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    Date submitted
  • 20-Sep-2016

Better On Call

Abstract

Better On Call is a pioneer in digital services for the healthcare industry to facilitate decentralized care. Our vision for the company is to implement logistics optimization, intelligent scheduling software, and meaningful use verification software to enable quality care in the comfort of a patient’s home.

Video

Original Vimeo URL: Open

Introduction Video

Additional Questions

Who is your customer?

Better On Call is dynamically pursuing hospitals and large clinics with our software solution, as well as a direct-to-patient model which involves utilizing our software in conjunction with employed physicians to make direct primary house calls.

What problem does this idea/product solve or what market need does it serve?

For our hospital/clinic model, we will not be supplying healthcare workers, only software support and customization. For the hospital market, we are specifically targeting programs that take care of medicare patients who are either homebound or found to be at high risk for hospital admission or readmission. According to Centers for Medicare and Medicaid services there are 58 million Medicare beneficiaries in the U.S. accounting for $700 billion in expenditures. About 50% of the Medicare budget is spent on around 5% of Medicare patients. Nationwide, there is an overuse of inpatient hospital and emergency department services and preventable hospitalizations and readmissions. The Affordable Care Act implemented penalties and incentives for hospitals to reduce costly readmissions, valued at $17 billion per year. Medicare’s Independence at Home Program, which is a pilot program to incentivize hospitals to perform medical house visits, demonstrated savings of over $1,000 per beneficiary in their pilot programs. We plan to start our validation strategy with partnerships we are working on with Banner University Medical Center Tucson, Southern Arizona VA Health Care System. In parallel, we will deploy our direct-to-patient model, improving on our current minimum viable product, and validating our pricing strategy. We look to partner with insurance companies as we are not yet accepting insurance, and extend our coverage potentially by charging a house call premium on top of the copay that patients have today. Arizona’s primary care industry is worth $36.2 billion. Our experiments prove that we can convert a portion of the 9% of patients who pay for their expenses out-of-pocket to download our app and receive care from home. We calculate our total available market in Arizona to be $2.7 billion.

What attributes will make this idea/product successful? Why do you believe that those features will create success?

Our business model leverages comprehensive and longitudinal services for the purpose of providing more convenient and personalized medicine. We aim to optimize hospitals/clinics’ homecare programs so they can decrease costs spent per beneficiary, but also deliver care to more patients in a timely fashion than ever before. Our goal is to double currently realized costs savings seen in house call programs from an average of about $1,000 in savings seen in pilot programs to $2,000 per beneficiary. Our other goal is to increase the number of visits that can be made by a healthcare worker by 20%. Better On Call’s aligned plan of care, which involves nurses, pharmacists, physicians, social workers, and other health care workers can collect information from disparate health and non-health sources. We aim to offer a logistics and scheduling solution for larger institutions with nascent house call programs. A key component that we plan on building into our software is fraud prevention for medicare. By leveraging our app and GPS location, we know when a healthcare worker arrives and leaves a house and thus can more accurately bill medicare. We also plan to build in safety and quality metrics that aim to prevent drug adverse events, opiate abuse, and medication errors. We plan on integrating our system with existing electronic health record systems like Epic and Cerner two of the nation's most used programs. An optimized software solutions can also reduce patient backlog at VA hospitals and provide faster and more cost effective post-hospital care. We are creating predictive analytics to provide optimized services to reduce idle time and waste by creating a dynamic and smart roster, and thus helping to reduce operating costs and match patients with their preferred healthcare provider that will come to their home.

Explain how you (your team) will execute to make this idea/product successful? What gives you (your team) an advantage over others already in the market or new to this market?

A house call visit may draw upon the resources of many services provided by different companies. There are regional mobile house call companies, like Pager.com and GetHeal.com, who sell the traditional house call service and leverage technology for patients to use them when they want, wherever they are. Regional house call competitors price their services at promotional prices of $50-200 per visit and some accept insurance. Smaller competitors such as direct primary care physicians or concierge doctors see patients at home, but do not have the technical capability of automating and optimizing their operations at scale. They charge between $350-600 per month on a subscription model. There are also companies that provide ancillary services for lab work, radiography or mobility services that can taxi a patient to a healthcare provider. Software companies that specialize in navigation, billing, analytics, telemedicine, electronic health records, electronic prescriptions, or scheduling each provide a small piece of the puzzle, but don’t exactly offer the specialized suite of services that larger institutions like hospitals require for housecalls. Better On Call is competitive because our model of care integrates physical house calls, telemedicine and cloud based computing to reduce overhead costs so that a physician can work for themselves, in a medical group, or at the hospital level. We will sell our software as a service and charge for support, maintenance, and EHR integration. We assist in optimizing logistics and coordinated care of patients using state-of-the-art technology to achieve better health outcomes, lower costs, increase patient safety and reduce fraud. Better On Call will implement intelligent billing protocols that incorporate duration of the visit verified by GPS tracking and will output an appropriate ICD-10 intervention diagnosis for billing. We have been tracking the Geographic Information Systems industry and are implementing their advances in servicing real-time queries that can be translated to the medical world. We want to use Artificial Intelligence to automate our triage systems to determine appropriate responses to acuity and incorporate patient history; have sensors and wearables talk with our systems for improving chronic and geriatric care; and finally use house call environments to collect relevant bioinformatics data, crunch them using supercomputing like Watson Health Insights, and measure appropriate outcomes that can correlate or cross diagnose in superior methods that physicians use today.