Ask HN: What problem in your industry is a potential startup?

241 points by choogi ↗ HN
This has been done two other times before:

https://news.ycombinator.com/item?id=13139638 (2016), https://news.ycombinator.com/item?id=9799007 (2015)

Both threads generated a lot of really interesting discussion, and I was curious what the discussion would sound like if this were asked again in 2018.

252 comments

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From a technical side of things: - data management - faster analytics software - test and learn optimisation - faster model deployment

From a business side of things: - loyalty program/rewards - pricing optimization - financial services to underserved customers including entrepreneurs, families, millennials, freelancers, etc.

im creating something for loyalty rewards but most small businesses seem apathetic, too busy for anything new
Yes, that's typically the case for small businesses. You'll find much better luck mid-market.
Open hardware and software for PLCs for manufacturing.
Along with this, we need a better way to program robots. I program Fanuc i200D and that whole industry makes my blood boil. Want more than 200 variables in your program? Shell out $10k.

High level programming language to program robots with safety in mind would be amazing. RoboDK is the only one that is doing this and they still suck.

Does the Fanuc need to be constantly reprogrammed? Or is it a rare occurrence?
If you have arrays why don't you implement a turing machine and compiler to turing machine so that you can have more variables without shelling out? Or some other model of computation.
The PLC/robotics/industrial automation space is often ten to twenty years behind in software best practices, with things like source control being completely alien to many vendors. Documentation can also be hard to come by, buried behind layers of paywalls and service agreements.

Of course, installations are usually expected to function for ten to twenty years at a minimum...an order of magnitude greater than anything your typical js-framework-of-the-day considers.

No one is saying to use the latest javascript framework for programming robots.
Even just allowing us to patch the servers would do wonders... a lot of this crap is running on 20 year old operating systems.
Integrating with 20 year old PLC's and robots is such a pain. Most people we work with have stacks upon stacks of abstraction to keep them safe and give them a sane wrapper for the functionality of the robots. So many labs have homebrew monstorous python scripts made by a grad student that left 2 years ago that everyone uses and no one can maintain.
I have worked in process and equipment R&D for ten plus years, off and on:

What I want is a PLC: 1) A PLC which has a hard real-time process and soft real-time processes. Beckhoff and B&R do this, other PLC's do this as well. 2) I want to do the hard real-time programming in Rust or Ada, or "Safe/restricted C"... Rust and Ada are so much more expressive than structured text. 3) I would also like to have a simple API to allow deterministic, hard real-time communication between the real-time control domain and a soft real-time domain so that higher level languages can be used for control problems. And I would like the PLC to support one of the high level languages: CLISP or Racket, F#, Julia, Python, Elixir... don't care what it is. This is actually doable on Beckhoff but the tight connection between hard and soft real-time was not really there.. and beckhoff runs windows. Would prefer Linux, VXworks, or QNX.

I'll take a startup in a box. I want Kubernetes, Elastic, Kibana, FileBeat, Prometheus, Consul, Grafana, databases, HTTP gateways, etc all set up on on the cloud (or set of servers) of my choice and a dashboard that lets me add users (e.g. like a modern Webmin/cPanel+WHM) and make minor config changes if I don't want to run these myself. I want those things HA and I want stable hostnames for them (e.g. Consul DNS on every box). Then I want an empty app template where I can provide a few things: commands to build my app (including dependencies), a systemd conf for start/stop of my app, a config value to tell you where the logs will be, a config value to tell you how to consume metrics from me (e.g. a local HTTP path for prometheus), etc. I feel like we're close with Helm and Kubernetes but I'll be damned if coordinating and setting all of this stuff up HA, getting notified of failures, getting notified when I need to add more servers, being cloud-independent, etc isn't an extreme burden to entry.

I want to write code and deploy, not spend most of my time on ops or marry myself to a cloud vendor. I started my company as the only tech person and I feel like I have to be more admin than dev even though I'm doing the same thing as everyone else.

Aren't you talking about Heroku?
No. Some of my quotes: "set up on on the cloud (or set of servers) of my choice", "being cloud-independent", "not [...] marry myself to a cloud vendor", etc.
If you bought all of this pre-made from a vendor, you'd be tied to that vendor, subject to their pricing whims, support SLA, etc. Maybe they'd be multi-cloud, maybe not.
I don't want to buy it pre-made. I want to buy the coordination/orchestration software. And I don't want to spend forever in yaml/chef/ansible whatever to setup these things every company does. I want to download it and I want to run it. I'll give it a list of servers and some SSH keys. It can tell me if it needs more capacity. The dashboard can even be local.
That sounds like an open source collection of things, rather than a startup idea.

i like it though, could really help in some situations.

You know why you can fill your car's tank on any petrol station? Because all the different players -- pump vendors, car makers, oil companies etc -- are using the same standards for the size of nozzle, fuel composition etc. They have concluded that standardisation is in their interest, as opposed to locking the customers in.

In software there are no such standards, or rather there are too many standards, and new ones are being released every day. Currently there is no clear incentive for vendors to standardise, and it's quite possible there will never be, it's early to tell.

What you're describing currently requires enormous resources, and no single company can pull that off -- even Google is struggling with keeping both back-end stability and front-end simplicity (I'm currently working on a new GCP tool which just got into beta, so I can see it firsthand). Standardisation allows many different vendors to focus only on a part of the whole supply chain, while with the cloud you have single vendors trying to cover everything under one roof.

