CAMTech Diabetes Innovation Hack-a-thon

October 8-11, 2015 | Hyderabad

Committed to the concept of ‘Make in India’ and sourcing local health innovation, the Consortium for Affordable Medical Technologies (CAMTech) at Massachusetts General Hospital Global Health, introduced path-breaking solutions at the CAMTech Diabetes Innovation Hack-a-thon at the Indian School of Business (ISB) in Hyderabad.

The event brought together over 200 participants, industry mentors and organizers to develop innovative and affordable health technologies that can improve the prevention, diagnosis and management of diabetes in India. The event also included keynote speeches from distinguished leaders from the Indian healthcare industry, who challenged participants to focus on specific, diabetes-related problems, such as access to care, affordable treatment and a lack of awareness and education about diabetes.

Diabetes Hack-a-thon Winners

Winners took home monetary prizes in several categories, including:

  • $1,000 CAMTech Grand Prize: Team Cheeni Kum – a multi-parameter early screening and detection tool to help diagnose diabetic peripheral neuropathy.
  • $1,000 Marico Innovation Foundation First Place Prize: Team E Stick – a non-invasive device that uses infrared light to measure blood glucose through the earlobe.
  • $500 CAMTech First Runner-Up: Team Cool Guys – a reliable, reusable, affordable and user-friendly storage case that keeps insulin pens refrigerated through the use of an organic gel.
  • $250 CAMTech Second Runner-Up: Team Aankhey – a mobile application that helps doctors and paramedics diagnose and raise awareness about diabetic retinopathy.

Clinical Challenges

These challenges were sourced from our network of clinical partners, including  Apollo Sugar Clinics, L.V. Prasad Eye Institute, Biocon Foundation, Madras Diabetes Research Foundation and other experts and healthcare professionals specializing in diabetes care in India.

Recording and reporting of blood glucose measurements
Routine monitoring of blood glucose is a key aspect of diabetes management. The frequency of intended monitoring varies based on what the doctor prescribes.
Current blood glucose meters require patients to prick their skin with a lancet, squeeze out a drop of blood, and apply it to a test strip. This pinprick deters patients from testing their blood routinely.
Second, this patient has to share this data with his/ her care provider. Currently, patients predominantly maintain written records. This is a tedious and error-prone process.

Click here to learn more about this challenge, including how it affects patients and existing solutions and limitations.
Giving dietary advice to Indian patients
Diabetic patients need to maintain strict control over their diet. It is important for them to track their macronutrient (proteins, carbohydrates, fats) consumption (proteins, carbohydrates, fats), so that they can keep their blood glucose levels in check. Hence, there is a need for diet planning tools that can translate commonly available foods to their constituent macronutrients.
This problem is exacerbated in India due to social and religious reasons – which limit they types of foods available to diabetics.
None of the current diet management solutions are designed for Indian palates. Current solutions are based on western diets (avocado & ham sandwiches, anyone?), and fail to cater to regional dietary preferences across India.

Click here to learn more about this challenge, including how it affects patients and existing solutions and limitations.
Enabling diabetes triage – across patients, paramedics & doctors
Diabetic patients require routine guidance & therapy, for which they traditionally approach doctors. However, the paucity of doctors in India the limits the time/ access that doctors can provide to patients. This may lead to inadequate service delivery to patients.
Second, diabetic patients can face life-threatening emergencies due to hypoglycemia or hyperglycemia. The current system of in-person hospital visits is not equipped to provide timely support in such cases.

Click here to learn more about this challenge, including how it affects patients and existing solutions and limitations.
Enabling diabetic patients to access social support
Diabetic patients are different from most patients who enter a hospital. The latter come for a cure; diabetic patients, on the other hand, have to be counseled on how to manage and live with their chronic disease. Apollo Sugar clinics have observed that when diabetic patients have access to social supports, they are more likely to make positive changes to their lifestyle/ adhere to medical protocols.
Hence, there is a need for a system that provides a social support mechanism to diabetic patients – where they can draw upon each other’s experiences and feel more empowered to manage their disease. Such systems should also extend to the family caregiver (such as the spouse or child), so that they are better prepared to offer support. Such systems should also allow diabetic patients to set goals (such as fat loss and better diet control), share with the community, and draw upon others’ support and advice.

