Some exciting startups in the HealthTech Space #health2india

James Matthews, a good friend and entrepreneur invited me to attend the Health 2.0 Conference for entrepreneurs and healthcare professionals today and speak about Health Tech investments. About 80 to 100 folks were in attendance, featuring about 30 entrepreneurs, 25 investors and the others were from Pharma companies, Hospitals and diagnostics chains.

Our panel featured an entrepreneur (Poonacha), a healthcare product company (GE) VP (Partha) and Ravi from Zanec.

There were 4 startups that were allowed to pitch the investors, and while there was no commitment from the investors, the startups were not looking to raise immediately either. This was a session for them to get some feedback from potential investors.

There are 3 high level observations that relate to investing and entrepreneurship in the space that I want to highlight first and then talk about the interesting companies.

1. Older Indians overall have little respect for preventive healthcare or do not value it at all. If you are in the wellness space or “be healthy” space, the market will be relatively small is what I gathered. I hear many entrepreneurs say their target market is 25-40 year olds. I think the real market for wellness products, services and solutions is 25-30 year old’s. How can I prove that? Look at gym membership in India. There are 70K members for the 300+ gyms and the prices are fairly high. Why? Because gyms are a luxury item in India. The average cost of a membership is between INR 500 per month (non chain) to about INR 4000 (Gold’s gym). It is not that older Indians dont want to live healthy. They think that paying for “wellness” is overrated.

2. Going after solutions for doctors, clinics or hospitals is a curse from hell for startups. Most smart entrepreneurs are focusing on the patient (consumer) via the influencer (doctor). Which means that for healthtech startups, distribution and sales are less of an issue, but consumer adoption and more importantly usage is more critical. Most consumers in India dont have the discipline to master wellness and focus on preventive health choices, and the ones that do are far and few between.

3. Indian doctors see almost 2-3 times the number of patients a day as American doctors do, and still make 1/3 as much them. Solutions to make doctors more productive by educating patients, transferring more work to nurses, etc. will likely do well.

Here are the 7 interesting companies I met at the conference today, and here is a summary, in the order of when I met them.

1. Diabeto: is a diabetes management analytics application and device. It transfers your glucose readings from your Glucometer into your smartphone and cloud so your caregiver can monitor it. Rather than do a lot of automation, which will force the company to get an FDA approval, they do just enough. Very interesting company and a neat product and they have many inquiries from distributors from other countries. The global diabetes care market is fairly large so I think they are on their way to raise some amount of early seed funding.

2. Zest.MD: is an online clinic for nutritionists. The SaaS solution helps bring any nutritionists services online so consumers can review and purchase via the web. Longer term the company is looking to be a curated marketplace for people wanting to make healthy choices. I thought this was fairly good, but I am still skeptical of the size of this market.

3. Praxify: is a connected patient records management for doctors and patients. They were positioned as an EMR (Electronic Medical Records) but the market for that is long gone and dead. The average doctor hates using the EMR product and the patients dont understand its benefit enough. Good team and product, so this is a company to watch. Disclosure: they are a Microsoft Ventures company.

4. Fitternity: is a directory, content website, ecommerce platform and database for people wanting to be healthy. The product is aimed at people who care about being fit, by offering advice, products and service referrals. I have seen many such offerings, so I am not sure what their differentiation is.

5. Care Companion: is a education tool for care-givers: nurses, wives, parents, etc. Since doctors dont have time to explain the same things to each patient’s care givers, this product aims to provide the standard advice my means of videos. E.g. Assume that your child, after a doctor’s visit has to to avoid certain foods, take pills in the morning and night, but not afternoon, etc. this product will provide those simple instructions by disease or symptom.

6. Cyber Liver: They provide a breathalyzer which nudges you to avoid drinking too much alcohol. This is a extension (hardware) to your iPhone or Android phone that you breath into every time you drink. It keeps track of how much you drink each week and uploads that to the cloud, ensuring that you know if you had too much to drink. Very interesting idea, but users have to remember to breath into the device after they consume alcohol each time, and I don think they will do this often enough to make a difference.

