February 2025 | Athera's Odyssey: Decoding Healthtech in India
Three seasoned leaders shed light on the healthtech sector in India.
In this month's edition of Odyssey, we spoke to D A Prasanna, the luminary who led GE Healthcare in India and founded Manipal Acunova, Ramesh Emani, the pioneer who founded Insta Health which was later acquired by Practo, and Prashant Desai, popular health influencer who all shared their thoughts on India’s heathtech sector.
Happy reading, and have a stellar month ahead!
The Luminary: D A Prasanna
Over a distinguished career steering institutions like Manipal Hospital and GE Medical Systems, Mr. D A Prasanna faced myriad challenges - and emerged wiser, and stands as one of India’s healthcare luminaries.
In the fledgling days of GE Medical Systems, Mr. Prasanna and his team found themselves outmuscled by entrenched competitors. Winning head-on was technically possible, but prohibitively expensive.
"We could win, but at a huge cost, at a loss of profitability," he recalls ruefully.
The breakthrough came when they identified an untapped segment - smaller clinics and hospitals in tier-3 cities, underserved by the big players. By tailoring offerings, financial solutions and support to this niche's unique needs, they gained a foothold.
The strategic pivot proved a masterstroke.
Mr. Prasanna's takeaway from this David vs. Goliath battle?
"Create a market where you can set the rules of the game to be able to win profitably."
Sound advice for any underdog taking on giants.
Healthcare Is an Infrastructure Business
Another light-bulb moment came courtesy of a senior executive.
In a frank talk, he reframed Mr. Prasanna's conception of the healthcare sector.
"This is an infrastructure business, not a product business."
The message hit home. True success required transcending the role of mere equipment supplier.
GE needed to invest holistically in the service, applications, spare parts, and remote diagnostics that make those products viable for customers.
Shifting focus from manufacturing to building this supporting ecosystem proved game-changing.
"As the installed base grows, that infrastructure will become a more defining part of the business, a more profitable part of the business," Prasanna realized.
A lesson in seeing the big picture beyond the immediate transaction.
Sophistication Shouldn't Intimidate
Prasanna credits much of his perspective to the mentorship of Dr. Ramdas Pai, the visionary behind Manipal's ascent. One particular insight has stayed with him.
As the Manipal team mulled a major upgrade to the hospital's facade, Dr. Pai intervened with a gentle admonition: "If you make a building so sophisticated that a middle-class or poor patient feels intimidated to even enter, the very purpose for which you established the institution is defeated."
His words were a reminder that institutions must be welcoming to all, not just aesthetically but in their processes. Mr. Prasanna internalized this philosophy. "It's not about making it a five-star hotel," he says. "It's about ensuring that when people enter, your reception makes them feel welcome, not just through nice words but through simple systems."
Big Impacts from Small Touches
Over the years, Prasanna, who has also written the insightful book ‘Innovate Locally to Win Globally’, discovered that the most meaningful patient experience factors aren't always the obvious ones.
He shares how a Manipal Hospital survey threw up a surprising finding. When patients were asked to rate various facilities, the most appreciated service was not the cutting-edge diagnostics or luxury amenities. It was the humble valet parking.
For stressed patients rushing to the hospital, the assurance of leaving their vehicle in trusted hands proved a major anxiety reliever. As Mr. Prasanna puts it, "These are things that are different from what you normally see on the surface. Once you get insight into these aspects, you learn to build a better business."
Demolishing Disciplinary Silos
Another recurring theme in Mr. Prasanna's leadership philosophy is the power of multidisciplinary synergy.
He noticed that in large institutions, individual departments often become isolated silos, focusing myopically on excelling within their niche. To truly differentiate Manipal, he championed initiatives to demolish these walls.
One such brainchild was a first-of-its-kind life sciences center integrating medicine, pharmacy, biotechnology and biomedical engineering. Another was an innovation hub where mechanical, electrical and electronics engineers collaborated on societal solutions.
The goal, Prasanna explains, was to "bring together the best minds across disciplines to produce output that reflects their combined brilliance." He adds, "Breakthroughs and innovations that impact society rarely come from a single field. They require multidisciplinary effort."