Click here to learn more about this challenge, including how it affects patients and existing solutions and limitations.
Raising awareness around retinopathy and diabetes
Patients claim they were not aware that they should get their eyes checked as soon as they have been diagnosed with diabetes. In fact, they claim they were never told that diabetes can affect their eyes. General physicians/internist may not be educating patients about eye health in general among diabetics. Coordination between internists and ophthalmologist must improve.
Educating patients on acceptable blood sugar levels
Many patients think that a blood sugar of 200 to 250 mg% is in acceptable range, though they know that it is not normal. They know patients whose sugar is 300-400 mg%, and hence 200 is very much 'acceptable.'
Improving frequency of blood sugar checks for poor patients
Patients with diabetes check their blood sugar once in a month (paying patients), or once in 3 months (poor category patients).
Improving access to physicians
Many patients do not have a family physician who can manage their diabetes. They are unable to visit a trained physician regularly.
Stressing the importance of regular blood sugar monitoring
Patients think taking medicines/pills can take care of diabetes and avoid all complications. They do not realize that monitoring the blood sugar and keeping it under control is equally important.
Bridging the gap between awareness and care
Even where there is awareness, there is neglect of actively caring for the disease. Near relatives of hospital staff (clinical/paraclinical staff), who come in contact with patients every day, neglect the disease. Awareness may be present, but the will to follow through is lacking. Is it fear of some disease, is it stigma -- we do not know. Lack of awareness and neglect exist together.
Hastening referral of patients with advanced diabetic retinopathy
Many specialists in an eye institute do not refer patients with advanced diabetic retinopathy to retina colleagues in a timely manner. There is a lack of confidence that someone can avoid complications. There need to be easy-to-access to core standards.
NCD hubs at sub-centres
Diabetes needs to be managed at the community level, since opportunistic screening and treatment will not help to control the epidemic. Diabetes is a part of the spectrum of lifestyle diseases and for optimal control and prevention of complications, it is time to look at this cluster in a holistic way. Sub-centres in villages can act as great hubs for education, early screening and diagnosis, and also compliance tracking of patients. In order to create these sub-centre hubs, the ANM or ASHA requires a single tool with a DSS which will help set these communities up for patients.
Glycosylated Hemoglobin
The latest international protocols for Diabetes management are based on the values of Glycosylated haemoglobin. HbA1c gives the average glucose levels in the blood over 4 months thereby negating the effect of sporadic fluctuations. The other advantage is that the patient does not have to be in the fasting state for this test. Unfortunately this test is limited by its cost. If a cost effective method ($1) which uses capillary blood (finger prick) to measure HbA1c can be developed, it would greatly augment optimal management of Diabetes in the community.
Increased risk in driving for diabetes patients
Diabetes patients have consistent issues with the lack of feeling in their limbs - particularly their feet. This issue leads to an increased risk for the patients in everyday activities, including driving their cars as the individuals can no longer feel the pedals. To help support these patients, podiatrists have created alternative shoes that help address this issue; however, they are extremely expensive and not always available for patients. There is a large need for an alternative shoe that not only addresses this issue, but is also affordable.
Availability of medication in rural villages
There is a continuing issue with availability of medication to manage diabetes in rural villages. This leads to delays in treatment for patients as health care workers in the villages are unable to provide medication to the patients and the patients then need to travel to the closest PHC. Many patients are not able to travel to the PHC due to health, transport and distance. There is a need for available medication and/or treatment for rural villages.
Diabetes medication adherence
There is a challenge across India in medication adherence for diabetes management. This is due to the lack of motivation for patients to receive regular treatment, which then leads to growing health issues with diabetic patients. There is a need to create a technology that will provide consistent motivation to patients to continue treatment.
Lack of awareness of diabetes
Over 30 million people in India have been diagnosed with diabetes. Although this number is substantial, there is a lack of awareness of the population for both the prevention and effects of the disease.
Managing diabetes at home
It is important for every patient to understand that they need to manage their diabetes at home. There is a large need for meaningful education and messages to the patients especially in rural areas.
Translating messages in diabetes to rural populations
Currently, there is no way to translate meaningful messages from doctors to patients in rural areas. Messages are often lost in translation and patients are not consistently updated on the developments of the disease or options for management.
Lack of nutritionists in diabetes care
Nutritionists play an important role in working with diabetic patients to manage their lifestyles.
Evidence-based information systems for tracking diabetes in families
Doctors in India have no current way of tracking patients or their family members to determine the risk of diabetes. This is normally based purely on the communication of patients. There is a need for an evidence-based information system for doctors to understand the risk of their patients and determine if further prevention tactics are needed.
Education of children in diabetes prevention
As diabetes is often genetic, there are many families as a whole that suffer from diabetes. As children are being raised in environments where their parents are not aware of diabetes management and prevention, there is an increasing amount of children being diagnosed with diabetes. It is necessary to create a solution that will address the education specifically of children to help promote health within the family system.
Integration between healthcare workers in the treatment of diabetes
Currently, there is a lack of integration between the groups diagnosing diabetes (ASHA Workers, and General Practitioners) and the diabetologists. There is no system in place to ensure that these patients are receiving the correct information at the right time and that there is communication between these providers.
Behavioral change - education and awareness
There is a lack of educational tools for individuals and a need to empower patients to change their behavior. Empathy and emotional connection can be tools for creating this change.
Functional foods for diabetes patients
There is a need to raise awareness/availability of healthy foods for diabetes patients. We need to take into account local eating habits, food sources, socioeconomic and cultural diversity, and religious beliefs. We need to demystify food myths and facts by hard, evidence-based facts.
Cardiometabolic risk
Glucose reading, action conversation maps, There is a need for integrated solutions for co-managing diabetes.
Measurement, recording and reporting of Blood Glucose (BG) is too complex
We need to:
- Move away from pin-prick based BG readings
- BG reading transfer without manual intervention
- Sweat gland based readings
- Affordable solution
Improvement to dietary advice to patients
We need to:
- Design a solution for Indian cuisines (regional tastes matter) with awareness of calorie intake
- Avoid entry of different food intake. Need a better method like identification of food based on a picture
- Tie-back to caregiver for better understanding of variance to diet plan
Enable diabetes triage – across patients and doctors
We need:
- Solution for physicians to look for patient’s health status
- Specific emergency alerts and triggers from back-office
- Improve patient's trust and confidence in care pathway
Enable diabetes patients access to social support
We need:
- To promote communication between patients and their near/dear ones
- Engagement between diabetics, across geographies/social strata
- Exchange information between diabetics and doctors for better compliance

