Rock Bridge alumni develop telemedicine app

Thursday, April 24, 2014 | 6:00 a.m. CDT

COLUMBIA — Most college freshmen are more worried about their grade in intro to biology than the state of health care in India.

While Rock Bridge alumni Nahush Katti and Vikram Arun certainly still worry about their classes, they are more concerned about their pet project: DoctorOn.

DoctorOn isn't a game. It's an app that Katti and Arun believe has the potential to improve access to eye check-ups.

Although Katti, 19, is studying at Purdue University and Arun, 18, at Washington University in St. Louis, they are also longtime friends and the teenage CEOs of the telemedicine company that is developing the app for smartphones.

DoctorOn uses the phone's camera and a special attachment, called iOn, to take a photo of the eye. The photo is then uploaded to an online database where doctors can access and diagnose a patient from anywhere. The app would be geared more to health care providers, making it easier for them to screen patients in rural areas.

DoctorOn uses a wireless or 3G Internet service to transmit photos. Katti and Arun are banking on improvements in Internet access in rural India.

"In the U.S., 3G is all over the place, but in India now it’s kind of spotty but it’s improving," Arun said. "So we’re thinking that by the time we actually deploy it, the data signals there would equal that of the U.S. right now."

The iOn attachment and DoctorOn app has a 92 percent accuracy rate.

iOn uses slit lamp technology, a large, bulky piece of ophthalmic equipment that is used to take photos of the front of the eye. It is most commonly used to diagnose cataracts, which cause 80 percent of blindness in India, according to the International Development Association.

Although the app would still require patients to interact with a nurse or some sort of paraprofessional, training to use DoctorOn would take only a couple of days and would not require a medical degree to use. The app would also make slit lamps much smaller and easier for aid workers, nongovernmental organization workers or other health care workers to carry into rural communities.

Katti and Arun used a 3-D printer to build iOn, first using a machine at the Columbia Area Career Center and then in the MU 3-D Prototype Lab.

With new slit lamps costing thousands of dollars, Katti and Arun estimate that they would sell iOn to ophthalmic hospitals for about $100, or in a package with a smartphone for about $500. If health care providers would like to use their own smartphone, it needs to have at least an 8-megapixel camera.

"Initially we want to start with big hospitals because they have the manpower to distribute it to the masses," Katti said. Eventually he wants to bring smaller city nurses and family practice doctors into the network to serve as check-up points in smaller villages.

Arun said the app is a win-win situation. Because doctors in India are usually paid based on the number of patients they see, doctors will make more money and patients will no longer have to travel long distances for a short visit.

"We are essentially increasing their field of access," Arun said via email.

Too far for help

Much of the problem in India isn't that the people can't afford care but that care is too far away to conveniently access, according to the National Center for Biotechnology Information. Hospitals are located in large cities, several hours away from India's many rural villages. Many of India's rural roads are also not paved, making travel difficult, according to a report by the International Labor Organization.

Katti knows about this problem firsthand.

Katti and Arun's journey started almost four years ago, when Katti's grandfather was diagnosed with Alzheimer's disease. Because he lived in rural India, Katti's grandfather had to commute two hours each way from his village to the hospital for his hour-long treatment. This seemed like an excessive amount of time to his grandson living in Columbia.

"I just thought that was ridiculous," Katti said in a TEDxCoMo talk given in April 2013. "So I heard about this and I started talking to my friend Vikram Arun about it, and a couple of months later, and after some more discussion, we started DoctorOn, a telemedicine company."

Katti and Arun had been friends for years, playing tennis against each other and joining their first tennis team together in middle school. It was not a surprise then when Katti decided to pair up with Arun to work on the idea of DoctorOn.

The pair pitched the idea to the Reynolds Journalism Institute's Innovate!2010 Pitch Slam competition in August 2010. First place winners got the chance to compete in a global contest to find the 100 most innovative ideas in the world. Katti and Arun placed second. They weren't discouraged, though, and went right back to work to improve their idea. 

The project received $25,000 in funding from the United States-India Science and Technology Endowment Fund last summer, Katti said.

Concept to prototype

Initially the pair wanted to create an app that would work in any and all types of medicine, with the ability to video conference between patient and doctor. After deciding that plan was a little ambitious for a first project, they focused on eyes and ophthalmology.

It's one thing to build an application, though, and another to see if it actually works.

Katti and Arun paired up with Sankara Nethralaya, a charitable eye hospital in Chennai, India, to field test their program. Katti and Arun met the founder of the eye hospital, Sengamedu Srinivasa Badrinath, in the winter of 2010 when he visited MU to receive an honorary degree. The pair pitched their idea to Badrinath, and a partnership was born.

Katti and Arun were allowed to work on DoctorOn when they were students at Rock Bridge High School, as a part of an internship class for the Gifted and Talented Program. During that hour and a half every other day, they did research, designed in engineering software and 3-D printed their prototype of the camera attachment.

Looking forward

Although they've come a long way in almost four years, there's more work to do. Sitting in their rooms nearly 300 miles apart, the biomedical-engineers-to-be continue to develop the app.

“We try to dedicate at least some time every week or, if we can’t do it one week, then make sure we do a little bit extra the next week," Katti said. "Just to make sure our mind is on it and we’re working on it as much as we can without compromising our studies.”

They don't have a strict timeline for when they want to roll out their first product, but they estimate DoctorOn will be available in India in about two years. More field testing in India and approval by the Food and Drug Administration means that DoctorOn could be available in the U.S. as soon as a year after its rollout in India.

They won't stop with just ophthalmology, or with the estimated 845 million people who live in rural India — they want to diagnose the world.

"One thing that both of us have decided is that we don’t want to be a one-product company," Katti said. "That means we have to be able to design other things, and so we have to have an emphasis on our college education in order to be able to do that for the long run. Obviously the sooner, the better, but we also want to be able to roll out something that will help the masses.”

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