Sustainable preventive-care for Diabetes for bottom of the pyramid

The Context
Healthcare in India
And
beyond
1

c: Rtn. Srihari Boregowda, CONFIDENTIAL +91 98441 19490

25/04/13

On a
Saturday
Morning
at a
Rotary
convention

Why?
2


25/04/13

The Problem: Tsunami of Non Communicable Diseases (NCD)
Diabetes, Cardiovascular, Hypertension, Cancer, Pulmonary
180 million at Risk from NCDs,
55% of deaths are due to NCDs and
can be prevented or at fraction of cost

India

Diabetes affecting young population, (40s) can be a
nullify the “demographic dividend of India”
4

. ©Srihari Boregowda +91 98441 19490

CONFIDENTIAL

Diabetes leads to other NCDs

> Half of the
population
is undiagnosed
> 20% of 30+
are at pre diabetes

Impact of Diabetes is 3
times more on BoP,
leading to economic Ruin
of the entire family
V8:04-Aug-13

Why Diabetes to begin with?: Silent Destroyer, leader of NCDs
Diabetes :
1.Holistically
Addressing Diabetes,
you are addressing all
the triggers for other
NonCommunicableDiseases, like
Hypertension, Cardiac,
Kidney etc.,
2. General awareness of
the “Sweet Disease”
Madhu Meha is high
even among rural folks
5


CONFIDENTIAL

V8:04-Aug-13

Acceleration due to Causes(Lifestyle)

6


25/04/13

NCDs are easily preventable by Lifestyle modification
Chronic Stages

Stage#1

Stage#2

Stage#3

Stage#4

ß cell mass

IBSAPG

Evidence of Insulites

(IVGTT)

Glucose Intolerance,

Environmental
l Modifiersà

Auto antibodis to
Insulin IA-2

47%

Financial Model
of Diabetes as a
Preventable
disease
7

Loss of first phase
Insulin Response (IV Glucose)

Addressed by
Preventive care

Genetic
Predisposition
Of population

7%

Beta cell
Pathology

PreDiabetes

Healthcare Cost V/s Age-,Risk factors in population
35%
22%
18%
10%

Healthy-Risk

Clinical Model of
Diabetes as a
Preventable
disease

At-Risk

Chronic

Loss of Glucose
Tolerance (Oral Glucose)

Diabetes
48%
17%

Acute

Years

Health Expenses

Beta cell Function

100%

Proposal for Year 2013-2014
Presentation for Rotarians
8


Srihari_b@yahoo.com

25/04/13

Target segment : BoP under S-E-G
Just economic criteria (e.g. earning $4 -$8/ day)alone will not suffice to fit the product into the space. The
suitable criteria for selecting India target segment are Socio Economic classification and further tune with
Geographic i.e. Towns that have population between 1 and 5 hundred thousand, having > 100 villages in Cluster

Economic

Socio-Economic

Geographic
City

Population

Tier-1
Tier-2
Tier-3
Tier-4
Tier-5
Tier-6

< 500,00

Tier-7

>100,000

Annual Household Income in 000s

9

. ©Srihari Boregowda

CONFIDENTIAL

25/04/13

6-Step Process: Value focused delivery across the care cycle
Critical Success Factor: Financial efficiency / throughput, keeping value high
Value=

Value&'&Strategy&Map&

ΣHealth Outcomes
Cost of delivery

Traveling ASHA worker
Care at Doorstep, Relation build
Culture sensitivity, Awareness creation
Mobile Health enabled, Empowerment
Protocol based seeding for max coverage

10"
9"
8"
7"
6"
5"
4"
3"
2"
1"
0"

9"

10

9"

9"

Integrated PHC
TRAYEE"

NRHMENCD"

9"
8"

7"

High throughput
5" 5"

5"

4"

Outcome Tracked
Postponement
Quality of life

3"
2"
Reachout"

1
Integrated PHC
Lowest cost of screening
All data in digital form
Evidence based, Customer Affinity

Camps"

2" 2"
Screening"

2

Scientific, Measurable
Back-office connect EMR
Expertise access , multi domain
Risk (Prediction) quantification
Evidence based


Prognosis"

3

1" 1"

Advice"

4

0" 0"

Management"

Preven@on"

5

Holistic, Integrated
AYUSH and integrative medicine
Patient centric,
Wellbeing: Physical, emotional, Social & Spiritual