Man, Medicine and Machine
For all the technological strides in modern healthcare, Mr. Prasanna worries that reliance on machinery has diminished the human touch.
"There's an over-dependence on technology today," he rues. "Doctors and nurses have stopped looking into the eyes of the patient." The result is an irony - patients are lonelier than ever in crowded hospitals.
He emphasizes that gadgets, while invaluable, are meant to augment human care, not substitute it. "Patients crave communication and connection," he stresses. "Ultimately, medicines and technology contribute only 50% to recovery. The other 50% comes from the patient's trust in the doctor."
His parting advice to caregivers is poignant: "A good doctor always finds time to talk to patients. A good nurse does her duty, but also cares for her ward like family. These are eternal principles that shouldn't change."
A Calling Like No Other
To the next generation eyeing healthcare careers, Mr. Prasanna offers equal parts caution and encouragement.
He acknowledges that the field is rife with frustrations.
Treatments don't always succeed.
Patients and families lash out.
That's par for the course. What aspirants must remember, he says, is the incomparable nobility of the profession.
"It's only in healthcare that what you do directly impacts life," he emphasizes. "You're not just writing code or processing files. You have the privilege of saving lives. Remind yourself of that greater purpose, and you'll find the strength to persevere through inevitable rough days."
Mr. Prasanna also urges budding professionals to think beyond borders. With the right certifications and track record, healthcare offers global possibilities. "If you're good, you can work anywhere in the world," he points out. "But you have to take charge of connecting to those opportunities yourself."
Bridging Access and Affordability
A perennial challenge in healthcare leadership is balancing cutting-edge care with affordability and accessibility for the masses. Mr. Prasanna's approach relies on deeply understanding the customer's definition of success.
He illustrates with an example from his GE days. The company realized that for small clinics, acquiring high-tech equipment was only half the battle. Concerns about financing, infrastructure, and permits often proved insurmountable hurdles.
So GE evolved its role, partnering clinics in areas well beyond its traditional ambit - from construction advisory to innovative unsecured loans to workflow design. The aim, Mr. Prasanna explains, was to "put yourself in the customer's shoes and see how you can contribute to their success, even beyond your product or service."
Light at the End of the Tunnel
When asked about the state of Indian healthcare, Mr. Prasanna sees definite silver linings.
He points out that homegrown models focused on affordability, from the Narayana Health template to Aravind Eye Hospitals, are now globally admired. Telemedicine and remote monitoring are bridging the last-mile gap in access. India's mass adoption of smartphones is opening up transformative new touchpoints between patients and providers.
Mr. Prasanna experienced this digital healthcare revolution firsthand during the Covid crisis. "Suddenly, you could find the nearest vaccine center on a mobile app, schedule appointments, and get certificates delivered to your phone," he marvels. "It was a level of access and convenience that was unthinkable before."
He's also optimistic about the impact of mass insurance schemes like Ayushman Bharat. By extending coverage to millions of families, such programs have made quality treatment financially feasible for historically underserved segments.
Collectively, Mr. Prasanna believes these developments bode well. While challenges remain, he's confident that India's unique constraints will continue to spur "out-of-the-box innovations" in pursuit of an exciting new paradigm - "healthcare which every human being deserves."
The Pioneer: Ramesh Emani
Pioneers aren’t born. They’re created.
For Ramesh Emani, the seeds of entrepreneurship were planted during his 25 years at IT giant Wipro.
As one of Wipro's early employees in the 1980s, Ramesh witnessed firsthand the rapidly changing landscape of India's burgeoning technology sector.
"The Indian IT industry was changing," he recalls.
"When I joined, we didn't have PCs, we had proprietary operating systems. The entire team used to sit on one floor."
Ramesh counts himself lucky to have joined Wipro during this pivotal time, when the company had less than 200 employees and under 6 crore turnover.
He fondly remembers the caliber of his colleagues, many of whom went on to become CEOs and presidents of various companies.
Ramesh himself took on diverse roles during Wipro's growth, from being their first U.S. sales manager to running a billion dollar business as President of Telecom and Product Engineering Solutions. He also worked briefly as CTO for Wipro.
