Here's an engaging and thought provoking presentation from @Berci about how social media tools like Twitter might be used to facilitate communication between patients and physicians.

 

http://www.shockmd.com/2009/01/23/twitter-and-doctors/

Here's the first in a series of posts about how Aperial is changing its business focus from supporting capital intensive interactive patient television networks to planning and buiding interactive social media networks for healthcare organizations. Specifically, we decided to start by publishing our business plan for PatientCast (working name, .org domain was available cheap, better name ideas welcomed) and ask the rapidly growing healthcare social media community to give us suggestions, scathing criticism, ideas and feedback. Using an open social network to get help with our PatientCast business plan may seem a bit strange. We certainly had moments of hesitation over the sharing the idea. In the end, we decided that sharing and starting conversations about the PatientCast business plan will ultimately lead to a better result.

So we're ready to try eating our own social media dog food. We've also published the PatientCast business plan summary as a comment in response to Mark Cuban's Stimulus Plan-Open Source Funding.

We're open to publishing the PatientCast business plan in relevant technology, healthcare and funding social networks. Suggestions? Leave a comment.

The PatientCast Business Plan summary appears below. You can create a login account and try PatientCast here: http://patientcast.org (this is an alpha stage demo, expect bugs, no investment in design, we are not designers.) Use the Feedback tab in the PatientCast.org demo to share your ideas. You will arrive at a generic example of how a physician practice or provider (hospital) might adapt PatientCast to its brand, services and patient community. Log-in to see what a patient might experience.

PatientCast Business Plan Summary

PatientCast: Delivering personalized ePatient relationships and conversations with physicians, practices, providers and payers. Helping providers and practices meet admission, pay mix and utilization marketing objectives.

PatientCast is a self-funded startup that has created an open source (Drupal), white label, cloud-based-pay-as used (Amazon Web Services) online service designed to accelerate ePatient collaboration and conversations with physicians, practices, providers and payers in a non-regulatory context. PatientCast drives and simplifies ePatient use (vs. clinician/organization use) of complex healthcare information technology (EHR/PHR) that saves lives and reduces healthcare costs by facilitating patient behavior change (e.g. diet/obesity) through patient education and adherence to medical advice/medication instructions.

PatientCast makes money through traditional year-to-year open source support, integration and customization service contracts (not license fees) paid by practices, providers and payers. (Affiliate store or advertising options are supported in the PatientCast content mgmt. system to provide incremental revenue options for subscribing practices, providers and payers but ad/affiliate revenues are *not* part of the PatientCast business plan/cash flow model.) PatientCast is based on Drupal, one of the world's largest open source communities.

PatientCast delivers value to healthcare organizations by aggregating and redirecting the fast growing ePatient healthcare search traffic to provider branded, personalized ePatient web pages without requiring new infrastructure or resources. PatientCast is a competitive answer for healthcare providers who are losing the healthcare search traffic battle to entrenched, well funded search engine optimization and search marketing campaigns of generic healthcare information/ad driven services like WebMD.

PatientCast is a logical ePatient add-on for providers that are planning to implement, implementing or have implemented complex and expensive EHR systems (typically $50K per physician in one-time costs) that are designed to meet government mandated standards, interoperability, privacy, security and certification standards. PatientCast is an affordable patient-centric jump-start ePatient relationship, referral and elective care marketing option for healthcare providers. PatientCast costs less for a year than a typical healthcare provider spends on one print, radio or television advertisment.

The PatientCast founders are experienced planners and builders of interactive networks involving healthcare organizations. One founder is focused on technology and product delivery. The other is focused on business development, marketing and sales. The founders are performing all the work on PatientCast.
There is formidable competition from the generic healthcare information sites like WebMD who have locked down search engine related traffic by controlling key words and are getting benefit from explosive growth in consumer use of the internet for finding healthcare information. PatientCast is designed to create a highly personalized, context sensitive online relationship between ePatients and current or prospective physicians, care teams, labs, hospitals and pharmacies based on starting a basic conversation about the healthcare concerns facing the ePatient. PatientCast sees future healthcare relationships amongst patients and providers being based on a "The Patient Will See You Now" premise.

PatientCast is designed to:

- compliment and grow traffic and loyalty for existing healthcare provider and practice web sites through branding, co-branding and domain names

- provide a common destination/portal for the growing list of secure online healthcare logins (EHR, PHR) that patients are required to remember for labs, pharmacies, primary care, acute care and medical records

- create an ePatient relationship bridge for healthcare providers and practices that are actively developing relationships through third-party social networks like Facebook, YouTube and Twitter.