It would be great if we could combine Digital Ocean's droplets with Google's BigQuery with Amazon's RDS, all through a simple front-end UI -- but the nozzle size is not standardised, and I wonder if it will ever be...

Oh, also: https://www.openshift.com/products/pricing/ is kind of like what you're talking about. It may not have everything, but it's managed k8s on your cloud with support.
Closer. Things like being able to see the logs of all your apps and searching them is a common thing I assume. We have all the tools today, that's not the problem. The problem is me having to read pages like [0] just to do what almost 100% of companies have to do. I am having trouble articulating the simplicity of what I would expect.

0 - https://docs.openshift.com/enterprise/3.1/install_config/agg...

Or maybe start small to test your startup idea and then you don't need a military grade server setup ready for WW3. :)
Depends on if, by "start small", you mean small effort or small money. Having those things I mentioned shouldn't be expensive, but are huge effort. I want to start small, but if I can't do something as simple as delegate SSH access or search my logs, I can't even test my idea. What I'm talking about is meant to increase the ability to start small for those of us w/out dedicated ops teams.
My point is that you don't need an ops team or lots of ops to being with. A single server can do miracles for a good period of time.
Just use a PaaS like Heroku? Keep the tech simple and vendor locking is minimal.
Could you not go with serverless and eliminate all of that complexity?
Not easily across cloud. If as part of this package, it included a "cloud functions"/"lambda" component, cool. There are a few vendor-independent ones out there. But I need to search logs, store data in a database, etc. I don't want to go to the Google console to see my logs. Also I think traditional apps have many benefits wrt cross-request state management that are not as easy to do generically when serverless.
I don't think for a startup you need K8s and most of the things you have outlined! Maybe for a late-stage startup, but then you are already doing something so a generic slap-it-there solution might not be the best idea.

You are describing a large-scale setup boilerplate, far away from what I'd call a startup in a box. Slap in a simple server like my own project [1] or no server at all until product-market fit, and then but only then start scaling.

[1] https://serverjs.io/

But if the cost of having those things is low enough, maybe it's worth it to have them sooner rather than later.

I've experienced many of those tools in the context of a 200-person company; I can definitely see how managed versions of them could deliver value to a much smaller org.

Of course you don't "need" them. However, I don't believe I'm describing a large scale boilerplate. You can get this with a few servers and a couple hundred a month these days. Heck, you can do it on a laptop w/ minikube probably (though obviously not ok to do in prod, just goes to show the costs are not the problem here). Sure it's easy to run an app. But it's not easy to admin it as you grow (even though you are not yet "big" and still may be only one or two people).
Who will troubleshoot when shit hits the fan?

It seems to me that you are introducing technical debt from day one because it’s cool.

What technical debt?
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The kind of technical debt otherwise known as premature optimisation. If you don't even know yet that your app has to scale - and in which way - preparing for that contingency is a waste of resources.
I wouldn't qualify that as a premature optimisation. Kubernetes is de facto standard of running applications now and you get all the benefits for almost free. Premature optimisation in this case would be over provisioning - throwing more servers than you need.
K8s is "de facto standard" already? When did that happen? No doubt that K8s has a great future and I personally like it a lot as well. But to call it a standard requirement itself is premature.
I mean, everyone has different requirements or preferences, so you don't get it all set up for you generally. But there is at least one such solution which more or less fits your description: DCOS.
> I mean, everyone has different requirements or preferences

I've found this is only kinda true. Most people need the same supporting infrastructure and most people only need to deploy their HTTP-visible app, maybe a cron or backend daemon, and probably a data store. Everything else from logs to metrics to alerting to HA gateways and so on are quite universal.

Sounds a lot like Terraform https://www.terraform.io/
I am somewhat familiar w/ this product and I'm afraid I'm not articulating how simple I expect. Where do I click to search my logs?
besides the " marry myself to a cloud vendor" part it sounds like you want a platform as a service. AWS and Google both provide more or less what you've asked for. Just takes minimal glue to turn the features on.
Yup, I basically want self-hosted PaaS in a box, but also w/ opinionated interoperability (e.g. use Prometheus alert manager to tell if my DB disk is reaching 90%, use consul DNS to have stable names for my log server, use Grafana to show me memory usage across every container/app, etc). It's always the "minimal glue" that takes forever and often once "glued" it becomes stale because it's not maintained unless it's someone's job or something breaks.
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I've also been searching for this for years, and the closest thing I've found is Convox [1]. Unfortunately they only support AWS for now, but it's a really good PaaS on your own servers. It's open source, too [2]. You can run a convox rack without using their hosted console.

One problem is that it requires a minimum of 3 instances, so it can be more expensive than Heroku to start.

[1] https://convox.com

[2] https://github.com/convox/rack

Take a look at Cloud Foundry, especially the Container Runtime.

The Application Runtime (CFAR) is like an OSS Heroku, installable on AWS, GCP, Azure, vSphere, and OpenStack. Then just push your app and scale it out. It was first built as an enterprise Heroku competitor, and the commercial flavors power a bunch of big companies’ infrastructures. It even uses the same “buildpack” model that Heroku uses to provide language and framework dependencies.

The Container Runtime (CFCR) packages k8s in a way to make it easier to deploy, maintain, and scale, and it also deploys and manages the health of the underlying VMs. It originated in collaboration with Google.

