【 Interview 】
Real image of Startup Ecosystem in India and tips for business expansion there.

vol.31Yuichi Tamura(CEO of Cardio Intelligence)
Takashi Nakaoka(Beyond Next Ventures)


India, one of the biggest countries in South Asia, has over 1.3 billion population. The large market, where youth under 25 makes up the majority of total population, now attracts worldwide attentions. Many local startups offering IT and medical service have appeared in this market. What points are important when Japanese startups enter India? We interviewed two companies that have been proceeding with their business in India.

Could you tell us about your business?

Yuichi Tamura(CEO of Cardio Intelligence): Our service is to develop artificial intelligence (AI) diagnostic system to detect arrhythmias and heart disease from ECG data. When a patient comes to a hospital for arrhythmia or palpitation, a doctor must generally measure the ECG data for 24 hours and analyze them to find abnormalities. The analysis of a huge amount of data require a lot of time and resources and at least it takes one week. We have been developing a system that can significantly save the time required for both data analysis and diagnosis by utilizing our AI services. AI can also help doctors diagnose by finding symptoms. Furthermore we have been trying to develop a system that can cope with any ECG data taken by any medical equipment, which is one of our features.
We aimed to expand our business globally from the beginning. Considering a size of the medical market, it was small only in Japan. We had a strong belief that AI diagnosis can contribute to local medical services particularly in areas where access to medical specialists is hard. When I was pondering on expanding globally based on three points: large market size where business works in English, difficult access to medical specialists and good prospect for medical advancement, I joined an acceleration program in India hosted by Beyond Next Ventures.

Takashi Nakaoka(Beyond Next Ventures): Since we established our company in 2014, we have been supporting and investing in various startups as an accelerator specialized in technology startups. Partnered with Center for Cellular and Molecular Platforms (C-CAMP) in 2019, a government-affiliated entrepreneurial assistant center in India, we currently strengthen investment in India. We didn’t focus only on the size of Indian market, but also on the possibility for growth based on the fact that the population under 25 makes up the majority. Passion of local entrepreneurs and the abundant resources of IT engineer also attracted us. Seeking to create an opportunity to connect Japanese startups with the Indian market and to promote startup business in each country, we hosted the acceleration program “BRAVE x INDIA” to support Japanese companies which are targeting for expanding into India.

Could you tell us about the program in details?
Mr. Nakaoka: The program, which was attended by seven companies in total, started in October 2019. We had been mentoring and giving lectures for about two months in Japan and made materials for their pitches in India. After carefully elaborating the business plans, we visited Bengaluru (formerly known as Bangalore) in southern India in December. The purpose of the program was to propose cooperation with local companies and hospitals, participate in startup events and employ talented local people.
I’m sorry to say but Indian companies have the impression that Japanese companies are slow in business process. Many Japanese companies came to visit Indian companies with no concrete purpose and so local people are moving away from Japanese. Therefore, we mainly focused on actual business achievements with clear objectives and measures.

How was the program in India?
Mr. Tamura: It was my first time to visit Bengaluru, India. The city was more modern than I had imagined and infrastructure was in place. In such an environment, I think that smart city could be realized where you can take data from a device-free ECG such as steering wheel while driving.
Establishing a connection with a Japanese general hospital through this program was very fruitful. The hospital I visited wanted to offer patients the latest medical technology and use higher-precision test reagents to build a high standard of medical care in India. We are now considering business expansion in the near future in India taking local need into consideration. A large regional gap in a level of medical service is observed in India and some places cannot offer sufficient medical services. Of course a lack of specialized doctors is also a problem. That’s why I think doing business there is of great benefit.
When business people in India wanted to do business together, they immediately started taking actions. We can judge from their communication if our business was attractive or not, which was interesting.

Mr. Nakaoka: While I was exchanging opinions with local companies, I felt the difference in the market characteristics of India and Japan more than when I was in Japan. In the medical field, for example, way of thinking and treatment of diseases in Japan and India is different in the first place. In Japan, multifunctional and high-performance inspection equipment tends to be preferred. In India, however, single-function and low-cost equipment is widely accepted. I also learned about their thoughts on intellectual property. In India, if you have a good idea, it may be copied. We recommend that you consider your intellectual property and patents in advance when you enter into local field.

Could you share some advice for companies trying to succeed in the global market?
Mr.Tamura: I think it is important to understand local needs carefully. What is considered an issue in India may not be a problem in Japan and vice versa. It is also significant to determine whether your service is acceptable globally. In the medical field, for example, you can check detailed information on each country from the materials released by the World Health Organization (WHO) such as the type of disease and the age group of patients. It would be very useful for preliminary research.
I also realized that it might be dangerous to do business there without going through a proper channel such as a local company that was introduced by an acceleration program. We highly recommend that you visit there with someone who already has a network in order to meet a reliable partner. With different languages and cultures, finding a reliable partner who can keep your confidential information and provide credible information is an issue. The official language of all states in India is both English and local language. It is possible to start a business with English. But when it comes to developing services locally, many people speak only local language, which presents a language barrier. Going forward we would like to develop our business together with reliable partners.

Mr. Nakaoka: Indian startups and the healthcare market will grow significantly and attract more and more attention from the world. India has a large number of patients with the three major diseases:cancer, heart disease and cerebrovascular disease. There are still many problems to be solved. We will continue to implement acceleration programs in India. Since pitch events which are participated by many companies are not enough to carry out business in a concrete manner, we would like to focus on individual matching and support to get results that will lead to next step.