“I’ve always felt we should minimize hospital visits for patients. With technology we can guide them on what is the right thing to do remotely and ensure they come to the hospital at the right time than unnecessarily make trips to the hospital,” says Dr BS Ajai Kumar, CEO and chairman, HealthCare Global (HCG).
His belief was reinforced a few years ago when his son, who has muscular dystrophy and compromised immunity, had to be hospitalized after a fall. He developed multiple infections at the hospital and went into septic shocks. That prompted Dr Ajai to create a virtual ICU at his home.
“Some people say that I was able to do that because I’m a doctor, but it can be done for anyone,” he adds.
HCG is India’s largest provider of cancer care that runs 24 comprehensive cancer centres across the country. Individuals undergoing cancer treatments are considered among the groups with increased risk of developing more serious complications from COVID-19. Due to a compromised immune system and no vaccine in place, the only way to stay safe is to avoid getting exposed to the virus.
So far, Indian medical laws mandated doctors to only do in-person consultations with their patients. However, with COVID-19 related restrictions, they have now allowed virtual consultations to ensure the safety of both frontline health workers and patients.
With the amendment in place, HCG has adopted a new feature Microsoft Teams, called Teams virtual visits, to ensure its patients continue to get the care they require from the comfort of their homes without putting their health at risk.
Providing accessible, affordable cancer care
Dr Ajai started HCG with a vision of making world-class cancer care accessible to everyone in India. After immigrating to the United States to train at MD Anderson Cancer Center, University of Texas in 1975, he noticed the gap between oncology treatment in the two countries.
“When I visited India in 1979, I saw the difference between how cancer patients were treated. Even back then, in the US, patients were seen as long-term survivors even in advanced cases, while in India the practice was more of palliative or terminal care,” he says.He spent six months visiting cancer care centres across India and no matter where he went, people said India could not afford technology for cancer care.
“I saw a baby in Madhya Pradesh with a big tumor in his abdomen wait for 12 hours to get treated. I understood the government alone can’t solve this and private enterprise will have to take up the cause. That image made me realize that I have to do something in India,” he recalls.
It took almost a decade, when in 1990 he started the Bangalore Institute of Oncology with a group of oncologists. The team gained understanding of Indian oncology and the profile of patients. Then in 2003, Dr Ajai moved back to India to start HCG with a unique hub-and-spoke model with the hub in Bengaluru and spokes in tier two and tier three cities all across the country to ensure cancer care is accessible and affordable to everyone. This model ensures that irrespective of their location, patients get high quality care without having to travel long distances. HCG now also has operations in Nairobi, Baghdad, and Ho Chi Mi City, linked back to their Bengaluru hub.
“We see nearly 100,000 new cancer patients every year. Today I can proudly say that whatever technology MD Anderson has, we have it at our centre in Bengaluru. We have more than 400 oncologists and we are not only working on treatment but also research and academics,” he says.
Moving to virtual consultations
Dr Ajai had started remote conferencing with oncologists across HCG’s centres since 2008 for their “Tumor Board” meetings every Tuesday where everyone discussed and exchanged notes on cancer cases. Even though they did not have high resolution video conferencing, his experience with those weekly meetings had convinced him that virtual consultations could make HCG’s work more impactful.
When the lockdown due to COVID-19 was announced, Dr Ajai Kumar and his team saw it as an opportunity to move quickly to virtual consultations to care for his patients, many of whom were in the vulnerable group.
“Last year, we moved to Office 365 enterprise-wide and were already using Teams as a single collaborative platform internally. We were looking for opportunities to take the experience externally and the lockdown situation accelerated the need for us,” says Madhavi Kanumoory, the chief information officer at HCG.
Before choosing Teams as a platform Kanumoory evaluated other solutions too but certain features in Teams convinced her that it was the right platform.
“One of the primary reasons we went with Office 365 and Teams was the HIPAA compliance and security that comes with it,” she explains. “The integration of Office 365 with Teams makes it very seamless as a platform. And finally, we had a lot of experience working on Teams since the last one year.”
With the lockdown in place, HCG rapidly moved to virtual visits feature in Teams, that allows healthcare providers to schedule, manage, and conduct virtual visits with patients. Once a visit is scheduled within Teams, the patient receives a customized email with appointment details and a link where they can join the virtual appointment from their web browser or Teams mobile app.“Teams has been a big winner because it came with inbuilt features for the doctor’s view, the patient’s view, and what can be shown to the doctor without having to bombard the patient with the same information. The email templates were easy to customize,” add Kanumoory.
For Dr Ajai, it is also about the ease of use, not just for him and his team of doctors but for his patients too, while ensuring the security of patient data.
“Not having to come to a hospital is a big thing for patients, we are able to review the patients’ case history, go through their imaging and pathology reports, and give a definitive opinion to the patient and their families. I’d like to compliment Microsoft on how they have made it as easy as clicking a button for a common person,” he says.
A game changer
While the current COVID-19 situation might have accelerated the move to virtual consultations for healthcare providers, for Dr Ajai and his team at HCG, this is just the beginning. They can already see how it can make cancer care more affordable, especially for patients who come to them from other cities and even other countries.
“We might have accelerated the process due to the macro-environment, but this is a big game changer for HCG,” he says. “Think about our patients from Kenya, Iraq, or Vietnam. Why should they come here and stay for regular follow-ups if they can do virtual consultations? They should come to the hospital only when they are absolutely needed.”
With Teams, Dr Ajai feels that his vision of a virtual hospital is closer to reality.
“I’ve always had this concept of a virtual hospital—one where the parking lots are empty, but the hospital is still doing good. That’s what we should create,” he exclaims.