Source: I’m a Cloud Foundry Foundation project lead.

Are you starting new companies that frequently?
Could be good for a VC that doesn't want its' investments wasting money reinventing the wheel.
Even if someone assembles a product like you ask, how will they monetize it?

I'm assuming you want the product to be built with open source components, so then the startup would be selling a glue script to package these open components together.

The only feasible way to make money with this would be to sell a proprietary glue script. Not sure how acceptable that would be to you or to potential customer base of this startup.

How about giving it away and then offering consulting?
There is an inherent conflict with that kind of business model. If your product were simple enough, that would reduce your opportunities for consulting.

So to rope in consulting offers, you'd be inclined to add complexity and config options to generate more avenues for consulting.

Depends on your mission.

In my experience, the companies that succeed are those who are sincere in wanting to help their customers.

I'd second this -- and very occasionally I think of spinning off my current code into this.

If find PaaS can be a little too opinionated. You get boxed-in too quickly. Whereas IaaS is too raw. I had a bit of a head scratch when I recently moved to Google Cloud and was a bit flummoxed on where to put my (backend) session state. Similar experience trying to get Blue-Green deployments on GKE (Kubernetes).

I feel GCP/AWS and friends will get there. But for now there are definitely some gaps.

Hey! This is what we are building at Asyncy.com - we are inviting users into our private Alpha release in about a month. I highly recommend you inquire and check it out. 100% OSS, full stack app out of the box using microservices.
Someone recently mentioned to me that platform.sh does some of what you're looking for
Biggest problem in this is, one size does not fit all.

It is hard to compile a stack - which would be useful for most companies.

Yes, there have been attempts made - for Example, Open Stack. But then I feel, there is always an element of specific technology based on the needs of the product being built.

Take a look at https://robinsystems.com

​Robin enables an App-store like user experience to simplify deployment and lifecycle management of Big Data, NoSQL and Database deployments, On-Premise and in-Cloud. It supports application-level snapshots, clones, time-travel, QoS, scaling, backup/restore, etc. It takes care of HA, stable hostnames, Application templates, events, notifications.

Check out the demo clips for [video]

Cloudera https://vimeo.com/213037162/a66e0b4e77 HortonWorks https://vimeo.com/227832200/8d9c749984 MongoDB https://vimeo.com/206348836/a36e535add ELK Stack https://vimeo.com/225899966/6000bae6f2 Controlling IOPs in shared environment https://vimeo.com/171608156 1-Click deploy, snapshot, the clone of entire Oracle https://vimeo.com/195549219 Even RAC cluster https://vimeo.com/223730427/e8cb8c92f8 and SAP HANA many more applications

Disclosure: I am the lead developer at Robinsystems

We run background checks, and there is definitely a space for public record aggregation.

We directly interface with those interested in the results of the check, and there is an overwhelming amount of work in building integrations with schools, applicant tracking systems, hospitals, public records, courts...

We spend most of our time building XML and JSON parsers to cram their data into our models.

If there was a company that provided a single interface to this data, you could write your own ticket. I know we aren't the only company in this space with this issue.

shoot me an email with some more info, may be able to help you out
Interesting problem to solve - guess the pain will be when all the data sources change their endpoints and everything sort of breaks. At least that's been my experience with aggregating public economic data feeds.
How broad would a vendor's coverage need to be on day 1 to be valuable for you?
I think Socrata (now acquired by Tyler Technologies) was maybe tackling some of these challenges?
May I ask, how does that work with Privacy concerns? I am aware banks run background checks before you open an account. But I always assumed that the "checker provider" has a licence.
Inter-operable video and phone conferencing without prior setup required. Probably half the video conferences I’ve tried to participate in in the last year have been a disaater, with people having technical problems dialing in, dropping out, etc. Even phone confernces (using VOIP conference providers) have awful quality. I want to be able to email some people a link, and with no account creation, registration, or software install required, get an extrwmely high quality low latency (comparable to FaceTime) voice/video conference.
We pay for a high-end solution at work and still experience the same issues.
Have you tried appear.in ?
I’ve used it several times and while the UI was nice the audio quality was poor every time. It doesn’t seem to handle audio feedback loops as well as other videoconferencing tools.
Even phone confernces (using VOIP conference providers) have awful quality.

VoIP, especially multi-tenant voip like conferencing is 70% dependent on YOUR local network connection and 30% the provider's infrastructure. Having a high bandwidth pipe is no guarantee for 100% clear and jitterless voip communication. Have you had a network engineer take a deep inspection of voip traffic to see if there's any QoS or packet filtering going on that could degrade performance (i.e. if you're a small office that has your voice traffic occurring side by side with literally every other network device you're GOING to have a bad time).

maybe uberconference.com?
Amazon has the entire company dogfooding Chime[0]. Pretty happy with it. Really good for video/phone conferences. Half-decent imitation of slack for chatting.

You can join a concall via phone number + pin, from your desktop, or from the mobile app. The mobile app will even let you view screenshares or video conf.

