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I'm interested in learning how DrChrono is planning to market to physicians. I personally think DrChrono is going for a diminishing slice of the healthcare pie

I'm interested in learning how DrChrono is planning to market to physicians. I personally think DrChrono is going for a diminishing slice of the healthcare pie. The current trend in healthcare is that a decreasing proportion of physicians are working in small private practices - the cost of healthcare infrastructure, logistics, and billings means large practices and hospital based have significant savings on scale and tremendous bargaining power with insurance and etc. This kind of app, with the appointment scheduler and prescription system, seems very much geared to small private practices. I imagine this kind of system will make limited leeway in large healthcare practices and large academic institutions - this is the difference between enterprise software and web applications. Epic and the like, despite being aesthetically unpleasing and rather cumbersome, is dominating this segment of the market. It's not even a question of cost - these solutions cost much more than competitors, but there is a perceived level of stability and a proven track-record. In both culture and priorities, I think YC companies are not as well prepared to offer enterprise solutions. Large institutions are fickle, full of politics, and without a dedicated sales team, difficult to sell to. They are definitely going for the "meaningful use" incentives as part of healthcare reform - the healthcare reform gives physicians incentives to adopt an EHR (electronic health record) system and going for the sex appeal of using ipads - but I am wondering if that is enough incentive to adopt an electronic health system. Personally, I type 1000x faster on a keyboard than with an iPad, and speed would be an consideration - ie. even as a physician-in-training (hypothetically with comfort in technology), I would have to look hard to decide whether to use such a system. As a medical student, don't think there is enough of an market for general primary care physicians and not enough specificity (currently) to most subspecialities. There are a lot of older physicians that have limited comfort in medicine. I would imagine there is a good market for concierge medicine practices - the kind of places that already have iPads and are interested in distinguishing themselves from the market.

Skeletor 16y ago
Most US private practice healthcare providers (roughly 80%) practice in small groups of 1-5 physicians. That is our target market and still the way that the majority of personal healthcare is delivered in the US! There is a multi-billion dollar per year market in selling EHR services to the private practice doctors we all see everyday. Large hospital level systems are designed for hospital admins 1st, doctors 2nd; they are widely hated even in hospitals and unusable in a small practice. We are launching a speech to text integrated product in the coming few weeks that will remove the need for most typing on the iPad.
- alphaoverlord 16y ago
  "The percentage of U.S. physicians who own their own practice has been declining at an annual rate of approximately 2% for at least the past 25 years." http://www.nejm.org/doi/full/10.1056/NEJMp0808076 http://www.nejm.org/doi/full/10.1056/NEJMp0808076 Most numbers I have see range from 50-60% in small to solo practice, while I would argue that this is a lagging indicator - a lot of older physicians are in solo practice and seeking to pass on their patient panel. It might be more interesting to see where current residents are going after graduation. That said, there is still a large market and I think it's definitely something that should be pursued. Good luck!
- dools 16y ago
  I'm not sure if this is going to be relevant to you but it popped into my head whilst reading through the comments and in particular your note about speech to text. Have you ever heard of live scribe? http://www.livescribe.com/en-us/ http://www.livescribe.com/en-us/ It's this cool pad thing where the paper is timecoded. You write on the paper, and draw, with a special pen, and it records sound along with the time code. If you're familiar with Serato Scratch Live it's a similar concept to that - basically taking a "real world" interface and semi-digitising it using some form of time encoding. Speech to text is HARD and what's worse is inaccuracies in a medical field could result in some really serious consequences (misdiagnosis, improper dosage, incorrect medication being prescribed etc.) Doctors are pretty used to shorthand, and also my understanding is they quite often have a typist for dictations - perhaps an alternative to speech to text is to record speech by proximity in time to what has been typed. That way they could be saying something, take minimal notes but have a sound file linked to those notes. That way they can elaborate on the notes later if required, but also if they go back to their notes and can't remember what the hell they meant when they wrote "PKR instead", they can touch "PKR instead" to hear what they were saying at that time in the conversation, and fastfoward, rewind to get the context.

Skeletor 16y ago

Most US private practice healthcare providers (roughly 80%) practice in small groups of 1-5 physicians. That is our target market and still the way that the majority of personal healthcare is delivered in the US! There is a multi-billion dollar per year market in selling EHR services to the private practice doctors we all see everyday. Large hospital level systems are designed for hospital admins 1st, doctors 2nd; they are widely hated even in hospitals and unusable in a small practice. We are launching a speech to text integrated product in the coming few weeks that will remove the need for most typing on the iPad.

alphaoverlord 16y ago
"The percentage of U.S. physicians who own their own practice has been declining at an annual rate of approximately 2% for at least the past 25 years." http://www.nejm.org/doi/full/10.1056/NEJMp0808076 http://www.nejm.org/doi/full/10.1056/NEJMp0808076 Most numbers I have see range from 50-60% in small to solo practice, while I would argue that this is a lagging indicator - a lot of older physicians are in solo practice and seeking to pass on their patient panel. It might be more interesting to see where current residents are going after graduation. That said, there is still a large market and I think it's definitely something that should be pursued. Good luck!
dools 16y ago
I'm not sure if this is going to be relevant to you but it popped into my head whilst reading through the comments and in particular your note about speech to text. Have you ever heard of live scribe? http://www.livescribe.com/en-us/ http://www.livescribe.com/en-us/ It's this cool pad thing where the paper is timecoded. You write on the paper, and draw, with a special pen, and it records sound along with the time code. If you're familiar with Serato Scratch Live it's a similar concept to that - basically taking a "real world" interface and semi-digitising it using some form of time encoding. Speech to text is HARD and what's worse is inaccuracies in a medical field could result in some really serious consequences (misdiagnosis, improper dosage, incorrect medication being prescribed etc.) Doctors are pretty used to shorthand, and also my understanding is they quite often have a typist for dictations - perhaps an alternative to speech to text is to record speech by proximity in time to what has been typed. That way they could be saying something, take minimal notes but have a sound file linked to those notes. That way they can elaborate on the notes later if required, but also if they go back to their notes and can't remember what the hell they meant when they wrote "PKR instead", they can touch "PKR instead" to hear what they were saying at that time in the conversation, and fastfoward, rewind to get the context.