Mudit Dandwate & Gaurav Parchani Co-Founders, Dozee chat with Sanjay Swamy, Managing Partner Prime Venture Partners.

Dozee provides remote health monitoring solutions and devices that track heart health, respiration, sleep quality and stress levels. Its AI-based health intelligence module assesses user’s vitals data and conducts risk analysis. Dozee aims to partner with over 1,000 hospitals across India to help them upgrade critical care infrastructure through remote patient monitoring.

Listen to the podcast to learn about

01:12 - What got Mudit and Gaurav started with Dozee?

12:00 - Discovery Phase & Eureka Moments!

23:15 - Early Adopters & Moments Of Surprise

30:45 - Creating Impact & Scaling Dozee during COVID

54:35 - Regulations & Permissions for Healthcare Entrepreneurs

Read the complete transcript below

Sanjay Swamy

Hello, everybody. Welcome to another episode of the Prime Venture Partners podcast, where we bring you conversations with various folks from the startup ecosystem. Today, I'm delighted to have founders of one of our portfolio companies Dozee, Mudit Dandwate and Gaurav Parchani. Mudit, Gaurav, welcome to the show.

Mudit Dandwate

Hi, Sanjay, always a pleasure to talk to you. It's such an amazing platform to be talking. Yeah, looking forward to it.

Gaurav Parchani

Thank you Sanjay, for having us here. As Mudit said, an amazing platform to be looking forward.

Sanjay Swamy

Terrific. As you can see, we have already got an interesting pair here because the CTO is more formal than the CEO. Great, guys. So we've been very happy investors in the journey at Dozee. But for our audience would love for you to start with your backgrounds, as well as what got you started with Dozee and what the grand vision is. So maybe Mudit, you can start and Gaurav, you can chime in?

Mudit Dandwate

Sure. So I am Mudit. I come from Mechanical Engineering, IIT Bombay and my passion was race cars, that is what got me to IIT in the first place. Then working with the race cars over time got me very interested into sensors, data acquisition, analytics. That eventually, one day the eureka moment was that if we could also build something which can monitor health of the humans, as well as we do for the race cars. That's how we built Dozee.

Gaurav Parchani

All right. I'll go ahead next. Hi, I'm Gaurav. I come from Mechanical Engineering, IIT Indore. I'm actually from the first batch of IIT Indore. I love solving puzzles in mathematics and statistics and data crunching. That was my motivation to go into IIT. Somebody told me engineering is solving puzzles, and that's what got me there. Post IIT, I worked in the automotive space as an automotive simulation, simulation analysis, and so on, so forth. This is where I met Mudit. What got me into Dozee was the fact that, we both enjoyed our jobs. The problem statements and the puzzles were really good and really complex and that had that adrenaline rush for us. But then what was lacking was the value that we added to the society, in race cars and in automotive industry.

That is when we wanted to start something. We wanted something which is very high value and what higher value than healthcare. Primarily, it is the biggest puzzle that healthcare lags behind other industries, probably a decade behind other industries in tech adoption and data revolution adoption. Which is where I think we took it as a challenge to kind of get data into healthcare.

Sanjay Swamy

Wonderful. So let's fast forward a little bit today, where there is a little more clarity on the definition of what Dozee is. Maybe you can help get people to understand what Dozee is. Then we'll go back to the roots of saying and how you arrived here? So maybe, Mudit, you can give a quick background on what Dozee is?

Mudit Dandwate

Sure. So Dozee is one of its kind, continuous remote health monitoring service. That gives continuous remote patient monitoring never seen before globally. It entirely automates the otherwise very manual operations of collecting the healthcare vitals, arranging it in different charting, understanding the data, and then using that data to improve the patient outcomes. This is the entire flow of healthcare which Dozee entirely automates. That is what Dozee is, end-to-end. The biggest thing that Dozee brings to the table when this entire system works like a charm, then the impact that it creates is actually saving lives by bringing in timely actions. That is what thrills us about Dozee and motivates us to put even more energy with every passing day.

Sanjay Swamy

So Gaurav, maybe you can talk a little bit about what does this mean technically, and what does it monitor for a patient? Who's the person overseeing the monitoring?

Gaurav Parchani

So I'll take a step back as well. When we started Dozee, the problem statement in front of us was in healthcare, data is always missing in healthcare. We don't have healthcare data to build, let's say, risk modeling algorithms to build early warning system that Mudit spoke about. To build all of these cases, we didn't have data to do that. So the first problem statement was, let's build a device that collects data on anybody in any way, and anybody should be able to operate that device. So this is where when we started experimenting with a lot of sensors, we came across this technology called ballistocardiography. It was a very old forgotten technology. What that means is it captures the vibrations that the human body produces. Particularly the cardiac system, as well as the pulmonary system.

So when your heart is beating, or when your lungs are filling in air and giving out air, we capture those vibrations from under the mattress. On those vibrations, we apply machine learning algorithms, digital signal processing, and a lot of data analysis to extract meaningful biomarkers. Every heartbeat, every inhale, every exhale, every snoring movement, every body movement. Then we do a higher-analysis to figure out your health, your sleep, your health condition in general. So it's almost like, getting a health checkup every night at home. As well as in hospitals, it automates that process of capturing the data vitals.

That a nurse has to do once every four hours or six hours, depending on the hospital protocol. Now we can do it once every minute without the nurse having to intervene. The nurse can actually focus on the care aspect of their job rather than the manual data collection aspect.

Sanjay Swamy

That's amazing. Today, this is used in a few thousand hospitals. What scale is it that now and what are your aspirations for this over the next 24 months?

Mudit Dandwate

So today, we are present in over 270 hospitals across India, across almost 40 cities and towns across India. The first purpose was, of course, cater to Indian market and that's what we entirely focused on. In next 12 months, we are looking to go even deeper in this and scale up to close to 3000 hospitals across India. Get to close to 50,000 beds, save millions of nursing hours and the entire process and many lives. So that is a scale that we are looking at. At the same time, we'll be also looking at expanding to certain international markets as well, to take the impact global as well.

