URL

https://sentinelhealth.co

What

A healthcare assistant to help people navigate their own health and the healthcare industry.

Why

The current healthcare system is not really designed for the patient. Instead, it’s designed for the “business” of healthcare, which means treatment. Everyone that operates in the current healthcare system is incentivized to treat you because that’s how they make money.

There are a couple of problems with this. First, if they are incentivized to treat, what will they do? They will treat you, even if it’s not in your best interest. Second, if they get paid to treat, they’re often incentivized to treat you for the most expensive option, because that’s how they make money.

On top of these problems, you also have a massive problem of asymmetric information in healthcare. People just take the word of medical professionals at face value, because who’s going to question their doctor? Yet, doctors are human too. They make mistakes, they don’t always know best. Yet it’s also hard for the patient to get good helpful medical information they can trust outside of their doctor. Doctors overwhelmingly mean well, but they are busy, see tons of patients, and have their own self interests. That’s just reality. I hoped that by empowering the patient, we might be able to swing the balance a bit more.

With Sentinel, I set out to empower the patient because at the end of the day, only you care the most about your health and its outcomes. I felt with the developments in technology, like generative AI, we finally had the tools available to us to empower patients and rebalance the information gaps.

Learnings

• I learned a lot about the healthcare industry and trying to run a business in the space:
  • Primarily, the big thing I learned is that no one in the healthcare industry really likes insurance, except of course insurers ;). Insurance mucks everything up, it adds complexity, costs, overhead, etc. If you could wave a magic wand and covert everything to cash based instead of insurance based, you’d likely solve a lot of problems, make things easier and less complex, and on and on. But, obviously that’s not going to happen. And it’s not just insurance to throw the blame on here, people don’t like paying for health things, it feels like a right more than a privilege, which I am not disagreeing with, but that means the reality is insurance needs to exist and that makes the system worse. To create any kind of real offering for consumers in healthcare therefore means dealing with insurance, which is costly and complex.
  • Another thing I learned is that being HIPAA compliant itself is not all that hard but when you say you are a “healthcare business”, everyone automatically jacks up your pricing. There is almost no such thing as a “healthcare startup” because every vendor puts healthcare companies into the same tier as enterprise. Expect everything in startups to cost 10x if you’re a healthcare startup.
  • There are massive barriers to entry in healthcare. It starts with the expenses, the compliance requirements, etc but to be honest, if you’re decently funded those things are not all that bad. What makes the largest barriers is that in order to do things within the healthcare space, specifically, anything that could be deemed “medical”, you have to go through lots of gatekeepers. As a tiny company, no one wants to talk to you. And even if they do, everyone wants to charge you 10x normal pricing for similar services outside of the healthcare space. Therefore, you pay enterprise pricing with no revenue, customers, or funding. Not a recipe to hit the ground running and try new things. But you sort of have to play ball, unless you want to start a company that competes with the gatekeepers, which then means you’ll face a different set of barriers to entry.
  • Finally, there’s actually a bit of a cottage industry that has popped up around direct to consumer (DTC) healthcare startups. This is actually a pretty cool thing that I had no idea existed before I started. However, it does come with similar challenges like the above. Most, don’t love working with startups (for all the same reasons, small, no money, customers etc. etc) and are therefore more enterprise focused and therefore also expensive. This is part of that “barrier to entry” that I’m talking about above. I get it, small companies come and go and don’t pay you the big bucks, but that also makes it difficult to to get going if that’s your only other option.
    • Note to self/anyone interested: there’s maybe a company to be founded here? I.e. offer the same services as the existing companies but focus on serving the underserved, aka small companies. The reason this might not be a great idea is the same reason existing ones don’t serve startups today: there just might not be that many to survive off of.
• I continue to learn that the consumer market is really friggin’ hard to crack. Everyone knows consumers don’t really like paying for things, they churn easily, etc, yet if you can crack it, there’s massive opportunity. Likely just takes a lot of shots on net to do so, and a whole lot of luck.
  • Even startups that look “successful” from the outside struggle in this space. Take a look at Levels’ public finances, they’re not great. Not bad, but not exactly a business that’s crushing it, especially if VC backed (which I believe they are).
• I made a lot of obvious mistakes that I know better than to make, yet I still made them (will likely write a more in depth breakdown of these soon).
  • Most of these fall into the category of talking to more potential customers and don’t build something until you have more conviction something will work. However, this is more nuanced than most care to admit. You can talk to people until you’re blue in the face but at the end of the day, people make a decision whether or not to use something when it exists, not from conversations or identifying common problems. Regardless, I could’ve done more here to understand common problems and people’s willingness to pay to solve those pain points.
  • I could’ve/should’ve done more market research. Though there is still not a product quite like what I had a vision for, to get there would’ve meant I had to go step by step and at the early steps, there was a lot of competition. Doing more research would’ve perhaps given me more insights into taking a more unique approach/change up the strategy.
  • I was a company of 1. To do something in this space, rapidly, requires more than one person. I tried to get help through contractors but that didn’t end up working out and was a little too late anyways.
  • I didn’t have the money to make it work. I bootstrapped the business, which for all the reasons around expenses listed above is not the best thing in the world when you’re hunting for product-market fit in the healthcare space. It was also next to impossible for someone like me to raise the funds I would realistically need searching for product-market fit in healthcare.
  • Ultimate lesson: don’t start a business until you have more conviction in your idea with more feedback and/or have at least a team of more than one to do it with. A little funding wouldn’t hurt either.
• I underestimate a large risk and it turned out to not work the way I hoped
  • The big risk was that I saw Apple’s HealthKit as a way to bootstrap a lot of data initially, plus it was a great distribution channel to our target market. I knew there was some chance that Apple would be stringent on the review, but I underestimated the challenges the review process would pose. As a result, the app never got approved, after months of back and forth. Was there a potential way to make it work? Yes, but it required altering the product significantly and going back to the drawing board anyway, so that’s sort of what I ended up doing by shutting things down.