Gitika graduated in computer science from Harvard University and has an MBA from the MIT Sloan School of Management. She has over fourteen years of experience as an entrepreneur and investor in early stage high tech and health care companies. Gitika was the CEO of Skyris Networks, which was acquired by Draper Fisher Jurvetson’s Timberline Venture Partners. She holds patents in distributed networking, databases, and search technologies, and decision making. Gitika is a pre-career tutor for undergraduates at Harvard and an advisor to many start-up companies and young entrepreneurs. She is also a Partner at KAHM Capital - an early stage venture capital firm, investing globally in high tech and health care.
Naresh graduated from Harvard College where he was a recipient of the Rockerfeller Memorial Fellowship, and the Stanford School of Medicine. He completed dual specialty training at the University of California Los Angeles, and is a diplomate of both the American Board of Internal Medicine and the American Board of Emergency Medicine, and has a subspecialty certificate in Clinical Informatics. Naresh has several peer reviewed publications and book chapters in global health and protocols for medical decision making. His research work has been cited in the "Choosing Wisely" international clinical guidelines published by USA, Canada and other countries. During his medical training, Naresh helped design the curriculum as faculty at India’s premier pre-hospital institute, GVK EMRI (also known for #108 ambulance services) Hyderabad, India.
At Navya, Naresh is Founder and the Chief Medical Officer. He is the lead author of Navya's research presentations at the San Antonio Breast Cancer Symposium 2014 and 2016 and the American Society of Clinical Oncology 2016. His clinical and research interests are in clinical informatics, predictive analytics and medical decision making.
Navya is blessed to have the support of a large group of advisors and investors spanning medicine, academia, business, and industry. Navya’s advisors are oncologists from expert academic institutions in India such as Tata Memorial Centre, and the United States such as Massachusetts General Hospital. Navya’s investors have years of experience building companies serving large populations of people. Navya’s team of analysts is committed to building information technology decision engines to provide expert treatment decisions to patients. Navya’s team of customer service analysts are available on phone and email from 7am-11pm seven days a week and help each patient/caregiver navigate the complexity of decision making.
Gitika and one of her closest kin’s experiences led to the creation of Navya. In 2007, Gitika learned that one of her closest family members was confronted by a cancer diagnosis. Thereafter, Gitika’s family quickly rounded up opinions from several oncologists in the world. They used email, phone, in-person meetings, favors from friends and family and even extended family and coworkers. They sat through hours of Internet research and finally settled on medical evidence and results of randomized clinical trials published Pubmed/MEDLINE. They asked several questions of their oncologists and tried to learn the language, the “medical speak,” to better able to communicate with them. They sat through nights of discussions to make a decision on Treatment 1 versus Treatment 2, and then Treatment 1(a) versus Treatment 1(b) versus Treatment 1(c), etc. There were multiple complex decision points throughout the period of care and every decision point was equally important to the outcome.
Gitika’s relative showed them how important it was for the patient to be involved in his or her care. For instance, he made the decision to choose a protocol of care at a location foreign to him simply because his conversations over a conference call with the experts at three cancer centers revealed that that protocol might be percentage points better for a patient in his age group than the protocol practiced at his home base. Patient Preference matters, as the outcome ultimately revealed, and this soon became an important factor to consider when creating Navya.
This was not an easy process, even if it sounds so now. It was nerve wrecking, frightening, and confusing. The only approach to get through this ordeal was to try and get the best information, the best treatment option, the best recommendation by the best doctors, and leave the rest on God or fate. This is where Navya was born. Navya was born to do whatever is in our hands; being confronted with a complex diagnoses is not in our hands, undergoing the best treatment is. Navya seeks to deliver Clarity in Complexity by providing the patients and their family the best information for the best treatment decision for the patient. This is the crux of Navya.