Sanjay Swamy

Great. We'll come back more to the forward looking plans later on in the context of in the show. But coming back to the early days, you guys are embarking on doing something where there was a piece of technology that you discovered. But there's nothing really built on top of that and you had to imagine a product. There's a hardware element to it. There's a cloud element to it. There's a lot of data science and algorithm churning along the way. Also by the way, being a healthcare product, it needed to go through a lot of trials and validation, and so on. So in a multifaceted problem like this, which you all took if I recall, three to five years really to get this fairly robust.

Tell us a little bit about maybe two, three phases of the pre-product, so to speak? How you established the product, the science behind it, validated it, trialed it, and then said, "Okay, now, we're ready to roll it out as a production product."

Mudit Dandwate

So very interesting and fascinating journey, I would say, three to five years, which really took us very amazing in certain ways. So I'll tell you some of the instances in that. So first stage was prototyping. There were lots of fun. At that time, there was no one but me and Gaurav. So while I used to look after the heart sensor part of it, Gaurav used to look after the algorithm part of it. Then both of us used to double down as guinea pigs because what we had made, we had to test it on someone. So we then convinced few labs like, NIMHANS and all, and where we actually used to lie down with all of this bunch of sensors close to 32 electrodes attached to our body, and sleeping in that Human Sleep Research Lab.

The next lab to us used to be a rat research lab as well. So those kinds of places where we were there entire nights, testing and benchmarking our product. Although the science was there, but establishing it that without even touching a person, how you can give a medical grade data out? This is something which even we had to prove ourselves to start with and, that was the journey that we embarked on. Once we reached one level, then the idea was to get to that level that now we can use this to scientifically prove it to someone else. So then convincing it to few doctors, even employees as well. Getting and attracting the first set of employees itself was a fascinating journey.

In fact, I remember that time that I used to camp at people's place, whoever I used to acquire, to join us in our journey. I used to tell them about our vision, what we are trying to do? Then show them prototypes and make them visualize that, while they're sleeping on the mattress, see how their heart rate and how those things are coming along? That used to fascinate people and that gave us the initial momentum, which was required. Then came the phase of raising certain amount, to keep the company life. So getting convincing few friends and family, even government as well. So we raised some capital, even in the form of grants, biotechnology grants, and things like that as well.

Mudit Dandwate

So a lot of places where we started using all of the scientific data. That's how we started establishing the product. So this was the way we went from prototyping to scientific exploration. Then next phase was, of course to productize this. To make it into something which humans could use, I would say, and not just the lab rats. So that was the journey. It took us about three, three and a half years to actually do all of this. Gaurav you want to share something on this? This was, I think, one of the best times of our lives.

Gaurav Parchani

Oh, absolutely. As in less people to manage more work to do. Sometimes I think, can we go back to that phase. But yeah, it was a fascinating journey, for sure. I still remember the nights at NIMHANS and then convincing people. At NIMHANS, people at BIRAC for the grant and all of those things. So we had good help along the way. I think that is what is needed because hardware is tough, and then hardware in healthcare is even more tough. Healthcare probably is the second highest regulated industry in the world after space tech. So you require that initial three, three and a half years to kind of start. Have something in hand, which is usable in the field. Without that again, it's very difficult.

We had good support in sustaining that plus, we had a strong will as well. I think I will give that credit to Mudit. From then onward, we met Sanjay, and you know the story so far after that.

Sanjay Swamy

Yeah. We will share that story with people in the later part of the show. So tell us about some breakthrough moments, some aha moments? You talk about your dog having forced you to put this under the mattress and things like that. Some of these anecdotes that might have been some non-obvious insights that came about. So share some of those breakthrough moments with the audience, please?

Mudit Dandwate

That I think Gaurav, would you like to say that one?

Gaurav Parchani

Sure.

Mudit Dandwate

Pi one, Pi story?

Gaurav Parchani

Yeah. Actually, both me and Mudit are animal lovers. Especially we used to love dogs. So when we decided that, yes, we are going to start ourselves. We were very, very sure in our hearts that this is a long term commitment that we're doing. We thought it's the right time to kind of also get another team member with us, which we don't need any convincing. We got a puppy, which was Pi. He was teething at that point of time and used to chew everything. At that point of time, the most valuable asset in our office was the sensor that Mudit had worked on, which was actually working from over the mattress. Our initial thought process was not to go under the mattress. We had never thought about it. We had always thought about, can we attach something on top of the bed? The sensor was working. We were able to get heartbeats. You were able to get respiratory rate. That is what we wanted to celebrate.

So we wanted to go out of the house. It was daytime obviously, so we wanted to grab a cup of tea. So we discussed, okay, Pi is going to chew this thing apart. This is the most valuable thing. So let's just keep it under the mattress, where he won't be able to do anything. We forgot to switch off the recording and we went out, had tea, came back. He was sleeping on the mattress directly over the sensor. Then I observed that okay, there was minute heartbeats in the data. This is where I told Mudit. Mudit looked at it. Then we saw that okay, yes, these are heartbeats. Then we actually figured out the scientific reason why the heartbeats are better actually? Because we are essentially capturing vibration. So when we capture vibrations at a force node, the bed base cannot move. It's a hard object. The mattress top can. So it was actually working better than what it was supposed to on top of the bed. Mudit then optimized it. Actually added one more IP layer to make it work for multiple mattress thicknesses.

So we were very lucky at that point of time that Pi decided to do that. Our sensitivity matched the mattress that he was sleeping on. He slept at the exact same position where he should have. So I think all the stars aligned at that point of time. That's where we thought we can go one level beyond. It became contactless at that point of time, that it won't even touch you. I think Pi should get all the credit for all of that. After that, Pi has participated on multiple times, and even still does now. We have a bed in our office, which where we do all the testing. So whenever all the people are busy and there is nobody available as a guinea pig to test, we make Pi sleep on the mattress, and then we get this data and we test the sensors.

