Enaya Health

An intelligent mobile-based platform to help doctors & patients to reverse Chronic Diseases via nudge based care journeys.

Chronic diseases are among the most common, costly, and preventable of all health problems with the right interventions at the right time. In India, nearly 61% of deaths are attributed to chronic diseases (mostly hypertension and diabetes). Over 20% of the population in the country has at least one chronic disease, and >10% of the people have more than one.

This problem is further compounded by the shortage of doctors and low patient engagement. There are six doctors per 10,000 people making this average among lowest in the world. The existing engagement with doctors is episodic, highly transactional, and lacks continuity; the average time spent with the patient per visit is only 2 minutes.

The failure of primary and preventative healthcare results in expensive secondary care. This necessitates an innovative way to enhance healthcare delivery in a low resource setting.

We are an intelligent mobile-based platform to help doctors and patients prevent, manage and reverse hypertension, diabetes, and other chronic conditions via personalized nudge-based care journeys.

The first part of the platform is to understand patients better. This involves data collection which has two parts to it:

1. Data collection with respect to the lifestyle of patients in the area, their customs, and food habits.

2. Data from their medical records; physical visit encounters, biometrics markers, and laboratory tests.

Using a combination of both the data sets above, our proprietary algorithm generates individualized plans, combines it with the physician's advice, and delivers it using a combination of text and media-rich content. We are working on enabling the platform to use App notifications, SMS, and WhatsApp for content delivery.

We are confident in delivering this solution to the population at a cost of less than $1 per patient per month. This will allow us to reach large under-served populations working with governments and non-government agencies. We are working with a partners delivering primary care in rural India and will be reaching 5.5 million patients through them over the next 3 years. Studies and research show that a nudge-based model can lead to a more than 25% reduction in risk of chronic diseases. This will help billions of people worldwide. Also, considering global cost of just cardiovascular, it is set to rise from approximately US$863 billion in 2010 to a staggering US$1,044 billion. A 25% reduction in this will save the world economy more than $260 billion annually.

Our solution is innovative as it combines existing evidence-based medical literature with nudge theory, technology, and low cost delivery methods to educate and influence the behavior of people. This can have a significant effect on improving health outcomes. This has been proven in multiple research done on the subject. The most widely used being the “Effect of Lifestyle-Focused Text Messaging on Risk Factor Modification in Patients With Coronary Heart Disease: A Randomized Clinical Trial” which was published in the Journal of American Medical Association.

Technology is integral to our solution. It involves collecting data from different data sources and intelligent models to classify patients at different risk levels. Classified patients are assigned personalized care journeys, which are delivered to patients on their mobile phones.

Working with our partner in India, we are creating data sets about patients’ environment, habits, and medical records. We use proprietary algorithm with evidence-based medical guidelines to generate individualized plans, combines them with physician's advice, and delivers it on mobile using combination of text and media-rich content. We are enabling the platform to use multiple modes for content delivery.

Starting with our pilot of 700 patients, we are aiming to enable our primary care provider, iKure, to providers to address a population of 200,000+ people by the end of Year 1. We plan to automate risk stratification and subsequent recommendations and management journeys. 

We intend to scale this to 2 million people with iKure by the end of Year 2020 and 5.5 million people in over 2300 villages by Year 2021. We are have a number of advance stage discussions in progress with four state governments and other rural care providers to scale up our mission.

Our platform supports both feature phones and smart phones. This allows us to reach out to a large user base.

We are partnering with primary care providers and local governments to access the communities. These providers have healthcare workers on their payroll. We use them as a reinforcing mechanism to keep the users engaged and also enable them to deliver better care.

The population which we are currently working with is in rural West Bengal, India. These populations have a high incidence of cardiovascular diseases and don’t have access to good healthcare resources. The key economic activities in the area are agriculture and agricultural produce processing units. We are conducting the study with two randomly selected parallel groups: control group (200 people) and experiment group (500 people). We are using their demographics and medical data to calculate 10-year heart attack risk. We are aiming to reduce that by 25% or more post a four month trial period.

Starting with our pilot of 700 patients, we are aiming to enable our primary care provider, iKure, to providers to address a population of 200,000+ people by the end of Year 1. We intend to scale this to 2 million people with iKure by the end of Year 2 and 10 million people in over 2300 villages by Year 3. We plan to automate risk stratification and subsequent recommendations and management journeys. As mentioned earlier, we are already discussing partnerships with state governments and rural care providers in other states of India.

Enaya is currently a team of 4 MIT graduates with complementary skill sets. As a result, we are very well-rounded and well equipped to solve strategic problems in healthcare. We have a combined experience of more than 5 decades in diverse areas such as entrepreneurship, healthcare, technology, strategy, product, design, and business development.

Enaya’s business model is designed to be affordable to all, while maintaining a healthy margin, with future capital targeted at replicable expansion across other market segments

Our model has low per patient operating cost and our key expense will be in initial platform development. A fully functional platform is expected to cost us $1 million and will have an annual operational cost of $750-900K including salaries. With an expected revenue of $10 per patient per annum and a per patient variable cost of less than $1 per annum, we need around 82K patients for breaking even. This can be attained in our existing partnership with iKure itself, once we are able to demonstrate positive difference in trials.

This will help us to sustain in the long term and scaling up our solution as well as investing in innovations.

While we have been a part of MIT ecosystem and navigating this system is not easy, especially when you are only here for a short time as a graduate student. Being a part of Solve will connect us to the greater MIT network and Solve community, especially leaders in foundations, nonprofits, government, and academia. Through these connections, we will be able to build the partnerships needed to fast-track our product and scale quickly.

Development of intelligent healthcare products is an iterative process with a steep learning curve. Continuous optimization is required to adapt to variability introduced by the fast-growing user base.  

1. Prize money from solve will help us to continue to invest towards improving the solutions which will be improving millions of lives.  

2. Winning a prestigious competition like Solve will provide us with unprecedented exposure. It will help us to attract partners and magnify our impact.

2. Solve community will connect us with like-minded teams and individuals. We can contribute to the community from our experience and learn from it.