A Prescription For Healing The Healthcare Industry
We can only solve the problems we see, and most entrepreneurs don’t have experience working in healthcare. I deeply believe the biggest reason we don’t see more entrepreneurs in healthcare is that they don’t understand the problems, and don’t know where to start.
A few trends that are making healthcare an extremely attractive market right now:
- Large and massively inefficient $3.35 trillion market, and growing.
- Big regulatory shocks are happening, creating market openings for new players.
- The culture is increasingly open to new innovation
Below are 11 ideas to get anyone with an entrepreneurial interest started down the road to building a company in health tech. My goal is that these ideas will serve as inspiration.
1. Rethinking Advance Care Planning
Problem: Only about 30% of adults have an Advance Care Plan (ACP) expressing their wishes for end-of-life care. CBS reported that Medicare spent $55 billion on doctors’ and hospital bills during the final two months of patients’ lives, and that “20 to 30 percent of these medical expenses may have had no meaningful impact.” However, having an ACP significantly reduces costs to Medicare and other insurance plans — upwards of 60%.
Opportunity: Build a web product that makes it easy for people to create advance directives, easily access them anytime, and share them with clinicians or family members. This would give peace of mind to patients and families, while saving a significant amount of money for Medicare and other healthcare plans.
A few early-stage companies are working on facilitation and storage of Advanced Directives like MyDirectives and Everplans. Tangentially, companies like Grace are beginning to enter the market, positioning themselves as tech-enabled “concierges” for people planning for, and recovering from, the death of a loved one.
In 2016 CMS approved a CPT reimbursement code specifically for Advanced Care Planning conversations in Medicare. This means now is the perfect time to enter this industry and build something meaningful.
2. Better post-acute rating and referral system
Problem: Hospitals are fragmented and compartmentalized with few processes for tracking patients beyond their walls. At the same time, our Government (CMS) is financially incentivizing hospitals and skilled nursing facilities (SNF) to reduce hospital readmissions and post-acute cost.
Opportunity: Provide hospitals a (software) tool to gain visibility into the patient’s path after they transfer to an SNF/Rehab (and beyond).
A few structural realities make this especially interesting — hospitals have leverage over SNFs because they supply all the referrals. A hospital could make it mandatory for an SNF to use their patient tracking system in exchange for referrals. Once the system is in place, it would act as a feedback loop similar to other rating platforms like Yelp, Lyft or Airbnb.
Companies like SilverVue are early to market, but there is a lot of work yet to be done and the playing field remains wide open.
3. Better use of health tracking hardware
Problem: Collecting patient health diagnostic data is a manual process and a lack of data makes it difficult for doctors to turn it into actionable recommendations.
Opportunity: Bundle health diagnostic hardware together and build the software to generate simple health reports for doctors.
Patients should be using devices that specifically track health data relevant to their condition. This data should be seamlessly uploaded to the cloud. Once there, software can analyze it and present trends to doctors.
For example, most diabetics take their own blood sugar samples every day, manually. Many of those readings simply vanish. Instead, that data could be communicated back to the patient’s physician or stored in the cloud.
The bigger idea down the road is to use this data to detect trends and adverse events before they happen. One notable company, Noteworth has made significant headway, but lots of opportunities still exist.
4. Real-time logistics tracking within the Hospital
Problem: Health systems struggle with patient logistics inside the hospital, including patient delays, provider staffing errors, and general operational challenges.
Opportunity: Tracking the exact location of patients and staff within hospital walls.
Health systems are complex, multi-building organizations. They could benefit dramatically from technology that helps case managers and directors on the floor get a high-level overview of their staff and patient flow. Technically, this can be accomplished with beacon technology worn on the back of identification badges.
5. A Cost-Effective Alternative to the 9–1–1 Ambulance
Problem: Ambulances are very binary — there is no middle ground. They are expensive ($2,000 per ride) yet often not necessary. A 2009 study estimated that one in five medical-related 9–1–1 calls were “non-life threatening.”
Opportunity: An app that can be an alternative to a 911 phone call. It would offer the ability to triage and categorize the incoming call, with the ability to upload (pic, video, stream), assess the need for assistance and possibly offer a lower level/lower cost response team.
An opportunity exists to create an Uber-like app platform of “certified” emergency responders throughout a city. These EMTs would receive notifications from 9–1–1 dispatchers regarding an emergency near them.
6. Care Coordination Technology for the Public Sector
Problem: Lack of technology in caregiver management throughout the public sector results in huge amounts of wasted resources that accompany a paper-based operation.