Clinical Summit Schedule

October 9, 2015 L.V. Prasad Eye Institute, Hyderabad, Telangana 500034, India

8.00 AM
Breakfast Served / Registration
9.00 AM
Welcoming Remarks from CAMTech: Dr. David Bangsberg, Director, MGH Global Health
9.30 AM
Keynote: Dr. Gullapalli Rao
9.45 AM
Voice of the Patient
11.00 AM
11.15 AM
Redefining Diabetic Trajectory through Prevention
12.15 PM
Paradigm Shift to Integrated Care Management
13.00 PM
13.45 PM
Diagnosing Diabetes at Scale
14.45 PM
15.00 PM
Success and Failures in Current Diabetes Care
16.00 PM
Problem Statement and Pitch Workshop
(Interactive & Collaborative Session to Identify Clinical Challenges in Diabetes)
17.00 PM
Closing Remarks
17.30 PM
Technology Showcase & Innovation Sandbox

Hack-a-thon Schedule

October 10-11, 2015 Indian School of Business (ISB), Gachibowli, Hyderabad, Telangana 500032, India

Day 1, Saturday, October 10

7.30 AM
Registration begins
9.00 AM
Welcome Address by CAMTech - Khemka Auditorium
9.10 AM
Welcome Address by Dean of Indian School of Business
9.15-9.40 AM
Keynote Welcome Speeches:
Dr. Nadimity Ganapathi Sastry, Director and Consultant Diabetologist, Dr. Mohan’s Diabetes Specialty Centre
Dr. Sudhakar Mhaskar, Chief Technology Officer, Marico Limited and Dr. Shashank Joshi, President, Indian Academy of Diabetes
Gagan Bhalla, Chief Executive Officer, Apollo Sugar Clinics
Dr. Subramanian Kannan, Clinical Endocrinoligist, Narayana Health
9:40 AM
Hacking 101 (rules, formating, judging and prizes)
10.00 AM
Pitch Session Begins, Pitches Registered Online
12:00 PM
Move to Atrium, Tea is served
12.00 PM
Hacking begins
13.30 PM
14.30 PM
Hack Shop opens
16.00 PM
19.00 PM
Mentors can leave
20.00 PM
Dinner is served
21.00 PM
Hacker shop closes
21.30 PM
Hacking continues overnight
MidnightTeam online registration

Day 2, Sunday, October 11

9.00 AM
Mentors return
Practice pitch room opens
Practice pitch room opens
9.15 AM
Tea/Breakfast is served
9.30 AM
Hack Shop opens
13.00 PM
Lunch is served
Hacker shop closes
Practice pitch room closes
14.00 PM
Semi-Finals - Lecture Theaters 1 thru 4
15.30 PM
Move to auditorium
15.45 PM
Judges are introduced
16.00 PM
Final Presentations begin
18.00 PM
Participant feedback session;
Mentor acknowledgement and mementos;
judges break for deliberation; tea is served
18.30 PM
Post-Hack-a-thon Opportunities announcement
18:30 PM
Prize distribution ceremony
18.45 PM
Closing Remarks by CAMTech
19.00 PM

Diabetes Innovation Hack-a-thon Prizes

CAMTech will award a total of $2,500 USD in prize money to the top innovations focused on diabetes management and prevention. Teams will be evaluated by a panel of judges according to a specific criteria, including challenge addressed, public health impact, technology innovation, sustainable business models, team composition and overall pitch.

CAMTech Grand Prize: $1,000

Marico Innovation Foundation First Place Prize: $1,000

CAMTech First Runner Up: $500

CAMTech Second Runner Up: $250

CAMTech Sponsors and Partners