CONFIDENTIAL

6

Care Pathways
Behavior Modification
SMS Alerts, Coaching
Community creation

V8:04-Aug-13

Affordability and Access Driven by Technology
Value&'&Strategy&Map&

Reachout"

Sensor as
Service
Anywhere,
Anytime
Access

Screening"

SENSOR NETWORK

Advice"

1" 1"

Management"

MOBILE HEALTH


BIG DATA / ANALYTICS
CONFIDENTIAL

N
I
A
M

5"

0" 0"
Preven@on"
Behavior
Modification
& Reachout

Cloud Infrastructure: Device, Protocol, Telemedicine, Delivery, EMR/PHR

D4D:Data for
Development

11

Prognosis"

2" 2"

8"

O

3"

Outcome

D

2"

4"

5" 5"

9"

Disease Surveillance,
Predictive Care

V8:04-Aug-13

Te c h n o l o g y

7"

9"

Advice

9"

Prognosis

Reachout

9"

Screening

10"
9"
8"
7"
6"
5"
4"
3"
2"
1"
0"

Management

M o d u l a r I m p l e m e n t a t i o n : Camps" r tNRHMENCD" n yTRAYEE" t i c a l
Sta
with a
ver

1-Reach out:
Protocol driven, Risk stratification at Family level
In the first 2 months, Artoo helped ICTPH:

Artoo brings to life technical expertise, coupled with
the ability to collaboratively adapt, be it healthcare,
education or financial inclusion. Their entrepreneurial spirit
and close attention to every engagement makes it an
even more fulfilling experience.

Coverage of Chronic NCDS
1.  Diabetes,
2.  Cardio Vascular, 3. Hypertension, 4.Acute Lower Respiratory Illness
12


CONFIDENTIAL

V8:04-Aug-13

1Reachout: ICT enabling mobile Health workers

13

Src: Artoo
CONFIDENTIAL

25/04/13

14


25/04/13

Step-2 Screening: Integrated PHC for Diabetes:
Diabetes has multiple problem attributes: It is primarily Endocrinology but, it is also renal
problem, It is also vascular problem, Retinal problem and so on. Need to Integrate care delivery around
patient and not federated around clinical specialty
Integrating 3 Components
Measurement,
Diagnosis,
Forecastà

Decision Points

Platform assisted

Medical

/
Surgical

Specialists

Medical

Generalists

Paramedics

Patient

“At home /PHC”
healthcare

“CCC”
Telemedicine

“Secondary /Tertiary”
healthcare

Common Healthcare Platform

Multi-‐loop

Value
Creation

ß
Therapy,
feedback,
Prescription

15


CONFIDENTIAL

#1
Knowledge
component

#2
Technology
Component

#3
Operational
Component

Care Protocol
Disease
Management
Integrated
Medicine
Nutrition
Partnerships

EHR/PHR/
DHIS
Sensor Kits
Telemedicine
NW
BigData, analytics
Mobile Apps

Model Clinic: Low cost
medecine, Telemedecine
center, Screening Center,
Microlab
Local Resources:
Councellors, ASHAS,
Hygenists, Nutritionist,
Local Doctor

V8:04-Aug-13

2-Screening: Coverage across the Disease manifestation
Sample Process: Src: Karnataka Institute of Diabetology
Conducted by
Trained
Paramedics:
Opportunity for
Rural
employment

Test
Glucose

40 Paisa

Lipid Profile

15 Rs.

Kidney function test

16

Cost

12 Rs.


CONFIDENTIAL

25/04/13

PHAR

MACY

REGISTRATION

Wai:ng
/
Interac:on

Area

..

1.6m
x
1.5m

(Op:onal)

Storage

UPS

17

1

Educa:on
Posters

Low
cost
medicine

leverageGenerics

Re:nopathy

Neuropathy

Vasculopathy

Spectacles

Educa:on
Posters
/
LCD
panels

Educa:on
Posters

5

Educa:on
Posters

Step-2 Screening: Integrated PHC for Diabetes: Model Layout
Teleconsult

With
specialty
care

•  Diet

•  AYUSH

•  Physical
Ac:vity

6

3

One2One

counseling

2


4

Lab
+

Inves:ga:on

2.5
x
1.5m

CONFIDENTIAL

Creating Consumer
Experience:
India has moved on from
traditional to Modern retail
format.