[0]https://aws.amazon.com/chime/

I personally didn't mind it, but I saw a lot of dislike of Chime internally compared to something like Slack. Anecdotal of course. Worked great for large chat groups though.
I also want a screen for the audio/video conference to show where the sound is coming from, so we can mute that one guy who doesn't turn his mike off and is heavy breathing on the call.
Full disclosure. I work for Synergy Sky. For a single person our products are way too cumbersome, but if your issue is also on the level of an organisation/company, then your problem is what we solve.
I have been using jitsi for the past year or so and the experience is pretty much what you describe.

https://meet.jit.si

I used to use this in my company and while joining and creating meetings is pretty painless the audio/video quality was pretty crap. Perhaps they have improved in the three years since I've used it.
It's pretty good now.
The place I work uses BlueJeans and I really like it.

The dedicated app runs on just about everything'; iOS, OSX, Windows, Android.

On phones you can use Video and Audio or just plain Audio (Low Bandwidth mode).

You can send your BlueJeans room URL and they can join with just a web browser (Web browsers get less features though). Non-Hosts can join the meeting without signing up for anything. They just click and join.

I think the audio and video is pretty good. Much better than Facetime, which is not a good comparison because Facetime is pretty terrible. Audio quality is good.

There is dedicated hardware that supports BlueJeans so you can use it in conferences rooms.

You can record meetings.

All the standard stuff like screen share and what not. You can even ping pong back and forth. I worked with someone where they had to type in some stuff and I had to type in other stuff on their computer. They just joined my BlueJeans room and when I was not typing, they could type. No clicking to take control or give it back, it was more or less seamless.

Try using Ethernet instead of wireless, and make sure you have a decent router.
Patch distribution for games. Every desktop game does its own thing, with its own CDN, incompatible with other engines.
I don't really see a market for that. Most desktop games these days are handled by store fronts like Steam, GOG, itch.io, Origin or the Blizzard Launcher that already handle updates for you. But it's certainly an interesting topic and itch wrote about it a while ago: https://amos.me/blog/2017/efficient-game-updates/
A tool for managing software development that doesn’t suck. Especially if your developers are doing a lot of small projects, that while too small to have their own sprint or their own kanbanboard are too big to fit into a single card on Trello.

Possibly something that mixes business and process models into it, but again, something simple where you attach a single bpmn drawing and maybe an architectural sketch to the process. Add time management, deadlines and maybe a tie in to the web services of an ESDH system and it might even work for task management in case working.

Everything is build for theoretical approaches. Like we do SCRUM, but really, we’re doing scrumish things. We have an odd schedule, we work on multiple projects at once, depending on what resources are available and what has higher priority, sometimes something breaks and then we’re all doing operations rather than development, sometimes the mayor has a direct request and so on. I think we’ve tried all the tools from atlassian to trello and nothing fits, it’s all too textbook for a messy place like ours and often I think we should go back to postits and a fucking excel schedule but I really don’t want to ever print an excel sheet ever again.

Interestingly I do a lot of networking with other managers in the public set for, and everyone had this problem, not just in digitization. There isn’t a single efficient tool for managing your workforce in the public sector.

There are excellent tools, don’t get me wrong, but we can’t have our workers spend hours on them because we can’t sell those hours to anyone.

There’s a fundamental divide that most of these tools struggle with which causes the sucky behavior: you plan work at the team level but you manage scope at the project level. If you don’t have a clear correspondence between teams and projects (a team owns a project and does all the work), it will be hard to manage in all of these tools, because you’re always missing out on half the story. The process packaging like scrum or kanban merely obfuscates the fact that the team/project mismatch creates the confusion.
What you're saying here really resonates, and it's something that we, at Atlassian, have heard from many of our users. The Jira team has been hard at work on a brand new project type that aims to give teams running "scrumish" the perfect opportunity to build a board and workflow that will truly fit any style of work (even work with an odd schedule, multiple projects at once, and that requires a mixture between operations and dev!).

We've gotten a lot of feedback that often times the strict structures of scrum and kanban are overly burdensome, yet teams still want and need some basic guardrails (as well as the ability to modify their processes on the fly). Our Product team is still testing and iterating on this new project type quite a bit, and if you're up for it, we'd love to give you an early demo and get your honest thoughts and feedback.

If you're interested, please shoot me an email and we'll find some time for a demo: jake@atlassian.com

Jake

Jira PMM @ Atlassian

Been searching for something like this for awhile now. We have a small team that gets distributed across a handful of projects, but trying to find a good way to manage that has been a chore.

Originally we used JIRA, but it was complete overkill. We've settled on making adhoc GitHub Project kanbans and very creative use of the labels, and so far it's been ok, but not perfect.

The other thing we have to do is time tracking for specific tasks depending on the project/client, which has us going over to ConnectWise (the primary part of our company is an MSP), which is just terrible.

The final problem is tying all of the documentation together. The MSP side of the company uses ITGlue, but it's not enough for everything we do as developers. Confluence was actually nice for that, but since we've left Atlassian we're just tracking stuff using a doc folder attached to the project source itself.

I would look at clubhouse.io, or maybe cushionapp.com?

I've never used cushion, but I like clubhouse a lot.

