M OBI LE

M ED I CI N E

Kenneth ChengColumbia College

Thiago KapulskisMBA

David DabscheckEMBA

Lisa AhnGSAS Biotechnology

Alisa UmanskayaPhD Physiology

Serving medically underserved communities through a virtual web platform

Lean Launchpad: Day 5

Interview Day 1 Day 2 Day 3 Day 4 Day 5 Total

No. 24 16 14 18 5 77

Our Journey

• DAY 1: RESTART

• DAY 2: DISCOVERY

• DAY 3: DEEP DIVE

• DAY 4: NEW PATHWAYS

• DAY 5: ANALYSIS

Business Model Canvas: Day 1

Business Model Canvas: Day 1

What we thought:1.) The customer segments are:

-Disabled/elderly who have limited mobility/access to care Their PAIN: Difficulty getting to the Dr’s office Their GAIN: Accessibility to care and convenience of home visit

-Pts with busy schedules Their PAIN: limited time to see a physician Their GAIN: Convenience of timely appt. to location

and time specified by Pt

RESTART

Dale Armstrong: Homebound patient

Hi, I’m Dale. I have a sore throat, fever and chills. My address is 25 Skylar Drive. I am free

from 2pm-5pm tomorrow. Can I make an appointment?

M OBI LE

M ED I CI N E

Gina Harris: MCM Appointment Services

Hello Dale, I’m Gina. I’d be happy to set up your appointment. The MCM solution will arrive tomorrow between 2-2:30pm.

Business Model Canvas: Day 2

Business Model Canvas: Day 2

What we learned:

1.) START-OVER!!2.) -The elderly 24% would use Mobile Cloud Medicine. Use appointments as an opportunity to go outdoors

-Pts with busy schedules 16.7% would use Mobile Cloud Medicine if they had to pay a small fee.

-MDs Are not confident in an individual technician/PA/RN’sabilities to correctly diagnose

So…..

OUR NICHE

National Health

Service CorpRural Clinics/

Patients

Virtual Health

Platforms

Day 3

Day 3

What we learned:1.) -Low income rural community 69% would use Mobile Cloud Medicine

-MD/physician 75% would only relocate to urban areas if eligible for loan repayment program 1 Anesthesiologist expressed interest in volunteering to serve underrepresented areas 1

day per month free of cost

2.) Billing CPT Codes - $50 Average Medicaid reimbursement for check-up- Expect $40-$45 for online consultations

So…..So………

DEEP DIVE

Customer Archetypes

• Brooks County Clinic in

Georgia run by Dr. Jackie

Brown, GP

• Established and valued

patient/doctor relationships

in community

• In need of

assistance/training for

more complex or chronic

cases (eg cardiovascular

abnormalities)

Georgia Department of

Health

Underserved rural

areas result in less

preventative medicine

and higher costs

Already exploring

telemedicine solutions

2.5 million on Medicaid

•Dr. Julia Lamb, rheumatologist; married to Jason Schpiel, JD •Works part-time in private practice

–has patient cancellation—logs onto Cloud Health–has two “family”days—can take ad-hoc/pre-scheduled virtual appointments from home

Day 4

Day 4

What we learned:1.) The Channels are:

-Social workers 3 of 3 expressed willingness to serve as a social channel-State Medicaid policies vary widely. 39/50 state governments willing to consider telemedicine reimbursement if Pt health outcomes are comparable

2.) Revenue Stream: USDA granted ~30 million dollars to utilize telemedicine and collect outcome data

3.) Results: Preliminary data in ‘comprehensive reimbursement’ states show telemedicine health outcomes are comparable GPs benefit from virtual medicine by linking with specialists

So………So……..

Project Description Location Limitations How we differ

Project ECHO Telemedicine program developed to treat chronic and complex diseases in rural and underserved areas

New Mexico

• No ad-hoc component.

• Not clinic-friendly (interview).

