my fortnightly column, A Dose of IT discussing on the innovations in healthcare delivery and technology Kapil Khandelwal QuoteUnquote with KK www.kapilkhandelwal.com

1. c m y k c m y k
Bengaluru ●● Monday ●● 12 April 2010
Apple's new
iPhone soft-
ware has a
built-in adver-
tising system.
15
Technomics
Intel has
introduced
new
Classmate
PCs in India.
Nokia has
bought loca-
tion technolo-
gy firm
MetaCarta.
DDCC
RAMYA DILIPKUMAR
DC | BENGALURU
April 11: As one walks into
a CD or DVD store to pick
up a favourite
movie/album/video game,
or as one is about to hit the
cinemas before they put up a
‘house full’ board, often
these days, one takes a step
back to think, hey what am I
doing here when I could so
easily download this music
or movie sitting at home
from one of those numerous
Internet stores.
That’s a problem staring
music stores and games and
movie DVD outlets in the
face these days. In an age
when connections across the
globe are established in mil-
liseconds and content of
every kind can be down-
loaded onto any device
within minutes, real world
music and movie stores are
at risk of losing consumers.
“We live in an age of digi-
tal revolution. People are
doing away with most of the
physical formats that con-
sume space and require
maintenance. Digital music
offers superior sound quality
and also allows for easy file
transfer,” says Siddhartha
Roy, COO of Hungama Dig-
ital Media Entertainment’s
consumer business. Months
ago, Hungama opened up an
online music store.
A majority of India’s over
half a billion mobile phone
users listen to music on their
phones, says Roy. On aver-
age, an Indian consumer lis-
tens to nearly 100 songs a
month on the phone.
“There is more music con-
tent being consumed today
than 10 years ago. Hence
companies in this segment
have to change the way they
market products, with con-
tent being readily available
online,” says Apurv Nagpal,
managing director of
Saregama.com.
Sure enough, one survey
among Indian youth
revealed that a hot-selling
music album or video game
that is not available in India
can be downloaded from
Internet sites within days of
its launch in the US. Even a
good DVD print of a Holly-
wood blockbuster is avail-
able online within a week of
its release in the US.
DVD makers and music
stores are fighting this trend.
Moser Baer, for instance,
offers new Bollywood
movies much earlier than six
months that used to be the
standard time lag between
the release of a hindi movie
in cinemas and its availabili-
ty on DVD. Stores such as
Planet M today offer CD and
DVD bundles at slashed
rates. Yet, they seem to be
losing the battle.
For, in India, the flip side
of technology operates more
effectively, and more often
than not. Legal sales of
games have taken a backseat
to piracy, helped much by
the high prices demanded
for the genuine stuff.
Says Imran Khan, studio
head of video and online
games maker FXLabs,
“Pirated games have almost
killed the sales of PC games
in India. A game that sells
millions of copies in the
international market sells
only a few thousand copies
in India. The problem is the
price at which international
games are launched in India.
The obvious choice for peo-
ple looking to save money is
to go to the pirated games
market and buy games by
the loads.”
Studio executives argue
that pirated games are of bad
quality and users do not get
a good gaming experience.
But talk to a college student,
and he reveals that perfectly
acceptable versions can be
downloaded with little
effort, finding multiple
download sites for a given
game and checking out
online comments from reli-
able sources.
“You cannot blame piracy
for everything,” says Adil
Aziz, a student. Aziz, who
says he regularly downloads
Hollywood movies from the
Internet, points out that
online content has pro-
gressed so dramatically that
music and movie companies
simply need to come up with
new ideas to sell their stuff,
rather than depend on real
world stores alone.
Nagpal of Saregama.com
is doing just that. Not only
has the company gone
online for sales of music
CDs, it has also caught on to
the trend of packaging and
selling juicy bits of every-
thing, and from a variety of
platforms. For instance, it
sells music but also as
mobile phone caller tunes,
etc.
It runs an Internet radio
station through which it sells
latest regional music tracks.
And, if you still prefer the
old way of buying music
CDs, Saregama.com, which
holds the largest archive of
Bollywood songs, offers
customized CDs . Cus-
tomers can select which
songs to put on a CD and
HamaraCD.com will burn it
and ship it to you.
SANGEETHA CHENGAPPA
DC | BENGALURU
April 11: Light emitting
diodes or LED lights have
gained popularity in the cor-
porate world as they use 85
per cent less energy than
incandescent bulbs and a
third of what compact fluo-
rescent lamps (CFLs) con-
sume. Now, LED lights are
making way into schools
and studyrooms, bringing
positive behavioural and
performance changes in
children in their wake.
Bengaluru-based Innovlite
India, which specialises in
LED systems, has con-
tributed lighting solutions
that have changed the lives
of some 100 children of a
government school in
Coorg district of Karnataka.
