
Launch HN: Medumo (YC W18) prepares patients for surgeries - adeelyang
Hi HN! We are building enterprise software that prepares patients for surgeries (<a href="http:&#x2F;&#x2F;www.medumo.com" rel="nofollow">http:&#x2F;&#x2F;www.medumo.com</a>). Millions of patients go through these things every year. The problem is that patient instructions are provided months in advance, in the form of paper handouts or verbal instructions that are easily forgotten. As physicians, we saw firsthand how poor patient experience can impact hospital operations and surgical outcome. For example, when patients forget to stop medications that can cause bleeding, the surgeries have to be cancelled last minute which is costly. Or worse, poorly prepared patients get the surgery and have avoidable complications.<p>Our team came together to solve this problem with patient navigation software that gives turn-by-turn instructions, reminders, and educational material through friendly, accessible medium (SMS&#x2F;email) to deliver the best experience and surgical outcome.<p>Unfortunately, health systems are notorious for moving slowly, so introducing a new digital platform can be challenging and slow. We are overcoming this by starting with simple use cases like colonoscopy, proving our value quickly and expanding to other areas. Another challenge is that patients respond differently to instructions; so instead of taking a one-size-fits-all approach, we are constantly varying instructions and A&#x2F;B testing patient behavior to improve outcomes.<p>12 hospitals use our software to date. We have demonstrated improvement in show rate and procedure preparation quality. Here’s an example: <a href="https:&#x2F;&#x2F;bwhbulletin.org&#x2F;2018&#x2F;02&#x2F;01&#x2F;endoscopy-center-sees-success-with-text-message-reminder-system&#x2F;" rel="nofollow">https:&#x2F;&#x2F;bwhbulletin.org&#x2F;2018&#x2F;02&#x2F;01&#x2F;endoscopy-center-sees-suc...</a><p>We know HN has a lot of people who have experience building or selling software to hospitals and faced tough obstacles with the scars to prove it. We&#x27;d love to hear your thoughts around hospital enterprise sales, pilot design, patient engagement, and anything else that you&#x27;ve seen come up on your journey!
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z3ugma
The #1 takeaway I have from my time watching small companies try to integrate
into big EMRs in surgery areas is to find a physician champion. Convince one
physician who will make it happen. Periop and procedural areas are run like an
assembly line and are more rigidly opposed to change in their workflows and
processes than a lot of the rest of the hospital. As a small company, your
biggest obstacle will be to convince the hospital IT shop that you're worth
the trouble and security risk. The best way to do that is to convince the
customer of the hospital IT department - i.e. the physician champion.

A company I think has a great strategy for this is Redox, have a look at their
strategy kit: [https://www.redoxengine.com/blog/integration-strategy-
kit](https://www.redoxengine.com/blog/integration-strategy-kit) They've got a
great blog too:
[https://www.redoxengine.com/blog](https://www.redoxengine.com/blog)

I'd be thrilled to have a chat with you about your implementation strategy.

~~~
adeelyang
Thanks for the very "heart felt" advice. The hospitals that we have traction
all have great champions. Coincidentally we are working with Redox on a few
deployment already. I'd love to chat with you more. What's the best way to
connect?

~~~
dr_
Although having a great champion is important, I’m not so sure if that person
necessarily has to be a physician at the hospital. Dave Chase touches on this
briefly here (I don’t necessarily agree with the title of the article):
[http://hitconsultant.net/2017/03/30/new-walking-dead-
digital...](http://hitconsultant.net/2017/03/30/new-walking-dead-digital-
health-startups-meeting-maker/)

Just as you are working with colonoscopy centers, working with large medical
groups that do a lot of their procedures through surgical centers (pain
management, basic ortho stuff), would be a good way to start before working
into hospital systems.

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DoreenMichele
_HIPAA Compliant

Rigorous 3rd party security and compliance validation._

I worked for a large insurance company for over 5 years. You say you currently
have 12 hospitals as clients. My experience in insurance suggests that if you
expand your business to include smaller facilities, you will find that small
offices can vary a lot in their understanding of things like HIPAA. This can
de facto result in more burden on you to make sure compliance actually
happens.

​Somewhat random thought: I bet you could expand this service to provide
support for people who are elderly and/or chronically ill.

There is a huge market for tech to help seniors maintain their independence by
making sure they are safe etc while living alone in spite of declining
abilities. People who are chronically ill sometimes express the wish that an
app or service might help them stay on track with taking meds etc. Chronic
conditions that are well controlled can mean a mostly normal life. But things
can spin badly out of control quite rapidly because of a single missed dose of
medication.

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tincholio
In Finland this is already happening. This app is being used (and it is
actually very useful, too): [https://www.buddyhealthcare.com/news/supporting-
pediatric-su...](https://www.buddyhealthcare.com/news/supporting-pediatric-
surgery-patients/)

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madamelic
Wow, this is actually something useful.

This isn't another "Uber for X" or "AirBnB for Y". I can't wait for you all to
get huge and for this to succeed just for the fact this idea is so simple +
pure but has such huge promise.

~~~
walshemj
Interesting I have had 3 surgeries (two abdomen and one transplant) in the
last year in the UK and they used paper based systems and verbal instructions
for the two planed ones.

The NHS still runs on paper :-) still cant do my regular bloods at my local
ahead of my regular check up at another specialist hospital.

~~~
adeelyang
We'd love to explore the UK but have no clue what's the best way in. Any
suggestion?

~~~
DoreenMichele
Perhaps not obvious, but you can expect to need to do localization:
[https://news.ycombinator.com/item?id=16333599](https://news.ycombinator.com/item?id=16333599)

That might be a place to start, with translation and localization of
instructions.

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dwelch
As a medical student with an interest in software, this is great to see. A
great solution to a costly problem that is likely underestimated by most. As I
spend more time "on the ground" in the healthcare system, I see more of these
practical problems that have very real consequences, with outdated pseudo-
solutions. I'm excited by the prospect of emerging solutions like this.

~~~
orb_yt
I'm interested in hearing your thoughts on the current state of healthcare
software.

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shantanubala
I'm not a doctor, but I know Adeel (the doctor who wrote this post), and can't
say enough positive things.

More often than not, doctors use printed pages to give instructions, and those
pages subsequently get thrown in my trash can. As an occasional patient, I
want my doctors on Medumo.

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gingerlime
Congrats on the launch. We're[0] in the medical education space and it's
always good to see more being done in this space. We're not targeting
patients, but rather students.

We'd love to collaborate and support you guys with anatomical illustrations or
other content that can help patients understand their procedures or medical
conditions (We cover Anatomy, Histology and Medical Imaging. Although we don't
yet cover much in terms of pathologies, but healthy anatomy). We know how hard
it can be to license accurate and high quality content in this field. Feel
free to reach out to us (you can email me directly, details in my profile, or
via our website).

[0] www.kenhub.com

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jknz
I am wondering if insurance companies would be interested to pay for this as
well.

For surgeries that need pre-authorization from the insurance, the insurance
has enough information about the upcoming surgery to use your services and
prevent avoidable complications. (Insurance companies don't like to pay for
avoidable complications!)

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abrichr
Hi Adeel, congratulations on launching! I'm curious, how is Medumo different
from SeamlessMD?