Mudit Dandwate

He thinks it is his moral responsibility to be on that bed. So whenever that bed is empty, he goes and occupies that. So he's like, I've made them achieve that eureka moment once, I'll keep on doing that. So that’s still the thought process probably. Sanjay on that, I think depending on that, this was our first eureka moment. The second one for us was actually our first lifesave. So in healthcare, it is easier to think that when we are doing something, it actually saves lives but another thing to actually realize that. Even we didn't know what is the impact of the technology that we have actually built? When we had given first set of devices close to 100, the first batch that we had created, we distributed it out in different all the people whom we knew and so on. So that was our first batch. We got the feedback. After that, we created a batch of 500.

That was something which really changed our thought process because then we gave it to some people, who were not really people we knew but people who're really going to get benefited from that. In that batch was one lady, who was actually living away from her mother. Her mother actually had certain cardiac conditions and so on. That's where once when Dozee gave an alert and they go to check with an expert, they found out that she was actually approaching that stage, her heart failure episode was kind of coming back and they needed a pacemaker. Then it was a big moment for us. The family shared their story with us. They told us how exactly Dozeee has changed their life. That really brought that belief, not just between me and Gaurav, but to the entire team that what we actually have now it is our responsibility to now take it to next level, because this is a life saving technology. Done correctly, we can just replicate our success in many ways.

Since then, it became the motto of the company. From then, there our focus entirely change. We are not just thinking that it is heart, respiration, sleep, good to have data. But we actually started thinking and taking Dozee as a serious product, which can help people manage their chronic condition on a day-to-day basis. So that was second very big moment. Then third, of course, was when we cracked that first hospital after doing a three month long trial. So these are different phases, and then that becomes repeatable.

Sanjay Swamy

So I was going to get to that. That was actually a natural segue way to my next question, which is the trials phase. So you come up with an idea, a lot of hard work and some luck. You stumble upon what seems like a product. You create a few instances of it, give it to a few friendly customers initially. After that some are in the next level, which is let's say, a beta phase and you see some initial successes. But along the way, you need the healthcare ecosystem to also appreciate what you're doing and validate a lot of what you're doing. So how did that journey happen? I know you had a lot of partnerships with NIMHANS and Jayadeva Hospital and a few others. Can you share some insights into that part of your journey and you can probably help other entrepreneurs in the sector?

Mudit Dandwate

It is one of the most critical parts. Healthcare cannot be done without having healthcare deep involved right from the time when we embarked on the journey. So we were very clear in fact. So with few contacts that we had with a few hospitals, doctors, we started approaching and bouncing off the idea that what we are trying to do. In this first was NIHMHANS because one of the problems that even they were facing on everyday basis was that, doing a sleep study, the awareness levels are very low and that sleep study is very cumbersome process. So what the Human Sleep Research Lab saw in Dozee was that, if this actually comes to a success, this is going to help us automate this entire process and is going to make it very easy for client. You know what is today a very technician-oriented procedure. In fact, putting those 32 electrode takes almost one and a half hours and that too, with a precision.

I still remember by the time and he actually became our very good friend, Dr. Gulshan. By the time he used to start putting his last electrode, I used to fall asleep on the chair itself. One and a half hours what a gruesome time that we have to do a pre-prep and end-prep and everything. So it was a painful procedure. They thought that this will become very easy for them, and then they latched on to that. So which was our first insight into that hospital, where they opened up their doors to work with us very closely but similar thing that happened. Idea is that, you have to keep on pitching. A the end of it, will require only one or two to start with, of course. Doctors who're really believe in what we have as a vision, and they are ready to work with you as a co-collaborators in what you're trying to achieve.

So of course, most of the people will think that we have gone crazy under the mattress, how is that even possible? In their 30 years of experience, they will not seen something like this. So they won't even listen to us to start with and that was what happened. But after hitting it with 40-50, at least all that you require is one, who really believes in you, who believes in the product, and more than that believes in the people who are running it? That's how it is. It is true for everyone, Sanjay. I think same thing, we have also spoken about how it happens with your key employees? How it happens with your key investors? How it happens with your key collaborators? So detection is just a phase of it. You have to keep on doing it till you don't find the perfect ones. Once you have that, then latch on to it, build on the relationship and go ahead with them.

All that it takes is just convincing one or two or three key opinion leaders. Then suddenly, you have opened up a Pandora's box and world is there to listen to. I think that is what my understanding from this field is. Gaurav, you can add on.

Gaurav Parchani

Just adding a small bit to it, I think Mudit summarized it really well. Healthcare is like any other industry that you have to kind of look for. There will be people who will be early adopters, and there will be people who will follow them. There will be people who will be laggards, who won't even look at you, if it's a new thing. The only complexities here that you're adopter. Even if they are early adopters, they don't have time here. In healthcare, it's a very time crunched segment, where a doctor busy in their clinic or hospital hours won't even have time. After their hospital hours, they're very exhausted to look at something. You have to keep trying and keep kind of hitting that sweet spot.

You keep looking for people, especially in our case, who're very interested in research earlier on and were willing to listen to new ideas. It was Mudit's idea as in we had built an ad hoc system on the laptop, where you put the sensor, then we used to give them a live demo. So as Mudit said that they were very surprised that, how is this going to work from under the mattress? I have not even seen it in my 30 years. So look at the demo, give us five minutes. You only lie down and look at it. So that is where that really helped. It does now making a comeback in our product for every consumer to kind of get that as well.

Mudit Dandwate

In fact, you know how that you brought it. I actually remembered it. The way we used to play, that has been some time I've also forgotten a lot of these tricks now. So the way we used to do it and run it is, when I used to approach a doctor, they make you sit in a cabin or something. By that time in the chair, I'll set it up entirely in that way that it will work. I'll sit on that he said, "No, it won't work." I'll show in my laptop then that, see this is working while I'm talking to you right now. So only thing is, we have to just make it more stable and now make it something. So then they get tons of idea, oh wow, this we can do it here there. That's how you're to latch on to it then. But that moment of surprise need to be created as well and it's very important to-

Gaurav Parchani

You wouldn't believe it, Sanjay. Mudit has done it at a wedding also. He put it on three chairs there. Then he met people after dancing or after consuming alcohol or something. You lie down and then now check your vital signs. All you need to do is just lie down-

Sanjay Swamy

I thought he was checking the blood pressure of the groom as he was tying the knot?

