East meets West in this multinational startup, to take care of your heart - The Kallows story
Kevin Scott Kreger and Gajanan Satish Nagarsekar came together in Goa to start a healthcare venture, Kallows Engineering, which among other things has built ultra-portable and low-cost smartphone and tablet-based cardiac monitors. This year, Kallows Engineering was selected as the Tech30 of 2013 at TechSparks. I had the privilege of interacting with this passionate founding team which wants to make a tangible difference in the healthcare space. Please find below an inspiring narrative by Kevin on their journey so far and what drives this team to create cutting-edge products.
The starting point
Gajanan and I started Kallows a little over six years ago in Goa. We were both working for GE Medical Systems (now GE Healthcare) on magnetic resonance image scanners (MRI). We met in October of 2006 and became fast friends. I visited Goa, Gajanan's home state, in December 2006 for holiday.
I really liked India, the pace, the excitement -- and I saw the demand and need for more tech resources -- I felt I could make a bigger contribution beyond the confines of a corporate. Gajanan felt the same way. Subsequently, we spoke about my returning to Goa to found a startup with Gajanan. I quit the consulting contract at GE and took a holiday around the globe which ended in Goa three weeks later, in February 2007. Gajanan found a nice flat in Panjim and I settled in.
By this time, Gajanan had quit his job at GE and was teaching at his engineering college. We immediately connected with a team of final-year students at his college and we became professor/ mentor/ teacher for them in embedded systems and Java coding. The sitting room of the flat was converted into our first office where we crowded in more than 10 students at a time. I also did a few lectures (I was a professor at University of Wisconsin in the US, and I was lecturing on smartphone technology and embedded systems). As a result, we picked up our first contract with the National Institute of Oceanography in Goa after networking with one of my lecture attendees.
Meanwhile, Gajanan and I were discussing product ideas. We were showing the students how to interface with a J2ME smartphone from Motorola running Linux (an early incarnation of the Open Handset Alliance's work with Linux that predated the iPhone and which culminated in Android). We had talked to one of Gajanan's professors and he thought, with our medical device background, that we should make something such as an ECG monitor. He also pointed out that mobiles were a fast-growing market.
I have to admit that I was originally very sceptical, as there was heavy competition in the ECG marketplace (including GE and Siemens, past employers of myself and Gajanan). Also, the mobile market was fragmented with each mobile's manufacturer having its own OS and own requirements for building apps and receiving revenue. However, we did tie up with Motorola's Developers Network and hoped to make a good impression with Motorola. Also, the kids on the team, with help from Gajanan and me, were able to build a plethysmograph that could monitor pulse and interface to the headset microphone input to the Motorola mobile. Things eventually coalesced a few years later when Android was released, but I am getting ahead of the story.
On naming the company: Kallows
The name Kallows was actually a completely fanciful invention by Gajanan. I was in law school studying intellectual property (on leave for a year while in India), so when Gajanan asked me what we should name the company I had a somewhat legalistic answer. I told him that he shouldn't spend too much time on it, but just make up a fanciful word that no one else would likely have to avoid any possible trademark conflicts (the strongest trademarks are these fanciful words like Xerox that no one else could possibly have). He had a few contenders and he asked about "Kallows" He thought the 'K' from my name would be a good letter to use and he found a similar English word 'kallow' which meant inexperienced and he liked the wordplay. I googled it and found the domain was available and it was not a trademark in the US or India, so we went with it.
Pain point, and the product
Well, we make medical device for cardiac monitoring -- ECGs and pulse oximeters (for measuring blood oxygen). So, I suppose we could be glib and say 'cardiac pain if you want to get to the heart of it.' Now, stop moaning, it is a bad pun, but the truth is contained within the pun. I have over ten years of experience processing ECG and other cardiac data working for GE. Typical ECG monitors sell for a much higher price than ours and even the small ones are not nearly as portable as ours, which fit in the palm of your hand. We believe we have the world's smallest 12-lead ECG.
So, these factors, viz., ultra-portability and low-price, are solving two problems; more people can buy the monitors due to lower price, and they are easier to transport (also battery-powered). Our products are designed to reach more patients. I think you can see that our monitors could also be used for emergency services quite easily, or in a GP’s facility that would not normally have a higher priced system.
