1. Leonid Popov Sergey Baranov Bimohit Bawa Nikhil Mane
Patients Providers
Legal &
regulations
Insurance
companies
House calls
providers
Indirect
competitors Investors Hospitals
54 30 3 6 3 6 1 7
TOTAL INTERVIEWS:
110
Improving drug compliance and patient communication to reduce readmissions.
2. Lessons learned
Even acknowledging that it is more convenient and saves time people are willing
to pay only a very small premium for house calls
It appears to be very hard to convince people to use house calls instead of
emergency room in not very complex cases
We we able to convince nurse practitioners to work on our system. They valued
flexibility of working hours and decrease in administrative work
Hospitals are interested in cost efficient solutions to decrease readmission levels
We have creative solutions for that
Individuals are not willing to pay more for medical house calls
People generally see house calls as an alternative to primary or
urgent care but not to emergency room
There is enough supply to support house calls business model
The supply we can organize can be used to help hospitals with
follow-ups and home care
Improving compliance with medications and discharge plan can
reduce readmissions rate
3. Reality Hits!
Week 2
Who pays?
Week 3
Supply problem?
Week 5
We got supply covered!
Yeah! but, Who pays?
Week 7
B2B – What’s that?
RESTART! CODE RED
Our Flawless Plan
(Week 0/1)
B2C service! Let’s do it!
Week 8
Any Hospital willing to pilot?
Week 9
An Academic Hospital –
Let’s talk. Yeah!
Here’s what happened!
4. BMC Week 1
• Initial focus on Families with kids
• Our initial value proposition was not clear to our potential customers
5. BMC Week 6
Night & Day urgent medical house calls for those you care.
• NP are willing to participate on the platform (validated)
6. BMC Week 9
Whole New BMC!
Helping Hospitals increase profit by reducing readmissions
7. How It Works
Improving drug compliance and patient communication to reduce readmissions.
Visual and
personalized
materials
Phone, text,
email
remainders
24/7 access
to a nurse via
phone, email
Hospital shares
discharge and
medication plan
Connected
“PillsPal”
bottle
Non-
compliance
phone or
house call
Prepaid
return box
Confirmed
follow-up
schedule
Planned
outpatient or
house call
visits
No-show
phone or
house call
CommunicationDrugcomplianceFollowup
At discharge Day 1 Day 30
8. Process diagram
Improving drug compliance and patient communication to reduce readmissions.
Family
Regular phone and house calls
Remainders
Non compliance phone and house calls
Pharmacy
PillsPal return
Drug usage monitoring
Programmed PillsPal with medications
Hospital
CMS Metrics
Discharge info + $ Discharge plan
Insurance
3% savings on fees
CMS Metrics
9. Dashboard Smart bottle Instructions
MVP
Improving drug compliance and patient communication to reduce readmissions.
• Light and voice
reminders
• Just in time dispense
• Visual instructions
• Connected (reports
medication misses)
• Voice instructions
(not in MVP)
• Discharge plan
• Risk assessment info
• Communication
• Medications intake
data
• Follow-up records
• Personalized
• Visual
• Brochures and
posters
10. MVP
Improving drug compliance and patient communication to reduce readmissions.
MBAs approach to electronic engineering!
http://people.ischool.berkeley.edu/~nikhilm/dashboard/
11. Market Size
Improving drug compliance and patient communication to reduce readmissions.
TAM
SAM
TM
$14B
$2.5B
$1B*
Top three
reasons only
US discharges – 35M
X Average readmission rate – 16%
X Cost / readmission - $2.5K
+ Medicare penalties - $0.5B
US discharges – 35M
X 1 st. dev. Above national rate – 2.3%
X Cost / readmission - $2.5K
+ Medicare penalties - $0.5B
US readmission expenses
+ penalties
Above national rate
+ penalties
Caused by top three reasons
+ penalties
* Our assumption, needs additional validation
Source: http://kaiserhealthnews.org/news/medicare-readmissions-penalties-2015/
12. Per unit economic assumption
Improving drug compliance and patient communication to reduce readmissions.
TrueCare24 (Physical service, Existing Market)
Per unit Break even
# of hospitals 1 11
x discharges / hospital 1,400 1,400
= # of discharges 1,400 15,400
x price per discharged patient $200 $200
Gross revenue $280,000 $3,080,000
(Less) phone support (5 x $10) ($70,000) ($770,000)
(Less) house call (0.5 x $100) ($70,000) ($770,000)
(Less) PillsPal rent ($15) ($21,000) ($231,000)
= Net revenue $119,000 $1,309,000
(Less) Sales and operating costs ($1,200,000) ($1,200,000)
Cash Burn for period ($1,081,000) $109,000
13. Timeline
Business Model
Validation
Finalizing
platform
with pilot
customer
Run a pilot Growth
Major
Tasks
Useof
Funding
• No need in
funding
• Source – customer’s
prepayment
• Product & Management
team
• Initial equipment and
trainings
• Sales team and sales
commissions
• Product & Management team
• Equipment
• Administrative
• Validate
product –
market fit
• Validate WTP
• Finalize MVP
3 months
6 months 12-18 months to breakeven
• Hire Product team
• Build Web and Mobile
apps
• Hire MD, NPs & PAs
• Purchase equipment
• Hire sales & marketing team
• Building awareness & Brand
• Sales process
• Product optimization
Improving drug compliance and patient communication to reduce readmissions.
LF MVP HF MVP
14. Scalable business worth pursuing?
Urgent and Ubiquitous Problem
In 2014, Medicare fined 2610 out of 3500 hospitals for excess readmissions.
The fines totaled $430 million
Readmissions cost to Medicare is around $14 billion per year
Large Market
Readmissions is the first use case! SAM is 2.5 B.
Drug non-compliance is a huge issue in other functions i.e. Behavioral Health,
Addiction Psychiatry, Drug clinical trials to name a few.
Strong fit between drug compliance ( Value Proposition ) and Hospitals (
Customer Segment )
Validated by CDP interviews and clinical studies
Team
Tech savvy and data driven!
Yes!
Urgent and Ubiquitous Problem
Product-Market Fit
Large Market
Team
Will We Pursue?
