Empowering health workers without behaviour change

BACKGROUND: Biocon Foundation is the CSR arm of India’s largest domestic branded biologics company. Its goal is to provide sustainable, affordable healthcare and educational services to underserved rural and urban communities in India. The Ministry of Health & Family Welfare, Government of Karnataka began its association with Biocon Foundation for free oral cancer screening camps for marginalised communities in 2014.

CHALLENGE: For effective screening at scale, it is vital to collect comprehensive data on behaviour (risk factors), a basic clinical exam and future intent. Since the interview is conducted by community health workers who are trained to engage with the patient, but not diagnose, the data they collect must be accurate and as much as possible, structured – to allow for quick analysis and interpretation by clinical experts at a later date.

Biocon, in association with ASHA (Accredited Social Health Activist) workers had been using a mobile phone based application to collect questionnaire data. It was time consuming for the health workers to interact with the patient and also input data on a small screen. Intermittent Internet connectivity issues also increased the length of the interview and the overall project.

SOLUTION: Doxper is a AI powered data capture solution that allows health workers to instantly digitise their questionnaires using a smart digital pen and encoded paper. A single page, structured questionnaire was created in both English and Kannada printed on regular, encoded paper. Encoding (a unique printed dot pattern) allows the pen to automatically identify the sheet and create a patient record. Every ASHA worker was given a Doxper digital pen. To start using, they switched it on and started writing (battery lasts for 5 hours of continuous writing on a full charge). Data was captured and tagged automatically in the pen’s local memory (up to 1000 A4 pages). Every week, the pens were handed to the supervisors at the primary healthcare centre (PHC) where data was transferred to the Doxper app via Bluetooth and synced to the cloud.

IMPACT: More than 5000 patients were screened in record time. Doxper also provided analytics and data on 400 high risk patients for follow up. There was no need to fiddle with mobile phones or any apps apart from charging the pen at the end of every day. There was no need for a stable, Internet connection as the pen could work independently and offline. Overall, the average face time with the survey respondent was significantly less compared to the use of mobile phone apps. A free-handwriting and digital image capture solution allowed local language to be captured on both free-hand and structured fields. Once the data was transferred from the pen, a rules based engine on the server could read any checkboxes ticked, and automatically segment patients into relevant ‘buckets’ for further analysis. Since every pen stroke is time-stamped, administrators also had precise data on average time taken for every house visit, number of visits and over what period.

TESTIMONIAL: I have known Dr. Randeep Singh for last 3 years in professional capacity. His start-up, InformDS Technologies (P) Ltd. has been working closely with us on Oral Cancer screening data collection and analytics. We have used their innovation, Doxper – digital pen and paper solution in the field and got very good results in data capture in local language, they later supported us in data analytics and insights generation.

Dr. (Prof) Praveen Birur

Biocon Doxper Template

Semi-structured paper template.


    • Easy to use and intuitive – just pen & paper
    • Fill in local languages
    • Analytics from structured fields
    • Transparency & accountability
    • Who wrote what & when
    • Log & audit trail