I work in health tech. Here are some problems: * Helping patients select the right doctor. Currently most people use Yelp or through referrals. The problem is that Yelp has little correlation to quality of care. It's very difficult for patients to evaluate a doctor - usually what they end up doing is evaluating the customer service aspect of the doctor (did they speak to me nicely, did they make me wait for an appointment, etc.) but no one is able to evaluate doctors based on the quality of care. * Helping doctors and patients estimate costs - Neither doctors or patients understand costs. it is very routine for a doctor to suggest getting a lab test from X place because they have experience working with the center. They have no idea that for your specific insurance plan this will cost you 2x another place and so you with an unhappy patient who blames their doctor for ripping them off. There should be tools to patients and doctors estimate costs. * Helping patient select a health care plan from their employer or a marketplace - most patients have no idea what health care plan they are best on. However, theoretically if you have their history of claims and some guess on their future behavior, you should be able to tell them which health care plan makes the most sense for them * Helping patients manage their chronic conditions. Most people are very lax about managing their health conditions, they skip appointments, choose brand names over generics, ignore refills, etc. Technology should be able to nudge them in the right direction and help them optimize on quality and costs. * Building technology that encourages health behavior - A majority of the diseases attacking Americans are caused by lifestyle issues (diet, stress, drugs, exercise). If you could build technology solutions that help nudge people to healthier behavior, you would make solve a billion dollar problem for insurance companies; they would love to reduce the risk pool of their patients. This is a tough battle because even people who care about health are inundated with false information (think Dr. Oz or anti-vaxxers or people who insist every person in the world is a celiac and should go gluten free).

As you can see the bulk of the problems in the health care industry is understanding how to navigate the huge mess of the US healthcare system. A longer term solution is for us to build a single payer system and incentivize patient care over patient procedures but I doubt that will happen.

What's your opinion on current healthcare startups like zocdoc or Oscar insurance? I've seen a lot of new doctor review sites popping up but like you mentioned that's only 1 problem out of many/bigger issues
Doctor reviews are not correlated to patient outcomes. There are tons of excellent doctors with terrible bedside manner that have bad reviews and incompetent doctors with excellent bedside manner who get great reviews. Quality metrics should be based on data like patient outcomes (but even that is hard because surgeons currently will reject "hard" patients to juice their numbers). As a non doctor, you honestly are not qualified to assess the abilities of your doctor.

I do think Zocdoc is a great idea because anything that makes scheduling an appointment easies is a win. I'm just saying that patient reviews give people a false sense of security that their doctor is good. In reality, almost no one knows if someone is good or not unless you have directly worked with that doctor and have a lot of stats on their outcomes (which only anyways works on specialities that have a lot of procedures). Assessing doctor quality is a very hard problem.

Patient reviews are good for assessing if your personalities will mesh but beyond that they don't go far.

I am not really too familiar with Oscar; what are they doing?

Hi would you like to setup a call to talk more about these issues?
Sorry I don't have time for a call but happy to give my perspective on HN if you have any questions.
Fair warning: Healthcare has a long sales cycle, is heavily regulated and is difficult to break into as an outsider. Generally you'll want someone on the founding team with a significant healthcare background and connections (even better if they're a MD). Once you have found a way to sell you'll find that the competition is fairly minimal compared to other industries.
Totally agree. All the problems I listed are quite hard and will monetize slowly. Sales are really long; the company I am a part of had an all star founding team with a history of exits so they gots lot of funding which helped give them a cash cushion to deal with the long sales cycles.
> Helping patients select the right doctor. Currently most people use Yelp or through referrals. The problem is that Yelp has little correlation to quality of care. It's very difficult for patients to evaluate a doctor - usually what they end up doing is evaluating the customer service aspect of the doctor (did they speak to me nicely, did they make me wait for an appointment, etc.) but no one is able to evaluate doctors based on the quality of care.

We actually explored this for a startup idea. The problem is that it is difficult to find a group of people who can do the evaluations in a truthful and holistic way:

* Hospitals will never want to give out outcome data because outcome data will be used against them for ratings by people who don't understand it (for example, some community hospital in Montana may be rated higher than Mass General because of case complexity issues). Or worse, it will be used by people who DO understand it :D

* We explored having doctors rate other doctors in a variety of ways (which I think would reflect the "truest" measure of quality). Residents and fellows could rate attendings, but they might not know how attendings in their hospital compare to attendings in most other hospitals. Additionally, attendings or hospitals might apply pressure to these groups to provide good ratings. Specialists could rate other specialists in their field, but then you might see collusion, false negative reviews, or retaliation. How you would avoid these problems is not immediately clear to me.

* As you point out, patients are really only able to evaluate bedside manner and not quality of care.

One way we thought about it is having a rating system which would have public profiles for physicians and anonynmous reviews from other physicians and members of the care team. Ratings coming from other physicians in the specialty and providers at their institutions would be weighted more than ratings from other physicians. The highest rated physicians would also have more weight within their specialty than an average rated physician. You could bootstrap the system by asking specialists to provide the names of the top X people in their field. These people would automatically be rated highly.

Patients could log in and provide comments about patient experience; hospitals could log in and provide outcome data if they wanted.

I am not entirely sure how you would really monetize it. It's the equivalent of the dating app problem; the better you are at matching, the less money you make as users exit the platform. I do agree that it would be great if osmeone could solve this problem though.

> Helping doctors and patients estimate costs - Neither doctors or patients understand costs. it is very routine for a doctor to suggest getting a lab test from X place because they have experience working with the center. They have no idea that for your specific insurance plan this will cost you 2x another place and so you with an unhappy patient who blames their doctor for ripping them off. There should be tools to patients and doctors estimate costs.

