Alum Ventures: healthIO – Sanjay Mohan, PGP 1994

Every idea is conceived on the basis of a personal experience or when an individual finds a void in the system, that can be improvised with a better set-up. Sanjay Mohan, co-founder of healthIO, did exactly that. While the health institutions were in place with many advancements, bridging the gap between a person to these services triggered the need for sick-care. healthIO is a digital platform which follows a preventive approach, rather than a reactive approach thereby improving the quality of life.

Please tell us something about yourself and your work?

Every industry has shown that there is an exponential relationship between the time it takes to detect a problem and the cost to fix it. The later the problem is found, the more expensive – and sub-optimal – the fix is. Hence, we see the investments in preventive maintenance of machines as well as software across industries. From automobiles, to infrastructure to computers. Healthcare, however – arguably the most pertinent industry to our lives – still operates on this principle of “break-fix.” We will worry about fixing our health later – when it breaks down, when we get sick. This reactive system was designed when infectious disease and injury constituted the primary burden of healthcare. As the world transitions to a chronic disease burden, however, we need to employ a prevention-focused model. While this stands to reason, sadly the current system continues to resist a preventive approach – as is exhibited by numerous studies and the lack of funding for prevention programs.

Prior to founding healthIO, I spent 25 years in the consulting industry working with large clients across the globe. My time was spent on finding ways of effectively using technology for business transformation. Before I came to IIM, I was at Indian Institute of Science working on Artificial Intelligence. While my final year thesis was on AI and its use in Power Systems, the first project I ever did on expert systems was for medical diagnosis. It feels I have come full circle with healthIO.  

How and when did you get into this space?

As a first-generation immigrant, I found myself struggling with health issues with aging parents half-way around the world. From elementary aspects like adherence to medication to more involved activities like monitoring sugar levels for recalibrating medication, I saw the elderly struggle to ensure a regimen that can give them a healthier and longer life. More fundamental, however, was the realization that healthcare is largely sick-care. We all interact with the healthcare system only after something’s gone wrong – either the onset of a condition or an adverse event. Healthcare systems were designed when infectious diseases were the primary cost burden. That has changed now, however, a system designed to deal with infectious diseases has trained a population in a way that creates a reactive, rather than proactive, management framework.

As I understood this better, I discovered an opportunity to use digital health for perhaps achieving the aspirational compression of morbidity. Health care systems have, and are very good at handling, episodic data. The determinants of health, however, stay unmanaged till the time of an event/episode. healthIO was created to establish a longitudinal data pattern, in the 5000 hours/year spent away from the physician, that can be used to predict and prevent the onset of morbidities and any adverse events resulting from such conditions. ​​

What are the different services offered by healthIO? Is it a plan based program?

healthIO aggregates user-generated sensor and non-sensor data to understand changes in an individual’s physiology. It believes that by combining the forces of IoT, Big Data and AI, we can achieve an improved quality of care while minimizing the cost burden on the system. healthIO follows a B2B2C model for distribution. Our primary segments our self-insured employers and capitated providers. Employers gain significant benefit from deploying the healthIO program because they not only bend the cost curve on health care costs, they also realize significant productivity gains in their operations. Capitated providers are value-based healthcare service providers who use healthIO to decrease resource utilization and, hence, improve profit margins.

healthIO is available to the consumers only via these partners. We don’t sell to individual consumers directly yet.

You mention – Prevention, Prediction and Participation on your website. What do these signify?

These are the three cornerstones of the healthIO platform. Participation refers to active participation for a larger community of people (a secure micro-social network) that could have an active interest in keeping an individual healthy. This shifts the conversation from just between the physician and the patient to a larger network that gets access to the individual’s data as well as any alerts that might get triggered by the data. The network can include the physician but typically also includes family and friends. Prediction is focused on the aggregation of determinants of health and eventually predicting the onset of health events that may require attention. healthIO wants to move the definition of “healthy” from the “absence of diseases” to a continuous curve with a quantified index. And lastly – Prevention – that’s focused on finding ways in which we can intervene to prevent the progression of a condition. For instance, preventing the movement from pre-hypertension to hypertension.

How can one avail of your services? What are your current serviceable locations?

