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The next big leap in healthcare for rural India | Dr. Kanav Kahol | TEDxGateway


[Music]

[Music] [Applause]

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[Applause] now a couple of years ago a question

now a couple of years ago a question

now a couple of years ago a question started to intrigue me and the question

started to intrigue me and the question

started to intrigue me and the question was how many medical devices and

was how many medical devices and

was how many medical devices and diagnostics do we need in a country to

diagnostics do we need in a country to

diagnostics do we need in a country to provide universal health coverage I

provide universal health coverage I

provide universal health coverage I started to look at India as my case

started to look at India as my case

started to look at India as my case study and focus specifically on diabetes

study and focus specifically on diabetes

study and focus specifically on diabetes now the International Diabetes

now the International Diabetes

now the International Diabetes Federation actually says that India has

Federation actually says that India has

Federation actually says that India has 60 1.2 million people with diabetes

60 1.2 million people with diabetes

60 1.2 million people with diabetes right now if you actually follow the

right now if you actually follow the

right now if you actually follow the standard practice standard operating

standard practice standard operating

standard practice standard operating procedures on each one of them and do

procedures on each one of them and do

procedures on each one of them and do all the tests and all the treatment that

all the tests and all the treatment that

all the tests and all the treatment that they’re supposed to do here’s what we

they’re supposed to do here’s what we

they’re supposed to do here’s what we are actually faced with for a year three

are actually faced with for a year three

are actually faced with for a year three billion blood sugar tests three billion

billion blood sugar tests three billion

billion blood sugar tests three billion blood pressure tests two billion urine

blood pressure tests two billion urine

blood pressure tests two billion urine tests two billion hemoglobin tests 250

tests two billion hemoglobin tests 250

tests two billion hemoglobin tests 250 million visits to the doctor 2.5 million

million visits to the doctor 2.5 million

million visits to the doctor 2.5 million hospitalizations 5.4 billion syringes

hospitalizations 5.4 billion syringes

hospitalizations 5.4 billion syringes and countless number of dialysis session

and countless number of dialysis session

and countless number of dialysis session for people who actually end up getting

for people who actually end up getting

for people who actually end up getting end-stage kidney disease because of

end-stage kidney disease because of

end-stage kidney disease because of diabetes this is a large number and when

diabetes this is a large number and when

diabetes this is a large number and when you actually total up the cost that’s

you actually total up the cost that’s

you actually total up the cost that’s associated with it it comes to around

associated with it it comes to around

associated with it it comes to around 0.8% of our country’s GDP let me put

0.8% of our country’s GDP let me put

0.8% of our country’s GDP let me put that in perspective India for its entire

that in perspective India for its entire

that in perspective India for its entire healthcare budget only spends 1.8

healthcare budget only spends 1.8

healthcare budget only spends 1.8 percent of its GDP so not only are you

percent of its GDP so not only are you

percent of its GDP so not only are you gonna need a 67 percent increase to take

gonna need a 67 percent increase to take

gonna need a 67 percent increase to take care of diabetes let’s actually add the

care of diabetes let’s actually add the

care of diabetes let’s actually add the cost of cardiovascular disease let’s add

cost of cardiovascular disease let’s add

cost of cardiovascular disease let’s add the cost of reproductive and child

the cost of reproductive and child

the cost of reproductive and child health cancer airborne pollution related

health cancer airborne pollution related

health cancer airborne pollution related diseases and essentially this vibrant

diseases and essentially this vibrant

diseases and essentially this vibrant and young India’s picture starts graying

and young India’s picture starts graying

and young India’s picture starts graying a little bit and the problem is

a little bit and the problem is

a little bit and the problem is essentially that India does need to

essentially that India does need to

essentially that India does need to spend more money on health care but also

spend more money on health care but also

spend more money on health care but also we need more health for our money so

we need more health for our money so

we need more health for our money so what works is the fact that most of the

what works is the fact that most of the

what works is the fact that most of the medical devices and most of the medical

medical devices and most of the medical

medical devices and most of the medical diagnostics are essentially made for the

diagnostics are essentially made for the

diagnostics are essentially made for the top 1%

top 1%

top 1% of the world’s population right and then

of the world’s population right and then

of the world’s population right and then we in India just adopt them and wait for

