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In conversation with: Innovation strategist Devmalya Sarkar

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"Mobile health offers staggering but yet massively unrealised potentialities for people who need it the most" - Devmalya Sarkar

Devmalya Sarkar speaks to Caroline Barry about the outlook for digital health and the need for contextually-relevant innovation.

Devmalya (Dev) Sarkar is a health tech and digital health innovation strategist, passionate about solving unmet needs through empathic and meaningful innovation. He has served on the board of Healthcare Information and Management Systems Society (HIMSS) USA’s India chapter as joint secretary, where he co-chairs its India Innovation & Start-ups Committee.

More recently, he joined the University of Cambridge, UK, for his doctoral research on improvements to the digital health innovation process at the university’s Engineering Department (Institute for Manufacturing), where he is a Cambridge Trust, Research & Development Management Association (RADMA) UK, and Trinity Henry-Barlow Scholar (honourary) scholar.

He tells Health Tech World: “What’s simple to use for the end-user is often not easy for innovators and firms to strategise, develop, and deliver. Both in healthcare and in our approaches to innovation, considerable time and resources are spent trying to address problems, many of which can be prevented early on.

“While many information and communication technologies-based solutions do offer the luxury of much quicker iterations, compared to medical devices, iterative improvements can only build on a strong foundation. If you want to reduce a host of complications downstream, an informed start upstream is critical.”

“Eighty per cent of over 375,000 mobile health apps fail to deliver their intended impact. While success for these and other promising health tech innovations relies on multiple parameters, building a usable and useful solution that can improve lives begins with a sound understanding of your users and their unmet needs, behaviours, challenges, and aspirations. But it is challenging to get this right early in the innovation process, and is reflective of the uncertainty or ‘fuzziness’ in the front end of innovation.

“In our work, based at the IfM’s Centre for Technology Management, professor Tim Minshall and I are exploring ways to help firms reduce this uncertainty through a better understanding of user need identification and user participation so that firms can enhance their user-centric digital health innovation ability.”

Dev completed his foundational training in biomedical engineering at India’s Manipal University, followed by a master’s degree in biomechanics from the University of Manchester, UK.

Over the last decade, his work has focused on designing and delivering user-centred products, services, and ecosystem initiatives spanning diverse clinical needs for global corporations, start-ups, innovation labs, and venture acceleration groups across India, the US, and the UK.

He invented India’s first preventive solution addressing cumulative stress disorders in clinicians whilst his work on business model innovation in diabetes was integrated into India’s largest home healthcare firm’s service delivery model. In 2014, he was inducted into the Government of India—Department of Biotechnology’s flagship Stanford-India Biodesign (SIB) program in 2014 to train in frugal innovation and is a certified bio-designer.

Reflecting on his experiences, he says: “My initiation into healthcare was through a wonderful group of people at a budding start-up in Bengaluru, India, who were committed to bringing home healthcare to address sleep apnea, diabetes, and respiratory distress across India’s diverse socio-economic strata.

“Having witnessed the application of engineering principles in solving everyday needs in healthcare, I was curious about the lens clinicians and life sciences researchers adopted to solve problems; this led me to explore research in the UK, back in 2011. I then returned to the industry and continued working with medical devices across various clinical areas, exploring how these innovative solutions addressed or failed to address the contextual needs of the population they intended to serve.”

Dev adds: “My time at SIB, under the tutelage of Professor Balram Bhargava, got me interested in the contextualization of innovation and helped me truly appreciate the essence of frugal innovation. Frugal innovation often gets myopically reduced to Jugaad, a Hindi term which loosely translates to quick-fix; but it is much more than that—it’s a contextually-informed lens to design ingenuously for impact, both for resource-constrained settings and for wider global needs.”

Speaking of his previous experiences in digital health, he says: “In 2016, I got an opportunity to lead the development of operations, partnerships, and projects for an NYC-based digital health lab in India. With an eye on New York city’s thriving digital health ecosystem and the other on India’s emerging one, it was quite an interesting challenge to address. I found revisiting this integral question useful: how can we ensure we’re contributing to the Indian ecosystem’s particular needs, and not force-fitting what has worked elsewhere?”

After his tenure at the lab, Dev’s continued search for these answers led him to HIMSS India in 2019. HIMSS is a global, cause-based, not-for-profit organization focused on better health through information and technology.

Headquartered in Chicago, with additional offices in North America, mainland Europe, the UK, and Asia, HIMSS is a global voice, advisor, and thought leader with a unique breadth and depth of expertise and capabilities to improve the quality, safety, and efficiency of health and care outcomes.

Formed in 2010, HIMSS India is the first country-specific chapter of HIMSS outside the US, and works closely with stakeholders in digital health, including policy makers and governmental organisations to drive digital health public policy, sense-making, and adoption.

He says: “How do you bridge gaps and activate the potential that exists across India’s software prowess, a burgeoning start-up and investment ecosystem, and a government keen on enabling a nationwide digital health infrastructure, for an enormous population that seeks improved health and care experiences?

“A group such as HIMSS adds value by helping diverse stakeholders make sense not only of evolving digital technologies but, more importantly, of what it means for India’s unique care delivery and access issues.”

Amid rapid acceleration of health tech, where does Dev see the future going?

“The future is always in flux and it’s challenging to accurately capture the impact of many extraneous variables. Two years into the COVID-19 pandemic, and we’re still learning to adjust to what disruption can truly mean at various levels. That said, what we focus on now through the next 2-5 years is important.

“Digital tools and technologies can be the lever that Archimedes spoke of; but to ‘move the earth’ we need to choose an optimal fulcrum—focus our efforts on addressing both yet unsolved and emerging needs and see how best the technology component fits in. And that means being open to exploring avenues that are less lucrative but can result in solutions that integrate with existing systems and behaviours to optimise health outcomes. While mostly well-intended, disrupting healthcare is perhaps not the most helpful vision to begin with.”

Acknowledging that this is easier said than done, he adds: “Effecting a collective directional change in healthcare is complex because of diverse actors with non-overlapping interests but can be enabled through supportive structures—training, regulatory, investment—and incentives.

“Personally, I’m optimistic about mobile health: it offers staggering but yet massively unrealised potentialities for people who need it the most. Take digital therapeutics [DTx] for example—thankfully, there has been much appreciation around generating real-world evidence for DTx solutions, which is important to be able to sustain trust and enthusiasm in these evolving technologies—not just for insurers and regulators, but for the wider ecosystem.”

Dev concludes by quoting Aristotle: “well begun is half done”—and Plato: “the beginning is the most important part of the work.”

“This philosophy underlines my current work…a better understanding of users’ needs can lead us to develop more useful solutions, largely transforming digital health’s potential to impact.”

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