A two-day international workshop on Futuristic Healthcare Technology: Telemedicine and Medical Drones was held on 16^th and 17^th December 2017 at Apollo Children’s Hospital, Chennai. It was organised by National Design Research Forum (NDRF), Bengaluru and the Institution of Engineers (India) in association with Apollo Tele Health Services (ATHS) and National Institute of Advanced Studies. Dr. Sunil Shroff, Managing Trustee, MOHAN Foundation is on the National Advisory Committee for these workshops and was invited to moderate the panel discussion. The workshop was well attended with engineers, scientists, technologists, transplant surgeons, doctors, and tele health specialists participating.

The aim of the workshop was to look at how healthcare delivery could be augmented by leveraging advances in interdisciplinary engineering practice to develop affordable and innovative medical and healthcare devices. Access to better and appropriate technologies to match the health needs of the population (especially in rural and inaccessible areas) would enable disease prevention, early diagnostics, and effective treatment.

The eminent speakers included Dr. R. Surendran, Director, MIOT Hepato-Pancreato-Biliary (HPB) Centre for Surgery and Transplantation, who kick-started the liver transplant programme in the Government Stanley Hospital, Chennai. He said that technology could help in pooling of resources, establishing primary centres from where drones could pick up and drop off materials. Dr. Gomathy Narasimhan, Senior Consultant – HPB & Liver Surgery, Gleneagles Global Hospitals, Chennai emphasised the need to develop a Liver Assist Device that was a cost effective alternative for Acute Liver Failure with an effective outcome. Dr. Anil Vaidya, Senior Consultant Transplant surgeon, Apollo Hospitals, Chennai elaborated on the ex-vivo transportable normothermic liver perfusion system called OrganOx metra. In UK, it was found that liver transplants resulted from only 65% of donors. The OrganOx metra developed at the University of Oxford has been used in the UK for preservation and safe use of marginal livers. This success may potentially allow many more livers from extended criteria donors to be transplanted reliably. Dr. Paul Ramesh, Cardiothoracic surgeon, Apollo Hospitals, Chennai explained the biochemical aspects of organ preservation. He also felt that initial trials of organ transportation could be done with sheep hearts. Dr. Santosh Varughese, Consultant Nephrologist, Christian Medical College (CMC), Vellore spoke on ‘Organ storage and transportation challenges in kidney transplants’ and said that the advantage of static cold storage was the lower cost as compared to machine perfusion. However, he added that studies that compared cold storage and machine perfusion have shown that primary non-function, delayed graft function and graft failure were all better with hypothermic machine perfusion. The benefits were more obvious in the borderline/marginal kidneys. Dr. T. V. Gopal, Anna University, Chennai explained some of the meta-physical perspectives of technology-enabled healthcare.

 

Prof. K. Ganapathy, President, Apollo Telemedicine Networking Foundation & Director, ATHS spoke on the future of telemedicine. He emphasised that technology could be effectively used in wellness, prevention, diagnosis and treatment, and that digital health programmes were the future. Prof. Thais Russomano spoke on the deployment of technology in space medicine and Dr Russell Andrews through Video Conferencing from California spoke on ‘Drones in disaster management.’ Mr. Arun Shroff’s session on Artificial Intelligence (AI) gave the audience an interesting insight into how AI could impact healthcare (ideally suited for telemedicine deployment).

There was a full session dedicated to the use of drones in emergency medical care including organ transport. Dr. Kota Harinarayana, Chairman, General Aeronautics Pvt. Ltd., spoke about the challenges of medical drone operations in a civilian environment in India. He said that the flying height of drones in USA was 400 feet, in Europe it was 700 feet, while in India the Directorate General of Civil Aviation (DGCA) was looking at 200 feet in its draft guidelines. One of the other challenges he mentioned was non-availability of test facilities for drones. Dr. K. Ramachandra, Director, NDRF, elaborated on drones for organ transport. At present drones can carry a payload of up to 4 kg and cover a distance of 5 km. For organ transport, the payload would be around 25 – 40 kg, range 150 – 300 km and an endurance of 3 – 4 hours. He said it would be essential to set up virtual “air” corridors with the help of digital/aerial mapping. He felt a national programme was needed for drone operations. Prof. B. Gurumoorthy, Indian Institute of Science shared details of an active heart perfusion container called ‘LifeBox.’ This has been designed by students using dry ice based cooling for transport by drones. Prof. Senthil Kumar, Madras Institute of Technology said that a DRONE (Dynamic Remotely Operated Navigation Equipment) was suitable for use in 3 Ds - ‘Dull, Dirty and Dangerous’ environments! Ms. Ayushi Mishra, DronaMaps, Indore emphasised that with 3D/contour mapping every detail can be captured for eternity. She expressed her interest in innovations regarding hypothermic machine perfusion and how it could be integrated into organ delivery through drones.

Dr. Sunil Shroff moderated the panel discussion on ‘Challenges in deploying drones in healthcare.’ Dr. Shroff and the panel members discussed and debated on all the relevant aspects – regulatory & licensing, safety/reliability, operations, and practical issues related to medical drones. Some of the takeaways from the discussion were that intra-city delivery of organs could be explored first, clearances from the Indian Council for Medical Research (ICMR) and clear guidelines from the DGCA needed to be pursued. Lt. Gen. Dr. V. J. Sundaram, PVSM, AVSM, VSM (Retd.), Advisor (Micro-Nano-Bio Systems), NDRF who heads the National Advisory Committee in his summing up said that with a medical drone safety and security were of utmost importance, especially in organ transport since organs were an invaluable resource. He reiterated that certification of drones and an Air Traffic Control system for drones needed to be looked at.

 

Following the panel discussion and interaction with the delegates, it was decided to form a Special Interest Group (SIG) to start working on the possibility of making medical drones available to facilitate healthcare in remote areas as well as for organ transport. Another important event was the signing of an MoU between ATHS & InnovaSpace.

 

Mr. V. Krishnan, Consultant, MOHAN Foundation, Bengaluru who has been liaising with NDRF attended the workshop. Dr. Sumana Navin, Dr. Hemal Kanvinde and Ms. Ann Alex from MOHAN Foundation Chennai were also present.