1 Keep it Simple ! Innovate to Create Scalable Impact Creating Healthcare Access Through Product Innovation

60% of Healthcare expenditure is out-of- pocket Access Affordability Transition to Chronic Disease Management e.g. Diabetes, and other NCD’s (50 million Type 2 Diabetes cases as of 2010) Too many patients, too few clinicians E.g. 8 million premature babies to be screened for ROP 25 paediatric ophthalmologists The Indian Healthcare Ecosystem

curative Primary vs. Secondary vs. Tertiary PREVENTIVE CURATIVE Primary Tertiary Significant proportion of Healthcare spend is “curative” not “preventive” Private sector participation is mainly restricted to tertiary and secondary care Greater spend on prevention can minimise overall spend on cure, in maintaining a healthier population Healthcare Delivery Systems

Diagnostics: What to Treat? Who to Treat? How to Treat? Relevant assessment tools to aid a clinician in arriving at a suitable treatment decision Wellness Monitoring Vaccination Preventing Illness Probable cause Severity of illness Diagnosing Illness What should treatment be Response to treatment Treating Illness Screening/ Early Detection Differential Diagnosis / Prognosis Theranostics / Companion Diagnostics Monitoring Management of Illness/ Wellness Opportunity in India SCREENING BY NON-CLINICIANS NEED NEW TOOLS FOR SCREENING

The Problem Statement : TOOLS Imported Into INDIA Expensive Very “What is Available” Focused

Problem Definition – A tool for ROP Screening

Redefining the Problem: Innovate to Simplify

Vs.

The Central Hypotheses Use Constraints as an Opportunity to Innovate ?

A Case Study Define the Need Locally Identify the Constraints Start with a Clean Slate – Lets NOT re-engineer !

The BIG Picture 285 million people worldwide with visual impairments; 39 million blind annually 90% from low income countries Source: GLOBAL DATA ON VISUAL IMPAIRMENTS, WHO % Preventable Blindness Burden due to Acute Conditions ‒ 19 Million: Cataract & Corneal Diseases Burden due to Chronic Conditions - 21 million : Diabetic Retinopathy & Glaucoma

Increasing distance from the patient Decreasing Access to Technology & Specialists Small Eye Clinics In Remote Areas Urban Eye Care Institutions Public Health Centres Prevailing Situation in India

Increasing distance from the patient Decreasing Access to Technology & Specialists Small Eye Clinics In Remote Areas Urban Eye Care Institutions Lack of access to early screening Increase in expense on tertiary care Increasing prevalence of preventable blindness Prevailing Situation in India Public Health Centres

Increasing distance from the patient Decreasing Access to Technology & Specialists Small Eye Clinics In Remote Areas Urban Eye Care Institutions DIFFUSION OF NOVEL SCREENING TECHNOLOGY How do we Enable a Scalable Model in Screening for Eye Health? ? Public Health Centres

Increasing distance from the patient Decreasing Access to Technology & Specialists Small Eye Clinics In Remote Areas Urban Eye Care Institutions DIFFUSION OF NOVEL SCREENING TECHNOLOGY TELEMEDICINE OVER MOBILE NETWORK Public Health Centres ? How do we Enable a Scalable Model in Screening for Eye Health?

Bulky Complicated Needs Extensive Training Why can’t current imported systems be used in this Model ? ? Non-Intuitive

Innovate keeping Simplicity in Mind Consumer Devices have over the years Ushered in Simplicity of Interaction …..

Innovate keeping Simplicity in Mind While Medical Devices have over the years only Evolved Feature-wise but have not on Simplicity of Design and Use

Innovate keeping Simplicity in Mind Implement the Physics but with the Simplicity of Use Of a Smartphone Physics Redesign the Science

Ultraportable Smartphone Imaging From Cornea to Retina Smartphone Based Eye Imaging

Compact, Portable Simple to Use Battery Operated Deskilling: Can be operated by non-specialists High Quality of Images Affordability: 1/5 th the price Ultraportable Smartphone Imaging

Implementing a Novel Screening Model: 28 Districts of Maharashtra Local media carries articles on the camps – boosts morale of NGO/CBO groups; multiplies awareness MOBILIZE Screening Camps Organized in Public Places using smartphone based device Expert diagnosis by Vision India Eye Foundation over the Smartphone Network Providing treatment support at nearest hospital for those in need

Local media carries articles on the camps – boosts morale of NGO/CBO groups; multiplies awareness MOBILIZESCREEN Expert diagnosis by Vision India Eye Foundation over the Smartphone Network Providing treatment support at nearest hospital for those in need Implementing a Novel Screening Model: 28 Districts of Maharashtra

Local media carries articles on the camps – boosts morale of NGO/CBO groups; multiplies awareness MOBILIZESCREEN EXPERT DIAGNOSI S Providing treatment support at nearest hospital for those in need Implementing a Novel Screening Model: 28 Districts of Maharashtra

Local media carries articles on the camps – boosts morale of NGO/CBO groups; multiplies awareness MOBILIZESCREEN EXPERT DIAGNOSI S TREATMEN T REFERRAL Implementing a Novel Screening Model: 28 Districts of Maharashtra

NEWS MEDIA PUBLICATION MOBILIZESCREEN EXPERT DIAGNOSI S TREATMEN T REFERRAL Implementing a Novel Screening Model: 28 Districts of Maharashtra

KEY ELEMENTS OF MODEL – Media, Civil Society, Clinician, Tech Developers Media & Logistics Partner NGO Partner Clinician Specialist Partner: Vision India Foundation

Points to Ponder Define the Problem and Constraints Locally but Execution is Global Affordability alone may not create Access; Simplicity is Key – think beyond the Skilled Healthcare Access on a Large Scale - Needs ground-up Innovation on new Technologies and New Delivery Models Innovate to Simplify, Simplify to Impact.