However, these pain points are not the main problem we are addressing. We are addressing the shortage or lack of immediate availability of a cardiologist that can diagnose the patient's condition from the ECG. The best thing about our product is that it runs on a smartphone or tablet so you can use it to transfer the ECG to a remote cardiologist anywhere in the world within a few seconds. We have several killer 'tele-ECG' features that leverage this capability including a remote live ECG plot that rings the doctor's phone and displays the scrolling plot when he answers. We can also share ECG via apps like email, WhatsApp, and the like. So, our products are also designed to allow cardiologists to reach more patients at that time when they are critically needed; it is a life-saving feature.After returning to the US, I resumed where I had left off at law school and finished my juris doctor degree. I also picked up the consulting work back at GE on MRI, but this time as an employee of Kallows, so we were getting some funds from these transactions. Gajanan was chosen as a research scholar and offered a position at University of California San Diego, to write pulse sequence code for a research project at one of the UCSD labs. So, Gajanan came to live in the US, with his new bride, Juilee. We travelled to visit each other and they spent time with my family during traditional holidays. We managed the office in Goa remotely where the programmers continued doing contract work for the NIO.
After completing his assignment at UCSD, Gajanan came to my hometown of Milwaukee to work on his PhD (doing more MRI research). He was also minoring in business marketing to grow skills for Kallows. At that time, he received an email from the business college about a business plan competition. He entered and won, based upon our plans for smartphone-based cardiac monitors. He subsequently went to the regional competition and was selected as one of four academic entrants in the governor's business plan competition (the rest of the entrants were commercial, not academic teams). We were runners-up in the IT category, and we were subsequently groomed by Biz Starts Milwaukee, who introduced us to potential investors and helped us refine our business plan.
We were approached by a business mogul, who had made his fortune with ECG monitors, and subsequently we were offered a sizable investment sum, but this was a potential competitor and the conditions were too onerous to accept. We made a difficult choice at that time. We decided we would leave the US, and return to Goa, where we would be able to do the product rollout with less expense and get it to market quicker. So, January 2011 is when our serious product development started; we were no longer an IT services company but a budding Indian medical devices company.
Competitive advantage
We have the highest speed of access to patient's ECG by the cardiologist, which is a life-saving feature. We are also the most portable and one of the lowest priced.
Market
We are focused on the global market using India as the most logical launch pad due to the market need here and the high cost and high bar to entry of medical product in the US. Our next target markets are Bangladesh and Africa (in particular Malawi which is one of the world's poorest countries), and we will start sales in the US when we gain FDA approval.
Growth plan
A lot of my current focus on the product is the innovate/ iterate cycle, but we have laid the groundwork to scale our technical work, with the proper quality process for tracking and fixing issues that arise. This process is important, because soon I will not be able to manage all of the people individually; the engineers I manage now will be the new technical managers tomorrow, so our process must be scalable. Moreover, Gajanan is handling the plan for scaling of the sales team into several tier I cities in India, and then into Bangladesh and Africa.
We produce hardware products, so most of our revenue is generated through the sales of our devices. We also plan on giving out the product for rental usage. As well, we have customers who do not own the product; they view the patient data remotely. These customers purchase the app. Finally, we provide online storage, browsing and printing of the electronic medical records (EMR), and there is a fee charged for this service.
Motivation
Speaking for myself, I am driven to create in general. Sometimes, there is just satisfaction in making something beautiful. For a technical product, that means it works beautifully for the customer. In the case of our current products, there is an additional satisfaction because of the life-saving capabilities. This is the third startup I have worked on, so I also enjoy the freedom to create and the general atmosphere of pressurized innovation. The other motivations are related to success. I want to be successful enough here in India to be able to make a life here for the foreseeable future and to split my time between here and the US.
An inside peek into the individual behind the venture
What should I say? I'm fun to be around. I enjoy watching movies and I'm a music buff. I studied art before becoming an engineer, and I have mastered sculpting (something that drew me to India was lots of great sculpture). So the creative aspects of my background sometimes complement what is needed for the startup. I am also a fitness buff. Gajanan and I trained together in the US, and took part in a yearly event to raise money by running the stairs to the top of a skyscraper in Milwaukee. We also believe that the team that plays together stays together. Even though we can be quite the 'task masters' at times, we take time out to celebrate milestones - and we also brought our programmers to TechSparks 2013 as a reward and to inspire them. In short, our team is great and we all enjoy working together.