We had a startup that came at this in an indirect way. We were trying to make it easier for labs and other providers to perform eligibility checks and facilitate prior auths in real time. Our proposed solution would have involved running the check during ordering, and then having the phlebotomist or lab tech at the hospital doing the sample collection contact the doctor and inform them that something would or would not be covered by insurance. The provider could then talk to the patient about out of pocket costs etc. I think this actually could have worked; our team imploded before we could prototype it however :(

While I like the other ideas, glhf trying to get people to practice lifestyle management or be adherent to a treatment regimen XD

I am also in healthcare tech and also worked with the idea of a doctor rating system focused specifically on using doctor procedure/diagnosis billing data and PQRS. We abandoned the idea due to lack of data for each healthcare field (cardiology, radiology, oncology, etc.) and hospitals not wanting to participate.

However, I have looked into incentivized, distributed platforms such as wings.ai or golem.network and believe that this could be applied to healthcare. If patients were incentivized on going to the doctor for a copy of the CPT/DGX codes on their bill and survey information around PQRS you would have a lot of useful data. This data could be used not only to provide a rating system of doctors, but also price comparison on CPT/RVU across the United States and the ability to provide PQRS data for doctors. Its an all in one, decentralized, healthcare platform for patients, doctors, and insurance providers.

As a frequent patient, I see such incredible need for "disruption" in healthcare, both in terms of transparency/ empowering the patient, and in terms of cost suppression. However, anyone who tackles this space has to be aware that there are some huge entrenched interests who like the current inefficiencies and cost opacity very much, thank you. Breaking into this space would be 1 part technical know-how to 10 parts legal jujitsu.

As an example, look upon the bloodied corpse of the failed startup Remedy, which was actually doing something really good -- helping users find billing errors and getting money back for them on bad charges. But incredible amounts of pushback stymied them:

https://www.fastcompany.com/40483774/remedy-wanted-to-cut-pe...

Are there any books you could recommend to learn more about why the American healthcare is a mess, how it became this way, as well as comparisons with other healthcare systems and why they work.

Could a PMR system help with some of these issues? Giving patients access to their records making it easier to aggregate data abiding with HIPAA?

I recently saw an episode of Dirty Money on Valeant. Is Valeant a good representation for most pharma companies and also a reflection of most for profit medical businesses whose primary obligation is to increase shareholder value?

What would be the best way to start aggregating and comparing prices in the USA? If it isn't possible, why do prices vary so much?

Sorry can't recommend any books. The main reason US healthcare is a mess is because we have structured it to be a free market system when it lacks the key characteristics for a free market to work. Free markets work really well in some areas (say groceries stores) and would work terrible in others areas (a national military) See: http://www.who.int/bulletin/volumes/82/2/PHCBP.pdf

Patient medical records won't help with pricing issues, but data transparency would help with automated solutions to manage care.

There is no easy way to aggregate and compare prices. If you could get billions of health care claims then you could build algorithms to estimate pricing or perhaps you could convince the large health care companies to share their pricing with you (highly unlikely). Prices very widely because there each institution negotiates their own set of prices with a specific set of providers. Basically imagine your health care plan is basically a set of discount codes for a set of doctors and providers. Except those discount codes are never shared with you and vary for each doctor and each provider and can change at any time.

I work in the humanitarian field in a poor country ravaged by war and famine. We have a number of humanitarian actors currently working in this country and no one actually has access to accurate population statistics. Well, none exists. The last census was conducted in 1975. I believe someone could use technology to get a much better estimate of the population. One thing that always springs to my mind is the possibility of using aerial imagery. It doesn't have to be exactly that, though.

I think this need, a real need that is, can potentially make millions for the enterprising type, here.

Why don't I try the same, you might ask. But, while I have some ideas, I am may not be able to raise the resources needed, at the moment.

How much penetration do cell phones have into a lot of these countries? May be a way to tease out a rough population from cell phone use statistics.
Somalia, is the country I am talking about and cellphone penetration is quite high. Most people might not have smartphones, though. I have been thinking about this too. Using cellphone network data and come up with estimates.
What I can tell you from my experience in the Gambia is that there many people have cellphones (not smartphones), but most have 2 or 3 because provider have lower rates when calling to the same provider, so one phone for Qcell, one phone for Africell,... Not sure if it's like that in many other places, there is a lot of tourism on the coast and returning tourists often bring their old phones to give to the locals.
Not sure how it is where OP is, but in many African countries it's common to have multiple SIM cards, to take advantage of in-network calling deals or to compensate for spotty coverage maps.
I'm curious how exact you would need. Like within 90%? 80%? 50%?

For those that want to follow up on this, you could use current satellite imagery to make population estimates, but it wouldn't be really accurate. You could wait for companies like Planet Labs[1] to get daily photos of the Earth (IIRC 4m resolution), and increase accuracy. You could also hire pilots to strap a camera and survey the interested areas. There are also, IMO, unethical spins (especially in oppressive regimes) that you could do with that data (ie: civilian surveillance). Or even cheaper, use drones (because you don't need daily or real time surveillance). That could also have other spinoffs. Or you could literally just send people to go count. Don't know which would be the cheapest.

