Nine points of reflection after my medical O2O project failed

Jeffnovich, with a rare, honest introspection, analyzes why his digital medical company eventually failed to start a business, and the company was originally developing a "doctor-patient Communication platform" (marginalised

Communicator), a portal site for physicians to manage the patient's customer relationship. The arterial network found his first confession in January 2013, the bitter lesson of a failed venture:

My father was a GP, and in 2009 he asked me to help him develop a product that would allow his patients to access him over the internet instead of on the phone. This abbreviation for PC (marginalised

Communicator's doctor-patient communication platform is built on these fronts: Patient Portal + Doctor's customer Relationship management system + Business management system, which completely changed my father's business. Then in January 2012, I became the first group to join blueprint

Tiyatien's entrepreneur, a medical incubator, is a branch of the TechStars company, Me and co-founder Larry

Cobrin spent 3 months trying to commercialize the doctor-patient platform.

All of our efforts include hundreds of telemarketing calls, tens of thousands of emails, seminars, Fox News broadcasts, advertising, and leveraging our own contacts and blueprint Tiyatien

The company's circle-the end result was a pay-for-doctors user (who went bankrupt later) and a partnership agreement with a small company that worked on the 20 Electronic medical records (EMR).

We spent another 3 months trying to raise money and visited more than 40 investors, but ultimately we decided to give up, and here are our reasons:

1. Business > Products

PC was originally involved in my father's business products. I've never evaluated a patient's market demand for a portal. It is very difficult to commercialize a product that is designed for a particular user to market.

I remember when I was in the two years of product development, I used to ask my father, "is xyz such a trait that other doctors would want their office to use?" Is this what other doctors need to deal with? "My father's answer is usually yes, which feeds my thinking and makes me think that the product we are developing has a wide range of needs." At the same time, I never really took the time to test other doctors to see if anyone would want to do the same and use a PC. Others join Blueprint

Tiyatien's companies also start by evaluating demand or pain points in an industry, which explains why many of these companies haven't developed products yet.

2. Impenetrable black box

I learned that a typical doctor's office model works in a stubborn "black box", meaning that doctors do not change even a little of their infrastructure. They are unwilling to try any new technology that affects the workflow. They stubbornly retain the 80-Year-old Secretary Betty, Dial telephone, paper charts, fax machines, 10-person staff, and the sale of a PC means that we will break the black box, let both internal and external reorganization: doctors will need to adjust the behavior, staff need to use the new system, Patients will have to learn new websites. It turns out that it's not going to happen without a fight ... Or, as with electronic medical records (EMR), if there is not a large amount of government subsidy to encourage doctors to join the 21st century Electronic medical records, we will not win a large number of users.

As one salesman told me, it was a ground war. What is the secret to winning the war? To provide services to such a black box, but also to obtain a clear return.

ZocDoc started without touching the office area, they just said, "pay 250 dollars/month, we will deal with 三、四十个 new patients." "It's their problem if doctors are too expensive to deal with these patients ' paper forms and fax machines," he said. Same with Hep

O Clock

A record company's deal does not cover the costs of the original workflow, but operates outside the black box, between them and the law firm, the insurance company that requires medical records. They manage these needs and charge and participate in the action. Secretary Betty still wants to put Jon

Smith's medical records sit in front of a fax machine for 12 hours (this is a "black box" task), but at least the issue of requests and charges will be processed on the site.

3. My father's operation is an exception, not a typical

Unlike almost all the doctors I've talked to, my father welcomed the new technique and was happy to make unremitting attempts to improve the operation of the business. He expects to optimize everything and is happy to try to switch to a new billing system, as long as the new system delivers more value, whereas a typical doctor's office will use the same technology for years, fearing or unwilling to make a change. My father would think rationally and pragmatically about how to reduce costs. He will learn new technology, reduce staff, and turn to do more "secretarial" work. And my assumptions about the market are mostly based on the atypical workings of my father's technology.

4, the doctor dragged down the technical acceptance curve

We found in the market that doctors are often the "laggards" of technology. Although they may buy the latest ipad, this does not translate into increased operational efficiency or willingness to adapt to their workflow. The PC "doctor-patient Communication platform" relies on doctors to understand that more contact with patients means more income, better results, and a lot of savings. The problem is that doctors have almost never changed their course of operation. They cling to the fax machine, rely on their employees to respond, and (at least my father's experience) prefer to stop their business or join the unsaturated team business rather than control and update their operations to get the best business.

