5 ms·

Medisas (YC W13), A Company That Saves People's Lives

30 points by jakek 12y ago

hga 12y ago
How can doing this in purely in "the cloud", "the web", possibly be a good idea? Yes, there's a real problem this is solving ... until a shift change happens at the same time the hospital's Internet connection is down. Surely you could put a small, generic machine or two running your own software on the hospital's net that does the local work, or takes over if the Internet connection is down, etc. Or do you depend on cell phone tech as a backup for the hospitals? In that case, the infrastructure at your end had best have some serious redundancy ... which is fortunately fairly easy and not that expensive to arrange nowadays. Why I'm obsessing on this detail, besides normally rock solid AT&T have a long outage that might have covered our entire town or more yesterday? I live in tornado country, and know how easily services can get knocked out by weather of all sorts. Here's an extreme case I avoided by luck and preparation: http://stormdoctor.blogspot.com/2011/06/first-response-mode-may-22-2011-joplin.html http://stormdoctor.blogspot.com/2011/06/first-response-mode-...
- cliveowen 12y ago
  When it come to the sad state of technology in hospitals, any improvement is better than the current state of things. Sure, this is the kind of software that would really benefit from redundancy and a waterproof disaster-recovery plan, but the main thing here is that someone tried and actually managed to make a dent into a very real problem in the industry. This is a small step in what I hope will be a near-term future for better healthcare. You have to start somewhere.
  - hga 12y ago
    I don't think I've communicated clearly: Bad paper handoffs beat no handoffs at all, or I suppose ad hoc last minute verbal ones, if this system is dead due to a transient communications outage. Do you disagree with this point?
    - webjprgm 12y ago
      Existing electronic health record (EHR) systems already have to deal with this. The ones I am most familiar with have on-site data centers, so it's not purely in "the cloud" but you can have webapps running from on-site servers and call them "cloud" systems if you want. The existing systems have ways for printing out important data from a redundant computer system to hand out paper copies if the user workstations, network, or servers are down. I don't know what they would do if there was no electricity anywhere, but I assume hospitals could use their backup generators for this since medical equipment also needs electricity.
      - hga 12y ago
        Hospitals tend to have specially provisioned power from the local electric company to minimize the change they'll have to use generators, which I assume are universally in place, although you can't always depend on them, e.g. Charity Hospital in New Orleans (a place where my mother worked in the '50s) only suffered a flooded basement during Katrina ... but of course that was were the generators were. See my other comment for how this company sure doesn't seem to be telling hospital IT departments that they've got on side redundancy.
    - cliveowen 12y ago
      i don't think cloud means on a public infrastructure. It's a term widely abused, I think they mean it's on a server and can be accessed by multiple clients through a common API. That also means that is likely a self-hosted solution that runs on the same backup-generators the hospital uses during outages.
      - hga 12y ago
        This is what their web page says for hospital IT departments (http://www.medisas.com/product#it-depts http://www.medisas.com/product#it-depts): "100% in the cloud and monitored 24/7 by our highly skilled technical team, so you won’t have to worry about getting your servers back up. The specialist IT console allows you to monitor and control the system from your computer, tablet or phone. Naturally, we use the same level of security as banks and government security organisations. Finally, hassle free software for you & your organisation." "100% in the cloud" and the rest doesn't sound like they're putting a system in the hospital to me. I'll bet it doesn't sound like it to hospital IT departments, and that could well be shooting down a lot of sales, and damaging their reputation for those who remember it as this. If they are putting a system in the hospital, this would very poor advertising copy, an unforced error.
freehunter 12y ago
As a Midwesterner, when I hear about medical tech companies saving people's lives, I immediately think of Epic based out of Madison WI. Is Medisas going to be going toe-to-toe with Epic? Epic is one of the very few Midwestern companies that I can liken to what I hear about the silicon valley mindset: Don't hire anyone over 30, don't ask about work/life balance, and you can't have the day off because we're saving lives, dammit! It's really weird knowing and hearing about companies and products you never knowingly interact with.
- webjprgm 12y ago
  It sounds like Medisas is solving only a single problem while Epic, Cerner, etc. are larger solutions for the bulk of health record tasks. I would be more interested to know whether Medisas will integrate with these existing enterprise systems or be an independent source of information. In terms of Medisas's long-term plans, could Epic, Cerner, etc. just add this same feature to their software and wipe out Medisas's market?
  - freehunter 12y ago
    Yeah the article talks about Medisas doing one thing, but it's hard for a successful company to continue doing one thing forever. Eventually, it's likely they will branch out.
- Iftheshoefits 12y ago
  I don't care for Epic. It is painful watching my physician and pediatrician use their software. Their market is extremely ripe for disruption, but the barrier to entry is very high (not because of cost, but because of politics, both in the business/enterprise of medical practice and actual politics).
samstave 12y ago
We built a similar service in 2009 and applied to YC with it... but it was HL7 agnostic and ran an appliance in the hospital connecting to various EMRs and other components... We were too early - this was on the first iphone and touch (pre-ipad) We were bloked by the big EMRs and various other "too-early" nay-sayers (the average age of a nurse is quite high, and at the time - they thought there was no way they coud interact with a screen as small as an iphone) Here's to hoping that medesis can succeed, and that this ideas time has come....
wehadfun 12y ago
This is a management problem first. A technical problem second. There are plenty of companies that run 24/7/365 that have people taking over others task without making the amount of mistakes found in the medical profession.

