SindiColpo: AI based cervical cancer screening

Cervical cancer is the second most common cancer of females. Globally estimated new cases of cervical cancer 600,000 & deaths due cervical cancer were 340,000 in 2020. India witnessed 120,000 cervical cancer cases as per reports published in Globocan. Every 9th minute an Indian women is loosing her battle to cervical cancer. Less than 2% women have been screened over past 5 years in India as per WHO country profile (2021). 

Colposcopy is a primary screening tool for detection of cervical cancer and invasive lesions, needs highly skilled manpower and a specific infrastructure and being expensive or bulky it can't be used for population based screening. Hence, we need cost effective and point-of-care diagnostic tools to early identify cancer cases in stage-I and triage them to tertiary facility to prevent it. 

We have developed & patented SinDiColpo - a low cost, point of care, battery operated and AI enabled device for cervical cancer screening that can be used even by a primary health care provider. Through our controlled study to determine if the low cost portable colposcope is equivalent to conventional colposcope for screening of cervical lesions, SinDiColpo has proven to be 100% sensitive when subjected to the gold standard histopathology. It's being used by 20+ early customers on field to collect feedback and refine for industry standard manufacturing.  

Product video: SindiColpo

Broadly speaking, our target population is 1) B2B: Women Hospitals/ Gynaecologists and General Physicians from low resource settings 2) Expectant mothers (and their families). 

Awareness of cervical cancer screening across rural & tribal parts of India/Africa is substantially less. The population in lower income settings is the most vulnerable. Hence, in the developed world or those in the developing world with access to a reasonable health facility has been our immediate focus. Since cervical cancer visual inspection & assessment is needed to avail the primary course of treatment, we have been working with a team of obstetricians, surgeons and cancer specialists to better understand the associated decision making process, and focus the solution development efforts on the unmet clinical need. 

The other target population that can potentially benefit from our solution, though in the longer term, are women with access to midwives or a low resource health facility, e.g., in parts of the developing world or remote regions of the developed countries. Such patients and their caregivers could benefit from our solution to objectively decide if continuing with the use of some relevant intervention is justified.

To reach out to this population with SindiColpo, we plan to use the existing network of over 1000+ rural hospitals (customers) from 12 states to scale SindiColpo initially. CareNX (MIT Solver 2019) has been already working for maternal & child care sector since 2015 through a patented fetal heart monitoring solution in India, Africa and SEAsia. CareNX also has 35+ partner NGOs (customers) working for low income class in tribal and remote regions across 1200+ villages. CareNX is also partner with National Health Mission (NHM) project implementation plan for FY 2023-24 for government of India. 

There are 100,000+ active gynaecologists in India who will be the primary customers to reach out vulnerable population. India also have over 1 million general physicians and 2 million front line healthcare workers who can use SinDiColpo for on-field screening and remote connectivity with gynaecologists. Government is also a huge customer which has over 150,000+ major public healthcare facilities. 

Team:

Cofounders have left out of PhDs high paying jobs and built the company since last 7+ years just because of a high level of motivation for social impact. Rest is an interdisciplinary team of 6 product engineers, 2 biomedical & 2 public health experts and 9 sales/marketing personal. Team is mentored by professors from KEM Hospital Mumbai and IIT Bombay. The team has experience of developing and commercialising technology products related to maternal and child health since last 7+ years and has built a sustainable business with annual revenue of over USD 900K covering for over 1000+ healthcare facilities, 400000+ pregnancies and 2500+ gynaecologists so far.

Learnings so far:

1. Partnerships is a key in delivering care. We have had worked with 30+ big inter country NGOs/Governments partners and learned that no single organisation can create end-to-end system for comprehensive care and management.
2. Repeated training and capacity building of partners is very essential.
3. Behavior change can't be underestimated for new innovations, particularly in healthcare sector.

Why we are positioned in a right manner to scale SindiColpo:

1. We have 5+ years of experience of scaling up fetosense fetal monitoring solution to 1000+ B2B hospitals including government, NGO, private and premium settings. Top private maternity chain of hospitals Cloudnine group, Sahyadri group, O&P group, Rainbow group and reputed government medical hospitals AIIMS, KEM, Nanavati, GMCH, AFMC etc. have been using our solution since 3+ years and have performed over 400000+ tests. 
2. We have established exclusive annual distribution and service partnership with a pharmaceutical companies for PAN India presence. A team of 50 regional sales managers have been activated to onboard 1000+ B2B hospitals to facilitate home monitoring for patients in FY 2023-24.
3. The product has been patented and validated with leading cancer care institute as per the standard clinical protocol in adherence with CDSCO regulatory body.

