June 2016 - Elevar · ZocDoc’s broad set of customers and markets can be seen through the “120 million annual doctor searches showing ZocDoc in the top results.” 4 Part of their

June 2016

1 The Startup Success Framework: A Guide to Innovating in Healthcare |

HEALTHCARE INNOVATION

Over the past few years, interest in healthcare innovation has been at an all-time high. While much of this has helped push healthcare to be more effective, efficient, and valuable, our healthcare is still broken and we have a long way to go.

With a lot of activity happening across healthcare: from incumbents to new-entrants, regulatory priorities to backlog needs, and legacy platforms to shiny new apps, it’s often difficult to wade through this complexity and understand which pain-points rise to the top as main priorities of executives and decision makers. Because of this, many entrepreneurs in their journey to fix healthcare often feel lost and uncertain.

Questions often come up such as: What problem should I tackle? Why is this relevant now? How can I fix it? Who should I involve?

ELEVAR LABS®

At Elevar, we decided to create a way to shed light on these questions through our Elevar Labs program. Elevar Labs offers a way for both entrepreneurs and healthcare executives to come to the table and find ways to solve enterprise’s most pressing issues together. Not only has this been a great opportunity for the industry to connect directly with innovation but for entrepreneurs to have an open dialogue that extends to a direct invitation to help solve these challenges.

Through our various innovation programs, we’ve uncovered dozens of real pain points felt by healthcare executives and noticed a pattern across the problems that healthcare systems are asking innovators to solve. Many hospital administrators, physicians, and nurses are increasingly looking to entrepreneurs to help them better utilize technology as patient behaviors, engagement patterns, and clinical care continue to evolve.

Surveying the specific problem statements discussed across our Labs programs, the following three problem areas consistently emerged:

How can we help consumers better navigate healthcare? How do we make it easier to access the right type of care when patients need it?

How do we enable a care team of medical professionals and family and friends to deliver coordinated care and support to the patient both in and out of care facilities? How do we do this in an easy and intu-itive manner?

How do we empower patients to more actively participate in their own care and follow care treatment plans when at home and in-between doctor visits?


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The solution’s usage across its intended users

The user’s interaction and engagement experience

The solution’s functionality in solving the problem

The capturing of, integrating with, and analysis of data

The solution’s ability to deliver value to stakeholders

ELEVAR STUDY

A recent Elevar study showed that from a sample of 250 startups focused on healthcare systems, over 40% are developing solutions to address at least one of these problems. However, our Labs programs revealed that many of these solutions have not yet achieved mainstream adoption and sometimes fail to meet the needs of healthcare systems.

UNDERSTANDING THE GAP

Our experience in working with both startups and healthcare enterprises show that in order for entrepreneurs to be successful in bringing innovation to a healthcare system, not only do they need to possess the strong startup foundational attributes—e.g., great team, strong execution, etc.—but they need to also critically think through how their solution addresses five key areas: adoption, user experience, capability, data & integration, and return on investment. These five areas form our definition of a Startup Success Framework. Let’s take a look at examples of how both successful and failed startups have oriented around these areas.

Where Healthcare Startups Focus — from Elevar Study

Is the solution being adopted and used repeatedly by its intended users?

What’s the approach to drive sustainable traction and adoption?

Does the solution have the right user experience for the intended audience?

Does the solution have an easy-to-use and intuitive experience?

Is the solution solving the right problems and achieving the desired outcomes for the user and buyer?

Is there competitive advantage or patentability in the way the solution solves the problem?

Is the solution gathering and analyzing the right data to solve the problem?

Is the solution integrated with the right technology and data ecosystem required to enable its capabilities?

Does the solution deliver a good value proposition for the user, customer, and buyer?

Is the solution priced correctly with sustainable unit economics to support the customer?

