4 ms·

I don’t have a site to point to anymore, but me and some cofounders built out a physical therapy vertical saas (patient management + mobile patient portal). Th

by nscalf 5y ago

I don’t have a site to point to anymore, but me and some cofounders built out a physical therapy vertical saas (patient management + mobile patient portal). The issue: many PTs are VERY analog—sheets of papers with exercise, very few touch points, no data collection, etc. The solution: modern patient management system for doctors, a mobile app that will remind you to do your prescribed exercises, track your response, have reminder videos so you’re doing everything right, and feed difficulty levels, etc to the doctor in real time to monitor recovery. The problem: selling to doctors is hard. Replacing their entire day to day interface for their whole staff is a giant barrier to pass. Many patient management systems bundle in handling insurance, so his ended up being a “solve everything, then we’ll talk” type of system. What I’ve learned: you need to make sure you’re MVP is ACTUALLY viable. We talked to a lot of PTs, and they were interested but not forthcoming with exactly what they would need to switch—still not sure how to pry out that info. Vertical saas is a double edged sword: the customers are bigger and stickier, but the sales process is slower and harder. Doubly so if you are trying to dethrone other deeply ingrained saas businesses from day one. A better approach likely would have been an extension to improve existing ones, then our own system.

bendergarcia 5y ago
Do you think offering some kind of onboarding/deployment service would have helped? Helping them migrate all their data and workflows into this new tool?
- nscalf 5y ago
  It likely would have helped on the margin, but honestly it seemed like we were selling a much better experience to patients, and only marginally better experience to doctors. We really needed to nail the doctor experience, but there is some nuance there. Generally, PTs have front office people who spend their day in these tools, while doctors have fairly limited exposure. The shortcomings of the existing tools aren't as obvious to them. One thing was completely clear---this was not as close to product market fit as we expected it to be, so we decided to back away from the project instead of raising money and doubling down on trying to force a solution to a problem that wasn't very important to our direct customers. In other fields, tools that affect our customers customers are very successful IF that drives more sales, or can affect the bottom line in some way. Physical Therapy is less of a sales business and more of a referrals business (from other docs), so we didn't have much impact. If anything, we may have prevented business by increasing exercise adherence and improving outcomes, therefore cutting "recurring business" (decreasing the amount of visits/injury, or the overall amount of recurring injuries).
  - scyzoryk_xyz 5y ago
    “ In other fields, tools that affect our customers customers are very successful IF that drives more sales, or can affect the bottom line in some way.” Very insightful - whatever solution you have must actually drive enough $ for someone to really want to give it a try. Which is a huge ask if someone’s business isn’t really tech oriented and they don’t really believe the optimization is worth breaking through existing ways of doing things.
jbmsf 5y ago
My spouse is a PT and hates her software. I get the sense that she also has an above average appreciation for the needs of the admin staff. They quote literally make the difference between a good day and a bad one by the choices they make around scheduling. The problem is that she works for a large chain and the people with purchasing power are not clinicians.
- nscalf 5y ago
  Good point, and this was another problem we hit. Procurement for larger practices was done outside of the individual offices, making the sales less direct and more complicated to find the right person to talk to. Ultimately, we decided to target smaller practices hoping for a more straight forward sales process due to this.
skrtskrt 5y ago
Did you know much about the PT field beforehand? It seems to me that really successful entrepreneurship requires enough time in that field to really understand the rough edges of the domain, but not so much time in the field that you actually start to accept the existing solutions as “good enough” in a sort of stockholm syndrome. You need to be an expert with a beginner’s mind, which is extremely difficult.
- pier25 5y ago
  Domain knowledge is by far the most important in starting any business.
- nscalf 5y ago
  I didn't work in the field, but I had a good friend who was doing weekly product planning calls and getting us in front of PT's on a regular basis to show our product and discuss what they felt was important. I agree with you, it would have been better to have some personal experience, but I'm not sure if this was sufficient or not.
mtlynch 5y ago
I know another indie founder I believe is working in this space. Their app is called Rehabit: https://rehabit.co.za/ https://rehabit.co.za/ They've been building it in public for the past year, but I haven't seen updates for a few weeks: http://whatgotdone.com/michaelcampbell/2021-11-05 http://whatgotdone.com/michaelcampbell/2021-11-05
kmarc 5y ago
Sorry to hear that it became a failure. My PT uses a software exactly like this, and that made it possible that my progress was tracked during my months long vacation too, all online. The app: https://medbase.physiapp.com/ https://medbase.physiapp.com/ (in German) PS. it worked, my back problems are gone.
- nscalf 5y ago
  Ahh yes, I know a few people who work in healthcare tech in Germany and it seems like you're way ahead of us. I'm glad you're able to leverage tech a bit more effectively over there. My impression is that the tools the US uses are far behind due to over regulation, which I hope is changing as a result of covid. And don't be sorry! Most people who have a successful startup have many failed startups behind them, there's only one way to learn most of these lessons.
posix86 5y ago
How many doctors did you ask? I've considered a similar startup idea with some colleagues. I think what's important in this field is that you find _a_ doctor / therapist willing to work with you on this, others will follow suit once they realize that it works. Further, finding this doctor will be hard. So you have to ask and pitch to many, many doctors, until you find one that is willing to work against the "tried and tested" method, risking going bankrupt, but also having a chance of being at the front if the next disrupting change.

