28% tele-ICU spoke hospitals in Karnataka not functional, 1 fully deactivated

BENGALURU: Two tele-ICU clusters were opened in the state recently, with the govt claiming the initiative will enable hub hospitals to address shortage of specialists in spoke hospitals in the hinterland. However, what was glossed over was the fact that only 29 of the 40 state-run tele-ICU spoke hospitals in Karnataka are currently functional, while the rest are dormant.
Data accessed by STOI shows the tele-ICU spoke hospitals in Bengaluru Rural, Chikkaballapur, Kolar, Shivamogga Chamarajanagar, Gadag, Kalaburagi, Koppal, Raichur, and Yadgir are dormant. These spoke hospitals come under Bengaluru, Mysuru, Hubballi, and Ballari clusters. One spoke hospital at Santemarahalli in Chamarajanagar district has been deactivated.
Tele-ICU clusters are based on the hub-and-spoke model wherein one big hospital acts as the hub and provides services to spoke hospitals in taluks and smaller towns. Karnataka’s initiative also includes two smart ICUs in Ballari district that facilitate AI-based interventions for critically ill patients.
Sources part of the hub-and-spoke model admit that tele-ICUs have been non-starters in the state as taluk hospitals have misplaced CDs and pen drives loaded with CARE (computer-aided regulation engineering) software distributed to them. Ideally they should’ve filed FIRs but they have not done it, they added.
Dr Vasanth Kumar DE, state nodal officer, tele-ICU, told STOI, “We’re facing problems with internet connectivity. Our ICUs require private internet connection.” Most of the taluk hospitals were given KSWAN (Karnataka State Wide Area Network) earlier.
Another official said CARE requires hospitals to have open internet and not KSWAN which is a closed network that only allows whitelisted domain access. CARE is still in active development and there are software releases every week to meet the demands on the field and KSWAN does not allow such dynamic systems to be whitelisted. Once CARE crosses the active development stage, enabling the same over KSWAN could be considered, the official explained.
The tele-ICUS are also facing a shortage of manpower. “We had hired doctors and nurses during the pandemic. They have been shifted to the labour room and casualty. We are getting them back now,” Dr Vasanth Kumar said, adding all the spokes will be functional soon and that efforts are being made to set things right. “It is important to have SOPs in place so that once ICU clusters start functioning, they are up and running,” another source said, referring to standard operating procedures.
Karnataka made headlines as it launched state-run tele-ICUs in 2022. Two new tele-ICU hubs were launched at Trauma Care Centre, Victoria Hospital, Bengaluru, and Ballari district hospital earlier this month, and they will be linked to 20 taluk hospitals in Bengaluru and Kalaburagi divisions of Karnataka.
Tele-ICUs were implemented in the state in a public-private partnership (PPP) model at a cost of Rs 40 crore for the hardware. Around Rs 60-70 lakh was spent for spoke hospitals in taluks, which included the cost of 10 beds, ventilators, multipara monitors, ABJ machines, and laryngoscope.