 A young professional named Chirag Shah has come up with a unique solution in the physiotherapy sector of medical industry. His company called RIMO focuses on accelerating physical recovery by providing objective and goal-based training using robotics and virtual reality. Welcome to another edition of Chainmakers. Technology-based solutions for physical rehabilitation can provide a wide range of benefits for patients. They can provide more accurate and precise treatments, reduce cost, reduce the need for manual labour and even allow for more efficient rehabilitation. Technology-based solutions can also provide a more personalized experience for patients, allowing them to monitor their progress more closely and easily. Today we have with us an entrepreneur who has made a mark in the field of technology-based rehab solution. Let us know more about it from the man himself. Hello Chirag, welcome to the Chainmakers. Thank you so much for inviting me to the Chainmakers and featuring our story. I am looking forward to our discussion today. Yeah, thank you Chirag for being with us. Achirag, what is the problem that you are addressing through your startup? Startup is actually focused on a very specific domain which is kind of encapsulated in our name itself. So, the startup name is RIMO and it stands for Redisturb Your Mobility. In India and across the world, if you look at the number of people who are finding it difficult to move on their own independently, it is a whopping 2 billion people. Now, if you look at what they need to start moving themselves or become independent, the simple question is physiotherapists. But if you look at the vast difference in the number of skilled therapists and the number of people who require it, you realize that there is some drawbacks which come along with it. Especially from a patient perspective, there are three major pain points. The first is they find it very difficult to understand whether they are improving. When we COVID came and hit us, we all had our COVID reports which showed us our difference scores or severity of COVID. But in physiotherapy, it is very difficult to do that. So, patients don't realize whether they are improving. Second problem is it takes a lot of time. So, it probably could take you one week, or it could take you one month, or it could take you even five years to recover your independence. So, it is a very time-staking process to do it traditionally. With the use of robotics or different technologies, we believe that we can kind of help them recover faster. And the third most important aspect is to make sure that people don't give up and they are motivated to continue. Like many difficult things, exercise is a very, very difficult habit to form and not many individuals can do that. Physiotherapy is exercised when you are in pain. So, nobody likes pain, nobody likes exercise. If you mix it together, that is physical therapy. So, for us, it was important to make sure these demographic people can recover, they can become independent and live life like they are supposed to, full of freedom and full of energy. So, this is probably where AIMO comes in to make people independent and live a complete life. Thank you, Chirag. Thank you for sharing your insights on the problem of your startup is addressing. It is inspiring to see the impact you are making in the healthcare industry. Chirag, please tell us in detail about the work that you are doing. So, thank you so much for bringing upon the impact that we are making. And that is probably the only reason why we began this journey. So, so far, I think so, we have just touched the surface, probably not even touched the surface yet. Going is just to cover up what we have been doing in the healthcare sector. First, as we identified the problem and the domain, we spent probably more than two years in evaluating the problem and spending time with patients and physiotherapists. In this journey, we learned about different aspects of rehabilitation, specifically physical rehabilitation and occupational therapy. And we've integrated that to technology and made a very portable and easy to use device, which is built on the technology stack of robotics and virtual rehabilitation are also known as gamification. These two technology stacks have been incorporated and a company is now focused on making it accessible to the world. So, we have kind of launched this in India. We have 20 plus installations across India. Probably we have now located in all the four macro cities and looking going forward, we are looking at expanding this to the world. So, we have just started and though we have had around 700 patients in their recovery journey, I think so, we could reach 7 million in the future. So, that is why I would stress on the point we have just begun. But yeah, great. But you just, you are saying that you just begin, but you are beginning with the 70 places already, your devices installed in 70 places, it's good to know. From your informative response, it's clear that you have a deep understanding of the work you are doing and the impact it can have on patients. What are the advantages of using robotics and VR in the rehab therapy, Srirag? So, there are predominantly three advantages that we are looking at when we try and do technology in physical therapy. Like I mentioned the first problem was of lack of awareness or monitoring progress. So, when do you use or incorporate robotics or virtual rehabilitation or virtual reality into physical therapy, you can measure. With robotics, you can measure how much a patient has moved, how much strength he is applying and whether physical therapy or whatever treatment he is doing, it be it medicines or anything else, whether that is okay. So, you have a number to your recovery and when you see progress, you kind of, you know, are more motivated to do further. The second thing and the most important thing is you get personalized training for accelerated recovery. Suppose imagine you are, you don't have any robotics or virtual reality training, you would end up doing a traditional thing for a few days and you leave it out. But with robotics, you can give a patient enough assistance which is customized for the patient. So, even if there is a