The Startup Success Framework: A Guide to Innovating in Healthcare |

When ZocDoc started in 2007, many people thought the problem they were trying to tackle was easy and straightforward – enabling online appointment scheduling. On the surface that may have been the case, but behind the scenes ZocDoc’s complexities included having to figure out a multitude of system integrations, door-to-door leg work to sign up physicians, and going beyond scheduling to “address the hidden supply of healthcare; the 10 to 20 percent of appointments that are made and then canceled within a day or two of the appointment date,” explained COO Dr. Karraz.2

ZocDoc has grown at an extremely rapid pace while raising $223 million from top name investors

including SV Angel, Marc Benioff, Khosla Ventures, and the Founders Fund amongst a slew of others. When they initially launched, “for three years [they] were in New York just to figure out the scheduling piece.” 3 Since then, they have systematically rolled out their service to all 48 contiguous states by 2014.

Much of their success can be attributed to their defined strategic direction, the strong back-end integration to fragmented scheduling systems, and funding success.

ZocDoc’s broad set of customers and markets can be seen through the “120 million annual doctor searches showing ZocDoc in the top results.” 4 Part of their deliberate strategy was to carefully open up markets based on the healthy supply of doctors available through their platform for patients to choose from. This targeted roll out helped ensure quality by working out any kinks in their system which in turn, led to increased adoption from referrals as they expanded across the US. Though their core users are everyday patients, they have increased access to many types of consumers from those with hearing

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HEALTHCARE NAVIGATION

The Problem

Today, many care providers still rely on phone calls to schedule appointments. When a patient decides they need to see a clinician, they either drive into the Emergency Department (ED) where they know they can get immediate care or they call a provider only to find out the next available appointment is two to three weeks out. A study by Truven Health Analytics showed “71% of ED visits were unnecessary” 1, and with better tri-aging prior to visiting the ED, more appropriate care can be administered.

Healthcare navigation constitutes everything from the ease of scheduling an appointment from the patient’s perspective to finding the right care at the right time. From the perspective of the care provider, they want to not only make it easy and convenient for patients to schedule appointments, but match patients with the right care provider while minimizing no-shows and optimizing clinician schedules.

How ZocDoc is Finding Success


impairments to the severely ill patients who require more custom appointment scheduling processes.

In 2013, ZocDoc won Silver in the UX Awards and by simply comparing them to any traditional provider finder search feature on a health plan or hospital’s website it’s easy to see why they won. Whether it’s through the web or mobile app, consumers have come to expect their experience to be beautiful, intuitive, and convenient. ZocDoc certainly stands out when it comes to scheduling appointments. They have designed a consumer-focused tool that allows users to be both informed of helpful information and able to schedule appointments from a vast array of healthcare providers with only a few clicks.

ZocDoc’s core functionality focuses on allowing patients to easily find and book healthcare appointments. In that effort, they have continuously improved their platform to further customize features to users’ preferences from only displaying doctors who take their insurance to increasing transparency with verified doctor reviews.

What ZocDoc has done behind the scenes is integrate with over 100 practice management systems so medical practices can synchronize their schedules when using ZocDoc. Healthcare in general is a fragmented industry and platforms that are able to integrate and operate between multiple systems is part of the key to streamlining and improving the patient experience.

ZocDoc delivers value to doctor’s offices through the simple premise that they will help bring more patients. Their business model is based on a simple monthly fee schedule for services to drive increased business revenue. For $250-$300 per month per doctor, this straightforward pricing model and the promise to bring in “100 new patients a week,” has been working to attract physicians to sign-on. If they can deliver on that promise, the value they provide is significant.

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PRICECARE’S FAILURE

Adoption

Adoption was the ultimate downfall for PriceCare. Healthcare institutions were not signing up fast enough and the mentality needed by these executives to buy-in to PriceCare, was so radical, it was very difficult for them to embrace this kind of change. One key lesson learned by PriceCare is how difficult it is to compel healthcare executives to change

until they are truly forced to by competition or government regulation. Unfortunately, “no

one wanted to be an early adopter.” 5

PriceCare was founded in 2008 by an anesthesiologist to help patients find affordable healthcare while enabling hospitals to compete for business. It was a web portal that calculated and displayed the entire cost of procedure including professional and hospital fees. At the time, consumers were able to comparative-ly shop online for a procedure by geography. What was rather revolutionary then doesn’t sound out of place compared to today’s healthcare innovations. Unfortunately for them they were unable to make an impact and eventually failed.


