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I'm a doctor - help me disrupt healthcare

news.ycombinator.com

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Re: I'm a doctor - help me disrupt healthcare

#91

Post by akrasia »

md2be wrote: post #34
smalter wrote: post #8

My unsolicited advice: rather than being "fairly certain" that you can make $500/mo with your idea so that you would prefer to start a company first, I suggest that you reverse the order of operations. First, be certain that you can make $500/mo by building it yourself and get the hospital paying $500/mo. Then, if the opportunity looks good, start organizing (aka building an organization, a company) around that. You'…

The guy is a first year resident and should be working 70 hrs a week perfecting his skills. If he is cheating the system now by not being fully committed, I can only imagine what he will be doing 7 years from now.

> should be working 70 hrs a week perfecting his skills

I already work 60-80hrs/week, should I be working more? Would 100hrs/week make you happy?

> I can only imagine what he will be doing 7 years from now

6 years from now if I continue on this road keep my head down and work hard I'll be making 300-400k/year as an attending physician. I can work 4 days per week and make 200k. I don't care too much about money as long as I can pay my loans off and eat out once in awhile. That's all nice and dandy but I'd rather spend some of my free time building something that helps the healthcare system.

Re: I'm a doctor - help me disrupt healthcare

#92

Post by lostlogin »

md2be wrote: post #33
healthenclave wrote: post #2

Sorry to piggy back on your post. But Indian Medical Doc here pursuing Orthopedic Surgery Residency who also codes in Python, Django, Frontend and Excellent in UI/UX is also looking for some help !! If there is anyone in the audience who is a full stack python guy located in India or USA and can help me disrupt Health care Kindly get in touch. Have lived and worked in some of the finest hospitals in US (viz: Ny Presb…

Your a first year resident. How about finishing your training? This sickens me.

Unless you have paid for his training, why does this bother you?

Re: I'm a doctor - help me disrupt healthcare

#93

Post by lostlogin »

venomsnake wrote: post #21

Here is one question. How will you do with all the tape? This creates a potential lawsuit point in case of failure (or even in case of blamestorming, when the software worked correctly but a scapegoat is needed). So you will need some form of insurance or regulatory approval. I can create a very few extremely simple solutions in my mind that will be quite precise. You don't even need much coding. In the worst case OC…

Get out the US. Other places have less crap in the way and have better performing services (ie their lack of regulation in the IT area is actually capable of producing better results). Are the regulations just protecting incumbents? Or am I overly cynical?

Re: I'm a doctor - help me disrupt healthcare

#94

Post by lostlogin »

akrasia wrote: post #87
anoncow wrote: post #23

As a fellow doc, i say welcome! Have you looked at DICOM? Most medical s/w, h/w support it. And congrats on the radio residency!

Yea DICOM is for imaging though (CT scan, MRI, etc ...) but I think you know that already. Even though DICOM is a standard, there are still stupid things that go on (e.g. radiologists have to hand type radiation doses that the patient received because apps do not talk to each other). HL-7 is the standard for other medical apps. Even though these standards exist, the problems are still there and solutions are sometime…

Some systems automate the sending of dose data, but send it as an image with the data hard burnt into it. Amazingly crap. I highly doubt that radiologists are recording dose as they very rarely do any examinations that give dose. It would usually be radiographers/Medical radiation technologists/Technicians etc (pick your naming convention!). DICOM is capable of handling data other than images, I believe some neurology systems produce data into the format. It has a ton of fields that seem to be able to be filled with user defined data and yet not break the DICOM spec. There are many things about hospital IT that are way more crap than hand recording of radiation doses.

Re: I'm a doctor - help me disrupt healthcare

#95

Post by lostlogin »

md2be wrote: post #56
zodiac wrote: post #51

Earlier quoted context omitted.

Residents don't need to spend every waking hour focused on their job. As long as he is doing his job properly, what's wrong with doing some coding / business on the side?

A First year resident know jack shit about medicine and works 13 hrs a day making mistakes along the way in hopes of learning enough so not to make these same mistakes when they will be in command (5 years from now).