Ini:al
consult

3.0m
x3.0m

The PHC is integrated to
screen, refer and manage and
deliver under one roof as a
Convenient Daycare
clinic to give differentiated
consumer experience
V8:04-Aug-13

3-Prognosis: Tele Expert advice, EMR,
Sensor data,
Questionnaire

Screening

Hosted
Archived data

Prognosis
EMR, Care
Pathway

Video / Audio
conference

Expert-in
loop

i2i telesolutions

18


CONFIDENTIAL

V8:04-Aug-13

Step-4 Advice
Advice is generated from Expert’s inputs and care pathways. It is generated to be Patient centric based on Sex, Age, Culture, lifestyle, economic status.
It is calendar of action in the daily life of the patient. The orientation is not absence of Disease but overall wellbeing

Value 4.1: Diet Advice: Fit to Local, enjoyable, Cuisine

Value 4.2: 1 to 1 counseling, Eliminate chronic stress

TOMATO DOSAFor 1 serving (3 Dosas):
Calories

319 kCal

Carbohydrate

55.3 gm

Protein

10.5 gm

Fat

6.8gm

Value 4.3: Exercise to fit daily routine, monitored

Value 4.4: Medication using Generics reduce cost:1/3rd
to 1/10th

Sample
Exercise
Plan:

Schedule # Branded
Rate
15151
3 X
₹&&&&&
0.55
05051
1 Y
₹&&18.00
05051
1 Z
₹&&&&&
4.50
Total;cost;per;day

Price
Locost
₹&&&&&&&&&&1.65 Metformin
₹&&&&&&&&
18.00 Atorrastitin
₹&&&&&&&&&&4.50 Atemol
₹;;;;;;;;
24.15

Cost;Per;Month55> ₹&&724.50

19


CONFIDENTIAL

Rate
₹&&0.39
₹&&2.20
₹&&0.28

5&times&Saving&@@>

V8:04-Aug-13

Price
₹&&&&&&&&&&1.17
₹&&&&&&&&&&2.20
₹&&&&&&&&&&0.28
₹;;;;;;;;;;3.65

₹&&109.50

Wellbeing = Health

W.H.O. Definition
Of Health

Step-5 Wellness Management
(Spiritual)
Emotional
Mental
Physical

Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.
Wellness is an active process of becoming aware of and
making choices toward a more successful existence

Treatment
Compliance

Green

New/Un-‐Familiar

Dot

Is
done
one

time

Span

Has
duration

such
as
40

days

Path

Is
a

permanent

change

20

Install
Solar

Panels in
house
GREEN
DOT

Car pool
to
work

for
3
weeks

Blue

Old/
Familiar
Tell
a
Friend

about
eco

friendly

Purple
Increase

Plant
more
trees

and
local
plants

MOBILE

BLUE
DOT

Bike
to
work
for

a
month

GREEN
SPAN

BLUE
SPAN

Start
growing

own
vegetables

Turn
off
lights

while
leaving

room

GREEN
PATH

BLUE
PATH

PURPLE
DOT

GRAY
DOT

Take
public
bus

for
one
month

Take
shorter

showers
this

week

PURPLE
SPAN

Purchase
more
local
produce

Behaviour

PURPLE

ModificationPATH


Gray

Decrease
Buy
fewer

bottled
water

GRAY
SPAN

Eat
less
meat
from
now
on
GRAY
PATH

Black
Stop

Turn
off
space

heater
for
one

night
PURPLE
DOT

Don’t
water

lawn
during

summer
PURPLE
SPAN

Never
litter

again
PURPLE
PATH

CONFIDENTIAL

Value 5.1: Addressing through Holistic and
integrative (Alternative) medicine
Value 5.2:Treatment Compliance and wellness
management through behavior modification
V8:04-Aug-13

Implementation Model
Financial and Business related
Note: These are budgetary figures, Actual Numbers may vary while implementation

21

. ©Srihari Boregowda, CONFIDENTIAL +91 98441 19490

25/04/13

Even Philanthropy has changed

Service above self:

I sought my soul, my soul I could not see
I sought my god, my god eluded me
I sought my brother, I found all three
22


