Dr. Shriram Nene, cardiovascular & thoracic surgeon, healthcare expert, entrepreneur, and tech innovator is committed to improving lifestyles and lifespans through precision, and personalized health approaches. An active collaborator in the healthcare innovation space, Dr. Nene has developed ‘Pathfinder Health Sciences, a medical tech platform.
Queenie Nair of ET Edge Insights caught up with Dr. Nene on the recent episode of InConversation, Dr. Nene talked about how he approaches his unique roles, and the opportunities he sees in healthcare, he also explains why innovation and technology in healthcare are vital.
Queenie Nair: In the recent past aging was established as one of the factors for heart attacks, however off-late, we see the younger generation frequently succumbing to heart attacks. Cardiovascular diseases are globally known to take an estimated 17.9 million lives each year – out of every 5 CVD deaths, more than 4 are due to heart attacks. Why in your opinion has this health hazard become so prevalent in the younger generation?
Dr. Nene: To answer this, coming out of the pandemic, we don’t how many more passed away. we have many high-profile youngsters who succumb to this disease, and honestly, it’s an interesting disease in India. What happens with heart disease, is often linked to family risk factors, smoking, obesity, secondary lifestyles, and high-pressure job stress. So, you can view it in just the context of one factor i.e. age, rather than a whole myriad of different things that comes together. It is a combination of genes and how you perform.
The study showed that in India, heart disease hits India 10 years younger than its western counterparts. It’s a different kind of disease that triggers factors such as fat transfers in the body. When they are very high, they can deposit in the arteries thus blocking the blood flow, thus you end up experiencing a heart attack.
The other thing to notice is that, unlike its western counterpart, where heart disease impacts at the age of 50, while in India and Southeast Asia, it often happens at the age of 40. So why are we having individuals in their 30s and 20s experiencing heart attacks is something to investigate.
There are a couple of factors. My guess is the ability to broadcast this with different types of media, particularly social media. We are actually now, recognizing what was already there and we are becoming a little more conscious of what’s going on.
The second thing, while moving on from an agrarian towards an industrialized society, our eating habits, and socialization has changed. I think all of this play a role in this. Ultimately, if you are combating heart disease, it has to be a campaign of awareness and access to a world-class healthcare system of global standards and that’s what we have championed along with our partners. India has great doctors, a great healthcare system, but it lacks uniformity. In the rural areas, we have 1.8 million doctors who are allopathic and only 2 percent of the MBBS make it to rural areas, which is in fact 70% of India.
In the US we would count door to Balloon Time meaning the time you hit the floor to the time you go to the cath lab and get an artery opened up. In India it’s your door to Rickshaw time to another door then being evaluated then getting the right care and since it’s not uniform in terms of facilities not every facility has the ability to take care of everything and so I think as we grow as a country, this must be one of the high-level mandates that we should democratize access to advanced healthcare for everyone, and for that, it is important to educate about the expectations and the way to deal with them.
Queenie Nair: Taking this forward lets look at Gen Z, they are known to prioritize their well-being and are known to take fitness as one of the ways to stay relevant online. In your opinion Dr. is this a curated routine, what is it that is still lacking?
Dr. Nene: A lot of times today, staying fit is a fab and trend-oriented. The real problem is how you maintain it. At times, what you see is necessarily not what you get. The infodemic is alive and this was something we saw in the pandemic, and so created YouTube channels to provide evidence-based links to what’s best. The idea is we need to start a dialogue on health together and a grass-root movement where we are looking after each other in a way just like a family. Everyone out there is your family. We are all in this together. In India, during the pandemic, it was very special to me because people did bond together in a very desperate time and I see that as a future.
Regarding instagrammable pictures, I completely agree. There is a need to figure out a way to cure it. We are working on something like that. The idea is that you can at least raise awareness, channel the activities and excitement by bringing them together, social media can be a good tool provided it is curated right by the right experts with good evidence-based links, not just science or the like of it.
Queenie Nair: How would you align healthcare with technology?
Dr. Nene: We are eluded to the fact that there is a huge gap in numbers. Around 1.3 billion patients are served by less than a million allopathic doctors and everyone is trying to do thier part. What I see is that India leapfrogs into technology. We got the 3G 4G phones much sooner than most of the West and similarly with 5G we’re about to hit that
The current govt. has talked about getting basic internet to the masses and it’s an interesting topic. As the access to this connectivity increases among the population, this can be used as a tool for the dissemination of great information and access to qualified help.
We can also help them track their variables and bring them together, so we can have a feedback look. The idea is not just learning about what is good for you but about seeing how you are doing with the help of a dashboard. The need is to make it as a dialogue for the present generation as well as the upcoming one and technology will enable this as we will have real-time tools which will help us understand how we are doing.
Queenie Nair: This brings us to Pathfinder Health Sciences, the healthcare platform iinitiated by you.