by nscalf 5y ago

bendergarcia 5y ago

Do you think offering some kind of onboarding/deployment service would have helped? Helping them migrate all their data and workflows into this new tool?

nscalf 5y ago
It likely would have helped on the margin, but honestly it seemed like we were selling a much better experience to patients, and only marginally better experience to doctors. We really needed to nail the doctor experience, but there is some nuance there. Generally, PTs have front office people who spend their day in these tools, while doctors have fairly limited exposure. The shortcomings of the existing tools aren't as obvious to them. One thing was completely clear---this was not as close to product market fit as we expected it to be, so we decided to back away from the project instead of raising money and doubling down on trying to force a solution to a problem that wasn't very important to our direct customers. In other fields, tools that affect our customers customers are very successful IF that drives more sales, or can affect the bottom line in some way. Physical Therapy is less of a sales business and more of a referrals business (from other docs), so we didn't have much impact. If anything, we may have prevented business by increasing exercise adherence and improving outcomes, therefore cutting "recurring business" (decreasing the amount of visits/injury, or the overall amount of recurring injuries).
- scyzoryk_xyz 5y ago
  “ In other fields, tools that affect our customers customers are very successful IF that drives more sales, or can affect the bottom line in some way.” Very insightful - whatever solution you have must actually drive enough $ for someone to really want to give it a try. Which is a huge ask if someone’s business isn’t really tech oriented and they don’t really believe the optimization is worth breaking through existing ways of doing things.

jbmsf 5y ago

My spouse is a PT and hates her software. I get the sense that she also has an above average appreciation for the needs of the admin staff. They quote literally make the difference between a good day and a bad one by the choices they make around scheduling. The problem is that she works for a large chain and the people with purchasing power are not clinicians.

nscalf 5y ago
Good point, and this was another problem we hit. Procurement for larger practices was done outside of the individual offices, making the sales less direct and more complicated to find the right person to talk to. Ultimately, we decided to target smaller practices hoping for a more straight forward sales process due to this.

skrtskrt 5y ago

Did you know much about the PT field beforehand? It seems to me that really successful entrepreneurship requires enough time in that field to really understand the rough edges of the domain, but not so much time in the field that you actually start to accept the existing solutions as “good enough” in a sort of stockholm syndrome. You need to be an expert with a beginner’s mind, which is extremely difficult.

pier25 5y ago
Domain knowledge is by far the most important in starting any business.
nscalf 5y ago
I didn't work in the field, but I had a good friend who was doing weekly product planning calls and getting us in front of PT's on a regular basis to show our product and discuss what they felt was important. I agree with you, it would have been better to have some personal experience, but I'm not sure if this was sufficient or not.

mtlynch 5y ago

I know another indie founder I believe is working in this space. Their app is called Rehabit: https://rehabit.co.za/ https://rehabit.co.za/ They've been building it in public for the past year, but I haven't seen updates for a few weeks: http://whatgotdone.com/michaelcampbell/2021-11-05 http://whatgotdone.com/michaelcampbell/2021-11-05

kmarc 5y ago

Sorry to hear that it became a failure. My PT uses a software exactly like this, and that made it possible that my progress was tracked during my months long vacation too, all online. The app: https://medbase.physiapp.com/ https://medbase.physiapp.com/ (in German) PS. it worked, my back problems are gone.

nscalf 5y ago
Ahh yes, I know a few people who work in healthcare tech in Germany and it seems like you're way ahead of us. I'm glad you're able to leverage tech a bit more effectively over there. My impression is that the tools the US uses are far behind due to over regulation, which I hope is changing as a result of covid. And don't be sorry! Most people who have a successful startup have many failed startups behind them, there's only one way to learn most of these lessons.

posix86 5y ago

How many doctors did you ask? I've considered a similar startup idea with some colleagues. I think what's important in this field is that you find _a_ doctor / therapist willing to work with you on this, others will follow suit once they realize that it works. Further, finding this doctor will be hard. So you have to ask and pitch to many, many doctors, until you find one that is willing to work against the "tried and tested" method, risking going bankrupt, but also having a chance of being at the front if the next disrupting change.