Things & Thinks Half & Half Ed. 7

After the mid-year edition of Half & Half, I took a gap last month. This month I am back with another fantastic conversation!

Mohan Raghavan is Assistant Professor at IIT Hyderabad’s Biomedical Engineering department. He was also a co-founder and head of the Centre for Healthcare entrepreneurship at IIT Hyderabad. Trained as an engineer, he spent a good time in the Embedded systems industry at Motorola before changing career track to do a PhD in computational Neuroscience and now runs a research lab around motor systems simulation.

T&T: Hi Mohan, welcome to Things & Thinks! I am so happy to have you as a guest. Let’s begin with your backstory?

MR: My professional journey has been quite unconventional, especially if you consider the way I have entered academics, starting with computer sciences and routing via industry! Although I was quite keen to be in academics from early on, there came a point when I was close to 30 and I realized I think my dreams of academies are all over and it’s all done! But a common thread throughout all my career has been whenever I think I am done with something, I am proved terribly wrong.

When I was in high school, I used to hate Biology. And when I took my last exams, I was thinking- good riddance, biology! Similarly I loved software and programming, but I didn’t like circuits and electronics much. And so over the time I have realized that this is the problem with presentation and not interest. The way high-school biology was all about latin names of flora and fauna, or the way electronics was all about circuits and so on…this is something I follow myself in my teaching. By applying these labels, we lose the interdisciplinary nature of many of these topics, precluding some interesting combinations of subjects.

So after my graduation, I went into the industry, spending most of my 20s in the tech industry. At that time, I felt it was getting too much of a routine. But now when I look back at those times, I find that I gained perspectives which would have been difficult to get by in a purely academic setting.

T&T: then you quit the industry; that must have been quite an unorthodox move for the time?

MR: Yes, absolutely! Especially, when I was quite well set professionally. I quit the industry at 29 after about 7 years of work there and started all over again from scratch. My career could have been completely over and I could have been left in between…but luckily things worked out for me.

T&T: And so how has been the journey at IIT?

MR: My experience at IIT has been wonderful. I could have asked for nothing more. I did not have to struggle for my tenure here, so that was a huge benefit to take more risks! I am allowed to do original, non-ordinary things and that has been wonderful. It would have been easy to do normal, ordinary things but I thought that the only way to give back to this system for the luxury of security I enjoy would be to pursue high risk high gain ideas.

T&T: You are quite busy with a lot of interesting work at IIT.

MR: That’s true. One is the very core stream, which is my primary research, that my lab is centered around. The other part is the innovation work that I did, largely around setting up, mentoring innovators and operationalizing the Center for Healthcare Entrepreneurship(CfHE) at our institute. And then the third is largely around education and teaching, as in creating new curricula, setting up new programs, shaping the way programs run, making sure that students will be introduced to the right areas, be available at the right times, have a good career, and so you know… And then the 4th part again is, you know, basically some offbeat stuff like archaeology or contextual themes like mathematical modeling of epidemiology and stuff like that.

So coming to my own core research, when I joined I came from a neuroscience perspective, in computational neuroscience, so most of it was modeling and creating simulations of small parts of the brain. So when I started off here at IIT, I asked myself one question-we are learning so much, we are discovering so much, we are understanding so much about the brain and how it works, etc. How much of this gets used and in what manner? So I spent a good amount of time during the early years with hospitals and doctors, largely with neurologists, neurosurgeons. I tried to understand how they make their decisions. I realized that there is a huge gap between the discovery and the actual practice. I also spent time comparing the state of our area with other industries and one insight I got was how availability of the right tools leads to exponential growth of fields, like for e.g. the impact of CAD tools on the electronics industry.

So I started applying these insights to human movement and motor systems — my area. I asked what can I do to bridge the discovery — application gap ? What kind of tools or systems to build ?! I converged on the vision of a simulated virtual moving human as a platform… a sort of playground where discovered information will come together as a whole.. That clinicians can observe, examine and query much like a real patient.. That helps transfer of information and shaping of knowledge across academia and medicine. This would provide a meeting ground for researchers and clinicians to have a conversation.

So today we have a spinal musculoskeletal moving system, with the capability of simulating health, disease, drugs and so on…it’s modular and multiscale… so you can update it, add more modules to it, just like with other software or with other technologies.

