Frustrated at the lack of interest by the medical establishment in reducing the costs of diagnostic testing, and seeing almost no chance of getting the necessary research grants, Kanav Kahol returned home to New Delhi in 2011. He was a member of Arizona State University’s department of biomedical informatics. Kahol had noted that despite the similarities between most medical devices in their computer displays and circuits, their packaging made them unduly complex and difficult for anyone but highly skilled practitioners to use. As well, they were incredibly expensive — costing tens of thousands of dollars each.

Kahol knew that the sensors in these devices were commonly available and inexpensive, usually costing only a few dollars. He believed that he could connect these to a common computer platform and use commercially available computer tablets to display diagnostic information, thereby dramatically reducing the cost of the medical equipment. He also wanted to repackage the sensor data to make them intelligible to technicians with just basic medical training — the frontline health workers who do the tasks of physicians in parts of the world where physicians are in short supply.

ahol and his Indian engineering team built a prototype of a device called the Swasthya Slate (which translates to “Health Tablet”) in less than three months, for a cost of $11,000. This used an off-the-shelf Android tablet and incorporated a four-lead ECG, medical thermometer, water-quality meter, and heart-rate monitor. They then enhanced this with a 12-lead ECG and sensors for blood pressure, blood sugar, heart rate, blood haemoglobin, and urine protein and glucose. In June 2012, they sent this device to 80 medical labs for testing, which reported that it was as accurate as the medical equipment they used — but more suitable for use in remote and rural areas, because it was built for the rugged conditions there.

By January 2013, Kahol’s team had incorporated 33 diagnostic tests, including for HIV, syphilis, pulse oximetry, and troponin (relating to heart attack) into the Swasthya Slate and reduced its cost to $800 per unit. They also built a variety of artificial-intelligence–based apps for frontline health workers and started testing these in different parts of India.

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