Written evidence submitted by “Dozee” - (Turtle Shell Technologies Private Limited)

 

February 2023

Submission to International Development Committee

Inquiry into “Investment for development: The UK’s strategy towards Development Finance Institutions”

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About Dozee:

 

  1. Dozee is India’s first contactless AI-powered remote patient monitoring company.  Its AI algorithms enable early detection of any health deterioration, to save lives in time. The health information generated by Dozee can be accessed remotely by doctors and caretakers on Dozee's patient monitoring system and its application. Dozee's contactless ballistocardiography technique is proven to have medical grade accuracy and is a Made in India technology that follows best global standards and practices . Dozee is ISO13485 and ISO27001 certified. The most recent FDA 510(k) clearance received for Dozee VS in December 2022 is an important milestone for the company as it is the gold standard when it comes to medical devices and algorithms.
  2. Dozee’s non-invasive vital monitoring device ensures multiple key outcomes. Most importantly, it enhances patient safety as it removes the need for manual spot checks by nurses in wards. Multiple global studies have shown that spot checks tend to miss health deterioration in many cases that may lead to code blue events outside of the ICU. Dozee ensures hassle-free continuous vitals monitoring without compliance of patients and no hassle for nurses. It has been found that each nurse spends 2.5 hours of their 8-hour shift in performing manual spot checks and charting in wards each day. Dozee’s automated solution has proven to save 80% of this time spent thereby reducing their workload. The use of Dozee devices also optimizes the use of hospital resources and cost to patients. Automated vitals monitoring and real-time alerts in case of deteriorating patient vitals allow ICU beds to be used for the most critical patients and enable an earlier discharge of patients in both hospital wards and ICUs. Optimisation of ICU usage in the public hospitals helps the government reduce their expenditure as ICU care is a considerable cost to the government. Additionally, ICUs are scarce especially in public hospitals, shorter ICU stays ensures access of care to more patients.
  3. Dozee can track vitals such as heart rate, respiration rate and non-contact blood pressure (NcBPTM) in a contactless manner. Non-contact blood pressure (NcBPTM) monitoring launched by Dozee is globally one of its kind and is definitely a breakthrough for the healthcare ecosystem globally. Along with this, Dozee ensures digitisation of patient health records and easy integration into any HIS.
  4. Dozee works on the principles of ballistocardiography - the Dozee sensor sheet placed under the patient’s mattress captures the micro-vibrations that are emitted from the body through heartbeats, respiration cycle, and body movement. The data is sent to the secure cloud which converts it into meaningful bio-markers. The processed vitals information can be accessed on Dozee’s application.
  5. Dozee’s proprietary technology is trusted by top-of-the-line healthcare providers across the country, with its growing presence in 370+ hospitals covering 40+ districts across India. With its vision of ‘Make in India, Made for the World’ - Dozee’s innovative technology aims to bridge the healthcare gaps in India and emerging markets like Africa and South East Asia.
  6. In October 2022, Dozee was awarded the Federation of Indian Chambers of Commerce & Industry (FICCI) Healthcare Excellence Awards 2022 in the Digital Innovation in Healthcare category. The award acknowledged the path-breaking work done by Dozee in uplifting the state of the healthcare system in India by engaging in public-private partnerships to ensure that quality care is made available to every patient. Having collaborated with hospitals across the public and private healthcare landscape of the nation, Dozee has contributed to addressing the shortage of ICU beds as well as healthcare workers in the country. The award was presented to Dozee by Smriti Irani, Minister of Women and Child Development & Minority Affairs of India. Apart from this, Dozee has been a recipient of the BML Munjal Award 2022, IHW Digital Health Summit & Awards 2022, Medicall Made in India Innovation Awards 2022, NASSCOM Emerge Award 2020, Economic Times Innovation Awards 2020, among others.

 

What current investments does BII hold?

  1. BII has made an investment into Dozee of $2.5Mn towards the upgradation of 6,000 public hospital ward beds into step-down ICU beds.

 

How does the BII’s strategy align with the FCDO’s development agenda?

