
VetPronto (YC W15) Brings Veterinary House Calls to San Francisco - joewaltman
http://techcrunch.com/2015/01/16/vetpronto-brings-veterinary-house-calls-to-san-francisco/
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7Figures2Commas
> “Once I got into the veterinary industry, I noticed there were a lot of gaps
> in technology all the way through,” Hur explains. “And since getting out and
> practicing medicine, I’ve really focused on bridging those gaps and making
> sure that veterinary medicine can be upgraded for the dot-com era.”

This sounds like a lot of fluff. Vets that do house calls are not new. The vet
I use is a full-time mobile vet in the Bay Area and she has been for way
longer than the founder has been practicing veterinary medicine. All of my
furry friend's records are stored electronically so my vet can retrieve them
on her tablet, and she has a mobile credit card reader for payment. She emails
me lab test results and when I needed to be referred to a specialist for
diagnostics that couldn't be done in a home setting, records were transferred
to the specialist within hours.

What doesn't my vet have? A mobile booking app and a network of
independent/subcontracted vets who she refers leads to. I don't care about the
former (email and phone work just fine) and I don't want the latter (I
specifically selected my vet based on her qualifications and references and
continued relying on her based on the quality of service).

There's nothing wrong with VetPronto's model, of course. If the vets provide
good service and customers are satisfied, that's great. But to pretend that
veterinary medicine is behind the times and that a network of mobile vets with
a booking app represents real innovation is silly.

> Since launching in September, the company has done north of 300
> appointments, and recently participated in the Y Combinator startup
> accelerator which offered them a bit of seed funding. But beyond that and a
> small friends and family round, VetPronto has been bootstrapped.

So you can raise six figures in capital from Silicon Valley's most prominent
startup accelerator, as well as friends and family, and still call yourself
"bootstrapped" today?

~~~
brianhur
First of all, thanks for voicing your concerns as it helps hearing from other
pet owners. It makes sense that most people are not aware of what happens
behind the curtain with the medicine their doctors practice.

I am sure your home vet is a great veterinarian and cannot speak to the
quality of medicine they practice as I do not work with them that I am aware
of. However, I can let you know that you don't need to look at me as an
individual to assess the medicine VetPronto practices as almost no medical
decisions are not made by me individually. We actually have a board of
veterinarians meeting weekly to ensure our standards of care are the very best
as peered review practices are generally the gold standard. I do not know the
exact number of years experience combined we have, but it is greater than any
individual veterinarian.

As for the technology. This is a huge discussion but let me see if I can
address this briefly ass to what makes us different than another home vet.
There is a lot of issues regarding the management of pet health care that has
not been worked out. Luckily we don't have the same amount of regulation that
makes it difficult to create software readily, but it is also not a lucrative
business to just make veterinary software. There are also currently no
veterinary practices built around technology that I am aware of either which
means most record systems actually decrease a veterinarians efficiency rather
than improving it and are primarily designed to track billing and inventory.
Our software is being built from the ground up ensuring that it allows vets to
focus on what they do best, practice medicine.

Finally, we only received funds a less than a month ago and haven't even got
our funds from YC yet, so yes...we have very much been bootstrapped although
it is debatable if we still are today.

If I didn't answer your question well enough please let me know or you have
additional questions, please let me know.

~~~
7Figures2Commas
> ...as almost no medical decisions are not made by me individually. We
> actually have a board of veterinarians meeting weekly to ensure our
> standards of care are the very best as peered review practices are generally
> the gold standard. I do not know the exact number of years experience
> combined we have, but it is greater than any individual veterinarian.

I'm not sure what you're trying to say. It's great that you have established
practices for the vets in your network in an effort to ensure a high standard
of care, but what makes you think that other vets don't adopt best practices?
Just because you assemble a team ("board") of vets with, say, 70 years of
combined experience doesn't mean a lot to me. I could pull 10 software
engineers with 40 years of combined experience into a room and it wouldn't
mean that I have access to more expertise than a single engineer with 20 years
of experience.

