Creating Value Creation in Healthcare by Innovating Thoughtfully with Ashim Roy, Co-Founder & CEO, Cardiotrack

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there’s one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That’s why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I’ve been able to reach thousands of people every single month that I wouldn’t have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That’s outcomesrocket.health/podcast.

: Welcome back once again to the outcomes rocket podcast where we chat with today’s most successful and inspiring health leaders. I really thank you for tuning in again because we have an outstanding guest for you. His name is Ashim Roy. He’s the co-founder and CEO of Cardiotrack. Ashim champions the cause of value creation in every activity and uses innovation as the key tool for such value creation. After an illustrated career in the telecommunications industry with successful deployment of several generations of products from PSTN through 4G, Ashima is now working to bring I.T. solutions to healthcare industry health care technologies of the past have created access barrier for people in the developing economies. His focus is development of disruptive innovation to challenge the dominance of standalone medical technologies. On the podcast, we’ve had the privilege of having several international guests and Ashim is here to round out his experience and talk to us a little bit about what it is to create health care solutions for this international world. He has worked in several countries like Australia, Canada, USA and India where he’s coming to speak to us from. And he’s created talented teams to deliver technology and business solutions to clients across markets in these areas. It’s a pleasure to have Ashim on the podcast. Ashim, welcome.

: Thank you. Thanks for the great introduction. I really appreciate.

: Absolutely esim. Now that I leave anything out of your introduction that you want to share with the listeners.

: Oh sure. Actually what happened is that since my graduation undergrad is in India I had left the country. I did my Ph.D. in Australia and then I stayed overseas. I most stayed from Canada to US and I came back to India about 30 years later. It was a different country. Fortunately I had the opportunity at that time to travel to some of the areas from where I live. I live in Bangalore India at the moment and within a hundred kilometers you see a lot of rural territory and what I realize to many journeys in these areas is that affordable healthcare education and financial services were really significant barrier for many of the people living in those communities. And I wanted to do something about that. And I just wanted to add that and you know as part of my reflection.

: Now and that’s a really important factor Ashim, and so kind of gets us to the first question that I want to ask is what got you into the medical sector to begin with? You’ve highlighted why you’re focused on what you’re focused on today around the globe journey that’s brought you back home. But what got you into healthcare to begin?

: Ok looking at some of the challenges that face people living in rural communities in India and I’m sure similar conditions exist in many of the developing economies. What I saw was something interesting. I come from telecom background as you told your listeners and I have seen the effect of Moore’s law being applied to telecom industry and the computer industry. You know the cost comes down every two years and the performance goes up every two years. I don’t see that. I didn’t see that in the healthcare sector and I felt intrigued by the fact that the healthcare solutions are being provided in silos there. There was no opportunity to bring innovation into healthcare industry particularly in a country like India. And that was a challenge and I felt that if we applied some of the principles of information technology and telecommunication etc we would be able to bring down the cost of healthcare. We would be able to deliver better care to communities in the rural areas because people in the urban area are generally taken care of. There’s lots of infrastructure available expertise available etc. If you take a look at a simple problem not so simple for people living in the religious but cardiovascular diseases which is very common in India. And yet the cardiologists are only available only in the top 25 cities. So I felt that something had to be done and that brought me into the medical sector.

: That’s awesome. Hasheem and you know what. It’s great that you identified this need. Like you pointed out even in developing countries we do have that care gap and it’s important that we start looking to different ideas and technology to bridge that gap and so I’d love to hear your thoughts Ashim on an example of something that you and your team have done to create results to address this really what it is it’s it’s access right access to healthcare. So I’d love to hear your thoughts and any stories you have to share in that room.

: Some of the things that I feel I feel that healthcare to the right of every citizen, everywhere, every country. Healthcare leaders need to shift their attention from primary care from tertiary care to more into primary care. If you look at many countries today particularly where there is love healthcare solution that is a larger importance to primary care. I’ll give two examples. Either the NHS in the UK our health services in Singapore they probably are among the best in terms of healthcare being provided to the citizens of the country and there is adequate not only adequate it’s really been established network of primary care physicians etc. and services available and I don’t see that in countries like India developing countries like India. If there’s a huge amount of infrastructure available in urban centers you know from the place that I live in Bangalore within 3 kilometer radius 2 mile radius then 6 major hospitals so I’m really lucky in case something happens to me that I got good services. Whenever I go out not even 50 miles maybe 30 miles outside of the city and that situation changes drastically. Finding a cardiologist is a prayer. Finding a specialist of any kind, finding simple diagnostic capabilities which are taken for granted in developing countries like USA will not be available.