Mudit Dandwate

At the end of it, doctors are everywhere, engineers are everywhere. You just have to keep on demoing till we find that-

Sanjay Swamy

That's part of being resourceful entrepreneur. You take all your opportunities, and you don't know when the right one is going to knock at the door. So you go through this sort of phase of validation, and so on. Then what was the aha moment from a healthcare providers perspective for them to realize, Boy, this actually could work and it's a quantum leap to what we have. Measuring vitals of a patient, this is always a task that a nurse has to perform. Now all of a sudden, put this sensor under the mattress, connected to the internet. Lo and behold, I'm getting real-time data from hundreds of beds in the ward. So today, if you fast forward to your sales experience or demo experience. What is the expectation people have and how are they able to and how does it work? What's the process? How do people get convinced?

Mudit Dandwate

So now, the thing that has changed is that they have heard about Dozee one way or other. Either from their peers, or they have read about it something. So they do have some idea that something like this is there, which works in XYZ hospital. At least that level is there. But still, they want to see it in their own practice. Seeing is believing at the end of it. So still how we run the demo and all that, our sales team is entirely prepped. So before becoming a Dozee sales person or Dozee ops person, you need to be entirely trained on Dozee on how to run a demo. So that's still a very important part of it. You asked about the aha moment of that, right? So it still keeps on happening.

But for us, a big breakthrough in this was actually IGGMC, Nagpur, because this was something which proved another thing. Even us, we thought about Dozee as something which was only there for higher resource settings. We were going after top tier hospitals and in the tier one metros, and so on. But in this one place, we got an opportunity where they were very willing to adopt this technology and this was in Nagpur. So tier two city in public hospitals. No internet, no power, close to almost nothing in that setting. The nurse to patient load, like any other. At that point, we actually established a central command center, where six wards were being remotely monitored in more than 150 beds. That single center alone in last six months, has achieved more than 800 successful transfers. Eevery successful transfer is close to touching the life over there.

Sanjay Swamy

A lifesaver.

Mudit Dandwate

Yeah. In fact, that center got even awards, as well for giving that kind of care. In fact, because of such adoption and such forward looking thinking, that center IGGMC, Nagpur, they were able to achieve the best recovery rates in the entire Vidarbha region. In COVID, wave 2, which was one of the worst hit places, not just in India, but globally. Every day, they were getting more than 7000 patients as IPD and they were managing that using technology. So, that really changed our own outlook also, that actually the real impact can be there where we had not even thought about, which is in low resource settings, where we can just create a different level of impact. So that was for me, still when I'm narrating that is still I have response site.

Mudit Dandwate

So every time I think about that, that really changed us as a company, as a founders. How we look at the industry.

Gaurav Parchani

In fact, Mudit was there at ground zero in Nagpur. He stayed there for a few months. He made sure that that center is a success. Then he was himself, basically running the ops and running the show from Dozee side, and delivering all of the data there. There are many aha moments as Mudit said, but one of the aha moment in terms of people that we had spoken to a long time ago as well. They came back during COVID themselves because their inertia to try technology was very low. Because of COVID, they wanted to look at new solutions. They wanted to explore new solutions on how we can minimize healthcare professional infection rates? How we can, let's say, make sure that we have optimized resource utilization? You're not burning out resources, and so on and so forth. How can we have better patient outcomes? We had less number of ICUs. How can we multiply quickly? So they were looking for more solutions and we were just right there.

So I think that was one of the magic eureka moments that where we got this opportunity to serve, and just kind of blossomed into another solution. So really second what Mudit said.

Sanjay Swamy

So as you said, COVID ended up being a huge inflection point for the company. As tragic as the circumstances where ultimately, for Dozee, it was also an opportunity to showcase the value of what you had and to serve and to help the Vidarbha region to have outstanding, relatively speaking outcomes here for the doctors, the nurses, and more importantly, the patients. So tell us a little bit of some of the war stories you all had during COVID? I think it's easy to celebrate the successes but really, you guys and the entire team rose to the challenge, so to speak. I wouldn't say occasion or opportunity, but rose to the challenge and really focused on serving rather than for commercial reasons. Tell us some of those experiences, maybe a couple of anecdotes? How that has changed the trajectory of the company for the longer term as well, in terms of its focused? And there are two parts. One is about the interactions with the clients and all. Gaurav, if you could also talk about what impact it had on the product and how you all had to scale up and so on?

Mudit Dandwate

Sure. Talking about few of the challenges we had, one of the most this stiffest one that I had, was given to me by Dr. Madhuri Kanitkar. She is the highest ranking women officer in the country, and also head of the Armed Forces Medical Services. So her team was tasked to basically erect a step down ICU facility, one of the largest, one of the country in Delhi. The time that they had been given was close to a week. She rang me up and she said, "I have this much time and I need to erect a step down ICU facility. So while beds and everything will be ready, you need to ensure that all the monitoring part is there. We also set up the central monitoring station. The time that I'm giving you for this is three days." Then we were in Bangalore. So close to at where logistics, and everything was close to shut down.

In that time, not just we ensured that it has delivered, but every bed had Dozee. Every bed had monitoring. All the nurses, doctors were trained in three days. Then on the day that she had asked us, we had a pre-demo. So she had given us a timeline of Friday. We gave her a demo on Thursday that see, this is how entirely it is running. From tomorrow, you can just run the entire facility. That was one of the toughest challenges which was given. That was also a big opportunity for us because working with army, that is always something that we all look up to. It is a next level of challenge altogether. But then in certain way, we also took that responsibility of working with the army to have that stuff, call it that we got from ma'am as well that, we actually work like Indian Army. The reason why doctors would sleep in my facility today is because Dozee never sleeps. That ensures quality care is being delivered to everyone.