"We partnered with an
NGO which works in the
area of supplying renewable
energy solutions to rural
schools”, says Harish Rao,
COO, Innovlite India,
“Constant power cuts,
which sometimes lasted 24
hours at a stretch, meant
that these children were
often unable to complete
their home assignments.
That would make them anx-
ious, irritable and unwilling
to go to school for fear of
being punished.
“We created an LED read-
ing light that they could
strap onto their foreheads,
much like miners do. This
resulted in a 45 per cent
improvement in homework
submissions, happy chil-
dren who are no longer
afraid of going to school,
and relieved parents, of
course.”
Innovlite has also provid-
ed students with LED table
lamps with rechargeable
battery packs. Every day,
students detach the battery
pack and take it with them
to school. There, the batter-
ies get charged on a charg-
ing station that Innovlite has
provided to the school. And
all that energy comes from
the cleanest source – the
sun. The charging station
draws power from a solar
panel installed on the
school’s roof. The children
take the battery pack back
home with them at the end
of the day, plug it into the
study lamp, and they are on
their way to completing
homework again, Mr Harish
explained.
Yet another Bengaluru-
based company, BPL Tech-
noVision Pvt Ltd, devel-
oped are-chargeable study
light for children, partner-
ing with a team of experts
from Sankara Nethralaya.
BPL engineers, too,
zoomed in on LEDs for the
StudyLite because they are
energy efficient, flicker-
free and give out consistent
light, with no ultraviolet or
infra red radiations. With a
compact Nickel Metal
Hydride (NiMH) battery
pack, it even serves as an
emergency light during
power cuts. “Children are
the most critically affected
by power cuts. Their study
time gets disrupted, which
in turn creates a stressful
atmosphere at home. More-
over, children end up using
sub-optimal lighting substi-
tutes such as candles, oil
lamps and lanterns that
cause stress and discomfort
to the eye”, said K Gopi,
COO, BPL TechnoVision.
JOHN MARKOFF
PALO ALTO,CALIFORNIA
April 11: Hewlett-Packard
scientists have reported
advances in the design of a
new class of diminutive
switches capable of replac-
ing transistors as computer
chips shrink closer to the
atomic scale.
The devices, known as
memristors, or memory
resistors, were conceived in
1971 by Leon O. Chua, an
electrical engineer at the
University of California,
Berkeley, but they were not
put into effect until 2008 at
the HP lab here.
They are simpler than
today’s semiconducting
transistors, can store infor-
mation even in the absence
of an electrical current and,
according to a report in
Nature, can be used for both
data processing and storage
applications.
The researchers previously
reported in The Proceedings
of the National Academy of
Sciences that they had
devised a new method for
storing and retrieving infor-
mation from a vast three-
dimensional array of mem-
ristors. The scheme could
potentially free designers to
stack thousands of switches
in a high-rise fashion, per-
mitting a new class of ultra-
dense computing devices
even after two-dimensional
scaling reaches fundamental
limits.
Memristor-based systems
also hold out the prospect of
fashioning analog comput-
ing systems that function
more like biological brains,
Dr. Chua said.
“Our brains are made of
memristors,” he said, refer-
ring to the function of bio-
logical synapses. “We have
the right stuff now to build
real brains.”
In an interview at the HP
research lab, Stan Williams,
a company physicist, said
that in the two years since
announcing working
devices, his team had
increased their switching
speed to match today’s con-
ventional silicon transistors.
The researchers had tested
them in the laboratory, he
added, proving they could
reliably make hundreds of
thousands of reads and
writes.
That is a significant hurdle
to overcome, indicating that
it is now possible to consid-
er memristor-based chips as
an alternative to today’s
transistor-based flash com-
puter memories, which are
widely used in consumer
devices like MP3 players,
portable computers and dig-
ital cameras.
“Not only do we think that
in three years we can be bet-
ter than the competitors,”
Dr. Williams said. “The
memristor technology really
has the capacity to continue
scaling for a very long time,
and that’s really a big deal.”
As the semiconductor
industry has approached
fundamental physical limits
in shrinking the size of the
devices that represent digital
1’s and 0’s as on and off
states, it has touched off an
international race to find
alternatives.
New generations of semi-
conductor technology typi-
cally advance at three-year
intervals, and today the
industry can see no further
than three and possibly four
generations into the future.
The most advanced tran-
sistor technology today is
based on minimum feature
sizes of 30 to 40 nanometers
— by contrast a biological
virus is typically about 100
nanometers — and Dr.
Williams said that HP now
has working 3-nanometer
memristors that can switch
on and off in about a
nanosecond, or a billionth of
a second.
“We believe that that is at
least a factor of two better
storage than flash memory
will be able to have in that
time frame,” he said.
The HP technology is
based on the ability to use an
electrical current to move
atoms within an ultrathin
film of titanium dioxide.
