Technology, Entrepreneurship & HealthCare IT Evangelist
I am trying to compile a list of HealthCare Startup’s in India, mostly Technology startup’s focusing on building products/services for India and Emerging Markets like India.
Here is a list which I could put together. Please share with me if I have missed any names:
In his book Free, Chris Anderson begins saying that he is using a web book (costing at least 60% cheaper than a traditional laptop), storing his writings on Google servers (which is free), sitting in a Starbucks using their free wi-fi and not to undermine the air conditioning and luxurious sofa, where his only expense is the coffee. But, the book still costs us $20. Why?
When we have so many new ways of working smart, how many do we actually use? There are million publications on the best apps and software to use and there are user ratings which are public and help you decide what to use.
This is an account of my personal exploration of using technology to work smart.
Notes
Try Evernote, a simple yet powerful tool where you can store almost everything and related to your notes, including Hand written notes, attachments and files.
Why? Because you never know when you get the best idea or a plan to work on. Keeping your thoughts synchronised plays a vital role in us becoming smarter.
Presentations
Presentations are the reflections of our creativity. We try to get creative with the available tools. What if there is something which will help us be more creative? Prezi is the answer. If you have seen a Prezi presentation earlier, you have got it. It is such an amazing and simple tool which can help us get more creative. Conveying our idea on a illustration would reach people 80% faster (my estimate and experience) than bulleted points.
Prezi is for Presentation, what Xerox is for Photo Copy.
Documents
Ever wondered what makes the 9 wonders of the world really a wonder? Because they are a treat to the eyes. When you see a Taj Mahal, your mind is thinking of what would have the architect been thinking when he designed it.
The same applies to your writing. When you hand over a document to someone, the writing should immediately take the reader into a different world (let it be a sales projection or Balance Sheet).
Your creativity in writing is 80%, but the tools you use will add the remaining 20%. Even though Keynote quite does not do as much as Word, the simplicity by which you can create your documents is what keeps me with Keynote. The font typeface’s make huge difference and help you engrave beauty into your writing.
Disclaimer: I do not get paid from anyone for this article. After exploring quite a few tools, I have stuck to the above list.
As 2014 Dawn’s, it is quite natural for us to ponder on what are the trends coming up.
Here are the Top 5 trends in Technology which I accrued.
5. Mobile
Mobile is one device which is more personal than anything for each one of us. It would be interesting to watch out for the emerging trends in the space, however, as various other technologies become part of our lives, we need to see what other innovations on mobile would change the way we use it.
4. Bid Data
In the last 20 years of technological evolutions, as more and more people started accepting one or the other form of technology into their lives, we have data. Enough data to spot the minuscule aspects of our lives. As more and more data is shared between various stakeholders, Big Data plays a very crucial role in defining our lives of the future.
3. TV
When was the last time you frantically switched channels on the TV trying to find something what you “wished” to watch rather than just watching what you are shown? Am sure it is not long ago. TV is the next big technology influence in our lives. TV is becoming personal like the mobile devices. Private telecasts, Personal channels streaming “passion” programs are beginning to evolve. In the near future, you will be able to create your own channel and air your own programs.
2. Startup’s, Startup’s and more Startup’s
Small Businesses or Startup’s as they are more savvily called, are the backbone of the growing/emerging economies. The rate at which these small enterprises contribute to the economy is changing every day. According to an advertisement by IBM, small businesses account to 99% of all the enterprises and two-thirds of employment.
1. Social Media
Building your brand (personal/business) is going to be very big in 2014. We have been seeing this trend picking up on Facebook in the later part of 2013 and you will see this gaining momentum in 2014.
My sources of information include Bloomberg, Forges, HBR Blogs, Newspapers and various readings on the Net.
Today, for the first time, had an opportunity to see the KC Chief’s in action live at an almost packed stadium playing the Indianapolis Colts. It was electrifying. The open stadium is filled with Red (the official colour of KC Chiefs) beating odds of a mild snowfall too. I loved the passion in each of the supporters. I cannot really compare to the crowds of a Cricket Match in India, but still, the passion was electrifying and i was so very impressed. I did learn few things from today’s game.
KC Chief’s has had a very good track this season, winning 11 Games out of the 16 games they played. The KC Arrowhead Stadium recorded to be the loudest stadium in the world on 13 October 2013 recording a sound level of 137.5 dB and I was looking to hear it. Unfortunately, the Chief’s did not fare well today and hence it was not that loud.
