4 ms·

I'm in the Health IT space but we took a different approach. Early on we realized most Health IT companies are really pharmaceuticals but they don't realize it.

I'm in the Health IT space but we took a different approach. Early on we realized most Health IT companies are really pharmaceuticals but they don't realize it. What I mean by this is, you need to have the budget of a pharmaceutical to play in this space: 1 - you need to spend millions to win over consumers and 2 - you need to have an existing network of connections into doctor's offices to convince them of your solution. Big Pharmas have both of those. They have reps that constantly visit doctors or hospitals to engage them and they have a well spent marketing budget to build awareness for their product. Most startups can't do either of those. Then there is the long cycles. We signed some global Big Pharma brand (can't disclose). They actually approach us and were very eager to work with us. But even with that, it took exactly 2 years before we were able to roll out our pilot partnership. Basically you need to go into this knowing it'll take 3-4 years before you can show any traction.

5706906c06c 11y ago
> Basically you need to go into this knowing it'll take 3-4 years before you can show any traction. This x10MM
- benihana 11y ago
  An upvote is preferable to a meaningless comment like "this" which adds very little value to the discussion.
  - tronreg 11y ago
    this
demian 11y ago
Basically you need to go into this knowing it'll take 3-4 years before you can show any traction. I hope some visionaries VCs will start thinking in those terms, and start investing in this kind of high-impact life-time ventures.
criley2 11y ago
Considering that the average new molecular entity requires about $1 billion dollars over 10 years (factoring in cost of refining approximately 10,000 candidates into 1 entity capable of succeeding in Phased trials and receive approval), I'm not so sure these startups are anywhere near the "pharma" level.
- ThomPete 11y ago
  It's more the perspective. I.e. you can't just apply tech to healthcare and expect to become successful anymore than you can apply it to ex. the shipping industry. Some businesses are so intertwined with everything from unions, to legality to human behavior that you need to know what you are getting into before you even start.
ThomPete 11y ago
What a great insight. You should really write a blog post about it because this is such a helpful perspective and needs to be understood both by entrepreneurs and investors.
specialist 11y ago
This comment and the OP mirror my own experience(s). Additionally, data interchange between competitors is a non-starter. Possible solutions (work-arounds) will be single payer or continued market consolidation (hospitals merging and then implementing one of the big systems like EPIC). Not mentioned is that continued churn like HL7 v3, ICD-10, meaningful use, etc. are hugely onerous while adding zero value. A cynic might wonder if its just make work for the consultants. --- Source: My team designed, implemented, and supported the backend of 5 exchanges. Like this one: MedPlus to Implement Clinical Portal and Information Exchange for the Brooklyn Health Information Exchange (Jan 11, 2008) http://newsroom.questdiagnostics.com/index.php?s=30649&item=94401 http://newsroom.questdiagnostics.com/index.php?s=30649&item=...
- selimthegrim 11y ago
  You don't think HL7 v3 being somewhat of a markup language was an improvement?
  - specialist 11y ago
    It's a massive step backwards. Bad has HL7 v2 is, it was a known evil. With HL7 v3, there's so many more places to stuff data. And when it wasn't clear what goes where, partners created novel solutions. Just like with v2, but now with XML syntax. We participated in an early NHIN competition (shoot out). The official WSDL only worked with one tool stack (Visual Studio?). I finally gave up and just screen scrapped the good bits. Used xpath to pull out the useful bits. Used SoupUI to create prototyped requests, manually massaged them to work, then turned them into Velocity templates. We captured "official" requests and responses, stored them in source control. When something broke, we'd use diff to find the mutation. Turn-around was a few hours. Our two person team ran circles around our partner's teams with dozens. I still use the fake it strategy for anything XML or web related.
    - ethbro 11y ago
      As someone else who works in this space, this rings incredibly true. I get the sense that the reality of any medical exchange format is 50% data structuring and 50% legal structuring. Which is unfortunate... as lawyers aren't very good at commenting their code for non-legal professionals.
tixocloud 11y ago
From what you've described, it sounds like the majority of target customers tend to be large companies? It would make sense with the longer cycles and probably less of an urgency to take a risk on new technology.
- Mz 11y ago
  FWIW: The study on physician practice arrangements found that six in 10 doctors were in small practices of 10 or fewer physicians in 2014, a number that's unchanged since 2012. http://www.uhc.com/bmtn-categories/bmtn-news/2015/07/14/majority-of-us-doctors-still-work-in-small-practices http://www.uhc.com/bmtn-categories/bmtn-news/2015/07/14/majo...

