The problem we solve: Between patient no-shows and cancellations on the day of surgery, hospitals are losing $24B in revenue each year. Nationwide, 12% of canceled surgeries are due to patients not following required preparation prior to surgery. The cost of cancellation varies with specialty, for example, neurosurgery and urology incur the highest loss per case-$5,962 and $4,758, respectively. Researchers at Tulane University Medical Center found that in 2009, 327 of 4,876 (6.7%) scheduled elective outpatient surgeries were canceled, costing the hospital nearly $1 million that year alone. Because surgeries bring in approximately 60% of the hospital’s entire revenue, that loss has a major effect on the bottom line. Moreover, readmissions are costly to the hospitals and frustrating to the patients. Researchers found nearly one in four patients readmitted within 90 days at a cost of $300 million a year.
About our solution: MedAux standardizes preoperative and post-operative follow-ups through automated SMS. An EHR/EMR compatible solution, MedAux interacts with patients through SMS/Text Message, guiding them through various stages of care while striving to provide real-time, clinical data to surgical providers, with zero workflow interruption. We work with hospitals and ambulatory surgery clinics to design custom follow-up programs to match their current protocols. When the patient is registered for the surgery, s/he will receive series of precisely timed bite-size instructions through automated text message with a link to an additional web application. The contents of the text messages are short videos, surveys, or reminders that help patients prepare and be on track for their surgery. MedAux provides a practical solution to optimize patient health preoperatively, accelerate postoperative recovery, and monitor at-risk patients post discharge.
Progress to date:We launch our product less than a year ago, and now we have trials with 8 major hospitals in the U.S. with $1.3M inside letter of intent.
We entered the U.S mark with programs in prostatectomy, bladder cancer, kidney stone, penal implant, colonoscopy, and vascular surgery.
We are working with major healthcare organizations such as UCSD, Johns Hopkins, UCLA, and the University of Buffalo. Also, 12 hospitals and ambulatory surgery clinics are in our pipeline and have accepted to start a trial with MedAux platform.
Creator: Elnaz Sarabchian
Location: California
Education: Hofstra University
Bio: Elnaz Sarabchian, CEO & co-founder at MedAux is a doctorate of education from Hofstra University. She started MedAux company with her husband, Behzad Jazayeri, MD. Her passion is to solve problems by using technology and innovation. Elnaz is the previous founder at ReLinking, an application for Iran's medical student research market, that was acquired by Tehran University of Medical Sciences in 2015.
Hospital Affiliation: Kaiser Healthcare System
Title: CEO
Behzad Jazayeri
Doctor, MD
Biography: Behzad Jazayeri is a surgery resident at Kaiser Fontana program and Chief Medical Officer at MedAux Inc. He earned his MD at Tehran University of Medical Sciences in 2013. Behzad’s passion is healthcare innovation, quality of life improvement, and personalized care. He has been selected as the top research award winner by AOSpine international community of spine surgeons in 2015. In United States Medical License Examinations, Behzad scored among the top 10%.
He has published two books, and more than 40 articles in peer-reviewed journals including Urologic Oncology, European Journal of Spine, Cancer Epidemiology, Neuroepidemiology, Urology (Golden Journal).
Title: Doctor
Advanced Degree(s): MD
Twitter:
@behjaz
LinkedIn:
https://www.linkedin.com/in/behzad-jazayeri-70053460/
Ali Alavi
CTO, Ph.D.
Biography: Ali Alavi is a Ph.D. in computer science, previous founder at Touchtect company, and advisor of numerous European startups. He has more than 14 years of experience in machine learning & product development.
Title: CTO
Advanced Degree(s): Ph.D.
LinkedIn:
https://www.linkedin.com/in/alialavia/
MedAux Inc.
Location: 10 Times Square
Apt 26208
New York, NY 10018
Founded: 2017
Website: https://www.medaux.com
Twitter: @askmedaux
Product Stage: In the Market
YTD Sales: Working on it
Employees: 3-5
MedAux helps patients to be on track for their surgeries from preparation till recovery post-procedure, that leads to optimizing health outcomes and reducing post-discharge complications.
