Pensions, market-linked insurance schemes and retirement plans cover a small subset of the population in India. For millions of elders, Government social protection programs and family support continue to be the lifelines, and keep them away from old age poverty.
Do we truly understand the multi-dimensionality of the longevity challenge?
What are the financial and social costs of longevity?
Are our social protection schemes addressing more contemporary needs?
Have pension reforms been meaningful in the Indian context?
In this essay, I look at the Indian experience and pension reforms from the lens of accumalating longevity risks.
The Silver Angels newsletter brings you news, stories and trends from the silver economy in India, in a short, easy-to-read format. Businesses, brands, investors, startups, researchers and analysts following this space are likely to find it interesting.
Silver Angels is an independent platform tracking the Silver Economy in India with focus on ageing journeys, longevity impacts and seniorcare. You can find more information on www.silverangels.in
Aamod Wagh is Pune-based founder of Tigertech Labs and Rhemos Health, with a career spanning 25 years in IT Consulting across Australasia, Europe, and USA. Tigertech Labs was setup in 2016 upon his return to India to develop remote health and safety monitoring devices for senior and dementia care. TigerTech also transitioned to Telehealth in 2019 with RHEMOS – an acronym for Remote Health Monitoring System – to deliver hospital grade care at home using affordable & easy to use medical devices.
Today, Aamod and his team serve over two lakh customers every month and their products are available through their website and also on e-commerce portals like Seniority. RHEMOS also works directly with 100+ hospitals, seniorcare companies, rural care foundations & telemedicine companies to further the mission of providing digital and remote health solutions to all, across the country.
Aamod, it was pleasure speaking with you earlier. Tell us a little bit about how you ended up creating Tigertech Labs. What triggered your decision?
I was based in the US for an extended period of time and would travel to India once a month for business. During every trip, I couldn’t help notice that a significant number of seniors in India lived alone, as their children were in another city or country and had little or no family support locally. It was also apparent that – while western countries had significant number of products and solutions available for assisted living & senior care, the same was missing in India. That was the spark that ignited the fire and the genesis of TigerTech.
You started with smart living solutions. How has this journey evolved and what are your core solutions today?
For us “smart living” encompasses personal safety, security & health and all our technology solutions resonate around this thought.
We launched India’s first senior care wearable devices called TigerTRACK & TigerFIT Pro. These were loaded with features & designed to provide 24X7 location tracking, automatic alerts on fall detection, SoS button, built-in cell phone, anti-wander sensors, monitors for heart rate & blood pressure and also instantly send alerts if an emergency is detected or if the user exits their home. The devices are designed to work independently and without any user interaction and can be monitored and controlled remotely by family and/or caregivers through an App.
Our products were welcomed with open arms by customers & we work with some of India’s largest senior care & home care companies, who use our devices to provide emergency support and care services to seniors across the country.
While our wearable products continue to do well, we also found that 70% of our seniors suffer from NCD’s like diabetes & hypertension and need to receive quality care at home. This got us exploring the possibility of providing high quality healthcare in the comfort of people’s homes and adding the benefit of remote health monitoring by doctors. This was the genesis of our RHEMOS Health product.
Today RHEMOS Health enables patients to receive “hospital grade” care at any location – in their homes and also in remote villages – without the presence of doctors or medical professionals. RHEMOS devices can measure 8 to 16 critical vitals within minutes using touch sensors. The smart technology also transmits the results instantly to an App & Cloud for remote access by doctors so that they can provide an accurate diagnosis & prescribe appropriate medications. RHEMOS also analyses all the vitals and generates a “health score” for each user to ensure that any preventive health indicators are provided well in time.
RHEMOS’s mission is to provide easy and affordable access to high quality healthcare at any location, for all and we are proud to have met and exceeded our mission.
You develop medical-grade devices for remote and digital health, including wearables. The overall awareness among consumers is still not as high and there is a lot of false advertising too. If I were purchasing a wearable device for an older family member, what should I look out for?