Starting up
This is interesting: I needed money to pay my school bills while attending university and I already had a part-time job as a commercial R.J. So, I started a portable D.J. service and made quite a bit of money entertaining at parties.
This new journey is really like an epic tale with all of these highs and lows, and being chosen for Tech30 is one of the epic high points -- we never know what to expect and it sometimes seems like we are living in some movie script wherein we are reaching the 'happy ending'. But, otherwise, most of the time -- usually seven days a week - is spent working on the products in some fashion. So it's not like we are dancing around the office, but we are anticipating and expecting greatness.
Future roadmap
Working on new products that are also setting a new bar for access to patient data at low price.
Headquarters: Goa
Well, Goa is actually an interesting place for me to be. For Gajanan, it is just 'home'. It is somewhat cosmopolitan due to tourism and the occupation by the Portuguese. Even though Goa is a tourist magnet, we seldom get to any tourist areas (except maybe to enjoy a nice dinner). However, my dad came for a visit in September, and we stayed on a nearly deserted beach in South Goa. It was tremendously beautiful. I also took him to an eco-resort on top of a nearby ghat, which dad said was the best part of his trip. One thing we do have to contend with is the image of Goa affecting our startup image negatively. We often hear how cool it must be to work in Goa as if we are sitting on the beach with our laptops. Well, this never happens and is purely fanciful if you ever see it in an ad. First of all, we are in a town in the interior, far from the beach belt. Second, if you were to try to work on the beach, the sun would be too bright to see your screen, and the sand would ruin your laptop. :-)
However, the thing that really interests me - more accurately, keeps me in Goa -- is having a support network here that has made Goa my second home. Otherwise, I would not be able to live and work so easily away from my family and life in the US. Gajanan's entire family has been a tremendous help to me, and he has always made sure that whatever may be, it is always 'us', as two friends that are together on this venture or endeavour. We started the company together with complete and equal dedication of purpose. In the early days we spoke about the serious issues of the company potentially taking us away from our family at times and how it could impact our friendship. We were testing ourselves to see if we were up to the dedicated tasks required - and we both passed. It is seven years on since Gajanan and I met. He is still my best friend, and he and his wife are my biggest supporters. I hope I am the same for them.
What inspired me most about this honest narrative is when Kevin shared one of his very personal moments to help understand that while data and numbers are of paramount importance, businesses are built out of passion and sometimes personal pain point.
Kevin says -
There is also a particularly personal point of pain that our product addresses. Just after we founded the company in 2007, I found myself having a serious heart attack while lifting weights at the gym. I had no idea what to do and did not even comprehend what was wrong. Gajanan got me to a local hospital in record time and there just happened to be a cardiologist nearby (I believe he was just finishing his dinner). He connected an old pen plotter ECG, diagnosed my heart attack, and immediately administered a clot buster.
It was really Gajanan's quick reaction, the availability of the cardiologist and the ECG that saved my life. I had the emergency surgery a few hours later (a stent was implanted). I have returned to weight-lifting and I do long distance swimming as well. So, I seem particularly well-suited for the task of helping others in the same straits. In fact, our first customer for 12-lead ECG is the local hospital where I was first treated.
This incident does tie our work to a more keen sense of purpose. I think most who work providing any type of medical devices or services feels the importance of the benefits of their work and not just a pure profit motive, but for us it is more personal. However, I want to stress that we are passionate about our work and our products, but we did a lot of market research that was not clouded by emotion before we decided to work on mobile health monitoring devices.
Kevin concludes by summing up his journey so far…
With us, it’s East meets West, ours is a real co-equal collaboration between the founders. We found a friendship and a common goal in building a company. We find strength in our differences - our different perspectives from different cultures, our different roles we play (I am engineering and he is marketing), and so forth. The friction and interest created by those differences, and the differences and similarities between our two countries have forged a company with a global understanding of our market and our trials have given us an iron will to succeed.
