clinacuity i-corps@nih 121014

Team 09

Stephane Meystre

Jeremiah Jones

Greg Jones

Unlocking the unstructured data in the

Electronic Health Record, producing actionable

information

TAM of 900k users at $3.85B

Targeting 30k users at $60M

-2-

Team members

Stephane Meystre, C-level

• Physician, Faculty in Biomedical Informatics (U of Utah)

• Clinacuity, Inc. Founder and CEO

• Long experience with NLP and clinical narratives

Jeremiah Jones, Industry expert

• Engineer and MBA, Resident Venture Developer for U of Utah

• Co-founded multiple businesses (Techuity, Sentius, Madra...)

• Experienced business leader specialized in tech commercialization

Greg Jones, PI:

• Engineer and MBA, Associate Director SCI and AVP for Research

• Clinacuity, Inc. Director

• Extensive software dev, business creation and commercialization

We talked to 106 customers (86 face-to-face)

Weekly average of about 12 interviews

-3-

Business Model Canvas Original Idea

-4-

Business Model Canvas Original Idea

-5-

What we did

We talked to > 100 potential customers or experts related to our

business:19

Healthcar

e

executive

s

40

EHR

users

8

Vendors

23

Industry

executiv

es

16

R&D,

coder

s, etc.

-6-

What we did

We talked to > 100 potential customers or experts related to our

business:19

Healthcar

e

executive

s

40

EHR

users

8

Vendors

23

Industry

executiv

es

16

R&D,

coder

s, etc.

-7-

LaunchPadCent ral

Va lu e Pr op os it ion s

Upto20x fasterpat ientchart

review

10x fasterproblem listent ry

Low erriskofm issedinform at ion

(5x m orecom pleteproblem list )

Meaningfulusecert ificat ion

com pliance(fortheproblem list )

Cu s t ome r Re la t ion sh ip s

Personalassistance(sales&

support )

Cu s t ome r Se g me n t s

EHRuser-Hospital-Inpat ient-

Specialist

EHRuser-Hospital-Outpat ient-

Specialist

EHRuser-Hospital-Outpat ient-

Prim arycare

EHRuser-Hospital-Inpat ient-

Prim arycare

CIO,CMIO

EHRuser-Pract ice-Specialist

EHRuser-Pract ice-Prim ary

care

EHRvendorbusdev(asopt ional

feature)

Casem anagers/Coders

Ret rospect iveclinicalresearchers

Ch a n n e ls

Salesforce

Partners(EHRvendors/resellers)

What we did: Value Proposition

-8-

What we found: Value Proposition for EHR users

• Obtaining a complete overview of a a patient takes far too

long from at least 10 minutes to …“a complex patient

sometimes takes up to 1 week to review!”

• Maintaining the problem list is too time-consuming

-9-

What we found: Value Proposition for EHR users

• Obtaining a complete overview of a a patient takes far too

long from at least 10 minutes to …“a complex patient

sometimes takes up to 1 week to review!”

• Maintaining the problem list is too time-consuming

10x faster

coded problem entry

up to 25x faster

patient chart review

-10-

What we found: Value Proposition for EHR users

• Obtaining a complete overview of a a patient takes far too

long from at least 10 minutes to …“a complex patient

sometimes takes up to 1 week to review!”

• Maintaining the problem list is too time-consuming

10x faster

coded problem entry

up to 25x faster

patient chart review

VPs each validated by more than 30 potential customers: This

would be big! …Could be enormously valuable! …Would be

very valuable …Would be most useful! …etc.

-11-

What we did: Value Proposition for EHR users

Automatically extracts problems and allergies in real-time from

all narrative text documents in the EHR

Congestive heart failure

Renal insufficiency

Allergy to cephalosporins

CliniWiz

-12-

What we did: Value Proposition for EHR users

MVP

-13-

What we did: Value Proposition for EHR users

MVP

-14-

LaunchPadCent ral

Va lu e Pr op os it ion s

Upto20x fasterpat ientchart

review

10x fasterproblem listent ry

Low erriskofm issedinform at ion

(5x m orecom pleteproblem list )

Meaningfulusecert ificat ion

com pliance(fortheproblem list )

Cu s t ome r Re la t ion sh ip s

Personalassistance(sales&

support )

Cu s t ome r Se g me n t s

EHRuser-Hospital-Inpat ient-

Specialist

EHRuser-Hospital-Outpat ient-

Specialist

EHRuser-Hospital-Outpat ient-

Prim arycare

EHRuser-Hospital-Inpat ient-

Prim arycare

CIO,CMIO

EHRuser-Pract ice-Specialist

EHRuser-Pract ice-Prim ary

care

EHRvendorbusdev(asopt ional

feature)

Casem anagers/Coders

Ret rospect iveclinicalresearchers

Ch a n n e ls

Salesforce

Partners(EHRvendors/resellers)

What we found: Customer Segments

-15-

What we found: Customer Segments

Complex customer segments in healthcare organizations

Physicians,

NPs, PAs

User

-16-

What we found: Customer Segments

Complex customer segments in healthcare organizations

Physicians,

NPs, PAsEHR Liaison

CMIO,

Tech.

