Building a Purpose Driven Digital Oncology Platform to Deliver World Class Cancer Care by R. Venkataramanan, Founder CEO, @karkinoshealthcare


KARKINOS HEALTHCARE (KH) is desirous to build an end-to-end technology driven oncology focused managed healthcare platform where almost no person is deprived of care either by lack of access or by affordability.

The design and delivery will be through bespoke solutions for cancer care, as a one stop shop in experience, addressing core market needs for this specialized health care. It will use technology and AI based continuous feedback to improvise care to our own needs, the learnings of which will be scaled up within India and beyond. Karkinos Healthcare is supported by an eclectic Founding Team with strong technology, healthcare and finance experience, and a panel of eminent Clinical Advisors in India and abroad. The team’s efforts are further augmented by its access to best-inclass architects, space planners, vendors, technology support engineers, pharma partners – all of whom combine to create the firm’s USP in the field of cancer care delivery. The team of Karkinos Healthcare has, in their earlier avatars, facilitated the design, development and commissioning of a 700-bed Specialty Oncology Hospital and the redesign/ modernization of an existing hospital, aggregating to 1 million square feet in less than a year’s time. Both have since been commissioned and are fully operational. In addition, they have also been instrumental in the design and development of a ‘hub & spoke’ Cancer Care hospital network in the North East of India that comprises of 12 hospitals, presently under construction. The Distributed Cancer Care Network model (DCCN) also finds a mention in Lancet Oncology.


With gross underreporting and inadequate diagnosis, there is a high burden of Cancer in India with almost 1.9 million new cases per year. More than ~50% cancer patients visit a doctor for the first time, at or past the third stage of cancer, thereby requiring multi-modal therapy, spread over 2-3 years and finally succumb to the disease. Cancer puts a massive personal and financial burden on not only the patient, but also on the patient’s entire family with the out-of-pocket expenses being as high as 70% of the total treatment cost. Along with the loss of working days for the patient there is loss for the family and resultant detriment to GDP. With the rise in cancer cases across the country, and lack of adequate cancer care infrastructure and medical professionals, there is a need to assess the cancer care requirement better and prepare to bridge the demand- supply gap by improving accessibility, availability and affordability of cancer care. In addition, there is also an urgent need for extensive early detection and prevention initiatives given the remarkably high tobacco consumption and low awareness in the country. The cancer care diagnostic and delivery platform in India is presently woefully inadequate. Multiple players mostly operate in silos thereby contributing to a health care infrastructure that is fragmented, inaccessible by patients and thus leading to the unsatisfactory patient experience. Existing data in the public domain and market research has demonstrated a significant gap in the supply of oncology beds, linear accelerators, radiotherapy technicians and oncologists. With ever-increasing demand from patients seeking treatment, the demand/supply gap widens with the passage of time. This is the unaddressed opportunity. However, there is a need to revisit the operating model and encourage the establishment of participatory systems rather than proprietary systems.


Karkinos Healthcare aims to significantly enhance access to cancer care services by creating a technology enabled data driven platform wherein the knowledge architecture is centralized, and the delivery systems are democratized and distributed. The solution encompasses a ‘hub- and-spoke and further spoke’ hospital infrastructure on the back of robust technology and clinical decision support systems that enables service delivery in a wide patient catchment. The model relies on a technology backbone that enables anchor referral hospital/s that cater to complex cases, surgery, and radiotherapy supported by a network of smaller centers for catering to diagnosis and ongoing treatment so that the treatment can be decentralized, thereby reducing the load on Apex centers for non- complex treatment while increasing accessibility and cutting down on loss of productive days for the family. The network is designed to be ‘wired’ to enable connectivity amongst all centers, seamless access to data, diagnostics, and patient consulting – which includes a combination of a central knowledge repository, diagnostic capabilities, and a common training HR pool. It is, therefore, essential that the ‘hub and spoke and further spoke’ cancer care hospital network be supported by core investments in infrastructure (“Karkinos cloud” and a clinical workflow orchestration and care coordination engine). This would entail tools/apps that will help collect data from Tier 3-4 medical clinics and aggregation & reporting from Tier 1-2 hospitals. The architecture will focus on the creation of the Karkinos backbone infrastructure and open APIs followed by a few “core apps”. Some of the apps would be open source for the developer community to emulate and develop more apps required by the Karkinos network. The priority of these applications is driven by customers, the diagnostics and treatment modalities that they currently have, and their maturity in handling clinical data.

