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Launch HN: Medumo (YC W18) prepares patients for surgeries

61 points by adeelyang ↗ HN
Hi HN! We are building enterprise software that prepares patients for surgeries (http://www.medumo.com). Millions of patients go through these things every year. The problem is that patient instructions are provided months in advance, in the form of paper handouts or verbal instructions that are easily forgotten. As physicians, we saw firsthand how poor patient experience can impact hospital operations and surgical outcome. For example, when patients forget to stop medications that can cause bleeding, the surgeries have to be cancelled last minute which is costly. Or worse, poorly prepared patients get the surgery and have avoidable complications.

Our team came together to solve this problem with patient navigation software that gives turn-by-turn instructions, reminders, and educational material through friendly, accessible medium (SMS/email) to deliver the best experience and surgical outcome.

Unfortunately, health systems are notorious for moving slowly, so introducing a new digital platform can be challenging and slow. We are overcoming this by starting with simple use cases like colonoscopy, proving our value quickly and expanding to other areas. Another challenge is that patients respond differently to instructions; so instead of taking a one-size-fits-all approach, we are constantly varying instructions and A/B testing patient behavior to improve outcomes.

12 hospitals use our software to date. We have demonstrated improvement in show rate and procedure preparation quality. Here’s an example: https://bwhbulletin.org/2018/02/01/endoscopy-center-sees-suc...

We know HN has a lot of people who have experience building or selling software to hospitals and faced tough obstacles with the scars to prove it. We'd love to hear your thoughts around hospital enterprise sales, pilot design, patient engagement, and anything else that you've seen come up on your journey!

18 comments

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shantanubala
I'm not a doctor, but I know Adeel (the doctor who wrote this post), and can't say enough positive things.

More often than not, doctors use printed pages to give instructions, and those pages subsequently get thrown in my trash can. As an occasional patient, I want my doctors on Medumo.

madamelic
Wow, this is actually something useful.

This isn't another "Uber for X" or "AirBnB for Y". I can't wait for you all to get huge and for this to succeed just for the fact this idea is so simple + pure but has such huge promise.

walshemj
Interesting I have had 3 surgeries (two abdomen and one transplant) in the last year in the UK and they used paper based systems and verbal instructions for the two planed ones.

The NHS still runs on paper :-) still cant do my regular bloods at my local ahead of my regular check up at another specialist hospital.

adeelyang
We'd love to explore the UK but have no clue what's the best way in. Any suggestion?
walshemj
Not sure I can ask at my next nephrology appointment I would suspect approaching individual NHS trusts.
z3ugma
The #1 takeaway I have from my time watching small companies try to integrate into big EMRs in surgery areas is to find a physician champion. Convince one physician who will make it happen. Periop and procedural areas are run like an assembly line and are more rigidly opposed to change in their workflows and processes than a lot of the rest of the hospital. As a small company, your biggest obstacle will be to convince the hospital IT shop that you're worth the trouble and security risk. The best way to do that is to convince the customer of the hospital IT department - i.e. the physician champion.

A company I think has a great strategy for this is Redox, have a look at their strategy kit: https://www.redoxengine.com/blog/integration-strategy-kit They've got a great blog too: https://www.redoxengine.com/blog

I'd be thrilled to have a chat with you about your implementation strategy.

adeelyang
Thanks for the very "heart felt" advice. The hospitals that we have traction all have great champions. Coincidentally we are working with Redox on a few deployment already. I'd love to chat with you more. What's the best way to connect?
z3ugma
Can you PM me on Reddit, /u/z3ugma?
dr_
Although having a great champion is important, I’m not so sure if that person necessarily has to be a physician at the hospital. Dave Chase touches on this briefly here (I don’t necessarily agree with the title of the article): http://hitconsultant.net/2017/03/30/new-walking-dead-digital...

Just as you are working with colonoscopy centers, working with large medical groups that do a lot of their procedures through surgical centers (pain management, basic ortho stuff), would be a good way to start before working into hospital systems.

jknz
I am wondering if insurance companies would be interested to pay for this as well.

For surgeries that need pre-authorization from the insurance, the insurance has enough information about the upcoming surgery to use your services and prevent avoidable complications. (Insurance companies don't like to pay for avoidable complications!)

abrichr
Hi Adeel, congratulations on launching! I'm curious, how is Medumo different from SeamlessMD?
dwelch
As a medical student with an interest in software, this is great to see. A great solution to a costly problem that is likely underestimated by most. As I spend more time "on the ground" in the healthcare system, I see more of these practical problems that have very real consequences, with outdated pseudo-solutions. I'm excited by the prospect of emerging solutions like this.
orb_yt
I'm interested in hearing your thoughts on the current state of healthcare software.
DoreenMichele
HIPAA Compliant

Rigorous 3rd party security and compliance validation.

I worked for a large insurance company for over 5 years. You say you currently have 12 hospitals as clients. My experience in insurance suggests that if you expand your business to include smaller facilities, you will find that small offices can vary a lot in their understanding of things like HIPAA. This can de facto result in more burden on you to make sure compliance actually happens.

​Somewhat random thought: I bet you could expand this service to provide support for people who are elderly and/or chronically ill.

There is a huge market for tech to help seniors maintain their independence by making sure they are safe etc while living alone in spite of declining abilities. People who are chronically ill sometimes express the wish that an app or service might help them stay on track with taking meds etc. Chronic conditions that are well controlled can mean a mostly normal life. But things can spin badly out of control quite rapidly because of a single missed dose of medication.

gingerlime
Congrats on the launch. We're[0] in the medical education space and it's always good to see more being done in this space. We're not targeting patients, but rather students.

We'd love to collaborate and support you guys with anatomical illustrations or other content that can help patients understand their procedures or medical conditions (We cover Anatomy, Histology and Medical Imaging. Although we don't yet cover much in terms of pathologies, but healthy anatomy). We know how hard it can be to license accurate and high quality content in this field. Feel free to reach out to us (you can email me directly, details in my profile, or via our website).

[0] www.kenhub.com