Big data revolution in healthcare sector

an article that appeared in the Mint on using Big data for healthcare 

What if an app on your phone could predict a malaria outbreak in your neighbourhood or your treadmill could diagnose your worsening cardiovascular health? 

If you think these ideas are too far-fetched, watch closely the big data revolution underway in India’s healthcare sector. The aim is to use the large, unstructured sets of data to discern patterns that can lead to the delivery of personalized treatment. 

 

KGB or Kooda, Gandagi, Badboo (garbage, dirt, bad smell) is an app developed by a team of researchers at the affordable healthcare division in the Public Health Foundation of India (PHFI). The app uses social networking platforms to address issues of sanitation and hygiene in urban areas. 

 

“We were just having fun with technology. One can click a picture of garbage or stagnant water, and post on any of the social networking platforms,” said Kanav Kahol, who is an expert in the use of information, mobile and sensor technology for public health. 

 

“There is nothing new about the technology. What is new is how it is now being put to use. People have been posting pictures on social networking sites. We are just channelling it to the right people to address issues of health and sanitation. The pictures on KGB will come to our central database and we forward it to relevant authorities. If there are more pictures from a single neighbourhood, we can tell what kind of vector-borne diseases can be expected in the coming weeks,” he said. This process is known as participatory epidemiology.

 

“There is so much to be done in this space. Gymnasiums have machines that already record speed and time of people working out on machines. This data could be used to develop a pattern of how much a person can exercise and any deviations can be used to predict worsening health conditions. Consistently deteriorating time period on a treadmill could be a warning of a heart check-up. We already have all the information. We just have to start looking at things in a new way,” said Kahol. 

 

At the Institute of Genomics and Integrative Biology, part of the Council of Scientific and Industrial Research (CSIR), Anurag Agrawal, a doctor and researcher, is even more enthused by the possibility of collecting copious amounts of data.

 

Agrawal is coordinating with hospitals as well as experimenting with standalone clinics as part of the CSIR project that Mint reported on 27 January. A clinic at Lakhimpur Kheri in Uttar Pradesh is one among several such centres in the country, the others being in Haryana and Hyderabad, which are equipped with equipment that analyses blood samples and heartbeat rhythms. The data is streamed into centralized servers in Delhi. Such data is gold, Agrawal said. “More than public health, it is about creating massive data sets that will give us a sense of what’s going to happen in terms of recognizing diseases in their early stages,” said Agrawal in the 27 January interview. 

 

Analysis of the data can throw light on hitherto unexplained phenomena, he said.

 

Drawing on his own work, Agrawal offers the example of impulse oscillometry (breath measurement) readings.

 

The impulse oscillometry reading of an asthmatic looks no different from that of a normal person between attacks. Yet, biopsies of an asthmatic’s lung indubitably reveal that there’s something distinctly different. “We asked ourselves if we can spot these differences beforehand,” said Agrawal. For that, Agrawal used computer algorithms to parse the oscillometry readings and found that at the level of mathematical functions, there were distinct signs of sickness among asthmatics even when undiagnosed for the illness.

Agrawal is now modifying these findings so as to be able to detect early signs of chronic obstructive pulmonary disease, globally ranked among the top three causes of death in smokers.

 

In a research paper on the electronic health centre concept published in the June edition of the journal PlOS Medicine, Agrawal along with other authors wrote that fungal skin infections, scabies, and allergic rashes accounted for a large number of patient visits on the basis of data from 3,677 such users.

 

Muscle or joint pain were reported at early ages, possibly, according to the authors, due to the demands of a strenuous agriculture-based lifestyle. Antacids, analgesics/antipyretics, and anti-histamines comprised the bulk of the medicines prescribed and relatively few antibiotic prescriptions were recorded. 

 

“That’s a good sign given a tendency to over-use antibiotics in India,” said Agrawal. “But on the other hand there were disproportionately fewer women between 6 to 18 years (relative to their proportion in that region’s population) who were visiting the clinics. Now that’s something we’d want to look deeply into.”

Others recognize the power of big data to make an impact in the area of health care.

