This Healthtech Platform Is Connecting Patients, Insurers And Hospitals Dr Suman Katragadda, founder, HEAPS.ai, details his journey into healthcare and the company's future

Dr Suman Katragadda, who is a PhD holder in statistics from the University of Tennessee, Knoxville, steadily climbed the corporate ladder and was working with PricewaterhouseCoopers as a director leading healthcare and AI strategy, back in 2016. His core competencies at the time were in dealing with healthcare companies and hospitals, setting up data science centres for hospitals and introducing a digital transformation in the space. While working, Katragada realised that there are certain loopholes in the space that needed a fix.

"I wanted to solve a major problem in the healthcare ecosystem, being the patients, the payers (healthcare insurance companies) and the providers (hospitals), the key stakeholders in the entire transaction, are disconnected. They don't talk to each other. Because of this disconnectedness, you don't have information transparency and no accountability in healthcare, which leads to trust issue," he told Entrepreneur India.

He further elaborates that in healthcare, whatever data is captured--transaction of patients, insurance providers, and hospitals--is completely unstructured and not ready to be used. This, he says, is a global phenomenon. Because of the unsorted nature of the healthcare data, an opportunity to treat the patient comprehensively, that is, give them a holistic treatment, and identification of potential care gaps and hence, intervention at the right time, is lost. Katragadda had a first-hand experience of this issue when he suffered a lapse in post-operative care while recovering from a surgery.

In late 2020s, he ventured into the healthcare space and bridge the gap in after-surgery healthcare himself with HEAPS.ai. "Securing the right kind of entry into the healthcare channel was very important for us. We realised that the best way to gain trust here would be where we can play an end to end journey role for the patient. We didn't want to go through a second opinion or an appointment channel. We basically thought that if we want to record end outcome of a patient, we need to enter through the back door, the back channel of the data on their clinical history. We have to track every detail of the patient after discharge, going through OPDs, advisors, surgeries etc. and figuring out exactly what issues could arise in the future," Katragadda explains.

The US-based Katragadda ventured back home to India to set up his entrepreneurial venture. The reason: data in India is easier to access. "Getting the data to establish the business would have been a nightmarish proposition in the US. In India, collection of the required data is easy, keeping in mind the principles of data confidentially. We are in the business of building trust and hence are not owners but custodians of the data. So, we want to ensure that security and confidentiality is met according to the security protocols of the country that we are operating in," he explains.

After initial pilot projects, Katragadda and his team at HEAPS.ai recognised that in order to make an impact, they need to find a way to optimise cost without compromising on the quality of care. For this purpose, integration of all the players is essential.

"I would think that the entire future of the Indian system has to depend on an integrated system in the future. I cannot imagine the current system to be smooth in the long run," he exclaims.

The journey of integrating the healthcare players on a single platform has not been easy for HEAPS.ai, since it's running a one of its kind business in the space. Katragadda shares that onboarding hospitals and insurance companies with HEAPS.ai and introducing the concept of value-based care has been one of the biggest challenges the company faces.

"Initially, hospitals outright said that we don't need an external intervention in recording the outcomes of a patient's engagement with them. "We have the best quality of doctors. You don't need to be worried for the patient receiving the best health support post surgeries,' was the common response we got. However, we were not worried about getting rejected at this stage," he outlines.

Katragadda took a different approach in onboarding both the parties since the company's inception. He says that the first thing HEAPS looks for in a partner hospital's outlook is whether they have a revenue-first or quality-first approach towards healthcare. "I on-board hospitals by picking those whose owners think of improving their quality of treatment. We tell them to treat on-boarding with us as an investment for about six months and it will pay off gradually," he explains.

He also understood that insurance companies may not completely know the concept behind HEAPS, as many haven't heard of value-based care in India. "In the initial months, we have been educating the insurance companies about the basic concepts of value-based healthcare. Eventually, we got one signup, then two, and now we have about 12 insurance companies on-board with us. Further, about 40-50 hospitals are with us pan-India," he shares.

HEAPS.ai has gradually built a healthtech SaaS platform which leverages advanced data analytics, artificial intelligence and machine learning to revolutionize healthcare delivery and payments model by building a "healthcare network' and a "value-based care' model. The startup secured $7.45 million in a Series A funding earlier this year.

However, getting investors on-board wasn't an easy feat, Katragadda explains, "When it was at a concept stage, we didn't really get interest from big investors. We had been in discussions with established VCs and investment bankers in early 2021, got rejected initially. Investors said that the concept was good but doubted whether it will work in India. We didn't have scale. Recent Series A only happened when we were able to demonstrate that the business was scalable in India and when we were able to give a reasonable degree of confidence to investors that this is an under-explored segment in the healthcare business and is worth exploring."

Now, with funding, HEAPS.ai is planning to expand the team to 15 employees in a bid to reach and on-board 300 hospitals by the end of this year. "By 2023 we will be able to get about 500-600 hospitals onboard," Katragadda asserts. The team also wishes to on-board 80 per cent of insurance companies on its platform.

HEAPS is also planning on expanding operations to other countries. Katragadda shares that the company has already started making initial footprints in the Middle East in April, is in the pipeline development stage in the US, and is closing a few clients there. However, they are more focused on expanding operations in India this year, making it a more scalable business in the country.

Katragadda advises fellow entrepreneurs entering the healthcare space in India to not focus on building solutions to temporarily patch a small gap in healthcare but focus on building solutions to transform how healthcare is being operated in India. "That is where I see opportunity and sustainability," he concludes.