In California, for example, In-Home Support Services program (IHSS) track all hours worked on paper timesheets for processing. When 65,000 timesheets went missing after a mail truck mishap in 2015, thousands of caregivers went unpaid for weeks or even months.
Opportunity: Create a simple process so caregivers can clock in for shifts with a mobile app and reliably receive electronic payment.
State and federal agencies are often slow to adopt new technologies. There exists a huge need for someone to develop specialized tools to help these public programs run more efficiently and at a lower cost.
7. Resident Scheduling and Communication Platform
Problem: Tracking resident schedules and communication is frequently managed manually with a paper-based system. Chief residents in charge of managing residents, struggle with fulfilling availability requests and keeping schedules up-to-date. Communication among residents is difficult and the system is prone to mistakes.
Opportunity: A scheduling platform specifically for residents would benefit stressed-out residents and their attending physicians, leading to better patient care.
There are a few players competing in this space, Medhub and New Innovations, but neither seems to be widely adopted. OhMD — a HIPAA compliant texting app, is intelligently targeting their marketing efforts towards residents, the youngest and most innovative thinking of all doctors.
Eventually, they or someone has the potential to grow into a full scheduling platform for residents. The big picture here is getting residents to love your software, then expand to other functions throughout the hospital (doctor to doctor messaging, patient to doctor messaging, nurse scheduling, etc).
8. A tool to manage medication reconciliation
Problem: Wrong medication, wrong time, wrong dosage, and noncompliance are just some of the major issues for patients taking multiple medications. The detrimental effects and costs of medication mix-ups in the elderly population is a huge problem.
Opportunity: Create a platform of trained people that go into the homes of seniors and do medication reconciliation (med rec).
Companies like TowerView Health and Tricella are developing pillboxes that detect and store patient adherence behavior. Others like PillPack and ZipDrug are developing more intuitive packaging and delivery options to take out much of the confusion of medication management.
However, tools like these leave ample room for error as patients keep taking old drugs and remain responsible for correctly separating their weekly medication.
An opportunity exists to build a network of low-cost medication reconciliation specialists. These specialists would do a 30-minute audit of the medicine cabinet and ensure the patient or caregiver understands which pills to take, and at what times.
If someone came to hospitals (and progressive payers) offering a managed service with an easy to use technology layer, it could be a game-changer.
9. Build Electronic Visit Verification 2.0
Problem: Medicaid fraud is a big problem in many parts of the country. Caregivers submit timesheets for shifts they didn’t work, leaving the disabled and elderly home alone.
Opportunity: Electronic Visit Verification (EVV) monitors locations of caregivers which would significantly reduce fraud. In the last few years, Texas and Illinois mandated the use of EVV technology, which exploded the demand overnight.
There is an opportunity to bring a stronger product to the market. It would manage specific State and Federal reporting requirements, use GPS to track caregivers, automate payroll and optimize staff matching. This would increase the efficiency of home health agencies, as well as reduce Medicaid fraud by providing detailed evidence of services provided.
10. A telehealth platform for integrative medicine
Problem: Americans are chronically sick and the medical industry repeatedly fails them by treating the symptom, not the root cause.
Opportunity: Build an integrative medicine platform to connect integrative medicine doctors with patients across the country using virtual telehealth (video/audio consultations instead of the traditional visit to the doctor’s office).
Integrative medicine combines traditional healing, prevention and natural self-healing philosophies of Eastern medicine, with advanced evidence-based research of Western medicine, to treat the whole person versus a set of isolated symptoms.
Integrative medicine is growing quickly. Over the last eight years, despite lobbied opposition, we’ve seen dozens of top hospitals and health systems — such as Stanford Health Center for Integrative Medicine and Cleveland Clinic Center for Integrative & Lifestyle Medicine — open integrative medicine departments in response to increased patient demand.
Telehealth is also rapidly growing. Governments, health systems, and patients all realize the financial efficiency and convenience.
The integrative medicine industry currently consists of only local providers. A big opportunity exists for a company to combine telehealth with integrative medicine. So far the leading integrative medicine company offering telehealth is Harvey.
11. Simple interface for insurance pre-approval
Problem: Insurance reimbursement is vague, confusing, and seemingly ambiguous to patients and providers. Patients and providers rarely know if procedures will be paid by their insurance.
Opportunity: Offer a simple tool to private practice providers giving them access to patient copay and deductible information.
A simple SaaS solution giving private practices access to patient copay and deductibles would save lots of time and money.