8 ms·

My unsolicited advice: rather than being "fairly certain" that you can make $500/mo with your idea so that you would prefer to start a company first, I suggest

by smalter 13y ago

My unsolicited advice: rather than being "fairly certain" that you can make $500/mo with your idea so that you would prefer to start a company first, I suggest that you reverse the order of operations. First, be certain that you can make $500/mo by building it yourself and get the hospital paying $500/mo. Then, if the opportunity looks good, start organizing (aka building an organization, a company) around that. You'll short circuit a lot of pain that way.

thetylerhayes 13y ago
Motion seconded. It sounds like you're seeing a lot of problems in healthcare. That's good you're noticing them. It sounds like you also want to solve some of them, mostly because you're fed up with them being problems. That's also good. The best kinds of solutions often come from scratching your own itch. Another similar recommendation: get more specific about what you want to solve. "Disrupting healthcare" is a platitude anyone can agree with because the news runs a segment every day about inefficiency in the health system. If you see 10 problems, does 1 stand out way above the rest? Work on that problem. Just building a quick & dirty solution and shopping it around like smalter suggests is the best thing you can do to prevent working on a problem you'll burn out of in 6 months. You'll very quickly realize whether you really want to do that thing or not.
- akrasia 13y ago
  I'm taking your advice and I'll hack together a prototype and see if the administration will bite.
wojt_eu 13y ago
> First, be certain that you can make $500/mo by building it yourself and get the hospital paying $500/mo. I'm currently chewing on ideas from "Lean Startup". It suggest to try and validate your idea before even building a product, for example with a interactive prototype. If the OP has a good contact with his hospital, he can show the prototype and ask: "If I build this, will you buy it? Will you pay upfront for a discount?"
- babuskov 13y ago
  I highly recommend reading Steve Blank's "4 steps to epiphany".
md2be 13y ago
The guy is a first year resident and should be working 70 hrs a week perfecting his skills. If he is cheating the system now by not being fully committed, I can only imagine what he will be doing 7 years from now.
- mdmarra 13y ago
  Since when has the technology community at large considered automating menial data entry to be "cheating?"
  - md2be 13y ago
    Hospitals spend hundreds of thousands of dollars training residents (med students learn practically (as in practical knowledge) nothing in med school). Therein lies the cheating.
- PeterisP 13y ago
  If you gain 10 minutes/week for every surgeon in USA, then you've done more healing than you could by simply being a great surgeon for your whole life.
  - md2be 13y ago
    This guy has one shot at learning medicine, his residency. If he wants run a trivial startup, so be it. But his first responsibility, at this time, in his training, (no he is not really a doctor yet) including his residence and fellowship.
    - PeterisP 13y ago
      His first responsibility is to whatever he wants to make with his life, not neccessarily his training. If he wants to run a medical startup that you call trivial, it's just as good (if not better) way to go as focusing on his residence and fellowship. The default career directions for anyone, including medical residents, are just that - simply defaults, not some oath or moral obligation to follow that exact career choice 'till death do us part'.
jtheory 13y ago
I'd suggest instead talking to the people who actually make buying decisions, and find out what other purchases they have approved recently (and how many other people needed to give approval -- e.g., the IT department), and why. Unfortunately I suspect the news will be discouraging. Don't just try selling something that interacts with medical data unless you have serious quality control (you may need various ISO certifications in place) and a good grasp of privacy law. That's what many of the frustrating hospital purchasing rules are trying to ensure. The reason that the healthcare world has so many problems with obvious software fixes that haven't been fixed is because they're very rightly paranoid about using unsafe software, because sometimes it kills people even when it's designed by a corporation with lots of quality control (cough cough THERAC-25), and not just a side-business with a doctor and a hired coder.
- akrasia 13y ago
  I will be talking to the purchasing dept after I build a prototype to show the director. I am aware that this will be an uphill battle since everyone in healthcare is paranoid including doctors and admins.
akrasia 13y ago
Your advice is duly noted. I am planning to talk to the director of the pulmonary team sometime this week and see if he is interested. I know most of the doctors who work in the lab will welcome the software. Seeing that most large hospitals pay 50+ million for their EHR/EMR setup, $500/month sounds reasonable. I looked briefly into building it myself (just in case this thread did not get a good response), and I can parse out the text using the pdf-reader gem and now I just need to use some regex to match what I want and then stick those values into a report. Thanks again for the advice.
- perplexes 13y ago
  > Seeing that most large hospitals pay 50+ million for their EHR/EMR setup, $500/month sounds reasonable. When I worked for a construction project management startup, this too sounded reasonable: many software systems for this audience were in the six-figure range... we were only asking $100/month or so. ("And a free trial!!!") We learned that when your monthly price point is the size of an accounting error, no one can take you seriously. This software was also holistic in nature: everyone, everyone, everyone has to use it for it to work well and as a core part of their organization. It's a superset of the marketplace business problem. To address these we had to charge more. Much more. This raised the stakes on both parties and also filtered out less serious buyers who would probably fail with our software. The construction companies who were serious buyers really considered thoroughly whether they could implement the change; we worked with them for, sometimes, months going through how the change would take place. And training, training, training. Usage metrics. Account hand-holders. Keep them using the system. -- As others have said, medical software is some of the hardest to break into. Medical staff HATE CHANGE, and need to. Change in the short term leads to mistakes and mistakes cost lives or careers. The system is bureaucratic, politicized and slow moving. Anti-disruption. I believe that a guerrilla approach to insurgent medical software is ultimately what will work - things like https://www.radiologyprotocols.com/ https://www.radiologyprotocols.com/, where a radiology tech wanted a common repository of knowledge for others in his field. Then, through word of mouth and using it with his colleagues, it gained first use in his hospital, then international use, and now it's starting to take off in the US. (Reminds me of "Big in Japan" first, or conversely Japanese artists having to become popular in the US before being taken seriously back in Japan.) -- Okay, advice. Sell it before you make it. If you have multiple hospital/medical contacts, play with pricing. Try outrageous things. If not, just try to work out any sort of deal and have them sign a piece of paper that says they'll pay. Then build it. Iterate with the first customer until it's "So Good They Can't Ignore You". After this, you might get better traction outside the US. There are hospitals in other countries who are desperate for good software and also don't have the money for the large EMR software many US hospitals use. GOOD LUCK!