That was a huge moment for us and also getting something like this from. So second such place was also, based on the success of IGGMC that I had shared, the entire Vidarbha region, we were given tasks to actually scale this up to five more general medical colleges across that region. So not just deploying devices, but even training and all of that. So our team actually rose from being close to a 40 member team to a 180 member team, in a matter of three months in that COVID time. At that time, also ensuring that everyone is aligned on the impact that we are for training them on how to train other people. All of that was done remotely. So other paradigm shift for us as a company was, what was a very high touch point training. Making it entirely digital, running it and scaling it at all the time.

In fact, now that has made us ready to scale up very fast as well. So in a way, all the adversities teach you and they are an opportunity, as we say. It has made Dozee more bullet proof as we have gone along. So those were two anecdotes, which I wanted to share. Gaurav, do you want to talk about how the product changed and tech requirements how they were evolved during that time?

Gaurav Parchani

When I start from the first go, as I said, when COVID started, a lot of people came back to us saying that, can we explore this technology? Which is where a lot of doctors and healthcare professionals felt that, Okay, you have pulse oxygen saturation, which is missing. But you have heart rate and respiratory rate, which is amazing. This will really help us, but if you can add potentially an SpO2 two module, that would really help us. So within days, our hardware team took that challenge. Added that as an accessory. Our supply chain team, they took that as a challenge. We imported and we kind of procured thousands of SpO2 modules in the time where they were going scarce. Attached it to our devices, make sure that they were working and they were all dispatched across the country.

The first installation, I remember which we did was in a stadium like environment in Mumbai. Our team was in Bangalore, who was making these devices. So making sure that when the devices reach there to have all that troubleshooting, and make sure that they work, was again another issue. One of the biggest challenges again, which was not solved with tech, but was solved with logistics was Wi-Fi. In most of these facilities in government, as well as private, the hospital did not have Wi-Fi and where they had, it was not good Wi-Fi. So our devices are facing problems in getting online and making sure that the healthcare professional have access to latest data, live data that is coming in from the patient. So we kind of make sure that we are on our personal Aadhaar numbers and other team members, we got SIM cards, we got dongles. Then we dispatch those numbers until we could procure a bigger batch of these Wi-Fi dongles.

Beyond that, there were always logistic challenges that were always there. For example, we were used to two to three terabytes of raw data coming to our servers every month. Suddenly, we have one we had 15 terabytes or so. Suddenly, we have to be at more than 30 terabytes that month. So that was the peak load. So there have been nights, where we've been fixing things in the background and making sure that the end consumer, which is the healthcare professional, the nurses and the doctors, they are receiving data on time. So 8:00 AM, the nursing report should go at 8:00 AM, should not go beyond that. So that was basically the challenge. We did have hiccups. It was not a perfect system. But then yeah, we managed to close all of them as soon as possible and deliver close to a seamless experience to all the health professions, which was basically which got us more and more installations going ahead.

Mudit Dandwate

So those reports and all of those, these were almost and I remember that time also. I'm almost in a ward outside that and I have writing made it on a paper. I told the team that, this is how the doctors wanted, need to be done it in next few days. That used to be done. That is how the pace of product change and development was. While the scale was increasing almost 10x every month, in terms of that load which was coming to server. So that was another challenge it was there which follows.

Gaurav Parchani

Everything was accelerated. From product development on what type of report is to be made? Mudit was there at the hospital grounds. He took the interview of the doctor okay, this is what we need. You write it down on a piece of paper, sent it to us. Within a couple of days, it was live and reaching the doctor. So the doctor themselves were surprised in terms of the speed, plus everything else. Like, development, management, deployment, testing QA. Everything was accelerated at that point of time. We did not care about structure at all. We did not care about tools. There was no formal. Everything was like, whatever is needed to get the job done as quickly as possible, let's do it. So we were as informal as possible as unstructured, but we made sure that we delivered on time.

Sanjay Swamy

At the same time, I have to add that this is also at a time that what we take for granted is that, the team was learning to work from home. You grew the team from 45 to 180, as you said. So you probably hadn't met, I guess, three fourths of the people during that period of time. They were being on boarded into the product, into the company and hit the ground running with something that was chartered with the responsibility of saving lives of people directly. So it's quite incredible if you look back, I'm sure. Hopefully, we don't have such scenarios. But these are moments that really bond teams together. Tell us a little bit about that part, which is less to do with healthcare and more to do with entrepreneurship. How these adverse moments, it become opportunities and how did you all handle it, and what advice you have for other founders?

Mudit Dandwate

So we have one more thing, which is very native and core to us. Since we are in healthcare and this was also time, and one challenge, which you missed to touch upon, Sanjay. Also, that all of us were also affected personally at one level or other. Everyone's family member, dad, mom. Even people who are being hired, people who are there, everyone was affected as well. That's where it created the second difference, that all of us almost have a positive impact because of this. We encourage every team member to use it. Not just for them, but also for their parents as well, grandparents if that they have that as well. So in fact, when they join Dozee, they get a package of lots of Dozees. So what we also want to instill is that entire feeling of caretaking. Taking care of your own health, taking care of your family's health. That is a feeling which cannot be taught. It needs to be learn on the go. That is our crash course into how you take care of each other. That instills a lot of values about the company and the way we build the culture. A lot is done for caring for others.

There were times when something happened or someone was affected, quickly someone else took up that job and ensured that there was no downtime. That is how we learned it. So the caretaking part is also not just looking at each other's data, but also sharing load, mental health and all of that. When my parents were affected, I left for my hometown. But at that time, business never suffered. Samir, Ritish, Gaurav, all of our team members were right there to share the burden. That is how it happens. That is the core of entrepreneurship, I would say. If we can understand this core value that how to work with each other, how to care for each other? I think that is worth it.

Sanjay Swamy

Gaurav, I'm sure you have some thoughts?

Gaurav Parchani

Sure. I think apart from what Mudit said, I think not just in healthcare, but in any type of entrepreneurship is I think persistence. COVID particularly made sure that a lot of industries suffered, particularly travel and leisure and all of those things. But persistence is something that keeps people going and kind of adaptability. So how do you adapt to it? How do you change pivot quickly? We saw a lot of companies that were into let's say, fabric-based businesses shifted and quickly started making masks, and so on and so forth. So persistence is something that I think both of me and Mudit had talked and touched upon even pre-COVID as well, because as I mentioned previously in our conversation also, hardware is tough in healthcare and hardware combined together is even more tougher. So this is where you require that initial three, three and half years in which is where you need to have that sort of patience and persistence as well, that it is going to work out. Let's keep at it. Let's not let our guard down.