we in India just adopt them and wait for

we in India just adopt them and wait for them to get cheaper for all of us to be

them to get cheaper for all of us to be

them to get cheaper for all of us to be able to afford it and India can’t afford

able to afford it and India can’t afford

able to afford it and India can’t afford that so what we ended up saying is why

that so what we ended up saying is why

that so what we ended up saying is why don’t we actually start developing for

don’t we actually start developing for

don’t we actually start developing for the bottom billion and that was the

the bottom billion and that was the

the bottom billion and that was the basic dream with which I came back to

basic dream with which I came back to

basic dream with which I came back to India in 2011 I traveled the length and

India in 2011 I traveled the length and

India in 2011 I traveled the length and breadth of this country I asked people

breadth of this country I asked people

breadth of this country I asked people what do you want from health what is

what do you want from health what is

what do you want from health what is health for you what do you want to

health for you what do you want to

health for you what do you want to improve in health care delivery and it

improve in health care delivery and it

improve in health care delivery and it was around those interactions that the

was around those interactions that the

was around those interactions that the concept of democratizing Diagnostics

concept of democratizing Diagnostics

concept of democratizing Diagnostics really started to hit me

really started to hit me

really started to hit me the idea of affordable reliable quality

the idea of affordable reliable quality

the idea of affordable reliable quality digital diagnostics available anywhere

digital diagnostics available anywhere

digital diagnostics available anywhere anytime now when we actually started

anytime now when we actually started

anytime now when we actually started this the problem was quite complex

this the problem was quite complex

this the problem was quite complex because you had to take stuff that was

because you had to take stuff that was

because you had to take stuff that was actually lying in three big rooms

actually lying in three big rooms

actually lying in three big rooms biochemistry analyzers you needed

biochemistry analyzers you needed

biochemistry analyzers you needed patient monitors you needed all this

patient monitors you needed all this

patient monitors you needed all this stuff that lies in big labs and these

stuff that lies in big labs and these

stuff that lies in big labs and these big labs take a lot of money from us

big labs take a lot of money from us

big labs take a lot of money from us saying we have three Tesla and four

saying we have three Tesla and four

saying we have three Tesla and four Tesla and we had to reduce it into

Tesla and we had to reduce it into

Tesla and we had to reduce it into something that can actually be used in

something that can actually be used in

something that can actually be used in the rural environment and had to be used

the rural environment and had to be used

the rural environment and had to be used in a very very rugged manner and that’s

in a very very rugged manner and that’s

in a very very rugged manner and that’s when me and my team started to work on

when me and my team started to work on

when me and my team started to work on this device called the swash slate which

this device called the swash slate which

this device called the swash slate which literally translates to a health tablet

literally translates to a health tablet

literally translates to a health tablet samasta slate is a powerful device that

samasta slate is a powerful device that

samasta slate is a powerful device that actually allows you to do 33 diagnostic

actually allows you to do 33 diagnostic

actually allows you to do 33 diagnostic tests on a mobile phone so instead of

tests on a mobile phone so instead of

tests on a mobile phone so instead of just doing one and then putting it on a

just doing one and then putting it on a

just doing one and then putting it on a mobile phone we said let’s actually put

mobile phone we said let’s actually put

mobile phone we said let’s actually put all 33 on it because disease is

all 33 on it because disease is

all 33 on it because disease is multi-dimensional so should be the

multi-dimensional so should be the

multi-dimensional so should be the solution let me show you let me show you

solution let me show you let me show you

solution let me show you let me show you a live demo so my dear friend here uncle