100% Result Driven Service
25/04/13

We need inclusive Revenue Models to Sustain

23

• 
• 
• 

Membership Model (Subscription)
Annual enrollment =X
Monthly subscription = Y

Base consultation charges=x
Lab and diagnostic charges =y
Generic Drugs = z

Total fees F= x+y+z
PPV+ Co-pay model
Visit Charges
• 
• 
• 
• 

Base consultation charges=x
Lab and diagnostic charges =y
Generic Drugs = z
P=part or whole is reimbursed by a
sponsor/NGO / Govt.
Total fees F = x+y+z-P


CONFIDENTIAL

Pre-Paid Based

Post-Pay Based

“Pay-per visit: PPV
User fee based model

•  Unlimited teleconsult
•  N #, Free visit, Tests, consult
•  Generic Drug, supplement
Total fee F = X + (12 x Y)

Micro Insurance for Health

•  Annual Insurance=X’ à to Micro Insurance
•  Society= Y’ à Co-op / SHG
•  Co Pay = Z
Micro Insurance pays part for Outpatient and
takes care of catastrophic care as well
Total fee = Formulated {x,y,z}

V8:04-Aug-13

Revenue / working Model
—  Procure Model
—  Cap-ex led

fixed cost of 1,200,000 (12L) one time procurement and
operational costs of Rs 75,000 per month

—  Operate Model
—  Op-ex led Fixed cost of for 2 pilots totally subsidized by Sponsors and new

ones will be charged 1,200,000 (12L) per center, operational costs recovered by
charging patients and /or re imbursement from Govt. at Rs 250/ - per patient
—  Build-Own-Operate model
—  Hybrid capex of 600,000– 50 % upfront paid by Sponsor, remaining 600,000

of Capex and op-ex recovered by charging patient or Govt. re imbursement of
Rs 500/- per patient till recovery period
24


CONFIDENTIAL

V8:04-Aug-13

Screening Workflow Model and costs
ASHA workers go house to house

1. 
1. 

1. 
2. 
3. 
4. 

1. 

5. 

25

Blood Glucose, Lipid profile, HB, BMD and BP - Rs 50/Those found Diabetic go through target organ tests - Rs 250/If CKD +ve then go for CKD staging test - Rs 75/- (optional)
Those who are hypertensive detailed ECG – Rs 100/- (optional)

PHC Counseling

3. 
4. 

Counseling done, data collected using tablet, high risk population identified and eHealth
Record created - Free

PHC Screening

2. 

One PHCenter for
40,000 Population

Screenings Per Hour
Screenings per month
Screening Revenue per month
Nott Expenses
Retaining per month
Breakeven..
(Subscription amount accelerates)

6
960
240,000
140,000
100,000
9 to 12
months

Counseling by dietician is free

All electronic records are maintained in the cloud and UID/ MRN number assigned for
each patient for follow up and staging information.
Disease management for Diabetes and Hypertension done by providing training material,
timely SMS, telephonic calls with the councilor/ doctor in case of emergency regulated by
councilor and periodic screening.

CONFIDENTIAL

V8:04-Aug-13

Risk Level

Achieving Sustainability: Timeline for One center
Inclusive Revenue model,
builds up sustainability
Infrastructure
setup

3M

Startup
Operation

Village Entrepreneur
Management
Transition

Plant & Machinery
capital

Rs.1,200,000

18Months

Market
Risk

Operational Risk
Operational
Capital
Rs. 500,000

Rs. 75,000 x 6 months

Spin-off one more Project
With retained earnings

Fully Sustainable
operation

9Months

6Months

Investment Risk

Capex

Project Cost
19 Lakhs

30 Months

Results


BoP learns value of wellness
Rural employment generation
Education, Diet foods as spinoff

Working Capital

Intangible

Rs. 200,000

Tangible

Rolling Cash will be retained

cost per test: Rs. 250 (600 tests pm – 20 ~ 30 a day) to cover opex
26

time

CONFIDENTIAL

Screen and mange 40,000 population
Sustainable Project

V8:04-Aug-13

Key Results for Rotary
—  Sustainable Healthcare
— 

Take Care of Chronic conditions, Prevent Disease, Save lives
o  Use of herbal medicine for minor ailment, Hygiene, maternal care

—  Social Good: Following are broad benefits to the villagers
—  Sociocare: ensure sustainability and scalability

—  ASHA workers, aspirational goal.(micro entrepreneurs). Avoid mindless urban migration