I think that is very, very important. Then apart from that for any entrepreneur to carry on for a long period of time, Mudit briefly touched upon that, an awesome team is required. A couple of guys or one person or two, three people cannot do it. You need a strong team standing at the back supporting each other. This is where I think a crisis like, COVID is also a filtration process as well as you get to easily kind of everything is accelerate. You can easily accelerate. In an accelerated manner, filter people in terms of look at okay, who is aligned with the vision? Who is willing to go the extra mile to get that vision into reality? At the end, that is exactly what matters. So I think the other two things, persistence and strong team, I would say that any entrepreneur, not just in healthcare. Any entrepreneur requires to kind of. These are a couple of things that may lead to success. Obviously, you need a lot of other things as well. But then these are good two core values to have.

Sanjay Swamy

Great. We had the privilege of being associated with you guys, just before I guess COVID started the first wave. Really at that time, had no idea that this product could have a role to play in that. But it just was fascinating to see how the need was there. You guys rose to the occasion without sort of thinking twice about, whether it was the right long term thing to do for the company or not? In hindsight, it ended up being something really good from the long term perspective as well because you all made the product really robust in the process. So looking ahead now, there are multiple opportunities facing the company. There's the entire inward monitoring of patients.

Whether it's for private hospitals or for public hospitals, there is the opportunity to turn every bed into a step down ICU, whether the patient is in the hospital or at home. That is the opportunity to take this product global. Of course, there are certifications and things like that, that need to be done and you all are working on. So maybe Mudit, you can talk about how you see the opportunity space, and what some of the specifics you all are doing for each of the sectors? Then Gaurav, maybe we can come back to you and you can talk a little bit about this whole certification process that intimidates any healthcare technology entrepreneur and how you all see it. So we'll start with Mudit and then I'll come back to you, Gaurav.

Mudit Dandwate

So opportunity is huge. It's a loaded gun. That's the phrase that I have actually picked up from one of the top cardiologists while I was speaking to him. So he was saying that India and the world is a loaded gun today because every year, we are adding close to 20 million new cardiac patients, and only 152 cardiologist. How are we supposed to take care of them without technology?

Sanjay Swamy

Can you repeat that number, again? 20 million new patients and an incremental 152 cardiologist specialists?

Mudit Dandwate

Right. This number is, I'm giving you a very specific one segment number but this is true for a lot. Diabetes, just pick it up. How many diabetologist we are adding? Close to 200. How many diabetes patients? Close to 30 million. Those are the numbers and I might be off. In diabetes, I might be off because I don't look at that one. Cardiac, sleep and all those-

This is India, but this is true. With elderly care and with elderly population growing like anything all across the world, these numbers are only growing. Second thing is that so far, last two decades, the world and healthcare has really done well in intervention. So there are three phases to care. First is prevention. Second is intervention, and third is management. Prevention is, don't let it happen. After it has happened, intervene and stop that. When it is there, then manage it so that it doesn't escalate further. So when the intervention has done really well, right now aortic valve replacement is like any other surgery. Anything that is happening like, just about anything. But when the valve replacement happens, that person needs to take care of their health for next 5 to 10 years till they are their. That's the huge market, which is over their. I don't want to talk in billions and billions over their but it's a huge number.

Secondly, and this is only growing as the elderly population is also increasing. So it's a huge opportunity. Second, you're going to talking about the second India trend now. India's dependency on medical devices and supplies, close to about 90% of medical devices that we import. Just imagine if we’re really talking AtmaNirbhar, as in how is it even possible that 90% of a big, a very important vertical we are importing? That's the opportunity over there. Even if me and Gaurav spend our lifetime also, still that I think opportunity is there for going after. That's why we believe that this is the one that we are entirely committed to. In fact, and I'll briefly touch upon one more initiative that we have taken right now that, we have to also scale this up very quickly. We have realized that what is the impact that what we have created, has on even public health care? MillionICU. So that is an initiative that we actually took during COVID times. But the idea was that, healthcare infrastructure is not ready for taking up the load, which is there. The loaded gun phrase, which I used.

So we have to quickly scale this up, unluckily, we don't have time for doing this. Our vision is that every bed should have quality care. Be it private hospital, be it public hospital. India like country and across as well, there should be at least a million ICU beds, in which quality care is delivered continuously, regardless of what kind of human resources are being committed towards it. Human resources are never going to be enough. We have to take care of a lot of people. So that's what the healthcare is about now. So that's what I'm looking forward to creating that.

Sanjay Swamy

Tell us a little bit about, it maybe another level of detail about MillionICU? Do you came up with a really creative way to fund the use of Dozee for public hospitals? Maybe you can explain that a little bit for our audiences.

Mudit Dandwate

So MillionICU, that's basically a concept for quick adoption across in public healthcare settings. In a way, giving a kind of accelerated trials in public health care setting, so that they can quickly evaluate the technology, and then adopt it in their day-to-day usage. So in that, not just we implement the devices, removing all the otherwise very painful processes of procurement and all of those. Removing them and then going about training, adoption and then really creating that value of saving lives, improving the efficiency and digitizing this entire system. When that the system realizes, then automatically the higher adoption happens. That is the concept, which is the MillionICU wants.

Sanjay Swamy

How is it financed?

Mudit Dandwate

So it is finance through foundations, CSR Purposes of Corporates. These foundations and corporates basically contribute for initial adoption of the technology. Once the value is realized, then the hospital takes over and then it continues. So it is also very sustainable way of adopting any new technology as well.

Sanjay Swamy

And because it's a IoT connected device enabling the bed, you can provide what should be real-time reports and things that even to the donor ecosystem?