But after reaching the upper echelons at Wipro, Ramesh found himself at a crossroads in 2008.
"I felt it was worth taking a risk," he says.
"I shouldn't regret at a later stage in life that I didn't do something on my own."
And so, at age 52, Ramesh took the plunge into entrepreneurship with healthcare technology startup Insta Health Solutions.
Identifying a Need in the Market
The idea for Insta Health originated from Ramesh's connections in the hospital sector. A friend introduced him to medium-sized hospitals in tier-2 cities like Vijayawada, Visakhapatnam and Kakinada. There, Ramesh identified a clear gap in the market.
"I started to understand that there is no good solution available to these people," he says. "And the market is big."
Ramesh set some initial parameters for his new venture - it would be a product company rather than services, and it would target emerging markets. He took over the IP rights to an existing hospital management system and brought on a talented CTO to help revamp the product. Thus, Insta Health Solutions was born.
Overcoming Hurdles and Expanding Horizons
The early years posed typical startup challenges for Ramesh and his lean team.
Though they had paying customers in India, Ramesh realized they needed to expand beyond the domestic market to build a world-class product.
"I felt I cannot take the product to the next level just by working with some of these local customers. They are not demanding enough in product features particularly in clinical/EMR aspects"
A serendipitous meeting led Insta Health to the Middle East market at an opportune time. Dubai was transitioning to a new digital insurance claims model that required hospitals to submit claims in a standardized format. Ramesh partnered with a distributor and hired a local team, while keeping costs lean. "It was almost like hand-to-mouth existence," Ramesh admits. "Every month we had to collect the cash to pay our people's salary."
But the hard work paid off as Insta Health's flexible, cloud-based hospital management system gained traction across the GCC countries.
Ramesh's bold decision to focus product development on the needs of these new markets proved prescient. "The moment Dubai started scaling up and we developed this insurance solution, I don't think we ever had to look back," he beams. Another important feature that made a difference to Insta, was offering a multi-tenant solution on cloud where one single database holds data of all the centers of a hospital chain while controlling access at individual centers. No one else had such a solution and it led the likes of Apollo Clinics to opt for Insta over their existing Wipro solution.
Knowing When to Pass the Baton
By 2014, Insta Health was poised for serious growth. But Ramesh faced a conundrum when their series B fundraising fell through. "Everybody was very interested," he recalls. "But they kept saying that the market is not proven.'" Companies like Practo were just entering the fray and investors were more bullish on B2C healthtech plays.
It was around this time that Ramesh began acquisition talks with Practo's founders.
He was impressed by their vision and felt it could be a strong match. After much soul-searching, Ramesh decided to sell Insta Health to Practo, noting his own age as a factor. "I felt by that time I crossed 60, I thought I would also become a risk for the company."
Having been on the other side of M&A deals while at Wipro, Ramesh brought a balanced perspective to Insta Health's exit. He ensured it was a positive outcome for all stakeholders.
"We made sure everybody, except me, got cash," he affirms.
"All the ESOP holders got cash on exit, all the investors got cash. It was a very clean transaction."
Advice for Aspiring Entrepreneurs
Looking back on his Insta Health journey, Ramesh offers some words of wisdom for those eyeing opportunities in the healthcare sector.
"If you ask me, nothing much has changed in a great positive way or negative way in the Indian health sector in tier-2 cities," he observes. We still don't have a good solution for very busy doctors
While the market size is substantial, he cautions that it's a challenging space that requires patience and agility.
For B2B healthtech startups, Ramesh advises a 'glocal' approach - developing solutions locally but with a global mindset from day one.
"Think globally, don't think only India, because the problem is the same across the world," he advises.
"But think local for development because it is easier to develop."
Ramesh also emphasizes the importance of deeply understanding the end user, in this case doctors. "Real understanding of customers, if you can come up with a solution for them, yes, it's a good market," he affirms. "But one must accept it's not an easy market."
Ramesh looks back on his entrepreneurial stint with Insta Health as the capstone to a long and illustrious career in tech.
For the new generation of founders looking to make their mark, Ramesh Emani's story offers valuable lessons from a true pioneer.
The Influencer: Prashant Desai
"We are just getting warmed up."