User Experience

PriceCare’s user interface and interaction flows were more challenging to track down since the startup closed down several years ago. Our research did not uncover anything particularly problematic, therefore we can only assume that this was not the primary focal point of PriceCare’s challenges.

Capability

PriceCare attempted to offer a useful capability for consumers and patients by helping them with comparative shopping and informed decisions at the right time. While the spirit and intention of the product was spot on, they ultimately required participation and data from hospitals and insurance companies to make the product whole. Without this critical relevant data, PriceCare’s feature rich core product could not directly address the problem of patient access and price transparency.

Data & Integration

Integration to relevant data sources was the underlying challenge that PriceCare struggled with, which led to its low product adoption and ultimate demise. While it is unclear exactly what PriceCare integrated with or the types and volume of rate schedules it obtained, research has shown that they really struggled with gaining enterprise partners like hospitals or insurance companies to divulge information. This information was key to giving the right product experience and value proposition for end users. Without it, perhaps PriceCare could have found alternative ways to triangulate or approximate pricing, but we struggle to determine if that could have provided enough value for the end user.

It’s worthwhile to point out that in today’s healthcare world, integration approach, data exchange agreements, and proprietary analyses continue to be the competitive advantages for

many transparency startups.

Return on Investment

Having a strong value proposition and return on investment is always necessary when building any solution. In the case of PriceCare, they entered a new market and struggled with figuring out how to define value for its different stakeholders. It was a combination of both not understanding complexities and costs associated with building out the product due to how outdated healthcare financial systems were and at the same time trying to convince healthcare executives that price transparency can actually add value instead of only driving up competition and thus reducing revenue. This difficult value proposition is certainly unique in healthcare and while we’re still trying to figure it out in 2016, it unfortunately led to PriceCare’s failure several years ago.


CARE COORDINATION

The Problem

Care coordination is a term that’s been in healthcare for a long time. When looking at its rooted definition, it speaks to healthcare professionals working with patients to ensure the right person is delivering the right care at the right time 12. However, as technology is enabling transformation of care delivery, much of care coordination unfortunately still remains in the dark ages.

When we think about an ideal case, it’s often an environment where doctors and nurses can care for the pa-tient effectively within the health system (e.g., in-patient, out-patient facility) and the patient is equally cared for by care takers at home and in-between visits. As advances in care treatment have shifted towards having multi-disciplinary teams spread across multiple locations both in facility and away at home, it’s become in-creasingly more complex to accommodate such a vast array of required touchpoints to coordinate care.

Looking at the digital age we are in today, it comes as a surprise that healthcare hasn’t evolved and taken ad-vantage of common technologies. Why is it that in a world where consumers have more modes of communi-cating and sharing with each other than we can keep track of, physicians and care teams seem to lack access to any of them? Why is this still a pain-point for healthcare practitioners in a world where this technology is so ubiquitous?

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How Cureatr is Finding Success

Cureatr started in 2012 and completed its Series B funding round in 2015, raising nearly $19 million since inception. It started out as a secure messaging platform between healthcare professionals, but ex-panded its capabilities to address challenges in care delivery amongst multi-disciplinary teams and facili-ties. They focus on being the care transition and co-ordination platform that connects the multiple par-ties together to enable the sharing of the right data at the right time with the right people, and in the right way 13.

Cureatr’s approach to adoption is by collaborating directly with businesses and organizations as pur-chasers and users of their product. In addition, it understood that much of its core adoption is hinged upon the ‘network effect’ – an effect in which the adoption and usage of a product grows exponentially as more users come on. They relied on developing great user experience and value added capabilities that helped them achieve ‘network effect’ with key

customers such as Montefiore Medical Center, Vis-iting Nurse Services of New York, and DaVita Healthcare Partners 13.

