Download - 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