Navya began to form shape in the mind of Dr Naresh Ramarajan as he went from being a medical school student to a resident. He was exposed, time and again, to difficult decisions in the ER and the ICU. He saw how physicians relied on information tools, encyclopedia, mobile applications, online tools, collaboration via email and phone calls with other physicians, and met in joint committees or tumor boards (for cancer care) to make treatment decisions for patients. Diagnosis is a challenge, but for a complex disease, the post diagnosis treatment is equally challenging. It is not always obvious, no two physicians always agree, it is not possible to rely on medical evidence for every single patient, not every physician can know and remember every piece of primary data and medical evidence, especially at the point of care, and the recent update of technology systems for clinical decisions started to shape Naresh’s professional experiences as a physician.
Most importantly, however, was the concept of applicability – applicability of worldwide conducted clinical trials published in prestigious journals, to a single patient and his or her clinical diagnosis. How can we conduct patient level meta-analysis of primary data so that it is clear whether or not a certain treatment studied in a certain clinical trial is relevant in the care of a patient?
Navya was created to address these goals and challenges, and to create a decision system that a physician could use at the point of care.
Tata Memorial Centre, Mumbai, India
Tata Memorial Centre, which is one of Asia’s largest tertiary care cancer center, is Navya’s research partner in the trial and validation of Navya’s decision engines. Navya and Tata Memorial Centre have successfully completed a retrospective trial of Navya’s Evidence Engine and Guidelines Engine and validated that Navya Expert System decisions are 98.6%-100% concordant with tumor board decisions and decisions of expert oncologists at Tata Memorial Centre. These results were presented at the San Antonio Breast Cancer Symposium in December 2014.
Navya and Tata Memorial Centre are now working on trials to validate Navya’s Patient Preference Tools, which is a self-administered decision aid that helps patient assess their risk/benefit tradeoffs across their available treatment options by using techniques like conjoint analysis.
Navya is partnered with Tata Memorial Centre(TMC) and National Cancer Grid (NCG) to provide expert opinions from experts at TMC and NCG to patients/caregivers worldwide. Patients upload their medical reports per Navya’s list of requirements. Navya translates the patient’s medical reports and questions into a structured case summary and decision question for experts at TMC and NCG. Using Navya’s ExpertApp, experts respond and provide an expert opinion on the patient’s case. Navya combines the opinion of multiple experts from different Disease Management Groups at Tata Memorial Centre and National Cancer Grid and prepares a final report for the patient. Navya’s reports are easy to understand and in patient-speak. Navya’s case summaries to the experts are quick to review and may include evidence and guidelines based treatment options for the experts to quickly choose from, thereby reducing the turnaround time for an expert opinion. Navya also includes evidence and guidelines information for the patient as necessary, which provides strength to the expert opinion. The strength of the expert opinion and the simplicity of the patient-speak, provide clarity in complexity of decision making for the patients/caregivers. They are comforted that they now know and understand their treatment options and are guided by an evidence based multidisciplinary expert decision.
Since May 2014, Over 18,000 cancer patients from 22 developing countries and 47 countries including worldwide including Bangladesh, Dubai, Kuwait, Iraq, Russia, Singapore, Hong Kong, Malaysia, Kenya, Mozambique, Nairobi, South Africa, Australia, Canada, United States, United Kingdom, and from all across the Indian subcontinent have reached out to Navya an expert opinion on their treatment options.
The National Cancer Grid (NCG) was formed in August 2012 with themandate of linking cancer centers across India. A modest initiative,which originally had 14 cancer centers, has rapidly grown now toinclude 85+ major cancer centers virtually covering the entire lengthand breadth of the country and is amongst the largest cancer networksin the world.
Funded by the Government of India through the Departmentof Atomic Energy, the NCG has the primary mandate of working towards uniform standards of care across India by adopting evidence-basedmanagement guidelines, which are implementable across these centers.
It is also intended to facilitate the exchange of expertise betweencenters and to create a ready network of centers for collaborativeresearch in cancer.
