MyMedRecs NYU Final Presentation
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- The document discusses a web-based application that helps streamline the process of obtaining patient consent for sharing medical records between doctors. - It aims to reduce the time required from over a week currently to just a few days by facilitating electronic consent forms and record transfers. - The target customers are small medical practices, smaller EHR vendors, and insurance companies who want to cut costs from delays in medical care due to lengthy consent processes.
MyMedRecs NYU Final Presentation
- 1. MyMed ecs Helping EHR vendors provide doctors with a time and cost efficient process for receiving patient consent for sharing medical records Chris Duderich Bre Patel Yiran Mao Total Interviews (through Day 5): 43 Total interviews from Day 4: 7 Small Practices: 3 CIO / Privacy Officers: 1 EHR Vendor Reps: 4
- 2. I need my records transferred… Bre, who suffers from a chronic disease, recently moved to New York to work. Needing to continue his treatment, Bre visits a new doctor near his apartment. In order to ensure treatments do not overlap, his new doctor in New York needs Bre’s medical records from his old doctor in Philadelphia. I need your medical records, Bre Here’s the records you requested Dr. Duderich 3. New doctor sends Bre’s consent to his You have my consent 1. Request sent to patient 2. Bre sends signed form back to new doctor previous doctor 4. Bre’s previous doctor sends his medical records to Bre’s new doctor
- 3. Tell me where it hurts… • +1 day after first treatment: Medical professionals needed to provide patient with consent form • +3 days: Patient would then need to sign it and then scan or fax it back to the doctor • +4 days: The doctor would then need to provide this request to the old doctor before finally • +8 days: The old doctor’s records would finally arrive to the patient’s new doctor via postal service “Why can’t I access my patient’s medical records from their old doctor faster?!?”
- 4. Day 1: Business Model Canvas Key Partners Key Activities Value Proposition Customer Relationships Customer Segments Physician Practices Hospitals Patients Insurance Companies App-based platform development Linking of dentist offices to network Facilitate transfer of medical records between doctors Simplify patient consent for transfer Reduce lead-time required for transfer of records Save patients time Give patients ability to have greater control over medical records Dentistry patients who are changing dentists or having surgical or cosmetic dental procedures performed Plan to expand into other medical fields where transfer of medical records is required Key Resources Channels Software dev. Security quals. App store PC software Cost Structure Revenue Streams Sales and marketing Ongoing maintenance Patients - App will be free Dentists - App and software will be available for monthly and annual subscription
- 5. I need consent to learn more detail… Bre, who suffers from a chronic disease, recently moved to New York to work. Needing to continue his treatment, Bre visits a new doctor near his apartment. In order to ensure treatments do not overlap, his new doctor in New York needs Bre’s medical records from his old doctor in Philadelphia. I need your medical records, Bre Here’s the records you requested Dr. Duderich 2. Consent is provided to both doctors 1. Request emailed to patient 3. Bre’s previous doctor sends his medical records to Bre’s new doctor
- 6. How are get there? The problem: The transfer of medical record is time consuming and inconvenient for both doctors and patients, leading to rising cost and longer waiting times respectively A web-based + device that helps both the authentication and transfer of medical electronic and paper record Due to EMR Mandate, all practice/hospital will switch to electronic medical record, transfer of record will be greatly simplified soon Pivot – value proposition Instead of focusing on the whole process, we feel authentication will still be a pain point to both party A web-based application that make the authentication securely and painless to both hospital doctor and small practice Decision-makers in large hospital are different from users and concerns are way more complicated Iteration – Focus only on small practice and vendors How about just take small practice? What about build our system in other EMR systems? A web-based application makes the authentication securely and painlessly to small practice. Other vendors can make it part of their system Most large vendors already have this feature within their bundle. However, it is only available if you buy their whole kit and smaller vendor don’t have it as a feature. Insurance companies also interested in the product. Iteration – Customer Segmentation - Small practice not have it - Smaller vendors cannot build it in house How about Insurance companies? Current product: A web-based application makes the medical authentication process securely and painlessly to small practice. It can be integrated into other smaller EMR systems who cannot build it.
