Every challenge faced, every strategic decision made, and every pivot that shaped the healthcare journey from 2017 to 2026. The story behind the story.
In 2017 Q1-Q2, Dharma built the LIVIT prescription monitoring hardware device with basic software. When he showcased the concept to Perform Rx (Orlando) and Centene (Orlando & Houston), the specialty pharmacies needed a full application suite: prescription management for patients, compliance monitoring for pharmacists, all integrated with the hardware. Building this application layer was prohibitively expensive for a startup.
In Q3-Q4, SharkDreams refined the hardware and built two separate apps: a prescription management app for patients and a patient compliance application for pharmacists at specialty pharmacies. This created a complete ecosystem — hardware device + patient app + pharmacist app.
The tech worked. The concept was validated. But the adoption rate was low. US pharmacies moved slowly, regulatory barriers were high, and the cost-to-acquire each pharmacy client was unsustainable for SharkDreams’ resources.
Even with working hardware and apps, pharmacies wanted more: virtual monitoring capabilities (video & audio calls between patients and pharmacy staff) and real-time vital data alongside prescription doses. Each feature addition drained startup capital with no revenue coming in.
2018 Q1-Q2: Built virtual monitoring — video and audio call features connecting patients directly with pharmacy staff. Launched the full ecosystem under the Fellow brand name.
2018 Q3-Q4: Added a hardware vital monitoring patch — enabling pharmacists to monitor patient vital behavior alongside prescription dose data. Presented at IoT India Congress 2018 in collaboration with Philips.
A complete closed-loop system: LIVIT device + patient app + pharmacist app + virtual calls + vital patch. Technically impressive. Commercially still struggling in the US market. But the Philips collaboration and IoT India Congress opened eyes to a different market.
The US market wasn’t converting. SharkDreams needed to find where the technology would be adopted. But every country had different regulations, different healthcare systems, different barriers to entry. The question: where could this technology actually scale?
Dharma took LIVIT on an international marketing tour, showcasing the concept across 4 countries and 7 cities:
Interest was everywhere. Adoption was nowhere — at least not at a pace a startup could survive. Every Western market had the same problem: expensive regulatory compliance, slow procurement cycles, low willingness to adopt from an unknown startup. But one market kept coming up in every conversation: India.
Two years of R&D. A complete tech stack. International marketing across 4 countries. And still no scalable revenue path. Capital raising was spiraling out of control with delayed permissions. But Dharma realized something bigger: there are millions of people in India who are uninsured — and even those who are insured face a broken chain where hospitals, diagnostics, clinics, and reimbursement are all disconnected. India didn’t just need better tech. It needed someone to fix the entire system. The intermediary: the broken Indian healthcare system itself — but at least the regulations were lighter and the need was massive.
India offered what the US couldn’t: easier regulatory pathways for both government-run and private hospitals. Instead of fighting US regulations, deploy the software side of the LIVIT ecosystem in India — where the need was massive and the barriers were lower. On July 24, 2019, Dharma formed Vera Smart Care as an attempt to launch Fellow through an Indian entity. The mission: build health profile proof-of-concepts at scale.
Build undeniable proof through two parallel projects in Q4 2019:
Project 1: Schools & Kids — Screen thousands of government school children for 38 health conditions. Generate real diagnostic data at scale.
Project 2: Villages, Towns & Church — Deploy door-to-door, mobile unit, and camp services across 3 states. Demonstrate community-level healthcare delivery.
Use this proof to win major healthcare contracts.
In 90 days: 47 schools, 4,824 students, 58 locations, 50,000+ patients, 400+ care providers, 2,547 health conditions detected across 3 states. The proof was built. See the full analytics →
COVID-19 hit. India locked down. Dharma was stranded, unable to return to the USA. But the real lesson of 2020: a massive undertaking like this needs heavy government lobbying, and government billing processes in India were fundamentally broken and corrupt. You could build and deploy, but getting paid required navigating a political maze. The intermediary: state governments — Telangana and Andhra Pradesh became both the enabler and the obstacle.
