5 ms·

Agile Diagnosis (YC S11) Launches: Helping Doctors With Diagnosis

73 points by jonlee 15y ago

jedc 15y ago
I find it fascinating that AgileDiagnosis went through YC, and then six months later through RockHealth. Would any of the founders mind commenting on how/why they chose this path?
- borna 15y ago
  Both incubators have been crucial in their own ways. YC has an immense experience and expertise in start-ups of every kind to draw from that helps us tackle general start-up challenges decisively. Rock Health has a deep network of health and medical partners and mentors for opportunities and challenges unique to health-tech start-ups.
  - rdl 15y ago
    In retrospect, would you have done them in that order, or done Rock Health first and YC second, or does it not matter? I don't think anyone can touch YC for the core value proposition, but domain-specific programs (for medical, enterprise, government, ...) might make some sense, and I could see the value in something like StartX as a pre-YC while-still-in-college thing.
namityadav 15y ago
This industry is not very open to change. But, Borna and Eric are very hard working (and equally smart) guys -- just the kind of guys who can bring disruption to the industry. I have very high hopes!
- siavosh 15y ago
  I think it's great that there's an increase in attention to the medical space from smart young folks. From my experience though, being smart and hard working have very little to do with success in the medical-tech space. It mostly has to do with 1) if you can show ROI with the least (can't emphasize this enough) change to anyone's daily workflow, and 2) having a very very hard working sales team
  - amper5and 15y ago
    Another critical aspect is to target the tech-savvy younger generation of students and residents, which Agile is doing with their recent offer of free lifetime access for participating medical schools. Almost all of us are using tools like Uptodate on a daily basis on the floors. Agile's algorithmic presentation of the same information makes a compelling case to use their product. Early adoption by trainees can lead to future paradigm shifts in the whole industry.
Homunculiheaded 15y ago
Every time I go to the doctor with anything that isn't obvious I'm always amazed that some basic ML tools aren't part of the standard practice. Especially since the standard reaction now is "here take a bunch of expensive tests, you won't be paying for most of them out of pocket so who cares!" We've had the tools for decades now to at least say "given these symptoms, it's very likely you X, Y or possibly Z". Additionally I'd be surprised if there weren't some unexpected correlations between various features that most doctors would miss. Of course I guess I shouldn't be too surprised since medical records keeping is still 30 years out of date. The fact that it's still common practice to share medical records by filling out a consent form and having one office fax paper forms to other is ridiculous. I really hope we start to see disruption in this industry, so much potential for not only cost savings but improved care.
- colonelxc 15y ago
  re: medical record sharing I don't think it is that ridiculous really. Assuming that the policy to require a signature from the patient stands, fax seems like a pretty natural choice for sending a paper form. Alternatively, they could take the time to scan the form then email it. Ideally, both you and I would probably prefer something completely digital (both forms and health records). Towards that goal, I think the biggest problem would be interoperability. Someone like Kaiser could (and maybe they do) use all digital things between themselves, because they can enforce a uniform software platform. One nice thing that I've seen about some digital medical record systems is that they print out nice reports. That is a good fallback system, so that you can still fax or email simple documents around.
  - moioci 15y ago
    Note that in the US, protected health information (PHI) may not legally be transmitted across the internet unencrypted, according to HIPAA, which renders emailing records much more cumbersome than simply faxing them, which is cheap and ubiquitous.
  - Kadrith 15y ago
    Kaiser uses Epic, so they have a system called Intraconnect; now Care Everywhere to share information. This also works between other Epic customers with Care Everywhere installed. For the non-Epic customers there is something called Care Elsewhere. But there are a LOT of smaller practices without an EMR or that don't want to go through the work of initial integration.
AaronWeissman 15y ago
Amazing work JonLee and crew! Congratulations on the launch!
bcjordan 15y ago
<conspiracytheory> http://paulgraham.com/ambitious.html http://paulgraham.com/ambitious.html was written before YC S11. </conspiracytheory>
rjurney 15y ago
I have chronic nerve pain in my entire upper body. I used to be a patient of a world class university pain clinic. I left there for an individual pain doctor because... I saw 4 doctors in 4 visits, none of whom knew my diagnosis, read my file, etc. If this flow chart was on the door of the patient room, my quality of care would have been MUCH better.
rwhitman 15y ago
I hunted down a long HN comment thread where I proposed something similar about 2 years ago: http://news.ycombinator.com/item?id=1399953 http://news.ycombinator.com/item?id=1399953 Pretty excited to see someone is executing on this
danso 15y ago
I'm sure a lot of people here have read Atul Gawande (of the New Yorker) article about The Checklist, in which a simple list of steps before surgery, such as "wash your hands", vastly reduced infections at hospitals. Yet the checklist faced resistance, including from doctors who thought that having such an obvious list was beneath them...even though even the smartest doctors mess these steps up in the rush of an operation. http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_... This is the mindset that any disruptive enterprise must face. It's not like in the coding community, where spending a substantial amount of time writing seemingly trivial and boring tests -- i.e. an automated checklist -- is considered to be a necessary step in writing software.
EwanG 15y ago
A space that IBM is hoping to own with it's "Watson for Healthcare" initiative: http://www-03.ibm.com/press/us/en/pressrelease/36989.wss http://www-03.ibm.com/press/us/en/pressrelease/36989.wss

