
MedXT (YC W13) Announces FDA-Cleared Medical Image Platform - brown
http://techcrunch.com/2014/07/15/medxts-platform-brings-medical-imaging-in-line-with-todays-cloud-technology/
======
Agathos
Any suggestion about medical technology startups on HN inevitably brings a
rain of comments (often including one from me) about how the regulatory burden
is too high, getting approval is a job for lawyers not coders, etc. Kudos to
MedXT for doing it anyway.

~~~
akiselev
Sadly most people who complain about regulatory burden know very little about
actual regulations. I can't speak to hospitals (they do a LOT) or medical
records but if you're doing something like running a clinical diagnostics lab,
the "regulatory burden" can be as little as hiring a part time (FDA certified)
lab manager who signs off on internal self-regulatory protocols and HIPAA can
largely be distilled to "KEEP PATIENT DATA SECRET" with sane retention and
security policies.

In my experience, healthcare and medical science are so difficult that the
cost of the regulatory burden is a rounding error when you consider the amount
of due diligence you have to do to make sure you don't badly mess up someone's
life/health.

~~~
VikingCoder
You're confusing the burden of running a practice, with the regulatory burden
of developing a medical device.

The two are completely different.

~~~
akiselev
FDA 510(K) approval for medical devices takes 3-7 years and tens of millions
of dollars for all but the extreme cases (i.e. artificial heart or the new
bionic eye).

If you're making stuff like pacemakers that keep people alive while implanted
in their body, the vast majority of that cost will be unavoidable if you don't
want to risk killing a bunch of people (which is, you know, a thing worth
paying for).

~~~
VikingCoder
And the approval process for changing one line in the polling interval in
version 19.64.101 of a back-end server that converts from one file format to
another file format takes WEEKS.

I'm just pointing out that all of your anecdotal stories were related to
practice, not device development.

~~~
akiselev
Please link me to the regulations that require you to wait weeks for approval
to change a line of code during device development (BEFORE deployment). After
deployment, you need to do a lot of paperwork and testing to change anything,
whether it is a drug, medical device, or clinical test and _for good reason._
You can't just do a git push when you're building a complex system where a
misplaced bit can easily kill someone.

As for my anecdotes, I worked on bringing online robotics and brand new
diagnostic tests (with and without golden standards) which are under entirely
different regulations than record keeping or the day to day operations of a
lab.

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ramoq
Firstly, Great job on launching! Secondly, get ready for the most difficult,
sloth-slow, gut wrenching sales cycles of your life. Any serious ($$) players
looking for software like this take absolutely forever to make decisions on
this. And, if you're workflow-process is even slower by a few seconds compared
to what rad's are currently using, they will shut you down. So please please,
make sure you are absolutely faster, smoother and better then _anything_ else
on the market.

Disclosure: I've worked with some serious venture backed (50MM+) companies
doing almost exactly this. I would love to give you a full heads up on what to
expect. But making excellent scheduling alone is an incredibly difficult feat.
Our team spent considerable time working with the absolutely top imaging
facilities in the US just to get scheduling down to a science.

Go destroy those big guys! (AGFA/Fuji/GE etc)

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dsugarman
I think the major gain here really is getting expert opinion over the
internet. I almost worked on a project in grad school trying to compress 3D
medical datasets compiled from CT scans using marching cubes, so you can
stream these to doctors. I know there is definitely a need, and this solution
looks far superior. Are there any plans for 3D datasets on either the server
or client side? Radiologists can discover plaque in your heart much faster
without sorting through each slide.

~~~
brown
(MedXT CEO here)

Yes, we're currently integrating "The X Toolkit" from Boston Children's:
[http://www.goxtk.com/](http://www.goxtk.com/) It should be ready in
October/November.

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nradov
How is this different from existing PACS applications such as what eHealth
Technologies offers?

[http://www.ehealthtechnologies.com/solutions/health-
informat...](http://www.ehealthtechnologies.com/solutions/health-information-
exchange/image-exchange)

~~~
bilbo0s
It's not... everyone already has this. It's integrated in most PACS... but
it's a WHOLE lot more expensive from the big guys. That said... yeah...
radiologists don't really care about cost... so why you would not just go with
one of the big guys from RSNA... I'm not sure.

We'd need to know a bit more about what this company offers to answer that
question. On its surface... it doesn't look like much more than what other
companies already put out.

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reshmakh
MedXT also has a reddit integration. Read about it here:
[https://medium.com/@reshmakhilnani/marketing-your-boring-
ent...](https://medium.com/@reshmakhilnani/marketing-your-boring-enterprise-
software-on-reddit-9109e0218113)

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acveilleux
3$/study with unlimited HL7 integrations? I'm really curious how that makes
financial sense unless HL7 integrations and their required VPNs are billed
separately or strictly a "on your own" proposition.

~~~
reshmakh
HL7 integrations that are for EHRs that we already support are included at no
additional charge. For example, you can export to PracticeFusion, Athena
Health and DrChrono automatically as part of the base platform and more are
coming. You can also customize your HL7. Some institutions require custom
medical/legal documents or complex integration with multiple on-premise EHRs,
VPN connections and advanced automation etc, and those are billed separately.

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jamra
Is this a plan to bring the health information closer to the patient or is it
just for the hospital to have the data in the cloud?