Mudit Dandwate

Absolutely right. Yeah, that's one of the things that, our donors love the transparency that we provide. In fact, our every donor also gets a dashboard, where they can see what is the impact of the money that they have donated almost in a near real-time as well. How many nursing hours? How many successful transfers have been achieved? How many patients have been monitored? How many hospitals it has been deployed across and all that?

Sanjay Swamy

Great. So I'll switch gears to Gaurav a little bit here. The moment you're talking about healthcare and data and crunching data and coming up with insights and things like that, obviously, the positive side is that we're able to get better outcomes and achieve a lot of that with scale like never before. Yet, the world as you look at in all other aspects, people are genuinely concerned and rightfully so about data privacy issues. Some of this is super sensitive information. Not to mention that, does this actually work properly? There are organizations like, the FDA and others that need to first of all, certify that it works. Then secondly, does it meet all the privacy standards? Especially with things like GDPR and Europe and India's Data Privacy Act and everybody getting sensitive. How have you all thought about it, and how is it baked into your architecture and how do you see yourself addressing both of these dimensions?

Gaurav Parchani

It's a very big and a valid question for any entrepreneur in a related space. If you look at the regulatory as an infrastructure and in combined together, it asks four to five different questions. The first and foremost is patient safety. If you have a hardware component in there, is the patient physical security compromised or not? Is there any issue that a device is going to cause that? So there are separate regulations and certifications for that. One of the ones that we've done is IEC 60601, which involves fire safety, which involves electrostatic, EMI/EMC, electromagnetic radiation, RF emissions, and so on so forth, which is where we prove that the device is very safe to use. All the values that I spoke about, of all the tests are within the control range. It's very safe to go into a hospital environment and then even the home environment of the user and can go on as a medical device.

The second question that comes is basically, is your data secure enough or not? Which is where data security whether it's in a hardware, whether it's in the cloud, wherever it is, is it secure enough or not? Which is where regulations and certifications like, ISO 27001, and the other ones come into picture. The next question that comes is, have you considered data privacy, while making your architecture or not? Do relevant people have access to data or can there be a leak of data privacy or can there be an abuse of it or not? Which is where exactly multiple regulations, you can actually prove it from ISO 27017, GDPR standards, HIPAA standards, where these apply directly.

Gaurav Parchani

Using these standards, you can actually test your system and get third party. Like, TÜV, BSI and other reputed agencies to do an audit of a system and give you a full report in terms of how compliant or how not compliant you are? So that you can take corrective actions post that. These are the three major important questions that start. But then post that, is when the tricky part begins, which is exactly where your risk benefit and your claims. All of these are put in a metrics and analyzed whether it's a good enough product to go into the market or not, depending on the geography.

So India has CDSCO, US has FDA. These are the bodies that analyze all of that. So they take an application on a case-to case-basis. There are multiple ways to go through each one of them. So for example, to go to FDA, you have two different strategies. Let's say, this is an innovative product and you say that, "Okay, none of this technology exists before." There's a de novo approach, where you have to prove that my claims and my benefits are aligned. Plus, the benefits are significantly outweighing the risk. So it is worthy enough to go into the field. Now for this, you need to do a usability study. You need to do a clinical trial to prove this case. So it's almost like, a fight a case in a court and you need to prove it. Then so that they give you an approval that you can go ahead and market it.

Similarly, the other approach is, let's say there is a similar product. Can you prove equivalence or prove non-inferiority to these products? If yes, then FDA has given them an approval. So you should buy that logic of induction, you should also get approval. So that's one of the way as well. Then based on this metrics, it's also analyzed on which category do you fall in? The Class A, B, C. A, being the least risk. B, being the moderate risk and C, being the highest risk. So they take the applications on a case-by-case basis. A's face with least amount of scrutiny and C the highest. So that's how long you can say that the application will go. Dozee falls in Class B category. So we expect a moderate pain while going through this process and all of those things. Similar is the structure for CDSCO here in India, where all devices now starting October 1, 2021, have to be registered with CDSCO in India, whether they are regulated or not regulated.

Next year onwards, everybody has to get a license, which is why license involves the classification of the device. Class A,B,C. So these bodies fall into that where they analyze your risk benefit and your claims and, see if everything is matching or not and if the product is worthy enough to go to market or not. The last one that comes in, which is a very good to have in, which is actually a prerequisite on the FDA and CDSCO one, is your process hygiene, are the processes in your company. This is not a product certification. This goes to the company level. Other processes in your company, built with good hygiene or not? Are they fail-safe or not? Are there backups or not? What is the procedure for let's say, if there are any claims, or if there are any failures in the field?

So these are ISO 13485, particularly for medical devices. For non-medical devices and non-medical companies, it's ISO 9001. But more scrutiny involved 9001 converge into 13485. You have similar versions of it covered in every geographies law. So India has MDR 2017, which is medical device rules. Europe has MDR 2017, which is European Union medical device rules. US has 21 CFR, which is basically their set of rules which are very well-aligned. If you go for a comprehensive ISO 134845, that satisfies all of them, which is basically a company's hygienic. So start from the first question, is your device safe to use? Are you handling data really well or not? Is privacy taken care of or not? Is your risk minimal and your benefit outweighs it? Are your claims in line with your benefit or not? Finally, your company's hygiene or compliant to the hygiene processes or not?

If you tick all of these five questions, then you're good to go and good to sell, good to scale up and good to market.

Mudit Dandwate

In a nutshell, what Gaurav is saying he's doing a very complicated job.

Sanjay Swamy

Actually, I like the way you simplify it at the end

Gaurav Parchani

Is these five questions that you need to answer? If you're answering them well, and you have justifications for each one of them, all of these agencies where I spoke about FDA, CDSCO, the third party regulatory agencies, BSI and TÜV and all of those guys. They only look for, whether you're compliant and whether you have justifiable answers for each of their question or not?Not just answers, evidence is also.

Sanjay Swamy

Great. So I'm going to close. It could go on and all things that are already well beyond longest podcast. But with two guests, people are going to enjoy the discussion. Two quick questions, or one last question for both of you. I guess two questions. One is, if you had not started Dozee, what would you see yourself doing? The related question is, what do you guys do for fun?