The data collected will be key drivers of understanding specific genomic profiles of tumours with the clinical annotation that will aid

a) A technology platform for diagnosis and data mining

b) A shared services infrastructure training facility and ongoing clinical R & D

Karkinos Healthcare strongly believes that technology will be the key enabler for the de- centralization of expert care. The technology platform consists of a distributed architecture with the development of tools/applications that will integrate seamlessly and securely to a Karkinos backbone in drug discovery, diagnostics and treatment strategies This will nurture innovation and newer therapeutic approaches to improve outcomes, in addition, to becoming a strong revenue generator. The clinical data repository, curated knowledge base and advance analytics will be part of the Karkinos offerings.


Detection & Diagnosis – Establishment of participatory systems and near home care, Research on genomics as a foundation approach for prevention, Innovation and game-based outreach approach for early diagnosis and wellness.

Data & Research – Contribute towards Atmanirbhar Bharat through drug discovery research and treatment innovation, Large scale screening and longitudinal data to build robust AI/ML analytics, predictive models and clinical decision support system for real world evidence.

Deliver managed health care – 2 million+ patients served annually, 10 million+ patient hours saved annually.


Karkinos Healthcare over the next 18 months, will be focused on creating the foundation for the following components –

• a state-of-the-art technology platform curated for oncology.

• a knowledge network with medical protocols, surgical skills, digital pathology center.

• along with fifty Level 4, fifteen Level 3, five Level 2 and one Level 1 centres.

The article was first published on the K-Vani Blog by Karkinos Healthcare, it has been republished here with the author’s permission, link to the article

R. Venkataramanan
R. Venkataramanan

Venkat is Founder and CEO of Karkinos Healthcare. He is currently engaged as an Advisor to the Chairman, Reliance Industries Limited, India’s largest private sector company.

Prior to his association with Reliance, Venkat spent more than a decade and a half with the Tata Group in various capacities. His last assignment in the Tata Group was as Managing Trustee of the Tata Trusts wherein he was responsible for the operations, oversight and co-ordination between the various Tata Trusts.

In his role as the Chief Executive Officer of the Tata Trusts, Venkat was engaged in redefining the Tata Trusts’ strategic approach with a view to making it relevant and responsive to the current needs of society while remaining within the mandate established by the Settlors. He was directly overseeing several large initiatives within the Trusts viz “Lakhpati Kisan – an program that aims to significantly enhance rural prosperity in under privileged and deprived communities, redefining Cancer Care across the country, technology enabled education initiatives in partnership with Massachusetts Institute of Technology (MIT) and the sanitation and nutrition projects in collaboration with Govt., of India.

He has over two decades of business and operations experience in the areas of finance, business support and strategy. From early 2007 to end 2012, he was Executive Assistant to Mr. Ratan N. Tata, the former Chairman of the Tata Group. During his stint in the Chairman’s office of Tata Sons, Venkat was part of several significant projects including the Tata Motors acquisition of Jaguar Land Rover, launch of the small car Nano, creation of several Joint Ventures, responses in operating companies during the 2008 financial crisis etc., and was also privy to several senior leadership transitions and change management processes in the Tata Group. On behalf of the Chairman, he was the key point person to several entities in India and abroad.