by smalter 13y ago

thetylerhayes 13y ago

Motion seconded. It sounds like you're seeing a lot of problems in healthcare. That's good you're noticing them. It sounds like you also want to solve some of them, mostly because you're fed up with them being problems. That's also good. The best kinds of solutions often come from scratching your own itch. Another similar recommendation: get more specific about what you want to solve. "Disrupting healthcare" is a platitude anyone can agree with because the news runs a segment every day about inefficiency in the health system. If you see 10 problems, does 1 stand out way above the rest? Work on that problem. Just building a quick & dirty solution and shopping it around like smalter suggests is the best thing you can do to prevent working on a problem you'll burn out of in 6 months. You'll very quickly realize whether you really want to do that thing or not.

akrasia 13y ago
I'm taking your advice and I'll hack together a prototype and see if the administration will bite.

wojt_eu 13y ago

> First, be certain that you can make $500/mo by building it yourself and get the hospital paying $500/mo. I'm currently chewing on ideas from "Lean Startup". It suggest to try and validate your idea before even building a product, for example with a interactive prototype. If the OP has a good contact with his hospital, he can show the prototype and ask: "If I build this, will you buy it? Will you pay upfront for a discount?"

babuskov 13y ago
I highly recommend reading Steve Blank's "4 steps to epiphany".

md2be 13y ago

The guy is a first year resident and should be working 70 hrs a week perfecting his skills. If he is cheating the system now by not being fully committed, I can only imagine what he will be doing 7 years from now.