As of now, the services are available only in the US market only via employers and capitated providers.

Except for the obvious known facts, what should one take away from the current Covid 19 crisis?

Well, this is what the healthcare systems were designed for. Albeit not the volume expected in the current crisis – and, hence, the emphasis on flattening the curve. We will get through this – as long as we are reasonably cautious about what we do in our daily lives. The R0 value of this virus is the biggest concern and not something everybody in any society appreciates.

Any positive thoughts, how will the world look post the crisis?

A hundred years ago, the world experienced a health catastrophe that has been unparalleled since – the “Spanish Flu.” The loss of life during that pandemic shook the fabric of our society and delivered major learnings that fundamentally reshaped the charter and the construct of healthcare systems, globally.

Until that time, disease had been considered a result of the natural degeneracy of the poor rather than a result of the environments they lived in. Public health had been all about isolating the elites from the “scourge” of the poor, and thus preventing the spread of disease in the society. That pandemic did not respect such social boundaries. The biggest structural impacts of the Spanish Flu included influencing governments worldwide to embrace the concept of socialized medicine, and, more importantly, to define the role of the physician as one who not only cures illness but also suggests ways to prevent it. Public health – as we know it today – was born.

Roll forward 100 years, and we will undoubtedly be looking back at the pain and anguish caused by COVID-19. Hopefully, we will also be looking for lessons that we can apply to our lives and to our healthcare systems to either prevent or lessen the impact of such catastrophic events in the future.

New and important lessons already seem to be emerging and they will have a strong bearing on the healthcare system as well as the nature of the interaction of the healthcare consumer with the system.

  • Improving self- awareness: In the absence of any pharmacological solution, the best course of action for the average consumer is to stay healthy. By keeping active and eating healthy, we can boost our immune systems and avoid the chronic health issues that make us vulnerable to disease. The good news is that a large percentage of chronic issues are either preventable or manageable. A heightened awareness of health and self-management will become, we hope, part of the daily lives of all human beings.
  • Engaging critically with community health: The current crisis has exposed capacity constraints in the healthcare system that prevent efficient & effective management of an event that impacts a large segment of the population. It has become evident that the traditional model of “the doctor will see you now” is not adequate and that healthcare – including patient-physician interaction – needs to move into the community and into people’s homes to ensure a healthy society. By using digital health channels, the healthcare system can be redesigned to provide a surveillance and prevention method that can maintain a healthier society.
  • Prioritizing the health of healthcare workers: While the people on the front lines continue to do a tremendous job of taking care of us, who is taking care of their physical and mental health? Through the use of digital health technologies, healthcare systems can be redesigned to balance the load on the healthcare worker, reducing unnecessary utilization and fatigue. Digital health technologies provide a great way to prioritize clinical workload while keeping healthcare consumers engaged.
  • Gathering robust longitudinal data: The cornerstone of public health is data – data that can be used to study patterns as well as cause and effect relationships in the health of a society. While population health data collection has been going on at the federal level since 1957, the time has come to leverage digital health technologies to improve the quality – and quantity – of data available. With increased geographical mobility of the population and changing lifestyles (including a highly switched-on and digital population), the types of data we need to collect have changed. An average individual spends 2 of the 5000 waking hours in a year with the healthcare system. Digital health will allow for analysis of more robust longitudinal data patterns via remote monitoring technologies that can be used for prediction and prevention of adverse health issues.

How has IIMB been a part of your journey as a person and an entrepreneur?

IIMB has been a critical part of defining who I am. I won’t even say anything about the education part because that goes without saying. I must say, after the last 4 years as an entrepreneur, I have realized the importance of all the classes that I bunked. The number of times I wished that I hadn’t skipped them is not even funny anymore. My two years at campus showed me how to work hard and play hard at the same time. I recently had the good fortune to attend our batch alumni meet. The camaraderie and the spirit of our batch is enviable. And they are all available to help anytime – that speaks volumes of the quality of human beings that the institute produces.

Any fond remembrance from your campus days?

Perhaps the fondest is finding my soul-mate. My wife without whose support healthIO wouldn’t have been possible. A startup takes a lot out of you and the burden does fall on the family at large. She has been a rock and has provided the motivation to keep going.

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