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The Innovations that are Transforming Telehealth

Telehealth or as I would like to call it healing from a distance in a large and developing nation like India encounters at least three major challenges. The first one is that of inequitable access what I mean by that is whereas 75 percent of doctors are actually located in urban India. Seventy five percent of the population of India is in rural India and this leads to a abysmal ratio of one doctor to 25,000 rural citizens.

The second challenge is that of access to specialists. So, even if there is a very good primary health care network, the ability to access an infectious disease specialist is scarce and it's costly when that access is available. And, the last one is about massive data overload and the requirement of massive analysis at the cloud. A smart hospital by reckoning generates about five terabytes of data per day, India roughly has about 10,000 hospitals; imagine if in another 15 years all of these 10,000 hospitals and many more become smart. The amount of data that the hospitals alone will generate is equivalent to one third of India's daily internet traffic today. So this problem of sending all the data to the cloud and analyzing is actually a growing one and it will it will be up on us before we before we know it.

At the core of telehealth is the ability to have fast, reliable low latency, and affordable connectivity such as that is promised by 5g; the second set of innovations are around energy efficient sensors for collecting and processing vitals, for collecting imaging, video, audio, patient biometrics, etc, in a very secure manner. It's paramount that patient’s privacy and patient’s secret personal information be kept secure. The third set of technologies focus on computing and artificial intelligence at the edge including computer vision; and this alleviates the problem of data overload at the cloud.

At Qualcomm we have been fortunate in lending an enabling hand to India's grassroots and high-tech innovators by incubating about 65 of the country's most innovative startups since 2016. Our startups use system design, this incorporates wireless, AI, innovative hardware, and also they learn to protect their inventions through patenting. While the startups represent many emerging industries, more than a quarter of them are in healthcare. Let me highlight three of them in alphabetical order – Artillus, Beto and Dosi.

Artillus is in the field of diabetic retinopathy diagnosis. Their innovation is to dramatically speed up the diagnosis of diabetic retinopathy which afflicts a third of diabetic patients. If detected early, it can be treated to prevent progression into blindness. What they have enabled is contactless screening which is enabled by AJI on a Qualcomm snapdragon device. Their machine does not need to be connected to the internet continuously but it can offer touch free fundus eye exams in less than three minutes with a preliminary diagnosis of whether or not the patient is a candidate for further screening. Because the AI analysis on the machine can determine the likelihood of diabetic retinopathy.

The second startup is Beto, whose technological innovation is that of a small form factor IoT Glucometer for those affected with diabetes. This Glucometer connects to your smartphone and it runs an AI-enabled triaging app on the phone itself, and it also trains a cloud model for diabetic care and management. They have an intelligent nudging system that helps users take corrective actions to gain better control over blood sugar levels. In fact, during COVID-19 they observed an elevation of glycemic index of more than 20 per cent due to lockdown stress, and they tighten their intelligence system real time and helped this set of users return back within the control group.

The last startup Dosi’s technological innovation is that of monitoring vitals such as pulse respiration stress, sleep quality, in-home settings, and also patient vitals including oxygen saturation levels, temperature in hospital settings. They train both an edge AI as well as a cloud-based AI model to derive inferences on sleep quality on vital strengths and also provide emergency alerts. Their business innovation is a consumer-oriented sleep management system which includes enhancements such as guided meditation and guided breathing. For the hospital side they can allow for nurse stations to monitor patients on multiple beds on multiple wards using their hospital grade system.

The innovations don't stop only at the point of care or at home or in the hospital situation, there are other startups that have learned to adapt their products and services to the demands of COVID-19. We have one startup called Black Frog, who came up with a medical grade last mile vaccine transporter. They adapted their vaccine transmitter for transporting other biologicals such as blood plasma.

The key point is all of these guys design end-to-end systems that include hardware, connectivity, and have a continuous AI-enabled learning for something that is unique for Indian healthcare settings. Collectively our startup alumni have filed upwards of 95 patents to protect their own innovations and hard work. The scope of intelligent and secure electronics is limitless for telehealth. Finally, sophisticated machine learning models are aiding both physician and robotic surgeons in making more accurate decisions during complex surgical procedures.

Incorporation of augmented reality into the medical field will further revolutionize the standard of care and the ability to help patients. For instance with XR glasses not only nurses and doctors would be would have their hands free but they would also have a superman style x-ray vision. Imagine a doctor looking at a suspected fracture and she can not only look at the hand, the x-ray that was taken would be side by side and she would know exactly know how to treat the broken limb.

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Sudeepto Roy

Guest Author Vice President, Qualcomm Technology Licensing, San Diego, USA

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