therapist who is not able to dedicate 100% of his time, they can still set the personalized protocol for the patient and get them to do the number of repetitions that they want. Especially in neurological cases such as stroke, it is proven that doing hundreds of repetitions helps improve the learning curve of the brain, which is also known as neuroplasticity. So, with robotics you can accelerate the process in which a patient, a paralyzed patient can learn how to do things again. So, robotics can help you significantly in improving your neuroplasticity and accelerating recovery. The third most important aspect is engagement and fun. You don't need to pop a medicine every day to recover from such diseases. Generally, that is also not a way to go forward. So, what patients have to undergo is physiotherapy. Once you are stabilized medically, your medications can continue. But for recovery, you need to take the daily dose of exercise that you require through physiotherapy. Now, like I mentioned before, it is difficult. So, by introducing games, patients start enjoying what they do. They don't realize that they have worked out for half an hour, one hour or sometimes even more. So, when you immerse a patient and make it fun for them, any activity which is fun, you end up doing for hours. We watch Netflix for hours. All of this kind of helps a patient recover. But predominantly, the baseline is a good therapist with robotics and VR makes them super-powered to treat patients in a better fashion. It is not an independent technology. It works with the physiotherapist and it is like with super power which helps you run 80 percent faster or something like that. So, that is how we know our technology is helping the patients. Yeah, great chair. It is good to know the numerous advantages of using robotics and VR technology in rehabilitation therapy. It is exciting to see the potential of this technology to transform the industry. What are the certifications and approvals were required for your devices? How did you manage to obtain those? So, when we started back in 2018, just after the smart India hackathon, physiotherapy was not regulated. So, when I say that any equipment being manufactured for physiotherapy did not require a certificate or license which is special. A normal license which is required for an exercise equipment would have been okay. But after 2020, Indian government has introduced multiple regulations for better managing the entire healthcare equipment area and physiotherapy which comes under it. So, it was to be honest and very truthful. It was definitely surprising and stressful. Being fresh graduates, we were not aware of how we will be able to do this. So, to come back to your question, what currently is required is based on the classification of your product. It could be class, severe class risky, higher class device if it is risky. A lower class device is safe, very safe and not much risk. You have to classify it and then take approval from CDSEO which is central authority to regulate these devices. So, so far, Raimo started our journey for regulating almost one year back and we are very happy to say today we stand on a position where we have international certifications like ISO 13485 which is the gold standard for a process to maintain quality of your medical device. We have an electrical and mechanical safety certificate as per international standards tested in an NABL accredited lab. And we have also received the necessary permissions from CDSEO and a final few communication stages are ongoing. But we have the necessary licenses to sell in India. Yeah, great, congratulations. You already obtained the international certifications. Thank you for sharing the regulatory process you went through to ensure your devices met the necessary standards. Hope it will be helpful for those innovators in the similar field. Apart from the technology or equipment, the vital part is that the therapist should be trained and skilled and the patient should be motivated. How do you deal with this? A very well thought question and something that was on top of our minds right from day one. We have heard stories where there are expensive equipment which are not being utilized because of lack of training. So, what we have done right from the conception stage, we have spent significant amount of time with the therapist with each of our prototypes as well. So, we have asked the therapist to use our devices right from the early stages and also the patient. So, what we got was very early feedback from the customer itself and which helped us build a very simple to use a very user friendly mobile application which the doctor uses or the therapist uses to use the machine, set different protocols, etc. With this, we have found out the training time to have reduced significantly with the easy to use product and just a three hour clinical training during installation. We have found our customers to become comfortable with the device at least to start exploring the product and then it takes around one to two weeks more of personal usage to get the confidence to use it without any doubts. To further on improve the experience, we have brochures, digital content specific to different parts of the body and different features of the product which we share with the doctors and they can refer that to train new therapists who join in or refresh anything that they've forgotten. So, that kind of helps and reduces their reliance on the developer and the manufacturer in learning to use the product. For the motivation, what we have found is a demo session. So, every patient, once they do a few sessions on the machine, we have heard the single most important feedback is the patients love it and whenever they come walk into the center, they want to use it and they demand for it. So, when something like this is coming from the patient, we have understood whatever we have built patient feedback has been working really well and our therapists and patients are enjoying what we have done. Chirag, it's good to know that already you have positive feedback from the patients for your equipment. The role of therapist and patient motivation in the recovery process is indeed critical. It is impressive to see the