Anumeha Srivastava on how Qure.ai is Transforming Healthcare with AI

By Arunima Rajan

In an exclusive interview with Arunima Rajan, Anumeha Srivastava, Chief Business Officer—Neurology, Qure.ai, discusses the company's journey and the future of AI in making healthcare more equitable across the country.

What are the biggest healthcare challenges in rural India, and how can AI help?

Rural India faces significant healthcare challenges, including limited access to medical professionals, inadequate diagnostic resources, and delayed treatment. The current healthcare system and its providers are massively under-resourced, and the care gap is too big for one solution to make a difference. AI can be the best solution to address these issues by enabling faster detection and aiding clinicians and healthcare workers in quicker decision-making. thereby improving access to timely and accurate medical care. Healthcare in India is fragmented and needs to be streamlined so that the hinterlands and the remote population get first-quality care, even in limited resource settings. Through AI-powered tools, we can bridge the gap and enhance healthcare delivery in underserved areas.

Qure.ai was founded eight years ago. Can you share more about what inspired the team to start the company and what you were aiming to address?

Qure.ai was founded in 2016 by Prashant Warier, who, with his expertise in AI and healthcare, wanted to create a team to address challenges in radiology. Prashant, previously involved in advertising tech, shifted his focus to healthcare after his previous company was acquired. The Qure.ai team identified radiology as a promising field for AI due to its extensive data availability and digitisation. They initially targeted chest X-ray interpretations and CT scans for trauma and stroke diagnoses. After overcoming data collection and algorithm accuracy issues, Qure.ai gained FDA and CE certifications, launching its technology in 2020. The company's breakthrough came with a 2018 project in the Philippines, where their AI significantly accelerated TB screening.

Our mission is to leverage AI to provide healthcare facilities to everyone, regardless of location. We aim to bridge healthcare delivery gaps, ensuring high-quality services reach even the most underserved communities. We aim to make healthcare more accessible and equitable, re-humanising it for those in need.

What are the cons of applying AI to radiology and medical imaging?

Applying AI to radiology and medical imaging can raise concerns such as potential over-reliance on algorithms, which might lead to missed or misinterpreted findings if not monitored carefully. There's also the data privacy and security issue, as handling large volumes of sensitive patient information requires stringent protections. Additionally, the Integrating AI systems may require significant training for healthcare professionals to use effectively. That said, Qure.ai's algorithms are trained on a dataset of more than a billion images, and our portfolio of products to interpret Chest X-rays, Musculoskeletal X-rays, Chest CTs, & Head CTs cover more than 62 different types of findings. It distinguishes itself in the field of medical imaging AI with a proven track record at over 2600 sites across more than 90 countries, impacting over 20 million lives. Our system reduces turnaround times by 40% with a normal-abnormal triage system, facilitating quicker interventions. Our algorithms use a vast dataset of over 1 billion data points to ensure precise medical image analysis. We have 6 FDA clearances, 25+ patents and more than 50 publications in top medical journals, such as The Lancet.

Trusted globally, Qure.ai collaborates with leading institutions such as AstraZeneca, NHS hospitals in the UK, and significant teleradiology companies in the UK and US. With this global presence, we can support our international partnerships and deployments from our offices in Mumbai, Bangalore, New York (US) and Birmingham (UK).

Can you share any interesting examples of how AI has improved rural healthcare in India?

In 2022, Qure.ai received funding from SAMRIDH to deploy our AI-driven Chest X-ray screening tool, qXR, to 50 rural and semi-urban healthcare centres across India. This initiative aimed to assist healthcare workers with the dual screening of COVID-19 and lung diseases such as TB. Such partnerships are essential for fostering innovation in healthcare, extending the program's reach to underserved areas, and advancing the role of AI in medicine. Another notable example of this impact is in Purnia, Bihar, where Dr Alexander Philip, Director of Christian Medical Centre and Hospital (CMCH) Purnia, addressed a surge in TB cases. With support from the SAMRIDH Health grant, Qure.ai's AI solution was implemented to enhance TB detection and improve patient care. Qure's qXR effectively addresses the doctor-patient ratio challenges and demonstrates how AI can transform healthcare at the grassroots level. We also recently completed an expedition to Everest Base Camp, deploying our AI-enabled chest X-ray solutions to address critical healthcare needs in Nepal's remote regions of the Khumbu Valley. This initiative is set to redefine healthcare access and delivery in some of Earth's most isolated and challenging environments.

Last but not least, our Hub & Spoke mode aims to revolutionise stroke care by creating a time-efficient system where primary healthcare facilities ("spokes") funnel patients into specialised centres ("hubs") for prompt, expert treatment. Our partnership with Medtronic India Pvt Ltd and the collaboration with CMC Ludhiana showcased the impact of AI and the hub and spoke model in reshaping the stroke care landscape. Since going live one and a half years ago, this initiative has established four hubs and 15 spokes across 13 states, impacting over 1000 lives until 2023. Embracing this AI-driven approach is setting a new standard for stroke treatment, promising improved patient outcomes even in the most remotest areas.

