“Pod hospitals can significantly enhance quality of healthcare infrastructure and delivery in India”

The COVID-19 pandemic has created havoc across the globe especially countries lacking specialised and quality healthcare infrastructure to treat those infected with the coronavirus. The pandemic also exposed the fact that the gap between demand and supply of healthcare infrastructure and delivery is only widening by the day and that there is an urgent need to come up with solutions that will help bridge this gap timely, effectively and efficiently. The pod smart hospitals concept, according to Mahesh Krishnachari, director and founder of the design and build firm “Vevra”, is one such game changing solution to the problem at hand. Read on for more details.

What led to conceptualising the pod hospitals? Is this something you’ve been working on for some time now?

It all started after the lockdown was implemented earlier in March. We all watched the chaos this pandemic has brought upon the healthcare infrastructure and delivery space. We also realised how helpless we were in addressing this situation. Being a design and build firm we began brainstorming for possible solution(s) to deal with airborne diseases like COVID. That was the starting point for this pod hospital concept.

We wanted to devise a futuristic solution that would prove beneficial in the effective treatment of such diseases that may surprise us going forward. The idea was to come up with a concept that can be easily scalable and ensures timely delivery of quality healthcare services.

A lot of efforts have gone into understanding/ identifying the pain points, taking feedback and interacting with healthcare professionals from the United Kingdom as well as doctors from private and government hospitals in Bengaluru. Additionally, feedback was also sought from nurses and other hospital support staff including the Class IV employees. This exercise revealed that lack of quality infrastructure was and continues to be the key issue in the treatment of diseases like COVID-19.

All the data and intelligence gathered were studied and brainstormed by the Vevra team to come up with possible solutions that will help overcome the hurdles in the overall healthcare delivery process. A fully-furnished prefabricated pod hospital concept was the outcome of this exercise.

Could you tell us about some of the key pain points being addressed?

Sure. I think one of the crucial issues was that doctors, nurses and hospital support staff were getting infected from coronavirus while performing their duties. So designing a safe “PPE” donning and doffing area for doctors and nurses who were getting exposed to this airborne virus while overseeing the treatments was critical to minimise the spread of this infection.

Most doctors were getting infected in the doffing area, basically at the time of removing their personal protective equipment (PPE). That’s because doctors and nurses are moving in an open area with 100 to 150 COVID positive patients and there is a huge viral load in the treatment area. Being airborne the viral load settles on the PPEs worn by the doctors and nurses. And these viral particles were infecting healthcare professionals at the time of removing the PPEs in the doffing area.

So irrespective of how many COVID patients a hospital is treating, if the healthcare staff including class IV workers are at a greater risk of contracting the virus due to lack of proper facilities, then we are not really fighting COVID effectively.

And the Vevra pods hospitals are capable of addressing this issue?

The ideal solution to address this problem, in my view, is to control the air quality inside the COVID treatment area(s) thereby curtailing the spread of this virus. That’s one of the key features of the pod hospital concept we’ve designed. The air getting circulated inside the premises is getting exhausted and fresh air (filtered using HEPA filters) is being pumped into the pod.

Eighty per cent fresh air and 100% suction ensures negative pressure in these pods. This is very important especially for patients in intensive critical units (ICUs) requiring oxygen, are on a ventilator and so on. You cannot have the same air circulating or split/ centralised air conditioning and that was the reason for the government to issue an advisory on use of ACs in such areas.

Apparently, the ICU section in most hospitals have a maximum of 15 to 20 beds. Besides, no hospital in India has got negative pressure ICU’s to treat any airborne disease. Pumping fresh air and exhaust the air at regular intervals brings down the load of viral particles inside the pod. As a result the possibility of these viral particles settling down on the PPEs worn by healthcare professionals, nurses and support staff is very low. This in turn helps reduce the spread of virus and related infections.

The fully furnished and prefabricated ICU and operation theatre pods designed by us can thus come very handy in such situations. This apart there are other variants like the general pod, doctors stay pod and scanning room pod that ensure patients being treated for such pandemics apart from other ailments can be properly isolated while ensuring there is no compromise on the quality of healthcare delivery. These pods are not just the regular mobile isolation rooms but a completely functional, fully furnished, internet of things (IoT) and artificial intelligence (AI) integrated smart hospital setup. (More details about the features of these pods can be found here)

What was the reason for partnering InnoWave group?

