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Disruptive Healthcare
The
Stanford-India Biodesign programme is spearheading a revolution in the
field of medical device innovation — the first in a fortnightly column
Asemi-automatic device that simplifies liver
biopsies and makes them safer. A mobile app that quickly references brand
names, dosages and prices of drugs sold in India. A device to manage faecal
incontinence in ICU patients. An affordable gadget that simplifies the
process of resuscitation of newborns, another that screens infants for
hearing defects in resource-constrained locations, a third that provides a
cost-effective solution to assess foetal well-being to reduce stillbirths.
For the elderly? A device that helps the aged get up independently from a
sitting position. A device to dislodge mucous from the respiratory tract of
those suffering from chronic obstructive pulmonary disease. I could go on,
but you get the picture.
There’s a quiet revolution going on in the field of
medical device innovation that not many outside the healthcare sector are
aware of. It is big enough that it has begun to attract not just serious
interest from industry — companies like Johnson & Johnson, Sushrut,
Medtronic, Stryker, Philips and Siemens — but also some solid venture
capital backing. What’s significant is that this isn’t just a flash in the
pan. Innovative, affordable and elegantly designed devices that add value
to existing medical processes and make them simpler, cheaper and more
accessible are emerging in the Indian horizon with delightful regularity.
And one of the catalyzing forces in making this happen is the
Stanford-India Biodesign (SIB) programme whose fellows are rising to the
challenge of addressing unmet needs of the medically under-served since the
programme began in 2008.
Revolution in the Lab
SIB has an unlikely trio of collaborators — Stanford University, the
New Delhibased All India Institute of Medical Sciences (AIIMS) and the
Indian Institute of Technology-Delhi (IIT-D) — and is funded by the Indian
government’s department of biotechnology. By using experiential teaching
methods with cross-disciplinary teams the fellowship has managed to create
a cohort that is focused on creating new, cost-effective, devices
customized to India’s healthcare needs.
The first thing SIB fellows are taught is how to
identify unmet clinical needs. They spend the first six months of the
two-year fellowship at Stanford, following the curriculum of the Stanford
Biodesign programme, which began in 2001 to help train leaders in
biomedical technology innovation. SIB fellows learn to examine clinical
needs within an Indian setting and identify opportunities for medical
technology innovation.
“We are trying to change the milieu of innovation
in India,” says Balram Bhargava, executive director of the programme and a
cardiologist at AIIMS. One of SIB’s stated missions is “to develop the
Indian medtech innovation ecosystem”. And talking to some of the fellows,
that does seem to be happening. ENT surgeon and 2012 fellow Jagdish
Chaturvedi has already invented 12 devices, of which five are already
successfully licenced and created a whole new career for himself. “I learnt
design thinking, mechanical engineering, business models, IP and regulatory
basics and also got a chance to work with steel, wood, plastics, nitinol
and foam, things that a doctor can never imagine to learn in a short course
of time,” he says.
He now limits his clinical work to two days a week,
spending four days working on his inventions as director, clinical
innovation and partnerships at start-up accelerator InnAccel, Bangalore.
When I asked some of the fellows to describe the value of the programme,
the most commonly used words I got in reply were “life-altering” and
“transformational”. In the words of a 2013 fellow, Abhinav Ramani, it
“changed the way I think about problems in our world and how medical device
innovations can disrupt the way we think about healthcare delivery in
India.”
Spreading the Vision
What’s even more interesting is how the programme teaches its students
to value failure, a basic building block of entrepreneurial spirit. As 2010
fellow Pushkar Ingale says, “The fellowship brought a new perspective to
failures in my mind. It taught me to enjoy failing with a purpose. One line
often quoted in our process is to ‘fail early, fail fast’.”
Innovation is at the heart of the very Indian
concept of jugaad, but when that is improved upon, structured and
documented, it can be scaled up, leveraged and monetized — and becomes more
useful to more people. And that is the real success of the SIB programme.
Singapore has now replicated the SIB model with the
Singapore-Stanford Biodesign programme, and other foreign universities are
also showing keen interest, some in tying up with SIB directly. Bhargava’s
desk at the SIB office is littered with business cards from the UK, Japan,
Finland and Australia. “We are good at identifying indigenous needs,
clinical immersion and early protoyping. But high-end electronics isn’t our
strength — we can use international help there,” Bhargava says.
With his cohort of bright, dynamic youngsters,
Bhargava is planning an international fellowship on frugal innovation,
which will create teams of three Indian and one international students. At
a recent medtech conference, I heard mottos like “Identify, Invent,
Implement,” and “Innovate, Educate, Collaborate”. But the one I liked best
was “Learn One, Do One, Teach One,” while referring to innovation. That’s the
one that captures the essence of what SIB and Bhargava are trying to do.
• :: Jyoti Pande Lavakare ETM140209
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