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Published on: Jan. 25, 2021, 12:13 a.m.
The broad canvas of start-up activity

By Sumit Ghoshal. Contributing Editor, Business India

Over the past couple of decades, the business of looking after people’s health and well-being has transformed from the medical profession, comprising doctors, nurses, medicines and hospitals, to the healthcare industry that encompasses many other professions as well. There were accountants and management professionals; marketing people, who analysed patients’ choices and behaviour; bio-medical engineers to look after the machines and information technology experts, who set up the linkages between various functions of a modern hospital.

Now, during the past few years, this spectrum of service offerings has widened even more, with a range of start-ups that focus sharply on one or other aspect of the healthcare industry. Thus, there is one that offers to set up video consultations with various medical specialists at any time of day or night while another conducts laboratory tests for customers who are unable to visit a laboratory. Another has established a giant ‘physician engagement programme’ through which pharmaceutical companies can run their promotional campaigns amidst a Covid-inspired lockdown covering the entire nation.

Earlier this month, the Central government announced a Start-Up Seed Fund of Rs1,000 crore to encourage hundreds of new companies to take birth and grow. This is only a small part of the total financial support that the government provides to the Start-Up ecosystem. Speaking at the Prarambh International Start-Up Summit, Prime Minister Narendra Modi also said a weekly Start-Up championship would be held soon; it would be telecast on Doordarshan for 12 consecutive Sunday evenings. This programme is not limited to healthcare but intended for a much broader ambit of business ideas.

More sharply focussed on health are the Marico Innovation Foundation Awards announced in October 2020. Among its Rising Stars category, the award winners include: Agatsa Software, and Innaumation Medical Devices. Agatsa Software, a Noida-based start-up founded in 2014, has come out with a hand-held ECG (electro-cardiogram) recorder that dispenses with the cumbersome requirement of attaching leads and wires to the subject’s chest. Through a mobile app that works both on IOS and Android platforms, it also provides a quick interpretation of the ECG, which can then sift out the genuine heart problems from the false alarms. In a country, where non-communicable diseases, such as blood pressure and heart disease, are rampant and growing by leaps and bounds, such a device can prove invaluable. The company’s founders, Rahul and Neha Rastogi, both of whom are engineers from Aligarh Muslim University, used their experience in working for leading electronics companies Samsung, Hewitt and LG while setting up their own venture.

With a $1 million funding from Indian Angel Network (IAN) and Technology Development Board (TDB) of the government, which they received in September 2019, the company has scaled up its operations. It is also planning to diversify into health-related wearable devices which measure the stress level of the subject and offer bits of suitable advice.

Cancer specialists know that nearly a third of Indian patients develop cancer of the mouth and throat, the treatment for which often involves removal of the larynx or voice box. The obvious consequence is loss of the ability to speak, which is devastating for most people everywhere. What is more, most such patients are from the weaker socio-economic section, who cannot afford the imported voice-box devices costing Rs25,000-35,000 each. “The core technologies we work on include speech and communication devices, computational biology and imaging devices,” says a statement on the company website.

Useful innovations

Help now comes in the form of AUM, an artificial speaking device, developed by a partnership of Dr Vishal Rao, a cancer surgeon and Shashank Mahesh, an industrialist. Together, they founded Innaumation Medical Devices, based in Bengaluru in 2017. The venture has received support from BIRAC (Biotechnology Industry Research Assistance Council) of the central government. It is also one of the winners of the National Start-up Awards 2020 instituted by the government. Earlier, it received Rs50 lakh grant from BIRAC. Curiously, the company website now has no mention of Vishal Rao. But Vishwas Uchila Shishir is listed as Director Operations, apart from Shashank Mahesh as director and co-founder. Two others mentioned as CEO and COO are Madhukar and Asif. 

In addition to these awards, the Marico Innovation Foundation has also provided financial grants totaling Rs1.37 crore to three start-up companies – Crea Worldwide, Log 9 Materials Scientific and Saral Design Solutions. These companies have come out with interesting and useful innovations to deal with the Covid-19 pandemic in India. 

Thus Crea Worldwide has cemented its place in the Covid-19 scenario with a breathable PPE (personal protective equipment) kit that enables the user to keep it on for as long as 12 hours at a stretch. Since it allows air to enter the kit, the problem of perspiration within the kit in the sweltering heat of summer was easily solved. CREA’s DRDO-approved coveralls bring relief to doctors and frontline workers connected to Covid-19 and increase longevity, thereby reducing the massive waste generated in fighting the pandemic. 

Log 9 Materials on the other hand has come out with a unique multi-focal UV disinfection chamber (called CoronaOven) that can sanitize any surface of all pathogens in only 10 minutes. This permits hospitals to re-use masks, gloves and other types of PPE, bringing about a massive reduction in expenditure and wastage. Each microwave-sized compact chamber (33-litre) can disinfect 40 masks per hour, thus holding the potential to not only largely reduce the current high pressure on PPE supply. Apart from hospitals that have to disinfect the PPE, the Log 9 device can also be used to sanitise departmental stores, households, and even production units that manufacture milk and food packets, watches, spectacles, carry bags and many other items.

