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Thinking of starting a Health IT company? Here are top three industry challenges

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Re: Thinking of starting a Health IT company? Here are top three industry challenges

#81

Post by guylhem »

frio wrote: post #71
guylhem wrote: post #41

Earlier quoted context omitted.

If it is legal it is no scam. Making patients pay as much as legally possible is legal. For ex, on preexisting conditions, the burden of proof is almost reversed. I'm simplifying, but more or less in an audit the opposite party has to prove the charge could not have been caused by the preexisting condition. It is almost impossible (good luck if you are trying to prove say that the chest x-ray had absolutely nothing t…

> It is almost impossible (good luck if you are trying to prove say that the chest x-ray had absolutely nothing to do with a physician making sure a cancer did not relapse - so I'll add that preexisting condition to the bill. it has a multiplier effect on the whole bill after a threshold) This is a somewhat emotional reply, but: as someone with a pre-existing, chronic condition -- this disgusts and terrifies me. I'll…

"First do no harm" means to me having everyone perform efficient medicine - going by the book, not cutting corners or adding useless tests (they won't be billable)

I am very sorry if you feel that the system works against you, but IMHO the consequence of the financial incentives is your physician will make sure you have no actual infection if you are in the hospital for any other reason. he will also check for possible bad consequence of your immunosuppressant - something otherwise he might have forgotten, say for a wrist problem.

It's an incentive. It has bad sides and good sides. I believe there is more good than bad.

Regarding providing coverage, the French market is different from the US system. It will certainly be changed soon, so I don't think I can provide an interesting/useful comment.

The french system is interesting and had many strengths, but it need some serious tweaks. Putting a big chuck of the US system (medicare) was a great idea - 8 years ago. Now we have to keep evolving it.

Re: Thinking of starting a Health IT company? Here are top three industry challenges

#82

Post by snowwrestler »

logjam wrote: post #68
guylhem wrote: post #41

Earlier quoted context omitted.

If it is legal it is no scam. Making patients pay as much as legally possible is legal. For ex, on preexisting conditions, the burden of proof is almost reversed. I'm simplifying, but more or less in an audit the opposite party has to prove the charge could not have been caused by the preexisting condition. It is almost impossible (good luck if you are trying to prove say that the chest x-ray had absolutely nothing t…

> If it is legal it is no scam. Making patients pay as much as legally possible is legal. Really. M.D. in U.S. here. Your profile page says you're an M.D., too. Please reassure me that you are not a licensed physician and that you have no patient care responsibilities. However, if you do see patients (or ever have), please comment on your medical licensing board's "belief system" on unethical (but legal) practices (e…

No medical system charges the average patient as much--legally--as the U.S. system does. When it comes to ethics vs. legalities of patient payments, U.S. doctors have the shortest legs in the world to stand on.

The French system, for all the praise it gets in the U.S., is a fiscal mess. That system does need to find a way to charge their patients more, or it will eventually go bankrupt. Conversely, the U.S. system needs to find a way to charge its patients less.

Re: Thinking of starting a Health IT company? Here are top three industry challenges

#83

Post by anon6567 »

I got this pitched to me a couple of months back, but why not start a Yelp-like medical tourism service? Americans can save a ton of money going to S. Korea or anther country with similar healthcare standards at the fraction of the price. It would have to be elective surgery, but you can save a ton of money.

Re: Thinking of starting a Health IT company? Here are top three industry challenges

#84

Post by xxpor »

FireBeyond wrote: post #19

Some quite good points: "For example, inside a hospital, operating rooms (OR) are often profit centers, and emergency departments (ED) are often cost centers. The hospital may be receiving subsidies to maintain its EDs based on its ratio of OR profits to ED losses, in which case a product that ultimately makes ORs more profitable may not be worthwhile to the hospital." To an ambulance service (emergency and pre-hospi…

Is 911 response REALLY a cost center? Around here, to get an ambulance, it's $500 (IIRC) up front + $16(!!!!!) a mile. And the closest hospital might be 10 or 15 miles away. And I dont think this includes material costs (any drugs, etc.)

Re: Thinking of starting a Health IT company? Here are top three industry challenges

#85

Post by tkl »

rficcaglia wrote: post #7
tel wrote: post #2

I'm in the 7th month of starting a Health IT company and would be happy to answer (some) questions if anyone has any.

