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Innovation in Healthcare for India
The Stanford India Biodesign Programme
Few Healthcare Issues: General
• Increasing middle age population
• Poverty and poor nutrition
• Pollution and water sanit...
Few Healthcare Issues: Low innovation

• Indian Med Tech industry low on innovation:
•
•
•
•

•
•
•
•

Only 1% of sales in...
Situation Changing: India’s decade of innovation 2010-20

“The country must develop an innovation ecosystem to stimulate i...
Healthcare Growth Driver: Growing economy

Indian economy expected to grow above 7%
Healthcare Growth Driver: Increasing healthcare spending

Healthcare spending over $200 billion by 2025
Healthcare Growth Driver: Government and talent

•
•
•
•
•
•

Government spending on healthcare is increasing
New schemes ...
Opportunity

Healthcare
Industry

Institutes

Investor

Healthcare
Innovation

Device
Manufacturer

Inventors

Unique oppo...
Capturing Opportunity: Stanford India Biodesign
• Only fifteen program/centers promoting medical device innovation worldwi...
SIB: Mission

• To develop leaders in biomedical technology
innovation in India

• To identify unmet healthcare needs and ...
SIB: Process
Where this approach leads to :

Let us have a look at some of the many
projects this philosophy gave birth to
Clinical Immersion
Need Filtration

456

Intuitive
Screening

172

Impact,
Market,
Feasible
outcome

50

Physician
Feedback
+
Research

15

T...
Project 1: A novel way to manage fecal incontinence in non-ambulatory patients.

Co-Founders:
Nish Chasmawala, Amit Sharma...
• Developed for all stool types and sphincter tones
• Easy and hygienic to use (profile and placement)
• Reduces nursing t...
Team: Jayant Karve, Srinivas Kiran, Dr Sandeep Singh

Project 2: A better way to gain intraosseous access in emergency pat...
Device

Placement

Insertion

Key features
• Manual operation
• Ergonomic design
• Sterility maintenance
• Needle guidance...
Team: Pulin Raje, Dr Darshan Nayak

Project 3: A better way to temporarily immobilize lower limbs in trauma patients.

15M...
A disposable splint manufacturing in Delhi box factory

Cost per unit estimate: Rs 40
Project 4: A novel hearing screening device for newborns in resource constrained settings.

Late detection of hearing loss...
Challenges:

Novel features:

Unique reusable electrode system, Novel algorithm, Novel noise cancellation

Milestones Achi...
Project 5 NeoBreathe

2.6 crore
annual births

15,00,000
won’t breathe
at birth

Birth Asphyxia:

2,10,000
babies die
ever...
Project NeoBreathe
Positions
neck
automatically

In-built
suction

Heart rate
counting

Built in
Timer

No power
required
...
Team:Dr Mansi Aggarwal, Shitij Malhotra

Project 6: A better way to transfer patients in hospitals.
About the device:
• Ne...
Team: Gaurav Kulkarni, Dr Sumita Gupta

Project 7: A better way to dislodge and remove mucus in patients with COPD.
Team: Vishal Agale, Chandni Kabra, Megha Agrawal, Dr Ramakant Beesetty

Project 8: A better way to detect blood vessels in...
Device
Team: Sonakshi Pandey, Vishal Agale

Project 9: A safe & better way to manage sharps during surgical procedures.

In Unite...
Product

•
•
•
•

Designed for local requirements
Cost effective
Disposable and bio-degradable
Tested and ready to be depl...
Team: Chetan A C, Deepali Chandratre, Ekta Sachdev, Rahul Das, Sneha Venkat

Project 10: A better way for the elderly to r...
Device

Key features
• Uses Natural Energy of Body
• Economical
• Portable
• Camouflaged
Value proposition
• No external p...
Team: Aanan Khurma, Neeraj Jasmathiya, Saurabh Bag, Ripunjay Chachan

Project 11: A way to reduce hospital Acquired Infect...
Device

Key features
•
Waist mounted
•
Disposable Cartridges
•
Easy dispense
•
Wearable over any attire

Value proposition...
Team: Siraj Bagwan, Jagdish Chaturvedi, Jonathan Pillai, Siddhartha Joshi

Project 12: Percutaneous Aspiration Needle Biop...
Redefining liver biopsy

Milestones Achieved:

•
•
•
•

Working prototype
Pre-clinical trials
Physician feedback
Business ...
Team: Jonathan Pillai, Siraj Bagwan, Jagdish Chaturvedi, Siddhartha Joshi

Project 13: Emergent management of variceal ble...
Novel Features:
Balloon for intuitive
device registration

Hermetic seals for
lumen collapse

Multi-colored port for
intui...
Team: Siddhartha Joshi, Jonathan Pillai, Siraj Bagwan, Jagdish Chaturvedi.