It’s something that you can build on. But I knew this was a long road and would take resources and efforts at that scale. It was like the difference between building a house in a city with all amenities vs clearing a forest.. But the results are starting to show now after years of toil….

T&T: Is there something about your college days that’s proved almost wrong or could have been different?

MR: All of us have a lot of fun during college, we know how to crack exams, study just a week before exams and I was not too different. However one thing I used to enjoy doing even during that last one week was to scrounge all material to understand the underlying concepts. So when I went back to studying after a break of 7–8 years, to write my entrance exams, this understanding of the underlying concepts helped me tremendously! I think this learning to learn, helping students learn the concepts is missing in our teaching institutions currently. The ability to summarize information in a single sentence, a single paragraph is really useful in that sense- you consume information and create knowledge out of that information.

T&T: Are you practising something deliberately these days?

MR: This is one question I don’t have a good answer for! I am not a big fan of sudden recipes of change…so my base remains the same. Of course, I keep making adjustments and changes all the while but those are different things.

T&T: Let’s shift gears towards healthcare. In the recent past, any personal learnings from a healthcare system encounter as a patient/caregiver?

MR: Of course I have had several experiences as a recipient of healthcare services however as a matter of principle I try not to read too much out of those. Largely because I feel that’s a trap! If your approach to either you know healthcare, innovation or healthcare research becomes anecdotal, it can cloud your judgement. You can get emotionally attached to the value proposition in your head, whereas it may just be your personal circumstance. I continue to think about these experiences but try to get those factored in the weight of evidence.

T&T: What do you think about our current healthcare ecosystem? And what are some of the top challenges?

MR: I think the current wholesale change in behavioral patterns will play a major role in all healthcare systems. This was evident even before the pandemic set in, but has accelerated because of the pandemic.

Changing behavioral patterns will be the biggest challenge but also probably the biggest opportunity in healthcare.

Most of the time, innovators are trying to fit in solutions considering the current paradigm but this might not work, considering the huge changes in behaviors. Take an example of our daily social lives, it is easy and quite acceptable to go fully cashless on travel now, while just a few years ago one couldn’t imagine. So the way we gain access to healthcare services, the way we consume these services are going through many changes and many trends will contribute. Look at wearable trackers-because of the influence of some health-conscious users, trackers are now universal-everyone is counting steps because many users see it as fun! Patients are asking for tele-consultations…the so-called core healthcare activities are moving out of their traditional domains. Look anywhere-be it hospitals, or pharmaceutical companies and so on-all of these traditional hubs are changing. Tech companies are increasingly doing Health and life science companies are going digital; due to this the separation between health, technology, education, lifestyle, wellness etc have started to collapse. This is especially true for non-critical healthcare activities and it will continue to be a major trend guiding the healthcare ecosystem. We are in the middle of this flux, probably will take some time to attain steady state. We recently started a B.Tech in Biomedical Engineering and there again we are using these observations on digital health to guide our curricula and its delivery.

T&T: If you are asked to bet on something about healthcare in future, what will that be?

MR: I don’t think I have a particular bet on something specific but I would bet that the next big thing will start from the lower end of the technology spectrum.

The critical mass will be gathered from people using healthcare services on their phones, people taking care of themselves from their homes.

I think typically it will be from that side. That does not mean the high-end technology will not be helpful but it will be on a longer timescale, over 10–20 years. So commoditization will have been one of the most important things to watch out for.

From the deep tech angle, I took a bet in 2014/15 time frame about the in-silico methods and at that time it was really under-appreciated. Today we have come to a point where the term ‘in-silico’ has gone mainstream and I think it will happen in content as well soon.

T&T: Do you have a favorite grudge in healthcare?

MR: Well no, not a grudge really but there are things that could be done better.

One of such things that come to mind is the innovation ecosystem in healthcare. Innovation has a different meaning to different people. Today it is about starting incubators and facilities; it is about bringing together multiple different capabilities and doing something new to provide much greater value, what is known as emergent phenomena, almost like nonlinear additional value. A critical factor in creating innovation hotbeds is identifying talent…. Manage talent… these people with diverse skills and matching them with right opportunities, connects and resources…. bringing them together…. The role of this hands-on management to create innovation factories is vastly underappreciated.

T&T: Mohan, it has been wonderful catching up with you! I have learnt so much from this discussion, thank you so much for your time and sharing your thoughts!