That's how Prashant Desai describes the current state of wellness awareness in India.
And he would know. With a rapidly growing following across social media platforms, Desai has a front-row seat to the evolving conversation around health in the country.
Covid as a Catalyst
It took a global pandemic to jolt health to the forefront of the collective consciousness. "Covid brought healthcare right to the center, especially in the 30-35 plus circles," Desai observes. Worldwide, the virus disproportionately claimed lives of the elderly and those with comorbidities. Suddenly, the statistical became personal.
This renewed focus dovetailed with the rise of social media as a medium for spreading awareness. Platforms like YouTube and Instagram gave a megaphone to voices like Desai's, empowering them to share knowledge at an unprecedented scale.
The Multiplier Effect of Pop Culture
But Desai believes the impact goes beyond the pandemic. He points to a fascinating cultural convergence in recent years. "I always feel that the Indian mind is influenced by four things - entertainment, sports, spirituality, and now health."
He rattles off examples of movies like Dangal sparking interest in fitness, and actors like Akshay Kumar and Vidya Balan championing health causes. And =the Indian cricket team has never looked fitter like today. Even the radical body transformation of Karan Johar and TV star Ram Kapoor went viral, inspiring many.
Desai argues that the combined might of these influences is spotlighting health like never before. "It was a confluence of a lot of things," he muses. "And then people like me saw an opportunity to educate."
Bridging the Education Gap
Education. That word comes up often in Desai's musings. For all the growing awareness, he believes India still has "a very, very long way to go" in terms of authentic health literacy. The core mission, as he sees it, is to drive sustainable behavior change. And that's easier said than done.
"Our job is to change habits, which is going to be extremely difficult," he acknowledges. The challenge lies in cutting through the clutter of misinformation and fads to deliver genuine value.
In his view, corporate culture is the key. Employees take cues from the top. "If the founders give importance to sleep, exercise, emotional wellbeing, you'll see it percolate down." He advocates for simple but symbolic changes, like replacing office colas and candies with healthier alternatives.
The 80-20 Principle of Health
Desai is on a mission to demystify the fundamentals of wellbeing. He's a strong proponent of what he calls the "80-20 rule" of health. "80% of your health comes from getting a few basic things right. The remaining 20% is all the trendy stuff."
He breaks it down into an elegantly simple framework: GENES, which stands for Gut health, Exercise, Nutrition, Emotional Health and Sleep. "If these five are not in place, wearing a fancy fitness tracker or splurging on superfoods will give you low ROI."
Desai reserves special emphasis for the most overlooked of the lot - sleep. He rattles off a list of ailments linked to inadequate rest, from insulin resistance to cognitive impairment. "The best blood pressure medicine ever invented is sleep. 90% of India has hypertension AND 90% of India is sleep deprived. That’s no coincidence. "
On nutrition, his advice is equally simple: eat less, eat less often. Protect the liver. In a world of food delivery apps and FMCG propaganda, he admits it's an uphill battle. "The universe is conspiring to ensure you die early," he quips darkly. His antidote? Make protein your best friend. "You can't overeat on a high-protein diet."
The Mirage of 'Biohacking'
Desai has a bone to pick with the cottage industry of 'biohacking' products and services aimed at the affluent. From nootropics to cryotherapy, he sees a lot of it as putting the cart before the horse.
"If your fundamentals are not in place, things like supplements and wearables are just noise before the defeat," he asserts. Not that he's against tech tools in principle. He routinely uses a continuous glucose monitor to track blood sugar and catch early warning signs. The problem, he explains, is the lack of proper context and counseling.
"Nobody measures their micronutrient levels before popping pills," he laments. "Supplements are meant to fill specific gaps, not substitute for a balanced diet." He advises a test-supplement-retest approach to gauge actual impact.
That said, Desai is hopeful that competitive forces will eventually democratize access to these tools, much like how smartphone prices plummeted over time. "As volumes grow, prices will come down. We're just not there yet."
The Ayurveda Conundrum
On the resurgence of traditional wellness systems like Ayurveda, Desai has a nuanced take. While he respects the ancient wisdom, he worries about the lack of standardization in interpretation and practice.
