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Overview of Online Healthcare Communities

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Healthcare Communities

If you have not seen the statistics yet, a quick preview:

1. US spends almost 16% of its GDP on healthcare – $2 Trillion. This equates to approximately $6697 per person. No other country spends more.
2. Over 56% of us insured are covered by employer sponsored plans, about 30% by Medicare, Medicaid and SCHIP. The rest (14%) are insured.
3. Healthcare costs have been increasing 2.5% more than US GDP and more than double the rate of inflation over the last 30+ years.
4. Spending on drugs (prescription) is about 10% of the total spend.

There are 5 major constituents in the healthcare “space” – Patients, Providers (Physicians, Nurses, etc.), Payers (Insurance providers), Government & Pharma/Biotech/Drug companies. There are several others (Employers, etc., but the 5 major ones influence it to a large extent.

The major trend is towards “consumerization” of healthcare – providing and arming patients with more information at their fingertips so they can make better choices. Hence online communities (where patients, doctors, etc.) can connect and get information quickly so they can make decisions or get second opinions.

Over the next few weeks I will have a series of posts on the healthcare community space, but here are the companies I am reviewing.

There are several (about 50) broad and niche sites focusing on several disciplines or diseases so its going to be difficult to categorize them. For policy information I recommend the Healthcare Blog. Others talking about it more eloquently than I do are Paul Krugman and also do visit the Kaiser Foundation.

Here’s the list of communities that I have reviewed. There are several more for sure, but I am looking at comScore and other metrics to get a sense for the ones with traction / traffic before I dig deeper.

  1. WebMD
  2. Medhelp.ORG
  3. SteadyHealth
  4. HealthyPlace
  5. Revolution
    Health
  6. Health
    Talk
  7. Health Line
  8. Health
    Board
  9. Health
    Vault (Microsoft)
  10. My Self
    Help
  11. Healthy Circles
  12. Kryptiq
  13. Pure Wellness
  14. Sound Health
    Solutions
  15. US
    Wellness
  16. American
    Heart Association
  17. Cap Med
  18. Daily
    Strength
  19. Zoc Doc
  20. Patients
    Like Me
  21. I C You
  22. Organized
    Wisdom
  23. Relief in
    Site
  24. Nurses
    Rate Doctors
  25. Health Tools Online
  26. M D
    Junction
  27. Gimme20
  28. Psych Central
  29. Hesperian
  30. My Health
    Gate
  31. Health
    Grades
  32. Patients
    are powerful
  33. iVillage Your Total Health
  34. Health
    Central
  35. Vimo
  36. Healthline
  37. TauMed
  38. Wegohealth
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Creating Artificial Constraints as a Means to Innovation

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Artificial Constraints

Many of the entrepreneurs I know have created new innovative startups thanks to real constraints they had. For example, I was hearing AirBnB’s Brian Chesky, on the Corner Office podcast and he mentioned that when he and his cofounder were trying to get some money to get started and the only way to keep afloat was to “rent” their air bed they had in their room. That, then led to Air Bed and Breakfast, which is now AirBnB.

This was a real constraint they had – no money to “eat” so they had to make it happen somehow.

I have heard of many stories of innovation where in the protagonists had real constraints of either financial, technology, supply, demand, economic, social or any number of other characteristics.

The interesting story that I have also recently heard of how Facebook has “pivoted” from being a desktop offering to getting a significant part of their revenue from mobile is how they were given the arbitrary constraint of only accessing Facebook via the mobile phone.

So there are ways that you can create “artificial” constraints to force innovation to happen.

Most larger companies and some smaller ones as well, have to constantly find ways to create artificial constraints – to find a way to innovate and be more be a pioneer.

While some constraints are good – lack of funds at the early stage for example and lack of resources, there are entrepreneurs that are stymied by these constraints and those that will find  a way to seek a path to go forward.

I think this is a great way for you to think about innovating in a new space. If you have constraints, find a way to use it to your advantage.