Project 14: A safe and standardized way to per...
A standardized way for paracentesis

Key Features
• Cannula like insertion ensures safety of internal organs
• Integrated ...
Team: Jagdish Chaturvedi, Siddhartha Joshi, Jonathan Pillai, Siraj Bagwan.

Project 15: Extracting impacted nasal foreign ...
The solution
Key Features
• Semi-automated hand-held device
• Specially designed retractable end
The results so far......

• 21 different devices
• 32 provisional patents
• 5 PCT applications
• 7 products in clinical tr...
Questions / Queries ?

• Now : Ask ..
• Later : drpjha@stanford.edu
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SIB Medical Technology Innovation Portfolio

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SIB Medical Technology Innovation Portfolio.
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SIB Medical Technology Innovation Portfolio

  1. 1. Innovation in Healthcare for India The Stanford India Biodesign Programme
  2. 2. Few Healthcare Issues: General • Increasing middle age population • Poverty and poor nutrition • Pollution and water sanitation • Lack of proper roads and electricity • IMR 58; China 28; Bangladesh 54 • Out of pocket expenditure: Driving into poverty • Fragmented system - unregulated private sector Malnutrition Infectious Diseases Life Style Related Diseases
  3. 3. Few Healthcare Issues: Low innovation • Indian Med Tech industry low on innovation: • • • • • • • • Only 1% of sales invested in R&D (vis-à-vis 11% in the west) 65% of Indian manufacturers focused on low end medical disposables Very few Class III devices Talent nonexistent – vicious cycle of opportunities and dearth of trained talent Med Tech ecosystem in infancy No money for high-risk ideas – small venture capital Regulatory and IP changes good but slow No facilities for product testing, validation and accreditation
  4. 4. Situation Changing: India’s decade of innovation 2010-20 “The country must develop an innovation ecosystem to stimulate innovations. Innovators must be challenged to produce solutions our society needs. And innovative solutions with potential must be nurtured and rapidly applied” Prime Minister, Manmohan Singh
  5. 5. Healthcare Growth Driver: Growing economy Indian economy expected to grow above 7%
  6. 6. Healthcare Growth Driver: Increasing healthcare spending Healthcare spending over $200 billion by 2025
  7. 7. Healthcare Growth Driver: Government and talent • • • • • • Government spending on healthcare is increasing New schemes like NRHM; RSBY for better care National Innovation Council creating new policies Grants and small business loans available and more coming Collaborations with leading world partners Adundant talent of doctors, engineers, designers, entrepreneurs
  8. 8. Opportunity Healthcare Industry Institutes Investor Healthcare Innovation Device Manufacturer Inventors Unique opportunity to lead with affordable Med Tech innovation
  9. 9. Capturing Opportunity: Stanford India Biodesign • Only fifteen program/centers promoting medical device innovation worldwide • Stanford India Biodesign (SIB) established at AIIMS is first such program in Asia. SIB at AIIMS *SIB (Stanford India Biodesign)
  10. 10. SIB: Mission • To develop leaders in biomedical technology innovation in India • To identify unmet healthcare needs and develop solutions in India • To help develop low cost, high quality devices for the “common man” • To help ignite the Indian MedTech Industry Educate Fellowship Collaborate Innovate Internship
  11. 11. SIB: Process
  12. 12. Where this approach leads to : Let us have a look at some of the many projects this philosophy gave birth to
  13. 13. Clinical Immersion
  14. 14. Need Filtration 456 Intuitive Screening 172 Impact, Market, Feasible outcome 50 Physician Feedback + Research 15 Team Priority 3
  15. 15. Project 1: A novel way to manage fecal incontinence in non-ambulatory patients. Co-Founders: Nish Chasmawala, Amit Sharma, Dr Sandeep Singh ICUs Wards Nursing Facility 16M patients affected every year No affordable device available Domestic
