[HN Gopher] Common pitfalls of digital health startups and how t...
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       Common pitfalls of digital health startups and how to avoid them
       (2023)
        
       Author : gone35
       Score  : 72 points
       Date   : 2024-04-12 20:53 UTC (3 days ago)
        
 (HTM) web link (bettychang.xyz)
 (TXT) w3m dump (bettychang.xyz)
        
       | oezi wrote:
       | One important thing which isn't mentioned in the article is that
       | you need at least 1m EUR/USD to become a company with a medical
       | device. So you better have a plan to to raise such money, spend
       | and recoup it with revenues.
        
         | Jimmc414 wrote:
         | Can you go into a little detail on the expenses that 1m needs
         | to cover?
        
           | oezi wrote:
           | Quality Management setup and certification
           | 
           | Clinical study
           | 
           | Technical file / DHF creation
           | 
           | FDA Submission (510k/DeNovo) or CE marking (via Notified
           | Body)
        
             | WA wrote:
             | Depends a lot on your product, your target market(s),
             | number of supported languages, number of employees, and
             | most of all: the risk class of the product.
             | 
             | QMS can be around 15-20k
             | 
             | Study: not necessarily needed if you do not need new
             | evidence. Then you can write a literature review, which is
             | A LOT cheaper
             | 
             | TechDoc: yeah, takes time
             | 
             | CE marking: depends a lot on the notified body. Here's a
             | slightly outdated list and apparently, you can pay anything
             | between 15kEUR to 500kEUR:
             | https://openregulatory.com/notified-bodies/
        
         | nradov wrote:
         | For most hardware devices that's correct. But software as an
         | FDA Class I medical device can be done cheaper than that. Under
         | US regulations, pure software with no hardware component can be
         | considered a "medical device" depending on functionality.
        
           | pintxo wrote:
           | In my past company we looked at EU MDR class 2a
           | certification, we established it would cost around 100kEUR/a
           | to get and maintain all necessary certifications. Essentially
           | hiring a full-time resource to do all documentation, plus
           | costs due to slower work cycles, plus certification reviews,
           | plus external consulting as needed.
           | 
           | Ultimately we closed shop before we starting going down that
           | route, so I cannot tell if that number was correct.
        
       | notamy wrote:
       | (2023)
        
       | tokyovigilante wrote:
       | They've forgotten the classic error of engaging only with client
       | at the management and IT and ignoring clinical requirements until
       | UAT, and a clinician revolt ends in project failure, adverse
       | media coverage, millions of wasted dollars, and ongoing patient
       | harm from unsatisfied requirements and persistent legacy systems.
       | 
       | Also needs an asterisk about not relying on your customer's BAU
       | resource to deliver projects, particularly those with large
       | integration components, and one about not buying a business for
       | its product as a replacement for yours which is EoL, then
       | immediately trying to push it on your customers as an "upgrade"
       | when you've lost half the acquisition's engineering talent and
       | you don't understand the product.
        
       | duffpkg wrote:
       | Wrote Hacking Healthcare for O'Reilly, former hospital executive,
       | built and operated hundred of hospitals and multi-practice
       | groups. Created the open source ClearHealth/HealthCloud EMR and
       | WebVista.
       | 
       | I advise a lot of health related startups. I think the list is OK
       | but the two most important things I have seen come up over and
       | over again are 'have a show pony' and KISS.
       | 
       | "Have a show pony" means you need to have a doctor associated
       | with your business, idea, etc that is high profile and a public
       | advocate for it. Doesn't necessarily mean as an employee or
       | consultant, etc, that can get complex because of corporate
       | practice of medicine regulations but advisory boards and research
       | partners are often good fits. This lets you be taken seriously by
       | what are extremely risk averse institutions in most cases,
       | especially when dealing with "two guys and a hard drive"
       | startups.
       | 
       | KISS is the old adage, keep it simple stupid, but really in
       | healthcare the overwhelming high priority problems are insanely
       | simple people issues. Getting people to wash their hands, getting
       | patients to show up at the right time and the right place, having
       | an organized and non-duplicative flow of operating information. A
       | tremendous amount of healthcare is done via spreadsheet, think at
       | that level. Complex solutions can be profitable but almost never
       | endure and can be extremely hard to sell.
       | 
       | I think a lot can be gleaned about the general dysfuction of
       | healthcare as an industry from this previous HN thread:
       | https://news.ycombinator.com/item?id=39186252
        
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