Harvard Grads Develop Tech to Help Patients Better Manage Diabetes in India

Recently, I asked Scientific Director of Jana Care, Dr. Ashok (A.J.) Kumar, to tell me how his startup is working to help patients with diabetes in India. Dr. Kumar received his Ph.D. from Harvard University, where he developed a density-based separation systems and worked on adapting technologies for use as low-cost diagnostics. Dr. Kumar has three patents. His goal is to harness science and technology to address issues of social justice and development. Previously, A.J. worked in the Peace Corps.

Marquis Cabrera: How did you get involved with Jana Care?

Dr. Ashok Kumar I've been active in the diagnostics development and global health space since I came to the Boston area in 2009. As a grad student, I used to organize a group called Diagnostic Innovations in Global Health and for one of our events, Michal Depa, the CTO and co-founder of Jana Care was a panelist. We stayed in touch while I was finishing up my PhD and then I got involved as a consultant. When I was considering what to do next, the opportunity came up to join Jana Care full time to lead the scientific efforts and set up a Boston office.

Marquis Cabrera: What has it been like running an early stage startup?

Dr. Ashok Kumar To be clear, I don't run the company. At the point when I joined, Jana Care had been around for a little over 3 years, but most of the team was in India. I help lead the Boston office. Having already been in Boston for 6 years and having built out a network in the medical and bioengineering research communities has made it a lot easier to get things going. Every day brings new tasks and challenges. Some of it is not glamorous, like setting up purchasing and receiving, but some of it is quite exciting, like meeting with top scientists and large companies to discuss potential partnerships.

Marquis Cabrera: What pain point is Jana Care is solving?

Dr. Ashok Kumar Diabetes and most chronic diseases are multi-faceted problems that can't be solved with a single technical solution, like a vaccine for infectious diseases. Type II diabetes is a silent killer that creeps up on people over time and slowly destroys their bodies. These kinds of diseases make up an increasing part of global morbidity and mortality. To turn the tide requires a multi-pronged effort: 1) early detection and better diagnostics to identify those with the disease or progressing towards the disease, 2) monitoring the various risk factors that come with the disease to prevent a spiral into kidney failure, heart failure, and other issues, 3) educating and empowering patients to take control of their disease through the food they eat, the activities they do, and showing them the results 4) linking together care providers with patients to get a holistic picture of disease management, and 5) making all of this work easy, seamless, and intelligent. Some companies are trying to solve one or two of these issues. Jana Care's approach is different.

We are creating an ecosystem to deal with the issues altogether: 1) our low-cost HbA1c test enables mass screening for diabetes and pre-diabetes, 2) the Aina platform (our reader) can measure multiple tests related to diabetes and other chronic disease, 3) our Habits program builds on decades of behavior change research to provide patients with education about their disease and tools to manage it, 4) from day one, we've been working with clinicians and care providers so that they can use the reports form Habits to make the most of their time with patients, and 5) by working on all these aspects, we have designed everything to "play nice" together and have created a cohesively designed user-experience.

Marquis Cabrera: Is your primary work in India? If so, can you speak to incidence of diabetes in India?

Dr. Ashok Kumar Our first market is India, but we have plans to expand to other countries because diabetes is really a global epidemic. In India, we saw a tremendous unmet need for diabetes care. The rates of diabetes in the U.S. and India are similar (~9% in the U.S. and about 8% in India), but that translates to over 65 million people in India compared to about 29 million in the U.S. An additional 77 million Indians are estimated to be prediabetic, that is, they are on the way to having diabetes. Worldwide, only about half of those with diabetes actually are diagnosed and even fewer of those with prediabetes know about it.

Marquis Cabrera: What is your core product? Can you give me a use case?

Dr. Ashok Kumar As I mentioned, we are really building an ecosystem comprising several products. Our core product, however, is the Aina device (see http://www.janacare.com/aina.html). This little device is a proprietary reader that we have developed that plugs into any smartphone and turns it into diagnostic analyzer capable of reading test strips for glucose, HbA1c, creatinine, lipids, and everything else we are cooking up in the R&D lab. It's small and affordable, so people with diabetes can carry one around in their pocket to check their glucose daily, essentially replacing their glucometer.

Once every few weeks, they could also check their HbA1c (a clinical measure of your overall sugar control) and hemoglobin (a measure of anemia) to make sure they are on the right track with their diet and activities. All of this data would be managed by Habits which can help interpret the results, send reports automatically to the care team, and provide feedback to a patient between visits to the doctor. The device also docks with our Aina Station, a point-of-care platform that can sit in a primary care office or clinic to screen patients and save time waiting for results from a central lab.

Marquis Cabrera: How do you help both patients and doctors using technology?

Dr. Ashok Kumar For patients, we provide a platform to not only measure and track your health, but also to learn about diabetes and strategies to manage it. For doctors we provide a more complete picture of all the patients they are managing, including summary reports and analysis, so that the physician can improve the quality of care they deliver.

Marquis Cabrera: Have you gained traction in the market?

Dr. Ashok Kumar At the end of 2015, we deployed our first commercial installations of the Aina Station in about a dozen hospitals and clinics around India. We've received great feedback and are busy working on scaling up in a big way throughout 2016. Our Habits app has 25,000 active users in India already and is growing.

Marquis Cabrera: How has Harvard Business School (HBS) helped you move your startup forward?

Dr. Ashok Kumar HBS has been a key resource for us. Two of the cofounders come from HBS: Sidhant Jena, our CEO, started Jana Care while he was a student at HBS, and Prof. Tarun Khanna, has been an incredible asset as we navigate entrepreneurship in both the U.S. and India. We got some of our initial funding through the HBS New Venture Competition in 2011. The Harvard Launch Lab gave us our first footprint in Boston.

Marquis Cabrera: What advice would you give to someone looking to prevent chronic disease like diabetes?

Dr. Ashok Kumar When you try to tackle a chronic disease like diabetes, begin by talking with all the stakeholders you can to understand why the disease is growing and what approaches are effective at changing behaviors.

Marquis Cabrera: What advice would you give to someone with diabetes seeking ways to manage their healthcare better?

Dr. Ashok Kumar Don't get discouraged! It can be hard to make lifestyle changes but it is possible and it is proven to help. Enlist help from your family and friends and take advantage of technology that exists to help you get ahead of diabetes. There are lots of us working very hard day in and day out to make it easier for you.