs represent a revolutionary shift in critical care, integrating advanced technologies to improve patient outcomes, enhance workflow efficiency, and optimise resources.
Dr Dileep Raman, co-Founder and Chief of Health, Cloudphysician shares, “The key challenge is to ensure that high quality care is accessible and affordable. Meeting the demand for access and quality and a lower cost is only possible by force multiplying clinicians with technology. Smart-ICU solutions play a key role in addressing these challenges by incorporating real-time monitoring, AI-driven analytics, and decision-support tools to enhance the efficiency and quality of care. These solutions help optimise resource allocation, streamline operations, and enable timely interventions, which are crucial for managing complex patient cases effectively. As healthcare systems in India continue to evolve, Smart-ICUs enable hospitals to meet the rising expectations of patients for high-quality, efficient, and personalised care.”
Dr Kapil Borawake, Director – ICU and Criticare Medicine, Sahyadri Super Speciality Hospital, Hadapsar, Pune opines that ICUs in India are a bit of mixed bag. He mentions, “While metropolitan hospitals have sophisticated critical care units, smaller and rural hospitals are poorly resourced, have old facilities, and are short of trained intensivists. As the World strived with COVID, there was clamour for devices that improve critical care efficiency and scope. Further compounding the case for smart ICUs is the rising incidence of critical illnesses, such as sepsis, acute respiratory distress syndrome (ARDS), and multi-organ failure, which necessitate better monitoring, medical intervention and subsequently enhanced patient prognosis.”
Stressing on the shortage of manpower as a significant challenge facing ICUs, Dr Sankalp M Vanzara, Sr. Consultant & HOD – Critical Care & Emergency Medicine, Sterling Hospitals, Rajkot said, “Currently, ICUs in India are staffed by human personnel who operate electronic machines and monitors displaying patient information. This data is interpreted by doctors, nurses, and intensivists to determine appropriate treatments. However, a significant challenge facing ICUs is a shortage of manpower. Many dedicated nurses and doctors are opting for less stressful roles, leading to significant staff shortages in hospital ICUs. This trend not only impacts the quality-of-care patients receive but also places immense pressure on remaining staff. It’s crucial to address the work environment to retain skilled professionals in these vital areas of healthcare.”
There is a growing need for smart ICU solutions to alleviate human stress, similar to how banks and offices have adopted computers to reduce the need for manpower. Another issue is that when staff has to focus on one critical patient, they may overlook problems with other patients, leading to delays in identifying and addressing these issues. AI can help by quickly identifying these problems, thereby addressing the challenges faced in ICUs.
Technologies powering smart ICUs
Smart ICUs are a blend of technologies, aiming at enhancing patient outcomes and optimising healthcare resources.
Technologies like Artificial Intelligence (AI) to analyse large amount of data tp predict potantial complications, Internet of Things (IoT) based remote monitoring for constant patient supervision, big data and predictive analytics are shaping this transformation.
Talking about the need for technology, Dr Yash Javeri, Director- CCM and Emergency Medicine, Regency Health, Lucknow said, “Healthcare is fundamentally a human experience. Any technology or platform implemented should aim for greater access & human connection as its end goal. Technology and processes shouldn’t create more abstraction. Tech solutions should promote real connections. Less time on administrative paperwork means more face-to-face time for patient care!”
“There is a growing awareness of the detrimental impact of the ICU environment on patients, families, and staff. Current ICU designs have not kept up with advances in medical technology and models of care, and there is no current ‘gold-standard’ ICU design. Improvements in ICU designs are needed to optimise care delivery and patient outcomes. The key to achieving enhanced patient satisfaction & experience, reduce staff “burn out” & decrease healthcare spending is to have a strategic mix of modernised technologies and hyper personalisation.”
Traditionally resource-intensive and heavily reliant on manual monitoring, ICUs are now evolving into high-tech hubs with the integration of smart technologies.
Dr Borawake explains, “At the heart of Smart ICUs are technologies that enable seamless integration and analysis of patient data. AI provides comprehensive solutions in predicting complications, establishing ventilator settings, and even assisting in decision making through its interaction with large data sets.”
