In 2011, Neha and her husband, Rahul Rastogi faced a personal emergency. Rahul’s father was admitted to the hospital after complaining of a heavy feeling in his chest. Tests showed that he had been on the brink of a massive heart attack. Every time he felt uneasiness, Rahul would have to rush him to a hospital, sometimes in the wee hours of the morning. Every episode of chest pain used to scare them and they would worry if it was something severe. That near-crisis and the stress of regular follow-up tests after the angioplasty made the couple, Rahul and Neha Rastogi, think about the possibility of monitor- a crisis as heart attacks are notoriously ing the heart differently, more precisely, difficult to detect. Research showed that at home. there was no such gadget on the market.
The Rastogis took matters into their For the Rastogis, this gap in the market own hands. Electronics engineers by ed- provided an opportunity to develop a ucation, both Neha and Rahul decided product that would offer a much-needed to quit their engineering jobs to create health care solution. They transformed a gadget to help people monitor their their bedroom into a lab and put their heart function on their own at home, to engineering expertise to use as Neha was be able to provide an early warning of previously working as a technical analyst.
with Hewitt, and Rahul was a design engineer at Samsung. Agatsa Software, the company they set up with their own funds, and with friends and family chipping in, started out as a rudimentary home lab in which the two studied the essentials of the ECG machine and how it captured information on the heart function. They then worked on developing a miniature model of similar efficiency. The principal challenge lay in developing sensors in place of the leads that are connected to different points on the chest. By 2013, a prototype was ready, which involved a micro circuit in a plastic casing marginally larger than a st
andard credit card with two thumb sensors that transmitted the read-out to a smartphone. Even the most basic models could capture the information. The device, called Sanket — signal in Hindi
— was showcased at an event organised.
by The Indus Entrepreneurs (TiE) called ‘Tie the knot’.
They were selected as one of the top five start-ups on the TiE platform. Although they didn’t get much funding initially, they got some good feedback on the device. A breakthrough came in 2014 when Sanket won the Anjani Mashelkar Award for frugal innovation, a multicountry contest that involved 300 entries. Subsequently, with some funds from the Department of Science and Technology of the Government of India, and mentoring by an incubation centre under the Start-Up India scheme, Neha, 34, and Rahul, 36, worked on improving Sanket’s circuitry to capture more chest leads, first six and then 12, through sensors embedded on the side of the device.
In July 2015, Agatsa launched its first Sanket electrocardiogram (ECG) device, at half the price of similar devices that, however, offer only a single-lead reading. Sanket is a disruptive high-tech innovative solution for personal cardiac care. This credit card-sized heart monitor acts like a portable ECG machine, making it possible to monitor the heart condition, as simply as one would monitor body temperature. The high-tech 12-lead ECG recorder connects to a smartphone wirelessly, and displays and records ECG graphs on a smartphone. The ECG report can be shared instantly with a doctor via e-mail, Bluetooth, or even via WhatsApp. The affordable device — its three variants range from Rs 3,500 to Rs 9,000 — marks a dramatic shift in the way we approach cardiac care, doing away with expensive ECG machines, distant hospitals or laboratories, and skilled technicians.
Agatsa has also filed three patents, of which two — for design and technology, have been granted. Over two lakh consumers — doctors and heart patients — have used Sanket to conduct over 400 hours of ECG, and the numbers are rapidly increasing. Their newly launched product SanketLife Muti Vital did record sales of more than 1000 units during
pre-launch. Their organisation, Agatsa, a healthcare technology company, has evolved to serve not only India, but also other countries like Turkey, Germany, the USA, Brazil, Australia, Malaysia, Bangladesh, and the UAE.
Recently, Agatsa also won the prestigious Aegis Graham Bell Award in the
‘Best Innovation in Diagnostics’ category. Aegis Graham Bell Awards (AGBA), established in 2010 by the Aegis School of Business, Data Science and Cyber Security, celebrates innovators and in- best in its category, beating competition from giants like Siemens Healthineers and mFine.