Now, what did I learn by being there?
The Passion
We see passion every day in many ways, but the way each of the audience were passionate about their game was electrifying. For all the 60 minutes, each one was so engrossed in the game that they did not even bother the chilly weather around them.
Learning – No matter what the situation is, be passionate of what you do. Results will definitely follow.
Pre-Game
When my friend Jeff, who was kind enough to invite me told me that he would pick me at 8:30 AM in the morning, I thought the game begins earlier only to understand they they get together, set up tent’s, cook, have a beer and then head to the game which starts at noon. It has been snowing for the last 24 hours (mild showers though), but even then, I saw families (adults and kids) by the time we reached there around 9 AM who have set up tents, heaters and grills to cook and have fun. Trust me, I would have given it a pass, but thanks to the opportunity, I wanted to see it. I heard these stories earlier, but experiencing in person is so different.
Learning – When you have a passion, you beat the odds. Have passion in you always so that it takes you places and gives you the confidence that you can do what other’s can’t. When I reached there and saw the parking lot, all my laziness was gone and I was part of the crowd.
Beating the odds
I said it earlier, the whole aspect of living is to beat the odds. Defying the weather, taking time out on a Sunday to be at the Stadium to cheer their home team was so awesome. I knew America took pride in their game’s and teams, but this is completely different for me.
Persistence
In the first Quarter, Chief’s made 7 and as usual, the energy was filled in the whole stadium. However, they could not get pass that mark in remaining quarters. No one in the crowd even thought of leaving till the last minute of the game just waiting to watch if things could turn around.
Learning – This is persistence for me. Wait till the end to ensure you support your passion and don’t bother of the result.
When the World is against you
I put myself in the opponent’s place for a moment. The stadium is packed with Red Colour, it is not their home ground, the first Quarter was bad with no point on the scoreboard. Technically, I could not hear any one voice supporting them, however, they played their best and went on to take over the game.
Learning – When you are following your passion to win, the whole world is not with you. Even then, standing there believing in yourself takes you places.
KC Chief’s play the Chargers on the 29 December in San Diego. I wish nothing but the best for them. KC Chief’s have not won a Super Bowl since 1969 and I really hope and wish this Christmas, they realise the dream and go on to with the World Championship title.
Go Chief’s….
No matter what music does – Motivation / Relaxation / Rejuvenation, it is all in the way you listen to it. Musicians take their lives out to create the best they can to ensure we live our dreams.
The key component of music is the notes, the notes which create the vibrations required to touch your senses and instigate you with the best of your thoughts.
Music does the same to me. Makes me romantic / inspires me and helps stimulate the best of the vibrations in me. I am sure it is the same for most of us.
When i chose to buy my home music player, I chose the speakers which gave the best sound out-put, which means all components of the music should be given equal importance and all notes are to be played they way they were recorded. The amplifier is the key, but what if the amp does its best and speakers don’t deliver as expected? 
I decided to upgrade and buy a Bluetooth Speaker to get more out of my music. There are good number of options available today, however, as we all have our economical and environmental influences, we tend to reduce or settle for something less just to keep our hearts content.
Considering the ease to carry, size and cost, I shortlisted the Logitech UE Mini Boom and the Bose SoundLink Mini.
The Logitech UE Mini Boom is a very handy, portable and light speaker which can fit in a corner of your bag and come along without adding a lot of weight. It also has a iOS app which can help you with a little configuration and also if you choose to “double” up the Mini’s, you can use the app to control the output.
The Mini Boom is Lightweight, comes in various colours and has a Battery life is around 8 Hours (in medium volume).
The output of the music is not to its best. It gives priority to the Bass and hence you feel that you are listening to your music having your ear on the wall/table. It gives you that vibrational effect which might kill the essence to the kind of music you are listening.
The Mini Boom costs $99 and you can double it up without much additions to the output. However, when you double up, the distribution between the two is good.
The second option I considered is the Bose SoundLink Mini. The one word I can use to best describe this piece is Value for your Money. It does what it needs to do – deliver the best music quality in its class. It is not too heavy (heavier than UE Mini Boom though), a little bigger in size, but can definitely get into your backpack.