measures you have taken to ensure that healthcare professionals receive proper training and patients receive personalized treatment plans. It's good to know all your treatment plans. Using robotics and VR to deal with the patient recovery in physical rehabilitation is not very common. Did you ever doubt the success or accessibility of your techniques? Actually, this is very true and I think so it is a good thing to doubt whatever you are building. When you are in the zone of critical thinking, you will try and improve and make it better for the end user or the customer or the doctor or the patient. So, for the initial two years, we did not incorporate as a company at all. We were just a group of individuals who are highly motivated trying to build something if it benefits only then we will form a company is what we have decided and I would say that almost two and a half years, we spent just doing this. This kind of helped us understand the magnitude of the problem and gave us the freedom to not be scared of failure. So, we tried different prototypes, we changed it across and we built what the end user wanted and not what we knew how to build. So, I think so there was a lot of doubts and even now we have some adaptability, more than 20 units are there installed in the market but we still feel that today also we have plans for doing clinical validation with prestigious medical institutions. So, the validation of the product is there. We are also trying to see how we can validate our product in different geographies. So, we are planning to do at least four or five international departments in this year. So, anybody who is watching this and has connects outside India, you know, feel free to recommend. So, this will also help us validate whether this problem is being addressed not only in India but outside India as well. We are also trying to figure out whether this is a solution only for the urban population or for the rural areas as well. So, we are trying to see if we can find some corporate partners or we can partner with NGOs through CSR engagements and see whether we can deploy this in rural settings and provide them also the best rehabilitation tools. So, we have some validation but the process is still ongoing. So, probably till we don't have 10,000 installations, I think so, we still need to keep asking this question. We wish you to have 10,000 installations very soon. It is inspiring to see that you have confidence in the potential of your technology to make positive impact in this industry. So, making patient recovery equipments for physical rehabilitation is a very specialized and demanding business. How challenging was it for you to start such a venture? This is something which is very true. What started as a small project in college and taking it to a business was extremely challenging. Three points like you mentioned in the question itself. First is domain expertise is not only engineering, you also require medical knowledge and domain specific knowledge which is medical also physical rehabilitation. The second aspect is we are quite young as students just starting off for the first venture. So, prior business experience was lacking. So, we also had to kind of, you know, learn all of that during the process. And the third thing is we had to do this in a very frugal budget and a resource constrained environment because it is not so easy to, you know, start a business without adequate resources. And a journey has been one hell of a ride. We enjoyed some moments. We've been down in the dumps. So, it's all been a graph of continuous learning and growth for both me and my team. Some few areas which, you know, were extremely challenging to name specifically three probably was the first decision to take, you know, probably set that goal for yourself that, you know, you want to build this. So, after the Smart India Hackathon, the first decision that we took was, you know, we gave up our campus placements and we said, yeah, we don't know what we are going to do, how this is going to help us or what is going to happen in our career. But let's kind of, you know, take this decision to build this. This is a technology or tool which will help patients recover from cases like stroke, paralysis, orthopedic injuries, what all. I think that was the most challenging and scary decision that we took because probably all of our friends were going somewhere outside India or taking up jobs and, you know, you are out there doing your thing in that room. The second most challenging phase was probably COVID where, you know, though we had by touch of luck a few grants, but we couldn't get that money into our banks because of some issues which came up during COVID. And, you know, the team there came out on top. All of our team was, you know, help went on working even if we couldn't draw salaries, etc. So kind of helped us a lot go through that phase. But that was definitely a very challenging journey. And third part is, you know, trying to take the decision of going from a project phase to a company phase. So in this, we had a very clear metric that if we find a buyer for a device, probably that is when we will, you know, start a company about it. And luckily, we found a few early people, customers whom we met at conferences and, you know, through demos, even during COVID who kind of supported us and told us, you know, what we're doing is good. And we will probably, you know, buy this from you. So give us your machine and, you know, that kind of helps us build a company. And I think so we are now facing a lot more challenges like fundraising. Now, launching in India is a different story. The quality requirements, the regulatory requirements are very different from launching in the US, the Europe or across the world. So the bigger challenges are that now, we have overcome the first barrier of taking that decision. But let's see what the story, how the story will unfold. Really, it's inspiring to see that you overcame the obstacles through persistence, hard work and passion. We wish you whatever the challenges you face and make it as a opportunity for your product. How did you make the product validation at the level of medical professionals as well as the patients, Chirag? So there