Assess.

CommitteePhysician

Leaders

CIO,

IT committee

Finance

Director

CFO COOPurchasing,

Legal

ITS

Decision-Maker

Economic Buyer

Saboteur

Influencer

User

-17-

What we found: Customer Segments

Complex customer segments in healthcare organizations

Physicians,

NPs, PAsEHR Liaison

CMIO,

Tech.

Assess.

CommitteePhysician

Leaders

CIO,

IT committee

Finance

Director

CFO COOPurchasing,

Legal

ITS

Decision-Maker

Economic Buyer

Saboteur

Influencer

User

Inpatient -

Specialist

Inpatient –

Medicine/Ped.

Outpatient –

Specialist

Outpatient –

Primary care

-18-

What we found: Customer Segments

Complex customer segments in healthcare organizations

Physicians,

NPs, PAsEHR Liaison

CMIO,

Tech.

Assess.

CommitteePhysician

Leaders

CIO,

IT committee

Finance

Director

CFO COOPurchasing,

Legal

ITS

Decision-Maker

Economic Buyer

Saboteur

Influencer

User

Inpatient -

Specialist

Inpatient –

Medicine/Ped.

Outpatient –

Specialist

Outpatient –

Primary care

-19-

What we found: Customer Segments

Customer archetype: Inpatient EHR user –

Specialist Interventional Radiologist

Male, 40-65 years old

Attending physician, specialist

Not the buyer, but the

champion

Motivations: Less time using

EHR and more with patient;

Easy clinical documentation;

High risk patient care; See

more patients; Optimize

revenue.

Influenced by: Department

chair, Peers, Scientific

knowledge (journals, web)

-20-

LaunchPadCent ral

Ke yPa r t n e r s

EHRintegrat ionpartner(e.g.,SansoroHealth)

Providerofclinicaldata(fort rainingandtest ing)

e.g.,hospital

EHRvendor

Ke yAct ivit ie s

Financialm anagem ent

Softw aredevelopm entandtest ing

AI/NLPdevelopm entandtest ing

Custom integrat ions

Custom erengagem entandsupport

Ke yRe sou r ce s

Softw aredevelopers

IPrights

EHRintegrat ion

Com put ingpow er(IaaS)

SalesandFieldEngineers

What we found: Key Resources

-21-

What we found: Key Resources

-22-

What we found: Key Resources

-23-

LaunchPadCent ral

Ke yPa r t n e r s

EHRintegrat ionpartner(e.g.,SansoroHealth)

Providerofclinicaldata(fort rainingandtest ing)

e.g.,hospital

EHRvendor

Ke yAct ivit ie s

Financialm anagem ent

Softw aredevelopm entandtest ing

AI/NLPdevelopm entandtest ing

Custom integrat ions

Custom erengagem entandsupport

Ke yRe sou r ce s

Softw aredevelopers

IPrights

EHRintegrat ion

Com put ingpow er(IaaS)

SalesandFieldEngineers

What we found: Key Partners

-24-

Integration with commercial EHRs:

Partners for integration and sales channels:

What we found: Key Partners

End user (EHR user)

Buyer

(CFO,

CIO)Epic App

Store?

Development and Channel

partner

R&D,G&A

,S

Profit Reseller

fee

[30%]

Discount

[10%]

$15,000 $15,00

0

$15,000 $5,000Final price: $45,000

-25-

Here is what we will do next

• The pain is more severe than we thought

• This is a viable business, and we plan to

pursue as a “GO with minimal pivot”

• Next step is STTR Phase II grant application, with

– Further business model investigation and refinement

– Integration into an EHR (Epic EpicCare, with Sansoro Health, at

the Huntsman Cancer Institute and University of Utah Hospital)

– Improvement of accuracy and processing speed

– Improvement of generalizability and adaptability

– Development of an advanced visualization interface for the local

adaptation of the system

– Code review, robustness, and delivery improvements

– Market analysis and communication

-26-

Business Model Canvas Evolution – 1

-27-

LaunchPadCent ral

Ke yPa r t n e r s

EHRint egra t ion

partner

(Transformat iveMed

Cloud-based

comput ing(e .g.,

AmazonEC2)