That was mainly for technology required to monitor the patients’ health records as well as the medical equipment inside the pod. We couldn’t find a local technology partner who could meet our requirements. I reached out to a former colleague from a Portugal-based company who was working with an internet of things (IoT) firm. We exchanged notes and figured out the synergies. It was a coincidence and a good one too. Interestingly, InnoWave was already doing this in hospitals across Europe and the Unites States of America (USA). However, it would be the first time this will be done in a movable pod hospital set up in India.

How far have you reached with this concept?

The conceptualising part was completed in May and its designing was finalised in June. Thereafter we got into sourcing the raw materials required for making the pod. Incorporating the negative pressure aspect was challenging because we couldn’t find a company who could do it in a movable pod. We were fortunate to find a company based out in Bengaluru, sourced the systems/AHU’s from Luxembourg based company that had the expertise and agreed to take up the project.

The prototype is currently in very advanced stages and we are testing the functionality, efficacy and mobility of the pods in our manufacturing facility. After thorough testing at our end, we will test the healthcare delivery through these pods on hospital premises to see if there are any final tweaks required. The pods will then be delivered to the healthcare facilities for treating patients. This will take a few more weeks. The pod hospitals will go live on hospital premises that have expressed interest in having them for specialised healthcare delivery.

Are these pods made used shipping containers by any chance?

These can be made using shipping containers. However, our pods are built using other durable and recyclable materials. Every care is taken to ensure we are meeting the required guidelines and standards of building a hospital premise. Our pods are made of a prefabricated structure and its surface, walls and roof is completely antibacterial. The power requirement is up to 20-25 kilowatts resulting in a monthly electricity bill of around Rs 25,000 or so. There is a three-and-a-half feet gap between each bed which is enclosed by thick PVC curtains that acts as a barricade for additional safety of patients.

While its designs are owned by Vevra, I don’t mind opening it to someone who’d like to do this on a large scale. As for the size of these pods is concerned, it is similar to that of shipping containers because it’s been done keeping the mobility aspect in mind. These pods can be transported anywhere by loading it on a low-bed trailer and it can be shipped to other countries as well.

Can these be used to construct modular hospitals?

Definitely. The pods can be annexed to existing hospital premises depending on the kind of open space they have. This ensures there is no cross contamination in the main hospital building when treating COVID patients. In fact, if the structural design of the hospital is good enough to take another five to six tonnes of load, we can easily place these pods on the hospital terrace (after analysing the building structure).

Another advantage is that the hospital can scale it up from four beds to 100 beds depending on the requirement. It can be done in a small space of 400 square feet to 100,000 square feet. We can also stack it one above the other to make a ground plus one hospital structure. The pods can be built in two weeks and shipped to the hospital/ healthcare service provider. The reusable, easy to maintain structure can be used for 20 years without much hassles.

There is a dearth of healthcare infrastructure facilities in Tier II, III, IV locations and rural India.

This concept can make a huge difference across such locations. This set up is also very appropriate for companies looking to set up or upgrade healthcare facilities at their manufacturing units located in the interiors or for that matter undertake healthcare related corporate social responsibility (CSR) activities in these areas. Overall, I think pod hospitals have great potential to significantly enhance the quality of healthcare infrastructure and delivery in India and across emerging markets.

Will these help in bringing down the cost of COVID-19 or healthcare treatments in general that’s going through the roof?

I cannot really comment on that because pricing the healthcare delivery will be decided by the healthcare service provider. As for the costing of our pods is concerned, we haven’t yet arrived at the final pricing either since final testing of the prototype is still underway. Besides, I am also working on various permutations and combinations of this pod hospital concept so that it can be made available across price points depending on the hospital’s requirement. The IoT and AI features will be offered on a subscription basis allowing hospitals to switch on/off depending on the requirement. All I can say is that pod hospitals are way too economical as compared to the conventional structure. And the best part is that it comes as a fully furnished unit.

How much have you invested in this concept so far? How are you funding this development?

It’s been done through internal sources so far. We will be looking at external funding in terms of bringing in a financial partner or even a strategic investor. We haven’t yet decided on the quantum of funding to be raised as all the focus currently is on getting the pod hospitals up and running.

Will you be looking at a leasing model for the pod hospital infrastructure?

Yes. A lot of hospitals may not have financial resources to acquire it upfront. In such cases leasing the pod hospitals for a certain number of years or maybe even renting it for a predefined period makes more sense. The lease model can certainly be explored on a case to case basis.

(The writer is a Mumbai-based independent business journalist and has extensively covered diversified consumer businesses over the last two decades. He can be reached at hello@ashishktiwari.com)