• Revenue model complicated in other states (not loan repayment-based).

Their focus: long-termGP/specialist relationships

Our focus: focus on ad hoc specialist component, with appointment-based longer term relationship options available

Ohio Department of Rehabilitation and Correction telemedicineproject

Telemedicine program between 32 prisons and Ohio State University Medical Center

Ohio • No ad-hoc component (seems to work in the setting)

Setting

Georgia Partnership for telehealth

Georgia • Urban specialists have “block time”-based apt scheduling (cumbersome).

Scheduling makes it inaccessible on ad-hoc basis.

Telemedicine Field Today

Medicaid Reimbursement Policy for Telemedicine across the US

: Partial reimbursement27

12 : No reimbursement

11 : Comprehensive reimbursement

Day 5

ChannelsRural clinic

Urban MD

Cloud Medicine

National gov’t (loan repayment programs)

Patient

State Medicaid

Direct Sales

Direct sales (med schools, hospitals, conferences), web advertising, etc.

Color

Black Cash flow

Other Distinct relationship

Reimbursement $50

Doctor’s fee $30

Customer acquisition/clinic $5000

Variable overhead/visit $5

Attrition rate 10%/year

Sale cycle/clinic 2 mo.

Sale cycle/doctor 2 wks.

ANALYSIS

A profitable Start-up? Months 1-18

-200000

-100000

0

100000

200000

300000

400000

500000

600000

700000

2 4 6 8 10 12 14 16 18

Revenues per Clinic

Variable Costs

Total Costs

EBIT

However….

0

100000

200000

300000

400000

500000

600000

700000

800000

900000

20 22 24 26 28 30 32 34 36

Revenue

VC

TC

EBIT

0

200000

400000

600000

800000

1000000

1200000

1400000

1600000

20 22 24 26 28 30 32 34 36

Revenue

VC

TC

EBIT

Conservative Case (300

Clinics Maximum)

With Continued Clinic growth of

5%

Financial projections

$(2,000,000)

$-

$2,000,000

$4,000,000

$6,000,000

$8,000,000

$10,000,000

Total Revenue Total Costs Net operating profits

0-18 Months

19-36 Months (conservative)

19-36 (with growth)

Lean Launchpad Conclusions

• Be on the same planet as your

customer.

Understand their needs.

ME

Customer

• Innovation is not always innovative.

• Focus---Solve one problem at a time. In the beginning stages, you can’t fix everything

• ‘If start-ups are your babies, you are married to your team’

ZeoniceDr. Ana

Heaven health

M OBI LE

M ED I CI N E

Kenneth ChengColumbia College

Thiago KapulskisMBA

David DabscheckEMBA

Lisa AhnGSAS Biotechnology

Alisa UmanskayaPhD Physiology

Serving medically underserved communities through a virtual web platform

M O BI LE

M ED I CI N E

We Serve medically underserved communi-

Mode Name Type No.

Interview Elderly 4

Interview Time restricted 12

Interview Disabled 4

Interview Law Student 3

Interview Hospital PT 2

Interview Dave K. MD 1

Interview Odeyl MD 1

Interview Jack M. MD 1

Interview Laura F. Sponsored Projects Officer 1

Survey MD 21

Survey Medical Student 13

Interview Randall L. Assistant Dean Rural and Underserved Program 1

Interview David G. Clinic 1

Interview Georgia Partnership for Telehealth 1

Interview Drew F. MD/MBA 1

Interview Domain Expert 2

Interview Mark R. Domain Lawyer 1

Interview S. Cicero Support Staff 1

Webinar ECHO 1

Interviews

Alina Genis, Emilie Wasserman, Akil Puckerin, Lana Pushlikova,Sofiya Chernyak Medical Students ___5__________

Interview May N. Georgia Department of Community Health

TOTAL 77

Mobile Cloud Medicine InterviewsMobile Cloud Medicine Interviews