- 7. How are get there? The problem: The transfer of medical record is time consuming and inconvenient for both doctors and patients, leading to rising cost and longer waiting times respectively A web-based + device that helps both the authentication and transfer of medical electronic and paper record Due to EMR Mandate, all practice/hospital will switch to electronic medical record, transfer of record will be greatly simplified soon Pivot – value proposition Instead of focusing on the whole process, we feel authentication will still be a pain point to both party A web-based application that make the authentication securely and painless to both hospital doctor and small practice Decision-makers in large hospital are different from users and concerns are way more complicated Iteration – Focus only on small practice and vendors How about just take small practice? What about build our system in other EMR systems? A web-based application makes the authentication securely and painlessly to small practice. Other vendors can make it part of their system Most large vendors already have this feature within their bundle. However, it is only available if you buy their whole kit and smaller vendor don’t have it as a feature. Insurance companies also interested in the product. Iteration – Customer Segmentation - Small practice not have it - Smaller vendors cannot build it in house How about Insurance companies? Current product: A web-based application makes the medical authentication process securely and painlessly to small practice. It can be integrated into other smaller EMR systems who cannot build it.
- 8. Day 3: Business Model Canvas Key Partners Key Activities Value Propositions Customer Relationships Customer Segments Key Resources Channels •Software developer •Legal counsel •Security certification to ensure HIPAA compliance •Customer service team •Funding Insurance Companies Insurance Companies Cost Structure Revenue Streams Patients •Patients who visit a new or out of network doctor •Have internet access and an active email account Doctors / “CIOs” at Group Practices • Doctors who need access to patient records from outside of existing network require patient consent for sharing of medical records • CIOs or decision makers Single and Group Practices •Save patients Patients time •Give patients ability to have greater control over medical records Get: Doctor would advice patient use Keep: Ensure security of consent and ease of use Doctors/Records Depts Get: Conferences, trade shows, industry magazines Keep: Ensure security of consent and ease of use Grow: Additional functions, integration with existing systems • Direct sales through reps. • Insurance companies (looking to save costs) Patients •Reduce time required for patients to authorize transfer of medical records •Able to receive safer and faster treatment Doctors/ “CIOs” at Group Practices • Reduce time required for doctors and staff to receive patient consent to share records • Saves cost of duplicate procedures/tests • Facilitate transfer of medical records between doctors •Software/process development and design •Security and verification of patient identification •Ensure continued HIPAA, Medicare, Medicaid security/ privacy compliance •Management of website and data transfer process •Marketing/promotion to doctors offices •Medical services staff •Decision makers at group practices (usually board of doctors) •Hospitals •Legal counsel •Patients •Professional organizations • Insurance companies • Fixed Costs: Network infrastructure • Variable Costs: Legal costs, sales and marketing, developer salary, insurance costs, customer trials Patients • Free to use Doctors / “CIOs” at Group Practices • Subscription (annual/monthly) • Transaction fee (under review) • Cut costs of delays in medical care
- 9. How are get there? The problem: The transfer of medical record is time consuming and inconvenient for both doctors and patients, leading to rising cost and longer waiting times respectively A web-based + device that helps both the authentication and transfer of medical electronic and paper record Due to EMR Mandate, all practice/hospital will switch to electronic medical record, transfer of record will be greatly simplified soon Pivot – value proposition Instead of focusing on the whole process, we feel authentication will still be a pain point to both party A web-based application that make the authentication securely and painless to both hospital doctor and small practice Decision-makers in large hospital are different from users and concerns are way more complicated Iteration – Focus only on small practice and vendors How about just take small practice? What about build our system in other EMR systems? A web-based application makes the authentication securely and painlessly to small practice. Other vendors can make it part of their system Most large vendors already have this feature within their bundle. However, it is only available if you buy their whole kit and smaller vendor don’t have it as a feature. Insurance companies also interested in the product. Iteration – Customer Segmentation - Small practice not have it - Smaller vendors cannot build it in house How about Insurance companies? Current product: A web-based application makes the medical authentication process securely and painlessly to small practice. It can be integrated into other smaller EMR systems who cannot build it.
