Sustainable preventive-care for Diabetes for bottom of the pyramid

Healthcare in India And

beyond

25/04/13 c: Rtn. Srihari Boregowda, CONFIDENTIAL +91 98441 19490 1

The Context

On a Saturday Morning at a Rotary convention


Why?

25/04/13 3

4

The Problem: Tsunami of Non Communicable Diseases (NCD)

> Half of the population is undiagnosed > 20% of 30+ are at pre diabetes

180 million at Risk from NCDs, 55% of deaths are due to NCDs and can be prevented or at fraction of cost

Diabetes leads to other NCDs

Impact of Diabetes is 3 times more on BoP, leading to economic Ruin of the entire family

Diabetes affecting young population, (40s) can be a nullify the “demographic dividend of India”

Diabetes, Cardiovascular, Hypertension, Cancer, Pulmonary

India

. ©Srihari Boregowda +91 98441 19490 CONFIDENTIAL V8:04-Aug-13

5

Why Diabetes to begin with?: Silent Destroyer, leader of NCDs Diabetes : 1.Holistically Addressing Diabetes, you are addressing all the triggers for other Non-Communicable-Diseases, like Hypertension, Cardiac, Kidney etc., 2. General awareness of the “Sweet Disease” Madhu Meha is high even among rural folks


Acceleration due to Causes(Lifestyle)


7

NCDs are easily preventable by Lifestyle modification

Genetic Predisposition

Beta cell Pathology Diabetes

Pre- Diabetes

Auto antibodis to Insulin IA-2

Loss of first phase Insulin Response (IV Glucose)

Loss of Glucose Tolerance (Oral Glucose)

Beta

cel

l Fun

ctio

n

100% Environmental l Modifiersà

Years

Clinical Model of Diabetes as a Preventable

disease

Of population

Chronic Stages Stage#1 Stage#2 Stage#3 Stage#4 ß cell mass IBSAPG Evidence of Insulites (IVGTT) Glucose Intolerance,

Financial Model of Diabetes as a

Preventable disease

47%

22% 18%

17% 7% 10%

35% 48%

Healthy-Risk At-Risk Chronic Acute

Hea

lth

Expe

nses

Healthcare Cost V/s Age-,Risk factors in population

Addressed by Preventive care

Proposal for Year 2013-2014 Presentation for Rotarians

[email protected] 25/04/13 c: Rtn. Srihari Boregowda, CONFIDENTIAL +91 98441 19490 8

25/04/13 . ©Srihari Boregowda CONFIDENTIAL 9

Target segment : BoP under S-E-G Just economic criteria (e.g. earning $4 -$8/ day)alone will not suffice to fit the product into the space. The suitable criteria for selecting India target segment are Socio Economic classification and further tune with Geographic i.e. Towns that have population between 1 and 5 hundred thousand, having > 100 villages in Cluster

Economic Socio-Economic Geographic City Population

Tier-1

Tier-2

Tier-3

Tier-4

Tier-5

Tier-6 < 500,00

Tier-7 >100,000

Annual Household Income in 000s

1 2 3 4 5 6

2"

4"5"

2"1" 0"

7"

3"

5"

2"1" 0"

9" 9" 9" 9"8"

5"

0"1"2"3"4"5"6"7"8"9"

10"

Reachout" Screening" Prognosis" Advice" Management" Preven@on"

Value&'&Strategy&Map&Camps" NRHMENCD" TRAYEE"Integrated PHC

10

Critical Success Factor: Financial efficiency / throughput, keeping value high

Value= ΣHealth Outcomes

Cost of delivery

Integrated PHC Lowest cost of screening All data in digital form Evidence based, Customer Affinity

Traveling ASHA worker Care at Doorstep, Relation build Culture sensitivity, Awareness creation Mobile Health enabled, Empowerment Protocol based seeding for max coverage

Scientific, Measurable Back-office connect EMR Expertise access , multi domain Risk (Prediction) quantification Evidence based

Holistic, Integrated AYUSH and integrative medicine Patient centric, Wellbeing: Physical, emotional, Social & Spiritual