[1] https://www.planet.com

I am not exactly an expert on matters demography but I think 50% would be low. At the moment, we have a study that was done by one of the UN agencies and the figures they came up with seem very disputed. They used 1975 census as the base for their extrapolations. Quite a lot happened since and their figures are not really believable.
Any way to get in touch?
my username 77@gmail.com
Why do you think there are millions to be made here? I'm sort of familiar with international development, and I'm surprised by that estimate.
I've been working in Kenya as a technical Co-founder of a startup in the ag space. We focus on smartphones, but I used to work with the telecom operators a lot in my previous work (where basic GSM connections gives some indication of population connected).

Some of the best stats you get for telecom coverage will come from the annual reports of commercial telecom companies. Eg in Kenya you can look at safaricom. In somalia I guess you can look at Telecom Somalia and some of the others (keeping in mind their market share).

GSMA do research every few years on the number of SIMs on average per market. This is how they get to a figure about subscribers (ie people) rather than connections (number of SIMs). The latter is what is usually reported by commercial companies.

You can quite easily do some online digging for a given market to get fairly current numbers (ie last year). For doing anything with sizing markets etc I'll always start here. Not with World Bank or similar data which is really outdated and not indicative of current trends in technology at all (which is important for me).

The international development sector is unfortunately so slow to realise what's going on technologywise - i'd wager Facebook will know a huge amount more about populations in a lot of these African countries than their governments or the international development sector do. Perhaps if they were a bit more genuinely philanthropy inclined they could do some amazing socially impactful stuff right now. But I don't think any of us will count our chickens on that one.

Journalism needs a WYSIWYG editor for stylized content -- content that is more visually diverse/interesting than the linear text+image+embed format, but not SO so custom/new as to truly require a developer to build it.
Have you seen WordPress' new Gutenberg editor that they'e working on?
LaTex?
... is just about as far from WYSIWYG as possible. LaTeX is not friendly for a newsroom full of non-technical journalists.
Digital marketing and programmatic advertising - TRAFFICKING. Everyone hates it. It's 100% required but no one has solved the issue. It can eat up so much time and if you make a mistake can cost valueable data.
What do you mean by this? As in, people hate doing marketing or they don't understand how to advertise? Plus, a mistake can cost valuable data? Where are you losing data?
Not OP, but worked in the field for a time. Trafficking usually means configuring your ad in the campaign management system. What are your targeting parameters, what are your tracking tags, uploading the ad itself, entering in lots of custom information that while conceptually similar across ad platforms usually has different names and often has to be manually entered. A lot of platforms do offer APIs of some sort to help with bulk campaign/ad creation, but there's often no "one stop shop" to be able to set up a google campaign and facebook campaign at the same time. There are some companies working on this, I think usually referred to as (or in conjunction with) "marketing automation".

A mistake can mean - misconfiguring your target (wasting money on ads that won't give you an ROI), misconfiguring your 3rd party tracking (letting data like conversions go unaccounted for, or not having your auditing tags setup, meaning you show ads to fraudulent users that you otherwise wouldn't have to pay for), etc.

Another ad guy here. The problem is best practice on one platform doesn’t equal best practice on the other. Additionally, there are many ad formats that don’t overlap on multiple platforms. Even GDN vs FB is a huge disparity. I would be interested in the product though if one existed.

Alternatively, one place to manage creatives and language as well as targeting for each campaign might be helpful as we use google sheets, excel and Trello for this now.

Do large agencies have systems for this? Or is everyone using Excel?
I do some illustration and have noticed on twitter how much every illustrator who gets some experience with 3d-tools likes to use 3d modelling to create block-outs for scenes they want to draw. By creating a simple scene out of blocks and shapes you can make your perspective work while drawing a lot easier. A tool that could be really populair would be something that makes making 3d mock-ups easier for 2d artstists without 3d experience.
I think both photoshop and manga studio can do it.
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A next generation internal / corporate portal. Everyplace I have worked at had either a really bad implementation of an internal portal or had a bunch of wiki pages clubbed together. It was incredibly difficult to get even basic info, such as where is the conference room, who works in the security team, what is the expense policy, so on a so forth. In my current multi billion dollar company, when I am meeting with someone new, I have to actually go to LinkedIn to understand what they do in the company and in what is their focus area.
I worked for a company within the a team that allocated quite some time to such internal tools as well as for others.

The real issue is how custom these solutions need to be and which weird rules and workflows some need to follow because of internal rules, iso norms and whatever else.

I don't think a one fits kinda all solution would ever really work. However i highly believe that companies need to allocate enough time to build tools that work _for them_

Some sort of enabler for content. I work in content marketing (not click bait shit but helping b2b companies tell their story without hiring a full design/marketing/dev team).

Our process and system is super efficient recording video + sending notifications to team members to edit, add captions, strip audio for your podcast, set up your podcast, set up your alexa flash briefing, etc.

But it takes hours to do all of this if youre on your own and thats ONLY if you know how to do it all. Content is the black box most have no idea how to do. If you don't pay our agency to do it for you you are kind of out of luck.

We sell a book on our process now and sell about 50 copies a week. These people are validated and want to learn how to do it, and are willing to pay to learn.

It only makes sense to build the platform that automates this process for these people and offer it to them. They've already paid to learn. Might as well offer the platform to do it.

I would love to check out the book. Can you mention it here?
A startup in the multi media field would basically be tooling creators. Innovation in the sense of just creating things easier to use, a jackknife agency that can develop specific tools per department.
A new operating system that allows peripherals like network cards, monitors, sata disks, bluetooth, speakers, fmri scanners, etc. to be used interchangeably between machines, locally and over the net.