After the location of an atom
has been shifted, even by as
little as a nanometer, the
result can be read as a
change in the resistance of
the material. That change
persists even after the cur-
rent is switched off, making
it possible to build an
extremely low-power
device. The new material
offers an approach that is
radically different —NYT
Hewlett-Packard sees a revolution in memory chip
LED lights
help children
say QED
India’s digital youth force
music stores to innovate
The memristor could lead to far more energy-efficient
computers with some of the pattern-matching abilities
of the human brain.
Real world music stores are seeing dwindling sales, as consumers increasingly buy
music and movies from online stores such as Apple's iTunes store.
Focus Lighting, a New York-based lighting design
firm, used LED's to create light paintings on the
exterior of the façade of The Marcus Center in
Milwaukee, US. —NYT
Dynamic lighting
Consumer electronics giant Philips commis-
sioned a year-long study in Germany that
revealed that dynamic lighting helps school
children reduce errors, calms rayed nerves
and reduces hyperactivity. In the process, chil-
dren score better grades.
“The idea was to find out whether dynamic
lighting could be used to influence learning
behaviour. The results are astonishing: Stu-
dents’ reading speed rose by 35 per cent
under dynamic lighting. Errors decreased by
45 per cent, and hyperactivity came down by
76per cent, compared to children in a control
group that used standard lighting,” said Murali
Sivaraman, MD & CEO of Philips Electronics
India Ltd.
KAPIL KHANDELWAL
India is going to be the
most populated country
in the world and also one
of the largest mobile
phone markets, with over
half a billion consumers,
who will soon be going
online at 3G speeds. The
Indian healthcare indus-
try and ICT innovation
delivery story has come a
long way. We witnessed
the telemedicine innova-
tion back in 1999, when
several large healthcare
facilities in India linked
up with healthcare facili-
ties in the rest of Asia.
Over the years we have
branched into niche
application solutions of
telemedicine such tele
diagnostics, tele surgery,
fetal telemedicine, tele
ophthalmology, to name
a few that are world-
class. But if we are to go
by the metric of number
of patents filed in this
area or having a fair voice
in global accreditation
and certification consor-
tia like Continua Health
Alliance, India has fared
abysmally. We still have
to break the code to
healthcare delivery inno-
vation and connect with
ICT that can impact
healthcare delivery to
millions of Indians!
For any aggressive
innovation programme
that can break the shack-
les in Indian healthcare
delivery, we need to
understand that our
healthcare system erects
an array of barriers to
each delivery innovation.
More often than not,
though, the obstacles can
be overcome by manag-
ing six key components
that have an impact on
healthcare innovation to
interplay with ICT indus-
try in India. These
include healthcare and
ICT industry players
themselves, including the
private, government and
social sector participants,
innovation funding, pub-
lic healthcare and ICT
governance policy, tech-
nology, customers and
accountability. Each can
help or hinder efforts at
healthcare delivery inno-
vation.
Individually or in com-
bination, the factors will
affect consumers, tech-
nology and the delivery
models in healthcare in
India. Hence an ecosys-
tem approach to engaging
the six components is
essential to move to
health 2.0 models that are
localized but still have
global applicability.
So what are the pre-
scriptions for the six
components? First, look
at the current mess in
healthcare delivery: Hos-
pitals and doctors blame
technology-driven prod-
uct innovators for the
healthcare system’s high
costs and failures. Med-
ical specialists wage turf
war for control of patient
services, and insurers
battle medical service
and technology providers
over which treatments
and payments are accept-
able. Inpatient hospitals
and outpatient care
providers vie for patients,
while hospital chains and
independent providers
spar over market influ-
ence. Nonprofit, for-prof-
it, and publicly-funded
institutions quarrel over
their respective roles and
rights. Patient advocates
seek influence with poli-
cy makers and politi-
cians, who may have a
different agenda altogeth-
er. None of this is easy to
fix. Quite clearly, fixing
the ICT part is the easiest
piece of the puzzle.
Next, funding and gov-
ernment policies are like
double-edged swords that
have sometime aided or
hindered the innovation
play. Governments will
need to step away from
the delivery of social
infrastructure in health-
care to shaping regulation
and real governance of
the delivery system.
Third, where we have
failed in the past is the
need to appeal to doctors,
who are in a position to
recommend and adopt
newer models to patients.
Lastly, as consumers
demand higher engage-
ment with providers and
companies that deliver
products and services,
their activism and behav-
iour will impact on busi-
ness outcomes for health-
care providers and com-
panies, and therefore
force change.
There is no secret sauce
for how to blend the six
components to enable
successful healthcare
delivery innovation in
India, accountability will
yet have to fall in place.
We simply have to try it
out!
Innovating in
healthcare delivery
A Dose
of IT
Hospitals and
doctors blame
technology driv-
en product
innovators for
the healthcare
system’s high
costs and fail-
ures. Medical
specialists
wage turf war
for control of
services.
Kapil Khandelwal is a leading healthcare and ICT
expert. kapil@kapilkhandelwal.com