Care Pathways Behavior Modification SMS Alerts, Coaching Community creation

Outcome Tracked Postponement Quality of life

High throughput

6-Step Process: Value focused delivery across the care cycle


2"

4"5"

2"1" 0"

7"

3"

5"

2"1" 0"

9" 9" 9" 9"8"

5"

0"1"2"3"4"5"6"7"8"9"10"

Reachout" Screening" Prognosis" Advice" Management" Preven@on"

Value&'&Strategy&Map&Camps" NRHMENCD" TRAYEE"

11

Affordability and Access Driven by Technology M o d u l a r I m p l e m e n t a t i o n : S t a r t w i t h a n y v e r t i c a l

Scre

enin

g

Rea

chou

t

Prog

nosis

Adv

ice

Man

agem

ent

BIG DATA / ANALYTICS

SENSOR NETWORK

Cloud Infrastructure: Device, Protocol, Telemedicine, Delivery, EMR/PHR

MOBILE HEALTH

Outcome

Behavior Modification & Reachout

Sensor as Service

D4D:Data for Development

DO

MA

IN

T

ec

hn

olo

gy

Disease Surveillance, Predictive Care

Anywhere, Anytime Access


12

1-Reach out: Protocol driven, Risk stratification at Family level

In the first 2 months, Artoo helped ICTPH:

artootrillsartootrills

Featured In

www.artoo.in

Customizable to your needsWorks even in offline mode

Realtime data capture

Artoo brings to life technical expertise, coupled with the ability to collaboratively adapt, be it healthcare, education or financial inclusion. Their entrepreneurial spirit and close attention to every engagement makes it an even more fulfilling experience.

Coverage of Chronic NCDS 1.  Diabetes, 2.  Cardio Vascular, 3. Hypertension, 4.Acute Lower Respiratory Illness


25/04/13 . ©Srihari Boregowda

CONFIDENTIAL 13 Src: Artoo

1Reachout: ICT enabling mobile Health workers

25/04/13 14 c: Rtn. Srihari Boregowda, CONFIDENTIAL +91 98441 19490

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Step-2 Screening: Integrated PHC for Diabetes: Diabetes has multiple problem attributes: It is primarily Endocrinology but, it is also renal problem, It is also vascular problem, Retinal problem and so on. Need to Integrate care delivery around patient and not federated around clinical specialty

Patient

“At home /PHC” healthcare

“CCC” Telemedicine “Secondary /Tertiary”

healthcare

Decision Points

Platform assisted

Common Healthcare Platform

Multi-‐loop Value Creation

ß Therapy, feedback, Prescription

Measurement, Diagnosis, Forecastà

Medical / Surgical Specialists

Medical Generalists

Paramedics Knowledge component Care Protocol

Disease Management

Integrated Medicine

Nutrition

Partnerships

#1

Technology Component EHR/PHR/DHIS

Sensor Kits

Telemedicine NW

BigData, analytics

Mobile Apps

#2

Operational Component Model Clinic: Low cost medecine, Telemedecine center, Screening Center, Microlab

Local Resources: Councellors, ASHAS, Hygenists, Nutritionist, Local Doctor

#3

Integrating 3 Components


25/04/13 . ©Srihari Boregowda CONFIDENTIAL 16

2-Screening: Coverage across the Disease manifestation

Test Cost

Glucose 40 Paisa

Lipid Profile 15 Rs.

Kidney function test 12 Rs.

Sample Process: Src: Karnataka Institute of Diabetology

Conducted by Trained Paramedics: Opportunity for Rural employment

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Step-2 Screening: Integrated PHC for Diabetes: Model Layout

PHAR MACY

One2One counseling

REGISTRATION

Ini:al consult 3.0m x3.0m

2

3

Storage UPS

Lab + Inves:ga:on 2.5 x 1.5m

4

Spectacles 1.6m x 1.5m (Op:onal)

Re:nopathy Neuropathy Vasculopathy

1

•  Diet •  AYUSH •  Physical Ac:vity

5

6

Teleconsult With specialty care

Educa:

on Posters

Educa:

on Posters

Educa:on Posters

Wai:ng / Interac:on Area ..

