MEDgram

Click, Snap, chat, Rx, free! 

Low cost, high impact, secondary prevention. 

Patients can have visible clinical signs of a disease but the problem is they do not necessarily receive timely medical attention because of barriers to access to care.  Non-ambulatory, lack of transportation, or living in a rural environment are some reasons why patients do not receive timely medical attention. For example, I have seen patients admitted to the hospital with month-old diabetic foot ulcers that then needed to receive foot amputations. If the patient had sent an image to their primary care provider four weeks prior to admission, perhaps the foot could have been saved. The result is increased health care costs and disease burden (disability, morbidity) on the patient. 

Outside of healthcare, it is common for people to visually assess a situation or point of focus within seconds and pick outliers. In art, architecture, financial markets, entertainment, fashion, and dating, people use visual cues for quick assessment. Medicine is not unlike. Physicians can quickly judge clinical images and triage medical urgency, or even treat. For example, if a patient is started on a new medication, and they start experiencing deforming blisters on their mouth, their prescribing primary care provider will know to treat this reaction emergently. If a mother is concerned about a persistent rash on their infant's bottom, the patient's pediatrician knows what to prescribe. U.S. medical licensing exams ask test takers to evaluate an image within essentially 90 seconds and come up with a diagnosis and treatment. 

The solution is MEDgram, a smartphone app for patients to send pictures or video to their health care provider and receive recommendations and e-prescriptions. MEDgram will help people because it is the next step in making healthcare more accessible. The app will be a simple and cost-effective tool that will distribute health services to those in need and meet HIPAA compliance. This app will be beta tested in a rural setting as well as in a developing country. The initial service will be no charge to the user. MEDgram will ultimately benefit patients, providers, and health payors. 

MEDgram applies existing technology to allow providers to manage minor or emergent conditions based on a picture, established relationship with patient, and a few more data points collected during the MEDgram encounter. 

The innovation, however, lies within MEDgram's vision on the design of the app and execution. The opportunities beyond the click, snap, chat of a MEDgram encounter include video and algorithmic primary care. 

What is integral to MEDgram is public access to smartphones across socioeconomic levels and age groups. Ten years ago the Apple iPhone was gaining momentum as a mobile-phone option. Now, smartphones are the default choice of communication with Android and iOS the dominant platforms. Cloud computing and wireless access have also reached economies of scale lowering the cost for app developers and internet users. 

MEDgram's goals over the next 12 months is to test a beta version in the U.S. and in the Caribbean, and provide access to care in rural areas and in a developing nation. 

Patient and provider user base will continue to grow commensurate to the app's infrastructure if MEDgram's vision is delivered in both design and function. 

There are only a handful of large private healthcare payors in the U.S. If these payors, and CMS and state Medicaid agencies endorse MEDgram, then the majority of insured patients will be covered. 

MEDgram is primarily focused on allowing patients to easily send pictures and data to their established health care provider for a medical opinion. However, as MEDgram's name implies, it is a form of communication that can expand beyond this initial focus. 

Reaching the rural U.S. patient population will be done by reaching out to rural providers and local physicians through medical society meetings and professional network. 

Reaching the population in an island nation such as Grenada will be facilitated by collaboration with student-run health fairs and local physicians. 

Patients and physicians will access the app by free download through their smartphone. 

In 12 months, we expect to be serving 2,000 to 15,000 patients. In three years, we expect to be serving 500,000 to 2,000,000 patients. 

MEDgram's team has a specific vision on design and function. Our medical training and interest in technology from a user standpoint are attributes that will enable us to attract investment and cooperation from partners. Communication and patient satisfaction are our strengths in medicine. 

Initially, MEDgram will be free for users and providers. MEDgram will then become fee-for-service or subscription based. CMS has proposed to reimburse clinician review of patient-submitted photos and videos. 

As services are added on to MEDgram, such as video, for example to film episodes of seizure, broader-based application will be feasible. 

Our goal is to be the healthcare app patients choose when sending photos and videos to their clinician. 

We are applying to Solve to increase our professional network, and believe Solve will nudge us with momentum. 

The help with marketing and PR can help advance our work. 

There are no key barriers at this moment. However, accelerating awareness of MEDgram is important at this point of time. Solve can help with raising awareness of MEDgram.