As the cry for oxygen and hospital beds continue to haunt the country, RxDx Healthcare, a chain of telemedicine enabled primary care clinics in Bengaluru, has rapidly ramped up its COVID care at home packages with an aim to prevent hospitalisations and reduce the load on hospital beds. It is currently managing 375 active patients at home and is ramping up capacity to 2000 active patients being treated at home at a time. This would amount to the work done by ten 200-bedded hospitals. According to Dr. Chhavi Mehra, Quality Head at RxDx Healthcare, thus far, less than 10% of the 2000 patients managed at home by the RxDx team have needed to be referred to the hospital for admission.
Home care includes 1) tele consultations with doctors, physiotherapists, nutritionists and counsellors 2) daily monitoring of vitals (including the oxygen saturation reading via the oximeter) and 3) pharmacy prescriptions and home drop offs plus nursing visits at home for lab blood draws or testing within Bengaluru. Unlike public perception, COVID care at home is not just monitoring the patient but also prescribing early and ongoing treatment with medications such as inhalational steroids, anti-virals and anti-clotting medications to reduce the chance of worsening inflammation and cytokine storms. The adults consult physicians and internal medicine specialists while children receive paediatrician’s consultations. In the ongoing pandemic, RxDx Healthcare has conducted over 200,000 COVID related diagnostic tests; 20,000 covid vaccinations; 150,000 teleconsults, 25000 home visits in Bengaluru and helped over 2000 COVID patients across India recover in the comfort of their home.
With the experience and expertise of now having managed over 2000 patients at home, the senior physicians of RxDx have also initiated training programmes for MBBS doctors. The junior doctors can attend the sessions to learn about home isolation treatment protocols developed by RxDx based on guidelines released by the MoHFW, AIIMS, ICMR, and other medical authorities on the subject. The treatment algorithm categorises patients according to age groups and comorbidity conditions. Topics like a case-wise justification of steroid prescription, situational use of high-resolution CT scans (HRCT), and other aspects of COVID management are discussed in detail. The doctors also get supervised experience in consulting patients in home isolation.
COVID care at home can open up the hospital beds for those who genuinely need them, the patients with moderate to severe symptoms. 85%-95% of patients fall in the asymptomatic to mildly symptomatic category and can brave the pandemic tsunami that is the COVID-19 second wave by recovering in the safety of their own homes under expert medical supervision. If home oxygen can be implemented, referral to hospitals can be reduced further. While the nation works on handling the shortage of hospital beds, and the medical oxygen crisis, COVID vaccine supply, testing, home isolation and early management to prevent worsening of the diseases along with social hygiene protocols seems to be the best bet.
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