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
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
Focus on pain point/time/cost
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
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