Oh. Business side? Yeah, I can talk on that more if people would like.
The important numbers are that annual US healthcare spending is nearly $3.8 trillion, and the Electronic Medical Records market is nearly $25 billion.
A good comparison to understand the scale of those numbers is to look at cataract surgeries (the single largest segment payout that Medicare makes), which we perform 2 million of per year, with $16.2 billion in direct medical costs, but which saves $123 billion in indirect costs. Cataract surgery in one eye or both is a billion dollar a year issue.
Oh, for sure. They’re buckling under the weight of all the data. The systems they’re built on simply weren’t designed for the data loads of biometric wearables and genomic analysis.
But I do think that for Meteor to succeed, it’s going to have to be a Google or Facebook to the IBM/Microsoft that Epic and Cerner represent. They’re too entrenched, and Meteor isn’t going to be able to compete by building a better EMR. But if Meteor can carve out the PHR market and handle biometric wearables? And can handle genomic datasets? Or provide easy-to-deploy solutions for the underserved nursing home market? It will be about using the strengths of Meteor to solve problems the current EMR systems can’t handle; and to open up entire new markets.
If we keep on message about Meteor being the 21st century version of M/MUMPS, and keep referring to Epic and the Veterans Administration, I see no reason why not.
As far as UI goes, there’s a huge need for airline style kiosks and displays, for both patients and employees. If you look at all the medical hardware on the market, very few of them expose a windowing system… they’re all kiosked with dedicated workflows, if they’re not locked down entirely to a single screen. So, I’m betting on a Card UI inspired by the Day Made of Glass videos will sell like hotcakes.
But the real question of whether the industry will accept us boils down to HIPAA compliance and FDA regulatory approval (Code of Federal Regulations Title 21, § 820.75, in particular.).
We’re making good progress (I think) with HIPAA compliance, by way of the clinical:hipaa packages and the HIPAA Policy Generator. We’re seeing companies in the Meteor ecosystem successfully use these packages to navigate due-diligence reviews; which is the first step to a full audit.
I’d say the single biggest challenge at this point is getting the testing story sorted out for FDA regulatory review. We’ve had the Validation testing infrastructure for two or three years now, with the Nightwatch framework. Unfortunately, the team members of the Velocity project actively rejected nearly $15K of contributions we tried to make to the project. So Velocity is pretty much dead-in-the-water as far as CFR 21, § 820.75 Validation testing goes.
But the good news is that the StarryNight utility is working like a champ; and we have an integration path to getting the Nightwatch launcher incorporated with the
meteor tool. Validation testing will probably eventually look something like:
meteor --release clinical:METEOR nightwatch
Of course, there’s still the Verification testing story which needs to be sorted out. Recently, the lead Nightwatch dev managed to add full Mocha integration to Nightwatch, which lets us use the
describe/it syntax in Validation testing. So that’s becoming an isomorphic API. And we’re making some progress with a fork of mUnit called clinical:verification, which lets us
describe/it syntax. Unlike the
mike:mocha package, by using a mUnit derivative, we are able to include core TinyTest packages in an FDA audit.
So, if we can get that all sorted out, we should have a testing utility/infrastructure that’s compliant with CFR 21, § 820.75.
That’s… actually, pretty close to what I’m aiming for. Maybe with a bit more airline kiosk and augmented reality look and feel. But generally pretty close.
Well, right now it’s still sort of a thesis project for me. There are the demo apps which will be released later this year, and I have a couple of apps I want to get into the iTunes AppStore. Once one or two of those get released, I think it will be easier to sit down and think about business structure(s). I would anticipate having more of those kinds of conversations in Q1 2016.
I don’t think there’s any community guidelines that would prevent you from simply opening up a new thread on the forum, and we can do it here. If we get enough of these kinds of threads, who knows? They might even make a ‘clinical’ category.