Dispatch from Bangalore
Sameer Sawarkar on why remote diagnostics can bring care to the last mile
While visiting Bangalore to learn about new programs working to improve the way health markets perform for the poor, we met techno-savant Sameer Sawarkar.
In founding Neurosynaptic with Rajeev Kumar, in 2003, Sameer set out to make the impossible possible: Get trained urban doctors to examine patients in remote villages of India. The magic carpet? Low-bandwidth internet connections linking trained urban doctors to patients who are examined by anyone trained to use a basic diagnostic kit with equipment including blood pressure monitors and thermometers. The kit is operated at village internet kiosks with a computer and video conferencing software. The ReMeDi™ (Remote Medical Diagnostics) range of product, developed by Neurosynaptic in collaboration with the TeNeT group of the Indian Institute of Technology at Madras, allows transmission of various vitals to a doctor for preliminary diagnosis, either in real-time or in a store-and-forward mode.
Already deep in meetings at 9am on a Sunday morning, Sameer took a break to speak to us about his vision for his company and health delivery.
What problem did you see with the health market? Patients don’t seek care promptly and the cost of transportation and services, and remaining out of work, makes them sell their assets. They are pushed below the poverty line. We knew the situation but we started thinking, can we change it? Can we bring doctors not physically present? We came at this with a technology solution because that was our background.
Do patients trust doctors who live elsewhere? Video and audio conferencing helps build trust between doctors and patients. It also helps doctors pick up cues, and that aids in ensuring a correct diagnosis. The operator also facilitates the exchange.
What organizations use your kits in villages? It’s about creating an ecosystem, it’s not about putting a box in a village. Right now we work a lot with World Health Partners in 150 villages, telemedicine centers catering to approximately 1500 villages in three districts in Uttar Pradesh and one district in Madhya Pradesh. In addition, we have deployments in Karnataka, Tamil Nadu, Andhra Pradesh and the Northeast. I met Gopi Gopalakrishnan in 2005 and learned about his transformative interventions with rural medical providers.
What obstacles remain to scaling up your approach? If patients do not encounter an end-to-end delivery ecosystem, the trust level in the system as a first option for healthcare reduces. Though connectivity has been steadily penetrating the villages, the reach and quality still needs to improve. There are various legal issues that have to be looked into, and an inclusive view has to be taken on various aspects, so that the access problem can be solved.
Where do you want your company to be in two years? I want to be collaborating on a large scale with implementation partners in other developing countries. We need to understand the processes required and ground realities with our partners first to get to large populations in a sustainable way. It is not going to be a two year grant-funded program. It needs to run on its own.