The bass is good and it differentiates the notes without mixing up the tunes. I listen to Rock, Indian Classical and Carnatic music and for these, the note differentiation makes all the impact. The bose delivers good sound output too.
When you add the SoundLink Mini to your iPad and watch a movie, you can definitely have a better output than your TV. I really enjoyed watching an action packed movie with the speaker.
There is an optional Speaker case which you can buy on Amazon which can organize your bag and speaker components.
In summary, considering where the Bluetooth technology today is, Bose has made the best use to give it’s best. Go for it and be Inspired..
When we look at understanding how we can address the major gaps in providing Quality HealthCare, the one point which comes to mind is why we are not utilizing the power of Technology to bridge this gap.
Let me start with a story – Few years ago, I had to take my Dad to a Doctor for cough. We went to a Speciality Hospital near to a home (a Major Brand, do not want to use the name here though). This hospital had two facilities in the City. When we went there, the first thing which happened in the Registration. A Plastic Card (dimensions of a Credit Card) was printed with a picture and basic details – DOB, MRN and Place of Issue were printed.
After the initial check up, the Doctor wanted a test to be done which was not available in this facility and hence we were requested to go to the other one. After going there, I provided the card to bring out the details of the test ordered. The front office person informed me that they do not have connectivity with the other Branch and hence I had to pay the registration fees (Rs.100) and post that, looking at the Hard Copy of the Prescription, entered the details. Then I had to go to another Doctor (since the consolidated list of Doctors in the Hospital is not available and the prescription had to be cross checked) to re-confirm the test and then we proceeded for the test.
This hospital has made major investments in using Technology in their Hospitals. Staff are trained and the charges of this Hospital is also definitely not nominal.
What does this story illustrate? A simple aspect of integrating two facilities has not been taken seriously. Why? Is it because they lack the technological infrastructure? Or, is it because they can make more money (Double registration fees)? Or, is it unwillingness to invest further on the technology required to integrate? There are many questions which arise, however, for me, it is just the fact of lack of “Ownership” from the management side.
In a country like India where the demographics play an important role, there are many multi-national Hospital Chain’s and single facilities which have setup shop across the country over the last decade and continue to do so with huge investments coming up in the next decade.
The Government, with due respects has its own, things to do and hence am not even considering the fact that they should take ownership to force Hospitals to implement any automation to their care facilities.
With the vastness of the Country dynamics and considering the fact that the system works in a silo, is it easy to consider implementing basic EMR across all Hospitals and Clinics across the country? I do not think so.
Even though technology has become affordable, the socio-economic factors like affordability of Care facilities with-in a 10 KM radius across the country makes it difficult to even imagine implementing EMR across the country.
Continued – Part 2
India ranks 112 in the World Health Organisation (WHO) Ranking of The World’s Health Systems. When it comes to per-capita spending on Health Care, India spends a little over 6% of GDP on HealthCare.
These are the common statistics which we see every day. What I wish to share are the other aspects of Indian HealthCare system which provide a strong support.
Imagine this, India is the World’s Second Largest Populated country and it is projected that we will overtake China by 2050 and the reality of data according to WHO is that India has about 0.49 Doctors and 0.80 Beds for every 1,000 Population in the country. When you hear/see these numbers, it does sound alarming! How are we going to put up with the Population Growth, provide basic HealthCare and create an Ecosystem for building robust Health Services across the country?
If the situation is bad when compared to other developed economies, then how is our Average Life Expectancy has been steadily increasing over the years? In 1947, when India got Independent, Life Expectancy was 47 Years and today, after 65 Years of Independence, we are at 65 Years. By 2025, it is projected that Life Expectancy would be 72 Years.
All the Health data which we see is primarily considering the English Medicine System or Allopathy. India and also other countries offer alternatives to the English Medicine. What we will look into here is how the HealthCare is structured and Health Education along with fundamental understanding on how Government spends its 6% on HealthCare along with what reaches the population living Below the Poverty Line (BPL).
HealthCare Systems in India
India has the most number of HealthCare systems when compared to any country in the world. Below are the five most known systems.
Formal Education for Doctors
India offers education in Allopathy, Homeopathy, Ayurveda, Unani and Naturopathy & Herbal Medicine. All education is recognised and Doctors who pass out of colleges are given license to practice any where in the country.