While there is no perfect method to drive adoption in the healthcare industry, it’s critical to identify a targeted groups of users, validate this adoption ap-proach, and then expand. This creates an iterative method that helps products improve upon what works in order to gain traction and drive adoption.


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The healthcare ecosystem and its multi-disciplinary teams are often inundated with a variety of technolo-gies and their associated complexities. Often times, when technologies are deployed, one hears of users plagued with added burden of using technologies in-stead of the benefits they claim to provide.

Recognizing that the core of improving care coordina-tion requires technologies that not only help the pro-cess but should not get in the way, Cureatr developed user experiences and interactions that try to accom-plish just that. They have developed secure messag-ing platforms that are clean and simple to use by mimicking standard messaging layouts, transition alerts that do not require opening apps but are only notification alerts, and data rich dashboard tools only for administrators. All these yield simple and effec-tive interactions to support the needs of its users.

One of the things healthcare startups often struggle to define is the set of capabilities their product should have that really resonates with customers and users. Cureatr overcame this at its start by having a core team that came with significant clinical experience. This is a key element that helped them tap into his-torical experience to develop capabilities which ad-dressed pain points they knew industry peers experi-enced. From this foundation they focused on devel-oping their first product, secure messaging. From that point, they branched out into other capabilities to support care coordination and transitions 14. Much of their product success is based on a vision to create a single solution that combines notifications, messag-ing and expertise in the clinical workflow.

A key element to healthcare solutions is to facilitate the transmission, storage, and analysis of required data to support healthcare professionals. A lot of fo-

cus in the industry has been around interoperability, specifically format standards and sharing protocols. Cureatr built upon that and further improved it. By realizing that “good” care coordination requires not only understanding how technology should interact with users but what data it needs to put in the hands of practitioners, it has been focused on conforming to industry standards.

However, one area where Cureatr differs is that in-stead of creating supported integrations to standard industry players, it has opened itself to 3rd parties via standard APIs. This is an area where it is both a strength and weakness. The strength is utilizing best technology architecture practices of other industries. The weakness is that deploying their solution across enterprises is often not plug and play. Their custom-ers would require source-of-truth platforms (i.e., EHRs) to develop integrations to Cureatr which can be a significant and time consuming undertaking.

Return on investment of care coordination solutions is often challenging due to the many parties involved and the difficulties in capturing relevant measures. Cureatr is no exception in this space but has focused on driving towards enterprise ROI since their first ac-celerator program. They’ve built several measure-ment capabilities to look across improving customer revenues, lowering operating costs, and improving clinical outcomes 15. Based on publicly available data and the increasing relevance of care coordination needs in value driven healthcare systems like ACOs, Cureatr appears to be well positioned to deliver strong ROI.


WHY HEALTHSPOT FAILED

Adoption

HealthSpot believed that creating a kiosk-based healthcare environment could reinvent care delivery and coordination in the new telemedicine age. Unfortunately, product adoption was an uphill battle that it never really overcame. Due to the nature of being a kiosk-based telemedicine solution, it required many stakeholders to participate and we believe this complexity contributed to its downfall. In order to enable their solution, not only did they require buy-in from physicians on the virtual end of care delivery, but they also needed location partners (e.g., retailers and hospitals) to lease space for the kiosks, and finally the participation of patients to visit those kiosks. Going after all of these stakeholders in an attempt to commoditize virtual care delivery is very challenging 16. Even into 2016 the barebones model of telehealth (without having physical kiosks) has not yet revolutionized healthcare and is still finding its own bedrock.

User Experience

Due to limited information, it’s difficult to determine how the user experience of HealthSpot impacted its business model. However, looking at the engagement model it required of

its users, one could ask: Did consumers and patients feel like their interaction with having to travel to use kiosks saved time and added convenience versus visiting a doctor’s office 19? Did physicians feel like the diagnostic tools offered were easy to use for the type of consultation they needed to provide?