For wearable devices – especially for seniors – the most critical points to consider are (a) the size/weight & “wearability” of the device, (b) the ability of the device to do its job as an independent and stand-alone device. i.e. it should have zero dependency on the user carrying a cell phone, etc. and (c) ease of use including having little or no interaction with the device or technology – except pushing a button in case of emergency. All these factors determine whether seniors will use the device regularly.
For medical devices, the most critical point to consider when getting any medical device is that it should have at least 1 international certification – viz. CE-MED and/or FDA. These are mandatory for selling the devices in any EU country and in N. America. The rigor, dependability & accuracy of their certification processes ensures that the CE-MED certification is also acceptable across almost all other countries.
Other important points to consider for medical devices include (a) the ease of use, (b) whether the device is internet connected and automatically shares test results with your Doctor or your family, and (c) whether it can handle multi-functions to measure 7 to 8 vitals rather than having to buy 7 to 8 separate devices to do the same tests and finally (d) does the device provide any value added information after testing your vitals, that assists you in keeping a track of your daily health and provides you with any early warning information for preventive care.
What is Rhemos? How does it work? What parameters does it help measure? How can this information be used?
RHEMOS is an acronym for Remote Health Monitoring System. Its mission is “Healthcare. Anywhere” and its vision is to enable easy access to affordable & personalized care to all Indians at any location.
RHEMOS Health Ecosystem combines portable hand-held medical devices with an App/Cloud & health analytics to provide a comprehensive telehealth solution. The devices can be taken to any location to measure 8 to 16 vitals with hospital grade accuracy & transmits them instantly to All/Cloud for remote access by Doctors to conduct an accurate diagnosis.
The health monitor is a single pocket-size device that measures 8 vitals in 2.5 seconds. These include BP, Heart rate, ECG, Heart rate variability, Respiratory rate, Blood oxygen, Body temperature & blood glucose. Rhemos also provides small blood analyzers to conduct blood tests for Haemoglobin, HbA1c & Lipids at home in minutes and our digital stethoscope measures heart & lung sounds. All readings are instantly transmitted to remote doctors with alerts in case readings are abnormal. This allows people with chronic conditions like Diabetes, Hypertension or Cardiovascular disease to test & monitor themselves at home – while being monitored remotely by family & by their physicians.
I understand you work with the rural health system. Can you tell us how your solutions impact rural health?
RHEMOS identified some of the biggest issues faced by care providers in delivering healthcare to rural India. Some included availability of qualified doctors, nurses, medical infrastructure, power, wifi, vitals testing capabilities, etc. Also many rural hospitals face high traffic of 500-1000 patients a day which is difficult to manage. Finally, the biggest health issues in rural India are inability to detect comorbidities & NCD’s like diabetes & hypertension and women’s & children health issues like anaemia, pre/post-natal care. The RHEMOS solution was then designed to directly address each one of these issues.
RHEMOS does not need power or wifi and can be used by ASHA workers to check vitals for each patient – including blood tests & chest sounds. This ensures that hospital grade care can now be delivered to the deepest parts of the country even without presence of local doctors & nurses as remote doctors can now take care of patients & prescribe medications. A single RHEMOS device can handle 150-170 patients/day to handle high traffic. And, the multiplicity of tests conducted by RHEMOS also ensures easy identification of most comorbidities to enable personalized care & also conducts detection camps for diabetes, hypertension, anaemia, etc.
You mentioned that you partner with seniorcare organizations. How do these partnerships impact the quality of life of the end customer?
Many senior care organizations leverage our technology to provide their customers with additional services based on our devices. E.g. they run emergency response services that are connected to our devices and monitor all location alerts, fall alerts, health condition alerts and provide timely response services. The end customers and their families can now live with complete peace of mind that their lives are secure and that – if required – help is literally a click away.
It has been 8 years in this journey for you. How has the landscape changed? What are the trends that you observe today?
When we launched our products 6 years ago in 2016, the senior care & eldercare sector was just about starting to gather steam, and senior care products were limited to grab bars & wheelchairs. We were the pioneers in leveraging wearable technology to bring safety & health to our seniors in India. Also when it came to healthcare, telemedicine was a just glorified video call & most doctors & patients insisted on physical examinations as the only way of good treatment.
