
Show HN: JuvMed – Health practice management software - mariushn
https://juvmed.com/
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chrisgd
As a healthcare investment banker that just sold an EHR, practice management
and RCM I think it is really good. A lot of smaller doctor practices don’t
have the ability to schedule online so this could be valuable for them. I
would think about adding a patient facing iPad app so patients can check-in in
the office and something to accept payments.

To respond to other comments, this isn’t an EHR so you probably don’t have to
be HIPAA complaint.

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skwb
Yeah, but there's not exactly a strong trend of more independent non-hospital
affiliated practices springing up creating a huge market [1, 2].

I also sorta doubt that the practices that have a large need for EHR/RCM (i.e.
anyone who takes medicare/private insurance) don't already have a EHR/RCM
solution already that has this functionality built in a la
athenahealth/practice fusion.

[1].
[https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.0130](https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.0130)
[2]. [https://www.fiercehealthcare.com/practices/healthcare-
leader...](https://www.fiercehealthcare.com/practices/healthcare-leaders-look-
at-past-present-and-future-consolidation)

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chrisgd
True, but there is a market. The names you mentioned are moving upstream and
charging a higher price than many independent physicians are willing to spend.
Those names also have a practice management tool but want you to bundle their
EHR. An independent time management platform makes sense to me.

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klinskyc
Welcome to the Practice Management biz!

1) I'm not seeing any mention of HIPAA (or other medical privacy laws)
compliance. Lack of compliance would be a non-starter for basically all
medical professionals.

2) This is wildly cheap, when compared to other EHRs like AthenaHealth or Dr.
Chrono. Part of that makes sense due to the reduced feature set you're
offering, but something to consider.

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mariushn
Thanks :)

> 1) I'm not seeing any mention of HIPAA (or other medical privacy laws)
> compliance. Lack of compliance would be a non-starter for basically all
> medical professionals.

Since this is bootstrapped, I was hoping to get some customers, to be able to
invest in certification. Would you see any path going forward without
certification for now?

> 2) This is wildly cheap, when compared to other EHRs

I was hoping for this to be a differentiator, since this is at beginning. What
would be a better alternative?

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skwb
If I may be blunt, it seems to lack a TON of features any modern practicing
doctor would want. A lot of doctors need the ability to do documentation for
reimbursement, and I don't really see any demonstration that this was taken
seriously.

Given maybe the idea is to only focus on practice management, well you're
certainly then going to want to be able to integrate into major EHR vendors,
and well they probably don't have any incentive to help.

As a person who has a close idea of where the current EHR market is (MS in
health econ and a PhD candidate in health informatics), I'm not convinced that
there's a significant marketshare that hasn't been met by EHR vendors
(allscripts/athenahealth/cerner).

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mariushn
> A lot of doctors need the ability to do documentation for reimbursement, and
> I don't really see any demonstration that this was taken seriously.

Not yet. I'm trying to find some paying customers before investing more.

> you're certainly then going to want to be able to integrate into major EHR
> vendors, and well they probably don't have any incentive to help.

Indeed. I was aiming to evolve into an EHR itself to overcome this.

> I'm not convinced that there's a significant marketshare

Since I have a hard time finding customers, this seems right. How would to
recommend to proceed to carve out a niche in this market?

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skwb
I would say your primary strength right now is that you're clearly skilled in
developing an aesthetically pleasing front end experience, something that EPIC
and other major vendors don't do well (there's an entire PhD thesis to this,
but the tldr is that the vendors primary 'selling point' is to help increase
revenue from reimbursements).

The biggest opportunity area imho are clinical 'apps' using interoperability
standards (HL7/FHIR). While EPIC and CERNER have a lot of functionality, they
don't cover everything (like certain clinical calculators/ better visual
representations of data). There are certainly unmet clinical needs from these
apps, and if you're willing to put in the effort to do more background
research, I'm certain you can find some of these unmet needs. It's admittedly
a very different strategy that you're currently pitching, but I think it's
where there is significant growth for

For further references that are useful: [1].
[https://www.wired.com/2015/04/the-overdose-harm-in-a-
wired-h...](https://www.wired.com/2015/04/the-overdose-harm-in-a-wired-
hospital/) [2]. [https://apporchard.epic.com/](https://apporchard.epic.com/)
[3]. [https://healthtechmagazine.net/article/2018/10/everything-
yo...](https://healthtechmagazine.net/article/2018/10/everything-you-need-
know-about-smart-fhir-perfcon) [4].
[https://apps.smarthealthit.org/](https://apps.smarthealthit.org/)

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mariushn
Thank you! I'll look into this. Appreciate taking the time to list references.

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nickthemagicman
Would this be appropriate for mental health practitioners or is it primarily
for physicians?

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mariushn
Thanks for asking. I've started out with psychology my single customer is a
psychology clinic. However, it's designed to be applicable to any practice,
via dedicated modules, if needed.

How should I proceed to target physicians?

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nickthemagicman
Hi thanks for responding it's a good site.

I was actually inquiring for a friend of mine who's a social worker and has a
small Private practice.

I think a major issue you might encounter is HIPAA type regulations. Medical
practitioners are extremely risk-averse when it comes to patient information.

I didn't see anything on the site about this.

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mariushn
Right. Since this is bootstrapped, I was hoping to get some customers, to be
able to invest in certification. Would you see any path going forward without
certification for now?

~~~
nickthemagicman
I would never give up on any project I was working on. Everything has
challenges, you just need to figure out how to overcome or pivot in some way.