Capability

By looking at the features of a HealthSpot kiosk, from blood pressure cuffs to e-stethoscope, one could surmise that they focused on kiosk-based care to enable telemedicine of more rich consultations and diagnoses than a simple video call 17. Looking at their solution we wonder, for the targeted types of virtual consultations, did these kiosks provide enough of the right combination of tools needed? Did they over complicate the product (e.g., having to require an onsite nurse) or not provide enough diagnostic tools (e.g., blood work)? It’s difficult to say how product capabilities led to the company’s downfall, but would you do the same for your lean telehealth startup?

Data & Integration

HealthSpot was relatively strong in the area of data and

integration. Based on public data, it appears they had a good cloud-based platform for enabling virtual visits and well integrated medical devices to enable strong data-driven virtual visits.


Perhaps the biggest impact that led to HealthSpot’s failure is in its return on investment and value delivered to stakeholders. When we break apart key elements of their solution’s value proposition, it becomes more evident why their business model struggled.

First, let’s take a look at the value provided to consumers. HealthSpot makes an assumption that consumers derive value from virtual visits. However, in their execution, it was difficult for them to demonstrate convenience since they had very few kiosk locations and restricted consumers’ ability to ad-hoc initiate virtual visits. By forcing kiosks visits to be appointment based only, this removed any convenience a consumer might have had otherwise during their normal daily routines.

Second, it’s unclear if physicians or retail partners derived significant value from HealthSpot. For physicians, it’s unclear how

HealthSpot was a telemedicine company focused on kiosk-based care between providers and patients. Despite raising $43 million in funding, it was unable to overcome challenges with its business model and ultimately closed its doors in early 2016 16.


HealthSpot’s business model impacted revenues or clinical workflow administration. For retail partners, it’s unclear if the kiosk visit volume was able to overcome the real-estate impact.

Finally, the most challenging value directly applies to HealthSpot itself. Many data

points have detailed the expensive capital requirements for developing and installing telemedicine kiosks. Given the lower clinical complexity of virtual visits, it’s very likely that these services are reimbursed at lower fees 18. This, in combination with also having an onsite staff to support kiosk

based telemedicine, created very challenging unit economics that likely made for a very loss-heavy business model.


PATIENT ENGAGEMENT & ACTIVATION

The Problem Patient engagement is a broad term that encompasses everything from patient health education to patients actively caring for their health. A primary concern we’ve heard from healthcare executives is how can tech-nology be used to more actively engage and assist patients in-between visits? While many startups have started to address this, some are more successful than others.

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How Omada Health is Finding Success

Omada Health is a startup founded 5 years ago that’s looking to improve chronic health management through “digital therapeutics”. They have successful-ly raised over $75 million in venture funding and some have even associated them as a darling of the digital health industry. Their “digital therapeutics” solution leverages technology to influence lifestyles of individuals, actively drives patient engagement and activation, and ultimately hopes to help patients be healthier and happier.

Omada’s flagship product, Prevent, is a technology enabled care program focused on preventing type 2 diabetes and heart disease. They’ve had success in working with clients such as Stanford Hospital and Kaiser Permanente. Through a clinically validated care curriculum, Prevent tracks key indicators through smart connected devices and with the help of an on-demand health coach and social support

network, many consumers have shown strong adop-tion and adherence to this product.

Though diabetes can affect all age groups, the elderly are most at risk to medical issues and complications. Omada has seen a very strong adoption of its product not only across its commercial patient population but especially within the elderly.6 Beyond high adoption rates, they have reportedly seen a 65% engagement rate, 10x higher than leading weight loss plans.7 Much of their adoption and engagement success can be attributed to a really valuable product and pro-gram that combines well-integrated technology with health coaches to keep patients accountable and on track with plans.

