Vikram Kumar, M.D., is hardly your typical tech chief executive. He shares a two-bedroom apartment with a sister and a nephew and gets around town by bicycle or in a 20-year-old Mercedes Benz. The 28-year-old graduate of the Massachusetts Institute of Technology, Cambridge, works days as a pathology resident at Brigham and Women's Hospital across the Charles River in Boston and only turns his energies at night to his business: improving rural health care in the developing world with handheld computer technology.
With degrees in medicine and engineering, Kumar could have plenty of lucrative opportunities. Instead, he's opted for a venture with dicey moneymaking prospects. The chief customers of Dimagi, his two-year-old startup, are not-for-profit Third World health agencies.
With software co-developed by Dimagi, nurses in India manage information collected in the field on more than 70,000 patients. And in rural South Africa, outreach workers use software that Dimagi helped develop to distribute HIV test results in remote settings while ensuring confidentiality.
The handful of regular Dimagi employees do not take salaries, while earnings from Dimagi's contracts with public and private health care organizations are invested in new projects for the developing world.
Kumar believes delivering high tech to low-tech corners of the globe isn't just socially transformative but also carries potential for huge financial gains for companies like his because health problems are so great in emerging markets.
"This is so much more interesting than anything else I could ever imagine doing," Kumar said. "It is fascinating to think that you can impact thousands and conceivably millions of people with properly designed innovation."
For advancing the use of such technology, Kumar won the annual Technology in Service of Humanity award last month from MIT Technology Review magazine.
Born in Jamestown, N.Y., while his father was studying neurosurgery, Kumar moved back to his parents' native India when he was 10 and returned to the United States to attend college and grad school.
He created Dimagi with a handful of other recent graduates of Harvard and the Massachusetts Institute of Technology. The company -- which takes its name from a Hindi term meaning "smart guy" -- started out with seed money and does not disclose current finances.
Mentors and colleagues say Kumar has a knack for overcoming bureaucratic and cultural obstacles.
"He has an absolutely amazing ability to bring people and institutions together and get the right thing done," said Sandy Pentland, Kumar's former adviser at MIT's Media Lab.
The software Dimagi developed runs on PalmOS or Linux-based PDAs. The product used in South Africa, called HIV Confidant, is part of a project to monitor the spread of HIV among 45,000 adults tested annually.
Health counselors meet with people who have undergone blood tests. Together, they use handhelds to retrieve encrypted, password-protect test results -- a better option than distributing results on computer printouts to 20 far-flung counseling centers.
"We calculated that the paper and printing alone would cover the cost of the handhelds," said Kobus Herbst, an official with the Africa Centre for Health and Population Studies who helped work on HIV Confidant.
The person being tested can keep their results confidential -- without fearing a breach should paper records end up in the wrong hands -- and seek help from a health counselor if they choose.
In the Indian state of Haryana, Dimagi software allows nurses to more easily manage health information gathered door-to-door in villages.
The program, which Dimagi calls "Ca:sh," an Urdu language term that roughly translates to "If only," helps collect data on patients, schedule immunizations and prenatal care and record routine demographic changes.
"The challenge was to look at how to create handheld tools for nurses who had never seen a computer before," Kumar said.
Despite skepticism from Indian officials, Kumar and his Dimagi colleagues had few troubles testing the program with nurses.
"Within an hour, they knew how to use it," Kumar said. "We would go to the village during the day, show the nurses mock screens and ask them, 'Does it work? Do you like this?' Then we would quickly go back at night and redesign it."
The nurses were willing partners because the handhelds free them from lugging heavy documents or manually transferring data from one written ledger to another, Kumar said. They can also access health data from the field by linking with computers at health agencies.
Another Dimagi project is DiaBetNet, software to help children around the world monitor juvenile diabetes.
Intuitive games encourage kids to predict and measure their blood-sugar levels, helping them to learn more about a disease they may have their entire lives. Children use handhelds to transmit readings to a central database that doctors can access.
DiaBetNet has completed an initial clinical trial at a Boston hospital and is being improved for eventual commercialization.
Because Dimagi's open-source software is freely shared, Kumar hopes users around the world will test the technology and suggest improvements in the interest of improving global health care.
"A lot of these problems are so big, the more people can come together and solve them, the better," Kumar said. "There's always business in doing the right thing well."