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The Great Mobile App Migration of March 2020

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Mobile App Migration

Over the last few weeks as many in the world have been in lockdown, there has been a temporary “mobile app migration” happening. There are new apps downloaded and they replaced existing apps on the “home screen”.

While some of these apps are likely temporary use, for e.g. I have 6 “conferencing apps” – Zoom, Uber Conference, Webex, Google Hangouts, Blue Jeans and Goto Meeting. That is because of the many people I have conference calls with – each company seems to have chosen a different web conference solution.

Other apps seem like they will have staying power – Houseparty, for e.g. which has games, networking and video conferencing all built into one app to keep in touch with friends and relatives.

Houseparty

The apps that have moved away from my “home” screen, which I expect will come back once the crisis will be behind us include – Uber, Lyft and all the airline apps from Delta, Alaska and United.

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Perseverance with the Ability to Pivot on Data: 21 Traits We Look for in Entrepreneurs

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Perseverance with the Ability to Pivot

There are 5 key inflection points I have noticed which makes founders question their startup, to either make a call to continue working on their startup, pivot to a new problem or quit their startup altogether.

It is at these points that you really get to know the startup founder and their hunger and drive to be successful. I don’t think I can characterize those that choose to quit as “losers” or “quitters” because of many extraneous circumstances, but there is a lot of value that most investors see in entrepreneurs who face an uphill part of their journey to come out on the other side more confident and stronger.

These five inflection points are:

  1. When you have to get the first customers to use and pay for the product you have built after you have “shipped” an alpha / beta / first version. Entrepreneurs quit because they have not found the product-market-fit – because the customer don’t care about the product, there is no market need, or the product is really poorly built, or a host of other reasons.
  2. When you have to start to raise the first external round of financing from people you are not familiar with at all. Entrepreneurs quit because while it is hard to get customers and hire people, it is much more harder to get a smaller set of investors to part with their money, if you do not have “traction”, or “the right management team” or a “killer product”.
  3. When you have to push to break even (financially) and sustain the company to path of being self sufficient. Entrepreneurs quit at this stage because they have now the ability to do multiple things at the same time – grow revenues and manage costs, and many of them like to do one but realize it is hard to do that without affecting the other. So, rather than feel stuck they decide to quit.
  4. When you have to scale and grow faster that the competition – which might mean to hire faster, to get more customers, to drive more sales, or to completely rethink their problem statement and devise new ways to grow faster. Entrepreneurs quit at this point because they are consumed by the magnitude of the problem. They overassess the impact the competition will have on their company, give them too much credit or focus way too much on the competitors, thereby driving their company to the ground.
  5. At any point in the journey, when the founders lose the passion, vision or the drive to succeed. Entrepreneurs quit a these points because they have challenges with their co founder, they don’t agree with the direction they have to take, or encounter the “grass is greener on the other side” syndrome.

While I have observed many entrepreneurs at these stages at  discrete points in time, I have also had the opportunity to observe some entrepreneurs in the continuum, and I am going to give you my observations on 3 of the many folks I have known, who, have quit.

Perseverance separates great entrepreneurs from good ones
Perseverance separates great entrepreneurs from good ones

One went back to college to finish his MBA after getting a running business to a point of near breakeven, another found the business much harder than he originally thought he would and got a job at a larger company and the third was just unable to have the drive to go past 11 “no’s”‘ from angel investors.

Over the last 8 years, if I look at my deeper interactions with over 90 entrepreneurs, who I would have spent at least 100+ hours each, I would say that of the 24 people that are not longer in their startup, the one thing that stands out among the ones that persevere is that it is not “passion” or “vision” at all.

It is the inherent belief that they are solving a problem that they believe is their “calling”. They also don’t believe that there is any other problem that’s worth solving as much, even though there may be easier ways to make money.

So most of my questions of entrepreneurs to test whether they will pivot or quit are around why they want to solve this problem (which I am looking to see if they know enough about in the first place) versus any other one.

The answer to that question is the best indicator I have found to be the difference between the pivots, the leavers and the rest.

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