Educa:on Posters / LCD panels Creating Consumer Experience: India has moved on from traditional to Modern retail format. The PHC is integrated to screen, refer and manage and deliver under one roof as a Convenient Daycare clinic to give differentiated consumer experience

Low cost m

edicine

leverageGe

nerics


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3-Prognosis: Tele Expert advice, EMR,

i2i telesolutions

Screening

Sensor data, Questionnaire

EMR, Care Pathway

Prognosis

Hosted Archived data

Video / Audio conference

Expert-in loop


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Step-4 Advice Advice is generated from Expert’s inputs and care pathways. It is generated to be Patient centric based on Sex, Age, Culture, lifestyle, economic status. It is calendar of action in the daily life of the patient. The orientation is not absence of Disease but overall wellbeing

Sam

ple

Exer

cise

Pl

an:

Value 4.1: Diet Advice: Fit to Local, enjoyable, Cuisine

TOMATO DOSAFor 1 serving (3 Dosas):

Calories 319 kCal

Carbohydrate 55.3 gm

Protein 10.5 gm

Fat 6.8gm

Schedule # Branded Rate Price Locost Rate Price15151 3 X 0.55₹&&&&& 1.65₹&&&&&&&&&& Metformin 0.39₹&& 1.17₹&&&&&&&&&&05051 1 Y 18.00₹&& 18.00₹&&&&&&&& Atorrastitin 2.20₹&& 2.20₹&&&&&&&&&&05051 1 Z 4.50₹&&&&& 4.50₹&&&&&&&&&& Atemol 0.28₹&& 0.28₹&&&&&&&&&&

24.15₹;;;;;;;; 3.65₹;;;;;;;;;;724.50₹&& 109.50₹&&

Total;cost;per;day5&times&Saving&@@>Cost;Per;Month55>

Value 4.4: Medication using Generics reduce cost:1/3rd to 1/10th

Value 4.2: 1 to 1 counseling, Eliminate chronic stress

Value 4.3: Exercise to fit daily routine, monitored


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Step-5 Wellness Management

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

(Spiritual)

Emotional

Mental

Physical

Well

being

= H

ealth

W.H

.O. D

efin

ition

O

f Hea

lth

Treatment Compliance

GreenNew/Un-‐Familiar

BlueOld/ Familiar

PurpleIncrease

GrayDecrease

BlackStop

DotIs done one

time

Install Solar Panels in house

Tell a Friend about eco friendly

Plant more trees and local plants

Buy fewer bottled water

Turn off space heater for one night

SpanHas duration

such as 40 days

Car pool to work for 3 weeks

Bike to work for a month

Take public bus for one month

Take shorter showers this week

Don’t water lawn during summer

Path Is a

permanent change

Start growing own vegetables

Turn off lights while leaving room

Purchase morelocal produce

Eat less meatfrom now on

Never litter again

GREEN DOT

GREEN SPAN

GREEN PATH

BLUE SPAN

BLUE PATH

BLUE DOT

PURPLE SPAN

PURPLE PATH

PURPLE DOT

GRAY SPAN

GRAY PATH

GRAY DOT

PURPLE SPAN

PURPLE PATH

PURPLE DOT

Behaviour Modification

MOBILE

Value 5.1: Addressing through Holistic and integrative (Alternative) medicine Value 5.2:Treatment Compliance and wellness management through behavior modification


Wellness is an active process of becoming aware of and making choices toward a more successful existence

Financial and Business related

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Implementation Model

Note: These are budgetary figures, Actual Numbers may vary while implementation

Even Philanthropy has changed

Service above self: I sought my soul, my soul I could not see I sought my god, my god eluded me I sought my brother, I found all three


100% Result Driven Service

We need inclusive Revenue Models to Sustain

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Post

-Pay

Bas

ed

“Pay-per visit: PPV User fee based model •  Base consultation charges=x •  Lab and diagnostic charges =y •  Generic Drugs = z Total fees F= x+y+z

