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Following Their Hearts: 2 Founders’ Struggle To Bring AI-Driven Cardiac Care Solutions To Tier-II Cities

Following Their Hearts: 2 Founders’ Struggle To Bring AI-Driven Cardiac Care Solutions To Tier-II Cities


As a disruptive healthcare diagnostics company, Cardiotrack has been extensively using artificial intelligence in cardiac care solutions. With an aim to significantly reduce the cost of diagnosis, the team, lead by Ashim Roy, is focused on addressing key challenges in underserved areas where an on-time diagnosis can make a life-changing difference.

Analytics India Magazine caught up with Ashim Roy, who along with Avin Agarwal and a team of 15, are driving their passion for serving the needs of people especially in Indian Tier-II cities. Having grown up in smaller cities in Uttar Pradesh and Rajasthan, Roy and Agarwal could relate to the need of having timely diagnosis, which is the key force that drives them, as well as Cardiotrack.

While Agarwal has a degree in Medical Electronics with a work experience in the Netherlands for five years, Roy is a graduate of BITS, Pilani and IIT Delhi and has worked in Australia, Canada and the US for 25 years. Roy shares, “Cardiotrack as a concept we created during numerous discussions with medical researchers at St John’s Research, the outcome of which led to a focus on improving healthcare delivery and chronic illness diagnosis in India”.

The founders connected primary care facility with AI to bring solutions focused on the needs of cardiovascular diseases, which is a prime reason of concern in many countries. Especially in India, where 60 million people suffer from cardiovascular diseases, there are less than 10,000 cardiologists. Sadly, most of the cardiologists and cardiac care facilities situated in urban centers.

Cardiotrack Platform And How Is It Revolutionising The Cardio Healthcare Industry
The Cardiotrack team is democratising healthcare by offering better diagnostics at primary healthcare centres which are more accessible to patients. Their platform has three components:

  • Healthcare IoT Device, which is a patient monitor device capturing accurate 12-lead ECG data of a patient.
  • mHealth App, which allows a user to see the captured ECG. Physicians can review the ECG anytime later when patient revisits, allowing to keep a track on other health vitals of the patients through a connected set of diagnostics devices such as blood pressure, cholesterol and blood glucose.
  • Cloud Services And AI, that includes data storage and AI analytics.

AI At Cardiotrack
Roy explains that the AI work at Cardiotrack could be broadly categorised into two parts:

Diagnostics Aid: It pertains to their offering to cath labs. The AI interpretation is based on a neural network that compares a patient’s ECG with a database on 500,000 ECG scans that are already reviewed by cardiologists. The neural network works like a fast comparator to identify nearest match. The advantage of this approach is that AI engine finds several matches with different levels of accuracy. The accuracy of interpretation is purely a function of number of scans in the database for a given heart health condition.

Prediction: The health prediction is the next big frontier of AI. Cardiotrack has started their own research in AI prediction to bring multi-parameter analytics to help assess heart attack probability with a high level of accuracy. The model which is based on six parameters— ECG, blood pressure, blood Sugar, cholesterol, smoking and BMI, will take few months to come up with initial prototype. The basic idea is to develop a model that provides an accurate prediction of adverse heart diseases such as heart attack within few months. Roy believes that this AI approach based on real patient records is likely to yield accuracies higher than 80%, i.e. much more accurate than Framingham Score, which according to researchers from Harvard Med School is only 56% accurate.

Cardiotrack AI—Use cases

Roy is quick to share that they have more than a dozen ongoing discussions with hospitals and cath labs across in India as well as internationally. “Most promising among these are discussions with Braunwald Hospital Group, which is a new hospital offering low cost acute cardiac care through a chain of hospitals”.

Explaining how it works, Roy said, “We deploy Cardiotrack 12-lead ECG device at each of the clinics, after performing a due diligence of the primary care physicians. Our team trains the physician and medical team to ensure that information flow happens properly. When a patient complains of chest pain or other symptoms of cardiovascular disease, the primary care physician capture patient’s ECG, which is uploaded to cloud server and analysed using the AI interpretation engine. The AI interpretation is sent to the physician immediately, which typically reaches physician in less than two minutes. Based on the AI interpretation, physician takes necessary steps in intervention. In severe cases, physician forwards the patient’s ECG scan to the hospital and recommends that the patient visit the hospital immediately”.

He also added that they are working with Paras Hospital in Delhi NCR, Star Hospital in Ahmedabad and Columbia Asia in Bengaluru. “The results are remarkable in some cases. For instance in Paras Hospital where we have deployed 10 Cardiotrack devices, where in five months, we could identify 13 cases requiring Angiogram and seven cases requiring angioplasty”, he said. “We are now in discussion with Paras to expand the Cardiotrack deployment by adding 50 primary care clinics”, he added.