  1. The Foreign, Commonwealth and Development Office (FCDO) aims to promote the interests of British citizens and safeguard the UK's security, defend its values, reduce poverty, and tackle global challenges in partnership with other nations. One way in which the FCDO is addressing these goals is through the British Investment International (BII) investment in Dozee. Dozee is working to tackle the critical issues faced by the Indian public healthcare system, which was particularly exposed during the Covid-19 pandemic.
  2. According to a 2021 report from Niti Aayog, India is facing a critical shortage of hospital beds and skilled health workers. The current ratio of hospital beds per 1,000 people is 1.3 and 0.65 physicians per 1,000 people, which falls far below the World Health Organization's standards. This shortage is putting immense pressure on India's healthcare infrastructure and exacerbating the challenges faced by healthcare workers, which ultimately negatively impacts the health and well-being of citizens.
  3. To address these issues, Dozee has established the MillionICU initiative, which aims to upgrade regular hospital beds into connected step-down Intensive Care Units (ICUs) through the use of AI-based early warning systems and contactless remote monitoring. The goal of this partnership is to reduce nurse burnout and fatigue, save nursing time, and increase access to quality healthcare, particularly in low hospital density regions. The ultimate objective is to unburden the healthcare system and improve the well-being of both citizens and healthcare workers.
  4. AI-based early warning systems and contactless remote monitoring have the potential to revolutionize the public healthcare delivery system in India by providing connected care. The BII-Dozee partnership will bring this vision to reality and make a positive impact on the nation's healthcare infrastructure. Dozee's innovative approach, combined with BII's support, will help improve access to quality healthcare and reduce the workload of healthcare workers in India.
  5. With BII's support, Dozee will upgrade regular hospital beds to step-down ICUs through its MillionICU initiative. This initiative was established in 2021 with the aim of installing one million step-down ICUs across India, bringing about a rapid and long-term transformation in the country's public healthcare infrastructure. To date, the MillionICU initiative has already helped 46 hospitals in over 15 districts and monitored over 10,000 patients, saving over 25,000 nursing hours. The BII-Dozee partnership is making a significant contribution to improving access to quality healthcare in India and reducing the burden on healthcare workers, which will have a lasting impact on the health and well-being of the nation's citizens.

 

How effective are the governance structure and internal oversight mechanisms of BII (e.g., oversight over direct investments, fund investments, BII controlled companies)?

 

  1. The BII investment team conducted a comprehensive diligence process prior to investing in Dozee. This included visiting multiple deployment sites, speaking with healthcare professionals who use the device, and conducting independent research to understand the need and impact of the technology. BII places a strong emphasis on good governance and business best practices, and as such, has implemented a comprehensive approach to ensure the success of the investment.
  2. As part of this approach, BII has established governance frameworks and a well-defined monitoring protocol to continuously assess the project's progress. Dozee is required to submit quarterly reports to BII containing predetermined parameters, allowing for timely intervention if necessary. The BII team has provided valuable support throughout the association, offering expertise and guidance in areas of governance and ESG framework.
  3. This support has been critical for a company like Dozee, which is still in its infancy. BII's guidance will ensure that Dozee's operations and business practices align with the highest ethical and sustainability standards. By working with BII, Dozee is not only receiving funding, but also the resources and expertise necessary to build a strong and successful business.
  4. In conclusion, the diligence period conducted by BII was thorough and the focus on good governance and business best practices is a testament to the investment team's commitment to ensuring the success of the project. By partnering with BII, Dozee has access to valuable resources and support that will help them to achieve their goals and make a positive impact in the healthcare industry.

 

How does BII evaluate the impact of its investments?

  1. The British International Investments (BII) evaluates the impact of its investments through a comprehensive approach that involves tracking metrics and monitoring progress on a regular basis. BII invests in companies that are focused on creating positive impact in their respective industries and has a focus on impact-focused management. This is demonstrated in its investment in Dozee and its MillionICU initiative, which aims to upgrade regular beds to step-down ICUs and bring about a rapid transformation in India's public healthcare infrastructure.
  2. To ensure the success of this initiative, BII has put in place a system of quarterly reporting and measurement of predetermined metrics. This helps to track progress, hold the initiative accountable, and maximize impact. As an active investor, BII also provides dedicated experts who offer support in critical areas beyond just business, such as ESG and business integrity, which is particularly valuable for a young company like Dozee that is scaling up in a highly regulated industry like healthcare.
  3. In addition, an independent study by Sattva Consulting found that the adoption of automated monitoring systems like Dozee in public healthcare has the potential to reduce the overall shortage of nurses in India by approximately 1 million, leading to estimated savings of $300k for every 100 Dozee beds and potential total savings of $330 million for the public healthcare system in India.
  4. Overall, BII's impact-focused management style and its dedicated support to its portfolio companies make it a valuable partner for companies like Dozee, and its MillionICU initiative has the potential to bring about significant positive impact in India's public healthcare infrastructure.