Omada realized that the core of delivering an effec-tive consumer health product is one that is continu-ously engaging and focused on great user experience. They not only have done remarkably well in this but also offer great user experience for the whole care team as well. Furthermore, they understood that success of the product relies on tight coupling of their solution with the workflows of enterprises. As a re-sult, Omada has spent extensive time working with the enterprise to make operations as seamless as possible across legacy processes and systems.


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Omada’s strength is focusing on developing a core care management product that can really improve the behaviors and healthcare outcomes of patients. As an example, patients on the Prevent weight loss program lost almost 2x the weight over a 12-month period versus patients in a traditional in-person dia-betes programs.8 These results and outcomes begin to showcase that their solution and capabilities are more effective than others. To further demonstrate the impact of their product, it was recently an-nounced that “Medicare will begin reimbursing CDC-recognized providers like Omada Health for adminis-tering the Diabetes Prevention Program (DPP) to eli-gible beneficiaries.”9

Being integrated with quantified-self technology de-vices is a core element behind Omada’s engaging so-lution. As such, this was a key selling point of their solution from the beginning. These integrations to

devices like weight scales and pedometers make it intuitive and easy for patients to adhere to the out-lined program and stay on track with their goals. In addition, Omada has started to work with integrating their data directly into large enterprises, such as health plans, thereby making it easier for their solu-tion to fit into the holistic health of a patient.

Omada has been successful in part because it aligns its product with driving proof on return on invest-ment. Typical outcomes impact to health plans and employers are realized after 24-36 months on their Prevent program with the effectiveness of their pro-gram leading to decreased medical costs of diabetes patients by 56% in Year 3, and 295% in Year 5.10 Their laser-like focus on capturing metrics, con-ducting clinical studies, and hyper focus on specific health conditions have helped them stand out in an otherwise crowded care management and patient engagement solution space.

WHY BETTER FAILED

Adoption

The consensus and post-mortem on Better is that it was “ahead of its time” and the market simply wasn’t ready for it. Better was trying to solve a problem that was still developing as healthcare laws took shape and shifted consumers towards being more responsible for their healthcare costs and needs. Better’s consumer facing freemium business model put the monthly cost of value-oriented solutions on the consumers. This model likely curbed adoption.

User Experience

The Better app offered a great user experience by all accounts and took care in designing it for the consumer. Unfortunately,

design and user experience alone was not enough as they didn’t strike the balance of providing enough value to consumers for sustained usage and growth.

Started in 2013, Better was a startup that allowed patients to cen-tralize health information, access health resources, and connect with a Personal Health Assistant. They allowed consumers and pa-tients to access personalized health content through their app and a partnership with the Mayo Clinic helped deliver credible and rele-vant information. For $50 per month, patients were also provided access to Personal Health Assistants who could direct you to appro-priate next steps, navigate insurance, or even schedule your next clinical appointment. Better was backed by prominent venture firms like Social+Capital Fund and the Mayo Clinic, but despite an experi-enced founder and premier partners, they shut down in 2015.


Capability

In an interview announcing the shutdown, Better’s CEO, Geoff Clapp remarked, “We’re early in a market, trying to define the market, and solve a big problem. We are actually tracking to where things are going rather than to where things are.” 11 While Better offered a lot of capabilities they perceived as useful such as activity booking, nutrition

research, meal planning, and other lifestyle recommendation, the offering wasn’t focused. A more focused offering to a select group of high complex, high risk

patients could have pinpointed exact capabilities they needed and worked out an economic model to support the business. They were caught in a transitional stage, much like we see today, where much of the cost burden in the American health system is still on the employer and government, and consumers are still reluctant to pay out of their own pockets.

Data & Integration

Although Better was able to pull certain information from personal health records, they primarily relied on manual user input to track, log, and interface with the app. This lack of integration put more reliance on consistent and accurate input by patients themselves.


