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

2. 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

3. 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

4. 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

5. The Problem Statement : TOOLS Imported Into INDIA Expensive http://www.preparation-voyage.com/wp-content/uploads/2013/11/expensive.jpg Very “What is Available” Focused

6. Problem Definition – A tool for ROP Screening

7. Redefining the Problem: Innovate to Simplify

8. Vs.

9. The Central Hypotheses Use Constraints as an Opportunity to Innovate ?

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

11. 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 2010 80% Preventable Blindness Burden due to Acute Conditions ‒ 19 Million: Cataract & Corneal Diseases Burden due to Chronic Conditions - 21 million : Diabetic Retinopathy & Glaucoma

12. 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

13. 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

14. 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

15. 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?

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

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

18. 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

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

20. Ultraportable Smartphone Imaging From Cornea to Retina Smartphone Based Eye Imaging

21. 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

22. 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 1 23 4 5

23. 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 1 23 4 5 Implementing a Novel Screening Model: 28 Districts of Maharashtra

24. 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 1 23 4 5 Implementing a Novel Screening Model: 28 Districts of Maharashtra

25. Local media carries articles on the camps – boosts morale of NGO/CBO groups; multiplies awareness MOBILIZESCREEN EXPERT DIAGNOSI S TREATMEN T REFERRAL 1 23 4 5 Implementing a Novel Screening Model: 28 Districts of Maharashtra

26. NEWS MEDIA PUBLICATION MOBILIZESCREEN EXPERT DIAGNOSI S TREATMEN T REFERRAL 1 23 4 5 Implementing a Novel Screening Model: 28 Districts of Maharashtra

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

28. 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.