Kaushal Pandya, Senior Director, Dozee highlights that technology offers a lifeline, enabling healthcare systems to function efficiently in resource-constrained environments
He explains, “India’s ICU ecosystem is grappling with a dual crisis of capacity and capability. With only approx. 1,25,000 ICU beds for a population of 1.4 billion, the numbers starkly highlight the infrastructure shortfall. However, the challenge isn’t limited to infrastructure alone. A severe shortage of intensivists and skilled ICU nurses compounds the issue, with rural areas facing the brunt of this disparity. While urban centres manage to deliver critical care, rural regions are often left to operate with minimal resources and undertrained personnel. The drivers for adopting smart ICU solutions stem from these very gaps. Smart ICUs, through innovations like tele-ICU models, facilitate a hub-and-spoke approach. Specialists in urban hubs can now remotely guide and monitor rural ICUs in real-time, bridging the expertise divide.”
Explaining how smart ICUs improve patient monitoring, Himanshu Baid, Managing Director, Poly Medicure shares, “Smart ICUs are an advanced type of critical care that has improved patient outcomes through high-accuracy monitoring, low error rates, and improved decision-making. By integrating real-time data collected from monitors, ventilators, and others, it constitutes a comprehensive health profile, finding slight variations in the condition of a patient and enabling response before it occurs. A key benefit is a lack of human error. The automated system will handle the routine matters like recording vital signs and dosages, reducing mistakes due to fatigue or stress. Advanced alert systems further help doctors by prioritizing critical issues and filtering out nonessential information.”
“Smart ICUs offer decision support, also an essential feature for life-threatening situations where every second counts. They analyse enormous quantities of real-time clinical data to provide predictive insights, such as AI-based warnings, which can be used against complications like sepsis or cardiac arrest. This leads to better outcomes and resource optimisation with a reduced workload on healthcare practitioners.”
Smart ICUs: Sustainable and long-term solution?
Since smart ICUs leverage technology, they can help in optimising care delivery, reducing costs and overcome resource constraints, providing a scalable and cost-effective solution tailored to India’s unique needs.
Dr Vatsal Kothari, Director-Critical Care Medicine and Consulting Physician, Kokilaben Dhirubhai Ambani Hospital, Mumbai said, “Traditional ICUs are very resource-intensive with significant investment into infrastructure, equipment, and staff. Manual monitoring and interventions often lead to inefficiencies and a correspondingly high cost of operations. In rural and semi-urban hospitals, there is lack of the trained specialists in critical care, which is a challenge.”
Ruchin Kumar, VP – South Asia, Futurex stresses, “Smart ICUs address these challenges by utilising automation, real-time monitoring, and data analytics to optimise resource allocation and reduce expenses. Additionally, they enable remote monitoring, allowing specialists to oversee multiple units. This reduces dependence on on-site personnel and enhances the efficiency of healthcare providers in managing resources. These technologies empower hospitals to deliver high-quality care without incurring additional operational costs. By streamlining workflows, improving staff productivity, and reducing patient stays through more effective treatments, Smart ICUs provide a sustainable, long-term alternative to traditional ICUs.”
Traditional ICUs, while indispensable, are no longer sufficient to meet the demands of a growing and aging population. Smart ICUs offer a transformative solution, blending innovation with sustainability to create a future-ready critical care ecosystem.
Challenges and opportunities
Smart ICUs equipped with advanced technologies such as IoT, AI, and telemedicine promise to address longstanding issues in traditional intensive care units. However, the implementation of smart ICUs comes with its own set of challenges and opportunities that demand attention from healthcare providers, technology companies, and policymakers.
Dr Javeri opines that prospects for critical care may look questionable now, but solutions are available and the future just might be brighter than expected. Smart ICUs must prepare for bigger challenges.
