The Story behind how we created the TeleICU

It was May of 2021, the delta wave of Covid was mercilessly sweeping across the country. Delhi was gasping for breath due to a lack of oxygen. Mumbai, Bangalore, and many other cities were running out of ventilator beds, leading unfortunately to a number of fatalities.

One evening, I received an SOS call from a friend in Bangalore. He said, “Srikanth, my aunt will die if we can’t get her a ventilator ICU bed by tonight.” Dr. Sudarshan (Founder of Karuna Trust) at BR Hills was telling me that the delta variant was spreading in rural areas too, except there were no ICUs in the smaller towns and rural areas. I decided to start creating ICUs in Govt. Taluka (sub-district) hospitals, where there were few or no ICUs and the need was the greatest. That's how we started the 10BedICU project (see 10BedICU.org).

Within 4-5 weeks, we had raised funds from various individual and institutional donors, and we had set up 40 10BedICUs at govt. hospitals in Telangana, where we equipped them with ventilators, 5-para monitors, and all the essentials of a state-of-the-art ICU. The dedicated young volunteers of the Hyderabad-based NGO Nirmaan, taking huge risks of Covid infection, worked day and night setting up ICUs all across Telangana. The ICU beds were filling up the day we launched these ICUs. All of this coordination and creation was happening amazingly over Zoom calls, as we were working under a state of lockdown. We quickly moved to Andhra Pradesh, set up 30+ 10BedICUs there, and soon noticed the North East was reeling under the Covid load. We inducted an incredibly dedicated Bisoya Loitonbam from Manipur and started working in Manipur, Nagaland, Assam, and so on.

While we had mounted an ICU creation drive on a war footing and the beds were filling up everywhere, we noticed a problem. There were not enough specialists in these secondary government hospitals in these smaller towns and remote areas. There were not enough intensivists, pulmonologists, anesthetists to handle the patients in these ICUs. What do we do? The answer came from Mysore - my hometown.

I am a technologist by background. I had led a team to create the technology behind Aadhaar, but I had no time to build technology to address the rapidly advancing Covid wave. Nachiket Mor had told me about this fantastic team of dedicated youngsters in Kerala that had built a system to manage the pandemic at 300 hospitals in Ernakulam district. Soon, we brought in this fantastic team of Sanjay, Bodhi, Gigin, Aparna, Amruta and others into the eGovernments Foundation (an NGO Nandan Nilekani and I started in 2003), and we started building the CARE platform to power the 10BedICUs.

We had started setting up 10BedICUs in the taluka government hospitals of Karnataka. I was working from my mother’s house in Mysore (See my post: A Chief Minister's Launch and a Mother's Memory). At a conference we had organized of doctors and healthcare epxerts at the Infosys facility in Mysore (that Nandan Nilekani had kindly arranged), we had heard of an effective TeleICU capability by a startup, CloudPhysician. We decided that night we would build a TeleICU module for the Govt. healthcare system, to take care of ICU patients by doctors from afar.

I called the CARE software team from Kerala to come over to Mysore. A half dozen software developers with their laptops crowded into 3 upstairs bedrooms of my mother’s house in Mysore. The downstairs transformed into a bustling hub for meetings, discussions, and group dinners, we lived and breathed TeleICU for weeks.

We went over to the KR Hospital in Mysore, named after the progressive King Nalvadi Krishna Raja Wodeyar, who I'm sure would have approved of our methods! We met with the medical superintendent, Dr. Nanjundaswamy, along with his boss, Dr. Dinesh, the dean of the Mysore Medical College. Not only did they confirm the need for a TeleICU, but they also wanted to avoid a large number of patients from rural areas crowding and inundating their hospital in Mysore and bringing it to its knees.

We designed a TeleICU module with doctor-to-doctor video connection, installed hi-resolution cameras in the 10BedICU ward for medical college hub specialists to view and monitor patients. We connected the CARE EMR (electronic medical record) to the hub, and we integrated the 5-para monitor of the ICU patient over the cloud so the hub specialist could view the patient vitals on a screen hundreds of kilometers away. All this was built at break-neck speed in less than 4 weeks; another couple of weeks later, we had installed it in KR hospital and tested it. It worked beautifully!!

To cut a long story short, the TeleICU tipped the balance in this life-and-death situation for many patients. It provided patients not just with access to modern ICU facilities within their local communities but also the expertise of seasoned specialists remotely from a medical college. As the trite saying goes, “necessity is the mother of invention,” the need was indeed great, and we had created a life-saver.

As I sat at the launch of our TeleICU hub at the Victoria Hospital (named after another monarch, Queen Victoria) in Bangalore yesterday along with the Deputy Chief Minister DK Shivakumar and the Health Minister Dinesh Gundurao, I couldn’t help but think of the  journey we had traversed, from KR Hospital Mysore in May of 2021 to Victoria Hospital Bangalore in February 2024. In the process we had created 12 TeleICU hubs across 9 states, connecting 200+ 10BedICUs and saving a whole lot of lives.

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