You are very sure of how he should learn and contribute, why is this?

Re: I'm a doctor - help me disrupt healthcare

#96

Post by lostlogin »

tpainton wrote: post #45

As a physician of 15 years in internal medicine all I have to say is residency must have become ridiculously easy if you have time to start a company.. For me, 100 hours a week made that impossible so I waited until I was done. Your idea is an old one. It's been deliberated and contemplated. You forget that you're writing code that is essentially a medical tool that potentially affects peoples lives. You will need ma…

I know one registrar who built his house while doing the program. I know another who got a few medals sailing whilst doing his etc etc. I'm not sure that you can generalize about how much time people have.

Re: I'm a doctor - help me disrupt healthcare

#97

Post by anoncow »

akrasia wrote: post #87
anoncow wrote: post #23

As a fellow doc, i say welcome! Have you looked at DICOM? Most medical s/w, h/w support it. And congrats on the radio residency!

Yea DICOM is for imaging though (CT scan, MRI, etc ...) but I think you know that already. Even though DICOM is a standard, there are still stupid things that go on (e.g. radiologists have to hand type radiation doses that the patient received because apps do not talk to each other). HL-7 is the standard for other medical apps. Even though these standards exist, the problems are still there and solutions are sometime…

Thanks for the informative reply. It might be a long road but it's a part of your journey. Enjoy every mile.

Re: I'm a doctor - help me disrupt healthcare

#98

Post by perplexes »

akrasia wrote: post #76
smalter wrote: post #8

My unsolicited advice: rather than being "fairly certain" that you can make $500/mo with your idea so that you would prefer to start a company first, I suggest that you reverse the order of operations. First, be certain that you can make $500/mo by building it yourself and get the hospital paying $500/mo. Then, if the opportunity looks good, start organizing (aka building an organization, a company) around that. You'…

Your advice is duly noted. I am planning to talk to the director of the pulmonary team sometime this week and see if he is interested. I know most of the doctors who work in the lab will welcome the software. Seeing that most large hospitals pay 50+ million for their EHR/EMR setup, $500/month sounds reasonable. I looked briefly into building it myself (just in case this thread did not get a good response), and I can…

> Seeing that most large hospitals pay 50+ million for their EHR/EMR setup, $500/month sounds reasonable.

When I worked for a construction project management startup, this too sounded reasonable: many software systems for this audience were in the six-figure range... we were only asking $100/month or so. ("And a free trial!!!")

We learned that when your monthly price point is the size of an accounting error, no one can take you seriously.

This software was also holistic in nature: everyone, everyone, everyone has to use it for it to work well and as a core part of their organization. It's a superset of the marketplace business problem.

To address these we had to charge more. Much more. This raised the stakes on both parties and also filtered out less serious buyers who would probably fail with our software.

The construction companies who were serious buyers really considered thoroughly whether they could implement the change; we worked with them for, sometimes, months going through how the change would take place. And training, training, training. Usage metrics. Account hand-holders. Keep them using the system.

--

As others have said, medical software is some of the hardest to break into. Medical staff HATE CHANGE, and need to. Change in the short term leads to mistakes and mistakes cost lives or careers. The system is bureaucratic, politicized and slow moving. Anti-disruption.

I believe that a guerrilla approach to insurgent medical software is ultimately what will work - things like https://www.radiologyprotocols.com/, where a radiology tech wanted a common repository of knowledge for others in his field. Then, through word of mouth and using it with his colleagues, it gained first use in his hospital, then international use, and now it's starting to take off in the US. (Reminds me of "Big in Japan" first, or conversely Japanese artists having to become popular in the US before being taken seriously back in Japan.)

--

Okay, advice.

Sell it before you make it. If you have multiple hospital/medical contacts, play with pricing. Try outrageous things. If not, just try to work out any sort of deal and have them sign a piece of paper that says they'll pay.

Then build it.

Iterate with the first customer until it's "So Good They Can't Ignore You".

After this, you might get better traction outside the US. There are hospitals in other countries who are desperate for good software and also don't have the money for the large EMR software many US hospitals use.

GOOD LUCK!

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