MedAux Platform:
Significantly reduces surgery late cancellations:
Enhances revenue opportunities
Lowers liability risk
Documents delivery of protocols from scheduling through to post-operative/procedure care
Significantly reduces readmission
Standardizing preoperative and post-operative communication
Better health outcomes
Increase in patient compliance
Increases in patient satisfaction levels, resulting in higher HCAHPS scores for MedAux clients
Provides hospitals and surgical centers with a turnkey solution to:
Complex protocol communication
Monitoring patient compliance
Bridge clinical and research workflows by collecting valid data from patients
MedAux Platform:
Significantly reduces surgery late cancellations:
Enhances revenue opportunities
Lowers liability risk
Documents delivery of protocols from scheduling through to post-operative/procedure care
Significantly reduces readmission
Standardizing preoperative and post-operative communication
Better health outcomes
Increases patient compliance
Increase in patient satisfaction levels, resulting in higher HCAHPS scores for MedAux clients
Bridge clinical and research workflows by collecting valid data from patients
Monitoring patient compliance
Complex protocol communication
MedAux Platform:
Significantly reduces surgery late cancellations:
Enhances revenue opportunities
Lowers liability risk
Documents delivery of protocols from scheduling through to post-operative/procedure care
Significantly reduces readmission
Standardizing preoperative and post-operative communication
Better health outcomes
Increases patient compliance
Increase in patient satisfaction levels, resulting in higher HCAHPS scores for MedAux clients
Bridge clinical and research workflows by collecting valid data from patients
Monitoring patient compliance
Complex protocol communication
Market Size
Dr. Behzad Jazayeri is a surgery resident at Kaiser Fontana program. He earned his MD at Tehran University of Medical Sciences in 2013 and has been selected as the top research award winner by AOSpine international community of spine surgeons in 2015. In 2013, Behzad founded ReLinking, an application for Iran's medical student research market. In United States Medical License Examinations, Behzad scored among the top 10%. He has published two books, and more than 40 articles in peer-reviewed journals including Urologic Oncology, European Journal of Spine, Cancer Epidemiology, Neuroepidemiology, Urology (Golden Journal). Elnaz Sarabchian is a doctorate of Education from Hofstra University. She previously founded ReLinking, a platform to connect medical students with research positions. ReLinking was acquired by Tehran University of Medical Sciences. Ali Alavi is a PhD in computer sciences from ETH Zurich University and has more than 14 years of experience in software development.Projected 3 Year Growth
In the last three months, we started three trials with major healthcare systems including UCSD, Johns Hopkins, and the University of Buffalo. Also, we signed a contract with two paying customers with $12K annual subscription fee. Our next milestone is to partner with Pharmaceutical companies to fund the hospitals' subscription fees. At MedAux, we are collecting patient-reported data that has value for pharma and medical device companies.How We Will Make Money
We intentionally differentiate MedAux by providing a low-tech solution that does not require any app download and has no barrier in patient engagement. As a result, we have been able to reach over 86% of the patients which is far away greater than our competitors. In terms of workload, our system runs automatically in the background, it does not require new communication channels to manage and we notify nurses when a patient is having a problem. Finally, we have a very quick deployment model that allows us to launch with or without EMR/EHR integration in less than 4-6 weeks that shortens the sale cycle.About our Competition
We work closely with our customers to design follow-up packages to match their current protocols. The time and resource investment from MedAux and surgeons to design custom follow-up packages make it hard to replicate the designed programs.Progress with Customers to date
We got pre-seed from Rethink Venture in September 2017. We have been bootstrapping and we participate in startup competitions and win 9 out of 10 challenges. On April 2017, MedAux won the first prize in Hofstra Venture Challenge (link:https://news.hofstra.edu/2018/04/27/jump-start/). We will open our seed round in November 2018.New Orleans and Our Company
Intellectual Property Summary
We have continuously learning algorithms that predict which patients are likely to fail and cancel the surgery. Also, by monitoring patients post-discharge, we can predict probably of readmission to the hospital and alert the surgical team to intervene in advance. We can also target patients' preferences in terms of how they receive information and anticipate the questions that patients might have all along the continuum of care.
Patent Link
N/A
Clinical Information
In general, the continuum of care around major surgeries takes part in three contiguous, yet distinct healthcare system entities: preoperative care, index hospitalization and follow up after discharge. All three of these areas are ripe for intervention to avoid readmissions.