I'm in the 41st month of a Health IT startup and I'd be happy to give you a preview of the questions you havent even thought of :) Honestly if you can't fund full speed (dev, QA, support, sales, mktg, ops, clinical studies) for a minimum three years before the first hospital sale , assuming you are selling to hospitals, then get out now. Happy to shar war stories over a pint!

Hi rficcaglia, I would like to buy you a pint, or lunch, or coffee or something. Are you in the Silicon Valley area? Your email is not listed, but mine is. I am interested in natural language processing and machine learning in the medical field. Would you know anything about this?

Re: Thinking of starting a Health IT company? Here are top three industry challenges

#86

Post by tkl »

FireBeyond wrote: post #28
lucidrains wrote: post #3

i've been thinking about how to create something that can disrupt the medical industry for a long time, ever since beginning medical school. the sad truth is that medical industry doesn't welcome software disruptions. software adoption is usually a bureaucratic process due to the direct risk to human health, not to mention HIPAA and other regulations. quality of the software is not as important as selling the softwar…

I'd also like to throw myself into the ring as someone with significant medical and IT experience curious and keen to do something here. Perhaps contact me (and anyone else is welcome to, too), if you'd like to talk further.

Hi FireBeyond, your email is not listed, but I'd appreciate it if you could email me as I have a few questions. I am curious as to what companies you may have meant when you said, quote: "There are entire companies devoted to nothing more than this - taking a ICD9/10 diagnosis, some procedure codes and massaging the bill to get the biggest possible bill". I had searched before for exactly this and found very little to lead me. Any help would be appreciated.

Re: Thinking of starting a Health IT company? Here are top three industry challenges

#87

Post by tkl »

lucidrains wrote: post #38
robbiep wrote: post #27

Earlier quoted context omitted.

Hi - As a fellow med student I'm interested in what you mean here.. Are you suggesting that patients should be able to order their own tests?

hey robbie, don't know what year you are in, but basically yeah. a physician in a hospital basically looks at data on a patient to assess the state and then make decisions on management to affect the state. the problem is that these tests are hard to find off-the-shelf and often costs an obscene amount of money as well. i would look into the efforts of companies like scanadu, alivecor, cellscope. once we can get data…

Hi lucidrains, I'd be curious too what kind of thoughts you have about the health startup field. If you'd like to email me, I would love to chat.

Re: Thinking of starting a Health IT company? Here are top three industry challenges

#88

Post by robbiep »

lucidrains wrote: post #38
robbiep wrote: post #27

Earlier quoted context omitted.

Hi - As a fellow med student I'm interested in what you mean here.. Are you suggesting that patients should be able to order their own tests?

hey robbie, don't know what year you are in, but basically yeah. a physician in a hospital basically looks at data on a patient to assess the state and then make decisions on management to affect the state. the problem is that these tests are hard to find off-the-shelf and often costs an obscene amount of money as well. i would look into the efforts of companies like scanadu, alivecor, cellscope. once we can get data…

Im just entering my final year.

Like you I think there's plenty of room for disruption, not just on the medical devices side but also in terms of efficiencies.

So the three companies you reference are basically disrupting devices that cost thousands of dollars (ECG and otoscopes/dermatoscopes) - great for bringing down the costs of clinics or solo practitioners. A lot of these devices I think are probably being angled at the home user as well (particularly ECG) but the clinical relevance of giving a patient their own rhythm is pretty minimal... I mean if they have a dicky heart they likely have a pacemaker or ICD which will record suspect rhythms themselves.

I'd be fascinated to talk more to you and see where you are taking this because I think you are really saying is that if we give patients their results or order their own (bloods, EUC, any ELIZA etc studies) then we will be empowering them to make better health decisions. I have my own opinions on this based on what i've seen and if you're interested in discussing further my email is in my profile - although seems like you have a lot that would like to talk to you!

Re: Thinking of starting a Health IT company? Here are top three industry challenges

#90

Post by z00mer »

error54 wrote: post #17

As a current developer for a health IT company, much of this is true. Even with the current incentives to go electronic, many doctors just simply prefer paper charts and are willing to forgo the $40k a year just to keep things the status quo. My particular company is growing by leaps and bounds because we started with a very simple Practice Management model and grew out from there whereas I see a lot of startups try…

e54 : What are your contact details?
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