Tata Trusts are amongst India's oldest, non-sectarian philanthropic organisations and their work is in several areas of community development. In keeping with their strategy of harnessing technology for social good, the Tata Trusts has supported the Navya online expert opinion service at Tata Memorial Centre. This service aids in standardising cancer care, by providing treatment opinions from the world’s leading experts to every cancer patient, irrespective of their geographical location or ability to understand medical information. The support from Tata Trusts enables Navya to keep its processing fee down and serve the below poverty line patients free of cost.
National Institute of Health (NIH) Big Data 2 Knowledge (BD2K) Center BD2K is a trans-NIH initiative established to enable biomedical research as a digital research enterprise, to facilitate discovery and support new knowledge, and to maximize community engagement.
The BD2K initiative addresses four major aims that, in combination, are meant to enhance the utility of biomedical Big Data:
To facilitate broad use of biomedical digital assets by making them Findable, Accessible, Interoperable, and Reusable (FAIR). To conduct research and develop the methods, software, and tools needed to analyze biomedical Big Data. To enhance training in the development and use of methods and tools necessary for biomedical Big Data science. To support a data ecosystem that accelerates discovery as part of a digital enterprise.
Overall, the focus of the BD2K program is to support the research and development of innovative and transforming approaches and tools to maximize and accelerate the integration of Big Data and data science into biomedical research.
The NIH Center of Excellence for Big Data Computing at UCLA assembles six international investigator teams in medicine, data science, and computational biology.
Dr Reddy’s Indian Breast Cancer Resource (IBCR)
Navya Network developed the Indian Breast Cancer Repository as part of Dr Reddy’s Indian Breast Cancer Resource, which is a collective initiative between several academic cancer centers in India to collect and make publicly available all clinical and epidemiological research on breast cancer in India.
Much of this research has either never been published (such as doctorate or post doctorate students thesis) or has only been presented as abstracts in major conferences. Therefore, the effort involves hand searching major conference abstracts, dating as far back as 1998, and collecting theses from libraries of major academic institutions.
The IBCR repository also includes published research on Indian breast cancer patients, sourced from MEDLINE and global conferences such as ASCO, AACR, St Gallen, EBCC, ESMO, and St Antonio. The repository is indexed and searchable by patient characteristics, disease characteristics, treatments, and major aspects studied in the research. The repository is the first of its kind, focused on both published and unpublished research on breast cancer in India.
The IBCR is facilitated by Dr Reddy's Laboratories and developed by Navya Network, Inc., with oversight from several esteemed oncologists from Tata Memorial Centre, Mumbai, All India Institute of Medical Sciences (AIMS), New Delhi, and Rajiv Gandhi Cancer Centre, New Delhi.
Harvard Business School
Researchers and professors from Harvard Business School’s Organizational Behavior Unit are interested in participating in Navya Network’s trial on Patient Preferences. They are interested in studying the role of gender biases (husband vs wife) and the role of women (vs other decision makers in the household) in decision making on matters related to the treatment of women patients. For example, studying the results of a prospective trial on decision making between mastectomy (complete removal of breast) and lumpectomy (removal only of the cancerous lump in the breast), which have similar outcomes but differ in considerations mostly personal to an individual, such as cost, logistics, side effects, quality of life, etc.
Navya Network has been issued two patents by the United States Patent and Trademark Office with international filings in several countries. A third patent is in final office action.
1. United States Patent Application Publication US 2012/00166901
Treatment related quantitative decision engine.
Abstract: A system and method, for use with a computer system, generate a report to help decide among a plurality of treatment options for a patient with a given medical condition. To that end, the system and method receive patient information related to the patient and the medical condition, and query a treatment option database to generate a plurality of potential treatment options for the medical condition. In a corresponding manner, the system and method also receive preference information indicative of the patient's preference(s) for potential treatment outcomes of the treatment options. The patient's preference(s) are used to produce a preference value. The system and method also analyze indexed study data relating to the plurality of treatment options to produce (e.g., at least in part in a computer process), based on the analysis of the indexed data, a study score for each of the treatment options. Accordingly, for each treatment option, the method and apparatus produce a treatment score as a function of at least the preference value and the study score, thus permitting generation of a report listing the treatment options and a) the treatment scores or b) the information derived from the treatment scores.