a live demo so my dear friend here uncle

a live demo so my dear friend here uncle he has a girlfriend

he has a girlfriend

he has a girlfriend let’s take a look at his heart if it’s

let’s take a look at his heart if it’s

let’s take a look at his heart if it’s any different right so here is his live

any different right so here is his live

any different right so here is his live ECG that you can actually see this is a

ECG that you can actually see this is a

ECG that you can actually see this is a tablet that I’ve picked up this is a

tablet that I’ve picked up this is a

tablet that I’ve picked up this is a tablet on which you can play Angry Birds

tablet on which you can play Angry Birds

tablet on which you can play Angry Birds but it’s also a tablet on which you can

but it’s also a tablet on which you can

but it’s also a tablet on which you can actually do a live ECG or funk it and

actually do a live ECG or funk it and

actually do a live ECG or funk it and then at the end of it go ahead and

then at the end of it go ahead and

then at the end of it go ahead and produce a report just like this that can

produce a report just like this that can

produce a report just like this that can actually tell a clinician on whether onk

actually tell a clinician on whether onk

actually tell a clinician on whether onk it needs to be in a hospital or not let

it needs to be in a hospital or not let

it needs to be in a hospital or not let me show you something other cool stuff

me show you something other cool stuff

me show you something other cool stuff that happens as this ECG is being

that happens as this ECG is being

that happens as this ECG is being captured we actually reduce all of his

captured we actually reduce all of his

captured we actually reduce all of his patient data into a six

patient data into a six

patient data into a six a kilobyte file that can actually be

a kilobyte file that can actually be

a kilobyte file that can actually be then uploaded onto the internet by 2 G

then uploaded onto the internet by 2 G

then uploaded onto the internet by 2 G by 3 gee by 4 G but also without any G

by 3 gee by 4 G but also without any G

by 3 gee by 4 G but also without any G it can actually be uploaded onto the

it can actually be uploaded onto the

it can actually be uploaded onto the internet via an SMS that can then send

internet via an SMS that can then send

internet via an SMS that can then send data to our SMS server and then moved on

data to our SMS server and then moved on

data to our SMS server and then moved on and that works beautifully for example

and that works beautifully for example

and that works beautifully for example in Lake where we are out there where

in Lake where we are out there where

in Lake where we are out there where mothers need to be transmitted or

mothers need to be transmitted or

mothers need to be transmitted or transferred to a hospital we want the

transferred to a hospital we want the

transferred to a hospital we want the data to transmit with them and you don’t

data to transmit with them and you don’t

data to transmit with them and you don’t have internet so how do you do that you

have internet so how do you do that you

have internet so how do you do that you can do that with these kinds of system

can do that with these kinds of system

can do that with these kinds of system let me show you something else here is

let me show you something else here is

let me show you something else here is an example of antenatal care visit app

an example of antenatal care visit app

an example of antenatal care visit app antenatal care as a pregnancy related

antenatal care as a pregnancy related

antenatal care as a pregnancy related preventive app so it’s already recorded

preventive app so it’s already recorded

preventive app so it’s already recorded GPS that this particular hazard happened

GPS that this particular hazard happened

GPS that this particular hazard happened in Mumbai let me show you another cool

in Mumbai let me show you another cool

in Mumbai let me show you another cool feature so we go ahead we’ll show some

feature so we go ahead we’ll show some

feature so we go ahead we’ll show some questions you can answer these questions

questions you can answer these questions

questions you can answer these questions and as these questions are answered the

and as these questions are answered the

and as these questions are answered the system will actually throw back advice

system will actually throw back advice

system will actually throw back advice that you can tell the patient so the

that you can tell the patient so the

that you can tell the patient so the frontline health worker is actually

frontline health worker is actually

frontline health worker is actually getting advice so if you can focus on

getting advice so if you can focus on

getting advice so if you can focus on that it actually gets standardized

that it actually gets standardized

that it actually gets standardized advice that you can give a patient

advice that you can give a patient

advice that you can give a patient anywhere about what they are supposed to

anywhere about what they are supposed to

anywhere about what they are supposed to do and that’s very critical it also

do and that’s very critical it also

do and that’s very critical it also generates referrals so for example if

generates referrals so for example if

generates referrals so for example if the mother is bleeding from the vagina

the mother is bleeding from the vagina