Prior to his stint with Mr. Tata’s office, Venkat was associated as Head of Business Support at the Qatar Foundation, a not for profit entity engaged in Education, Science and Community development based in Doha, wherein he played a key role in establishing partnerships with a number of leading US universities.

Venkat is a Science graduate and has done his MBA from the Sri Satya Sai University, Puttaparthi. He is also a Law Graduate from Mumbai University and has completed his Advanced Management Program (AMP) from the Harvard Business School. He is currently pursuing his EngD from the University of Warrick, UK on role of Technology in Health Care Systems.

Over the past several years, in his personal capacity, Venkat actively supported Mr. Ratan Tata in his investments in the technology, digital and e-commerce space that have now begun to attract significant attention in India and abroad. He was also the CEO of UC-RNT Fund, a US$ 350 million VC fund that Mr. Tata established in collaboration with the University of California. A key proponent of societal platforms, he is the midst of incubating alternative business and investment vehicles that work in the intersection of business, philanthropy, non-profits and governments on the notion of sustainable shared value creation for societal benefit

– Advisor to Chairman, Reliance Industries Ltd
– Chief of Staff to Chairman, Tata Sons and Managing Trustee of Tata Trusts
– Tata Memorial Hospital and Tata Medical Centre Trust, conceived Tata Centers for cancer care
– CEO and Partner of UC-RNT Fund and RNT Capital Advisors, a $350 million fund

What’s the cost of ignoring your employees’ emotional wellness to your organization? Puneet Manuja, co-Founder of YourDOST answers

What’s the first thing that comes to your mind when you hear the phrase ‘employee wellness’? Chances are you’re thinking of physical fitness, exercise, healthy eating, and prevention/management of lifestyle diseases like hypertension, diabetes, etc. But an essential component that we seem to lose sight of is employees’ emotional wellness.  Puneet Manuja, co-Founder and COO, YourDOST, in this post, highlights on how corporate employees’ mental health and emotional wellness has been affected and how nearly 36% of them suffer in silence with no one to turn to. In a fireside chat, Puneet discusses the company’s technology platform that offers stigma-free therapeutic solutions to create happier workplaces followed by an authored piece on the consequential impact of an employee’s wellness on an organization.

Health-tech startups focus on riveting children’s health screening programs through digital platforms

The onset of the Coronavirus pandemic has completely thrown school health programs out of gear. Lockdowns over the last 2 years have affected most school-based health programs. The silver lining here is that there were health-tech companies who had already forayed into the space of providing digitally-enabled care programs/platforms to school children. These platforms were scaled up gradually to take the screening camps completely online. This post discusses the effectiveness of school health programs and how health-tech companies like Trawello Healthcare are doing their part to ensure children’s health is prioritized.

The distinct feature of X-ray technology in COVID-19 diagnostics, by Navjot Singh, President – Medical Imaging, Trivitron Healthcare 

Imaging procedures are of great value in the COVID-19 pandemic when the question of assessment of suspected cases and determination of the course of the disease arises. While a multitude of radio diagnostic tools is employed, the role of X‑ray imaging in COVID-19 infection has distinct importance. This post by Navjot Singh, President – Medical Imaging, Trivitron Healthcare, touches upon the importance of X-ray imaging and technological advances.

These last mile telehealth enablers travail to deliver care despite digital infrastructure challenges

ISRO may have sown the seed of telemedicine in India, but it was the Coronavirus-caused pandemic that propelled the widespread adoption of telemedicine and made it an irrefutable need for the present and the future care delivery methods and one that could be exploited to achieve sustainable healthcare solutions for our country’s semi-urban and rural communities. Few organizations and startups mentioned here in this post have gone several extra miles with their efforts to enable telehealth in their own ways.

Things & Thinks XXIII

I am happy to bring my monthly newsletter to the HCitexpert Blog from this month onwards. In this edition of my newsletter, I reflect upon the learnings from the COVID innovations that proved to be marginally useful at the most, followed by regulatory changes being rolled out in EU with the advent of MDR. There is the usual round-up of interesting digital health news, Tweet of the Month and Chart of the Month.