Roy list down some of the benefits of Cardiotrack as below;

  • Benefits to Patients: It makes health diagnostics accessible to more patients.
  • Benefits to Physicians: They can now better understand heart health of the patient and provide better guidance when there is a severe case.
  • Benefits to Hospitals: Hospitals have been struggling to get sufficient patients to keep their cardiac catheterisation labs (CCL) busy. Most CCLs have utilisation levels of less than 25% of their operational capacity. The process of diagnosis at the primary care level and interpretation using AI improves operations at two levels
    • Identifying patients and bringing severe cases to patients, just in time, increases capacity utilisation
    • Cardiologists can devote more time on patient care rather than sorting out normal and abnormal patients.

Growth Story And Roadmap Ahead
“Our story is that of coincidences and lucky breaks”, says Roy. In the initial days, the two founders shared the cost of early development, and when they tried to raise funds in India, they did not receive traction from early-stage investors. Later, based on the results of field testing of early prototypes, they contacted potential investors in Singapore. Till now they have raised over $1 million in funding from multiple sources and countries.

“After initial trials, we approached Columbia Asia, Paras and Star hospitals, and Columbia Asia was a first to try out our solution”, he said.

On A Concluding Note
Roy says that while they have witnessed a phenomenal growth, a startup without challenges would not be a startup. “Challenges, constraints and competition keep us on our toes and make us innovate in every aspect of our activities. We must hire good people in the team, constantly improve upon our ideas and collaborate with academia to keep R&D cost affordable”.

He further shares that when it comes to AI, data Interpretation is just the beginning and perhaps the simplest of the tasks as long as one has large annotated datasets to train the AI engine. “The excitement of AI is in prediction and that is really close to our heart”, he said on a concluding note.

Artificial Intelligence Launches A New Era In Cardiac Care

Artificial Intelligence Launches A New Era In Cardiac Care

From diagnostics to therapeutics, artificial intelligence is set to change the way cardiovascular diseases are identified and treated By Marjo Johne

A diagnosis of coronary artery disease usually comes after a series of procedures, including blood tests, exercise to reproduce symptoms, an electrocardiogram, a chest X-ray and, finally, cardiac catheterization, where
a thin tube is inserted through the heart’s blood vessels to check blood flow and function in various parts of the organ.

It can take weeks, even months, for each patient to go through these gold-standard procedures. But this decades-old way of diagnosing coronary artery disease could soon be a thing of the past, thanks to artificial intelligence (AI) technology.

“With our technology, you just lay down, take off your shirt and, with a hand-held, battery-operated device, your doctor can take a three-minute recording that collects 10 million data points,” explains Don Crawford,
president and CEO of Analytics 4 Life Inc., a Toronto-based company focused on artificial intelligence-based medical devices. “This data is then sent to a cloud storage device, and from there our computers take that data and create a three-dimensional image of the heart, along with a detailed report,” explains Mr. Crawford.

“By the time the patient has their shirt back on, the physician has already received the report on their computer. And based on this report, they can let their patients know whether or not they need to go to the
cath[eterization] lab.”

The Analytics 4 Life technology, currently being tested in a dozen hospitals in the United States, is at the leading edge of artificial intelligence in cardiac care – an emerging field of science that’s set to change the way
cardiovascular diseases are diagnosed and perhaps even treated.

At the University of Nottingham in England, researchers used machine learning – where AI algorithms trained themselves – in order to find patterns to predict which patients would have their first heart attack over the next 10 years. After scanning close to 300,000 patient records, the researchers found that the AI algorithms did significantly better in predicting heart attacks than assessments based on the commonly used American College of Cardiology/American Heart Association guidelines.

In India, a start-up called Cardiotrack recently rolled out a technology platform that uses a hand-held device, cloud storage and artificial intelligence to capture and analyze electrocardiogram signals for specific
heart conditions.

“The possibilities with artificial intelligence are truly exciting,” says Brian Golden, Sandra Rotman Chair in Health Sector Strategy at the University of Toronto (U of T) and the University Health Network (UHN) and vicedean
of professional programs at U of T’s Rotman School of Management.

“The ability to instantly recognize patterns and make sense of data from these patterns will improve diagnosis speed and quality, reduce wait times, improve health outcomes and reduce costs.”

In Canada, the stage is set for AI to transform how heart disease is diagnosed, treated and managed. And the Peter Munk Cardiac Centre (PMCC) is right in the centre of this exciting transformation, powered by digital data, ubiquitous connectivity and intelligent machines.