Repurposed technology to build iCheckPoint (originally called TTS — Travel Tracking System). A virtual checkpost system with digitalized sampling, permanent/temporary pass system for intracity & intercity access, and real-time containment zone monitoring. Deployed across Hyderabad, Srikakulam, and Vijayawada.
Launched iMASQ — Intelligent Monitoring Analysis Services Quarantine. A fully automated system for identification, surveillance, and quarantine management. The mobile units built for health profiles were now repurposed for pandemic response.
iMASQ mobile units scaled massively as COVID response. On behalf of Telangana and Andhra Pradesh governments: 220+ buses deployed, 65,000 samples per day, less than $1 per sample, 2 million+ tests conducted.
What started as a health profile proof-of-concept company became a frontline COVID response operation. The same mobile infrastructure, the same tech platform, repurposed at national scale. Vera proved it could pivot in real-time.
End of 2020: AP government ran out of COVID funds and stopped paying Vera’s bills. 1,000 employees went unpaid. But the patient intake marketing problem was real: patients only trust their local doctors or RMPs (Registered Medical Practitioners). The clinic referral model controls everything — you can’t just build a hospital and expect patients. The intermediary: hospitals & local doctors — yet another layer between Vera and the patient.
If you can run a state government health department — deploy iMASQ across 13 districts, manage 1,000+ staff, handle COVID testing for an entire state — then you can lease and run hospitals. Q1 2021: leased NImra Medical College (Vijayawada), Sai Hospital (Tanuku), and a hospital in Tirupathi.
COVID second wave hit Q2 2021. NImra Medical College treated 2,000 patients at ₹25,000 each (~$335/patient, a fraction of private hospital rates). ₹5 Crore in treatment delivered. But Q3: local political issues blocked bill collection again — the same pattern as iMASQ. Delivered results, never got paid.
Hospital bills were blocked by politics. Dharma was trying to save his software by deploying it anywhere — hospitals, mobile units, anything. A church approached him to build 60 COVID treatment mobile units called “Bzozo.” The intermediary: the church — yet another organization between Vera and the patients who needed help.
Built all 60 Bzozo mobile units. Invested in manufacturing, staffing, and medical equipment. Every unit was ready for deployment.
Nobody showed up from the church. Zero staff deployed. Zero patients treated. Zero revenue. The entire Bzozo project became pure debt — added to the mountain of unpaid iMASQ bills, blocked hospital payments, and burning capital. Dharma was trying to save his software through every possible channel. Every channel failed.
Q4 2021: The SEC initiated enforcement action against SharkDreams Inc and related entities. Every hospital, mobile unit, and software company — in India and the USA — was shut down. NImra Medical College, Sai Hospital, Tirupathi, the iMASQ fleet, the Bzozo units, SharkDreams Inc (USA), SharkDreams PVT LTD (India) — all closed. 1,000+ employees lost their jobs. Five years. Three countries. $10M+ invested. Everything gone.
The knowledge. The experience. The relationships. The proof that the software works — 50,000+ patients profiled, 1.5M+ COVID samples collected, 2,000 patients treated. And the most important lesson: every intermediary between you and the patient — pharmacies, governments, hospitals, churches — will eventually become a wall.
From 2017 to 2021, every single attempt to reach the patient went through a middle layer. The goal was always the same: make it better for the patient. But the approach was always the same too: help intermediary companies serve patients better. Every intermediary became a wall.
The Lesson
Every year from 2017 to 2021, the goal was the same: help the patient. Every year, the approach was the same: work through an intermediary. Pharmacies. Regulators. Investors. Governments. Hospitals. Churches. Every single one became a wall. The technology worked. The deployments worked. The patients were served. But the business model of reaching patients through middlemen was fundamentally broken.
After building hardware, building software, modifying it for pandemic and non-pandemic, for mobile hospitals and regular hospitals, for clinics to multispecialty hospitals, for government and non-government entities, for different billing systems (government, private, cash, insurance) — across towns, cities, and entire states — Dharma discovered the fundamental problem: the cost of treatment for the same condition is always different from person to person. It depends on gender, location, awareness, coverage, referral source, quality expectations, and lifestyle. No two patients pay the same. No intermediary solves this.