Empowering a housewife on health and socially has 3 times benefit to the family. (Micro
Insurance)
—  spiritual orientation and cultivation of human values to eradicate Caste and other social ailments.
Leads to social inclusion, inculcating moral values, leadership
— 

—  Package Healthcare through Society:—  supplement other skills that can lead to better lifestyle
—  e.g. apiculture, floriculture, financial literacy, food processing, tailoring
Despite Governments' efforts and being signatory to Millennium Development Goal, It has not been able to take
off on cracking NCD problem. Pnly Private-Public-NGO –Rural entrepreneur partnership can make difference

27


25/04/13

Proposal and way forward

28

Rtn. Balasubramanyam K S
President RY-2013

Rtn. Srihari Boregowda
Secretary RY-2013

25/04/13

Creating Revolutionary Wealth
Through Social Business
—  Which is the greatest gain? Health!
—  Which wealth is the best? Education!
—  Which treasure is the best? Skill!
Yakshaprahna: an F.A.Q in 3000 BC.
29


CONFIDENTIAL

V8:04-Aug-13

‘As On 30th Jan 2013

3800 Rotarians

Section
B

RI District 3190

87

Clubs

55 from Bangalore, 32 from surrounding areas
In the 4th decade of service

The Hospital is located in Ideally
potential place. It blends the
Rural (Uttarahalli cluster) and
the Sprawling Urban location
Rajarajeshwarinagar
Rajarajeshwari
Medical college &
Hospital
BGS Global Medical
College and Hospital


Rotary club of Bangalore,
MOU with Rajarajeshwari hospital

Lab

Registration

Entrance

Consultation

The existing operations are
mostly carried out in
Ground floor. Mainly OPD
consulting, LAB tests and
Patient Stabilization. This
can continue as is

Medicine

Ground Floor

Footfall:15-20 Patients / day, Urban Poor
32


25/04/13

Changing
Room

Repurposing
The existing
Facility
Gynec

Free Space
(Landing)

Operation
Theater
Optholo
mology

5 Bed Ward

33

c: Rtn. Srihari Boregowda, CONFIDENTIAL +91 98441
19490

—  First Floor
This Area is
underutilized. Can
be re modeled for
the Integrated
Diabetes Clinic. The
area and sections
neatly fit for the
purpose and also
does not impact the
existing operations
25/04/13

Global Grants
—  Support the goals of one or more of the areas of focus
—  Produce measurable outcomes in the benefiting community
—  Achieve results that can be sustained after the grant funds

have been expended
—  Have been developed in conjunction with the benefiting
community to address their most pressing needs
—  Seek to address community needs in an integrated manner
34


25/04/13

Result based Project funding
—  If results are not measurable Goals, you cannot tell success from

failures
—  If you cannot see Success,

—  you cannot reward it.
—  If you are not able to clearly reward success, then in all probability you are
rewarding failure
—  You cannot learn from it.

—  If you cannot recognize failure, you cannot correct it.

If you can demonstrate results you will obtain stakeholder
support in large
35

19490

25/04/13

Reachout: Integrated Rural Clusters
Devara Hosahalli
1 of 135 Villages
Population: 800
3 k.m.s

NCD
PHC

PHC Location: e.g. Channapattana:
Tier-6 city/ town. Population 95,000
55 KMs from Bangalore
36


CONFIDENTIAL

25/04/13

Results

Results Framework
Goal

Reduced Mortality and Morbidity from Non-Communicable Diseases

Outcome

Value Focused Preventive care Delivered

Implementation

Delay / Prevention of disease {Measured}
Improved Quality of life {Measured}
Wellbeing {Assessed @ Physical, Mental Social, Spiritual. Quality of life}

Output

37

• 
• 
• 
• 
• 
• 

10 Integrated PHCs rolled out, 10,000 people screened
50 Health professionals trained, deployed, 500 Volunteers enabled
Sustainability ensured {Financial model established}

Activities

• 
• 
• 
• 

Conceptualize, design, Implement and operationalize through Pilot
Interact with Govt., corporate and other agencies for reimbursement of costs
Campaign, Brand build,
Train with feedback

Inputs

• 
• 
• 

Funds, Equipment, Expertise
Volunteers, Trainers, Clinicians
Place (PHCs), Mobile Vans