Armed with a $100-million donation from the Peter and Melanie Munk Charitable Foundation, the centre has forged a partnership with U of T’s Vector Institute for Artificial Intelligence, which was launched last March
to advance deep learning research and develop world-leading AI talent.

“This is the first formal health-care partnership that the Vector Institute has engaged in, and we anticipate that what we do with the Vector [Institute] will be the model for what it does subsequently with cancer, neurosciences and other health disciplines,” says Dr. Barry Rubin, Chair and Program Medical Director, Peter Munk Cardiac Centre

Together, the PMCC and the Vector Institute will build an AI team that includes a lead computer scientist, software engineers and PMCC clinicians. This team will work to identify heart problems that can be solved
through AI and machine learning.

“We will use predictive models and decision support to tailor patients’ care to their unique clinical and genomic traits,” says Dr. Rubin. “We will use natural language processing to communicate with patients in real time, no matter what language they are speaking. Taken together, this will improve the efficiency of health-care delivery, outcomes and patient satisfaction.” What will AI-supported cardiac care look like to patients and healthcare
professionals? Dr. Rubin paints a sample scenario, where doctors can remotely monitor patients with conditions such as abnormal heart rhythms and then bring to the hospital those who are identified as at risk of death or serious heart damage, based on AI algorithms that can analyze billions of biological and research data points.

“You can use the AI approach to pinpoint which patients face potentially lethal events, and bring them to the hospital before that happens,” says Dr. Rubin. “So you’re managing patients outside the hospital and using the
real value of AI to predict and prevent these lethal events.”

The great wealth and quality of digital health and research data at the PMCC are critical to the success of the centre’s AI goals, says Dr. Rubin. The PMCC recently flowed six of 47 disparate clinical and research databases
into a vast “data lake,” and it is now working to bring the remaining databases into the same central reservoir.

By integrating all this data – blood tests, clinical notes, X-rays, ultrasounds, CT and MRI scans, pathology slides and genetic information – in one location, clinicians and researchers can use AI to discover potential
causes of heart disease. These discoveries, in turn, can lead to new cures.

“For example, if we have data on 10,000 patients with a narrow heart valve, and it turns out that 2,000 of these patients have a similar gene mutation, we could determine how that gene works and develop new
therapies that would prevent the heart valve disease from ever developing in patients with that mutation,” says Dr. Rubin.

Toronto is one of the two epicentres for thought leadership in AI – the other place is Silicon Valley in California – and boasts a robust ecosystem for AI- and digital-based health-care innovations, says Ying Tam, head of health at the venture services for MaRS Discovery District, a Toronto innovation hub that connects entrepreneurs, business experts, researchers, educators and social scientists.

He points to Ontario companies such as Cloud DX and Deep Genomics, which use AI and machine learning to diagnose disease and design more targeted therapies.

While AI champions continue to innovate in health care, it will likely take years before many of these new technologies are adopted in clinical practice, says Mr. Tam. Regulations that govern medical technology are complicated, says Mr. Tam, and could work against the very nature of artificial intelligence. For instance, when an organization such as the U.S. Food and Drug Administration approves a medical solution, it does so based on a specific information package. With AI, information continues to change as the underlying algorithms learn from existing and new data

“What we do with the Vector [Institute] will be the model for what it does
subsequently with cancer, neurosciences and other health disciplines.” Dr. Barry Rubin, Chair and Program Medical Director, PMCC

Nevertheless, AI solutions have already been proven in other areas in health care. Dr. David Jaffray, Senior Scientist at Princess Margaret Cancer Centre in Toronto, points to the use of algorithms at the hospital
to automate the design of treatments for cancer patients.

“The technology is very attractive because it allows us to design the treatment sooner, treat patients sooner and even ensure that the treatment plans follow the appropriate protocols,” he says.

This level of AI-enabled efficiency can, in the future, also help hospitals to optimize the use of their resources, while ensuring the best outcomes for patients, says Dr. Rubin.

“If we had complete data on all of our patients, we could use AI to predict which patients that had heart valve surgery would stay in hospital three days or 10 days after their operation,” he says. “Using this AI-based
approach, we will be able to better plan and better utilize our health-care resources.”

Having cemented its partnership with the Vector Institute, the PMCC must now work to integrate AI into practice – an undertaking that requires a shift in mindset around patient care.

“We will need to train clinicians and students at the PMCC to work in environments where AI-based predictions will inform treatment decisions and the management of patients,” says Dr. Rubin. “There’s no question that
AI and machine learning are the future.”

