In India, we have 1 doctor for every 1,700 patients (WHO recommends 1:1000). We produce about 30,000 doctors and 18, 000 specialists every year. It is estimated that we will need four lakh doctors by 2020 to meet the minimum WHO requirement of 1:1000 doctor-patient ratio.
Inventing medical devices: A perspective of India is the first published book that focuses purely on medical device innovations in India and describes ways for clinicians and engineers to work together as a team. I hope that entrepreneurs who wish to develop new medical devices that will help patients in our country can refer to this book to access some information about inventing medical devices in India in our otherwise infantile yet rapidly emerging med tech ecosystem.
Based on my experiences as a clinician and as a serial MedTech innovator, I recommend that every clinician should keep in mind the following before they venture out to invent something new.
1. Form a team
Find an engineer and a product designer who are willing to take the idea from conceptualization to commercialization on a full-time basis as a start-up company and include them in your team. Most doctors, who understand the clinical problem well, seldom understand the technical challenges. Also being burdened with work it is practically impossible to drive the 24-36 month effort of development all by themselves. By forming a team that starts a company, a formal entity is created to take the idea to its logical conclusion.
2. Work with professionals
Many doctors have tried to co-develop new technologies with engineering students by partnering with engineering colleges. However due to the academic setting and limited clarity on how the technology licenses can be transferred to a private entity for funding and commercialization, these efforts end up as student projects that never leave college boundaries. Therefore, it is recommended Doctors find working professionals with 2-5 years experience at healthcare hackathon’s (jugaadathon’s), engineering conferences and social medical groups.
3. Have realistic expectations from your contributions
Ideas that come in a few minutes or hours of brainstorming alone don’t always solve a need. It is ideas that are developed meticulously over 2 to 3 years by following all the recommended processes and guidelines to create something which can be used safely, effectively and reliably on patients are the ones that eventually can solve the need. It can take INR 2-4 crores and a multidisciplinary team of 6-8 individuals and 2-3 years to make even a moderately complex device like a hearing aid. Therefore, it’s probably realistic and fair for the doctor who is only providing intellectual input and time to expect a low single digit royalty or company share for their efforts.
4. Have necessary know-how on the entire process
Not just idea generation but there are many other things that are involved to take the product to the Market successfully. It helps to know that a prototype that works once is not the final product. In fact to get to the stage of a product, the prototypes must be repeatedly tested, improvised and validated before it becomes a clinically tested and reliable product that can improve patients’ lives. The sustainability through an effective business model is probably the most important factor that will keep the product accessible to the patients in a consistent manner. This can surely help in the reduction of the overall clinical burden of the problem.
5. Do not discontinue your clinical engagements entirely
While it is great to invent devices it is equally important to continue clinical work as it keeps clinicians grounded to the need. This is important to have the depth of understanding in both clinical usage and technical development. As a clinical innovator, I have found a way to balance my time doing both. And if one has a good team, a few hours in a week which is probably the time spent writing research article’s (Which doctors do anyway) is all that one needs to spend in order to develop a new technology.
6. Raise smart money and don’t dilute equity early
Start with Government funding opportunities till you develop a proof of concept and have hired a team. Today, with the Make in India efforts, there are numerous grants available to take an Idea to proof of concept. These grants even allow funding of company incorporation and salary expenditures. These can, therefore, allow a clinician to form a team, incorporate a company and file intellectual property in addition to developing a proof of concept. Further private/public investment can be raised thereafter which will be welcomed investors as they prefer to invest when the team and concepts are developed to some extent rather than investing in a very early stage ideation phase. This also helps startups save their company shareholding/equities until a later dilution.
7. Be more than just a feedback provider
Clinicians understand the clinical space and the problems very well. It is, therefore, vital to share that information with the engineering, design and business team members so that the technology is suited to be used in a realistic clinical setting. Educating the team, leading the clinical testing/validation and improving product adoption should be provided in addition to critical feedback on the developing technology.
8. Don’t be afraid to fail
As a clinician trained in India, I can confidently state that we are trained to have a very narrow window of error. As important as this is in the clinical setting because we deal with living patients, this resistance to failure is probably counter-productive in the field of inventions. For a product to be failure proof, it should have failed in all possible ways during the development and bench top testing and all these causes for failures systematically rectified.