LIVIT was built for B2B (pharmacies). Fellow was converted for patients but still delivered through B2B channels (governments, hospitals, churches). Every middleman failed. The solution: convert Fellow into a gap insurance model driven by smart health. Remove every intermediary. Go directly to the patient.
Dharma collaborated with Care Insurance to design a completely new model: zero co-pays for patients through better negotiated rates from the insurance company. The condition: the patient must use Fellow for everything — pharmacy, checkups, diagnostics, labs, doctor consultations. And every healthcare provider must use only Fellow’s reports — eliminating duplicate tests, unnecessary procedures, and hidden costs.
Instead of reaching patients through pharmacies, governments, hospitals, or churches — make Fellow the single platform the patient uses. Insurance pays. Providers follow Fellow’s standardized reports. Costs drop because duplicates and unnecessary treatments disappear. The patient saves money. The insurer saves money. The provider gets reliable volume. No more middlemen.
With the concept designed, Dharma launched the All India Fellow trip to validate the gap insurance model on the ground. Not through intermediaries. Not through government contracts. Face-to-face with patients, doctors, pharmacies, diagnostics labs, and insurers across the entire country.
29 states. 2 union territories. 31 cities. 12,144 km. 20 days. Validated the three pillars of India’s healthcare crisis: Awareness, Accessibility, Affordability. Gave away 1,000+ free health insurance policies. Published the “Incredible Healthcare” magazine documenting the journey. The proof from 5 years of work — 50,000+ patients profiled, 1.5M+ COVID samples, 2,000 hospital patients — was now evidence for a new model. See the Fellow campaign →
Returned to the USA to face the SharkDreams legal suits head-on. The SEC enforcement action and related legal matters had to be resolved before any relaunch was possible. Dharma dealt with the consequences of the 2021 shutdown while the Fellow validation data from 29 states sat ready.
With legal matters addressed, Dharma made the defining decision: relaunch everything — Vera, SharkDreams, Fellow, and all concepts — back in the USA, built around a revenue-centered approach. No more chasing government contracts that never pay. No more intermediaries controlling patient access. Five years of proof — schools, villages, COVID response, hospitals, the all-India trip — became the arsenal for a model that puts revenue first and the patient at the center.
The technology was the same. The mission was the same. What changed was the business architecture. Instead of B2B through middlemen, Fellow would be the direct bridge between patient and care — with insurance as a financial layer, not a gatekeeper. See the 2022 analytics →
Revenue-centered means starting with a service people need, that insurance pays for, delivered where the patients are. Dharma had 5 years of mobile healthcare vehicle expertise (iMASQ, Bzozo) but needed a new vertical with clear revenue. Dental was the answer: direct insurance billing, predictable per-visit revenue, and a massive underserved senior population.
Q1: R&D to convert dental to mobile — learned the entire dental business from service delivery to insurance billing. Q2: Converted a fifth wheel into a dental mobile unit with 2 chairs and front office under Vera Medical Vehicles. Q3: Explored the equivalent market — discovered nursing homes and ALFs as the ideal captive audience. First POC at Crown Court, Citrus County. Q4: Visited hundreds of ALFs across Florida to promote mobile dental.
Unlike pharmacies that wouldn’t adopt, governments that wouldn’t pay, hospitals blocked by politics, and churches where nobody showed up — ALFs wanted the service. Their residents needed dental care. Transportation was a barrier. Mobile dental solved it. Insurance paid directly. No middlemen. See 2023 analytics →
Q1: Built services team and billing team under Vera Healthcare. Started active dental services at contracted ALFs. Q2: Expanded operations from Pensacola to Miami — 163 facilities tracked across 15 Florida counties, 61 with data collected, 94 remaining in pipeline.
Q3: Why just serve ALFs when you can own them? Entered contract to buy Crown Court (the same facility where the first dental POC was done) for $4M via VSEVA LLC. Simultaneously purchased Pleasant Grove. Both in Inverness, Citrus County. Rebranded to Vera Assisted Living Facilities. 79 beds across 2 locations. Created 60–80 new jobs.
