The Cilika digital microscope could go a long way in the health sector with its imaging and transmission advantages
Raghunath Unni never quite appreciated, until a few months ago, the full benefit of the digital microscope he has been using for years. The pathologist, who heads MedHelix Laboratories in Kochi, received a biopsy sample that needed urgent diagnosis. “Our senior consultant works from a different location, and we often send her slides to view,” says Dr Unni. “But she had gone abroad, and we had this complicated case that required her attention.”
The consultant logged on, studied an image of the slide that had been forwarded to her, and offered her opinion. “It was an emergency case, and we needed the report in an hour or two,” says Dr Unni. “As we had feared, it turned out to be ovarian cancer, which is sometimes difficult to detect.”
Dr Unni was able to manage this entire process because of a digital microscope called Cilika. Created by the healthtech startup MedPrime Technologies, the microscope — which comes with an iPad attached — enabled Dr Unni to send high-resolution images of the sample to the consultant easily. Thanks to Cilika’s technology, the consultant could remotely see exactly what Dr Unni and his team were looking at. In fact, the lab uses Cilika for a wide range of functions, from histopathology and cancer detection to blood smears.
“The most important thing about digital microscopy is that it enables telepathology,” says Greeshma Unnikrishnan, the cofounder of MedPrime which is backed by Social Alpha, an organisation supported by the Tata Trusts. “You can remotely access and report on samples without having to physically handle them yourself.”
Digital microscopy can generate good-quality images and videos, and there is also scope of incorporating AI and machine learning. “At some time in the future, algorithms based on machine learning may assist in diagnosis using pattern recognition,” adds Ms Unnikrishnan. Cilika is already halfway there with its tablet attachment.
The idea of a digital microscope came about as part of a project undertaken by Ms Unnikrishnan’s business partner, Samrat Singh, the cofounder and chief executive of MedPrime.
While he was studying at the Indian Institute of Technology, Bombay, Mr Singh’s mentor, Debjani Paul, received funding to create a portable system that would check for sickle cell anaemia. A mobile phone-based imaging device, with an algorithm to read blood samples, seemed an obvious choice. Mr Singh was tasked with working out the imaging aspect. The criterion was a high level of magnification so that red blood cells could be viewed, and the image could be captured on a smartphone.
Once fabricated and demonstrated to doctors for validation, Mr Singh’s team began receiving encouraging feedback. That’s when he and the founders of MedPrime, who were batchmates, realised that a similar system could help with other kinds of diseases and diagnoses. Perhaps a device with increased and variable magnification, more focusing and light options, and one that could be read on a tablet instead of a phone screen. The idea of the Cilika microscope was born.
Unlike traditional microscopes, the tablet attached to Cilika allows for more than one person to view the sample. It can even be projected on a larger screen. Cilika’s patented design and TrueView technology ensure that you get the same results and viewing experience as that of traditional microscopes, with all the added benefits of digitisation.
And one of the best parts? It is ergonomic. The user doesn’t have to hunch over the microscope for long hours. Cilika allows him or her to sit back and study the sample on a screen.
Since the tablet can also capture images, Ms Unnikrishnan says this can be used to create a database of images. Tara Prasad Mohapatra, chief executive of the Bengaluru-based Asian Health Meter concurs.
Dr Mohapatra’s company supports a primary healthcare centre (PHC) in a remote part of Tumkur district in Karnataka. “With Cilika, we can have online checkups and images being sent to experts all over the world,” he says. “And a database will help reduce the disease burden in the rural areas.”
For instance, malaria, filaria, dengue and chikungunya all have similar symptoms. “So, sometimes a doctor at a remote PHC, while waiting for tests results to come in, may prescribe a blanket cover of antibiotics, hoping that one of them will prove effective,” adds Dr Mohapatra. “If we know exactly what the ailment is, we can start immediate and targeted treatment. This could save a patient’s life and significantly reduce the body’s resistance to antibiotics.”
Additionally, with Cilika there is no need for a pathologist to be present at the PHC. It only requires a pharmacist or lab technician to prepare the sample, place it correctly under the microscope, capture an image and email it to a pathologist. This is helpful since suitably-trained staff may be hard to come by in peripheral hospitals.
Screen sharing applications can be used to live stream the sample to a pathologist anywhere in the world so that he or she can view and diagnose it remotely.
“Most path labs operate on a hub-and-spoke model,” says Ms Unnikrishnan. “The samples are collected in some remote area and brought to the main lab, the hub. You will hardly find any pathologists in villages or districts; most stay in cities or towns.” Transporting samples may lead to their contamination in transit. An accurate, magnified image eliminates such problems. The biggest advantage, Ms Unnikrishnan says, is the shortened turnaround time in reporting results.
Available at a price ranging from 100,000 to 890,000, Cilika can be made affordable, through government procurement, for cash-strapped district clinics. However, since its launch in 2017, private labs have been a major customer segment. Cilika is also widely used in medical colleges as a teaching aid. That’s because the images it generates can be projected on a screen to be viewed by an entire lecture theatre.
“It was a huge effort to get to this point,” says Ms Unnikrishnan. “We were an unknown brand and people were not familiar with the technology. Pathologists felt they might miss something if they moved away from the traditional microscope.” Then, when a well-known chain of path labs began placing orders, a lot of customers followed suit.
Ms Unnikrishnan says Cilika may not have got off the drawing board as soon as it did had it not been for Social Alpha’s seed support and its corralling of other investors to support MedPrime.
As for the future, Ms Unnikrishnan is certain about one thing. “Our microscope may have secondary uses, as a learning tool in medical schools or for young interns at labs, but our primary beneficiary will always be the patient.”