- 10. Day 5: Business Model Canvas Key Partners Key Activities Value Propositions Customer Relationships Customer Segments Key Resources Channels •Software UI/UE Designer •Software developers • Direct sales force •Customer service team •Funding •AWS or other web-server service Small EHR Vendors OEM Individual/Group Practices Direct Sale Cost Structure Revenue Streams Small EHR Vendors •Those either not having capability or cannot cost-effectively build it internally •Those who urge to gain competitive edge to increase market share •Those who are not expert on HIPAA regulation Individual Practice Doctor/ CIOs at Group Practices • Those who don’t have EHR system or this specific function built in their existing one • Have high volume of consent requests •Decision-makers within each practice Small EHR Vendors Get: Conferences, direct sales force, trade shows, industry publications Keep: Make it easy for integration and provide competitive price for the solution and add on new features to patient protocol Individual Practice Doctor/ CIOs at Group Practices Get: Conferences, Direct Sales Force, word of mouth Keep: Ensure security of consent, HIPAA compliance and ease of use Small HER Vendors •Task: Integrate our solution into their EHR system as patient protocol •Gain: Add competitive edge to their system •Pain: save their money to develop and be HIPAA compliance Individual Practice Doctor/ CIOs at Group Practices •Task: Help doctor make paperless requests and patient being able to consent via a link •Gain: ability to concentrate, save opportunity cost •Pain: Reduce time required, less annoying • Software design and development • System implementation • System integration • Ensure HIPAA, Medicare/Medicaid security/ privacy compliance •Marketing/promotion to customers •Small EHR vendors •Consultant for legal issue, especially HIPAA compliance •Professional practice organizations • Industry magazines • Insurance companies • Fixed Costs: Employees salary (Developers/ Designer/ Sales etc..), Sales and marketing, Server rental and other service fee, Legal costs Small EHR Vendors • Pay-per-request of installation Individual/Group Practices •Monthly Subscription
- 11. Customer Archetype • Small/Group Practice Doctor • Work at small clinic (< 5 doctors), ambulatory, critical access hospital • Integrated medical record staff and other functions • Busy with other administrative burdens • High variability of requests on weekly basis • Relatively small EMR vendors • Have focused customer group • Urge to gain competitive edge to large vendors like Epic and McKesson • Limited developer resources to web communication and implementation of security protocols
- 12. Here’s our prescription… Customer Segment Continue reaching out to small EHR vendors, doctors and small medical practices Value Proposition Understand whether small EHR systems are interested in providing patient consent features Channels Test whether this feature should be a stand-alone EHR-related service or a bolt-on technology Revenue Streams Test how doctors offices and small EHR vendors are willing to pay for this service
- 13. Appendix Slides
- 14. Value Prop. and Customer Segments • EMR Vendors will reduce paper Value Propositions Customer Segments work for doctors and insurance companies and further encourage the use of EMR systems by facilitating the patient consent process. • Doctors can reduce time in obtaining patient consent for sharing of medical records via a web based system while speeding up the ability to verify authenticity of digital EMR patient records. • Insurance Companies can reduce risk of using digital EMR patient records through keeping electronic records of patient consent. Insurance companies will also aim to cut cost by reducing the amount of time medical staff spends obtaining patient consent. EHR Vendors •Smaller vendors seeking to offer cost-effective options •Patients who visit a new or out of network doctor •Have internet access and an active email account Doctors / “CIOs” at Group Practices • Doctors who require patient consent for sharing of medical records • CIOs or decision makers Single and Group Practices EHR Vendors •Allow medical practitioners to receive patient consent electronically •Offer practices a time-saving option vs. current fax-scan heavy process Doctors/ “CIOs” at Group Practices • Reduce time required for doctors and staff to receive patient consent to share records • Faster consent will save cost of duplicate procedures/ Insurance Companies • Reduce risk of healthcare providers using wrong or incomplete information Insurance Companies • Cut costs of delays in medical care • Electronic record of consent