The third company to receive a Marico Foundation grant is Saral Design Solutions whose specialty is the capacity high quality 3-ply surgical masks at a tremendous pace – 80 masks per minute! Its cost of production is also much lower than others in the market. Hence, there is a huge demand for their product, which has prompted the management to set up factories in 20 Tiers II and III towns. This has a huge potential to generate employment as well.

Service at doorstep

Over and above these award winners, the healthcare scenario in India is teeming with a large number of small companies focussing on one or other aspect of this vast industry. While most diagnostic laboratories across the country, where pathology tests are conducted, expect their patients to walk in, DoctorC provides this service at the doorstep of the patient. In the Covid-19 lockdown scenario, this has proved invaluable. In the first five months of the Covid-19 pandemic, the Hyderabad-based start-up has served 50,000 families in 10 cities through its network of government certified and accredited laboratories. The aggregation of patient volumes enables DoctorC to offer its services at an affordable price.

“Covid-19 has made consumers more aware of their health than ever before,” explains Neehar Cherabuddi, co-founder & CEO of the six-year-old company. “With the increased adoption of tele-health and at-home testing, customers are able to access high-quality healthcare more easily than ever before.”

Another interesting experiment, perhaps not as unique as the others, is that of Meddo, which is a digital platform connecting physicians, pathology laboratories and other services. Their primary offering is a one-stop shop where a patient can get every kind of service that is needed. Thus, a customer can have a consultation with a physician of whatever specialty that is required, then book a laboratory examination (like a blood test for example) or have an x-ray taken.

Among the value additions that Meddo offers its partners is an upgrade from physician clinics to full-service health centres. “Yet, we do not own any of the health facilities ourselves,” says Dr Naveen Nishchal, one of the co-founders of the company. “We empanel them and work with them to enhance their services.” Saurabh Kochar, the other co-founder points out that the Indian healthcare system is designed to push a patient towards the hospital. In his view, this happens because ‘ambulatory care’ which a prospective patient can obtain by walking into a physician’s office is often incomplete and inadequate. The only place where he can get everything under one roof is a big hospital! Meddo aims to change this way of doing things.  

Perhaps the youngest of all at this point of time is TREAD, a company that offers group workout sessions which can be live-streamed through both its website and the mobile app. The start-up, slightly over six months old, having been established in July 2020, offers a range of fitness regimes including yoga, cardio, muscle strengthening and conditioning workouts. These are conducted under supervision of some of the leading fitness trainers and experts from all over the country. 

“In this post-Covid world, people are cautious about social distancing and hesitant to head back to the gyms and fitness centres,” argues Dinesh Godara, founder & CEO, TREAD. “Workout from home has become a new normal in fitness around the world. TREAD is squarely positioned around this need.”

While almost all the healthcare-focussed start-ups are designed for patient services or to enable practicing doctors to do their job in a better way, there is one exception. Doceree, which describes itself as the world’s largest physician engagement programme, has a totally different objective. Every pharmaceutical company in the world depends on doctors’ prescriptions to drive its business. While this had become extremely crowded and often ineffective even before the Covid-19 pandemic, the lockdowns imposed because of the disease have made such interactions completely impossible!

Hence, a group of eminent healthcare marketing professionals got together to solve the problem. Sometime in late 2019, they conceived the idea of a digital platform to seamlessly connect over one million physicians all across the world. Over 300,000 of these are based in India. Doceree used its proprietary Artificial Intelligence engine to understand the behavior of doctors and enable the pharma brands to serve their interests better. Dr Harshit Jain, founder, Doceree, is a unique blend of a medical degree with extensive training and experience in healthcare advertising and marketing with several awards to his credit.

Impacting lives

A problem that often limits people’s behaviour in seeking healthcare is that of funds – the money required is simply not there. This prompted Piyush Jain, a former investment banker, to set up Impact Guru, which he describes as a crowd-funding platform. “Every minute 100 people get hospitalised in India and 30 health insurance claims are filed, while 70 per cent of India’s middle class do not have any health insurance. And those who do are typically underinsured as average cover in India is just Rs5 lakh,” says Jain.

As a consequence, many families often have to pay 60 per cent of their hospitalisation expenses from their own resources; this is three times the global average!  The demand for healthcare financing of critical illnesses is therefore a huge market opportunity with crowd-funding being the only feasible solution. It also allows people to raise money quickly with minimum hassles and hardly any burden of repaying loans. 

In its six years of existence (it was founded in January 2015), Impact Guru has mobilised more than Rs1,500 crore through its own platform and with the help of global partners. This works out to about two donations every five minutes on a global scale. On its registers, it has over one million donors, based in 165 countries. 

With this broad canvas of activity in the start-up community, many of the problems affecting Indian healthcare such as access to services, cost of hospitalisation and even ambulatory care could soon become a thing of the past. Some of these would grow into unicorns that command billion dollar valuations, while a few might develop into giant corporations serving millions of people across the world. Some might also fail or become transformed into completely different entities, for such is the nature of the start-up universe. But one thing is for sure – the more start-ups sprout in the country, the greater is the opportunity for new ideas to bloom.

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