73 points by jonlee 15y ago

jedc 15y ago

I find it fascinating that AgileDiagnosis went through YC, and then six months later through RockHealth. Would any of the founders mind commenting on how/why they chose this path?

borna 15y ago
Both incubators have been crucial in their own ways. YC has an immense experience and expertise in start-ups of every kind to draw from that helps us tackle general start-up challenges decisively. Rock Health has a deep network of health and medical partners and mentors for opportunities and challenges unique to health-tech start-ups.
- rdl 15y ago
  In retrospect, would you have done them in that order, or done Rock Health first and YC second, or does it not matter? I don't think anyone can touch YC for the core value proposition, but domain-specific programs (for medical, enterprise, government, ...) might make some sense, and I could see the value in something like StartX as a pre-YC while-still-in-college thing.

namityadav 15y ago

This industry is not very open to change. But, Borna and Eric are very hard working (and equally smart) guys -- just the kind of guys who can bring disruption to the industry. I have very high hopes!

siavosh 15y ago
I think it's great that there's an increase in attention to the medical space from smart young folks. From my experience though, being smart and hard working have very little to do with success in the medical-tech space. It mostly has to do with 1) if you can show ROI with the least (can't emphasize this enough) change to anyone's daily workflow, and 2) having a very very hard working sales team
- amper5and 15y ago
  Another critical aspect is to target the tech-savvy younger generation of students and residents, which Agile is doing with their recent offer of free lifetime access for participating medical schools. Almost all of us are using tools like Uptodate on a daily basis on the floors. Agile's algorithmic presentation of the same information makes a compelling case to use their product. Early adoption by trainees can lead to future paradigm shifts in the whole industry.

Homunculiheaded 15y ago

Every time I go to the doctor with anything that isn't obvious I'm always amazed that some basic ML tools aren't part of the standard practice. Especially since the standard reaction now is "here take a bunch of expensive tests, you won't be paying for most of them out of pocket so who cares!" We've had the tools for decades now to at least say "given these symptoms, it's very likely you X, Y or possibly Z". Additionally I'd be surprised if there weren't some unexpected correlations between various features that most doctors would miss. Of course I guess I shouldn't be too surprised since medical records keeping is still 30 years out of date. The fact that it's still common practice to share medical records by filling out a consent form and having one office fax paper forms to other is ridiculous. I really hope we start to see disruption in this industry, so much potential for not only cost savings but improved care.

colonelxc 15y ago
re: medical record sharing I don't think it is that ridiculous really. Assuming that the policy to require a signature from the patient stands, fax seems like a pretty natural choice for sending a paper form. Alternatively, they could take the time to scan the form then email it. Ideally, both you and I would probably prefer something completely digital (both forms and health records). Towards that goal, I think the biggest problem would be interoperability. Someone like Kaiser could (and maybe they do) use all digital things between themselves, because they can enforce a uniform software platform. One nice thing that I've seen about some digital medical record systems is that they print out nice reports. That is a good fallback system, so that you can still fax or email simple documents around.
- moioci 15y ago
  Note that in the US, protected health information (PHI) may not legally be transmitted across the internet unencrypted, according to HIPAA, which renders emailing records much more cumbersome than simply faxing them, which is cheap and ubiquitous.
- Kadrith 15y ago
  Kaiser uses Epic, so they have a system called Intraconnect; now Care Everywhere to share information. This also works between other Epic customers with Care Everywhere installed. For the non-Epic customers there is something called Care Elsewhere. But there are a LOT of smaller practices without an EMR or that don't want to go through the work of initial integration.

AaronWeissman 15y ago

Amazing work JonLee and crew! Congratulations on the launch!

bcjordan 15y ago

<conspiracytheory> http://paulgraham.com/ambitious.html http://paulgraham.com/ambitious.html was written before YC S11. </conspiracytheory>

rjurney 15y ago

I have chronic nerve pain in my entire upper body. I used to be a patient of a world class university pain clinic. I left there for an individual pain doctor because... I saw 4 doctors in 4 visits, none of whom knew my diagnosis, read my file, etc. If this flow chart was on the door of the patient room, my quality of care would have been MUCH better.

rwhitman 15y ago

I hunted down a long HN comment thread where I proposed something similar about 2 years ago: http://news.ycombinator.com/item?id=1399953 http://news.ycombinator.com/item?id=1399953 Pretty excited to see someone is executing on this

danso 15y ago

I'm sure a lot of people here have read Atul Gawande (of the New Yorker) article about The Checklist, in which a simple list of steps before surgery, such as "wash your hands", vastly reduced infections at hospitals. Yet the checklist faced resistance, including from doctors who thought that having such an obvious list was beneath them...even though even the smartest doctors mess these steps up in the rush of an operation. http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_... This is the mindset that any disruptive enterprise must face. It's not like in the coding community, where spending a substantial amount of time writing seemingly trivial and boring tests -- i.e. an automated checklist -- is considered to be a necessary step in writing software.

EwanG 15y ago

A space that IBM is hoping to own with it's "Watson for Healthcare" initiative: http://www-03.ibm.com/press/us/en/pressrelease/36989.wss http://www-03.ibm.com/press/us/en/pressrelease/36989.wss