- 15. Medical Record Transfer Market US Electronic Health Records Market 9.3 Billion Feasible market size 2.73 Billion Five year target 20 Million • Total EHR market size 9.3 Billion • Total office-based physicians 230,187. • 89.9% within 5 people group • 6.3% within 10 people group • 3.7% consist more than 10 • Overall cost for implementation of EHR system (on average): • Office-size: 9,600/year • Mid-size: 50,000/year • We are targeting 1,000 doctors on average for the first 5 years
- 16. EHR Incentive Program “Mandate” • Centers for Medicare and Medicaid Services • EHR users eligible to receive incentive payments if they can prove “meaningful use” of capabilities • Three Stages • Stage 1 – (2011-2015) providers capturing and sharing patient data with patient or other healthcare professionals • Stage 2 – (2015 – 2016)provide patients the ability to view online, download and transmit their health information • Stage 3 – (2016 and beyond) providers must demonstrate meaningful effective use of these systems to improve patient care
- 17. EHR Incentive Program “Mandate” • What does all this mean? • Electronic health records are becoming a requirement and over the next several years, various phases of medical practices implementation is occurring (incentives for compliance and penalties for non-compliance) • HIPAA mandated patient consent for transfer of records is still a pain point for many stakeholders such as doctors, records staff, patients and even CIOs. • Consent forms • Require printing, faxing, scanning and manual signing • Estimated to take 45 – 90 minutes of medical staff time per request • Extrapolated across multiple requests, could add up to 10 hours per week
Editor's Notes
- #3: Focus on pain point/time/cost
- #17: Healthcare providers eligible to receive incentive programs if they can prove “meaningful use” - EHR Incentive Program is not reimbursement for purchasing or replacing systems Depending on system used – maximum incentive to be received over number of years can vary. - $44k if under Medicare (program run by CMS) – 5 year timeline (75% of medicare allowed charged up to annual cap – over 5 years $44k) - payment reductions in 2015 if providers use medicare and chose not to comply (start at 1% of reimbursement – up to 5% over time) - $63,750 if under Medicaid where each state runs own program – 6 years of participation - no medicaid payment reductions if noncompliance Incentives not available to medical groups – only to individual providers… even if EHR belongs to the practice - hospital based phsyicians cannot participate In order to receive incentive payments, providers must meet 15 core objectives (all 10 required), and 10 menu objectives (must meet min of 5 that are based on needs of doctors) Stage 2 criteria place an emphasis on health information exchange between providers to improve care coordination for patients
- #18: Healthcare providers eligible to receive incentive programs if they can prove “meaningful use” - EHR Incentive Program is not reimbursement for purchasing or replacing systems Depending on system used – maximum incentive to be received over number of years can vary. - $44k if under Medicare (program run by CMS) – 5 year timeline (75% of medicare allowed charged up to annual cap – over 5 years $44k) - payment reductions in 2015 if providers use medicare and chose not to comply (start at 1% of reimbursement – up to 5% over time) - $63,750 if under Medicaid where each state runs own program – 6 years of participation - no medicaid payment reductions if noncompliance Incentives not available to medical groups – only to individual providers… even if EHR belongs to the practice - hospital based phsyicians cannot participate In order to receive incentive payments, providers must meet 15 core objectives (all 10 required), and 10 menu objectives (must meet min of 5 that are based on needs of doctors) Stage 2 criteria place an emphasis on health information exchange between providers to improve care coordination for patients