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Certain businesses manage to invent the future and win present-day battles at the same time. In a commercial released on Fox Television in November, for a fleeting second, Microsoft allows you to glimpse it.

“I am in India, and I’m going to see how Microsoft AI is helping people from going blind,” says the commercial’s lead actor. For 60 seconds, it’s a wide-eyed trip down a crowded street. A man on a bike unpacks a fundus camera, and people begin to queue up for eye screening. The device is made by Bengaluru’s 9-year-old startup Forus Health, but it’s the AI (artificial intelligence) from Microsoft that is doing the magic. At least that’s what the commercial implies.

In reality, Microsoft is just getting started as far as screening of diabetic retinopathy (DR)—a diabetes complication that affects the eye—goes. Out of some 1,700 retinal cameras installed in India by Forus, the largest by any one device maker, Microsoft AI runs on just a few. Less than a handful, actually. The two companies wouldn’t talk but sources at Forus say the association is about screening and validation of the algorithm. The device checks out a person, sends the image to the cloud, the algorithm screens it for DR, and sends its interpretation back to the device or the doctor.

The commercial claim, therefore, of ‘helping prevent blindness in India, is over the top. But that’s Microsoft’s AI in healthcare—top-down, publicity-driven. In sharp contrast to Google, which is building products and databases bottom-up. In 2016, Google published its first DR screening work in partnership with Aravind Eye Hospital in Madurai, and by early 2019, it officially announced its algorithm had entered clinical use.  

Top-down, bottom-up, or lateral entry (think Amazon), big tech has set its eyes on healthcare. In the race for supremacy and greenfield business, Cloud plus AI is the new finish line, and healthcare, the new track. 

In a press release in August, Microsoft said it had ‘screened’ over 200,000 people using “the AI-powered API across Apollo Hospitals” for cardiovascular diseases, even predicting the risk score for some. (There’s no peer-reviewed publication yet.) Medically speaking, this is a mere warm-up before the marathon. Nearly all hospitals in India have dark data—unstructured data in PDFs which are hard to mine. 

“This is just a fancy way of selling their Azure cloud. Hospitals don’t have digitisation to achieve AI results. Azure or any other cloud service is just the highway, not the car. Hospitals will have to build their own car,” says the promoter of a hospital which, incidentally, uses Azure. “Even Starbucks has better technology [than hospitals],” he quips. 

Most big companies don’t have a commercial strategy yet. Certainly not for India, where healthcare is fragmented and the market for such services non-existent.


Seema Singh

Seema has over two decades of experience in journalism. Before starting The Ken, Seema wrote “Myth Breaker: Kiran Mazumdar-Shaw and the Story of Indian Biotech”, published by HarperCollins in May 2016. Prior to that, she was a senior editor and bureau chief for Bangalore with Forbes India, and before that she wrote for Mint. Seema has written for numerous international publications like IEEE-Spectrum, New Scientist, Cell and Newsweek. Seema is a Knight Science Journalism Fellow from the Massachusetts Institute of Technology and a MacArthur Foundation Research Grantee.

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