ICU equipment deal gives patients in counties new lease of life

Moses Tanui was involved in a fatal motorcycle accident three years ago. He suffered lethal injuries that required specialised treatment at an intensive care unit (ICU).

But he was subjected to a long waiting queue as the ICU facilities were fully booked at a public referral hospital where he was admitted.

“I waited for months in pain. I couldn’t do the manual jobs I relied on for income. So I didn’t have money and my family was suffering.”

Casualties of various roads accidents like Mr Tanui, as well as Kenyans suffering from other severe health ailments like cardiovascular diseases or cancers may at some point require ICU services.

These facilities greatly determine the survival chances of critically ill patients.

For instance, upon undergoing heart operations or other major surgeries, patients are transferred to the ICU for close monitoring to prevent severe health outcomes or even death, in case they develop complications.

Whereas ICUs in major private hospital function well, public facilities have been lagging behind. Some hospitals have inadequate equipment such as special beds, thus rendering them ill-prepared to handle the magnitude of patients flocking the health facilities.

But tides of change are now beckoning for these public health facilities, as Philips moves in to revamp ICU departments and install state-of-the-art digital equipment for managing critically ill patients.

The company bagged a Sh3.3 billion contract from the government’s Sh38 billion medical equipment leasing project - to supply and manage ICUs in county hospitals. Other medical companies awarded similar tenders are General Electric, Bellco SRL, Esteem and Mindray. They will supply counties with cancer radiology machines, dialysis kits and theatre equipment respectively.

Health secretary James Macharia said the equipment would enable counties deal with a myriad of ailments such as cancers, diabetes, renal conditions and maternal complications.

Previously, patients had to travel over long distances to major facilities like Kenyatta National Hospital (KNH) or Moi Teaching and Referral Hospital to seek most of these services.

The devolution of healthcare is now opening up county hospitals to the latest health technologies whilst providing business opportunities to medical companies supplying appropriate technologies that meet Kenyan’s needs.

Roelof Assies, general manager at Philips East Africa Limited said the digital ICU equipment — already working at Machakos Level Five Hospital — is aimed at ensuring ICUs in targeted public hospitals meet international standards.

“There’s no bias. What we are installing here is similar to what is in the developed world.”

The digital ICU equipment include monitors for assessing patients’ wellbeing, defibrillators for resuscitation and ventilators for helping patients to breathe well.

In ICU wards, patients usually have many wires attached to their bodies that feed information about their physical and psychological health status to a bedside monitor.

Philips is deploying its digital IntelliVue MX series of touch screen monitors to perform this key function. They allow doctors to easily scroll through the interface and assess vital signs of critically ill patients such as their blood pressure, heart rate and oxygen absorption levels.

Doctors can use the monitors to capture personal details of patients and create corresponding electronic medical records. Each of these monitors is then linked to a central one that allows authorised health workers to see all ICU beds or monitors on one computer screen.

They click on any bed number and immediately get information on the health status of a patient. These medical records can be saved in a digital document (PDF) format directly from a USB port of any of the monitors. SEE VIDEO

The central location may also be outside the hospital in a remote centre allowing for telemedicine. The Ministry of Health is banking on this e-medicine technology to deal with the perennial shortage of specialist doctors in county hospitals.

“The idea is to make all ICU processes paperless and efficient,” explained Elvis Mududa, ICU expert at Philips.

Doctors can also set alarms through the monitors that are programmed to emit specific types of sounds depending on the magnitude of a patient’s problem — low, medium or high risk.

Such alert systems are especially useful in public hospital settings where health workers serve many patients at any given time.

For instance, if complications arise that cause the heart of critically ill patients to suddenly stop beating, the alarm sounds will be extremely loud and rapid, indicating a high risk situation.

Philips will also supply hi-tech machines known as biphasic defibrillators to resuscitate patients and rapidly restore heart functioning in such critical moments.

The conventional monophasic defibrillators required doctors to shock patients many times during resuscitation. This archaic technology could also cause side effects like brain damage and was especially not recommended for use in infants.

In case patients develop breathing difficulties as a result of lung complications, the Philips V680 ventilator machines can be used to aid breathing through inserted tubes (invasive) or by breathing masks (non-invasive).

The latter approach minimises infection risk and is thus gaining popularity.

Philips is also equipping hospitals with mobile ICU beds that can change positions — at the touch of a button — to guarantee patients comfort and their accessibility for various treatment procedures. For example, doctors need the beds to be as low as possible during resuscitation. And some patients my need to have their heads slightly raised for comfort.

Aside from supplying the required ICU tools, Philips will also be in charge of managing them to maintain their optimal functioning at all times. “We are also training biomedical engineers and healthcare workers who will use the equipment. And this will be done continuously,” said Mr Mududa.

This leasing deal allows the government to save on equipment purchase, training and maintenance costs that have burdened it for years, thus crippling service delivery in public hospitals. The contract also entails the establishment of infrastructure that may be required to improve the quality of ICU services offered in public facilities.

“So if we go in and find that ICU wards in certain hospitals are too small, then we have to put up appropriate additional structures,” stated Mr Assies.

For instance, he notes that a complete redesign of the Machakos Level Five Hospital’s ICU department was necessary to enable it meet international standards.

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