• 1000+ hospitals
• 400000+ women
• 2500+ Gynecologists
• 12000+ health workers

Product Innovation:

1. Designed developed and patented by a gynaecologist
2. 3x low cost, device will be priced under USD 1K
3. Non invasive
4. Point of care diagnostic device 
5. No special expertise required to operate
6. AI enabled inbuilt software for Cervical scoring system, patient data management, report generation with RCI evaluation

Business Innovation:

1. We plan to commercialise SindiColpo through a per test based subscription model instead of fixed cost device sale. This will avoid capital investment for customers and provide revenue generation opportunity at no cost. 

Since 2015, ‘CareNX’ program has registered 400,000+ pregnancies(12000+ high-risk) via 260 frontline workers across nine states of India, in rural, urban and tribal areas, with 15+ Government, non-profit and corporate partners. SindiColpo will be implemented within CareNX, to focus on women reporting visual inspection, in two rural and two tribal settings (primary health centres and sub-centres). These sites include 4153 pregnancies (39.6% clinically high-risk). Indirect beneficiaries will include frontline workers and primary care doctors who will use SindiColpo for timely management of cervical cases (n~100 staff).

Moreover, the present commercially available Fetosense solution is being used by 1000+ maternity hospitals from sub-urban areas, having registered 400000+ pregnancies with a rate of 6000+ pregnancies per month. SindiColpo will be made available to selected facilities.

Considering both channels and their growth rate

1.   Year 1
   1. SindiColpo with CareNX - rural - 100 front line staff - 3000 women
   2. SindiColpo with Fetosense - semi-urban - 300 facilities - 70000 pregnancies
2. Year 5
   1. We aim to install SindiColpo at least 10% of maternity clinics (~5000), 1% of general physicians (~10000) and 5% of public healthcare facilities from urban and semi-urban areas (~7500)
   2. Considering adoption over time and monthly average coverage rate of 25 women patients per month - total beneficiaries will be around 6 million 
   3. We also intend to scale SindiColpo cross-countries, particularly south-south countries viz Bangladesh, Nepal, Kenya, Nigria and Tanzania. We already are working with partner organizations via CareNX in these countries and SindiColpo innovation will solidify those partnerships further.  

Full time: 6

Part time: 3

Interns: 2

Consultants: 3

CareNX workforce consist of highly skilled interdisciplinary team of computer scientists, biomedical & public health experts and management. Team is mentored by professors from KEM Mumbai, IITBombay, National University of Singapore (NUS) and Stanford University. As company is Incubated in IIT, it has access to all the fabrication facilities and DSIR certified labs at IIT Bombay. Also the team has experience of developing and commercialising a product related to maternal and child health since last 7+ years Our advisors are from strong public health background, technology and start-up scaling. 

• CareNX's mission is to develop digital technologies for better women healthcare. We have a medical lead doctor who is a women for this project. There are 2 other supporting women team mates. 
• Project targets pregnant women as direct beneficiary. The geography we have selected is non-metro regions of the towns in which the access to care is limited. We will cater to beneficiaries from all ethnicities, minorities, race or religion. 
• The diversity and social inclusion is to be achieved by providing respectful women care through all the partners. The fetosense & SindiColpo technology has been developed with neutral perspective and principles of responsible AI. 

1. Customer segments: 
   1. Maternity Clinics
   2. General Physicians
   3. NGOs and Governments
   4. Pharmaceutical companies
2. Value propositions: 
   1. 7-fold reduction in the price as compared to market options
   2. Auto-interpretation of prematurity
   3. Portable & ease-of-use 
   4. Digital record storage & remote monitoring
3. Revenue streams:
   1. Fixed cost model: One time instalment cost + consumables (recurring) + AMC
   2. Pay-as-you-go model: One time deposit at instalment + Per test revenue sharing

1. CareNX will fund 50% of SindiColpo model expansion through revenue of Fetosense solution for next 12 months. 
2. Rest 50% matching amount would be made available through SindiColpo revenue + grants.
3. With current projected commercial model, each rented device shall generate break even revenue within 18 months.