7. mTatva: is a prescription transcription and alerting tool. Your prescription is scanned at the hospital to the cloud and your dosage and medicines are sent by SMS. Then it also send the prescription to your favorite pharmacist via SMS and will alert you each day and time with the dosage information. I liked the idea, but adoption is currently sparse.

There were a few other companies, measuring (using multiple sensors) the weight of your pill box to intelligently alert you when you dont take your medicines, etc.

Overall the signal to noise ratio at this event was VERY high. James has curated an excellent set of entrepreneurs and I was pleased to see such a diverse set of folks innovating in Heath Tech.

13 thoughts on “Some exciting startups in the HealthTech Space #health2india”

  1. I am not sure whether focusing on patient via whatever means is such a smart thing in the current state where care seekers in India look for care only on extreme condition. But I do agree that transferring more work to nurses/support staff will make the tools more viable. I think smart and intuitive clinical decision support system will eventually play a role in reducing doctor’s workload (take 3nethra for example) and tools around it will become very critical in such situations.

    I don’t think EMR is dead, the buzzword may die, but it has to take shape in India in some form or another!! I believe, In India we need either private or government standard bodies to ensure health data interoperability to make EMR more viable and also we should find a mechanics for ethical standards and guideline for care delivery; otherwise the fragment will continue to increase to create more confusion and mess. (I know government has done some work around this, but there are a lot more to be done)

    1. Totally agree
      1. EMR is not dead but evolving in India, adaptability for any health care product is slow.
      2. Large conferences in the private-sector should take place to discuss standards etc.. we don’t need to follow the standards set by Americans or any country follow.
      3. Main reason of slow adoption is because large organizations like Dr. Lal Path Lab, Religare, Apollo, Max, Fortis etc… FEAR that they will lose patients, in turn revenue if patient records become digital. They are building their closed systems and strangulating this noble profession by not sharing.
      4. Doctors in large setups take this thought to their clinics and community.

  2. Excellent article and I am in agreement with #2 and #3 observation as I have some data. We did one good thing while starting mTatva. We started it around doctors and patients. mTatva team shared office space with a big clinic and what we learned with them changed our thinking significantly and hence simplified problem we were solving.
    One of the biggest learning was you do not need to create complex and technologically cool looking products rather do simple products with bigger impact.

    Our learning so far living with doctors/patients:
    1. As techies do not focus on cool solution with all the features in the world which makes products complex. Rather you need to understand how doctors/patients conversation/relationship works. Today in peak hours GP takes 3-5 minutes on average to see a patient. And still there are many many patients waiting outside for their turn. You have to think of reducing doctor time per patient and not increasing it by giving complex technologies in the hands of doctors. Anything you give in hands of patients will have big adoption curve.
    2. Any technology you give in the hands of doctors will be heavily resisted. I have seen cases where best of doctors do not know browsing or sending emails and believe me patient loves these doctors. You can not expect these doctors to use technology to slow down the process. They are expert in their domain but not in technology usage. Though upcoming youngster doctors want to use technology but not at cost of efficiency. Writing on prescription pad is around 30 secs job in 3-5 mins time doctor gives to patient.
    3. EMR solutions are long way in India for GPs. The variations in writing prescriptions and possibilities changes with every doctor. We are seeing these variations and in same hospital we see tremendous variations. While EMR may work great in super specialties where doctors spend more than 15 minutes with patient and it is easy to make a template like for diabetes specialists. Also, most of the EMR companies focus on US market first and then try to adapt same solution to India.
    4. For patients health is no fun. Patients only do what is mandatory for health. Optional stuff will mostly be dropped out. Patients trust doctors (mostly). And it is fair because when you are not well, doctor is your only hope. So solutions need to have doctor’s blessings. If a patient senses that you are a third party they tend to drift away from you.
    5. DO NOT change current work flows. You will get high resistance from front-desk, nurses, doctors, management and patients.
    6. India loves services (I may be wrong). Healthcare has been a service. Try to fit your products in that model if you want it to be used. You can still sell your products but they will hardly be used. I have seen hospitals with HIS products having all great features already but normally the feature set which is used is very minimal.