: So how do we address that?

: Yes. So very good question. So let me kind of come to the main point that I’m trying to bring here is that to provide quality health care you need new technologies. Innovation in healthcare and design for developing economies like India. We cannot use the technologies that are available in the US or many of the developing countries because they would be too expensive for deployment in a country like India which is affordability that it would not be possible. However there are lots of things that can be done little things that can be done. Take a simple case of cardiovascular disease where it’s a chronic illness get worse and worse over a period of time. If a simple EKG capability exists at the primary care level in these rural communities what happens is that all of sudden we are able to diagnose people early enough and early diagnosis on basics like and it’s always less expensive. By no means it’s rocket science. It’s a very simple solution and yet we don’t have those kinds of solutions today and that’s exactly what we are trying to bring to the known urban areas to communities that are underserved. We want to provide those kinds of solutions.

: I think that’s great achievement. And you know we recently had a guest. His name is Rani Shifron. He’s over in Israel and his organization Global health is very much focused on the impact that you’re working to effect then one of the examples that he provided much like your example is you know the technologies that exist in developed countries really have a ton of bells and whistles that aren’t necessary for basic functions like an EKG for example. And so what can we do if we want to address the needs of the broader global population. This is a conversation really kind of at the government level. How are we going to address it? Right. And so to ashram’s point we’ve got to take a look at small shifts small things that can be done in order to make that type of impact an EKG for example is one of those things that can be done. Have you guys Ashim started any programs anything that’s yielded results thus far?

: Okay so I think thanks for pointing out that the technologies that are developed. You know you can look at it better developed in the Western countries and to fit the budgets of the developing communities. And just to illustrate that in another way. One example I would like to give is everyone most of your listeners will be Mulier that Microsoft Excel spreadsheet. I’m a power user of Microsoft excel and I think I use only maybe 3 percent of the capabilities the bells and whistles that are there. I rarely use them.

: Yep.

: So that’s either actually thing that can be done in healthcare. And what you have done the EKG. There are expensive solutions that are available which are suitable for IC use. That’s the market that we want to go to because for us the diagnosis must happen at the primary care level.

: Yes.

: If One actually will reach the ICU so we can provide very simple solution hand-held solution robust solution that’s been worked in that pressure are the other environmental conditions that exist at the primary care level. There’s no air conditioning. You know the temperatures can go up to maybe higher than 10 degrees Fahrenheit. The device has to work under that condition. What we can take advantage of certain things that are actually coming down in price so fast that it’s amazing take for example that smartphone. We don’t really need a printed piece of paper to give you see the output because what is patient going to do with it instead. If that information is available to it on an Android phone which cost less than 100 dollars all of a sudden we have the capability of displaying the mission. That information is available electronically that can be sent to a cardiologist hundred miles away or maybe across the world. And all of a sudden we have created a solution based on existing technologies around us. And yet the solution is very low cost.

: Yup. So taking this example is a great way of doing things and so tell us a little bit about a time when you tried one of these things and maybe you ran into some obstacles, Ashim. What did you learn from those obstacles?

