Vikram Sheel Kumar: Software Design

Dimagi—the name of Vikram Sheel Kumar’s Cambridge, Massachusetts, medical software company—means “smart guy” in Hindi. So it’s interesting that so many of the 29-year-old CEO’s smarts come down to good sense. As a graduate student at the Harvard-MIT Division of Health Sciences and Technology, Kumar found himself pondering the problem of adherence—the difficulty of creating “sticky systems” that encourage patients to take medicine. “My first idea was, let’s create a tool for doctors to be better,” explains the shaggy-haired, disarmingly friendly Kumar, a graduate of Harvard Medical School who was named one of the world’s top 100 young innovators by MIT Technology Review in 2004. Then he had a revelation: “Doctors have enough instrumentation. Patients need some instrumentation.” So Kumar developed DiaBetNet—an easy-to-use game installed on a PDA that encourages diabetic children to test their blood sugar by awarding points for successfully guessing their glucose levels.

Kumar’s smarts again asserted themselves in 2002, while he was in India doing graduate work. Considering the nearly 300,000 nurse-midwives who serve much of India’s patient community, Kumar and classmates Vishwanath Anantraman and Tarjei Mikkelsen realized, he says, “that they are the best node of delivery of health care—they go everywhere. Why not give them some technology so they can make more informed point-of-care decisions?” The result was Ca:sh—Community Accessible and Sustainable Health System—a mobile electronic medical record system that enabled the nurse-midwives, again via PDA, to collect data, access treatment information, and schedule patient visits.

Then Kumar’s smarts reached critical mass. “I was at a public-health conference where everyone was discussing the health crisis in Africa—big multimillion-dollar ten-year solutions,” he recalls. “And we’d just done this project in India—it took us a couple of weeks in the field—and I realized: You can have $5,000 solutions as well. I can’t change policy, but I can work with local players and help them do their job better.”

And so with Anantraman and Mikkelsen, Kumar designed Dimagi, software-based information systems and mobile technologies that facilitate patient-level management of disease while also collecting information for the creation of robust medical databases. In addition to making Ca:sh more broadly applicable Dimagi has developed HIV Confidant, a PDA-based application that, by employing a two-key encryption system, removes the stigma from AIDS testing by ensuring confidentiality (used in South Africa), and has begun developing the Center for Disease Control’s Continuity of Care program in Zambia (in partnership with Salar, Inc.); this allows patients to carry their medical histories on smart cards, enabling effective treatment at clinics lacking Internet access to health records.

The company, which boasts a staff of eight and a bare-bones budget, has also completed a handful of consulting projects in the United States. “At this point we’re funding our international work with government contracts,” Kumar says. “If we build expertise locally, we can start implementing the work overseas, if we need to, for free.” All of which amply justifies Dimagi’s motto: “We do things here.”

Kumar hopes that within five years Dimagi will have designed more open-source software that, like the Zambia application, can be adapted for use worldwide. “For example, Windows can work anywhere,” he observes. “If you create a system like that, you can install it locally and customize it for each clinic. That’s useful.” Information tools that deliver high-quality point-of-care medicine to self-managing patients throughout the developing world—supported by up-to-date intercommunicating databases—would be very useful indeed. When asked what motivates him, Kumar smiles: “If you look at life expectancy in the United States and compare it to Zambia, we live two lives here for every one life there. So we owe it to ourselves to spend one of our two lives working on important problems.” Now that’s a dimagi.

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