“We are thrilled to receive this award. This is like a Noble prize for innovations in different areas which can also be commercialised and help people in general. This award is given after much grilling and validates all the hard work and years of research to develop a product like SanketLife, which is the first in the world. We are happy that our product is not just adopted by the users and the novations, and recognises the talent with the potential to grow as technology leaders; start-up founders; innovators; entrepreneurs; and intra entrepreneurs, who are transforming the lives of millions of Indians by their work. The 13th AGBA is supported by the Ministry of Electronics and Information Technology, and the Government of India’s Skill India campaign. Rahul Rastogi and the entire Agatsa team were felicitated as the winners under the Innovative Diagnostic
Solution. The device was adjudged the patients but also by the doctors’ pan India,” said Rahul Rastogi after receiving the award. Agatsa is currently working on integrating SanketLife with AI to provide advanced cardiac diagnostics and to aid medical professionals with a portable, digital tool equipped with the highest tech like AI and Blockchain. This will make it possible to detect heart disease at a very early stage and will help both the healthcare professionals and the patients to monitor and manage their hearts.
In the long term, Agatsa is looking at a ‘complete fulfilment plan’. This involves extending its offering to measure blood pressure, blood sugar, and blood oxygen as well as a paid service in which a panel of doctors can review the read-outs. The company has developed an algorithm that can measure stress levels through Sanket, and a foetal monitoring device is also being researched.
Cardiovascular disease is the leading cause of death in India, accounting for about a quarter of all mortality. With nearly 30 million people suffering from heart ailments, India is unfortunately known as the heart disease capital of the world. Globally, the problem affects many more millions as heart attacks are difficult to detect. A cheap and portable ECG like Sanket could be godsend for millions of Indians who are grappling with the high costs of private healthcare system, especially at a time when the public-health machinery is failing to meet the demands of the nation’s one billion-plus population. It stands to have the most impact in India’s villages, which house 70 percent of the nation’s population, and where hospitals and doctors are scarce.
Sanket’s current iteration is almost as efficient as the big hospital ECG machines. Eighty percent of cardiac problems can be diagnosed by this thumbbased product. Moreover, the SanketLife app connects patients with physicians who can provide immediate feedback on their ECG reports for a small fee
General practitioners have found the device useful for their private practices as even patients as young as 25 are now having cardiac problems in India. It can be tricky to determine whether symptoms are heart-related. When they do detect a cardiac problem through Sanket, they refer that patient to a specialist.
Neha finds the device especially important for patients who’ve undergone an operation. “A person who has had a surgery needs to be handheld for three months after the surgery,” she added. Patients can talk to doctors through the app. It makes them confident.
Sanket isn’t a first-of-its-kind clinicalgrade heart monitor. In fact, this type of portable ECG technology has already been introduced in the United States. In 2014, the Food and Drug Administration cleared a finger-based heart monitor, Kardia Mobile, developed by the American company AliveCor. It’s now available for purchase in more than 25 countries through online marketplaces and costs $99 in the USA.
Sevith Rao, founder of the Indian Heart Association, a non-profit working on awareness and outreach about heart disease, affirms that “Sanket has tremendous potential to reach India’s rural populations, as doctors are in extremely short supply in India, especially in the villages”. Rastogis have already started testing the waters in rural India. Last year, they collaborated with a non-profit, Tata Trust, to bring Sanket to 45 primary health centres in the northeast Indian state of Tripura. Government doctors, who sometimes have only basic medical training, have been using them for over a year to check for heart problems in patients. If they detect something serious, patients are referred to a bigger hospital with specialists.
According to data, there is one government doctor available for almost 1,700 people. Smaller public-health hospitals, called sub-centres and primary health centres, do not typically have specialists. People with cardiac ailments are referred to larger district hospitals or community health centres. Larger hospitals serve multiple villages, and people often have to travel long distances to get to them. Sanket cuts down unnecessary referrals to distant district hospitals by allowing local practitioners to track cardiac symptoms in-house. Rastogis have received positive feedback from the primary health centres and are in talks with other governments to forge similar collaborations.
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