Pre-

Paid

Bas

ed

Membership Model (Subscription) Annual enrollment =X Monthly subscription = Y •  Unlimited teleconsult •  N #, Free visit, Tests, consult •  Generic Drug, supplement Total fee F = X + (12 x Y)

PPV+ Co-pay model Visit Charges •  Base consultation charges=x •  Lab and diagnostic charges =y •  Generic Drugs = z •  P=part or whole is reimbursed by a

sponsor/NGO / Govt. Total fees F = x+y+z-P

Micro Insurance for Health •  Annual Insurance=X’ à to Micro Insurance •  Society= Y’ à Co-op / SHG •  Co Pay = Z Micro Insurance pays part for Outpatient and takes care of catastrophic care as well Total fee = Formulated {x,y,z}


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�  Procure Model �  Cap-ex led fixed cost of 1,200,000 (12L) one time procurement and

operational costs of Rs 75,000 per month

�  Operate Model �  Op-ex led Fixed cost of for 2 pilots totally subsidized by Sponsors and new

ones will be charged 1,200,000 (12L) per center, operational costs recovered by charging patients and /or re imbursement from Govt. at Rs 250/ - per patient

�  Build-Own-Operate model �  Hybrid capex of 600,000– 50 % upfront paid by Sponsor, remaining 600,000

of Capex and op-ex recovered by charging patient or Govt. re imbursement of Rs 500/- per patient till recovery period

Revenue / working Model


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1.  ASHA workers go house to house 1.  Counseling done, data collected using tablet, high risk population identified and eHealth

Record created - Free 2.  PHC Screening

1.  Blood Glucose, Lipid profile, HB, BMD and BP - Rs 50/- 2.  Those found Diabetic go through target organ tests - Rs 250/- 3.  If CKD +ve then go for CKD staging test - Rs 75/- (optional) 4.  Those who are hypertensive detailed ECG – Rs 100/- (optional)

3.  PHC Counseling 1.  Counseling by dietician is free

4.  All electronic records are maintained in the cloud and UID/ MRN number assigned for each patient for follow up and staging information.

5.  Disease management for Diabetes and Hypertension done by providing training material, timely SMS, telephonic calls with the councilor/ doctor in case of emergency regulated by councilor and periodic screening.

Screening Workflow Model and costs One PHCenter for 40,000 Population

Screenings Per Hour Screenings per month

6 960

Screening Revenue per month Nott Expenses Retaining per month

240,000 140,000 100,000

Breakeven.. (Subscription amount accelerates)

9 to 12 months


Investment Risk Operational Risk Market

Risk

Plant & Machinery capital

Operational Capital

Working Capital

Rs.1,200,000 Rs. 500,000 Rs. 75,000 x 6 months

Rs. 200,000 Rolling Cash will be retained

Capex

Risk

Lev

el

time 3M 6Months 9Months 18Months 30 Months

Spin-off one more Project With retained earnings

Infrastructure setup Startup

Operation Village Entrepreneur Management Transition

Fully Sustainable operation

Intangible

Tangible

Results

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Achieving Sustainability: Timeline for One center

cost per test: Rs. 250 (600 tests pm – 20 ~ 30 a day) to cover opex

BoP learns value of wellness Rural employment generation Education, Diet foods as spinoff

Screen and mange 40,000 population Sustainable Project

Project Cost 19 Lakhs Inclusive Revenue model,

builds up sustainability


Key Results for Rotary

�  Sustainable Healthcare �  Take Care of Chronic conditions, Prevent Disease, Save lives

o  Use of herbal medicine for minor ailment, Hygiene, maternal care �  Social Good: Following are broad benefits to the villagers

�  Sociocare: ensure sustainability and scalability �  ASHA workers, aspirational goal.(micro entrepreneurs). Avoid mindless urban migration

�  Empowering a housewife on health and socially has 3 times benefit to the family. (Micro Insurance)

�  spiritual orientation and cultivation of human values to eradicate Caste and other social ailments. Leads to social inclusion, inculcating moral values, leadership

�  Package Healthcare through Society:- �  supplement other skills that can lead to better lifestyle

�  e.g. apiculture, floriculture, financial literacy, food processing, tailoring Despite Governments' efforts and being signatory to Millennium Development Goal, It has not been able to take off on cracking NCD problem. Pnly Private-Public-NGO –Rural entrepreneur partnership can make difference


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Proposal and way forward

Rtn. Balasubramanyam K S President RY-2013

Rtn. Srihari Boregowda Secretary RY-2013

Creating Revolutionary Wealth Through Social Business

� Which is the greatest gain? Health! � Which wealth is the best? Education! � Which treasure is the best? Skill!