How do you see AI changing healthcare access and quality in rural India in the future?

AI holds immense promise to transform healthcare delivery in rural India, offering the potential to enhance access and quality of care significantly. The key will be to adopt a comprehensive and sustainable approach, ensuring that AI solutions are effectively integrated into rural healthcare systems and address the unique challenges of these areas. Qure.ai offers AI products that enhance healthcare delivery, focusing on three key therapeutic areas: lung cancer, global health, and stroke care, which are a few of the leading causes of death globally. Key products include:

• qXR: AI for chest X-rays identifying signs of TB and Lung Cancer

• qER: AI for head CTs triaging stroke signs and coordinating care

• qCT: AI for chest CTs

• Qure App: Care coordination app

These tools help healthcare professionals detect abnormalities, manage and triage cases effectively, provide faster diagnoses, and improve global patient care. For lung cancer, our AI solution helps detect nodules early, aiding in the early detection of lung cancer. The tools streamline screening, detecting TB cases, monitoring disease progression, and overall patient care management in tuberculosis. Stroke is the second leading cause of death in India, with around 1,85,000 cases reported annually. The first 60 minutes post-stroke, known as the Golden Hour, are crucial for intervention, significantly improving recovery outcomes. Qure's qER solution analyses head CT scans within minutes, highlighting critical findings and enabling physicians to identify stroke patients and initiate treatment quickly.

For example, Qure.ai has recently highlighted the transformative potential of Artificial AI in stroke care through a collaborative study with Baptist Christian Hospital (BCH) in Tezpur, Assam, India. This study focused on enhancing stroke diagnosis and treatment times, particularly in remote or resource-challenged areas. The study yielded notable results, including a sixfold increase in early intervention rates with patients receiving treatment within the first 30 minutes, a 27% reduction in treatment times that could significantly impact survival rates by expediting stroke interventions, and a high diagnostic accuracy of 97% in ruling out bleeds in suspected stroke cases. Thus, we can ultimately drive better health outcomes across underserved communities by supporting healthcare workers with these AI-driven tools.

Your recent study shows the impact of AI-powered stroke detection solutions. Can you elaborate on how it can overcome challenges like a lack of specialists and enable timely care in resource-limited hospitals in rural areas?

In India, approximately 934 million people lack access to neuro specialists, with 90% of these specialists concentrated in Tier-1 and Tier-2 cities. This means that a significant portion of stroke patients need to travel hundreds of kilometres to receive treatment. Given that stroke is a time-sensitive emergency, quick diagnosis is essential for timely intervention. Our study studying the impact of AI on stroke care with Baptist Christian Hospital Tezpur demonstrated a 27% reduction in time to treatment and a 179% increase in the number of stroke patients receiving intervention within the golden hour, a door-to-treatment time of 60 minutes or less. In settings where specialists are unavailable, or resources are constrained, our AI-powered stroke solution enables clinicians to accurately diagnose strokes and connect with comprehensive stroke hospitals, bridging the gap to timely critical care.

What are the key areas in which AI can make the most significant impact? What are the major challenges faced by AI companies like Qure? And what sort of policy support do you need to realise the potential?

AI can significantly impact healthcare by enhancing diagnostic accuracy through advanced imaging analysis, improving patient outcomes with personalised treatment plans, and optimising healthcare operations with predictive analytics and workflow automation. These advancements lead to earlier disease detection, tailored interventions, and more efficient use of resources.

The health tech AI sector faces challenges in trust, transparency, regulatory compliance, data privacy, and clinical validation of AI algorithms. Obtaining high-quality, diverse datasets is crucial for training accurate models, but this cannot be easy, especially in underserved areas. Navigating complex regulations and obtaining certifications (e.g., FDA, CE) can be time- consuming and costly. Integrating AI solutions into established healthcare practices and systems can take time and effort. Ensuring that AI models are unbiased and generalizable across different populations is critical for equitable healthcare. Lastly, scaling solutions effectively while maintaining performance and reliability across various settings and regions is a significant hurdle. Qure.ai addresses these by adhering to stringent regulatory guidelines and working closely with healthcare providers to meet clinical standards.

To realise AI's full potential, robust policy support is needed, including clear regulations for data security, incentives for technology adoption, and robust frameworks to facilitate the integration of AI solutions into existing healthcare systems.

As the CBO of an AI startup, what drives you to do the work you do every day? Why did you choose to join an AI startup focused on healthcare, and what motivates you to keep pushing forward Qure.ai's mission?

Having worked with patients suffering from chronic disabilities due to inequitable healthcare access across different countries, I realised early in my career the urgent need for transformative change. These patient stories have profoundly influenced my drive to seek solutions through technology, as it is a tremendous and one of the only equalisers in healthcare. Qure.ai is one of the few companies that has successfully made advanced technology accessible to patients in underserved regions and countries, achieving this sustainably and at scale. Furthermore, Qure.ai has inspired other health startups in India to pursue ambitious patient impact goals. This mission and our extraordinarily talented team's dedication motivate me to push forward every day.