 

Ashutosh Pande, an engineer who’s spent most of his professional life designing GPS applications entirely unconnected to the world of medicine, quit his job in 2010 to launch his own company, Arogya Mobile Health Pvt. Ltd. Arogya has just begun preliminary trials in Uttarakhand to collect and scan assorted health parameters in the hope that they will throw up patterns. As part of his plan, which essentially aims to marry the ubiquity of mobile phones with burgeoning concerns over lifestyle diseases, primary school-educated health workers will collect weight, temperature, blood pressure and electrocardiogram readings from roughly 50,000 villagers in 50 villages. The Bluetooth-enabled devices that they use will send the information to the cloud and a pre-programmed algorithm will instantly determine whether someone needs to go see a doctor. In return for a monthly fee of less than Rs.100 a month, Pande hopes to access a trove of data that can be parsed through analytics and then be used for predicting early onset heart disease, diabetes and cardiovascular disease. “These were once supposedly the diseases of the affluent but new data shows that such afflictions are increasingly found in rural areas,” he added. 

 

Although India’s prowess in information technology and the myriad health afflictions of its people should have made it a natural hotspot for big data applications in health, “progress has been painfully slow”, Agrawal said.

Getting even basic data was exceedingly difficult and few companies and institutions were investing enough to improve access, he said. While sectors such as banking, insurance and retail have already benefited from the big data revolution, the health sector is yet to use the unstructured data generated by hospitals and other institutions to generate predictive health interventions. 

 

Healthcare in India has always lagged behind in adopting radical ideas such as big data due to “risk of lives”, said Kapil Khandelwal, who runs a start up, EquNev Capital Pvt. Ltd, which specializes in the use of big data, referring to any radical change in standard procedure that could have an impact on mortality.

“The health sector will be the last to adopt big data, after it has been proven in other regulated industries such as consumer products, banks and financial services. We are seeing adoption in health financing, clinical trials and drug discovery, pharma and wellness segments of healthcare in India but hospitals are yet to use it to define tailor-made care for patients,” he said.

Indian start-ups sense big opportunity in big data

An article that appeared in the Mint 

A new crop of enterprise software start-ups in India is promising to translate mountains of digital data into practical business insights in real time, challenging the dominance of large technology firms, Oracle Corp. and International Business Machines Corp. (IBM), in the big data market.

Backed by some big investors including Blume Ventures, India Innovation Fund and Lightspeed Venture Partners, Indian big data start-ups such as DataWeave, Qubole Inc. and Formcept are helping online retailers price their products competitively, among other things, by allowing them to quickly sift through and analyse massive chunks of data generated by social media.

There’s a growing local market for this, and a pool of experienced professionals ready to quit Google Inc., Facebook Inc. and IBM to start big data firms. The market for big data in India is anticipated to grow at nearly 38% a year, from $58.4 million in 2011 to $153.1 million in 2014, according to a study by technology researcher International Data Corp. titled Here comes Big Data: Perspectives from Indian enterprises.

Big data

Big data refers to a collection of data sets or chunks of information too large and complex to be processed using traditional software tools. By applying big data solutions, enterprises are looking to sift through massive amounts of information about users, analyse usage patterns on a real-time basis, and prepare personalized campaigns that can potentially increase revenue per user. Apart from this, firms can make use of big data insights to cut costs and boost profit.

Intel Corp. estimates that the world generates 1 petabyte (1,024 terabytes) of data every 11 seconds, the equivalent of 13 years of high-definition video. IDC estimated that in 2011 all the data created in the world amounted to 1.6 trillion gigabytes (1.56 billion terabytes). By 2020, 50 billion devices will be connected to networks and the Internet.

This explosion of data is also driving entrepreneurs to start businesses focused on different industries, working around challenges specific to them to build big data solutions.

Bharti Airtel Ltd, for instance, handles around eight billion calls every day, generating petabytes of data to be analysed for identifying new revenue opportunities. And Royal Dutch Shell Plc., according to a McKinsey report in May, uses advanced seismic monitoring sensors to collect up to a petabyte of geological data per exploration well that need to be analysed; it plans to use the sensors on 10,000 wells.

Last month, when private equity firm TA Associates Inc. invested $25 million (around Rs.150 crore today) in Mumbai-based Fractal Analytics Inc., which provides advanced analytics to Fortune 500 companies, for a minority stake, experts said the deal was an acknowledgment of big data as the next big thing in India’s technology space—a segment, investors, particularly technology-focused ones, are keenly watching.

“The number of companies is small but the quality is good. Unlike in the Internet space where one sees lots of companies but a relatively broad mix of quality,” said Alok Mittal, managing director of Canaan Partners India, a technology-focused venture capital fund.

Investors such as Lightspeed Venture have taken multiple bets on big data, backing firms such as BloomReach Corp. and Qubole.

“We are seeing a lot of innovation from start-ups that leverage this data to create actionable insights for enterprises or use this data themselves to disrupt traditional industries like credit risk assessment,” said Bejul Somaia, managing director, Lightspeed Advisory Services India Pvt. Ltd, the local unit of US-based Lightspeed Venture. “The question becomes how will companies benefit from this.”