Dr. Nene: I have been working with a lot of companies and individuals via investing as well as direct participation and education. What we decided is the gap we see in healthcare other than the numbers is a lack of awareness and access to world-class evidence-based materials. No matter whether you are in India, the USA, or the UK, access to care is very limited in this location. The amount of money spent is drastic. In India, we spend very little, 4 percent of our GDP goes towards healthcare, and of that 2/3rds is private pay.
In the US, it went up to 16-18 percent during the pandemic, and life expectancy went down. What I think we need is something to empower patients by putting a doctor with them all the time who is aligned with their interests. The idea is simple if you can have someone throughout your walks of life who stands by you, incentivized to take care of you it will change everything. When you look at the outcomes, you will that all the shareholders benefit.
The doctors benefit as they lack the infrastructure in many cases to scale themselves. This was a major problem for me. I operated for a long time i.e. 1993-2011 and at the peak, I was doing 300-500 open heart cases and many such. The problem is how you scale the reach of serving the planet’s population of 8 billion people. Because of my previous background in technology, I knew there were ways of using the combination of media and technology. The idea is that we can take media technology and smart services to build a platform that is agnostic to how you provide care and aligns with patients’ interests and global standards. We started by raising awareness through YouTube channels, and products for OTT. We aim to teach patients about themselves with more novel means. The effort is to keep and make it simple for people to understand.
The second part is a technology-based product which is a cloud-based platform with AI and ML. What it does is, gives you a real-time dashboard that needs to break down even further. For the same, we have different types of modules for a whole lot of the population. The idea is to predict the data.
The last path is to bring all the shareholders together who participated in the care and make sure that everything is done perfectly from everyone’s end. We are agnostic to who is providing it. It could be another startup, but the idea is we are always aligned with the patient and navigating with them in the journey of life. We think, with that, you are going to have a huge difference.
Queenie Nair: What sets Pathfinder apart from other similar global initiatives?
Dr. Nene: We are agnostic as to who does it. We can incorporate any platform into our platform seamlessly. Our only difference is we will always align with the patient and in some cases, even the patients are aligned too. So, we looked at it from a competitive analysis in India and the US. I would say that by and large, they fall into a few categories. Some are in the wellness space, while some are in the direct medical navigation, and medical care space. What we need to do is to ask the patient about what they need and make this a design-oriented exercise that is different for every patient. As you go further along, we are agnostic to whom you use as partners. We are a uber platform just like Plug-and-Play if the outcomes are good.
In India, during the pandemic, no one knows the number of deaths that happened, we just estimated it. This is due to a lot of times, the patients coming in late which gives no time to offer any medical assistance. Just like for CVD, 17.9 million deaths are just an estimate.
It would be interesting to take that data to customize and personalize it and say can we change the way medicine is practiced globally.
The other part of this venture is to bring together all the academics. I am working very closely with a lot of institutions in the US of higher education and trying to make this an academic exercise as well.
As you have seen in the last 2-3 years, people are investing in startups like anything. The real question is can these guys survive in midst of a slowdown in financing due to the global crisis?
So, to answer your question, I don’t see it as competition but as collaboration. My purpose is to give people a longer and better life and If we can do that together then nothing like it. My goal is to show best practices and present outstanding outcomes. The patient is the center of the puzzle and they should be able to benefit from all this activity.
Queenie Nair: You wear so many hats – cardiovascular surgeon, tech innovator, entrepreneur – What inspires you?
Dr. Nene: While I was growing up, renaissance thinkers were my role models as they had so many things. For me, it is important to learn every day. The other thing I would like to mention is there is a horizontal architecture in m organization. I learn from every rank and I am always listening. With that outlook, it only improves things. The most recent personality that I look forward to is Elon Musk. He is wild and driven to do crazy cool stuff. So, the idea is to bring together cool people and create universal superheroes who can then help others to make the best of their lives. Every day is a discovery and that very thought keeps me on my toes and makes me put effort in every possible way toward creating something meaningful for society that is only going to make their lives better.
Queenie Nair: Three essentials you wouldn’t step out without
Dr. Nene: I used to have a little memo book that I use to write in. The phone has replaced it. The second one is I always carry an umbrella. The third one is a protein bar as I am into working out and need to keep up with my daily and scheduled intakes.
Queenie Nair: Your favorite book
Dr. Nene: I am a huge science-fiction fan. For casual reading, Isaac Asimov is my favorite author as he has pushed the envelope and used science with fiction to bring in things. I am constantly reading across different genres.
Queenie Nair: If you had to share some advice with aspiring professionals, what would you say?
Dr. Nene: I would say, that number one, it’s experienced over things that matter, but at the end of the day no matter what, it is family and friends and the people around you, that you create experiences with.
I would like to tell everyone that dream and execute. We should kind of look at our successes and our failures and learn from them rather than dwell on them the last thing is don’t judge anyone unless you’ve walked a thousand steps in their shoes and even if you have don’t ever, ever get into that because the bottom line is that they’re human and they’re doing the same thing you are and you just need to step up and help them. That would be my advice to the youngsters out there.
Written by Moulin Oza; Interviewed & edited by Queenie Nair