Service above self
ü  Social Activism
ü  Responsible Charity
ü  Conscientious Citizenship

38


25/04/13

Community/ Need Assessment Tools
—  Survey
—  Asset inventory
—  Community mapping
—  Daily activities schedule

Develop Community /
Village Development Index
with11 Points

—  Seasonal calendar
—  Community café
—  Focus group
—  Panel discussion
39


25/04/13

Exit to Sustain: STSTM framework
Rotary is a an
enabler. It is all
about from
community to
community. Long
term sustainability is
to ensure that a
model is built,
operated and
transferred to local
community /
resources
40

—  S.T.S.T.M
—  Serve à Do it yourself and iron out
—  Trainà Recruit and transfer knowledge
—  Support à Handhold, Co-Operate
—  Transfer à Assets and Operations
—  Monitor à thro the KPI. Key performance Indicators
It takes 18 to 36 months to achieve this. Involve the next 2 year’s team
from beginning, let the learning happen continuously
25/04/13

PARTNER ECOSYSTEM
network of organizations – including suppliers, distributors, customers, competitors, government
agencies fostering “Open Innovation”
41


25/04/13

Estimated Cost Schedule, Hybrid
Capex-‐1

Qty

Portable
Compact
Lab-‐Accuster
(Basic)

Ophthalmic
Prescreener-‐
3Netra

Neuropathy,
Vasculopathy
-‐

Integrated
Vital
measurement
(ECG,
NIBP,..)

I2I
Tele
solu:on
(Telemedecine+
EMR)

Tablets-‐
(Android/Windows)

Server+
Wi-‐ﬁ
network

Solar
with
UPS
(1.5
/
0.8
KVA)

1
₹
2,00,000

₹
2,00,000

1
₹
4,50,000

₹
4,50,000

1
₹
1,20,000

₹
1,20,000

1

₹
25,000

₹
25,000

1
₹
1,05,315

₹
1,05,315

4

₹
15,000

₹
60,000

1
₹
1,20,000

₹
1,20,000

1

₹
1,20,000

₹
1,20,000

Total
Capex
/
PHC

₹
12,00,315

42

Price

Cost

Opex-‐1

Paramedic
(Technician
&

Die:cian)

ASHA
Workers

House
Keeping
staﬀ

Consumables

Remuner
a:on

₹
25,000

₹
10,000

₹
2,000

₹
3,000

#

Cost
P.M.

2

2

1

5

₹
50,000

₹
20,000

₹
2,000

₹
3,000

₹
75,000

1.Hb, fasting and PP sugar, lipids, LFT
Rs 50/1.b creatinine( with eGFR)
Rs 75/- (opt only if CKD +ve)
Test
2.HbA1c
Rs 40/Cost
3.Ophthalmic examination(3Nethra)
Rs 90/Breakup 4.Foot neuropathy/Vasculopathy evaluation                                    Rs 40/5.Microalbuminuria
Rs 20/6. BP, 5 lead ECG, BMD
Rs 10/                                                                                                   ----------------------. ©Srihari Boregowda                                                                                                    Total      Rs 250/25/04/13
CONFIDENTIAL
                                                                                                    -----------------------

Accuster: Low cost Lab
Test
BMI

Free

Glucose

40 Paisa

Hb

30 Paisa

Lipid Profile

15 Rs.

ECG

25 Rs.

Kidney function test

12 Rs.

Liver function Test

Incubator: 25
samples
37 deg.c

Free

Blood pressure

Biochemistry
analyzer
23 Parameters

Consumable
Cost

12 Rs.

President Of India: Recognition

Centrifuge: 8
samples
600 RPM

Semi-automatic in which 23 blood parameters can be done, an open system type based on colorimetric principle), a micro
centrifuge (6000 rpm), a small incubator, a power back up (battery operated, on simple battery it can work for 7 days
continuous), micro pipette, micro tips stand, cuvette stand and all other small accessories
44

. ©Srihari Boregowda, CONFIDENTIAL +91 98441 19490

25/04/13

Forus Health diabetic retina screening

( Screened over 450,000 people with 110+ installations in

Forus Health & 8 other countries )
India
3nethra , Awards & Recognition Thank you….