One PatientCast Subscriber/One Full Year (Annualized) Business Proforma

How PatientCast Makes Money - EBITDA & Cash Flow (CF) Positive

Price: $24K/year prepaid or quarterly subscription (hosting fees billed direct by AWS)

COGs: 4K/year - CSS services/Support/Training/3rd pty support

Margin: 20K/year

R&D: 6K - Create/Customize Subcriber PatientCasts (my partner)

S&M: 6K - Sell/Sign/Renew Subscribers (me)

G&A: 3K - Home offices,svcs,travel,legal/acctg

EBITDA: 5KITDA: .5K - What we cannot expense

CapEx: .5K - Multiple monitors, anything that accelerates growth

NetCF: 4K

Really Simple 3/6 month and 1/2/3 year Scenarios Used to Establish Valuation

+3 months: 3 Subscribers/$36K revenue annualized/

+6 months: 6 Subscribers/$72K revenue annualized/+12K CF/$120K valuation @ 10x

+1 year: 12 Subscribers/$288K revenue annualized/+$45K CF/$450K valuation @10x

+2 year: 25 Subscribers/$600K revenue annualized/+100K CF/$1M valuation @ 10x

+3 years:50 Subscribers $1.2M revenue annualized/+$200K CF/$2M valuation @ 10x

Sources/Uses of Investor Cash & Equity/Ownership

Sources

Capital: $105K - equity or convertible debt with pricing/timing for ~20% ownership based on + Year 1 forward valuation, $15K assigned to working capital, balance disbursed over 6 months as milestones met, Investor liquidity options via cash on cash owner distributions (very old fashioned, we know), merger or acquisition.

Uses of Investor Cash for One Time Startup Expenses over 12 months

COGs: $3K/month - $18K/total

R&D: $5K/month - $30K/total

S&M: $5K/month - $30K/total

G&A: $2K/month - $12K/total

Working Capital - $15K/total

Month 1 (or Month 0 if you prefer)

Start Cash: $15K - Working capital

Cash Sources:

-Investor: +$15K - Disbursed against milestones-

Revenue: 0K

Cash Uses:

-Startup: -$15K - Make demo rock solid/clean up design/expand testing/marketing

End Cash: $15K

Month 2

Start Cash: $15K

Cash Sources:

-Investor: +$15K - Disbursed against milestones

-Revenue: $24K (first customer prepays 1 year)

Cash Uses:

-Startup: -$15K - Make demo rock solid/clean up design/expand testing/marketing

-Ops/COG: -$ 8K Pay third party for premium 24/7 Drupal support

End Cash: $31K

Month 3

Start Cash: $31K

Cash Sources:

-Investor: +$15K Disbursed against milestones

-Revenue: $24K (second customer prepays 1 year)

Cash Uses:

-Startup: -$15K Expand promotion/marketing

-COG/Ops: -$20K

End Cash: +$35K

Months 4 to 12:

Start Cash: $35K

Cash Sources:-Investor: +$45K

-Revenue: +170K (10 new customers, 5 prepay)

Cash Uses:

-Startup: -$0K

-COG/Ops: -$171K

End Cash: $76K

Other Stuff: We have slideware, spreadsheets and addressable market sizing information about PatientCast. Ask. We're not sitting around waiting for funding or feedback. PatientCast is evolving every day based on feedback from technology, healthcare and open source social communities and prospective customers. PatientCast is being built with Drupal6 on local, traditionally hosted and cloud hosted machines, including Amazon Web Services.

The current business and economic situation requires us to take a hard look at our many successes and relatively few failures over the last 3 years. We also see new service and product opportunities emerging in healthcare, performing arts and consumer electronics segments. In the days and weeks to come, we're going to refocus our marketing and professional services on these three segments.

The direct financial benefit to physicians for investing in Electronic Health Records technology and systems remains elusive but the patient/care provider benefits are increasingly clear.

Here's an excerpt from the article:

"A new study in the American Journal of Managed Care tries to substantiate some benefits, noting that patients are more compliant with care when they have PHRs, and doctors are better kept abreast of treatment changes.

Physicians working for ActiveHealth Management, a unit of Aetna, focused on alerts generated by changing readings which were sent to both doctors and patients.

When “2 messages are coordinated to reinforce each another,” the study concluded, compliance improved 12.5%, the quality of care improved, and the doctor-patient relationship was improved as well."