5706906c06c 11y ago

> Basically you need to go into this knowing it'll take 3-4 years before you can show any traction. This x10MM

benihana 11y ago
An upvote is preferable to a meaningless comment like "this" which adds very little value to the discussion.
- tronreg 11y ago
  this

demian 11y ago

Basically you need to go into this knowing it'll take 3-4 years before you can show any traction. I hope some visionaries VCs will start thinking in those terms, and start investing in this kind of high-impact life-time ventures.

criley2 11y ago

Considering that the average new molecular entity requires about $1 billion dollars over 10 years (factoring in cost of refining approximately 10,000 candidates into 1 entity capable of succeeding in Phased trials and receive approval), I'm not so sure these startups are anywhere near the "pharma" level.

ThomPete 11y ago
It's more the perspective. I.e. you can't just apply tech to healthcare and expect to become successful anymore than you can apply it to ex. the shipping industry. Some businesses are so intertwined with everything from unions, to legality to human behavior that you need to know what you are getting into before you even start.

ThomPete 11y ago

What a great insight. You should really write a blog post about it because this is such a helpful perspective and needs to be understood both by entrepreneurs and investors.

specialist 11y ago

This comment and the OP mirror my own experience(s). Additionally, data interchange between competitors is a non-starter. Possible solutions (work-arounds) will be single payer or continued market consolidation (hospitals merging and then implementing one of the big systems like EPIC). Not mentioned is that continued churn like HL7 v3, ICD-10, meaningful use, etc. are hugely onerous while adding zero value. A cynic might wonder if its just make work for the consultants. --- Source: My team designed, implemented, and supported the backend of 5 exchanges. Like this one: MedPlus to Implement Clinical Portal and Information Exchange for the Brooklyn Health Information Exchange (Jan 11, 2008) http://newsroom.questdiagnostics.com/index.php?s=30649&item=94401 http://newsroom.questdiagnostics.com/index.php?s=30649&item=...

selimthegrim 11y ago
You don't think HL7 v3 being somewhat of a markup language was an improvement?
- specialist 11y ago
  It's a massive step backwards. Bad has HL7 v2 is, it was a known evil. With HL7 v3, there's so many more places to stuff data. And when it wasn't clear what goes where, partners created novel solutions. Just like with v2, but now with XML syntax. We participated in an early NHIN competition (shoot out). The official WSDL only worked with one tool stack (Visual Studio?). I finally gave up and just screen scrapped the good bits. Used xpath to pull out the useful bits. Used SoupUI to create prototyped requests, manually massaged them to work, then turned them into Velocity templates. We captured "official" requests and responses, stored them in source control. When something broke, we'd use diff to find the mutation. Turn-around was a few hours. Our two person team ran circles around our partner's teams with dozens. I still use the fake it strategy for anything XML or web related.
  - ethbro 11y ago
    As someone else who works in this space, this rings incredibly true. I get the sense that the reality of any medical exchange format is 50% data structuring and 50% legal structuring. Which is unfortunate... as lawyers aren't very good at commenting their code for non-legal professionals.

tixocloud 11y ago

From what you've described, it sounds like the majority of target customers tend to be large companies? It would make sense with the longer cycles and probably less of an urgency to take a risk on new technology.

Mz 11y ago
FWIW: The study on physician practice arrangements found that six in 10 doctors were in small practices of 10 or fewer physicians in 2014, a number that's unchanged since 2012. http://www.uhc.com/bmtn-categories/bmtn-news/2015/07/14/majority-of-us-doctors-still-work-in-small-practices http://www.uhc.com/bmtn-categories/bmtn-news/2015/07/14/majo...