As for "almost no medical decisions are not made by me individually," this is
confusing to me. Let's say you palpate a dog on a house call and feel a mass.
Are you not going to make certain decisions on the spot? Is _every_ decision
or recommendation a vet in your network makes reviewed by a team whose members
may not have actually had the opportunity to physically evaluate the pet?

> There is a lot of issues regarding the management of pet health care that
> has not been worked out. Luckily we don't have the same amount of regulation
> that makes it difficult to create software readily, but it is also not a
> lucrative business to just make veterinary software. There are also
> currently no veterinary practices built around technology that I am aware of
> either which means most record systems actually decrease a veterinarians
> efficiency rather than improving it and are primarily designed to track
> billing and inventory. Our software is being built from the ground up
> ensuring that it allows vets to focus on what they do best, practice
> medicine.

This is all very non-specific.

Again, I'll use my experience as an example. I have received high-quality,
cost-effective service from my mobile vet. She arrives on time, is responsive
and very cost-effective. In short, she has taken great care of my pet, access
to special software or not. When she identified an issue that demanded the
expertise of a specialist, a referral was made to one of the best specialty
centers in Northern California. All of my pet's records were transferred
within hours.

With all due respect, it is absolutely not true that there are "no veterinary
practices built around technology." The specialty center I was referred to,
which is staffed by board certified vets, makes extensive use of technology.
Is a practice with everything from an on-site CT scan to one of newest linear
accelerators available for radiation therapy in pets not "built around
technology"?

In short, you seem to believe that custom practice management software with a
mobile booking app makes you a technology-based veterinary practice. While I
see nothing wrong with the nature of your service and wish you the best of
luck, I would simply suggest that you're underestimating what the word
"technology" means in modern veterinary medicine. Of course, this "wrap a
mobile app around a service business and call it a technology business"
approach is widespread today and not exclusive to your industry, so anything
that I wrote here which might be construed as criticism applies to many
startups.