For the first time, Dharma controls the entire chain: Vera Medical Vehicles builds the mobile units. Vera Healthcare provides services and billing. Vera Assisted Living Facilities owns and operates the ALFs (79 beds, 2 locations). Fellow powers the software. No pharmacies, no government contracts, no hospital politics, no church volunteers. Vehicles + Services + Facilities + Software = Vertical integration. See 2024 analytics →
With two ALFs acquired, the role changed: Dharma went from building and scaling to licensing and operating. Q1 focused on two parallel tracks — getting licenses for Pleasant Grove (the new location) while taking over complete operations of Crown Court. Under Vera Assisted Living Facilities, Dharma now controls 79 beds across 2 locations — managing staff, residents, compliance, inspections, and Medicaid paperwork simultaneously.
Q2: Shifted into investor support mode — helping investors secure loans and arrange owner financing for facility acquisitions. The same playbook that acquired Crown Court and Pleasant Grove was now being replicated: identify underperforming ALFs, structure the deal, bring in qualified buyers, and provide operational expertise as the bridge.
In 8 years, Dharma’s role evolved through four phases: Operator (running technology and services) → Licensor (getting facilities approved) → Advisor (helping investors acquire) → Support (ensuring buyer transitions succeed). Each phase built on the last. See 2025 analytics →
Q3: Helped the buyer close on Crown Court and secured licenses for Pleasant Grove. Both milestones hit in the same quarter — one facility transitioning out, one facility coming online. The pieces were in place for scaling.
Q4: Medicaid billing and insurance contracts were delayed. The same pattern that haunted India — governments and insurers that take months or years to process payments — showed up again in Florida. Dharma found himself solving operational issues for the new buyer on both facilities while revenue remained blocked at the insurance layer.
This was the same wall in a different country: 2020–2021 in India — government COVID contracts that never paid. 2025 in Florida — Medicaid contracts delayed indefinitely. The technology works. The service works. The patients are there. But the payment infrastructure moves at its own pace, and everything downstream waits.
Operating at 40% of projected income. Holding the fort for buyers while Medicaid contracts remain in limbo. The mobile dental fleet — ready to scale to 51 buses across 50 Florida counties — sits delayed. New ALF acquisitions that were in the pipeline are on hold. The revenue that should be flowing from insurance is trapped in administrative processing.
Ready: 51-bus dental fleet under Vera Medical Vehicles. Services and billing team under Vera Healthcare. Licensed facilities under Vera Assisted Living Facilities (79 beds, 2 locations). Fellow software platform. Expansion plans for MO, KS, NC, TX, GA. Blocked: Medicaid contract approvals. Insurance provider agreements. Revenue flow from completed services. Everything is built — the bottleneck is one layer: billing infrastructure.
Nine years. Four countries. Six companies. The same lesson at every turn: the hardest part of healthcare isn’t building the technology, delivering the service, or finding the patients — it’s getting paid. Every wall — pharmacies, governments, hospitals, churches, insurance companies, Medicaid — is ultimately a payment wall. The vertical integration model is the answer: own the vehicle, own the service, own the facility, own the software. The only piece left is unblocking the billing pipeline. See 2025–2026 analytics →
2017–2021: Built technology, deployed through middlemen, every one became a wall. 2022: Designed the direct-to-patient model. 2023: Built mobile dental, found the ALF market. 2024: Scaled to 163 facilities across 15 Florida counties, then acquired the facilities themselves. 2025: Transitioned to licensing, investor support, and buyer handoffs. 2026: Operating at 40% while the billing pipeline clears. From a prescription monitoring device in an Orlando lab to owning assisted living facilities, operating a mobile healthcare fleet, and building vertical integration across vehicles, services, facilities, and software — every failure was a lesson, every pivot was a step closer. The final wall isn’t technology. It’s not patients. It’s not even money. It’s getting paid. Care should follow people — and so should revenue.