Somaia, who is on the lookout for more investment opportunities in the space, said that in the past two years the number of enterprise technology-focused opportunities in India has increased. “It is still early. Are we seeing enough? Not yet. But the trend line is very positive,” he said.

Start-up opportunities

There are two segments being looked at by entrepreneurs for starting in big data—building pure technology infrastructure for managing the information, and analytical software that help enterprises in specific industries.

“The other problem we face and which has kind of motivated us is that there is not enough data available about India as such—and there is not enough data available on the Web. In countries like Europe and the US, anything and everything is available on the Web,” said Sanket Patil, head of product strategy of Bangalore-based DataWeave.

The DataWeave founders Karthik Ramesh and Vikranth Ramanolla trained their attention on the highly competitive and growing e-commerce market in India and developed a platform that would analyse huge chunks of data and offer competitive analysis of companies. Their aim was to “democratize data access” so anybody could have access to information for a small fee. Their flagship product PriceWeave offers pricing data and other competitive analysis for e-retailers such as Flipkart and Jabong.

DataWeave, founded in 2011, recently garnered close to Rs.1 crore in funding from Blume Ventures, 5 ideas TLabs and a group of angel investors.

The founders are now working on scaling their data products beyond India to markets such as Europe and the US through partnerships with data sellers. Currently, DataWeave is running a pilot project with a few online retailers outside India.

“We are approaching this as a global play. As the business model has been validated in India, we are looking to expand into other markets,” said Patil.

Qubole, founded by former Facebook engineers Ashish Thusoo and Joydeep Sen Sarma, is based on Apache Hadoop, an open source software framework, and offers cloud-based Qubole Data Service that focuses on making analytics accessible to all kinds of enterprises. “Our clients typically tend to be high-tech firms,” said Sarma, co-founder and head of the Bangalore and US-based company.

Formcept’s Suresh Srinivasan and Anuj Kumar offer an analytics software that drastically reduces the time it takes for companies to collect, organize and store data from various sources, including social media websites Facebook and Twitter, and handles most of their data infrastructure problems.

The Bangalore firm also offers competitive analysis of companies in a particular domain. For example, in e-commerce, Formcept’s software can be used to analyse and highlight the differences between products sold on Flipkart, Myntra and Jabong.

“Typically, a data scientist or analyst spends 80% of the time looking at things like data capturing, delivery, visualization, which we’re taking away with this platform,” said Srinivasan. “What we’re trying to do is solve the data infrastructure issues, which includes data capturing, data analytics, data delivery, data visualization and data management.”

Another Bangalore-based firm Bizosys Technologies Pvt. Ltd’s HSearch software is a patent search technology. The company is building new solutions on it and is in talks with a few investors to raise funds. “We are looking to raise $2 million,” said Sridhar Dhulipala, director-solutions, co-founder, Bizosys.

BloomReach says it generates 94% average annual incremental revenue for its customers through its BloomSearch product. “We are tied to a company’s revenues. Unless we make a financial impact, we don’t make money,” said Vinodh Kumar, head of BloomReach India. The company raised $5 million, $11 million and $25 million in three rounds of funding.

Other promising Indian start-ups with specialized analytics technology are Mitra Biotech Pvt. Ltd and Iken Solutions Pvt. Ltd.

Mitra Biotech’s software offers personalized therapy for cancer, analysing the effect of multiple drugs on cancer cells and recommending the best treatment for a patient in shorter than a week.

Iken Solutions, which was founded in 2008 and has so far received about $2 million in funding, counts Bharti Airtel as its biggest customer in the mobile value-added services analytics market.

For Bharti Airtel, India’s biggest telecom firm with more than 260 million subscribers globally, Iken uses its software to analyse the huge volume of data generated by the telco’s subscribers and personalize value-added services such as caller tunes and ringtones for each user.

Another Bangalore-based big data start-up, Frrole, uses analytics to sift through massive chunks of news data. The algorithm can tell a newsworthy Twitter post from a comment or a reply and sorts about half a billion posts a month based on four different analyses—metadata, language, semantics and statistics.

Small market

For the founders of Formcept, which was incubated at the Indian Institute of Management in Ahmedabad, the biggest challenge so far has been convincing companies in India about the value proposition of spending on a big data platform, with many small- and medium-sized businesses still hesitant about embracing and spending on new technologies.

“India is lacking in that arena where companies are more open to embracing newer technologies, unlike (in) the US,” said Srinivasan, who previously worked at IBM.

