Nilkunj Dodhia, CEO of Macusoft, one of the innovators currently on the DigitalHealth.London Accelerator programme, writes about work the company is doing in India that has saved the sight of over 120 people in the last three months, and how this has impacted their work in the UK…
237 million people globally suffer from Macular Degeneration (MD), the leading cause of sight loss in the developed world. MD causes rapid and devastating sight loss if not treated quickly. Both longer life-expectancy and the diabetes epidemic are leading to soaring global demand for Macular Disease cases (7.3% Cumulative Annual Growth Rate), with health systems struggling to cope. Affecting a staggering 1.6 million of the UK’s population, hospital departments are becoming overwhelmed, leading to delays and an increase in cases of sight loss.
For someone with Macular Degeneration, the current standard of care means that they have up to 12 appointments a year with an eye doctor and have around seven or eight injections. Patients need this care for life.
Rising demand and costs are overwhelming health systems and hospitals are struggling to provide the number of appointments necessary leading to delays in treatment. A study found that eight out of 10 patients for whom treatment is delayed will suffer sight loss, of which a third were registered sight-impaired (Foot & McEwan, 2017).
What does Macusoft do?
Macusoft assimilates clinical and patient data to recommend personalised treatment plans for eye patients for the best outcome. The software constantly learns from the information collected so that the best evidence-based decisions are made. It can determine whether the patient’s eye is stable or not without them having to see the eye doctors at every visit. This enables more patients to be seen and treated, in and out-of-hospital, creating much needed capacity for health systems.
Macusoft in India
India is the global epicenter of diabetes with approximately 77 million people living with the condition (International Diabetes Federation). There are many complications for people living with diabetes, but blindness is one that is often avoidable. Diabetic Retinopathy is the leading cause of blindness of the working age population in India, however, most of these cases can be prevented. But eye-screening services are virtually non-existent in rural India. This means problems are not detected early enough and that leads to hundreds of people becoming blind unnecessarily.
We wanted to apply our technology to make an impact to these statistics, and developed RetinaSense, supported by Innovate UK. In partnership with The Vision Academy, a local NGO, Macusoft deployed eye-screening pop-up camps using AI enabled mobile-phone technology. The ‘War Against Diabetic Blindness’ programme was launched in the state of Madhya Pradesh, covering 7.3 million people in villages surrounding the city of Bhopal.
The pop-up camps are set up temporarily for the day in small towns and villages, and diabetic patients are called to the camp by press notices, local healthcare providers and through directly contacting known diabetic patients. Camp teams travel to the site to set-up in the morning and can begin screening immediately. Camps last between four to five hours depending on the number of patients and a rolling programme ensures patients can be followed up at the same location at a future camp.
Typically, these diabetic eye screening camps see 100-150 patients, of which a quarter present with diabetic retinopathy previously undiagnosed, and eight percent present with sight-threatening disease if not treated urgently. In three months, the programme screened over 1,500 patients and has potentially preserved the sight of over 120 patients.
Besides eye-screening, the camps provide education to patients on diabetes self-management to defer the onset of eye disease, among other diabetes-related conditions.
The India project has been a success and has been extended for an additional 12 months. However, the COVID-19 pandemic has resulted in an abrupt national lockdown that has affected service delivery for the immediate future. We hope to be able to continue our work in India where we have plans to expand virtual out-of-hospital eye screening provision.
Macusoft in the UK
Macusoft’s MacuSense product is currently being trialed in the NHS. By overcoming the challenges in the provision of affordable and accessible rural healthcare in India, Macusoft is able to apply the learning to the NHS to deliver eye disease care more efficiently and at scale to meet current and future demand.
The impact of managing the COVID-19 pandemic on the UK NHS is forcing non-COVID healthcare services to be delivered online and virtually due to the pressure on the system. This scenario underpins Macusoft’s vision for service delivery, using technology to deliver high quality care that is convenient for patients, at lower cost.
We hope the change brought about by the pandemic will shape the future of healthcare delivery for the better, and lessons from this, as well as from our work in India, will ensure we continue to grow to deliver the best outcomes for patients, staff and healthcare systems.