Dr. McKendrick (2015), demonstrated that the rolling out of a preoperative preparation clinic in one of the district hospitals helped to decrease the number of cancellations on the day of surgery by about 50%, assuming no other interventions were involved. The authors of this study also discovered a dramatic 3-fold decrease in the number of no-shows with the introduction of the preoperative preparation clinic. These are noteworthy outcomes. Also, they found that CRs secondary to medical reasons dropped almost twice since the introduction of the preoperative preparation clinic.
Moreover, efforts to reduce readmission rates begin prior to admission. Education of the patient with regards to in-hospital and post-discharge expectations are important, as is early recognition and dialogue between the referring doctor (especially in rural areas) and high-volume surgeons. Preoperative care optimization should be considered for all surgeries. Readmission prevention should start before the surgery is ever performed. Consistent education and empathetic care may decrease patient anxiety, for example, in kidney transplant patients, consistent education delivered with empathetic care was associated with decreased anxiety levels 1 week after discharge and decreased readmissions at 30 days (Chandrasekaran A, Anand G, Sharma L, et al., 2016). Ways to reduce anxiety are to standardize the information conveyed and to have trained providers communicating the information to caregivers.
MedAux platform standardizes preoperative and post-operative communications by sending surveys, instructions, and reminders to track and monitor patients throughout the continuum of care. By capturing valid data post-discharge, MedAux identifies early readmission symptoms and allows for assessment and planning to address complications that arise early, decrease their severity, and should decrease resource utilization when a readmission is not preventable.
References:
doi: 10.1002/cncr.28586.
doi: 10.1186/s12913-017-2134-2
doi: 10.1001/jama.2014.18614
Regulatory Status
No FDA clearance required. The platform is compliant with HIPPA regulations.
How we will use the funds raised
1) Sales and marketing
2) 10 new paying customers
3) Expanding to 15 new specialties
4) 10k new patients/month
Thank You
We have reached this milestone by bootstrapping and winning healthcare competitions. We have around 12 hospitals and ambulatory surgery clinics in our pipeline and this funding will help us close sale cycles with the healthcare systems.
Market Size
Every year, 161 million surgeries and procedures are performed in the US and it is estimated that above 11 million lost slots are due to poor preparation and late-cancelations. So it is $24B problem that is addressable by better patient preparation and follow-ups.
And based on literature, by optimizing patients’ preparation and enhancing adherence, we can address at least a third of that problem. And assuming we capture a third of the value we provide for the hospitals, it is about $1.6B potential ARR for MedAux.
Projected 3 Year Growth
There are above 11 million lost slots in surgical procedures due to poor preparation and late-cancelations, leading to $24B cost every year. According to literature, by optimizing preparation before surgery, we can address at least a third of that problem.
Assuming we capture a quarter of that value we create for the hospitals, our projected potential growth is $41M ARR in 2021.
Revenue Model
We provide the platform for three to six months free trial to the hospitals to calculate the return on investment. We charge our customers a quarter of the saved costs from reducing cancelations and readmissions, which is around $100K annual subscription fee per surgery department (please review the investor deck for more details).
Competitors
We intentionally differentiate MedAux by providing a low-tech solution that does not require any app download and has no barrier in patient engagement. As a result, we have been able to reach over 86% of the patients which is far away greater than our competitors.
MedAux is fully customizable to match the clinic's current protocols. Surgeons can upload instructional materials (videos, images, short tips), surveys, and follow-up questions and define the follow-up time intervals specific to each procedure protocols. Each message can be customized to redirect patients to view a specific webpage, download a pamphlet, or fill out a form. The time and resource investment from MedAux and surgeons to design custom follow-up packages, make it hard to replicate the designed programs.
In terms of workload, our system runs automatically in the background, it does not require new communication channels to manage and we notify nurses when a patient is having a problem. Finally, we have a very quick deployment model that allows us to launch with or without EMR/EHR integration in less than 4-6 weeks that shortens the sale cycle.
Traction
We work closely with our customers to design their own follow-up programs, conduct a three months free quality improvement trial to make the required adjustments, and then start the payment. Below is an overview of our current programs and customers:
Johns Hopkins: Bariatric Surgery, Prostate Cancer
UCSD: Bladder Cancer, Kidney Stone, Prostate cancer
University of Buffalo: Vascular Surgery
Napa Vascular & Vein Center: Vascular Surgery
Southern California Vascular Institute (five clinics): Vascular Surgery (paying customer)
Hackensack Medical Center: Colonoscopy
Kern Vascular Center: Vascular Surgery (Paying customer)
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