Dr Piyush Girdhar, Consultant Critical Care, Aakash Healthcare, New Delhi also shares, “The challenges that come our way in integrating smart ICU technological advancements include training and integration. It also includes data analysis and managing the overload of extra data that needs to be segregated, while maintaining patient privacy. The initial investment cost for all the setups should decrease in the future. There should be clinical acceptance among all the physicians. Ethical and legal issues should be addressed. There should be adequate user experience for all these techniques, as well as compliance among all the stakeholders. And, of course, there should be ethical use of AI, ensuring it does not cause harm to the patient but benefits the patient.”
Dr Raman emphasises, “The healthcare sector has historically been slow to adopt cutting-edge technologies, often constrained by legacy systems and traditional clinical workflows. While advancements in medical equipment have progressed, critical care units have struggled to keep up. It is ideal to work with a team that has both technical and operational expertise while deploying and maintaining a smart-ICU. It is not just the technology alone, but its link with domain experts and outcome centric care delivery that makes a difference. To ensure challenges are minimal the hospital setting up a smart-ICU must collaborate both at a technology and a healthcare service delivery level with the domain experts.”
Dr Prashant Borade, Director critical care , Gleneagles Hospital Parel Mumbai also believes that smart ICUs is the future of Critical Care. By addressing current limitations, leveraging technological advancements and fostering public-private partnership, India can improve ICU infrastructure, enable remote access and enhance patient care transforming the healthcare landscape.
The transition from traditional ICUs to smart ICUs is neither seamless nor without hurdles. The journey requires addressing technological, financial, and operational complexities while also tapping into the vast potential these innovations offer.
Gerald Jaideep, CEO, Medvarsity stresses that all the advancements must align with robust regulations to ensure data security, ethical AI usage, and global standards. Innovation must be responsible to truly revolutionise healthcare.
Emerging regulatory frameworks and future of smart ICUs
As discussed above, technologies like AI, telemedicine and robotics will significantly influence the future of smart ICUs.
Explaining in detail, Dr Borawake said, “ Developments in AI, robotics, and telemedicine suggest that the future of Smart ICUs is bright. It’s easier to imagine AI algorithms taking over day-to-day clinical procedures, such as fine-tuning a ventilator or running dialysis machines, without human intervention. Telemedicine will be enhanced, making it possible to bring critical care resources into the most remote areas of the country. More and more, robotic systems will be responsible for performing minimally invasive procedures, administering drugs, and managing infections.”
However, as technology continues to evolve, healthcare providers need to stay ahead of emerging regulatory requirements to ensure compliance and protect patient privacy.
Kumar explains, “Emerging regulatory frameworks will significantly impact the adoption of these technologies. Governments worldwide are increasingly acknowledging the importance of stricter data protection and privacy regulations to safeguard sensitive healthcare information. In India, for instance, the introduction of policies like the Personal Data Protection Bill will be crucial in determining how healthcare providers manage and secure patient data within Smart ICU systems. Compliance with these regulations will be essential as healthcare providers incorporate more interconnected devices and technologies into their care models.”
Baid stresses, “Simplify compliance with risk-based classifications and streamlined licensing, accelerating market entry under regulatory reforms, such as the 2023 Drugs, Medical Devices, and Cosmetics Bill. Risk-based classification and streamlined licensing will encourage foreign investment and domestic manufacturing of affordable, quality solutions. This integration of technology with supportive regulations will revolutionise ICUs, improve patient care, and reposition India as a world leader in med-tech.”
Stressing on the data flow, Dr Javeri explains, “Future paradigm shifts will be in data use rather than data acquisition. Technology-assisted improvements in data management, integration, and presentation that will ultimately transform critical care practice. Man behind the machine is important in generating and analysing complex data. E-access to complete and accurate information is must for a smart ICU. Data privacy and confidentiality are pivotal in data management.”
Dr Ajit Pratap, Director and Head- Critical Care, Asian Hospital, Faridabad also highlights, “With a supportive regulatory framework and growing awareness, smart ICUs are poised to redefine critical care in India, ensuring world-class treatment in both urban centers and remote areas.”
Way forward
Smart ICUs hold the potential to bridge accessibility gaps and enhance efficiency in critical care. However, aligning it with robust regulations is critical.
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