Nestled on the fifth floor of a building in a crowded central business district in Bengaluru is InnAccel, a business incubator for healthcare start-ups. The incubator, which houses two start-ups, has rented around 3,000 square feet of space. There are empty chairs lying around in vacant cubicles. The emptiness is symbolic of the Indian healthcare industry.

While those in the cities have access to modern healthcare, large sections of Indians continue to live in 'empty' spaces when it comes to basic medical care. Even as access to a doctor, or a clinic is a pipe dream; the sector itself is handicapped, importing about 80 per cent of the medical devices used.

InnAccel is one of the few ventures in the country trying to find solutions to some of these problems. And these problems, varied and diverse in a country with the second largest population in the world, need to be tackled indigenously.

Coeo Labs, one of the two startups incubated by InnAccel, is hoping that frugal engineering will do the job. When the founders of Coeo Labs, Nitesh Jangir and Nachiket Deval met during a InnAccel fellowship, the two engineers found common cause in an ailment suffered by premature babies. “Our device prevents pneumonia in patients on ventilators by stopping nasal passage secretions from getting into their lungs,” says Jangir, an electronics engineer from the Rajiv Gandhi Technical University in Bhopal. Coeo, which the two founded in 2014, has also developed a prototype of another such device that helps newborns breathe when they experience respiratory problems.

Industry data points out that 30 per cent of Indians who are put on a ventilator contract ventilator-associated pneumonia (VAP). Similarly, in rural India, 50 per cent of child delivery happens outside a care centre, typically at least 5-10 kilometres away.

Breathing life A Vijayrakan, CTO of InnAccel, agreed that the problem was acute. He asked the two young founders to spend three months to identify problem areas -from ways to providing efficient care in ambulances to ICUs. “Jangir and his team saw a 55-year-old man die due to excessive bleeding, saw hospitals not having equipment, some did not follow processes and all these things were discussed animatedly,” he recounts.

After bouncing off the idea with doctors, Coeo Labs decided to develop the VAP product. Basically, it is a portable suction machine that is connected to a thin endotracheal tube inserted through the nose (or mouth) into the patient on a ventilator. Secretions from the mouth and nasal passage often get contaminated with germs.

“The machine senses and removes the secretions before they reach the lungs and an external machine-learning interface controls the suction,” says Jangir. He runs computer simulations and tests on medical mannequins to show how it works.

As the device is in the prototype stage, the founders did not share the cost of these products. But initial estimates show that the new device will be about 30 per cent cheaper than those now available in the market.

As the prototype was being built, some time in early 2015, the team pitched and got a grant from the Union government under the Biotech Ignition Grant. The biannual grant, introduced by the Biotechnology Industry Research Assistance Council, is designed to stimulate validation of research discoveries by providing very early stage grants for the development and maturation of those discoveries. “We got it approved in 30 seconds,” says a beaming Deval, an engineering graduate and Product Designer from National Institute of Design (NID), Ahmedabad. Coeo, which has also filed for a patent in the US, plans to start clinical trials in India this year.

Using frugal innovation techniques, the startup plans to bring down healthcare costs by 30 per cent. “Additional cost reduction is economic- a patient has to stay less in the hospital if he is not infected,” avers Vijayarajan.

Not everyone is impressed. “This is a marginal reduction in cost but the real gains can come only if the country is serious about addressing the complete gamut of healthcare devices- from stethoscopes to CT scanners,” says a surgeon from a leading Bengaluru-based private hospital. Vijayarajan, however, believes that considering the challenges faced by entrepreneurs, every step goes a long way. There are also challenges in distributing this product. “If you look at the ecosystem, venture capitalists are more comfortable investing in e-commerce whereas healthcare ventures get select few eyeballs.”