Yakshaprahna: an F.A.Q in 3000 BC.

29 . ©Srihari Boregowda +91 98441 19490 CONFIDENTIAL V8:04-Aug-13

RI District 3190 55 from Bangalore, 32 from surrounding areas

87 Clubs

Section B

‘As On 30th Jan 2013 3800 Rotarians

In the 4th decade of service

c: Rtn. Srihari Boregowda, CONFIDENTIAL +91 98441 19490

The Hospital is located in Ideally potential place. It blends the Rural (Uttarahalli cluster) and the Sprawling Urban location Rajarajeshwarinagar

BGS Global Medical College and Hospital

Rajarajeshwari Medical college & Hospital

Rotary club of Bangalore, MOU with Rajarajeshwari hospital

Ground Floor The existing operations are mostly carried out in Ground floor. Mainly OPD consulting, LAB tests and Patient Stabilization. This can continue as is


Ent

ranc

e

Reg

istr

atio

n

Lab

Med

icin

e

Co

nsul

tati

on

Footfall:15-20 Patients / day, Urban Poor

Repurposing The existing Facility

25/04/13 c: Rtn. Srihari Boregowda, CONFIDENTIAL +91 98441

19490 33

5 Bed Ward

Gynec

Operation Theater C

hang

ing

Roo

m

Optholo mology

Free Space (Landing)

�  First Floor This Area is underutilized. Can be re modeled for the Integrated Diabetes Clinic. The area and sections neatly fit for the purpose and also does not impact the existing operations

Global Grants


�  Support the goals of one or more of the areas of focus �  Produce measurable outcomes in the benefiting community �  Achieve results that can be sustained after the grant funds

have been expended �  Have been developed in conjunction with the benefiting

community to address their most pressing needs �  Seek to address community needs in an integrated manner

Result based Project funding


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�  If results are not measurable Goals, you cannot tell success from failures

�  If you cannot see Success, �  you cannot reward it.

�  If you are not able to clearly reward success, then in all probability you are rewarding failure

�  You cannot learn from it. �  If you cannot recognize failure, you cannot correct it. If you can demonstrate results you will obtain stakeholder support in large

25/04/13 . ©Srihari Boregowda CONFIDENTIAL

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Devara Hosahalli 1 of 135 Villages Population: 800

PHC Location: e.g. Channapattana: Tier-6 city/ town. Population 95,000 55 KMs from Bangalore

3 k.m.s

Reachout: Integrated Rural Clusters

NCD PHC

Results Framework

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Res

ults

Goal Reduced Mortality and Morbidity from Non-Communicable Diseases

Outcome Value Focused Preventive care Delivered •  Delay / Prevention of disease {Measured} •  Improved Quality of life {Measured} •  Wellbeing {Assessed @ Physical, Mental Social, Spiritual. Quality of life}

Impl

emen

tati

on

Output •  10 Integrated PHCs rolled out, 10,000 people screened •  50 Health professionals trained, deployed, 500 Volunteers enabled •  Sustainability ensured {Financial model established}

Activities •  Conceptualize, design, Implement and operationalize through Pilot •  Interact with Govt., corporate and other agencies for reimbursement of costs •  Campaign, Brand build, •  Train with feedback

Inputs •  Funds, Equipment, Expertise •  Volunteers, Trainers, Clinicians •  Place (PHCs), Mobile Vans

Service above self

ü Social Activism ü Responsible Charity ü Conscientious Citizenship


Community/ Need Assessment Tools

Develop Community /Village Development Index with11 Points


�  Survey �  Asset inventory �  Community mapping �  Daily activities schedule �  Seasonal calendar �  Community café �  Focus group �  Panel discussion