Today – especially post pandemic – the home care, senior care & telehealth sector has mushroomed and is now being accepted as mainstream by doctors & patients both. Also the awareness about using technology & the availability of products like ours has increased multi-fold.
People have started to recognize that products like RHEMOS plug the gaps that exist in telemedicine today and can ensure that telemedicine can actually provide comprehensive care remotely.
You can order these products from the Tigertech website and learn more about RHEMOS here.
The newsletter brings you news, stories and trends from the silver economy in India, in a short, easy-to-read format. Businesses, brands, investors, startups, researchers and analysts following this space are likely to find it interesting.
The Silver Angels newsletter brings you news, stories and trends from the silver economy in India, in a short, easy-to-read format. Businesses, brands, investors, startups, researchers and analysts following this space are likely to find it interesting.
Silver Angels is an independent platform tracking the Silver Economy in India with focus on ageing journeys, longevity impacts and seniorcare. You can find more information on www.silverangels.in
Chirag Shah is 26 years old and co-founder of Rymo, which is on a mission to transform India’s rehabilitative care infrastructure. Chirag and his team are building robotic solutions focused on rehabilitative care and their first product “Mobi-L” is also India’s first robotic and VR based technology for upper and lower limb rehabilitation.
I had the opportunity to chat with Chirag on this very unique product journey that is filled with passion, learning and experimentation.
Chirag, pleasure to connect. Tell me a little bit about yourself and the journey so far. How big is your team?
Hello Mahesh, glad to connect with you and Silver Angels. I am an electronics and telecommunication engineer and during college was fascinated by the potential of robotic technology in improving human lives.
A visit to our neighbouring physiotherapy college gave me a chance to see the difficulty of patients with limited physical mobility and turned out to be a tipping point. That day, I decided to use my engineering skills, time and efforts to build something useful for physiotherapists and the patients undergoing physiotherapy and help physiotherapists in their effort to spread the joy of independence and good health.
A small research project which we started back in 2018 slowly matured into a product with the help of 250+ physiotherapists and occupational therapists whom we spoke to better understood the problems various stakeholders in the rehabilitation ecosystem face.
Going forward with Rymo and our team comprising 8 members we aim to make the best and most advanced rehabilitation tools accessible for every patient undergoing rehabilitation and increase their chances of living an independent life.
Why rehabilitation? How big is this market as you see from your vantage point? Who is your primary user – physiotherapist, family member or the patient?
In the initial phases of development, we got a chance to visit 100+ physical rehabilitation centres in 6 different cities. One of the learnings for us was that majority of the patients undergoing rehabilitation visit private physiotherapy clinics and a small minority go to larger centres in big hospitals. As big hospitals have more space and higher budgets some of them are able to provide technology aided rehabilitation which helps in faster recovery.
As per our research there are 10,000+ rehabilitation centres in India and less than 1% of these rehabilitation centres can accommodate imported robotic solutions due to the which there is a huge gap in the market which can be filled by a portable and affordable rehabilitation solution like Mobi-L.
Mobi-L’s primary beneficiary is the patient who is undergoing rehabilitation. Our solution makes it possible for the patient to measure their recovery objectively, have fun while exercising and also recover faster due to increased compliance and high intensity rehabilitation sessions which Mobi-L can facilitate.
R&D, prototyping and assembling – everything is being done in-house. What has been your learning on this front?
R&D, prototyping and assembling in-house has proved to be of great benefit for us. It has allowed us to keep listening to our user’s feedback and have the bandwidth to keep improving the product.
We have so far made 7+ major electromechanical iterations and 50+ software updates for our users. This has also helped us zero down on the most important features which will become a part of our final iteration before a nation-wide launch.
The long-term advantage for Rymo is that we now have a diverse engineering team with expertise in mechanics, electronics, robotics, software and game development and this allows us to continue to innovate, learn and grow.