45

Step-5.3 Diabetic Retinopathy, Nephropathy
IP being created

1

Device: Optimized
attenuation and size
components
to create innovative and affordable pre-screening devices

2

Automatic Capture:
Software identifies
optimal focus length
for image capture

3

Retina Image
Enhancement:
Image is enhanced
by highlighting the
areas of interest

4

Intraocular
Pressure: The device
uses a proprietary
Mobile Enabled Diagnosis
method to measure
intraocular pressure

The following patents that have been filed:
1. OPHTHALMIC IMAGING DEVICE: An apparatus to optimize attenuation, size, components and power
consumption in low power ophthalmic Imaging devices using Multicolor LED (Light Emitting Diode) based light
sources.
2. AUTOMATIC CAPTURE: Method of detecting and capture of optimally focused image in digital fundus camera
3nethra forRETINA IMAGE ENHANCEMENT: Enhancement technique for low light conditioned fundus or retinal image
3. Neurology (MUMC+ Holland)
3nethra for Nephrology (RenalyX)
4. Pediatric (Rebiscan PRESSURE: A method and system to measure intraocular pressure of the human eye
3nethra forINTRAOCULAR - Boston)
3nethra forRoP camera: Device design and associated algorithms
5. Women's Health (PESMC)
Ultra Low Power Laser (Rowe - DC)
6. Diabetic Foot: Device design and associated algorithms
Handheld Fundus camera (NTU)
7. Method and tools for Photo refracto meter

Early Detection
Referral Evaluation
Monitor Patient for prevention

10

46


25/04/13

THERMOSCAN

A Device for detection of Inflammatory Pain, Vascular
Disorders and Breast Cancer.

47

19490

25/04/13

Step-5.2 Diabetic Vasculopathy, Neuropathy

Infrared thermo scaning or other
techniques can be used
Stage 1: Inflammatory Phase
Stage 2: Proliferative Phase
Stage 3: Epithelisation Phase
Stage 4: Remodeling
inflammation in diabetic foot callus
48


classification system of the plantar
thermo graphic patterns based on the
vascular anatomy
25/04/13

Sensors, Cloud, Big-data (Mobile)
Can this Address Societal Problems?

49


25/04/13

The Invisible Descent into Poverty

Hard-to-track erosive effects of slow-onset crises

The Crisis Information Gap

(vast oversimplification)

Crisis
•  Reduce Expenses
•  Get Help from Friends & Family
Economize •  Seek Additional Income

Deplete

•  Spend Savings
•  Sell Property
•  Go into Debt

Sacrifice

•  Give up Meals
•  Give up School
•  Give up Healthcare

Irreversible
Harm

Permanent Damage

Mobile Services as Human Sensor Networks
When our lives change, we change how we use services
Flashing

Health hotlines

Voice Calling

Agriculture hotlines

SMS Texting

Educational services

SIM Top-offs

Employment services

Mobile banking

Social networking

Money transfers

SMS Search

Microloan repayments

Citizen reporting

Tower hopping

Food vouchers

Health hotlines

Addressing the Information Gap with Sensors, Cloud, Bigdata

52

With Hunchworks

Data For Development
Orange Telecom’s Initiative:
The Orange “Data for Development" (D4D) challenge is an open data challenge on anonymous call patterns of Orange's
mobile phone users in Ivory Coast.

The goal :
To help address society development questions in novel ways by contributing to the socio-economic
development and well-being of the Ivory Coast population by analyzing the anonymized call records provided by Orange
Telecom and cross-compare it with other types of data to find useful insights.

53

SJB Research Foundation

Tuesday, 3 September 13

Pilot implementation
Data Parsing:
•  Hadoop HDFS
•  Hive Query Language
•  Map Reduce
Data Visualization:
•  Data Driven Documents
• 

(D3js.org)

•  Google API
•  Open Maps
54


Sentiment Analysis:
Analyze and visualize number of calls made on public holidays between the given
period from the data

Analyze and visualize important antennas and subprefecture based on:
Number of Calls, Duration of Calls, Users around the antenna and in the subprefecture

Obtain number of calls made everyday and aggregate it
monthly:
Visualize this data and correlate it with activities happening in the particular month
so as to come to an inference yielding to substantial change in the future
Correlate the above fetched data with data available from other sources to
bring about Inputs to Participatory development of society


Results
(Visualization: No. of calls per hour – map)

55



Results
(Visualization: Top hundred calls)

56



Sustainable preventive-care for Diabetes for bottom of the pyramid

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