Exit to Sustain: STSTM framework Rotary is a an enabler. It is all about from community to community. Long term sustainability is to ensure that a model is built, operated and transferred to local community / resources

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� S.T.S.T.M �  Serve à Do it yourself and iron out � Trainà Recruit and transfer knowledge �  Support à Handhold, Co-Operate � Transfer à Assets and Operations � Monitor à thro the KPI. Key performance Indicators

It takes 18 to 36 months to achieve this. Involve the next 2 year’s team from beginning, let the learning happen continuously

PARTNER ECOSYSTEM network of organizations – including suppliers, distributors, customers, competitors, government agencies fostering “Open Innovation”


25/04/13 . ©Srihari Boregowda

CONFIDENTIAL 42

Capex-‐1 Qty Price Cost Portable Compact Lab-‐Accuster (Basic) 1 ₹ 2,00,000 ₹ 2,00,000 Ophthalmic Prescreener-‐ 3Netra 1 ₹ 4,50,000 ₹ 4,50,000 Neuropathy, Vasculopathy -‐ 1 ₹ 1,20,000 ₹ 1,20,000 Integrated Vital measurement (ECG, NIBP,..) 1 ₹ 25,000 ₹ 25,000 I2I Tele solu:on (Telemedecine+ EMR) 1 ₹ 1,05,315 ₹ 1,05,315 Tablets-‐ (Android/Windows) 4 ₹ 15,000 ₹ 60,000 Server+ Wi-‐fi network 1 ₹ 1,20,000 ₹ 1,20,000 Solar with UPS (1.5 / 0.8 KVA) 1 ₹ 1,20,000 ₹ 1,20,000

Total Capex / PHC ₹ 12,00,315

Opex-‐1 Remunera:on # Cost P.M.

Paramedic (Technician & Die:cian) ₹ 25,000 2 ₹ 50,000 ASHA Workers ₹ 10,000 2 ₹ 20,000 House Keeping staff ₹ 2,000 1 ₹ 2,000 Consumables ₹ 3,000 ₹ 3,000

5 ₹ 75,000

Estimated Cost Schedule, Hybrid

1.Hb, fasting and PP sugar, lipids, LFT Rs 50/- 1.b creatinine( with eGFR) Rs 75/- (opt only if CKD +ve) 2.HbA1c Rs 40/- 3.Ophthalmic examination(3Nethra) Rs 90/- 4.Foot neuropathy/Vasculopathy evaluation Rs 40/- 5.Microalbuminuria Rs 20/- 6. BP, 5 lead ECG, BMD Rs 10/- ----------------------- Total Rs 250/- -----------------------

Test Cost

Breakup

BMI àMetabolic Station

Accuster: Low cost Lab

25/04/13 . ©Srihari Boregowda, CONFIDENTIAL +91 98441 19490 44

President Of India: Recognition

Test Consumable Cost

BMI Free

Blood pressure Free

Glucose 40 Paisa

Hb 30 Paisa

Lipid Profile 15 Rs.

ECG 25 Rs.

Kidney function test 12 Rs.

Liver function Test 12 Rs.

Semi-automatic in which 23 blood parameters can be done, an open system type based on colorimetric principle), a micro centrifuge (6000 rpm), a small incubator, a power back up (battery operated, on simple battery it can work for 7 days continuous), micro pipette, micro tips stand, cuvette stand and all other small accessories

Centrifuge: 8 samples 600 RPM

Incubator: 25 samples 37 deg.c

Biochemistry analyzer 23 Parameters

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Forus Health diabetic retina screening

( Screened over 450,000 people with 110+ installations in India & 8 other countries )

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Forus Health 3nethra , Awards & Recognition Thank you….