Providerof

clin ica ldat a(for

t ra in ingand

Ke yAct ivit ie s

Soft ware

development

Insta lla t ionand

localadapt at ion

Evalua t ionand

t est ing

Va lu e Pr op os it ion s

Comple terapid

overviewof

pat ient fact s

Improved

convenienceand

usab ilit yt o

Improved

performancewit h

fast erprob lem

Lowerriskof

missed

in format ion

Mean ingfu luse

cert ificat ion

support

Cu s t om e r Re la t ion s h ip s

Personal

assist ance(sa les

& support )

Cu s t om e r Se g m e n t s

Hospita lEHR

users

Physiciangroup

EHRusers

CIO,CMIO

Case

managers/Coders

Clin ica lt r ia l

researchers

Ret rospect ive

clin ica l

researchers

EHRvendors(as

opt iona lfeat ure)

Ke yRe s ou r ce s

Soft ware

developers

IPright s

EHRint egra t ion

Comput ingpower

Ch a n n e ls

Salesforce

Partners(EHR

vendors/rese llers)

Cos t St r u c t u r e

Softwaredeve lopment(HR)

Inst a lla t ionandsupport(HR)

Licenseroyalt ies

Re ve n u e St r e a m s

Sale(fixedpricedet erminedbyinst a ll.size ,savings,

andavo idedpenalt ies)

Servicefee(insta lla t ion,loca ladap tat ion ,support )

Roya lt ies

Sub licensefees

Business Model Canvas Evolution - 2

-28-

LaunchPadCent ral

Ke yPa r t n e r s

EHRint egra t ion

partner

(Transformat iveMed

Cloud-based

comput ing(e .g.,

AmazonEC2)

Providerof

clin ica ldat a(for

t ra in ingand

EHRvendor

Ke yAct ivit ie s

Soft ware

development

Insta lla t ionand

localadapt at ion

Evalua t ionand

t est ing

Va lu e Pr op os it ion s

Enab leupt o

20xfaste r

pat ient chart

10xfaste r

problemlistent ry

Lowerriskof

missed

in format ion(5x

Mean ingfu luse

cert ificat ion

compliance(for

Cu s t om e r Re la t ion s h ip s

Personal

assist ance(sa les

& support )

Cu s t om e r Se g m e n t s

Hospita lEHR

users

Physiciangroup

EHRusers

CIO,CMIO

Clin ica lt r ia l

researchers

EHRvendor

busdev(as

opt iona lfeat ure)

Ret rospect ive

clin ica l

researchers

Case

managers/Coders

Ke yRe s ou r ce s

Soft ware

developers

IPright s

EHRint egra t ion

Comput ingpower

Ch a n n e ls

Salesforce

Partners(EHR

vendors/rese llers)

Cos t St r u c t u r e

Softwaredeve lopment(HR)

Inst a lla t ionandsupport(HR)

Licenseroyalt ies

Re ve n u e St r e a m s

Sale(fixedpricedet erminedbyinst a ll.size ,savings,

andavo idedpenalt ies)

Servicefee(insta lla t ion,loca ladap tat ion ,support )

Roya lt ies

Sub licensefees

Business Model Canvas Evolution - 3

-29-

Business Model Canvas Evolution - 4

-30-

LaunchPadCent ral

Ke yPa r t n e r s

EHRint egra t ion

partner

(Transformat iveMed

Providerof

clin ica ldat a(for

t ra in ingand

EHRvendor

Ke yAct ivit ie s

Financia l

management

Soft ware

development and

t est ing

AI/NLP

development and

t est ing

Cust om

in tegrat ions

Cust omer

engagement and

support

Freedomto

opera teandIP

pro tect ion

Va lu e Pr op os it ion s

Enableupto20x

fast erpat ien t

chartreview

10xfaste r

problemlistent ry

Lowerriskof

missed

in format ion(5x

Mean ingfu luse

cert ificat ion

compliance(for

Cu s t om e r Re la t ion s h ip s

Personal

assist ance(sa les

& support )

Cu s t om e r Se g m e n t s

EHRuser-

Hospita l-

Inpat ien t-

EHRuser-

Hospita l-

Inpat ien t-

EHRuser-

Hospita l-

Out pat ient -

EHRuser-

Hospita l-

Out pat ient -

EHRuser-

Pract ice-Primary

care

EHRuser-

Pract ice-

Specia list

CIO,CMIO

EHRvendor

Ke yRe s ou r ce s

Soft ware

developers

IPright s

EHRint egra t ion

Comput ingpower

(IaaS)