Mudit Dandwate

So I would have been a Formula One engineer. That is how I think. What we have for fun? As we have dogs, we go to dog trail, cycling, hiking. I think that is where both os us also take off very well, because you know? What is this off work also, we really shared that interest. Now it is required actually to keep up with each other.

Sanjay Swamy

Gaurav, you're welcome to say different things.

Gaurav Parchani

So it's very difficult to pinpoint on what I would have been, if not for Dozee. I was kind of lost in lot of options when Mudit came and approached me that, let's do this. That gave me purpose, actually. That gives me meaning to my skills and my effort. But if not Dozee, it is very difficult, but there is a good chance that I would have returned back to academia. Gone for a PhD or become a professor somewhere, something like that. That would have been the idea. But I can't imagine it any other way now. So I think I'm very happy and content where we are, and looking forward to go in this direction. Apart from what Mudit said, in terms of dogs and tracking, and all of those things. Two additions. That was one is basically cooking and eating together. That's one. Then bike ride. So I have a good motorbike. Whenever I get free time, I try to kind of hop onto it, and then go and just plug off.

Sanjay Swamy

Great. Do you guys have anything else you'd like to add?

Mudit Dandwate

So I have a question for you, Sanjay. Related to the entire topic of healthcare and I think you did touch upon that. Since you are a Fin-tech guru and this really the inflection point of this entire payments adoption was the demonetization movement, which happened. So yesterday, I had actually shared one video with you of that, you know. The payment of the Diwali on a cow. So we reached that level now. There is no cash. Even for the smallest of thing, you're looking for Paytm now. That is Paytm, PhonePe and all of these that has become the norm. Do you think that for health care, the shook up that happened for the world with this COVID. COVID was that inflection time and or we are again, going to go back to that same old normal of not caring about our health and still being very blind about healthcare per se.

Sanjay Swamy

So actually, I would say that even for the financial services sector, really, unfortunately, COVID was the real trigger. I think demonetization kind of people learned about this whole new way of doing things. But then once the cash came back, people broadly went back to that. It was an education moment, but not sort of a forcing function. As much as COVID has been sadly very tragic for all of us in many ways. If there is a silver lining, it's that this whole idea that digital can actually address a lot of the issues. For the digital ecosystem, the world has been fast tracked by five years, at least. I don't think billions of dollars of marketing and education could have done what COVID has done for this. So it's sort of a bittersweet obviously. Obviously, we would have been happier had it not happened in some ways. But I think the world has learned that there are benefits, whether it is to digital payments, whether it's through telemedicine. Whether it's allowing people to work from wherever they are comfortable working and creating the future of work environment, which will be a hybrid environment.

You've seen several other new announcements coming out in the ways people are doing things. I think people now will be open to saying, the age old ways in which we were doing things are not necessarily better. That the newer ways might actually be better from an outcome perspective, from a results perspective. I think people will be less rigid about doing things in a very specific way. That's what we're seeing here. Whether it's the Dozee or we're also investors in Mfine in the healthcare space. Of course, we're seeing this in financial services in droves. We're seeing this across the board. I think you needed to go and meet customers in the past. But now, even if you go physically and in the same town, you're expecting to have a either a Zoom call or a Google Meet or what have you. So those boundaries have been broken down. So even the way you guys are approaching your FDA approval, you're not physically going and sitting in the US.

But I'm sure 24 months ago, you would have just gotten on the plane and sat there. It may be slightly inefficient in a few ways. But overall, the productivity will probably just go through the roof over a period of time. So yes, it is in many ways, I think it's going to be a moment like, I would say in my generation, I've seen 9/11 as a similar moment, where I think we had a certain mindset before and post that. We had a different thing. It's sad that having mankind, we tend to react to some of these negative moments and come out stronger but that's true with adversity. I think even in startups, even in our personal lives, adversity is really what forces us to think better. But I'm very bullish about the opportunity moving forward. So I think we are going to see a take off point from here, solutions from India, solutions for India, as you guys are working on. Really kudos to you guys for having gone through this amazing rollercoaster of a ride.

Hopefully from now on, I'm sure it will be still a roller coaster, but it'll be mostly trending in the right direction. Wish you all the best in the journey end.

Gaurav Parchani

I had one last question.

Sanjay Swamy

Sure.

Gaurav Parchani

This is not healthcare related. I'm sure you've seen companies go from zero to one, I think you've been a founder yourself. You've also seen companies go from 1 to 100. It is fair to say that in most cases, beyond 100 as well-

Sanjay Swamy

I've also seen companies go from one to zero, by the way. It's quite painful.

Gaurav Parchani

It is also very valuable period for sure. So in your experience, what is the common feature that the company is ranked in the right direction that made them hyper scalable? What was one common feature if you are going to point that out? Even more than one I would be happy, but at least one?

Sanjay Swamy

So I think the founders self-conviction. That cannot change over time. What we're really seeing are founders like yourself, who kind of have seen the future before us. Believing in it even though in between there will be people who don't believe in that and your ability to paint the future. Over a period of time, it becomes clearer and clearer to you yourselves as to how you're going to get there? But there is no doubt in your mind as to what there you're going to get to? If anything the future is probably a thousand times bigger than you, yourself had imagined? I think that really is.

If you think about folks like, Elon Musk and the others as well, they're seeing things that others had just not seen. People think that they're crazy, they're silly, they're whatever because people are not able to visualize what they're able to visualize. So that's one. But then coupling that with the grounded execution along the way and some calculated risk taking. I think those are probably the three common factors here. But along with that, it's obviously team building, making sure you get the right people on your side. So the empathy for them, et cetera. These are all things that are arrows in the quiver everybody needs to have. But none of that will work if there's no clarity of thought on the founders side as to where they want the world to go. Thanks guys. Enjoyed the conversation and look forward to publishing this. I'm sure, Gaurav is probably going to get a lot of questions from others, who are looking at the whole certification space. I guess you'll have to pay it forward with some free consulting with a lot of young entrepreneurs. But amazing work you all have done so far over the years. Kudos.

Gaurav Parchani

Thank you, Sanjay.

Mudit Dandwate

Thank you.

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