Forus will focus R&D efforts to create innovative and affordable pre-screening devices

3nethra for Neurology (MUMC+ Holland) 3nethra for Nephrology (RenalyX) 3nethra for Pediatric (Rebiscan - Boston) 3nethra for Women's Health (PESMC) Ultra Low Power Laser (Rowe - DC) Handheld Fundus camera (NTU)

Mobile Enabled Diagnosis

Step-5.3 Diabetic Retinopathy, Nephropathy

Device: Optimized attenuation and size

components

Automatic Capture: Software identifies

optimal focus length for image capture

Retina Image Enhancement:

Image is enhanced by highlighting the

areas of interest

Intraocular Pressure: The device

uses a proprietary method to measure intraocular pressure

IP being created

The following patents that have been filed: 1. OPHTHALMIC IMAGING DEVICE: An apparatus to optimize attenuation, size, components and power

consumption in low power ophthalmic Imaging devices using Multicolor LED (Light Emitting Diode) based light sources.

2. AUTOMATIC CAPTURE: Method of detecting and capture of optimally focused image in digital fundus camera 3. RETINA IMAGE ENHANCEMENT: Enhancement technique for low light conditioned fundus or retinal image 4. INTRAOCULAR PRESSURE: A method and system to measure intraocular pressure of the human eye 5. RoP camera: Device design and associated algorithms 6. Diabetic Foot: Device design and associated algorithms 7. Method and tools for Photo refracto meter

1 2 3

10

4

Early Detection Referral Evaluation Monitor Patient for prevention


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A Device for detection of Inflammatory Pain, Vascular Disorders and Breast Cancer.

THERMOSCAN


inflammation in diabetic foot callus classification system of the plantar thermo graphic patterns based on the vascular anatomy

Stage 1: Inflammatory Phase Stage 2: Proliferative Phase Stage 3: Epithelisation Phase Stage 4: Remodeling

Step-5.2 Diabetic Vasculopathy, Neuropathy

Infrared thermo scaning or other techniques can be used

Can this Address Societal Problems?


Sensors, Cloud, Big-data (Mobile)

The Invisible Descent into Poverty

Crisis

Economize

•  Reduce Expenses •  Get Help from Friends & Family •  Seek Additional Income

Deplete

•  Spend Savings •  Sell Property •  Go into Debt

Sacrifice

•  Give up Meals •  Give up School •  Give up Healthcare

Hard-to-track erosive effects of slow-onset crises

Irreversible Harm

(vas

t ove

rsim

plifi

catio

n)

Permanent Damage

The Crisis Information Gap

Mobile Services as Human Sensor Networks When our lives change, we change how we use services

Flashing

Voice Calling

SMS Texting

SIM Top-offs

Mobile banking

Money transfers

Microloan repayments

Tower hopping

Health hotlines

Health hotlines

Agriculture hotlines

Educational services

Employment services

Social networking

SMS Search

Citizen reporting

Food vouchers

52 With Hunchworks

Addressing the Information Gap with Sensors, Cloud, Bigdata

The Orange “Data for Development" (D4D) challenge is an open data challenge on anonymous call patterns of Orange's mobile phone users in Ivory Coast. The goal :

To help address society development questions in novel ways by contributing to the socio-economic development and well-being of the Ivory Coast population by analyzing the anonymized call records provided by Orange Telecom and cross-compare it with other types of data to find useful insights.

Orange Telecom’s Initiative:

Data For Development

Tuesday, 3 September 13 SJB Research Foundation 53

Data Parsing: •  Hadoop HDFS •  Hive Query Language •  Map Reduce

Data Visualization: •  Data Driven Documents

•  (D3js.org) •  Google API •  Open Maps


Sentiment Analysis: Analyze and visualize number of calls made on public holidays between the given period from the data Analyze and visualize important antennas and sub-prefecture based on: Number of Calls, Duration of Calls, Users around the antenna and in the sub-prefecture Obtain number of calls made everyday and aggregate it monthly: Visualize this data and correlate it with activities happening in the particular month so as to come to an inference yielding to substantial change in the future Correlate the above fetched data with data available from other sources to bring about Inputs to Participatory development of society

Pilot implementation

Results (Visualization: No. of calls per hour – map)



Results (Visualization: Top hundred calls)

Sustainable preventive-care for Diabetes for bottom of the pyramid

Health & Medicine

Transcript of Sustainable preventive-care for Diabetes for bottom of the pyramid