Qubole’s Sarma, too, said one of the biggest challenges for start-ups in India is getting access to potential clients. “People are more risk averse, they stick to other solutions that they are aware of,” he said.

The key market for home-grown firms, in fact, lies outside the country. According to technology researcher Gartner Inc., global spending on big data is expected to drive about $34 billion of overall information technology (IT) spending in 2013, up from about $28 billion in 2012.

Wal-Mart Stores Inc., the world’s biggest retailer, last month acquired Silicon Valley-based analytics start-up Inkiru to build its e-commerce capabilities by using their predictive analytics platform, as it looked to compete with Amazon Inc. For Indian big data start-ups such as DataWeave that focus on e-commerce it would make sense to target bigger markets such as the US, say experts.

They don’t think India as a market will support significant revenue scale for big data companies. “They may be able to build and test product here, but will ultimately have to target other markets to achieve scale,” said Somaia of Lightspeed Advisory Services.

Why IT companies TCS, Wipro, Infosys eyeing start-ups

The hunt for the next growth driver brought top IT companies - Infosys, Tata Consultancy Services, Cognizant, Wipro and MindTree - to a Nasscom matchmaking event last week, where they were serenaded by about a dozen technology start-ups hoping to be bought by one of them.

The event, the first of its kind in India, signals a growing trend of large IT companies based out of India turning to startups for innovative ideas and technologies. It also gave the young ventures a chance to sell their ideas to the bigger firms, which are otherwise not easy to approach.

"We are looking for partnerships as well as mergers and acquisitions with start-ups," said Srinivas Seshadri, an associate vice-president at Infosys, which in April set up a Rs 593-crore fund to back innovation.

Seshadri, who sold his startup Injoos to former Wipro chief executive officer Vivek Paul in 2010 before joining Infosys, is now scouting for cloud computing and enterprise mobility companies.

For their part, tech startups were upbeat about the four-hour session. "It's tough to reach large companies directly," said Manjunath Gowda, chief executive of enterprise software solutions maker i7Networks. The 43-year-old entrepreneur is in talks with all five IT companies.

This growing tango between outsourcing giants and startups is driven by mutual need.

Little choice for Indian IT giants
"There is no choice left for Indian IT companies but to look at product innovation through startups," said Praveen Bhadada, a director at consultancy Zinnov. "To come out of the traditional IT services model, they have to look for ideas outside."

For instance, Infosys has developed a few technology products - including its banking software Finacle - that currently account for about 7% of overall revenues. On the other hand, cross-town rival Wipro has taken the acquisition route. In May, the company paid around Rs 177 crore for a minority stake in data analytics provider Opera Solutions. It also bought a stake in Axeda, a wireless technology company, for Rs 29 crore.

Ravi Gururaj, chairman of the Nasscom Product Council, is of the view that over time engagements that begin as partnerships and strategic investments can lead to mergers and acquisitions.

Indian technology start-ups have struggled for want of a thriving ecosystem for mergers and acquisitions. Unlike in the Silicon Valley - where Cisco, Google and Microsoft are active buyers of young companies - Indian technology services leaders have been unwilling to loosen their purse strings. As a result, exit options have been few and far between.

Last year, there were 21 exits worth Rs 1,265 crore, according to research firm Venture Intelligence. However, none was led by a top Indian IT services company.

That could now change. Following last week's event, Wipro and Cognizant are both talking to startups, such as Bangalore-based DataWeave, which provides data analytics for e-commerce ventures. "We are looking at startups that can augment our offerings in all emerging areas, such as infrastructure management, automation, big data and cloud," said GS Nathan, who heads innovation at Wipro.

Cognizant has set up an emerging business accelerator that has incubated 20 ideas over the past 18 months. "We now want to look at ideas from outside the company and are open to acquisitions," said Mahesh Venkateswaran, a senior vice-president and venture partner at Cognizant.

At IT services companies, it is often former entrepreneurs who are leading the hunt. Just like Infosys' Seshadri, MindTree's Chief Strategy Officer George Zacharias, who has been tasked with identifying new acquisitions, also founded a company. In 2010, he sold his startup 7Strata, a remote infrastructure management firm, to MindTree.

"Any organisation, big or small, cannot cater to everything on its own and that is where partners like start-ups come in," said Arundhati Maitra, a consultant at TCS, which is working with Mumbai-based startup iKen Solutions for its artificial intelligence product to understand customers' online purchase behaviour.

With about four new technology ventures set up in India every week, experts believe they will need all the help they can get. "We are at the cusp of time, which is presenting a great opportunity for Indian startups," said Bhadada of Zinnov.