5 ms·

i currently work in the healthcare industry and am constantly amazed at how outdated anything we use is... this is the single largest industry in the US, it has

by eonw 11y ago

i currently work in the healthcare industry and am constantly amazed at how outdated anything we use is... this is the single largest industry in the US, it has money falling out of its pockets and is used to paying exorbitantly for everything. You could really pick any pain point in Healthcare and build a decent sized revenue stream with the right sales team in place.

ef4 11y ago
Having attempted to do exactly that, I have gotten a little wiser about just why the existing software is so bad, and why it's hard to supplant. Writing better software isn't the hard part. As you alluded to, it all comes down to the difficulty of selling to them. No matter the size of the customer, they all seem to take two years to make up their minds to buy. That is pretty harsh on a scrappy startup. To grow quickly, you need to pour a very significant pile of money into an enterprise salesforce two years before you actually want to start making money. That also leads inexorably to the conclusion that small customers aren't worth the hassle, so you need to target the behemoths who can spend enough money to justify their acquisition cost. And the behemoths are so scarred by years of disastrous IT projects that they are deeply risk-averse. I also think the industry remains in denial about the strategic value of software, so you don't actually get paid what you're worth. They all know they need software, but they see it more as a necessary chore than an opportunity to revolutionize their business. My hope is that a real technology company directly enters the healthcare market and starts kicking butt by building their healthcare services around great software from the ground up. That would shake the incumbents out of their denial.
- meatysnapper 11y ago
  Hospitals/Big Healthcare need to be sure the vendor will be around for a decade or three. It is very hard for a startup to offer this assurance in a believable manner. It will take someone like Google to tackle this.
  - ef4 11y ago
    Right, part of their problem is that they're demanding the wrong thing. Instead of demanding a high degree of stability from one vendor, they should be demanding open standards and real interoperability, so their eggs aren't all in one obsolete basket.
    - meatysnapper 11y ago
      Wrong. This is like saying we should demand only a small degree of reliability from airplane wings, but we should make them easily replaceable. I don't think their insurers would like that. When medical records start getting lost/exposed because of small outages or vendor changes, the Feds will come down very hard.
      - ef4 11y ago
        I didn't want to imply software that's not stable. I was replying to the point about wanting a big stable company to purchase from.
andycav 11y ago
Isn't it a little bit generic? Could you please make some significant examples? Thx, AC
- eonw 11y ago
  EHR, payroll, on-call management, paging, messaging, MDM, billing, mobile computing, HR, interfaces... pick ANY thing really, as almost everything will need to be hipaa compliant. the healthcare system i work for has 650+ applications we support, I was hired as a developer yet we do very little development here. Hospitals like the idea of a vendor they can call and make fix anything, because its very costly to have SMEs for every single piece of software we use. many of them requires us to send our staff our for training yearly. example: one vendor sells us diagnostic imaging software, but require us to buy a "certified" video card if we want their support... its just an old 90's nvidia card they rebrand and charge us $1500 each for. Epic and Cerner are probably the largest EHRs. Epic revenues were 1.56B in 2013. While Cerner did 2.66B in 2013. also, a lot of healthcare spending is government subsidized, which makes it even more lucrative. http://www.healthcare-informatics.com/hci100/healthcare-informatics-100 http://www.healthcare-informatics.com/hci100/healthcare-info... this illustrates the money moving around in healthcare

by eonw 11y ago

ef4 11y ago

Having attempted to do exactly that, I have gotten a little wiser about just why the existing software is so bad, and why it's hard to supplant. Writing better software isn't the hard part. As you alluded to, it all comes down to the difficulty of selling to them. No matter the size of the customer, they all seem to take two years to make up their minds to buy. That is pretty harsh on a scrappy startup. To grow quickly, you need to pour a very significant pile of money into an enterprise salesforce two years before you actually want to start making money. That also leads inexorably to the conclusion that small customers aren't worth the hassle, so you need to target the behemoths who can spend enough money to justify their acquisition cost. And the behemoths are so scarred by years of disastrous IT projects that they are deeply risk-averse. I also think the industry remains in denial about the strategic value of software, so you don't actually get paid what you're worth. They all know they need software, but they see it more as a necessary chore than an opportunity to revolutionize their business. My hope is that a real technology company directly enters the healthcare market and starts kicking butt by building their healthcare services around great software from the ground up. That would shake the incumbents out of their denial.

meatysnapper 11y ago
Hospitals/Big Healthcare need to be sure the vendor will be around for a decade or three. It is very hard for a startup to offer this assurance in a believable manner. It will take someone like Google to tackle this.
- ef4 11y ago
  Right, part of their problem is that they're demanding the wrong thing. Instead of demanding a high degree of stability from one vendor, they should be demanding open standards and real interoperability, so their eggs aren't all in one obsolete basket.
  - meatysnapper 11y ago
    Wrong. This is like saying we should demand only a small degree of reliability from airplane wings, but we should make them easily replaceable. I don't think their insurers would like that. When medical records start getting lost/exposed because of small outages or vendor changes, the Feds will come down very hard.
    - ef4 11y ago
      I didn't want to imply software that's not stable. I was replying to the point about wanting a big stable company to purchase from.

andycav 11y ago

Isn't it a little bit generic? Could you please make some significant examples? Thx, AC

eonw 11y ago
EHR, payroll, on-call management, paging, messaging, MDM, billing, mobile computing, HR, interfaces... pick ANY thing really, as almost everything will need to be hipaa compliant. the healthcare system i work for has 650+ applications we support, I was hired as a developer yet we do very little development here. Hospitals like the idea of a vendor they can call and make fix anything, because its very costly to have SMEs for every single piece of software we use. many of them requires us to send our staff our for training yearly. example: one vendor sells us diagnostic imaging software, but require us to buy a "certified" video card if we want their support... its just an old 90's nvidia card they rebrand and charge us $1500 each for. Epic and Cerner are probably the largest EHRs. Epic revenues were 1.56B in 2013. While Cerner did 2.66B in 2013. also, a lot of healthcare spending is government subsidized, which makes it even more lucrative. http://www.healthcare-informatics.com/hci100/healthcare-informatics-100 http://www.healthcare-informatics.com/hci100/healthcare-info... this illustrates the money moving around in healthcare