: We ran into lots of obstacles and I’m glad that we did because we come from myself and my other co-founder both technologies come from nonmedical background and as a result of that we made assumptions that were not necessarily correct. So I’ll give you three or four examples or maybe two or three examples depending on how much time we have but a simple one was that during the early testing of the product we had given the product to ambulance driver and he was driving around the whole day with the device. And India is very hard most of the year and his palms would get sweaty. He’s getting the device that could slip out of his hands and fall down. So by the time he finished his trial two weeks later he was very apologetic he was like sad face. And I spoke with him through a translator because I didn’t understand his language and he figured out that it failed on multiple times and has been very sorry about it. And yet it’s a simple feedback that actually changed the way it is now. We actually have per day silicone rubber grip around it. It’s easy to hold very very comfortable. It doesn’t slip out of the hand and more or less. Moreover if it falls down, nothing happens to the device. Another one I will tell you is we made the assumption incorrectly or maybe we were too naive and those days that we thought that if we allow our device and the information from our device to travel from the primary care physician to a cardiologist, our job is pretty much done. We got a cardiologist come on line provide guidance to the primary care physician. They will talk to each other. Everything is great. And the patient is taken care of. What we didn’t realize is how imbalanced the situation is in countries like India. There are 60 million people with cardiovascular illnesses less than 10000 cardiologists. So guess what? Every time a primary care physician wanted to get in touch with the cardiologist, they will be busy somewhere else and so they wouldn’t get any response on their query from the cardiologists or maybe a few or maybe never. In some cases because the cardiologist is really the busiest person under the sun. So what we have to do is that we have to rethink our solution. And that’s when we realized that interpretation if we want to deliver a solution that would work under all the circumstances then the solution has to be on the basis of either machine learning or the IBS and the patient that we can deliver to the primary care physician on time every time without hearing you. And that’s exactly what we ended up renting. So these are the market feedbacks that we got these are mistakes but in the end it’s actually all a better solution.

: That’s great. Now at this point how far is your reach how many are you working with clinics with hospitals?

: I have to use a much used the phrase call out of the box solution. So let me explain what I mean by out of the box solution is that our solution is designed for primary care. All the work that the hospitals. And I’ll explain to you why we work with the hospitals because the intervention with reluctantly committee happened in the hospital. Hospitals have the maximum affordability in terms of deploying these kinds of solutions. So what we do is that we actually work with the highest cardiac centers we deploy our solution. These devices at the primary care clinics around let’s say one or two mile radius of the hospital through this process and the hospital basically is a payer, meaning for us they are the customers they pay for the devices on a subscription model for this deployment number of scans are taken at the primary care level primary care physician doesn’t fairly have the affordability to pay for this kind of technology. So hospitals pays for it. The primary care physician is the user and the patient is the beneficiary. So now what happens is that when the patients come and they complain about a test ban the primary care physician says come on over I’ll take the scan. He tells the nurse to take a stand. Innovation happens by the time the patient is up after putting on their shirt. The information is already available and then the plan to get decides if this case is acute care case in which case they’ll call an ambulance and send a patient or to the hospital. Otherwise they’ll say that come back later on or whatever the case may be or maybe prescribe them some medication. But the end result is that now we have created a new flow of patients for the hospitals which didn’t exist before because the hospital didn’t know which patients are walking around the acute care condition.

: Absolutely. And so now you’ve got a good workflow established. What would you say is you started this company and you’re impacting the health of your community. Ashim, what would you say one of your proudest medical leadership experiences has been to date?

: Actually there are several but.

: If you have to pick one.

: Yeah ok I’ll pick one. So in the early days of our testing what happened is that we found a primary care physician and somewhat rural community where 50 miles away from Delhi, the capital of India. And what happened is that I had to talk to him at least three or four times and then I’d visit him one time to request him to use the device because we really wanted some rural experience in our side that okay. This device is being used in the rural area. This is how things happen. So after about two months or so when I checked back that this primary care physician I heard something that totally blew me away. First of all he told me that he had identified two patients who had acute care requirement and he shipped them over to a hospital and then he told me that you have given me something wonderful but I cannot use it. And I was totally blown away. I said doctor you have saved lives already. So I want to use it. And he said that you’ve given me a device where I actually found the patient could not afford to go do it at tertiary care facility. And a month later I found out from her case that her family that the patient passed away and the doctor felt really miserable. I had to sit down there and talk to the doctor for next half an hour ,maybe 45 minutes to explain to him that that’s a condition that you can control is beyond your control to be able to take care of everyone but just think of the number of life that you are saving for a primary care physician to save three lives in their lifetime. In India a particular country like India. People go for coffee gold etc. etc. some simple things. And yet he managed to save lives. That’s like getting three Oscars. So I had to extract every ounce ownself positiveness that I had inside me and not to this doctor to convince him that he should continue to use it. He’s been using this device since 2014 now and it still operational.