2. United States Patent Application Publication US 20120016206
Treatment decision engine with applicability measure.
Abstract: A system and (or) method, for use with a computer system, recommends a treatment among a plurality of treatment options for a given medical condition of a patient. To that end, the system and method receive patient information related to the patient and the medical condition, and search, at least in part in a computer process, a database with a plurality of indexed studies relating to the plurality of different treatment options for the given medical condition. The system and method then assign, at least in part in a computer process, a study value to each of the plurality of studies, and determine the applicability of the studies to the patient using the patient information to produce a plurality of applicability values. At least the study values and the applicability values are used to generate treatment scores for the treatment options for generating a report listing the treatment options and a) the treatment scores and/or b) information derived from the treatment scores.
3. United States Patent Application Publication US 20130254178
Medical research retrieval engine
Abstract: An apparatus and method of retrieving relevant documents having medical research evidence receives a request to access a plurality of documents in a database stored in a memory device. Each of the plurality of documents contains information relating to medical research evidence and has an associated relational expression. The method then causes display of a user interface with a plurality of fields (a set of these fields are selectable, prescribed terms), and receives a relational expression based on information received from the user interface. The received relational expression includes at least one of the selectable, prescribed terms in the user interface. Next, the method compares the received relational expression with the relational expressions associated with at least one of the plurality of documents, and causes the display of information relating to a set of documents in the database as a function of the comparison of relational expressions.
A partial list of Navya’s invaluable team of advisors, investors, and analysts include:
Sasha Mirchandani – Founder, Mumbai Angels and KAE Capital, India
Gautam Shewakramani – Mumbai Angels, MIT TechU Angels, MIT Sloan School of Management
Paul Perry – Senior Executive in information technology, formerly at Microsoft and Verizon
Mr. Rajiv Gulati – Industry veteran and former senior executive at Ranbaxy, Eli Lily
Dr Sudeep Gupta – Professor in Medical Oncology, Tata Memorial Centre
Dr Rajendra Badwe – Professor in Surgical Oncology, and Director of Tata Memorial Centre
Dr Purvish Parikh – Renowned former head of medical oncology at Tata Memorial Centre
Dr Elizabeth Lamont – Medical Oncologist at Massachusetts General Hospital
Dr Lakshmi Ramarajan – Assistant Professor at Harvard Business School
Dr Pramesh – Coordinator - National Cancer Grid (NCG)
Dr DCruz – Director, Tata Memorial Hospital
Haseen Taj – Operations Manager and Head of Customer Support
Srikanth Peru – Product Manager
Sameet Mudbidri – Operations and Outreach
Farzana Begum – Senior Analyst and Head of Quality
Pooja A – Senior Analyst
Rochelle Rego – Analyst
Armugam X – Analyst
San Antonio Breast Cancer Symposium 2014 :Validation of a Software Based Clinical Decision Support System for Breast Cancer Treatment in a Tertiary Care Cancer Center in India
Abstract published in conjunction with the 2016 American Society of Clinical Oncology annual meeting: A Machine Learning Approach to Enable Evidence-based Oncology Practice: Ranking Grade and Applicability of RCTs to Individual Patients
Abstract published in conjunction with the 2016 American Society of Clinical Oncology annual meeting: International Application of an Online Clinical Informatics Expert System for Breast Cancer
Poster presentation at San Antonio Breast Cancer Society, December 2016: Building An Experience Engine To Make Cancer Treatment Decisions Using Machine Learning
Oral presentation at American Society of Clinical Oncology, June 2017 : Global impact of a clinical informatics system: Scalable delivery of on-time access to evidence-based multidisciplinary expert treatment decisions for all cancers