Sa lesandFie ld

Eng ineers

AI/NLP

scient ist s

Ch a n n e ls

Salesforce

Partners(EHR

vendors/rese llers)

Cos t St r u c t u r e

Softwaredeve lopment(HR)

Inst a lla t ionandsupport(HR)

Licenseroyalt ies

Re ve n u e St r e a m s

Sale(fixedpricedet erminedbyinst a ll.size ,savings,

andavo idedpenalt ies)

Servicefee(insta lla t ion,loca ladap tat ion ,support )

Roya lt ies

Sub licensefees

Business Model Canvas Evolution - 5

-31-

LaunchPadCent ral

Ke yPa r t n e r s

EHRint egra t ion

partner(e .g.,

Transfo rmat iveMed

Providerof

clin ica ldat a(for

t ra in ingand

EHRvendor

Ke yAct ivit ie s

Financia l

management

Soft ware

development and

t est ing

AI/NLP

development and

t est ing

Cust om

in tegrat ions

Cust omer

engagement and

support

Freedomt o

opera teandIP

pro tect ion

Va lu e Pr op os it ion s

Enableupto20x

fast erpat ien t

chartreview

10xfaste r

problemlistent ry

Lowerriskof

missed

in format ion(5x

Mean ingfu luse

cert ificat ion

compliance(for

Cu s t om e r Re la t ion s h ip s

Personal

assist ance(sa les

& support )

Cu s t om e r Se g m e n t s

EHRuser-

Hospita l-

Inpat ien t-

EHRuser-

Hospita l-

Out pat ient -

EHRuser-

Hospita l-

Out pat ient -

EHRuser-

Hospita l-

Inpat ien t-

EHRuser-

Pract ice-

Specia list

EHRuser-

Pract ice-Primary

care

CIO,CMIO

EHRvendor

Ke yRe s ou r ce s

Soft ware

developers

IPright s

EHRint egra t ion

Comput ingpower

(IaaS)

SalesandFie ld

Eng ineers

AI/NLPscient ist s

HIPAA-

compliant data

st ore

Ch a n n e ls

Salesforce

Partners(EHR

vendors/rese llers)

Cos t St r u c t u r e

Softwaredeve lopment(HR)

Inst a lla t ionandsupport(HR)

Licenseroyalt ies

Re ve n u e St r e a m s

Sale(fixedpricedet erminedbyinst a ll.size ,savings,

andavo idedpenalt ies)

Servicefee(insta lla t ion,loca ladap tat ion ,support )

Roya lt ies

Sub licensefees

Business Model Canvas Evolution - 6

-32-

LaunchPadCent ral

Ke yPa r t n e r s

EHRint egra t ion

partner(e .g.,

SansoroHealt h )

Providerof

clin ica ldat a(for

t ra in ingand

EHRvendor

Ke yAct ivit ie s

Financia l

management

Soft ware

development and

t est ing

AI/NLP

development and

t est ing

Cust om

in tegrat ions

Cust omer

engagement and

support

Freedomt o

opera teandIP

pro tect ion

Va lu e Pr op os it ion s

Upt o20x

fast erpat ien t

chartreview

10xfaster

problemlistent ry

Lowerriskof

missed

in format ion(5x

Mean ingfu luse

cert ificat ion

compliance(for

Cu s t om e r Re la t ion s h ip s

Personal

assist ance(sa les

& support )

Cu s t om e r Se g m e n t s

EHRuser-

Hospita l-

Inpat ien t-

EHRuser-

Hospita l-

Out pat ient -

EHRuser-

Hospita l-

Out pat ient -

EHRuser-

Hospita l-

Inpat ien t-

EHRuser-

Pract ice-

Specia list

EHRuser-

Pract ice-Primary

care

CIO,CMIO

EHRvendor

Ke yRe s ou r ce s

Soft ware

developers

IPright s

EHRint egra t ion

Comput ingpower

(IaaS)

SalesandFie ld

Eng ineers

AI/NLPscient ist s

HIPAA-compliant

dat ast ore

Ch a n n e ls

Salesforce

Partners(EHR

vendors/rese llers)

Cos t St r u c t u r e

Softwaredeve lopment(HR)

Inst a lla t ionandsupport(HR)

Licenseroyalt ies

Re ve n u e St r e a m s

Sale(fixedpricedet erminedbyinst a ll.size ,savings,

andavo idedpenalt ies)