Rymo office in Mumbai
Rymo’s software toolkit includes an Android-based app, games and much more. Can you expand why this is important? How does it improve the overall experience of the user?
Our software toolkit was built for Android with the objective of making operation of the device intuitive and minimize training required for the same. As most individuals are comfortable with using smartphones our software toolkit which runs on a 10.1inch Android Tablet can be used very easily.
The software ensures that the physiotherapist and patient get continuous visual and audio feedback while exercising. This not only makes the rehabilitation session goal based and measurable but also keeps the patient motivated to comply to the rehab session as prescribed.
The software toolkit also has multiple games and simulations of various activities of daily living which further make the rehab sessions fun filled and something that the patients can look forward to, and enjoy.
What are the different stages of rehabilitative care and recovery with Mobi-L? Could you please break that down?
Physical rehabilitation of upper and lower limbs generally starts with physiotherapist assisted exercises especially in the initial stages followed by active exercises where the patient is exercising independently.
These assistive and active exercises help the patient to regain full range of movement of the affected joint and recover one of the major aspects of mobility.
Once the desired range of motion is achieved the focus shifts to strength training which includes training with resistance, isometric exercises and doing exercises with varying resistance.
In order to meet the varied needs of the patients at different stages of recovery, Mobi-L can be setup with different protocols for training including assistive, active, resistive and isometric exercises. Thus, making it useful throughout the patient’s rehabilitation journey
As with most medical and health related fields, there is a shortage of physiotherapists in India. How does Mobi-L fit into this landscape? Say in a hospital or a rehab centre.
We all know technology is a huge enabler to improving work efficiency. For a software developer a high-end workstation will make his job faster and allow him to improve his productivity. Similarly, in a rehabilitation centre where a therapist is seeing multiple patients over the days or even at the same time our machine reduces not only the physiotherapist’s physical effort but also offloads significant efforts that go into engaging a patient to undergo his daily dose of rehabilitation. It helps improve their work efficiency and energy levels throughout the day.
With COVID, most of us have seen the difference that an objective measure makes in the diagnosis and treatment of a disease. A rapid antigen test for COVID 19 and the patients’ symptoms together provides an approximate idea of the diagnosis but a RT-PCR test helps the doctor to be more confident regarding the correctness of the diagnosis and also severity of the same. Similarly in rehabilitation a therapist’s experience and patients’ word regarding his physical condition is good to make an approximate guess regarding one’s condition and progress but a tool like Mobi-L validates the same and gives more confidence to the patient and the therapist.
Home-based care is on the rise in India, and particularly the demand for eldercare services. Do you see an opportunity here? How can Rymo solve some of the challenges here?
Some of the biggest challenges in long term rehabilitation are the need to travel regularly to physical clinics which might not be in immediate vicinity of one’s place of abode. This results in economic, time and logistics overhead on the family.
Rehabilitation at home is possible but especially for neuro rehabilitation it can also reduce the quality drastically as the tools that can be made available at home are limited. We believe our product can be used in a home setup and benefit the patient greatly as the space occupancy is minimum and operation is easy but it would need a physical therapist’s continuous guidance to maximise clinical results.
Going forward once Rymo is associated with a larger network of rehabilitation professionals we foresee collaboration opportunities that can be leveraged to deliver the most advanced rehabilitation at home.
What’s on the cards for Rymo this year?
This year Rymo is on route to complete its industrial design and launch its first product Mobi-L in India and make it available to 100+ rehabilitation centres. We have a goal to reach and positively impact the lives of at least 4000 individuals by 31st March 2023. These are a few baby steps which will help us democratise technology in physical rehabilitation and move forward in our goal to make India’s rehabilitation infrastructure one of the most advanced globally.
You can learn more about Rymo’s robotic rehab solutions here and connect with Chirag on LinkedIn.
Silver Angels Newsletter
The Silver Angels newsletter brings you news, stories and trends from the silver economy in India, in a short, easy-to-read format. Businesses, brands, investors, startups, researchers and analysts following this space are likely to find it interesting.