Better’s value to consumers was difficult to demonstrate and prove, especially for additional paid services and features. This was a weakness in their business model. While the tool is useful and the concept of having health resources 24/7 at your fingertips

is helpful, justifying payment from users who have alternative free options and are not accustomed to bearing health costs is massively challenging. Better eventually realized a shift toward a hybrid Direct-to-Consumer and ‘business-to-business-to-consumer (B2B2C)approach was more appropriate, but this may have been a little too late for them. Perhaps if Better had focused their business model on a B2B2C play and marketed toward employer groups and health plans, that might have led to a stronger case for ROI. If for example, an employer group paid for the program which led to a decrease in ED visits due to the assistance of personal health assistants, this could have led to a more meaningful value proposition for a different purchaser.

Ultimately, the unit economics didn’t work out with their low monthly price point and the labor intensive services they offered.


ADVICE FOR ENTREPRENEURS The appetite for innovation in healthcare continues to be high. We’ve highlighted three problem areas that executives in healthcare systems today are actively looking to innovators to help them solve.

1. Healthcare Navigation

2. Care Coordination

3. Patient Engagement and Activation

Given that these problem areas are really big, the continued interest in innovations reveal that regardless of existing solutions, there remains a significant opportunity for new entrants to come in and add value.

Through the lens of successful and failed startups, we’ve highlighted to you how others have navigated the complex healthcare ecosystem and have either successfully tackled challenges or have paved the way for learning from their failures. On the next page, we have included a summary of the Startup Success Frame-work and some key starter questions for your startup. We hope as you go through your entrepreneurial jour-ney, you will reflect on how the Startup Success Framework can help guide you in your way of thinking.

As healthcare organizations focus on innovations away from traditional operations and into more user-oriented engagements, how will your startup be part of the solution? Will you be the one that helps provid-ers better engage with their patients? Will you help all of us better access care? Or how about finally helping our doctors and staff conveniently use technology instead of being burdened?

We would love to hear from you – whether you are a healthcare organization facing similar challenges or are an entrepreneur who has a great solution. Send us an email at [email protected] or see us in person at our next Elevar Labs event.


mailto:[email protected]


Sources:

1Beckers Hospital Review. Study: 71% of ED Visits Unnecessary, Avoidable, Apri 25, 2013. Web.

2NY Time Blog. Lessons From ZocDoc, a Health Tech Start-Up That Works, January 30, 2012. Web.

3MobiHealth News. ZocDoc to take doctor appointment booking nationwide by yearend, March 6, 2014. Web.

4ZocDoc, 2016. Web. 20 May 2016.

5Beckers Hospital Review. Sometimes You are Ahead of the Curve: 4 Lessons From a Failed Price Transparency Venture, May 30,

2014. Web.

6The Modern MD. Digital Therapeutics with Sean Duffy, CEO of Omada Health!, March 20, 2016. Web.

7Omada Health, 2016. Web. 20 May 2016.


9Omada Health. Medicare Will Cover Diabetes Prevention Program for At-Risk Seniors, March 23, 2016. Web.


11MobiHealth News. May-backed consumer health startup Better to shutdown, October 1, 2015. Web.

12Quality Connections: Care Coordination, Oct, 2010. Web

13Crains New York. A born-and-bred NYC health tech company lands $13 million, June, 2015. Web

14HIStalk. Interview with Joseph Mayer, MD, CEO, Cureatr, 2014. Web

15NYeHealth. New York Digital Health Accelerator - Demo Day - Cureatr, 2013. Web/Youtube

16MedCityNews. Why did HealthSpot fail? The telemedicine industry weights in. January 2016. Web

17MobiHealthNews. HealthSpot adds Sprint 4G, e-stethoscope to kiosks. Feb 2012. Web

18VSee. Three reasons why HealthSpot died. January 2016 Web

19Frost & Sullivan. Following up on HealthSpot. January 2016. Web


Documents

June 2016 - Elevar · ZocDoc’s broad set of customers and markets can be seen through the “120 million annual doctor searches showing ZocDoc in the top results.” 4 Part of their