the mother is bleeding from the vagina or has a leaking of watery fluid as soon

or has a leaking of watery fluid as soon

or has a leaking of watery fluid as soon as you press save hair it generates an

as you press save hair it generates an

as you press save hair it generates an emergency referral and that emergency

emergency referral and that emergency

emergency referral and that emergency referral as soon as you press ok goes to

referral as soon as you press ok goes to

referral as soon as you press ok goes to the first referral unit and the doctor

the first referral unit and the doctor

the first referral unit and the doctor has all the data awaiting them all he

has all the data awaiting them all he

has all the data awaiting them all he has to do is scan the mother’s iris or

has to do is scan the mother’s iris or

has to do is scan the mother’s iris or scan the mother’s fingerprint and all

scan the mother’s fingerprint and all

scan the mother’s fingerprint and all this information is available to him for

this information is available to him for

this information is available to him for the first time you actually have mothers

the first time you actually have mothers

the first time you actually have mothers showing up in rural areas for delivery

showing up in rural areas for delivery

showing up in rural areas for delivery with an entire antenatal care visits

with an entire antenatal care visits

with an entire antenatal care visits records with them and that’s beautiful

records with them and that’s beautiful

records with them and that’s beautiful now for you what if you wanted to know

now for you what if you wanted to know

now for you what if you wanted to know that that persistent fever is it typhoid

that that persistent fever is it typhoid

that that persistent fever is it typhoid is it malaria is it dengue well uncle’s

is it malaria is it dengue well uncle’s

is it malaria is it dengue well uncle’s here exactly just as we were speaking

here exactly just as we were speaking

here exactly just as we were speaking done a test on this machine which is a

done a test on this machine which is a

done a test on this machine which is a machine meant for urban India and that’s

machine meant for urban India and that’s

machine meant for urban India and that’s a machine where he’s actually going in

a machine where he’s actually going in

a machine where he’s actually going in and doing a malaria test and as he just

and doing a malaria test and as he just

and doing a malaria test and as he just press analyze within one second the

press analyze within one second the

press analyze within one second the system will actually tell you whether

system will actually tell you whether

system will actually tell you whether this person has malaria or not one

this person has malaria or not one

this person has malaria or not one second doesn’t take two weeks doesn’t

second doesn’t take two weeks doesn’t

second doesn’t take two weeks doesn’t take one

take one

take one doesn’t take a day it takes one second

doesn’t take a day it takes one second

doesn’t take a day it takes one second and that’s the beauty of this particular

and that’s the beauty of this particular

and that’s the beauty of this particular system

system

system it’s an end-to-end digitization solution

it’s an end-to-end digitization solution

it’s an end-to-end digitization solution we begin with decision support we go on

we begin with decision support we go on

we begin with decision support we go on to doing referrals we go on to doing

to doing referrals we go on to doing

to doing referrals we go on to doing advice and move on now the government of

advice and move on now the government of

advice and move on now the government of India actually partnered with us they

India actually partnered with us they

India actually partnered with us they put us in six to six of Jammu and

put us in six to six of Jammu and

put us in six to six of Jammu and Kashmir we’ve been live in Raj or a

Kashmir we’ve been live in Raj or a

Kashmir we’ve been live in Raj or a bunch and Doda these are places where

bunch and Doda these are places where

bunch and Doda these are places where you generally hear off unfortunately

you generally hear off unfortunately

you generally hear off unfortunately because of terrorism but slowly and

because of terrorism but slowly and

because of terrorism but slowly and steadily a health revolution is

steadily a health revolution is

steadily a health revolution is happening there you can actually see

happening there you can actually see

happening there you can actually see that mothers are actually showing up in

that mothers are actually showing up in

that mothers are actually showing up in these clinics and getting their tests

these clinics and getting their tests

these clinics and getting their tests done sixty-one percent was what we were

done sixty-one percent was what we were

done sixty-one percent was what we were reaching before the swashplate

reaching before the swashplate

reaching before the swashplate eighty nine point one percent today and

eighty nine point one percent today and

eighty nine point one percent today and the number of mothers who are getting

the number of mothers who are getting

the number of mothers who are getting all their tests done has actually grown

all their tests done has actually grown

all their tests done has actually grown by twenty five percent twenty five times

by twenty five percent twenty five times

by twenty five percent twenty five times rather and that’s where we actually feel