30 points by jakek 12y ago

hga 12y ago

How can doing this in purely in "the cloud", "the web", possibly be a good idea? Yes, there's a real problem this is solving ... until a shift change happens at the same time the hospital's Internet connection is down. Surely you could put a small, generic machine or two running your own software on the hospital's net that does the local work, or takes over if the Internet connection is down, etc. Or do you depend on cell phone tech as a backup for the hospitals? In that case, the infrastructure at your end had best have some serious redundancy ... which is fortunately fairly easy and not that expensive to arrange nowadays. Why I'm obsessing on this detail, besides normally rock solid AT&T have a long outage that might have covered our entire town or more yesterday? I live in tornado country, and know how easily services can get knocked out by weather of all sorts. Here's an extreme case I avoided by luck and preparation: http://stormdoctor.blogspot.com/2011/06/first-response-mode-may-22-2011-joplin.html http://stormdoctor.blogspot.com/2011/06/first-response-mode-...

cliveowen 12y ago
When it come to the sad state of technology in hospitals, any improvement is better than the current state of things. Sure, this is the kind of software that would really benefit from redundancy and a waterproof disaster-recovery plan, but the main thing here is that someone tried and actually managed to make a dent into a very real problem in the industry. This is a small step in what I hope will be a near-term future for better healthcare. You have to start somewhere.
- hga 12y ago
  I don't think I've communicated clearly: Bad paper handoffs beat no handoffs at all, or I suppose ad hoc last minute verbal ones, if this system is dead due to a transient communications outage. Do you disagree with this point?
  - webjprgm 12y ago
    Existing electronic health record (EHR) systems already have to deal with this. The ones I am most familiar with have on-site data centers, so it's not purely in "the cloud" but you can have webapps running from on-site servers and call them "cloud" systems if you want. The existing systems have ways for printing out important data from a redundant computer system to hand out paper copies if the user workstations, network, or servers are down. I don't know what they would do if there was no electricity anywhere, but I assume hospitals could use their backup generators for this since medical equipment also needs electricity.
    - hga 12y ago
      Hospitals tend to have specially provisioned power from the local electric company to minimize the change they'll have to use generators, which I assume are universally in place, although you can't always depend on them, e.g. Charity Hospital in New Orleans (a place where my mother worked in the '50s) only suffered a flooded basement during Katrina ... but of course that was were the generators were. See my other comment for how this company sure doesn't seem to be telling hospital IT departments that they've got on side redundancy.
  - cliveowen 12y ago
    i don't think cloud means on a public infrastructure. It's a term widely abused, I think they mean it's on a server and can be accessed by multiple clients through a common API. That also means that is likely a self-hosted solution that runs on the same backup-generators the hospital uses during outages.
    - hga 12y ago
      This is what their web page says for hospital IT departments (http://www.medisas.com/product#it-depts http://www.medisas.com/product#it-depts): "100% in the cloud and monitored 24/7 by our highly skilled technical team, so you won’t have to worry about getting your servers back up. The specialist IT console allows you to monitor and control the system from your computer, tablet or phone. Naturally, we use the same level of security as banks and government security organisations. Finally, hassle free software for you & your organisation." "100% in the cloud" and the rest doesn't sound like they're putting a system in the hospital to me. I'll bet it doesn't sound like it to hospital IT departments, and that could well be shooting down a lot of sales, and damaging their reputation for those who remember it as this. If they are putting a system in the hospital, this would very poor advertising copy, an unforced error.

freehunter 12y ago

As a Midwesterner, when I hear about medical tech companies saving people's lives, I immediately think of Epic based out of Madison WI. Is Medisas going to be going toe-to-toe with Epic? Epic is one of the very few Midwestern companies that I can liken to what I hear about the silicon valley mindset: Don't hire anyone over 30, don't ask about work/life balance, and you can't have the day off because we're saving lives, dammit! It's really weird knowing and hearing about companies and products you never knowingly interact with.

webjprgm 12y ago
It sounds like Medisas is solving only a single problem while Epic, Cerner, etc. are larger solutions for the bulk of health record tasks. I would be more interested to know whether Medisas will integrate with these existing enterprise systems or be an independent source of information. In terms of Medisas's long-term plans, could Epic, Cerner, etc. just add this same feature to their software and wipe out Medisas's market?
- freehunter 12y ago
  Yeah the article talks about Medisas doing one thing, but it's hard for a successful company to continue doing one thing forever. Eventually, it's likely they will branch out.
Iftheshoefits 12y ago
I don't care for Epic. It is painful watching my physician and pediatrician use their software. Their market is extremely ripe for disruption, but the barrier to entry is very high (not because of cost, but because of politics, both in the business/enterprise of medical practice and actual politics).

samstave 12y ago

We built a similar service in 2009 and applied to YC with it... but it was HL7 agnostic and ran an appliance in the hospital connecting to various EMRs and other components... We were too early - this was on the first iphone and touch (pre-ipad) We were bloked by the big EMRs and various other "too-early" nay-sayers (the average age of a nurse is quite high, and at the time - they thought there was no way they coud interact with a screen as small as an iphone) Here's to hoping that medesis can succeed, and that this ideas time has come....

wehadfun 12y ago

This is a management problem first. A technical problem second. There are plenty of companies that run 24/7/365 that have people taking over others task without making the amount of mistakes found in the medical profession.