In Conversation With > Vinayak Nandalike and Dr. Sanjay Sharma, Co-Founders at Yostra Labs

By: Aditya Gulwadi and Shruti Sheopurkar, 60 Decibels

In a nutshell: Yostra Labs is a health-tech firm based in Bangalore that is rolling out innovations to make healthcare more effective, affordable and sustainable. Yostra Labs used Lean Data to hear from 50 doctors and operators in India about their experience using NEURO TOUCH, a unique screening device for peripheral neuropathy (damage to the peripheral nervous system) and the only one worldwide to combine all 4 standard tests required for neuropathy screening.

Early detection of neuropathy is essential to decreasing the risk of amputation for diabetic patients. Yostra Labs was founded with the vision of helping patients avoid all preventable amputations. By digitizing traditional forms of neuropathy testing and combining these within a single, portable device, NEURO TOUCH eases the diagnostic and therapeutic considerations for physicians at the point of care. Currently, NEURO TOUCH has over 150 installations across India and has screened more than 25,000 diabetic patients over the last two years.

The Problem: Peripheral neuropathy is most commonly caused by diabetes, and it can lead to foot ulcers and amputation if it is not detected early. Typically, 25% of diabetics eventually suffer from peripheral neuropathy, and India, with more than 75 million diabetes patients, has the second-highest prevalence of diabetes in the world. There is a need to ramp up early detection of peripheral neuropathy, especially in rural India, and NEURO TOUCH allows doctors/clinics to do so in a timely and effective manner.

Insights: The 60 Decibels study showed that doctors are now able to diagnose peripheral neuropathy sooner than usual, and that the product gave their clinic a competitive advantage in their area. The majority of doctors reported that their overall level of patient care had improved after using NEURO TOUCH. Operators said their knowledge of peripheral neuropathy had increased and that being a trained NEURO TOUCH operator contributed to their success as a healthcare professional.

Action: The 60 Decibels study helped Yostra Labs validate their value proposition, effective channels for customer outreach, and strategy to follow up with customers with challenges. Also, based on the study results, Yostra Labs followed up by contacting users who were experiencing challenges to understand what could be fixed and how their experience could be improved. The Yostra team is also looking to strengthen their referral scheme to increase awareness of peripheral neuropathy and NEURO TOUCH.

Fun fact: The very idea of NEURO TOUCH was born out of a hackathon back in 2015! Co-founder Vinayak Nandalike met Dr. Sanjay Sharma, a podiatric surgeon, who expressed a need for a portable device that could perform all the tests needed to screen a diabetic patient for neuropathy.

Yostra’s NEURO TOUCH is a unique product improving the lives of some patients and healthcare professionals.

At 60 Decibels, we are passionate about listening to the end-users so that social enterprises can serve them better and create more impact. This month, we spoke with Vinayak Nandalike and Dr. Sanjay Sharma, co-founders at Yostra Labs. It was exciting to see how quickly they responded to the results from the 60 Decibels study — they took immediate action to address customer feedback and incorporate insights from the survey.

Highlights from the 60dB Interview:

> Q: Could you tell us a little bit more about Yostra Labs and NEURO TOUCH, and the journey since inception?

Vinayak: Yostra was formed with a vision of avoiding all preventable amputations. Diabetes generally leads to neuropathy, which can then lead to ulcers. Ulcers lead to gangrene and gangrene eventually causes amputation. There is a 5 to 7-year timeframe from when a patient is diabetic to the point when an ulcer is formed, and there was no effective screening available to identify neuropathy. NEURO TOUCH was launched to serve this purpose.

The first part is great, the product is there — it’s portable, multi-parameter and can perform all the tests and detect neuropathy early. The next part is actually enabling the physician to ensure that all their patients are screened early and effectively. The third part is educating the patients about this condition and ensuring that they don’t get into the danger zone.

I’m happy to say that NEURO TOUCH has over 150 installations across India and we have screened more than 25,000 diabetic patients over the last two years.

Dr. Sharma: NEURO TOUCH started off from a point where there was no quantitative screening device for neuropathy. Today we are able to diagnose early stages of neuropathy and start on the treatment and preventative measures much earlier than after the damage has happened. Additionally, with the report in hand (using data from the device), we know exactly what spots of the foot are not responding to various stimuli. It’s easier to explain it to the patient to help them understand the test itself and why it is important for their foot to be screened during the course of their diabetic treatment.

“Peripheral neuropathy is much more easy to detect and both doctor and patients can work effectively to cure problems. My patients prefer to follow up with us more now.”

— Doctor, 40

> Q: At the international level, are there other devices which provide a similar kind of service?

Vinayak: I am happy to report that NEURO TOUCH is the only product in the world which has combined all 4 tests required for neuropathy screening (protective sensation, vibration perception, hot perception, and cold perception tests).

In addition to that, we have the infrared thermometer. So where innovations are generally limited to the US and Europe, we have now been able to put India on that map and make a contribution.

> Q: What challenges have you faced in scaling NEURO TOUCH?

Vinayak: The first one is the awareness about the condition, its complications, and why it is important to do a foot examination early. The second one is the reach because we are a company with limited market presence. The third is the ever-changing dynamics in the healthcare system, especially in these times with the pandemic. Despite all of this, the fact that our customers are not limited to Tier-1 cities or bigger institutions means that we have been able to beat what we set out to achieve back in 2016 by enabling neuropathy screening at the grassroot levels.

> Q: Which Lean Data insights were most useful for you?

Vinayak: A couple of things that stood out was that NEURO TOUCH was able to enable better patient care and better foot care to the patient, and that’s the one key outcome that we are trying to drive. I am happy that more than 90% of our customers reported an ability to achieve better patient adherence to testing due to NEURO TOUCH. Also, the fact that more than 67% of doctors agreed that it has given their practice a competitive advantage.

> Q: Did some of these findings inform organisational decisions at Yostra?

Vinayak: From the post-sales team perspective, we formed a snapshot poster, which was a preview of the survey. We put that into a newsletter.

From a sales perspective, when we meet with doctors and give demos, we are able to talk about the survey and its results.

Finally, the results of this survey are now an integral part of our investment pitch deck because this gives confidence to the investor on how we value customer satisfaction and what we’ve done. It goes a long way in showing adoption of the product.

> Q: How could the Lean Data insights be more actionable for you?

Vinayak: One good thing that came out was the NPS, the Net Promoter Score. This helped us see where we stood. A Google search of the NPS of other companies tells us that our score of 41 for NEURO TOUCH is better than that of J&J and Medtronic and slightly below Abbot’s.

I’m happy to see this because it is something we want to build on, as this shows that the core strength of the company is customer satisfaction, so anything and everything is dependent on that in this space. We are building a global product and we want to be extremely customer-focused.

This Lean Data study was funded by Villgro, one of India’s pioneering incubators of social enterprises; Yostra is a Villgro Incubatee.

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