"Because it has survived for so long, everyone has their own take on the Sanskrit texts," he explains. "So many contradictory voices, it's hard to separate the signal from the noise."
His solution? An approach that marries tradition with scientific validation. He cites the example of ghee, a staple in Ayurveda but now villainized in India thanks to the vegetable oil companies’ campaign that ghee makes you fat. "If something has survived the test of evolutionary time, there must be merit to it. But we need to back it up with rigorous research to build trust."
The Road Ahead
Looking ahead, Desai sees both promise and peril.
On the plus side, he's encouraged by the emergence of homegrown models focused on affordability, from generic medicines to the AYUSH initiative. Technology too is playing a positive role, with telemedicine bridging last-mile gaps and the COWIN platform streamlining vaccination.
On the flip side, he worries about India's blind adoption of the SAD, the Standard American Diet. "Today, 88% of Indians are metabolically unhealthy. At this rate, our healthcare costs could mirror the US in a decade, which is 18% of GDP" He pins the blame on a combination of aggressive FMCG marketing, lax regulations, and deception-led marketing of unhealthy as healthy with the cultural glorification of processed foods.
Desai's clarion call is for every Indian to become the CEO of their own health.
"There is no knight in shining armor coming to save you. You have to take charge."
He's particularly bullish on two developments in the pharma space - the imminent arrival of affordable GLP-1 agonists for obesity and diabetes, which is a death knell for UPF companies as it attacks hunger, and, the rise of preventive diagnostics. "Catching chronic diseases early can dramatically bend the cost curve."
But the real war, he believes, will be won or lost in the court of public opinion.
"It's going to be David vs Goliath, health vs marketing. I'm betting on health, but it's not going to be easy."
As he signs off, Desai reiterates his faith in the power of one.
"I believe the world's biggest problems are also the biggest opportunities. In the next decade, I hope we'll see Indian innovators step up with solutions. I plan to be one of them."
Pathways - February
This time, we zoom out. Way out. Science, at its core, is an infinite journey—one that continually reshapes our understanding of the universe and our place within it. Prompted by a lunchtime discussion at our office this month, we recommend three books that challenge us to think beyond the immediate, to wrestle with ideas as vast as space and as fundamental as time. Beginners and aficionados alike should find some joy in these!
The “Pillars of Creation”, captured by the James Webb Telescope’s near-infrared-light view
Start with Cosmos by Carl Sagan. Few works have democratized astronomy and astrophysics with such eloquence and wonder. Sagan's masterpiece, companion to the groundbreaking television series, takes readers on a breathtaking journey through 14 billion years of cosmic evolution. What distinguishes this classic from other popular science works is Sagan's rare ability to marry scientific precision with poetic expression, making the vastness of space and time not just comprehensible but personally meaningful.
Next, step into The Beginning of Infinity by David Deutsch. This remarkable work transcends traditional popular science by proposing that human knowledge and understanding are fundamentally unbounded. Deutsch, a pioneer in quantum computation, argues that our explanatory power - our ability to understand the cosmos through scientific methodology - represents an infinite frontier. What's particularly striking is how he weaves quantum physics, evolution, philosophy, and artificial intelligence into a cohesive argument about progress itself. The book challenges readers to consider that problems are inevitably solvable given sufficient knowledge, and that the journey from ignorance to understanding is not just a scientific pursuit but the fundamental nature of human existence.
Finally, dive into The First Three Minutes by Steven Weinberg. In just under 200 pages, Weinberg lays out a gripping, lucid account of the first moments after the Big Bang. With a (Nobel prize-winning) physicist’s precision and a storyteller’s touch, he reconstructs the violent, high-energy birth of the universe—the period when fundamental particles formed and the cosmos took shape. The book remains one of the most compelling explanations of how we got here, offering a rare glimpse into the deepest origins of reality. And in a particularly poetic turn, Weinberg leaves us with a thought: The more the universe seems comprehensible, the more it also seems pointless.
Happy reading!
If you enjoyed reading this edition of Athera’s Odyssey, do reach out to us at contact@atheravp.com, whether you’re a founder building in health or have any feedback for us!