A device to convert any toilet at an outreach camp or a healthcare facility in to a smart biosensing toilet to screen and/or diagnose chronic kidney disease.

1. A platform that allows for the early identification of Chronic
Kidney Disease with a Urine Based Screening Tool
HiiiH Technologies

2. The Team
Multidisciplinary Team
Dr Jagdish Chaturvedi
Clinician
Founder, ENT Surgeon,
Innovator, Author,
Entrepreneur, Stand up
Comedian
Dr Rohan D’Souza
Clinician
Abu Saquib Tauheed
Mechanical Engineer
Clinician, Affordable
Inventions in Medtech
Fellow, Former Medical
Advisor at Pfizer
Mechanical Engineer,
Affordable Inventions in
Medtech Fellow, Former
R&D at Stryker
Ravi Jangir
Product Designer
Product Designer,
Innovator, Engineer,
Affordable Inventions in
Medtech Fellow
Saravanan A
Electronics Engineer
Certified Internal Auditor,
Former R&D at IoT, Coeo
and Ezemrx.
Dr Ravi Deshpande Nephrologist Clinical Expert & Advisor

3. Need Identification:
1 year, 50 healthcare centres, 11 states, 200+ clinical needs
Critical Care, Obstetrics & Gynecology
Minimal Access Surgery, Neurosciences
Epidemiology, Criticality, Complexity
Regulatory Landscape
40 Top Needs
Our need

4. Our Need Statement
● A reliable, simple, and affordable way to screen for early identification of patients with
Chronic Kidney Disease to initiate treatment early and thus reduce the health and
economic burden of end stage renal disease and cardiovascular events
○ Why reliable?
○ Why simple?
○ Why early?

5. Why Chronic
Kidney Disease
(CKD)?

6. Burgeoning Epidemiological Burden in India
Australian Bureau of Statistics. Australian health survey: First results 2011-12. 2012. Report No.: 4364.0.55.001
Agarwal, S. K., and R. K. Srivastava. "Chronic kidney disease in India: challenges and solutions." Nephron clinical practice111.3 (2009): c197-c203.

7. Disturbing Morbidity & Mortality Data
● Mortality: Double of those without CKD
○ When adjusted for sex, age, and race, mortality rates with CKD of 111.2 per 1,000 patient years more than
double that of those without, 45.2 per 1,000 patient years.
1. Morbidity and Mortality in Patients With CKD: 2016 USRDS ANNUAL DATA REPORT
2. Ohtake T, Kobayashi S, Moriya H, Negishi K, Okamoto K, Maesato K, Saito S. High prevalence of occult coronary artery stenosis in patients with chronic kidney disease at the initiation of renal replacement therapy. Anangiographic examination.
J Am Soc Nephrol. 2005;16:1141–8.
● Sky high Re-hospitalization rate
○ 21.4% of patients with CKD were readmitted within 30 days.
● High cardiovascular event risk
○ Patients have diabetes on dialysis have a Coronary artery stenosis prevalence of 89.9%

8. Astronomical Economic Burden
http://www.indianjnephrol.org/article.asp?issn=0971- 4065;year=2014;volume=24;issue=3;spage=141;epage=147;aulast=Satyavani
₹49,500
£1.37 billion
$49 billion
$4 billion
Median monthly cost for an
Indian patients on dialysis
UK (NHS) spend per year
USA (Medicare) spend per year
Australia spend per year

9. Current Management of CKD is stage
dependent
Stage 1, 2
Reversible
1 2
Stages of
Chronic
Kidney
Disease
3 4 5
Stage 3, 4
Irreversible Delay onset
of ESRD
Stage 5 (Late stage)
Renal replacement therapy
(Dialysis, Transplantation)

10. Current Gaps in the early CKD Management
are mostly in identification
• Massive at-risk population
• Lack of awareness & symptoms
• Lack of sensitivity of tests
• Lack of use/access to screening tools

11. More than 90% are not aware that they
have Chronic Kidney Disease

12. The current issues with Mass Screening
● Operational difficulty outside the laboratory setting
● Cultural stigma
● Resource constraints
● Cost effectiveness

13. Need Criteria
Must have
o Easy to implement (Cultural, Operational)
o Reliable in the early stages
o Ability to screen multiple individuals
o Quick (within 60 seconds)
o Aligned with clinical guidelines
o Cost-effective
Nice to have
○ Urine based
○ Data gathering, assimilation

14. OUR SOLUTION
A platform to Mass Screen a public cohort at
an outreach camp conducted by healthcare
providers based on clinically accepted renal
parameters detected in the urine by
converting regular toilets into a “Smart
Biosensing Toilets”
WHY IS IT BETTER?
●Facilitate detection at Stage 1 & 2
●Mass population based screening possible
●Ease of operability
●Cost effective

15. Value Proposition
● Improved Health outcomes
● Improved Quality of Life
● Reduced health based
expenditure
● Cardiovascular risk reduction
● No operational difficulty
PATIENT/PUBLIC
● Widening of the patient funnel
● Increased footfall
(hypothesized increase in
revenue)
● Operational ease of use
● Cost effectiveness
PROVIDERS
● Improved health outcomes for
their patients
● More reliable tests for early
CKD
CLINICIANS

16. Business Model Canvas
Key
Partners
• Govt bodies
• Private
healthcare
providers
• Nephrology
Association
• Diabetes
Association
• Hypertension
Association
Key
Activities
• PPP campaigns
• Awareness
campaigns
• Clinical trials
Value
Proposition
• Low cost mass
screening for
highly prevalent
disease
• Early diagnosis
• Improved
outcomes
• Global standard
screening
technique
• Simple urine based
Customer
Relationships
• Awareness
campaigns
• Training
• Epidemiological
studies
Customer
Segments
• At risk Patients:
Diabetics,
Hypertensives,
Smokers, obese
• Public sector:
Govt. Bodies,
Associations
• General public to
be screened
• Private sector:
Hospitals,
clinics,
pathology labs,
screening camps
Key
Resources
• Biomarker
Distributors
• Precise plastic
molding
Channels
• Direct sales to
public & private
partners
• PPP awareness
campaigns
Cost Structure
• R&D cost
• Manufacturing cost
• Testing & clinical trials cost
• Implementation cost
Revenue Streams
• Sales model:
• Device cost + Recurring Consumable
costs

17. Milestones
Project
Kick-Off
POC
MRD, Concept selection &
feasibility, Predicate
device analysis,
Preliminary design specs.
Design Inputs
Proof-of-Concept, Working
principle & Design Inputs (PRD,
SDD, SAD, SRS , PDD) freezed
Mar18 Sep18 Dec18 July19 Jan20 Apr20 Mar20 Jul20
Pre-pilot
Functional pre-pilot units
design, Mfg. & V&V (Validation
study with patients)
Manufacturing Transfer
Transfer for pilot unit mfg.
Design transfer inputs
DHF
Production & V&V
Production, Finished goods
Verification & Validation
Pilot Study
Mass screening study &
completion
Product
Launch

18. Why now?
- Enable and complement Govt. initiative
- Burgeoning Chronic Disease epidemic in India
- Shift towards sustainable healthcare models
- Value based healthcare delivery
What next?
- Diversifying across Therapy Areas
- Screening for bladder, prostate cancers
- Identifying pregnant mothers with eclampsia
- Epidemiological studies