Category Archives: Healthcare

Designing Hospital IT Infrastructure For Promoting Patient Centered Care

patient-centered-careThis is a re-post of discussion I had on Quora.com .  You can read it here by clicking this link

When designing an IT system for Hospitals, you would have to consider many factors like
1. Who are main users of the systems
2. What are the legal requirements
3. What are regulatory requirements

(img courtesy : blog.slkylight.com )

4. What are security considerations you have to follow
5. Would the users need access to the systems outside hospitals organizational or IT boundaries
6. How will you protect the privacy of the data you would be storing
7. What kind of redundancy do you need and how are you going to replicate the data
8. Will you be needing to integrate with other 3rd party vendors for example EHR providers and if it is then how do you plan to integrate them. Think in terms of integration issues, data migration/replication/access etc.This should also cover the different types of software/databases you or your organization would be using.

9. How many different systems does your hospital have and what kind of data they are creating/accessing/retrieving and in what format.
10.Also think about the regular IT maintenance tasks you have to follow.
11. Think in terms of the HW reliability and backup plans.
12. What kind of latency is tolerated while doing stuff real time for your users. This will help you plan your network issues.
13. Understanding the load/performance issues of your IT depending on the expected usage will help plan on selecting right infrastructure.

Here is how I would approach : I would build a patient journey template . The moment patient wants to visit your hospital to the moment they walk out . Along the process list all the interactions they will have with your staff and what kind of IT infrastructure you need to support them. 

This should also include what your physicians will need to support the patient like clinical decision support systems.

Next, build the template from the physicians  and/or hospital administration point of view.

Also think about how to monitor the patient remotely and how to process real time alerts and what kind of infrastructure you need for that. For example those alerts or data might be passed to hospital nursing station who would then filter and send it to order .

Do this from the point of view of all users of the system (or stakeholders of the system like patients/nurse/physicians/administration) etc and by the time you are done with this exercise you will have around 6-8 templates.

Now keeping all the templates in front of you, comeup with a top-down template that comprises whole system. If there are multiple systems (in the context of IT) doing the same thing, eliminate/simply them keeping price/features/support/security/privacy/compliance in mind.

You might have to iterate multiple times to build something you can go forward.

Next introduce the hardware required to support the IT systems you selected keeping reliability/costs/power in mind. This will give you a decent understanding of what your datacenter will look like . See if the HW system costs and electricity/cooling costs still makes sense. If not revise and make tradeoffs

Next introduce the connectivity part. What components needs to be on what kind of networks. Wireless/Wired etc. Think of network security here. Figure out a strategy on how you will protect against intruders/hackers/breaches etc…

Since you are hospital, you must be using some latest and greatest surgical equipment and many of them are wired and some are wireless or require different protocols. Plan ahead for these and include this as a part of IT development plan.

Use of ipads or tablets is increasing in hospitals. There might be additional devices your staff will be using . Sort of BYOD (bring your own devices) . So think what kind of mobile device management technology you want to use and how it fits in this picture.

There might be many more, but this is pretty broad picture and this is how I would approach if I were to design/develop patient centered hospital.

Few suggestions:
1. Stick few systems and vendors if possible. This will solve interoperability issues
2. Storage plays a key role. So select right database technology and database vendor. I prefer documented oriented databases.
3. I’m really not sure if you can have open access meeting all stringent legal/compliance/privacy/regulatory req. There will be tradeoffs. Ask your startup what you will be loosing or your patients/staff will be loosing and what you will be gaining.
4. How do you plan to have CMS (content management system ) serving both patients and medical staff. You need 2 CMS systems one where patients can access and other only hospital staff/physicians can access.Its very important from legal/security point of view to separate or have them in network boundaries.
5.Since you want state of art, what kind of login access are you planning to have ? Biometric? They come with their own sets of requirements
6. Same with clinical decision support systems. Collect all the requirements each of dept needs.

Would love to know from readers on how they would approach or design an advanced hospital IT infra with patient centered care in mind…

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Startups :Creating barrier of entries

next-great-idea

Very first qn that crosses the mind of first time startup entrepreneurs. How do I protect my idea ?

Foremost important thing : Ideas are worthless unless executed properly with viable business plan.

Here are some ways:
1. File for provisional patent if you plan to sell in US..its not very expensive, but creates some barrier of entry..If you are not in US, follow same in your country if it has IP laws
2. Register your company and file for trademarks ..again not very expensive, but its not very cheap…
3. Partner with a very reputable law firm.For example my lawfirm is WSGR (www.wsgr.com) and they are very good and rank among top 10 in US. Many lawfirms are startup friendly or find one who is. Many defer fees or don’t charge anything for 1st yr. Negotiate with them. Partnering with good law firm has its benefits and it also signal investors that you are advised by some good firms.
4. Build MVP faster . Ideas don’t matter much. Execution and viable business models matter. So work on that.
5. Once you register your company legally and have finalized idea/business model , start branding campaigns to generate some traction..these are not so easy and takes time.
6. Start thinking of EU/FDA compliance process…They require tons of documentation and are very process oriented..get familiar with it…Familiarity and knowledge is important and can keep your copy cats away for some time…
7. As I mentioned earlier, Start selling …Many think they should sell only when they have beta or final product…Selling should begin very early to really understand what works and what doesn’t with minimum resources…fail fast and fail often should be the key to accelerate your success 🙂

Would love to hear more ideas and thoughts from readers.