  16. 16. • Developed for all stool types and sphincter tones • Easy and hygienic to use (profile and placement) • Reduces nursing time (leakage and dislodgement) • Minimal training required Moving ahead… • Product refinement • Executing clinical & Regulatory strategy • India is the first go-to market • Robust IP portfolio – national phase • Angel investment
  17. 17. Team: Jayant Karve, Srinivas Kiran, Dr Sandeep Singh Project 2: A better way to gain intraosseous access in emergency patients. Pediatric Neo-natal Cardiac Arrest Hypotension Trauma Shock Geriatric “IO infusion should be the first alternative to IV in cardiac arrest patients” Obstetric Emergencies
  18. 18. Device Placement Insertion Key features • Manual operation • Ergonomic design • Sterility maintenance • Needle guidance & visibility Remove Guide Infuse Value proposition • Controlled access • Resource constrained environment • Suitable for both pediatric & adults • Affordable
  19. 19. Team: Pulin Raje, Dr Darshan Nayak Project 3: A better way to temporarily immobilize lower limbs in trauma patients. 15Million Road Traffic Accidents (RTAs) per annum in India 5.4 Million Incidence of Lower Limb Injuries in RTAs
  20. 20. A disposable splint manufacturing in Delhi box factory Cost per unit estimate: Rs 40
  21. 21. Project 4: A novel hearing screening device for newborns in resource constrained settings. Late detection of hearing loss leads to: Non- Institutional births Institutional births Screening for all • • • • Loss of speech for lifetime Impaired cognitive development Obstacle to education and employment Expensive to the entire system 100,000 are born hearing impaired in India. 500,000 babies are born with hearing loss all over the world. Congenital hearing loss is one of the most common birth disorder.
  22. 22. Challenges: Novel features: Unique reusable electrode system, Novel algorithm, Novel noise cancellation Milestones Achieved: • • • Working prototype Safety and efficacy clinical trials Customer feedback Next Steps Team: Nitin Sisodia- Stanford India Biodesign fellow 2010 Pragun Goyal – Computer science engineer, IIT D Mayank Kumar- Electrical engineer, IIT D • • • • Product development Comparative clinical trials IP portfolio Funding
  23. 23. Project 5 NeoBreathe 2.6 crore annual births 15,00,000 won’t breathe at birth Birth Asphyxia: 2,10,000 babies die every year. Effective resuscitation can save almost all these but requires advanced skill and regular training like a pediatrician Project NeoBreathe An easy-to-use, low-cost neonatal resuscitation solution that enables primary care staff to resuscitate newborns effectively
  24. 24. Project NeoBreathe Positions neck automatically In-built suction Heart rate counting Built in Timer No power required 136 Easier, better sealing with 2 hands Can work as manual transport ventilator Objective feedback, better performance Current status: Prototype bench-tested Allows 1 person to give chest compression s also
  25. 25. Team:Dr Mansi Aggarwal, Shitij Malhotra Project 6: A better way to transfer patients in hospitals. About the device: • Next generation medical bed sheet • Unique composite polymers for comfort & functionality • Patient transfer ability when needed • Salient features – works with different height, gap and alignment • Globally 200M of surgeries & Billion plus market
  26. 26. Team: Gaurav Kulkarni, Dr Sumita Gupta Project 7: A better way to dislodge and remove mucus in patients with COPD.
  27. 27. Team: Vishal Agale, Chandni Kabra, Megha Agrawal, Dr Ramakant Beesetty Project 8: A better way to detect blood vessels in pediatric patients. Need potential Global Need - 1 of 3 Vein-puncture fails in pediatric patients Difficulties Collapsed veins www.ncbi.nlm.nih.gov/pubmed Small crosssection of veins 1.5-2 mm Blind procedure
  28. 28. Device
  29. 29. Team: Sonakshi Pandey, Vishal Agale Project 9: A safe & better way to manage sharps during surgical procedures. In United States alone 800,000 injuries occur annually due to sharps. Globally it accounts for 3.5 million injuries per year. OT’s are the second most common environment for sharps injuries. Accounting for 25% of all sharp injuries. Cause for infections like Hepatitis B and C , HIV, etc.
  30. 30. Product • • • • Designed for local requirements Cost effective Disposable and bio-degradable Tested and ready to be deployed