were three phases to this. The first phase was through literatures, which is secondary market research. We went through probably hundreds of clinical studies. And probably that kind of helps you make a basic assumption, because this technology is probably new to the segment we are addressing. But in the world, robotic rehabilitation exists for 20 years. So we could back our work based on those secondary research documents. So there is research on how robotic and virtual reality or games are helping physiotherapy patients. And we kind of use that as a reference to draw the first step. The second is to understand whether this is relevant to the technology that we are developing. So we have always been in touch with a wise number of physiotherapists. So we always try and take this approvals or feedback right from the early decision making of the product from our esteemed panel of advisors. And they have been very upfront in giving us those feedback early on in the design piece, which ensures that the technology that we are building is similar to the secondary research that we have done, and is also consistent with the Indian ecosystem. And it will be helpful in this in terms of promotion and both technological and clinical perspective. And the third aspect is actual validation. Once we had the necessary quality standards approved, we have predominantly tested this device with more than 200 patients before we actually went out and started selling. So staying within the legal framework, we kind of validated it with proper concerns from the therapist and they kind of helped us do that. And in this one thing we did was we our team completely spent probably more than a month in a physiotherapy center with the machine and the patients and the therapist. So we also got firsthand experience on how the machine was being used, where the problems were, how the features need to be improved etc. So yeah, this was not a very simple problem to solve. And we are continuously trying to you know improve the validation that we have and the market acceptability that can be derived based on that validation. Yeah, yes Chirag, it's impressive to see the measures you have taken to ensure that your products meet the needs and expectation of medical professionals and patients. Every innovator need to concentrate more on their product validation. Chirag, how and when was the product accepted commercially and how did the demand unfold? Probably three years back just before COVID in December, we went to a physiotherapy conference with our prototype and then we met our first customer Dr. Gajanan Balerao who is also our very close advisor from Pune. So he told us that he would incorporate our technology into his clinical practice and we were all I am mighty. Okay, we found our first customer, we started the company incorporation process and as soon as March 2020 came COVID unfolded and everything went under the long term. So demand could not be scaled very significantly but as soon as things got better, we did deploy one machine into their clinic. But we changed our approach. We said now we don't want to sell. So you just tested and let's get feedback. So it took us a while probably one year of improvements and in June 2021 we made our first official sale to a clinic in Mumbai post that we have been getting a lot of customer referrals and probably one year while improving on the product we deployed and onboarded around one customer a month. So and luckily this was also customer referrals. We did not have a sales and marketing team and after the successful deployments, after then the new regulatory procedures came into picture and we had to get the necessary certifications. Last year again we started selling and we've been doing probably one or two units a month again. So this is more focused and now we are expecting three installations in the next month. We are seeing you know things pick up. So yeah now the demand will unfold a bit better is what we are looking at. Yeah good to know that you have at least three installation per month. Thank you for sharing the journey of your product from the development to commercial acceptance. It's really it's exciting to see the demand for your technology increasing and the positive impact it's having on patients. So marketing is a critical component of any successful business strategy. Without effective marketing it can be difficult to reach the potential customers. How are you marketing your products now? Is it based more on the reference or typical sales and marketing avenues work for you? Like you mentioned marketing is very critical but we have to understand the domain and accordingly adjust the marketing plan. So I don't think so a very typical sales and marketing plan will work for either IMO or for any other company they have to customize it within this. But are marketing and PR efforts are focused more on awareness because this is a new concept new technology. So we try and be present in all the scientific events that are predominantly focused for physiotherapy. Indian Association of Physiotherapists Society of Indian Physiotherapists have been closely associated with Ajwani. They have tried to be there at their events right from early incorporation days, idea stage to our current focus right now. And currently we have some awareness in this industry. People know about robotic and IMO. So going forward what we have done is to expand the reach we definitely need more people and expertise on the ground. So we have we are trying to partner with people who are experienced in this domain. So we can focus on the technology and we have good people who can help us do the sales and marketing. Yeah great. So it is important you need to invest time and resources into marketing efforts in order to achieve a long-term success and growth. So it's great to know that you have participated in many conferences and you have reached out to your target audience through that. Today how are you positioned as a compared to your competitors? So the single word I would say in India at positioning is value for many. Whenever a physiotherapist is buying our product probably we are one of the most expensive products in the centre. So our focus is to ensure that our quality and