Shahid Akhter, Editor-in-Chief, ETHealthworld spoke with Dr Rohit SharmaFounder and CEO, GRAINPAD and Co-Founder, ZINI AI to learn about the opportunities for healthcare start-ups and the challenges they face to emerge as winners.

Start-ups in the field of health: the challenges
I believe that the biggest challenges that innovative start-ups, especially AI start-ups, are currently facing in the field of healthcare is that there is still a lack of policies and guidelines for the part of the government or government agencies on many subjects. Many healthcare start-ups work in silos. Doctors don’t know how technology works, and technicians don’t know how the medical field works, and then policymakers sometimes don’t have a medical background, and they don’t know how to come up with good policies. So the policy makers, the doctors, the engineers, and then the insurance companies, those who are the payers, although they are not very big players in India, play a role. Payer, patient and provider, i.e. doctor and decision maker, are out of sync in our country, resulting in policy paralysis and lack of implementation. And that frustrates start-ups because they’re building a solution but don’t know where to go with it. I think that’s one of the biggest challenges.

Healthcare Startups: The Way Forward
I think the way forward is for the government to come up with implementation policies now. There was a lot of motivation and a lot of young stars jumped on the start-up train, there was this momentum and it was good, it was necessary. But now is when we need the policies for implementation. And I think the main solutions would be, number 1, that the government needs to incentivize the local bureaucracy to create start-ups in their own geographic area. And that would be a very big trigger for the local level of start-ups. Secondly, I think the motivation of innovative start-ups must increase. Right now, as I said, we’re focusing more on telemedicine and software and rule-based systems. While the West is focusing on AI-powered solutions, 3D bio-printing, genetic engineering, and those kinds of start-ups require a lot of motivation, a lot of research-driven mindset, a lot smart, educated people with high IQs need to start coming to start-ups. Teachers in educational institutions may have to start and there will have to be a lot of infusion of capital because, as I said, there has to be a lot of experimentation in these areas. I think the policies around implementing startup solutions, creating a payment system for startups where startups feel safer that the government is going to do pilot projects with them, and then certainly capital injection and research-driven startups need to have special policies around them. This will definitely help the startup ecosystem in our country. Idea behind ZINI and GRAINPAD
It started way back when I was still doing an internship during my medical school days. The trigger had only started then. We were assigned as interns in different departments. I worked with my professor in pediatrics and she was a very renowned doctor in this field. And I’d be sitting in her OPD and my job as an intern was just to stack the stack of lists so that the patient would come to her in the correct order. I used to see over 150 patients every day and see her within 9 to 3 and those would definitely include children but old ladies bringing their children and patients from all over the State. And I would see that they would come so far and barely get 30 seconds of his time and they wouldn’t be able to fully explain what’s wrong with them. And sometimes the old ladies forgot to say something and once they got out they couldn’t come in. And I used to watch that and I didn’t feel right. And it was kind of a seed but I didn’t know what to do, I wasn’t a technician, I wanted to do something but I didn’t know what to do.

When I came to private medical practice, I worked in private hospitals, I also did my own OPD. So there I observed that coming to the hospital is usually the last resort for the patient, like when nothing else works and they’d rather go to a local quack, go to a local chemist and save some money, save time and who would want to go to the doctor and spend so much time and money and all that and once they come to the doctor they still don’t know if they’re going to get a satisfactory answer or a satisfactory deadline. Even according to a WHO study, we give an average of 2 min 20 sec per patient in India. This is the average, so many patients need to receive less than this. This prompted me to build a kind of system where patients, from the beginning, receive the right advice.

ZINI and history
ZINI is an AI-powered story that takes the pod to be very technical. And what we have built, ZINI is an AI-powered chatbot that is able to automate this process. Until now in the history of mankind, only a qualified doctor could do this. And because he understood that, we could guide the patient, you have to go here to investigate and come back to me and follow this preliminary treatment path.

ZINI automates this process. We have invented a bot which is equipped with data-driven learning and many contributions from nearly 50 doctors and engineers, which is able to do all the talking with the patient, determine what is probably wrong with the patient in his AI-powered mind and guide the patient like what the probable diagnosis might be, how urgent the situation is, what type of specialist is best for him, where is the doctor or hospital located closer to where he could go, what type of examination can be ordered, etc. educational content to read. So it’s not a replacement for a doctor but it’s a smart engine that can become the first point of contact and a guide for the common man and it has also found applications in the B2B field where hospitals and telemedicine companies use it on their platforms to collect the first information about the patient. Insurance companies use it to essentially automate the underwriting process. Thus, many applications have come from the brainchild of ZINI.

ZINI clinic and future projects
So, going forward, we are very motivated and excited about the new concept that we have brought, it is called the ZINI Clinic. Recently we received the 5^e Parivartan funded by HDFC bank to support this initiative. So it’s a clinic that has an AI-powered robot to take the patient’s history, there’s a nurse to take care of vital patient monitoring, and the AI ​​system usually does a preliminary report which is shared with the doctor seated remotely who speaks again, video talks to the patient, and then sends a signed prescription. Thus, this model is not totally dependent on the availability of the human doctor 24/7, but at the same time has a bridging element to give basic advice and connect with the doctor. This is a new initiative that we are experimenting with and which has met with a very good positive response. We work with insurance companies and telemedicine companies, like I said, they find apps that use ZINI to collect basic patient information and then use that data for all kinds of patient benefits as well as their organization. And we look forward to publishing our research, we are doing a lot of research with our findings so far over the past 3-4 years. We want to work towards the publication of this research.

Future of healthcare
In general, I see the future of health care as very revolutionary in the coming days, because ZINI itself automates the conversation part when the doctor makes the preliminary determination of the symptom. There’s an Israeli startup that 3D printed an entire rabbit heart. So you could print human organs and it would be I don’t know where aging would go from there. Elon Mask has created a robot capable of performing brain surgery on a pig without any human intervention. So, from the initial assessment of symptoms, to examination, to investigations and even the impression of human organs, I see a lot of revolutions happening. I would like this to happen in India as well, but let’s see what we get from here. Overall, the healthcare industry has a lot to offer over the next 10 to 20 years.