mdmarra 13y ago
Since when has the technology community at large considered automating menial data entry to be "cheating?"
- md2be 13y ago
  Hospitals spend hundreds of thousands of dollars training residents (med students learn practically (as in practical knowledge) nothing in med school). Therein lies the cheating.
PeterisP 13y ago
If you gain 10 minutes/week for every surgeon in USA, then you've done more healing than you could by simply being a great surgeon for your whole life.
- md2be 13y ago
  This guy has one shot at learning medicine, his residency. If he wants run a trivial startup, so be it. But his first responsibility, at this time, in his training, (no he is not really a doctor yet) including his residence and fellowship.
  - PeterisP 13y ago
    His first responsibility is to whatever he wants to make with his life, not neccessarily his training. If he wants to run a medical startup that you call trivial, it's just as good (if not better) way to go as focusing on his residence and fellowship. The default career directions for anyone, including medical residents, are just that - simply defaults, not some oath or moral obligation to follow that exact career choice 'till death do us part'.

jtheory 13y ago

I'd suggest instead talking to the people who actually make buying decisions, and find out what other purchases they have approved recently (and how many other people needed to give approval -- e.g., the IT department), and why. Unfortunately I suspect the news will be discouraging. Don't just try selling something that interacts with medical data unless you have serious quality control (you may need various ISO certifications in place) and a good grasp of privacy law. That's what many of the frustrating hospital purchasing rules are trying to ensure. The reason that the healthcare world has so many problems with obvious software fixes that haven't been fixed is because they're very rightly paranoid about using unsafe software, because sometimes it kills people even when it's designed by a corporation with lots of quality control (cough cough THERAC-25), and not just a side-business with a doctor and a hired coder.

akrasia 13y ago
I will be talking to the purchasing dept after I build a prototype to show the director. I am aware that this will be an uphill battle since everyone in healthcare is paranoid including doctors and admins.

akrasia 13y ago

Your advice is duly noted. I am planning to talk to the director of the pulmonary team sometime this week and see if he is interested. I know most of the doctors who work in the lab will welcome the software. Seeing that most large hospitals pay 50+ million for their EHR/EMR setup, $500/month sounds reasonable. I looked briefly into building it myself (just in case this thread did not get a good response), and I can parse out the text using the pdf-reader gem and now I just need to use some regex to match what I want and then stick those values into a report. Thanks again for the advice.

perplexes 13y ago
> Seeing that most large hospitals pay 50+ million for their EHR/EMR setup, $500/month sounds reasonable. When I worked for a construction project management startup, this too sounded reasonable: many software systems for this audience were in the six-figure range... we were only asking $100/month or so. ("And a free trial!!!") We learned that when your monthly price point is the size of an accounting error, no one can take you seriously. This software was also holistic in nature: everyone, everyone, everyone has to use it for it to work well and as a core part of their organization. It's a superset of the marketplace business problem. To address these we had to charge more. Much more. This raised the stakes on both parties and also filtered out less serious buyers who would probably fail with our software. The construction companies who were serious buyers really considered thoroughly whether they could implement the change; we worked with them for, sometimes, months going through how the change would take place. And training, training, training. Usage metrics. Account hand-holders. Keep them using the system. -- As others have said, medical software is some of the hardest to break into. Medical staff HATE CHANGE, and need to. Change in the short term leads to mistakes and mistakes cost lives or careers. The system is bureaucratic, politicized and slow moving. Anti-disruption. I believe that a guerrilla approach to insurgent medical software is ultimately what will work - things like https://www.radiologyprotocols.com/ https://www.radiologyprotocols.com/, where a radiology tech wanted a common repository of knowledge for others in his field. Then, through word of mouth and using it with his colleagues, it gained first use in his hospital, then international use, and now it's starting to take off in the US. (Reminds me of "Big in Japan" first, or conversely Japanese artists having to become popular in the US before being taken seriously back in Japan.) -- Okay, advice. Sell it before you make it. If you have multiple hospital/medical contacts, play with pricing. Try outrageous things. If not, just try to work out any sort of deal and have them sign a piece of paper that says they'll pay. Then build it. Iterate with the first customer until it's "So Good They Can't Ignore You". After this, you might get better traction outside the US. There are hospitals in other countries who are desperate for good software and also don't have the money for the large EMR software many US hospitals use. GOOD LUCK!