: That’s awesome. Yeah. You did a really great job Ashim of putting it into perspective. Right. I mean it was it wasn’t in his control and ultimately if he didn’t use it who else would have died if they had. Yeah exactly. So that’s great and kudos to you for sort of getting him to see that side of the picture. Tell me a little bit more about an exciting project that you’re working on today.

: So we haven’t had a provider of solution. We have always been afraid of government organization because the issue is that with government organization requires a different mindset different level of patience etc. which at the start of organization we don’t have that in our DNA. Well what typically happens is that we get afraid but finally actually this month beginning of this month I happened to meet a very dynamic government official in this small town somewhat farming community in state of Gujarat which is in the western part of the country. So what happened is that I had a conversation with them after the interruption someone actually introduced me to him and then I had a conversation with him for 10 – 15 minutes. And next thing I knew is that a week later I was visiting him and following me. He actually launched the program. He got so impressed looking at what we had done. Obviously we tested it in front of him and showed him how this could be useful etc. We did all of those things and a week later he basically invited me for a launch of a program for heart health patients in rural part of the community and I was so blown away by that and this is a good example of a public private partnership. He is on the side of public healthcare side of things and we are a private organization patient that the deployment is all at the public health clinics. Are primary healthcare clinics where the art equipment is deployed and any time a patient is found they who require requires intervention are actually referred to a private hospital because there is no government facility available in the surrounding area where patients could be treated for calculus illnesses. So for even you have made it’s a really really good model for public private partnership and I’m very proud that we had a few of it. And I’m just amazed at the you know the dynamic gentlemen at the Public Health Center in that state who took the initiative and understood the solution and implemented it is really fantastic.

: Yeah that’s great. What a great success story Ashim and just kind of a reminder to us hey you could be afraid of something but you know what. Feel the fear and then just do it anyway because that’s how great things happen. In healthcare you just got to go forward with it. And like Ashim did you know what. Him and his organization were a little fearful of what could happen with working with government. But they did it anyway and partnerships have been made and great things to follow because of his courage and also the government’s foresight into their technology could do. So kudos to you my friend. Getting close to the end here of the interview with time flies. I want to build a leadership course with you through a lightning round. We’ve got four questions. We’re going to call this the 101 course of Ashim Roy. And so we’re going to form a syllabus for the listeners four questions that you’ll answer quickly and then we’ll finish it up with a book that you recommend to them you’re ready?

: I’m ready.

: All right. What’s the best way to improve health care outcomes?

: Preventive care close to the home.

: What is a biggest mistake or pitfall to avoid?

: Technology is not the answer to all health care challenges.

: How do you stay relevant as an organization despite constant change?

: Key thing here is to go the extra mile whatever the responsibility the person has. Every person has that and a lot of responsibilities. They should begin this possibility and to go the extra mile.

: There is no traffic in the extra mile right, Ashim? What’s the one area of focus that should drive everything in a health care organization?

: I think there are lots of people who are underserved just saving life for the people in the under subcommunities is the best thing that one can do.

: Love it. What book would you recommend to the listeners?

: Only the paranoids survive

: Very interesting, a very fascinating company in healthcare the way that they manage their health portfolio as well as their insurance. Only the paranoid survive folks check that out. You could find all of our show notes. links to Ashim and his company go to outcomesrocket.health/ashim which is ASHIM you can find all that there. Ashim, before we conclude. I’d love if you could just share a closing thought and then the best place where the listeners could get in touch with you.

: Healthcare innovation from developing economies really can change the way the healthcare is delivered in developing nations as well because the cost of healthcare is rising very fast. The frugal solutions coming out of developing economies can bring the cost down.

: Love it. And what would you say the best place for the listeners could get in touch with you is?

: ashim.roy@gmail.com.

: Outstanding. Ashim, thank you so much for your insights and visiting this really key topic of health in the rural areas and also access to health care. Keep up the great work. I know that you and your team will continue doing great things and we really appreciate you spending time with us today.

: Thank you very much indeed. Thank you for the opportunity. And I’d love to hear back from anyone who is listening to this podcast.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there’s one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That’s why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I’ve been able to reach thousands of people every single month that I wouldn’t have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That’s outcomesrocket.health/podcast.

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