Last week, I forget which day it was, some folks at office invited two academicians / entrepreneurs from Stanford to talk about Biodesign – essentially the science and art of developing medical technology and products.
An occasional shift from my lazy self, I took some notes. And so I thought I will put this out on the net, since it does not contain any hush-hush secrety stuff. Needless to say, if there is something inaccurate in the notes below, it is most likely the manifestation of my ignorance and consequential misinterpretation.
The presentation was divided into two parts, one part by each speaker. The first speaker, Dr. Anurag Mairal further broke it into two pieces of his own. He spoke on Medical Technology in India and China. He offered the hypothesis that while there were some similarities because of the emergent nature of technology and economy between the two countries, they were fundamentally very different (and hence the need to tackle them separately).
- Medical Technology in India and China
- India: A breeding ground for disruptive, quality innovation
- China: A device exporter in the making ?
The other speaker, Dr. Rajiv Doshi spoke about the Stanford Biodesign Process, what it is and what kind of results it has yielded.
India: A breeding ground for disruptive, quality innovation
- India has always tried to be innovative with medical technology, but successful only in small scale and the number of successes are few. Spoke about Jaipurfoot (jaipurfoot.org, product innovation) and Aravind Eyecare system (process innovation).
- Actual spend in healthcare as % of GDP has always remained lower than what is considered as optimal spend (~10%) in the western world
- Indian industry not very innovative
- 65% are low end medical suppliers
- Few class III devices
- Only 1% of revenue ploughed back into R&D, c.f 11% in the west
- Very little venture capital in this industry
- Low physician-industry collaboration
- This is considered "unethical" (unlike the west)
- In the other part of the talk, Rajiv Doshi mentioned (quite strongly and by self-admission, provocatively) that he considered working with doctors is NOT the right way to innovate
- Doctors in India consider themselves as gods. Not ready to listen
- They are so much into what they do and justify it, unable to see potential change in workflow etc
- Zero to little animal testing facilities
- Talent pipe-line non-existent
- Stressed that while people in themselves are intelligent and entrepreneurial, there is an acute lacuna in course structure and formal ecosystems
Reasons for Optimism
- Disease pattern shift: More of chronic lifestyle diseases, diabetes, cardiac etc, less of actue (infections) – malaria, pox etc ==> general healthcare apparatus improvement
- Emerging middle class: demand for better healthcare service, outcomes and devices
- Resurgence in rural healthcare:
- Asha : http://asha-india.org/photo-gallery/healthcare
- ANM :(Auxiliary Nurse Midwife)
China: A device exporter in the making ?
Primary thought was that China is good at manufacturing things, not necessary at inventing things
- 1.3 B people. 80% healthcare is urban
- 60% demand for imported western medicine
- Very costly to get sick, even with government support for healthcare – which does not advance beyond basic care
- People in china save for 3 things: Child education, healthcare, and if money is left a house
- China spends less that India on healthcare as a % of GDP (which was surprising to me)
- But significant government investment in healthcare infrastructure, but not enough training – the speaker cited examples he personally saw of floor cleaning machines in rural hospitals lying unpacked
- Insufficient capacity – everyone prefers to go to cities for healthcare
- Lack of high quality patient care
What China needs:
- Affordable technology
- Devices or solutions that require less training, ease of use
- Better clinical outcomes (patient care quality is not high)
|Jugaad is also prevalent in China; the people are very pragmatic and worry about "today’s problems and solution". Unlikely to come up with technologies for problems that do not exist today|
Second part of the talk was by Rajiv Doshi on the Stanford Biodesign Process. The Biodesign course taught in Stanford takes interns for 6 months, trains them at Stanford and then sends them back to India (or Singapore); depending on the country of the individual for 6 months to work on a project. Primarily the biodesign process, or the science/art of making medical technology products is based on this following book.
Principle philosophy is
- Identify (the need)
- Invent (the solution)
- Implement (the product)
This is a pretty well structured and involved methodology, I would highly encourage the reader to visit : http://www.stanford.edu/group/biodesign/cgi-bin/ebiodesign/
He spoke about a few key themes (in addition to describing the course)
- Engineers tend to focus on the solution rather than the problem. They fit technology to a solution, not the other way around (which we need to do)
- It is not difficult to find a problem to tackle; there are many. But the challenge is to prioritize which one(s) need to be solved. This lack of clear judgment is causing many startup to derail.