product utility is on par with their expectations. They should not feel that it is a splurging spend that they've done but it is a utilities spend and which is helping the patients and their business which is a physiotherapy centre. So what I'm positioning right now is based on value for money but if you look at competitors mostly all the competition right now is imported in the robotic segment and all of that due to the extra customs etc and also their R&D processes has given us a very big competitive advantage in terms of the pricing and the space requirements. Our device is probably 10 times more affordable and accessible because of both the space requirements, the clinical training etc but one thing that we've identified which is the biggest advantage for an Indian company and for IMO is that our customer support is indispensable. Being an Indian company we are able to resolve customer problems in matter of days if not ours and whether it is an important product generally the timeline could go into months if not weeks. So this ensures that a patient benefit is continuously happening. A therapist is not facing much discomfort and you know we are able to maintain the clear positioning of extremely great customer support and super western class value for money for our products. So it's good to know that customer satisfaction and the customer support is the key value and you are in the in such a way you are just positioning your startup with other competitors great. So what kind of growth have you seen so far and what are your targets for the future? So we have seen tremendous growth in terms of number of deployments in probably the first two years of our journey we had only around 10 installations. In the last six months we have made more than 10 installations so our concentration of number of installations is growing significantly. Like I mentioned in this year we are looking at more than 15 installations in India new installations is what I'm talking about with the help of our channel partners with the help of the positive word of mouth that we are getting from our customers and in the long term so let's say five years down the line Rhino signal focus is to be a global company. So and how do we do that? So here I would like to quote a dialogue from three idiots. So what Rhino is focusing on improving our product quality and adherence to international standards. Once we are ready in terms of regulatory and quality for US Europe we are sure that we will not only see 10,000 of installation probably we can even surpass that value we can probably not only affect thousands of patients but help millions of patients and not only help hundreds of therapists but help millions of therapists also. So that is how we look at growth. We definitely want to grow our business our startup 100x but we want to do it in a very structured manner. We are kind of looking very positively and with the right support from the ecosystem I think so we'll be able to do that. Great. Listening to your future plans it is clear that you have a clear vision for success. We wish you the best of luck in achieving your targets and continuing to grow your business. Chidak you have established a successful business using your expertise in the space of robotics and VR. What guidance would you like to offer to the budding entrepreneur who wish to make a mark in the space? We have probably touched surface probably again I think so we are like this industry is like an iceberg the more you go into it the bigger it is but according to me based on my learning so far I think so early entrepreneurs or young entrepreneurs should focus on the first thing and most important thing that is identification of a problem and they should always look at three critical factors the first is their intent to solve that problem. Probably if it is only money because of which you want to solve a particular problem I think so you should take a step back and reflect because the journey is going to be hard and it might not be always give you enough motivation to cross through those hurdles. The second is try and look at the impact that your solution can create or how big the problem is. If it is a problem which is concentrated to a very few people probably it is good idea to solve it as a research problem and help us scale it using a technology transfer but if it's only a big enough problem you should try and get into a business because then you will have to know figure out a way to sustain yourself for the next five, ten, probably 50 years down the line. So look at the opportunity how big the problem is and how big how far the problem is growing and last but not the least make sure that you value team above everything else if you look at it from an individual point standpoint things will become very difficult but if you have a good founding team probably any problem that comes from your way you'll be able to go through it so yeah that probably is what we've understood the most important thing is problem rest all you can figure out on your way if you have the right problem and a good team you can probably solve any problem in this way. Great Shirak as you rightly said identification of the problem and hunger to solve the problem with a good team is very much important thank you for sharing your valuable insights and advice I'm sure our audience will find it very helpful I appreciate you sparing the time to share the experiences and advice with us today we wish you all the best in your future endeavors both in your business and personal life thank you thank you so much for this insightful session it has been a pleasure sharing our experience to younger audience or older audience people who want to venture into this industry or entrepreneurship I hope that people learn from our experience and can you know solve even bigger problems which will in the end impact probably ourselves and the entire humanity thank you so much again for inviting us and covering our story all the best to all the audience members who are trying to start the business thank you thank you Shirak thank you so that's all for today we will meet some more motivating entrepreneurs in the upcoming episodes till then stay tuned for more such inspiring stories goodbye