Edit: I'm in the computing industry. Have you heard of it?

There's Plan9.
just wrote a blog post on this exact topic for the biopharma industry: https://newbio.tech/blog/bio_charts.html

its a $600B industry that is in decline because its traditional R&D engine is sputtering out, and big pharma has been amazingly acquisitive the last five years to replace off-patent blockbuster drugs (more IPOs and big M&A than software the last 5 years despite getting 1/5 of venture funding)

tons of really interesting new tech for startups to explore: synthetic biology, cell and gene therapy, bioelectronic medicine, many many others

A messaging/texting device with a long battery life and decent keyboard.
Try a Blackberry or Nokia device.
Technology adoption. I'm not necessarily talking about change management (although that could be a feature), but technology adoption in the broader sense. For example: if I'm a Health IT executive, how can I ensure the adoption of say, Kubernetes is the right path for my organization? I may have 20+ stakeholders, from actual practitioners, to finance pushing me in various directions. It's almost like there's space for adoption assurance, or some type of 3rd party integrator that sits in front of the bleeding edge of technology and helps dinosaur industries move faster through adoption. A layer that could understand my IT footprint, and recommend tools/improvements/etc. Like CreditKarma, but for IT.
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Modular template based responsive html email builder with version control, comments and approvals.

Our marketing department sends 10+ campaigns/week, each goes through multiple changes and compliance approval. It’s very time consuming, especially when someone needs to touch the code.

This looks interesting. Is there any solution that you are already using?

> especially when someone needs to touch the code

Do you not generally touch the code? Is some kind of WYSIWYG editor used to create an email or is the code human written?

Right now using an in-house app to make edits to emails initially built in dream weaver.

So, html email template (no unlined css) > merge word content in dreamweaver > upload to custom web app > app uses premailer to in-line the specified css > make changes to the content via ckeditor (which messes up the html in many cases) > export in pardot-ready format.

The app versions the content changes and allows comments as well easy email tests. We do 20+ revisions per campaign so that’s a necessity.

This was built 5 years ago and still works but getting inadequate for the complexity of responsive emails.

I’ve looked at this: https://beefree.io/ but it does not allow the creation of custom content modules. So looking into building a new version of our own, again.

It’s a pain but nothing compared to debugging email markup.

An app for installing and maintaining mixed fleets of lora/sigfox/... IoT sensors.

When installing these at scale in existing buildings you have to be able to send out local workforce to properly install and activate thousands of sensors, as well as maintain them afterwards, without prior training. It’s one of those things that sounds easy on the surface but is riddled with complexity, like how to register which sensor is installed where in a foolproof way, or how to easily locate faulty sensors for replacement.

what's the market for this? how many people are installing iot fleets?
The price of sensors is dropping and starting to reach the point where cost of retrofitting buildings is outweighed by savings in more efficient building use. That trend is going to cause most buildings to be retrofitted. You can do things like occupancy detection of every workplace which are very valuable to building managers.

There’s plenty of competition in people selling the sensors, providing connectivity, or doing data analysis, but I’m not aware of any solutions for installing the damn things which aren’t tied to a vendor.

What tools are used to maintain these now?
In healthcare billing with patient insurance companies, hospitals and doctors are contractually prohibited (and sometimes illegal) from sharing how much they get paid per procedure unit (RVU) from insurance co's. However, if you are a third party for the hospitals and have access to the billing info of a metropolitan area you could create some kind of price comparison system for all of the hospitals.
This is a really simple but basic one. Market size might not be billions of dollars, but a basic learning management system along the lines of Teachable/Udemy that allows for code with built-in testing would be used overnight by a dozen code bootcamps and would pull a lot of people out of the other platforms.

Maybe it's just a feature, not a full product, but it makes any "learn to code" MOOC unusable.

What exactly do you mean when you say testing? Like being able to write unit/integration tests? Or testing whether or not the submitted code fulfils some requirements/assignment?
Yes, unit/integration tests
I'm sorry, I for one am not really understanding what you're describing. Can you elaborate?
Stephen Grider on Udemy uses Jest to create automated tests for his JS and React courses that you can run while you watch and code his videos.

Jest and Mocha both have a watch feature that will test a file each time it is saved for "continuous testing", much like using Gulp watch or any type of dev live server environment.

Also Jest features Snapshot testing which will take a picture of a UI and test all changes made to the UI, as well as alerting you in tests if the UI has changed. I could see this being used in bootcamps as well.

Yeah, I just want that built into the LMS itself
learn.co does something similar thing.

you install a cli program, write the code, type something like: learn test .... tests are ran and results show. if all tests pass then dashboard is updated showing tests are passing.

Secure internet for people who travel frequently or work from coffee shops. Filter the “free” internet connection through a TOR router and protect your network/browsing.
Anything wrong with just using a VPN?
No, not at all. I view it similar to the classic Dropbox discussion. There were existing alternatives, but Dropbox took off because "it just worked" without having to use FTP and Linux. In this case, you eliminate the VPN step, by linking the router to your devices and using that single device to connect.

Secondly, with VPN, I first have to connect to the open network in order to activate the VPN. I also need to do it for each device I want to connect (phone, computer, tablet).

TOR is not meant for security, it's meant for anonymity.

If you are logging into services that can identify you, checking your personal email over a TOR connection, or doing work over a TOR connection, you're putting yourself and your company at risk.