[smalter]

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'll short circuit a lot of pain that way.

[thetylerhayes]

Motion seconded.

It sounds like you're seeing a lot of problems in healthcare. That's good you're noticing them. It sounds like you also want to solve some of them, mostly because you're fed up with them being problems. That's also good. The best kinds of solutions often come from scratching your own itch.

Another similar recommendation: get more specific about what you want to solve. "Disrupting healthcare" is a platitude anyone can agree with because the news runs a segment every day about inefficiency in the health system. If you see 10 problems, does 1 stand out way above the rest? Work on that problem.

Just building a quick & dirty solution and shopping it around like smalter suggests is the best thing you can do to prevent working on a problem you'll burn out of in 6 months. You'll very quickly realize whether you really want to do that thing or not.

[akrasia]

I'm taking your advice and I'll hack together a prototype and see if the administration will bite.

[jtheory]

I'd suggest instead talking to the people who actually make buying decisions, and find out what other purchases they have approved recently (and how many other people needed to give approval -- e.g., the IT department), and why. Unfortunately I suspect the news will be discouraging.

Don't just try selling something that interacts with medical data unless you have serious quality control (you may need various ISO certifications in place) and a good grasp of privacy law. That's what many of the frustrating hospital purchasing rules are trying to ensure.

The reason that the healthcare world has so many problems with obvious software fixes that haven't been fixed is because they're very rightly paranoid about using unsafe software, because sometimes it kills people even when it's designed by a corporation with lots of quality control (cough cough THERAC-25), and not just a side-business with a doctor and a hired coder.

[akrasia]

I will be talking to the purchasing dept after I build a prototype to show the director. I am aware that this will be an uphill battle since everyone in healthcare is paranoid including doctors and admins.

[wojt_eu]

> First, be certain that you can make $500/mo by building it yourself and get the hospital paying $500/mo.

I'm currently chewing on ideas from "Lean Startup". It suggest to try and validate your idea before even building a product, for example with a interactive prototype. If the OP has a good contact with his hospital, he can show the prototype and ask: "If I build this, will you buy it? Will you pay upfront for a discount?"

[babuskov]

I highly recommend reading Steve Blank's "4 steps to epiphany".

[akrasia]

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 parse out the text using the pdf-reader gem and now I just need to use some regex to match what I want and then stick those values into a report.

Thanks again for the advice.

[perplexes]

> 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!

[md2be]

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.

[mdmarra]

Since when has the technology community at large considered automating menial data entry to be "cheating?"

[md2be]

Hospitals spend hundreds of thousands of dollars training residents (med students learn practically (as in practical knowledge) nothing in med school). Therein lies the cheating.

[wbercx]

Isn't technology meant to make our lives easier? If this can increase the productivity of doctors, I reckon it's a good thing. That way they can spend those full 70 hours a week perfecting their skills, instead of wasting 20 hours to enter and retrieve data every week.

[DanBC]

Why don't doctors have clerical staff to do the data entry?

[akrasia]

depends on where you work and how much staff is hired for this type of work, but with the way the EMR is set up, and who legally has to start and sign notes (a doctor), you cannot avoid some data entry unless it is somehow automated for you

[thetylerhayes]

They do. Both do. No one is immune to data entry in the medical world.

[akrasia]

exactly what I'm trying to do

[PeterisP]

If you gain 10 minutes/week for every surgeon in USA, then you've done more healing than you could by simply being a great surgeon for your whole life.

[bigchewy]

Have lower level people, such as a Medical Assistant or a 1st year resident do the data entry.

ahhh, feels good to do more healing than a great surgeon, before I've even had my Sunday coffee.

[akrasia]

Unfortunately, the note that has to be entered in the EMR has to be started and signed by a fellow (a person who has finished residency but still in training before becoming an attending doctor for those who don't know), and this is the note with the data, and so I (a first year resident) would have to be sitting next to the fellow, he would have to start the note, then I would have to switch seats with him, do some data entry, then he would have to write his impression ("normal", "COPD", "asthma", but in more doctor like terms) and sign the note. The way the system is set up makes this impractical.

[md2be]

This guy has one shot at learning medicine, his residency. If he wants run a trivial startup, so be it. But his first responsibility, at this time, in his training, (no he is not really a doctor yet) including his residence and fellowship.

[PeterisP]

His first responsibility is to whatever he wants to make with his life, not neccessarily his training. If he wants to run a medical startup that you call trivial, it's just as good (if not better) way to go as focusing on his residence and fellowship.

The default career directions for anyone, including medical residents, are just that - simply defaults, not some oath or moral obligation to follow that exact career choice 'till death do us part'.

[fnordfnordfnord]

Working Smart > Working Hard

If a Dr. sacrifices their productivity for a short time, with the result that he increases the productivity for all Dr's; then the Dr. has done the opposite of cheating.

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

OP could follow your advice and be an average Dr. Or OP might actually succeed in improving wasteful processes in hundreds of hospitals.

[akrasia]

> 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.

[zodiac]

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?

[md2be]

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).

[lostlogin]

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