Finally, as for "but it is also not a lucrative business to just make
veterinary software," you might want to look at
[http://www.henryschein.com](http://www.henryschein.com), a Fortune 500
company that did hundreds of millions of dollars in sales of dental, medical
and vet practice management software in 2013.

~~~
brianhur
Sorry for the delayed response, I was on a plane. Great follow up questions
though. Let me answer them for you.

> ...as almost no medical decisions are not made by me individually. We
> actually have a board of veterinarians meeting weekly to ensure our
> standards of care are the very best as peered review practices are generally
> the gold standard. I do not know the exact number of years experience
> combined we have, but it is greater than any individual veterinarian. I'm
> not sure what you're trying to say. It's great that you have established
> practices for the vets in your network in an effort to ensure a high
> standard of care,

I'm glad you appreciate that we practice a high standard of care.

>but what makes you think that other vets don't adopt best practices?

I am not individually responsible for other vets and don't make that
assumption. I am just focused on the quality of our own medicine.

>Just because you assemble a team ("board") of vets with, say, 70 years of
combined experience doesn't mean a lot to me. I could pull 10 software
engineers with 40 years of combined experience into a room and it wouldn't
mean that I have access to more expertise than a single engineer with 20 years
of experience.

Good point, but just as paired programming can oftentimes help make a solid
product, peer reviewing cases is a great way to achieve better results than an
individual might be able to.

>As for "almost no medical decisions are not made by me individually," this is
confusing to me. Let's say you palpate a dog on a house call and feel a mass.
Are you not going to make certain decisions on the spot? Is every decision or
recommendation a vet in your network makes reviewed by a team whose members
may not have actually had the opportunity to physically evaluate the pet?

I meant that I don't make the standards of care myself. It is true that vets
must make decisions on their own, and getting rid of human error is something
that has not been accomplished at any clinic human or veterinary medicine .
However, all of our vets are very experienced and excellent clinicians as our
reviews can support this as well.

> There is a lot of issues regarding the management of pet health care that
> has not been worked out. Luckily we don't have the same amount of regulation
> that makes it difficult to create software readily, but it is also not a
> lucrative business to just make veterinary software. There are also
> currently no veterinary practices built around technology that I am aware of
> either which means most record systems actually decrease a veterinarians
> efficiency rather than improving it and are primarily designed to track
> billing and inventory. Our software is being built from the ground up
> ensuring that it allows vets to focus on what they do best, practice
> medicine. >This is all very non-specific. Again, I'll use my experience as
> an example. I have received high-quality, cost-effective service from my
> mobile vet. She arrives on time, is responsive and very cost-effective. In
> short, she has taken great care of my pet, access to special software or
> not. When she identified an issue that demanded the expertise of a
> specialist, a referral was made to one of the best specialty centers in
> Northern California. All of my pet's records were transferred within hours.

I think I would agree with Joe's previous comment addressed this pretty well,
but please let me know if it needs more elaboration.

>With all due respect, it is absolutely not true that there are "no veterinary
practices built around technology." The specialty center I was referred to,
which is staffed by board certified vets, makes extensive use of technology.
Is a practice with everything from an on-site CT scan to one of newest linear
accelerators available for radiation therapy in pets not "built around
technology"?

This sounds like a very technologically advanced clinic and I don't know what
software they run so can't really give specifics on what may or may not be
great about their systems.

However, I am fairly passionate about medical records in general so will dig
in a bit. Unfortunatley these days, picking veterinary practice management
software gives you the options of bad or worse so am skeptical of any third
parties assumption that any clinic is built on a great platform. This is a
problem I tried to solve directly initially in and out of vet school, but
veterinary clinicians generally do not care about having great technology
drive their practice as they were trained to practice medicine and view the
computers as getting in the way of that. Unless they see direct results to
their profit right away They are not interested in adopting new technologies.
This is why most practice management software just focuses on inventory. Many
practices are still largely paper based even if they have a practice
management software solution.

This is slowly changing though. I've been active with the Association of
Veterinary Informatics, performed collaborative research between human and
veterinary medicine on natural language processing of medical records with
amount Sinai and worked with Trupanion pet insurance in trying to pull
meaningful data from clinics trying to find ways to solve this.

I hope VetPronto can eventually help define some of the medical record
standards to help more seamless integration occur between practices, but for
now we are focused on delivering a great service to as many pets as possible.

>In short, you seem to believe that custom practice management software with a
mobile booking app makes you a technology-based veterinary practice. While I
see nothing wrong with the nature of your service and wish you the best of
luck, I would simply suggest that you're underestimating what the word
"technology" means in modern veterinary medicine. Of course, this "wrap a
mobile app around a service business and call it a technology business"
approach is widespread today and not exclusive to your industry, so anything
that I wrote here which might be construed as criticism applies to many
startups.

I am a bit confused with this. Is a veterinary specialty center your
definition of a technology based veterinary practice? If so, I think I
answered this but please let me know.

>Finally, for "but it is also not a lucrative business to just make veterinary
software," you might want to look at
[http://www.henryschein.com](http://www.henryschein.com), a Fortune 500
company that did hundreds of millions of dollars in sales of dental, medical
and vet practice management software in 2013.

Henry Schien is a drug distributor that bought out one of the largest practice
management software services (AVImark) to sell more product to clients and get
their foot in the door of more clinics. AVIMark was likely easy to buyout
because making practice management software because it wasn't very lucrative.
I can't speak for the other markets and practice management software outside
of veterinary medicine.

------
brianhur
I am very excited to have the amazing YC partners to help us bring the best
care possible to pets.

------
koji
Haven't looked at the app myself, but was curious to know if providing vet
feedback was available? Can specific vets be requested to build a repertoire
with your pet?

~~~
joewaltman
Yes. Right now, this is done informally....but we definitely have plans to
provide more structured vet request and feedback systems.

------
sorenberg
I'm very excited to be officially launched as a YC company!