Cardiotrack to Partner with Paras Hospitals, Gurgaon

Cardiotrack to Partner with Paras Hospitals, Gurgaon

Business Wire India

Bangalore-based start-up, Cardiotrack, which provides best-in-class predictive diagnosis for cardiovascular diseases announced today that it has expanded its presence in North India with its partnership with Gurgaon based multi-speciality hospital, Paras Hospitals, Gurgaon. This expansion will consolidate Cardiotrack’s position as a leading provider of AI-based cardiac care solutions.

Cardiovascular-related deaths continue to be a cause for concern in India. More people die of heart diseases than respiratory diseases, tuberculosis, and cancer put together.

The partnership with Paras Hospitals is the right step forward to address the growing concern with regard to heart disease, and deliver cardiac solutions that are real-time and preventive in nature. A life saved from cardiovascular diseases is a family saved.

Speaking on the partnership, Dr. D.K. Jhamb, Director & HOD, Cardiology, Paras Hospitals, Gurgaon said, “We are delighted to partner with Cardiotrack to reach out to a wide spectrum of population in Gurgaon and surrounding areas. By providing them with excellent preventive cardiac care we are working hard to ensure that the number of cardiovascular deaths is brought down.”

Paras Hospitals, Gurgaon has consistently noticed a steady rate of increase in the number of patients with heart problems in the scans that are done across their different hospitals. And the hospital chain is looking to reverse this worrying trend.

Cardiotrack will be deployed across all Paras centres. The hand-held IoT device that is driven by Artificial Intelligence (AI) will capture clinical grade ECG data using cutting-edge technology and ensure data portability through smart android-based devices.

Ashim Roy, Co-Founder and CEO, Cardiotrack said, “Heart diseases continue to be one of the main causes of death, globally and across age groups. 50% of these deaths can be averted if the delay in seeking the right medical advice is reduced. The best way to achieve this is preventive care and early diagnosis. We at Cardiotrack, pride ourselves on providing accurate and timely diagnosis for all cardiac related issues. Currently, Cardiotrack is present across India with leading hospitals adopting our technology to address the challenges in cardiac care. The partnership with Paras Hospitals, Gurgaon, is a step towards making cardiac care accessible to a larger number of people and thereby, saving lives.”

Headquartered in Singapore, Cardiotrack has a presence in over 15 countries including Myanmar, Mexico, Indonesia, Tanzania, Norway, Canada and Argentina among other countries. The pocket sized device has been well received by hospitals and primary health centres in tier 2 cities and rural areas.

About Cardiotrack

The Cardiotrack platform is designed to fulfil all the basic requirements of a primary care clinic. Using Cardiotrack’s technology and AI platform, doctors can detect heart health problems accurately, consult specialists, refer and track patients, maintain medical history and start the intervention process. Cardiotrack platform includes multi-parameter, light weight healthcare IoT devices and mobile health software that helps to screen illnesses such as cardiovascular diseases and hypertension and helps doctors to perform diagnosis and then safely store the patient records.

The Cardiotrack device was launched in September 2015 and it has been deployed across India, Myanmar, Indonesia, Mexico and U.S.A. The primary reason for getting traction in the market has been affordability, ease of use and mobility that the product renders to its users. Most of the expensive health diagnostics products can only be operated in hospital environments, which are air-conditioned. However, working environment at the primary care facilities in the developing economies is different. The diagnostics sensors used in Cardiotrack function at extreme temperatures, and dust ridden and humid environments. The Cardiotrack platform is built to overcome limited availability of specialists, lack of transportation, infrastructure and power breakdowns that are common constraints in emerging economies and provide effortless remote patient management and disease care.

Cardiotrack, Sumita Chakrabarty, +91-9880295991

sumita.chakrabarty@cardiotrack.io

Bangalore, Karnataka, India

The heart of the matter from the Cardiotrack point of view

The heart of the matter from the Cardiotrack point of view

Cardiovascular diseases continue to be a leading cause of death in spite of the many advances made by medical science and technology. This statement is even more worrying when one looks at the heart health landscape of South Asia. According to Stanford Health Care people from this geography which comprises Bangladesh, India, Pakistan, Nepal, Bhutan, Sri Lanka and Maldives are four times more likely to get a heart attack before the age of 50.

Cardiotrack’s arrival and evolution could not have come at a more opportune time. By pioneering preventive cardiac care in India, it is on track to creating awareness about how critical damage to the heart is avoidable.

This cardiac care platform provides clinical grade readings on an Android smartphone to which it is connected via Bluetooth. But that’s just the beginning, because Cardiotrack is powered with AI capabilities which can make a diagnosis. A senior doctor at the well-respected Fortis Hospital in Delhi, India has certified these diagnoses as precise and accurate.

