Myshkin Ingawale: A blood test without bleeding

I like to build stuff. I've always liked to build stuff. My team at Biosense, a startup I co-founded with my doctor and engineer friends, has built a technology called ToucHB, which can do blood testing of hemoglobin without pricks, without needles. I believe this is going to democratize health care. They're two big words, I don't know what they mean.

(Laughter)

In fact, in 2009, I was even more clueless. I had absolutely no idea what was going to happen next. I was, in fact, busy trying to finish off my Ph.D., which was in a completely unrelated area of how people interact, contributors interact, how articles are formed in Wikipedia -- trying to figure out how quality emerges from the system. I was also building something called the Copenhagen Wheel, which is just a really beautiful, beautiful electric bike at a lab at MIT called SENSEable City Lab. I was lucky enough that I visited Mumbai, my house, back for a vacation.

So at that time I was planning a road trip. I visited a place called Parol about two hours north of Mumbai. This is a place where my friend, Abhishek Sen was interning. He's a doctor there. And that's his actual photograph. (Laughter) So Abhishek actually made me wait. He was out there in Parol delivering a baby. I was waiting, and when he did emerge, he was ashen-faced. He told me that there had been two deaths; the mother and child both had died. The reason, he told me, was something called post partum hemorrhage. He explained this meant severe internal bleeding. What was really shocking for me was that he said that this is entirely due to undiagnosed anemia.

Now anemia -- I'm an engineer, but even I knew -- that anemia is something which is not supposed to be fatal. It is something which probably the cure is known. I mean, folic acid, iron tablets -- very cheap, affordable cures exist to control anemia. So why was this woman dying? It was completely preventable. Five minutes away from there, I had the center, the medical center, which was distributing subsidized iron tablets. So the whole nature of this thing completely shocked me. And I knew that there had to be a way to prevent this.

My mom is a pediatrician, and I asked her. She told me that this is how you would typically test for anemia. Take a blood sample and run it through a machine called a Coulter counter. This is a $10,000 machine which was available in Mumbai. It's also available here or in any part, I guess, in Europe and most cities in the world. But this is not available in Parol. Also, that woman who was operating the machine, the technician, is not available in Parol.

(Laughter)

Now this struck me as -- I love to fix things. I wanted to fix this. I got a friend of mine, an engineer, and three other doctors -- Abhishek joined the team -- and we wanted to solve this problem. By the time I step down from here there will be 10 people who have lost their lives through a completely, completely preventable problem.

Now let me take you back to Parol. You saw the woman there, the nurse. In India this is called an ASHA worker. It's essentially a village health worker, a matron. She is really the center of the health care system. Public health care runs on the ASHA worker, not the doctor. Now we knew we had to design something which she could use. We knew it had to be these three things that the machine had to have. We knew it had to be something which had no needles, no pricking, so it would have adoption, it would not have medical waste, all those problems. It had to be simple enough for that woman ASHA worker to use. And thirdly, it had to be something which she could carry in her kit. She goes village to village doing screenings.

We thought we could build it, so we built it. (Applause) But, but it didn't work. (Laughter) So we built it again. And we did this 32 times. (Laughter) But I'm very excited to tell you that last year we did build it -- it works. And I have it here in my purse. So this is a machine called the ToucHB Quik. What it does is it measures my hemoglobin, oxygen and pulse rate. I put it on my finger, switch it on, and in about 20 seconds it'll give me, on the little screen here, a value of hemoglobin, oxygen saturation and heart rate. This will help ASHA workers diagnose anemia at the point of care.

(Applause)

I'll explain a little bit about how it works. You might have seen a little light inside of it. In fact, there are three lights in there, three wavelengths of light. And we essentially pass light right through the tissue, and from understanding how much of it is transmitted, how much of it is scattered and how much of it is absorbed, we can figure out how much hemoglobin is there in the blood. And this is something which is based on a principle called photoplethysmography. We are actually really very excited about what else non-invasive techniques like this will be able to crack in the future. One of the things which my intern here, Pratesh, built is a mobile application, which can now send all this data anywhere it wants to go.

There's a bunch of very exciting stuff which we are doing. I would love to tell you a little bit more about it. But fundamentally, what I believe is that the map behind of me is called basically the map of anemia. It's the death rates caused by anemia globally. You'll notice, of course, that there are hot spots -- South Asia, Africa. My business plan is very simple. I'm just going to sell these to every clinic in the world. That's a simple bottom-line business plan. And by the time I'm done, in 2020, when the WHO publishes the data again, this is going to be the map of anemia.

(Applause)

Thank you.

(Applause)