Cloud computing services play a big part in addressing the needs of rural India’s fragmented healthcare ecosystem: Ashvini Danigond, ED & CEO, Manorama Infosolutions

Ashvini Danigond, Executive Director & CEO, Manorama Infosolutions is quite a revelation. Interacting with her means being enlightened on the varied aspects and nuances of new-age technology adoption in healthcare and its deployment in a patient-centric value-driven healthcare delivery system.

In this interaction with Anusha Ashwin, Consulting Editor, HCITExpert Blog, Ashvini shares her purview on digital health and how her company Manorama Infosolutions is bringing about the right difference and holistic digital empowerment to India’s healthcare ecosystem.

Exclusive Conversation: Deeksha Senguttuvan, Head of Digital Strategy, Kauvery Hospital, ascertains the power of predictive analytics in healthcare

It is a known fact that the adoption of technology in the health care sector has had a tremendously positive impact on medical processes. Artificial Intelligence-led predictive analytics, especially, is finding increasing applications in healthcare delivery and is largely explored to bring about positive patient outcomes.

Deeksha Senguttuvan, Head of Digital Strategy, Kauvery Hospitals, bets big on predictive analytics in healthcare. Deeksha, in this exclusive interaction with Anusha Ashwin, Consulting Editor, HCITExpert, shares her knowledge on the working of predictive analytics in hospital settings and how the technology plays a major role in tackling today’s pandemic health delivery needs.

Indian startups, DRDO, IISc exploit radiology AI for COVID-19 diagnosis and prognostication

Timely implementation of AI in desperate times like this has never been a miss by India’s digital technology specialists. From DRDO to some of India’s most prominent health tech startups, COVID-19 diagnosis based on radiology imaging augmented with AI-based clinical data has come to fore. This post highlights a few

How to introduce SaaS in your Healthcare Business – by Hanish Bansal

SaaS is a very important asset when it comes to healthcare organisations. It can significantly reduce the workload from regular tasks and help you shift your focus towards more important projects, explains Hanish Bansal in this post that highlights the benefits of SaaS in healthcare.

How (not) to implement population health informatics applications! – by Nachiket Gudi, @GudiNachiket & Gaurav Pradhan, @GauravP_Tweets

A digital informatics application is as good as its underlying processes and people. Even if the application is built on a best-in-class digital architecture, if the underlying people and processes don’t have checks and balances in place, it is bound to fail. Learn more from this post on what the authors intend to convey on implementing best practices in health informatics.

Will pampering the Me and I kind of patient consumers with digital intervention tools be the new sustained healthcare delivery model?

Servicing the ‘Me and I’ kind of patients is in trend now. Patients want benefits of their customization and they are wanting ownership of the experience itself. This post highlights how patient consumerism has changed and how healthcare companies are now structuring new models to personalize care.


As a doctor who has treated the COVID patients, it makes me wonder whether the treatment modalities currently in use, continue to be used in future or there is an ocean of possibilities still unexplored. For this reason, I started to review articles more on the Use of Newer treatment Modalities like Immunomodulatorsin COVID, also can Artificial Intelligence (AI)help predict the future? Can AI help for evaluating the newer treatment modalities?

Time to address the shortcomings of digital health, says Preventive Cardiologist Dr. Pratiksha Gandhi, By Anusha Ashwin @Ashwin_anusha

“Preventive healthcare can only be successful with the support of digital technology interventions as this is the era of digital tracking for healthy behaviors, wearables, apps to monitor various chronic diseases,” says Preventive Cardiologist, Dr. Pratiksha Gandhi in a short Q&A with team HCITExpert. Read on to know more about Dr. Gandhi’s ideas and opinions about digital health applications in this post.