rather and that’s where we actually feel

rather and that’s where we actually feel really really proud about what we’ve

really really proud about what we’ve

really really proud about what we’ve actually gone ahead and done what’s also

actually gone ahead and done what’s also

actually gone ahead and done what’s also interesting is it used to take fourteen

interesting is it used to take fourteen

interesting is it used to take fourteen days to get an antenatal care visit you

days to get an antenatal care visit you

days to get an antenatal care visit you had to run from one facility to another

had to run from one facility to another

had to run from one facility to another to another just to get a preventive

to another just to get a preventive

to another just to get a preventive visit for a pregnant lady now from

visit for a pregnant lady now from

visit for a pregnant lady now from fourteen days it just takes forty

fourteen days it just takes forty

fourteen days it just takes forty minutes flat and that’s better than what

minutes flat and that’s better than what

minutes flat and that’s better than what happens in Mumbai that’s better than

happens in Mumbai that’s better than

happens in Mumbai that’s better than what happens in Paris that’s better than

what happens in Paris that’s better than

what happens in Paris that’s better than what happens in London forty minutes

what happens in London forty minutes

what happens in London forty minutes flat a mother knows exactly what to do

flat a mother knows exactly what to do

flat a mother knows exactly what to do to protect herself and to protect her

to protect herself and to protect her

to protect herself and to protect her kid we have also now found that this is

kid we have also now found that this is

kid we have also now found that this is a problem for urban India when you go to

a problem for urban India when you go to

a problem for urban India when you go to your doctor don’t you waste two to five

your doctor don’t you waste two to five

your doctor don’t you waste two to five days just getting diagnostics going back

days just getting diagnostics going back

days just getting diagnostics going back to the doctor getting some medication

to the doctor getting some medication

to the doctor getting some medication and adjusting it now with the health

and adjusting it now with the health

and adjusting it now with the health cube which is this little device that

cube which is this little device that

cube which is this little device that you just saw there doctors can actually

you just saw there doctors can actually

you just saw there doctors can actually do the test right there and then and

do the test right there and then and

do the test right there and then and give you solutions as we speak and give

give you solutions as we speak and give

give you solutions as we speak and give you medications in fact in the Delhi

you medications in fact in the Delhi

you medications in fact in the Delhi government’s peer agree clinic which is

government’s peer agree clinic which is

government’s peer agree clinic which is their smart cities solution for health

their smart cities solution for health

their smart cities solution for health care a patient can walk in go to the

care a patient can walk in go to the

care a patient can walk in go to the doctor get Diagnostics go back to the

doctor get Diagnostics go back to the

doctor get Diagnostics go back to the doctor then go to the pharmacist get the

doctor then go to the pharmacist get the

doctor then go to the pharmacist get the medication all of the system done in a

medication all of the system done in a

medication all of the system done in a paperless system in four point three

paperless system in four point three

paperless system in four point three eight minutes flat that’s the beauty of

eight minutes flat that’s the beauty of

eight minutes flat that’s the beauty of this particular solution and that’s the

this particular solution and that’s the

this particular solution and that’s the whole point of being working for the

whole point of being working for the

whole point of being working for the bottom billion you know

bottom billion you know

bottom billion you know for me health and technology are

for me health and technology are

for me health and technology are intertwined

intertwined

intertwined they cannot be separated any more and it

they cannot be separated any more and it

they cannot be separated any more and it is up to us in India to lead this

is up to us in India to lead this

is up to us in India to lead this revolution by putting rural first and

revolution by putting rural first and

revolution by putting rural first and essentially enabling the digital version

essentially enabling the digital version

essentially enabling the digital version of healthcare thank you

of healthcare thank you

of healthcare thank you [Applause]

Oh

Oh [Applause]

”

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