The below graph shows the admission trend to Graduate Allopathic Medicine Course over the last 20 Years. If we carefully observe, there has been a decline in admissions in the last two years when compared to earlier. Interesting.
MBBS Admissions
The Dental Education has quite picked up in the mean time. However, it is a poor state where the enrolments to Post Graduate Programs has been less than 10% of the actual Graduates. There are certain strong reasons as to why this happens and we will look at it later.
BDS/MDS Admissions 1991 – 2011
Now, let us have a look at how the Medical Education System is structured in India.
Medical College Distributions
Allopathy accounts to only 39%, which is around 314 Medical Colleges. in the remaining 71%, Ayurveda has 31% (249 Colleges), Homeopathy has 23% (186 Colleges) and Unani has 39 Colleges, Siddha has 8 Colleges and Naturopathy has 10 Colleges.
In 2007, I posted a list of Incubation Center’s in India. However, in the last 5 Years, things have changed and there more and more center’s being added to the list. Below is an updated list and am sure am missing quite a few. If you know any center I am missing, please feel free to add as a comment and I will update the list.
NS Raghavan Center for Entrepreneurship and Learning (NSRCEL), IIM Bangalore
Technology Business Incubator BITS Pilan
Center for Innovation, Incubation and Entrepreneurship IIM Ahmedabad
Entrepreneurship Cell IIT Kharagpur
Center for Entrepreneurship SP Jain, Mumbai
C-TIDES IIT Chennai
TeNeT IIT Chennai
Society for Innovation & Entrepreneurship IIT Mumbai
Nirma LabsSIDBI Innovation & Entrepreneurship Center IIT Kanpur
Entrepreneurship Development Center IIT Guwahati
Foundation for Technology and Innovation Transfer (FITT) IIT Delhi
Abhiyan IIM Lucknow
E-Cell IIM Kozikode
Center for Innovation & Entrepreneurship IIM Kolkata
Entrepreneurship Development Institute Ahmedabad
ICFAI Center for Entrepreneurship Development Hyderabad
MICA Entrepreneurship Development Center Ahmedabad
Wadhwani Center for Entrepreneurship Development ISB Hyderabad
TIME-IS DST, Government of India
JSS Academy Science & Technology Entrepreneur Park Noida
National Institute of Industrial Engineering Mumbai
Entrepreneurship Center IIT Rorkee
Ekta Incubation Center West Bengal University of Technology
E-Cell NIT Trichy
VIT Technology Incubator Vellore
Technopark Technology Business Incubator (T-TBI) Trivandrum
Center for Bio-Technology Anna University Chennai
National Design Business Incubator Ahmedabad
NIT Calicut
International Crops Research Institute for Semi-Arid Tropics Hyderabad
Kongu Engineering College NEN e-Cell Erode
Advanced Materials Technology Incubator Hyderabad
Center for Entrepreneurship SPJMIR Mumbai
North Eastern Development Finance Corporation Guwahati
NSIC Technical Services CenterBirla Institute of Technology Mesra
NIT Suratkal
STEP, BEC Bagalkot
Maulana Azad NIT Bhopal
Science and Technology Park, University of Pune
Science and Technology Entrepreneurs Park Ludhiana
STEP – Thapar Institute of Engineering & Technology Patiala
STEP – PSG College of Engineering
IncuCapital TechnoPark Trivandrum
ICICI Knowledge Park Incubation Center Hyderabad
Gujarat GrassRoots Innocations Augmentation Network Ahmedabad
CIE IIIT Hyderabad
L-Pad
Over the last few years, have been fortunate enough to be working with the HealthCare sector in India.
In the due course of time, I have been interacting with IT Departments of various Hospitals (Very Large and Large and to some extent at the Primary Health level too). What I have been trying to understand is the key reasons as to why the IT penetration has been at a distant in the Indian Hospitals. There are quite a few valid reasons and I also encountered one other not-too valid reason, but will have to give it a benefit of doubt.
Time factor – One of the key factor why Hospitals see resistance from Doctors to use IT systems is because of the number of clients (patients) they need to see. On an average, a Doctor in any Hospital in India see’s an average of one client every two minutes (the raw data might be even more). In these two minutes, the Doctor has to understand his client problem, establish a connection (Important in the Indian Context), provide guidelines for the analysis and prescribe. The complete process takes definitely more than two minutes, and if the Doctor tries to spend time on the computer taking notes, his/her client might not appreciate it and not return back to them. People in Cities understand the importance of technology, however, in India, as 80% of the population still lives outside Cities, it might not be practical for the Doctor/Hospital to make them understand the same.