  31. 31. Team: Chetan A C, Deepali Chandratre, Ekta Sachdev, Rahul Das, Sneha Venkat Project 10: A better way for the elderly to rise independently from the sitting position. Population > 60 years expected to increase from 605 million – 2 Billion between 2000-2050.1 In India, 63.7 Lakhs (6.3M) elderly are confined to their home. Out of which, 14.34 lakhs ( 1.4M) are confined to bed.2 Rising from chair is a high frequency, effort-intensive activity among all daily activities. 1WHO 2Ref: Situation Analysis Of The Elderly in India, June 2011
  32. 32. Device Key features • Uses Natural Energy of Body • Economical • Portable • Camouflaged Value proposition • No external power is required • Eliminates the need of caregiver • By eliminating peak effort taking activity, increases mobility of user
  33. 33. Team: Aanan Khurma, Neeraj Jasmathiya, Saurabh Bag, Ripunjay Chachan Project 11: A way to reduce hospital Acquired Infections that spread through hands of Health Care Workers Why is hospital Hand Hygiene Low? • • • • Time Accessibility Convenience Negligence
  34. 34. Device Key features • Waist mounted • Disposable Cartridges • Easy dispense • Wearable over any attire Value proposition • Reduced cycle time • Zero contact • Last disinfection time
  35. 35. Team: Siraj Bagwan, Jagdish Chaturvedi, Jonathan Pillai, Siddhartha Joshi Project 12: Percutaneous Aspiration Needle Biopsy Need: A safer and easier way to perform percutaneous aspiration liver biopsy in order to reduce variation in tissue sample Physicians choose between: Safety + Skill (Aspiration) V/s Ease + Risk (TruCut™) 4.8 crores (48M) Patient: requiring histological confirmation and staging of suspected viral hepatitis
  36. 36. Redefining liver biopsy Milestones Achieved: • • • • Working prototype Pre-clinical trials Physician feedback Business Plan Competition won Next Steps • • • • Product development Clinical trials IP portfolio Funding
  37. 37. Team: Jonathan Pillai, Siraj Bagwan, Jagdish Chaturvedi, Siddhartha Joshi Project 13: Emergent management of variceal bleeds Need: “A better way to temporarily stabilize patients presenting with an emergent upper GI variceal bleed in order to reduce mortality and morbidity before definitive treatment “. 1.8 Crore (18M) patients with internal hemorrhaging from to liver failure (portal hypertension) Most can be saved if they are stabilized prior to endoscopy
  38. 38. Novel Features: Balloon for intuitive device registration Hermetic seals for lumen collapse Multi-colored port for intuitive identification Milestones Achieved: • • • Functional prototype Provisional IP Physician feedback Next Steps • • • • Product development Pre-clinical safety trials IP portfolio Funding
  39. 39. Team: Siddhartha Joshi, Jonathan Pillai, Siraj Bagwan, Jagdish Chaturvedi. Project 14: A safe and standardized way to perform abdominal paracentesis 3.6 Crore (36M) patients with ascites from liver failure require chronic care like abdominal paracentesis. The Problem: No dedicated equipment available for medical professionals to perform abdominal paracentesis http://www.hopkins-gi.org/GDL_Disease.aspx?CurrentUDV=31&GDL_Cat_ID=AF793A59-B73642CB-9E1F-E79D2B9FC358&GDL_Disease_ID=E19DBE4A-EE02-4BDE-9FF9-A8371834DE4A
  40. 40. A standardized way for paracentesis Key Features • Cannula like insertion ensures safety of internal organs • Integrated adhesive with the stabilizing members ensures that the product stays in place • Unique one way valve to control flow, yet allow needle entry
  41. 41. Team: Jagdish Chaturvedi, Siddhartha Joshi, Jonathan Pillai, Siraj Bagwan. Project 15: Extracting impacted nasal foreign bodies The Problem: No dedicated equipment available for medical professionals to extract nasal foreign bodies The Need: “An easier way to extract an impacted anterior nasal foreign body in a primary care setting”.
  42. 42. The solution Key Features • Semi-automated hand-held device • Specially designed retractable end
  43. 43. The results so far...... • 21 different devices • 32 provisional patents • 5 PCT applications • 7 products in clinical trials • 25 fellows and 52 interns • 6 medical technology summits • Five startups
  44. 44. Questions / Queries ? • Now : Ask .. • Later : drpjha@stanford.edu

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