Startups: Applying lean methodology and business model canvas frameworks

Startup-Image

I’ve been recently asked by many and also I’m seeing similar qns on Quora and coursera entrepreneurship courses.If you are wondering what the question is . Its very simple. It goes along these lines…I have couple of ideas and/or I have shortlisted few of them. Now what do I do?

I was in the same boat multiple times and having been part of multiple startups as early employee and also as someone who failed once before while trying to start a consumer electronics before, I started following this lean methodology framework for my current digital healthcare startup (www.sensoryhealthsystems.com)

1. Download lean canvas ( http://www.leanlaunchlab.com) to understand UVP of your solution. Have only 1-2 strong UVP that is directly addressing the pain points and must-haves
2. Break down your idea into multiple questions and for each qn
a. Talk to atleast 25 people.
b. Get feedback
c. Validate the hypothesis

3. Next download the business model canvas and fill in the whole canvas
a. Next change the customer segment and see how it impacts the cost/revenue stream
b. Keep doing this for all customer segments. You can make some approximations in terms of how much you might want to charge.
c. Repeat the above expt with Distribution channels. For example, if you are making an app that is downloadable via app store or google playstore, then you have give away 35% of what you make..web version you dont give any..so figure out how the distribution channel affects your revenue
d. Figure out who you want to partner with and what the partnership costs are

4. Next depending on whats your customer demographics , figure out the below by running mkting/ad campaigns
a. User acquisition costs (CAC)
b. Figure out the life time value (LTV)
c. Make sure LTV > 3 x CAC at the min
d. Figure out what the funneling looks like and how long does it take to convert a single user to paying customer
e. Figure out how you plan to retain customer and how much does it cost over the life time value of the customer..

5. Build up MVP and iterate it by constantly getting feedback from your prospects…try to sell them and see if they would be interested…if they are not interested, dig deeper why they dont want to ..is it not addressing the pain point directly, they dont see much value for the price you are offering , usability of product sucks or steep learning curve, trust etc….

6. Get some informal medical advisory team who is expert and understands the value proposition of your offering. Get 2-3 mentors as well who can guide on business side …

7. Once all the above are done, then form your core team, get a cofounder or principal, CTO and get the beta out….

Feel free to ping me if you have any qns. Good Luck…

My experience @ Founders Institute

Finally the day arrived . My company Sensory Health Systems graduated from the one of the worlds largest and finest startup accelerators “Founders Institute” . It was one of the most intensive program I have ever gone through and the key take away is ” Ideas are worthless unless thought , validated, derisked and executed well “. I went with a passion of doing chronic disease management app and I have pivoted at least a dozen times before I settled with my current idea of early detection platform for cardio-respiratory care . Without the expert mentors feedback and the weekly assignments aka company building activities , I would have easily wasted 2yrs of time and money. Every entrepreneur knows time is the essence of money and I’m grateful that I quickly learned from just 4 months.

The workshops , weekly company building assignments, group discussions and hot seats where everyone has to pitch in front of mentors/whole class really makes this a interesting program. There is lot of hard work and sweat involved. I was really stressed for time between full time job which involved working in 2 diff time zones , 2 kids under 3yrs and my spouse working for another startup. But what kept me going was the FI ecosystem of expert mentors and each of the mentor despite their busy schedule always responds and provides meaningful feedback . I never had the occasion where mentor would just say this doesnt work or this sucks. They always told me how best to go to my next stage.

Overall it was an awesome experience and I hope they will succeed in their mission . Like the way they are helping to achieve my mission, I would love to help them in achieving their mission as well. Good Luck FI.

If anyone has any second thoughts or has any question, please contact me via the comment section below.

Want to transform healthcare..Engage the patient first

The biggest change or revolution in healthcare will only happen when the patient is engaged. Most of the solutions I see in this area are very passive ..Its basically follows the old saying where you can take a horse to a lake , but cannot make it drink the water..You can only push so much. Yes, all the healthcare education, efforts in increasing awareness are all positive steps.

Unless , I misunderstood, one good part of the healthcare reform which Obama introduced was to give money to the patients to shop for the insurance that satisfied their needs. So, in the US healthcare system, where there are 4 parties involved, Individuals-Hospitals-Insurance-Employers with Insurance policy choices limited/controlled by the employer, now the employer can give the same money to the employee to shop around and select the best insurance plan. This complete changes the patient engagement . They are more proactive , will pay close attention to the costs and more likely they will invest their time in understanding preventive care.