5. Doctors are unreachable

Unless you have a clear distribution channel or partner, it's good luck to get a doctor's attention. Medicine, insurance, hospitals, group business, and so on, are spending a lot of money trying to get doctors ' attention. Doctors are often "sold" to many businesses and services, so you need to find a way to get around the noise and go into the doctor's ear. But doctors are accustomed to getting a Hawaiian golf trip, offering lunch and other activities (perhaps less than before, but the mind-set still exists). It is almost impossible for us to find the opportunity to talk with the doctor. It is important to insist, but is it worth the price? Even if we raise money, how can we remove this barrier? (Reliance on the partnership of Electronic Medical records ...?) ）

6. The patient portal has been commercialized

Most electronic medical records operate under similar systems. Our product may be five years ahead of these patient portals (we've seen dozens of of these sites, all pathetic), but it doesn't matter. Electronic medical records add a patient portal as a trivial matter (often a poor user experience), and doctors often think it should be free or very inexpensive. Tell me a doctor with a patient portal (except in a big hospital, not a dentist), but I can tell you 5,000 doctors who don't use the portal. We found that, for such products, the value of doctors and market recognition is very low. So they didn't use it, they valued about 50-100 yuan/month. We visited dozens of EMR service providers who had similar judgments. One of the EMR service providers adhere to the 20 fee to cooperate with us! But at the same time, my father can use 15% of the management costs in this industry not to hire staff, to provide quality services to patients without increasing the cost, which is due to using the PC. I'm sure the price of PC is 200-400 dollars/month, but I can't do it.

7. Crowded markets

We started out as a product and developed this "patient communicator" in an isolated state. I should have told my father to try to find out if there was anything in the market that would have made 75% of the product he wanted. If we had really done that, we might never have developed a PC. If we were to continue to develop at that time, we would be able to fully understand what our distinguishing factors were. After all, my father has tried some products with his patients, and has seen what works, what is ineffective, and what is lacking, and we find functional differences that may be worth pursuing. If we continue to develop in this way, we will not be so laborious to explain EMR to investors, why computers are different from the portals of all other patients on the market. We may be fully aware of how we are adapting to ecosystems in this way, or, more importantly, we may not even try to build it first!

8. Lack of passion

I am not proud to say that I am disappointed in the state of health care and innovation after I have dealt with all of these things. At first, I was angry because I saw this product have an incredible impact on my father's business and his 1200 patients. This model-a small amount of business, a lot of contact, low overheads, and the use of technology to improve operational efficiency and provide care-drives me to join blueprint

Tiyatien, and make a decision to promote the communication platform for the patient full-time. But I realize that many of the businesses that actually make money in the medical field have nothing to do with optimizing the GP service. In fact, we have no clients because no one is really interested in the model we are selling. Doctors want more patients than efficient office work. There are so many difficulties to overcome that I think it is better to find an area that is more likely to work.

9. No chief Technical officer

This is the last of the list because I think this is the least important reason why we failed. We need a full-time, work chief technology officer to replicate and improve the product. When we find a doctor who is interested in this, we have to assess the cost to weigh all the improvements and adjustments. This is not what a successful technology company should do. You need every day to have an important partner role to constantly refine the product. Test the various functions and see what you can do to make money. Just like most startups, we don't have enough intelligence to make these decisions. The challenge for startups in the early stages is to fund many of their own development plans, rather than financing them, which will always hinder success.

I hope my experience will help the medical entrepreneur. I'm discouraged by the industry, but I know a lot of talented people are trying to improve, and that's good for everyone. One of the most frustrating things to see in the healthcare industry is that the rapid flow of information and the potential for life-saving real cooperation did not actually happen. Perhaps medical entrepreneurs can push the industry in the right direction.

Jeffnovich has been pioneering many times, has more than 10 kinds of products to the market. Before, he worked as a mobile product manager at a car service company Groundlink. He is also the owner of social-learning application Grockit, a company recently acquired by Kaplan (Kaplan).