Servicefee(insta lla t ion,loca ladap tat ion ,support )

Roya lt ies

Sub licensefees

Business Model Canvas Evolution - 7

-33-

LaunchPadCent ral

Ke yPa r t n e r s

EHRint egra t ion

partner(e .g.,

SansoroHealt h )

Providerof

clin ica ldat a(for

t ra in ingand

EHRvendor

Ke yAct ivit ie s

Financia l

management

Soft ware

development and

t est ing

AI/NLP

development and

t est ing

Cust om

in tegrat ions

Cust omer

engagement and

support

Freedomt o

opera teandIP

pro tect ion

Va lu e Pr op os it ion s

Upt o20x

fast erpat ien t

chartreview

10xfaster

problemlistent ry

Lowerriskof

missed

in format ion(5x

Mean ingfu luse

cert ificat ion

compliance(for

Cu s t om e r Re la t ion s h ip s

Personal

assist ance(sa les

& support )

Cu s t om e r Se g m e n t s

EHRuser-

Hospita l-

Inpat ien t-

EHRuser-

Hospita l-

Out pat ient -

EHRuser-

Hospita l-

Out pat ient -

EHRuser-

Hospita l-

Inpat ien t-

CIO,CMIO

EHRuser-

Pract ice-

Specia list

EHRuser-

Pract ice-Primary

care

EHRvendor

Ke yRe s ou r ce s

Soft ware

developers

IPright s

EHRint egra t ion

Comput ingpower

(IaaS)

SalesandFie ld

Eng ineers

AI/NLPscient ist s

HIPAA-compliant

dat ast ore

Ch a n n e ls

Salesforce

Partners(EHR

vendors/rese llers)

Cos t St r u c t u r e

Softwaredeve lopment(HR)

Inst a lla t ionandsupport(HR)

Licenseroyalt ies

Re ve n u e St r e a m s

Sale(fixedpricedet erminedbyinst a ll.size ,savings,

andavo idedpenalt ies)

Servicefee(insta lla t ion,loca ladap tat ion ,support )

Roya lt ies

Sub licensefees

Business Model Canvas Evolution - 8

-34-

LaunchPadCent ral

Ke yPa r t n e r s

EHRint egra t ion

partner(e .g.,

SansoroHealt h )

Providerof

clin ica ldat a(for

t ra in ingand

EHRvendor

Ke yAct ivit ie s

Financia l

management

Soft ware

development and

t est ing

AI/NLP

development and

t est ing

Cust om

in tegrat ions

Cust omer

engagement and

support

Freedomt o

opera teandIP

pro tect ion

Va lu e Pr op os it ion s

Upt o20x

fast erpat ien t

chartreview

10xfaster

problemlistent ry

Lowerriskof

missed

in format ion(5x

Mean ingfu luse

cert ificat ion

compliance(for

Cu s t om e r Re la t ion s h ip s

Personal

assist ance(sa les

& support )

Cu s t om e r Se g m e n t s

EHRuser-

Hospita l-

Inpat ien t-

EHRuser-

Hospita l-

Out pat ient -

EHRuser-

Hospita l-

Out pat ient -

EHRuser-

Hospita l-

Inpat ien t-

CIO,CMIO

Ke yRe s ou r ce s

Soft ware

developers

IPright s

EHRint egra t ion

Comput ingpower

(IaaS)

SalesandFie ld

Eng ineers

AI/NLPscient ist s

HIPAA-compliant

dat ast ore

Ch a n n e ls

Salesforce

Partners(EHR

vendors/rese llers)

Cos t St r u c t u r e

Softwaredeve lopment(HR)

Inst a lla t ionandsupport(HR)

Licenseroyalt ies

Re ve n u e St r e a m s

Sale(fixedpricedet erminedbyinst a ll.size ,savings,

andavo idedpenalt ies)

Sale(variab leprice,asport ionofaddit iona lrevenue)

Servicefee(insta lla t ion,loca ladap tat ion ,support )

Roya lt ies

Business Model Canvas Evolution - 9

First Pass Canvas

Low Fidelity MVP

Product/Market Fit

Left-side of the Canvas

Market Opportunity

High Fidelity MVP

Metrics That Matter

Right-side of the Canvas

Problem/Solution validation

Investment Readiness Level – Where we started

IRL 2

Investment Readiness Level – Where we ended

First Pass Canvas

Low Fidelity MVP

Product/Market Fit

Left-side of the Canvas

Market Opportunity

High Fidelity MVP

Metrics That Matter

Right-side of the Canvas

Problem/Solution validation

IRL 6-7

P

P

P P P P

PP