Cardiotrack AI can filter out abnormal scans, make automated and unbiased diagnoses and even detect rare conditions like Brugada Pattern.

The combination of IoT and AI makes Cardiotrack’s technology cutting edge and relevant in a world where there are too few cardiologists far too many patients.

Operational efficiency in cardiac care is another area that is desperately in need of a reboot. This in turn is closely tied to trust in the overall healthcare system which has in recent years taken a significant beating. By bringing in unbiased and accurate diagnosis, AI completely levels the playing field. Immediate benefits include scheduling of patients based on criticality and ensuring that the cardiologist’s time is well used.

With a robust database of scans that is growing at a considerable pace, Cardiotrack also offers heart health professionals valuable data on cardiac conditions that can lead to innovations in treatment. It is time to ensure that technology upends the scourge of heart diseases.

The little box that saved a life

The little box that saved
a life

In the village of Gudageri, Taluk Kundagol, District Dharwad in Karnataka – far, far away from the sophistication of city medical care lived a poor farmer Hajaresab Rajesab Killedar. Like many of his kind he was a compulsive smoker and did not consider that it could kill him.

Luckily for him, the medical clinic closest to the village is run by Dr Mahesh Gadiginmath, who is a strong believer in the capabilities of his @Cardiotrack ECG monitor (http://cardiotrack.io/).

Dr Mahesh sees about 30-40 patients per day in his tiny clinic. Hajaresab’s village has a population of about 10,000. People from nearby villages also come to his clinic. The doctor told me that he sends patients requiring critical care to hospitals nearby. And so it was with Hajaresab. When he came to see the doctor he was sweating and complained of chest pain. The doctor immediately hooked him up to @Cardiotrack. The AI (artificial intelligence) component in the device immediately and accurately diagnosed the problem as inferior wall myocardial infarction.

Hajaresab was rushed to the nearest hospital in Hubbali town and a life was saved. @Cardiotrack co-founders @Avin Agarwal and @Ashim Roy have always passionately believed in the tremendous possibilities of the device. Dr Mahesh says that of the many patients he sees every month at least 12 or more have serious heart problems.

You do the math.

Preventive cardiac care is the only effective way to ensure that cardiovascular diseases do not continue to orphan families. Hajaresab’s family has felt the full force of this. As for Dr Mahesh, he refers to @Cardiotrack’s AI capabilities as ‘my friend’.

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Cardiotrack expands to Gujarat

Cardiotrack expands to
Gujarat

Bengaluru-based start-up, Cardiotrack, has expanded its presence to Gujarat. The company has partnered with Star Hospitals, a multi-speciality hospital chain based in Ahmedabad to deliver real-time diagnostic solutions in Gujarat. This expansion, makes Cardiotrack a Pan-India provider of AI-based cardiac care solutions.

The partnership with Star Hospitals is an attempt to address the growing concern with regard to heart disease, and deliver cardiac solutions that are real-time and preventive in nature.

Speaking on the partnership, Dr Bhavesh Thakkar, Interventional Cardiologist, Star Hospital said, “Cardiotrack will put Star Hospital on the path to proactive preventive cardiac care. With the high number of cardiovascular cases in the country, India strongly needs preventive methods to save lives and families. With Cardiotrack, we are working towards creating a more heart healthy population in Gujarat.”

Cardiotrack will be deployed across all Star Hospitals’ centres. Cardiotrack’s hand-held IoT device, that is driven by Artificial Intelligence (AI), will capture clinical grade ECG data using cutting-edge technology and ensure data portability through smart android-based devices.

Ashim Roy, Co-Founder and CEO, Cardiotrack said, “Heart diseases continue to be one of the main causes of death, globally and across age groups. 50 per cent of these deaths can be averted if the delay in seeking the right medical advice is reduced. The best way to achieve this is preventive care and early diagnosis. We at Cardiotrack, pride ourselves for providing accurate and timely diagnosis for all cardiac related issues. The testimony of our endeavour stems from the fact that Cardiotrack, today, is present across India with leading hospitals adopting our technology to address the challenges in cardiac care. The partnership with Star Hospitals, is a step towards making cardiac care accessible to a larger number of people and thereby, save lives.”

Headquartered in Singapore, Cardiotrack has a presence in over 15 countries including Myanmar, Mexico, Indonesia, Tanzania, Norway, Canada and Argentina among other countries. Their pocket sized device has been well received by hospitals and primary health centres in Tier II cities and rural areas.