These techies work round the clock to centralize information on ICU beds, oxygen, and other resource availability on social media

Listed here are a few active enthusiastic techies or organizations working relentlessly in times of this crisis to help save lives. This list, though not exhaustive, highlights the major contributors who are collating and posting verified leads on social media, during the toughest times that India is made to face today, in saving lives and in overcoming the pandemic.

Health coaches, AI-backed risk assessment platforms dawn to address avoidable mortality and health inequities in India – by Anusha Ashwin, @ashwin_anusha

The United Nations finds India’s disease burden and its associated premature mortality figures quite acute. Combined attempts are being made by the Indian healthcare stakeholders to bring about large reductions in premature mortality and simultaneously address healthcare inequities. This blog highlights how digital healthcare interventions have a profound impact on tackling mortality and inequity, especially in healthcare resource-constrained locations.

Common Pass: A novel approach to leveraging privacy preserving digital tools for COVID19 Pandemic – by Rahul Konapur, @ Rahul Konapur; Nachiket Gudi, @GudiNachiket; Oommen John, @oommen_john

Countries across the globe have been devastated by the COVID-19 pandemic caused by the SARS-CoV-2 virus. Over the span of a year 2,320,497 lives have been lost and 106,125,682 infected as on date1. The scientific community across the globe are racing against time to administer safe and effective vaccines to save lives and livelihoods. As the pandemic spread across the globe, strict border closures and travel restrictions have brought the aviation industry to a standstill.

Tele-ICU: India steps up this viable model to triage and beat Intensivist shortage – by Anusha Ashwin, @ashwin_anusha

Last year, in the month of November, when the pandemic reached its intensity heights, Kerala Health Minister, K Shailaja, inaugurated her state’s first tele-ICU command center. Sponsored by the National Health Mission (NHM), this tele-ICU command center was established at the Government Beach Hospital. The launch of this center is notably a breakthrough and a significant revolution in health-tech innovation and an outstanding example of a public-private partnership.

Things & Thinks XVIII by Santosh Shevade, @santoshshevade

Things & Thinks XVIII

Curated Thoughts on Healthcare by Santosh Shevade

Healthcare Innovation | Outcomes Research | Implementation and Impact

aśvinau health – health at your fingertips by Venu Malyala, @dubugu

EDIT – As of 28th Nov 2020, NDHM issued a clarification that HealthID will be made an OpenIDC as envisioned below. The below was written prior to that

India’s National Digital Health Mission (NDHM) is great opportunity to adopt a truly digital health platform. A pandemic staring at us and with the evolution of policy, standards & technology, a vibrant developer community, a workforce that can be trained, upskilled to deliver the digital services the timing has never been this urgent !

The importance of public-private partnership for an outcome-oriented approach in diagnosing and treating breast cancer in India by Anusha Ashwin, @ashwin_anusha

Breast cancer is the most common cancer among women and 80% breast cancer incidents are recorded in women above 40 years of age. This is especially worrisome because the number could be an underestimate as currently only 15% of the population is covered by cancer registries.

Indispensable supercomputers for Coronavirus structure research and vaccine development by Anusha Ashwin, @ashwin_anusha

The Coronavirus causing the pandemic COVID-19 is wreaking havoc in our lives. This efficient infection causing machine, SARS-CoV-2, is comprised of only 29 proteins with a genome 1/200,000 the size of a human being. It is remarkably evolved to trick human cells in its quick propagation causing innumerable deaths and sickness across the globes.

National Digital Health Mission and Role of Future Ready Healthcare Professionals by Dr. Oommen John, @oommen_john


India has been making steady progress in leveraging information and communication technologies in healthcare for over two decades. Efforts to build and act in the health information systems and electronic medical records in both public and private healthcare settings have been underway. For example, the Centre for Development of Advanced Computing (C-DAC), a premier research and development organization of the Ministry of Electronics and Information Technology (MeitY) developed and deployed India’s first indigenously developed total hospital information system (HIS) software in the 1990s.

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