Cost – The second most important reason which needs serious consideration. 70% of HealthCare costs are “out of pocket”. Hence, when Hospitals/Doctor’s Clinic implement the use of technology, client tends to understand that cost of treatment is “higher” and hence avoid’s those kind of Hospitals/Doctors.
There is no support for Hospitals/Doctor’s to use Technology from the Government. Hence, the cost has to be shared by the client, which directly impacts their revenue.
Technology Education – There are no initiatives by the Government to spread awareness of the benefits of using Technology to end users. Even though there might not be immediate acceptance for this, on the long run, people would definitely see the benefit.
As an illustration, Government of India spend considerable time and money on the “Eradicate Polio” initiative and this has been a success. Even though initially the message was not taken seriously, now when a child is born even in the remotest place of the Country, parents immediately inquire of the Polio Drops schedule and ensure that their child gets them. The results speak for themselves – Today, India is “Polio Free”.
Variety of HealthCare Practices – India is a very large country and has variety of HealthCare Practices – Homeopathy, Allopathy, Unani etc. People change their practice depending on the kind of ailment. I have also seen and known people who follow a certain practice sticking to the treatment in serious conditions too, but very rare.
This does not have a direct impact on the HealthCare System/Process, however, this plays a vital role when people shift their accustomed practice.
More detailed information on various practices and Infrastructure in my earlier post.
Acceptance by all Stakeholders – Even though every Individual accepts that IT is an integral part of delivering Quality HealthCare, acceptance by all stakeholders also plays a very vital role in rolling out technology solutions.
As an Illustration, Government employees need to submit manual receipts and documentation for their medical reimbursement. Also, many Insurance providers do not completely follow the approval and reimbursement process online.
In summary, a Hospital/Doctor’s office is not encouraged in all aspects to implement Technology. There are many a times when they need manual documentation. To avoid multiple process flows, Hospitals keep their Technology inquisitiveness away.
However, things are changing. With a recent success story of how the Andhra Pradesh Government implemented Aarogyasri, many states have been trying to follow the same.
There are quite a few other concerns and problems for Hospitals to implement IT, however, if we have a humble beginning, success will definitely follow.
I got associated with Startup Weekend recently and have been thoroughly enjoying my association with them. Am working with the team who is bringing the Hyderabad edition and wanted to share all the information regarding the event here.
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Entrepreneurship, technology and innovation have never been as important in our world as they are today. With that, entrepreneurs and innovators across India need all the help they can get through mentors and meeting the right investors.
At Startup Weekend (www.StartupWeekend.org) we bring together aspiring entrepreneurs and provide a platform to give shape to their ideas.
Startup Weekend (www.StartupWeekend.org) is founded by Andrew Hyde in 2007 and funded by Kauffman Foundation. You can read more about us at http://startupweekend.org/about/our-story/
What happens at SW?
More than 100 aspiring minds come together to identify ideas to give shape. All 100 can share their ideas or they can be part of another idea. Ideas are shortlisted, teams are formed and over the next 48 Hours, the idea takes shape. We have Investors, Idea Evaluators, and Mentors available to guide teams through the process. On the last day, ideas are presented and the shortlisted ideas take away cool prizes.
Startup Weekend in India
Startup Weekend came to India in 2011. The first two events were organized in Delhi (March 4-6, 2011, http://delhi.startupweekend.org) and Bangalore (March 11-13, 2011, http://bangalore.startupweekend.org).
During Delhi Startup Weekend, 34 Ideas were Pitched, 10 Teams formed; 8 Partners, 5 Mentors.
During Bangalore Startup Weekend, 67 Ideas were Pitched, 15 Teams formed; 7 Partners, 4 Mentors, 20% of teams won prizes.
Now, we are bringing Startup Weekend to Hyderabad from 2-4 September 2011.
To know more about the event, visit http://bangalore.startupweekend.org. You may also join our announcement only mailing list at https://groups.google.com/forum/?hl=en#!forum/startupweekendind, which will keep you posted on the event and other details.