Start-ups in health care: Challenges
I believe the greatest challenges that innovative start-ups, especially AI power start-ups, are facing right now in the health care domain is that there is still a lack of policies and direction from the government or government bodies around a lot of topics. A lot of healthcare start-ups are working in silos. The doctors are not aware of how the tech works, and the techies are not aware of how the medical domain works, and then the policy makers are sometimes not from a medical background, and they don’t know how to come up with good policies. So policy makers, doctors, engineers and then the insurance companies, those who are the payers, although they are not very prominent players in India, they are playing a role. The payer, the patient, and the provider, which is the doctor and the policymaker, are not in sync in our country, resulting in policy paralysis and a lack of implementation. And that frustrates the start-ups because they build a solution but don’t know where to go with it. I think that is one of the greatest challenges.
Starts-ups in health care: Way forward
I think the way forward is that the government has to come up with implementation policies now. There was a lot of motivation and a lot of young stars jumped into the start-up bandwagon, there was this impulse and that was good, that was needed. But now is the time when we need the policies around implementation. And I think the main solutions would be, number 1, the government needs to incentivise the local bureaucracy to come up with start-ups in their own geographic domain. And that would be a very big trigger for the local level of start-ups. Secondly, I believe the motivation for innovative start ups has to increase. Right now, as I said, we are more focused on tele medicine and software based, rule-based systems. Whereas, the West is focused on AI powered solutions, 3D bio print, genetic engineering and these kind of start ups require a lot of motivation, a lot of research-oriented mind set, a lot of high IQ intelligent, educated people have to start coming to start ups. Professors from educational institutes may have to come into startup and then there has to be a lot of capital infusion for sure because as I said there has to be a lot of experimentation in these. I think policies around implementing start up solutions, making a payment system for start-ups where start-ups feel more secure that government is going to do pilots with them and then definitely capital infusion and research-oriented startup need to have special policies around them. That will definitely help the startup ecosystem in our country. Idea behind ZINI and GRAINPAD
This started way back when I was still doing internship during my medical school days. The trigger had started way back then only. We were posted as interns in different departments. I was working with my professor in paediatric and she was very well renowned doctor in that area. And I would be sitting in her OPD and my job as an intern was just to basically pile up the stack of list so the patient goes to her in the right order. Every day I used to see more than 150 patient and see her within a span of 9 to 3 and these would definitely include children but old ladies bringing their children and patients from all across the state. And I would see that they would come from so far off distances and they would barely get may be 30 sec of her time and they won’t be able to completely explain what is wrong with them. And sometimes the old ladies would forget telling something and then once they go out-side they cannot come back in. And I used to observe this and didn’t feel right to me. And this was the kind of the seed but I didn’t know wat to do, I was not a techie, I wanted to do something but I didn’t know what to do.
When I came to private medical practise I worked in private hospitals, I did my own OPD as well. So, there I observed that coming to the hospital is usually the last resort for the patient, like when nothing else is working and their preference is to go to a local quack, go to a local chemist and save money, save time and who would go to a doctor and spend so much time and money and all that and once they come to the doctor, they are still not sure if they are going to get a satisfactory answer or the satisfactory amount of time. Even as per a WHO study, we on an average give 2 min 20 sec per patient in India. This is the average, so many patients must be getting less than this. This prompted me to basically build some kind of a system where patients from the very beginning get the right advice.
ZINI and history Taking
ZINI is an AI powered history taking pod to be very technical. And what we have built, ZINI is an AI powered conversational agent that is able to automate this process. So far in human history only a qualified doctor could do this. And because he had figured this out, we could guide the patient, you need to go here get the investigation done and come back to me and follow this preliminary treatment path.
ZINI automates this process. We invented a bot that is empowered with data driven learning and a lot of inputs from almost 50 doctors and engineers and this is able to do the whole conversation with the patient, figure out what is probably wrong with the patient in its AI powered mind and guide the patient like what could be the probable diagnosis, how urgent is the situation, which kind of specialist is best suited for them, where is the nearby doctor or hospital they could go to, what kind of investigation may be ordered, and a lot of educational content to read. So, this is not a replacement for a doctor but this is an intelligent engine that can become the first point of contact and guide for the common man plus this has also found applications in B2B domain where hospitals and tele medicine companies are using this on their platforms to collect initial information about the patient. Insurance companies are using it to basically automate the underwriting process. So, a lot of application has come up from the original idea of ZINI.
ZINI clinic and future plans
So, in future, we are quite motivated and excited about the new concept that we have brought, it’s called the ZINI clinic. Recently we were awarded the 5th Parivartan grand by HDFC bank to support this initiative. So, it’s a clinic that that has an AI powered Bot to take patient history, there is a nurse to take care of patients vital monitoring and the AI system generally make a preliminary report which is shared with the remotely sitting doctor who then again talk, video talk to the patient and then send a signed prescription. So, this model is basically not totally dependent upon the human doc being available 24X7 but at the same time has some bridging component to give basis guidance plus connecting with the doctor. This is a new initiative we are experimenting with and seeing a very good positive response. We are working with the insurance companies and tele medicine companies, as I said that, they are finding applications using ZINI to collects basic patients’ information and then using that data for all sorts of benefits to the patients as well as their organisation. And we are looking forward to publishing our research, we are doing a lot of research with our findings so far in last 3-4 years. We want to work on publishing that research.
Future of health care
In general, I see the future of healthcare to be very revolutionary in coming days as ZINI itself is automating the conversation part of it when the doctor does the preliminary figuring out of the symptom. There is an Israeli startup that 3D printed a whole rabbit heart. So, you can print human organs and that would be I don’t know where aging would go from there. Elon Mask created a robot that could perform brain surgery on a pig completely without human intervention. So, from initial evaluation of symptoms to examination to investigations to even printing human organs I see a lot of revolution happening. I would want to see a lot of that happening in India as well but lets see what we get from here. Overall healthcare sector has a lot to offer in the next 10 to 20 years.