    Would be nice to get some feedback on above.

    1. Baljit – You are on absolutely on target. EMR which disturbs the current flow will have very less takers in India. What is required is a non intrusive way to capture EMR data.

    1. Indian investors are more interested in investing into chain of hospitals or clinics, we all know the reason why.
    2. Would love to see a Health IT company succeed without investors in B2C space.
    3. Looking back at investments in health it, we have not seen remarkable turnaround for companies after they receive investments, like Practo.
    4. Best advice to startups forget about developing companies for pitching to investors.
    5. JAMES PLS NOTE : NEXT Love to participate in an Health event where companies pitch to common people, again not investors

  4. @Mukund: I found, like some others who have responded, your observation that “EMR is dead” quite exaggerated. Imo, EMR is not even born in India. Many EMR, EHR, PHR (used interchangeably) vendors are still trying to get their act together which includes creating and educating the market simultaneously.

    From my own experience, I believe that PHRs catering to specific chronic diseases or disorders are more likely to attract better traction than the generic ones. For those IT Healthcare start-ups which are keen on end-user adoption, be it patients or doctors, usability needs to be the focus rather than higher levels of technology or automation.

    Pitching to Customer (whatever that means) vs pitching for Investors cannot be an either or scenario. Unless backed by a profitable hospital, no start-up can afford to ignore the investors. And to pitch to investors, one needs to show traction on a sustained basis which can only come about if the product is user-friendly. In the initial days therefore, the importance needs to be higher on the user needs and once traction is built, start-ups can switch gears to make an effective pitch to investors. Riding on both horses can be tough but it needs to be done.

    Currently, most doctors and patients are not sure about the benefits of adopting IT and hence are resisting any attempts. Let us not forget that once the moment of crisis passes, we as patients adopt a ‘chalta hai’ attitude to our own health that includes following the diet and exercise regimen let alone IT tools.

    That’s my Rs.1.24 (2 pence at today’s rate)!!

    1. Agree. “EMR is dead” quite exaggerated. Attending conferences and concluding what is dead is wrong.

      The Hospital are creating their own record system
      The Doctors in private clinics are not interested
      The Big labs are sending email and not recommending

      So the patients are not being benefited by technology.

      In the end investment is moving away to hospital and clinic chains who is the best in catching and making a whole in the patients pockets.

      1. Ajay,

        You have left out an important piece of the jigsaw puzzle. Patients aka customers are not bothered about their health and that is the biggest challenge for the software vendors

      2. I can not say so strongly that “EMR is dead” but it is not alive either. EMR is a buzz with complete confusion as to why it is needed. EMR as of today increases the cost of healthcare due to in-efficiencies. I have heard doctors talking we can have EMR but then consultation have to be doubled up because I am going to take more time using it… And my question is why at all you need this? And I could never get a satisfactory answer… There has been chains who vouched great about using EMR for patient benefits but are clueless on its implementation. I have seen one of them to setup a team internally to develop it and finally gave up the idea due to adoption.

        EMR biggest challenge as of today is adoption… Even in US EMR adoption has to be backed up by obama care with fines around if not implemented. I see EMR long way in India. It has to happen in its current form or the other but we have to solve many other issues in healthcare first.

  5. Reblogged this on HCM532AAGD and commented:
    This blog was an extremely useful insight into companies that are attempting to utilize the concepts behind Health 2.0. All the aforementioned companies attempt to provide meaningful and expanded access to users in order to best provide increases quality of care.

    We must agree with Mukund Mohan in regards to the companies he reviewed. Applications such as Fitternity have already flooded the market, and applications such as Cyber Liver, though conceptually wonderful, seem a bit difficult for users to keep up with.

    We particularly though that Diabeto and Care Companion were great applications that truly epitomize Health 2.0. Diabeto, which personally hits home for some group members, is that engaging concept between the application and the user to create a more perfect system. Furthermore, Care Companion extends beyond professionals and enables users to gain true insight into providing proper care to family members.

    Thank you Mr Mohan, your review of this conference was a perfect example of the existence and flourishing of Health 2.0 internationally!

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