iWantGreatCare – Neil Bacon shares a few predictions

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He explained that patient ratings are directly related to outcomes, patient satisfaction, absenteeism and cost.

Transparency drives performance. Relative’s ratings of cleanliness in hospital predicts MRSA and C-diff rates.

In 5 years time your professional reputation will be determined by what Google says about you.

Your colleagues will be threatened by your ambitions. He had to sell his house in order to start doctors.org.uk and then invested all the money he got from doctors.org.uk in iWantGreatCare. It is going well but taking time to scale. Watch this space.

Proximie – An NHS Clinicial Entrepreneur Startup

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Proximie – augmented reality platform that allows surgeons/clinicians to collaborate in a AR platform.

Secure system – cloud based telesurgery. Allows you to work together locally and internationally. Crowdsourcing knowledge. Hardware agnostic. Virtually hands-on. Surgeons can reach the poorest from the richest areas.

AR is growing massively. What do the surgeons actually need? What does a consultant at home actually need?

They have now got some really diverse partnerships and have won some great awards.

She co-founded with a technical person and when they realised they were on to something they brought in a chairman and a director to make the team start to scale. It’s only when you have the idea, traction and team (with the right vision) that you can start to scale the business. They are now 25 strong! Good job!

Founder’s Story – Vivek Muthu – You don’t have to build a tech business!

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Didn’t build a tech business! He built a consultancy business. You don’t have to be in tech!

He feels he used to be the least entrepreneurial person that he knew. As far as he was concerned he was just doing the normal job and then he developed an itch – so he joined the BMJ. He was instrumental in developing the clinical evidence series. That’s where he met his business partner and the business started!

It was called Baysian and it helped publishers, commissioners, NICE and others to look at the evidence for various treatments. Then they got into guideline development and gradually became digitalised.

13 years on he sold the business to the Economist group who wanted to develop a health consulting wing. This led to a good relationship with them and he still consults for those who bought his business and has developed a portfolio career.

He was surrounded by good people. He feels that serendipity was helpful. He never knew where he would end up. Find people you trust and value who are more experienced than you – you are exposed and you have to realise who you are in yourself and what you believe in / your values are.

Find people around you who at their core have similar values to you. The idea is only a small part of success, execution and diligence in execution are so important. Keep an eye on your finances, staff, culture, products. It takes absolute commitment. There comes a point where you have to make a decision: It can be destructive so you have to watch your relationships. It also requires resilience. In 2007 his business partner developed breast cancer and had to leave the business.

On the flip-side it is the most liberating thing. Like anything that is hard you come out of it stronger, having survived. They managed to build their business without investors – perhaps it wasn’t as big as it could have been but it didn’t matter to him. He is living proof that consulting is a viable option for clinical entrepreneurs.

Notes on Lean Startup methodology with a veteran John Spindler aka Capital Enterprise

I learned so much from this guy I had to share it with others…

Now is the Time

Why bother starting a lifestyle business. You are sitting on so much value and you want to share that with the world not just make your life easier. you don’t want a checklist business!

‘Big will not beat small anymore. The fast will beat the slow’ — Rupert Murdoch. Even he is aware of it.

Ask yourself: Where can your business be in 12 weeks?

Incumbents should note that there are hidden ‘gun’s’ (startups) in peoples garages which contain bullets with other companies names on them.

‘Think big, act small, fail fast, learn rapidly’ — Eric Ries

Lean Startup: Eric Ries

As an investor, John Spindler finds the lack of background research by entrepreneurs to be one of the most commonly encountered frustrating problems. To solve this he suggested:

Make 2 columns:

  1. Fact column- 2–3 facts you KNOW about this business plan.

2. Second column- Hypotheses. What things do I need to find out to build this thing?

Work out what is your OPPORTUNITY HYPOTHESIS. Build, Measure, Learn. Call it a project rather than a business because it is easier to fail fast. (I like the psychology of this idea and have already found it helpful).

In the experimental stage check your are measuring the right metrics, evaluation of them will lead to excellent execution.

Startup Owners Manual: Steve Blank and Bob Dorf

Don’t build something nobody wants

3 types of advice: validated, negative and useless. (Validated/Negative advice in 8 weeks can be tested to see if it works. Good or bad it will help you. )

However, 95% of advice is useless in the next 8 weeks. Therefore, shelve it because it’s useless to you now.

Lean is just about organising the chaos, reducing waste and risk, providing more learning and a common language. IF your core assumption is wrong you need to test that FIRST. Then you will save yourself a lot of time.

It’s a common language. There is jargon and as soon as you learn it you can communicate with others — be ‘in the club’ as it were.

If you are going to build, do a lot of thinking. Then build the thing that teaches you what you need to learn.

The number one thing an investor will look at is the team. If you can convince a quality person to join you that is a sign of success. If you can recruit a quality army this is your number 1 asset! What quality of ARMY can you recruit? Investors will care about this more than anything else as it is the biggest single determinant of success.

Get OTHERS to validate your product. Your own validation is not that valuable but multiple external validations are.

Testing Hypotheses

A good hypothesis is simple & clear, written as a statement, establishes participants (who), variables (what’s involved) and prediction of an outcome (evidence).

The Pepsi Challenge type scenario is NOT the right first validation exercise. You have to assume that the first answer is wrong. Ask 5 why’s & eventually you might get to the nub of it. AVOID CONFIRMATION BIAS like the plague.

Most people are NOT early adopters in ANYTHING. Most people have habits that are very hard to break.

MVP is not a crappy version of the product. It is a prototype. Consierge MVP is legitimate. It can be a simple landing page, it can be a proof of concept, it can be something for people to engage with, it can be a paper prototype, a pitch, fake demo video, or something to help a developer to understand. It is just a way to answer the questions you need to answer.

Thanks to JP at www.transformcustomers.com for this great cartoon

Consierge means it is not scalable. It’s just there to allow you to learn. Beware, If your hypothesis is circular then its not a hypothesis and you need to think again.

Key assumptions you need to make

At least several other people are working on the same thing right now. How you think this your business idea will work is probably wrong. Your main job is to learn faster than the competitors. That is why the team is the key. It is the process and the people that win NOT the product itself.

The market is not stable and anyone who doesn’t keep moving forward will fall behind.

Call it a project, give it a name, sell something, convince someone else to join, set a goal that will inspire you, live 6 months in the future, fall in love with the problem and not your solution. Follow Peter Thiel’s philosophy as per ‘Zero to One’ (find it on Amazon its a good book.)

Teams

There are two types of teams. Napoleon team — they will follow your every command. The best teams however are people who are smarter than you and can do things you can’t and you bring them on the journey with you. They don’t want to just be footsoldiers for your army.

Bare minimum you need a hipster (domain insight), hacker (builder) and hustler (seller) to succeed.

Paul Graham- You need three things to be a successful entrepreneur — a great team, proof that customers want it and a willingness to do it with minimal money!

Regarding Customers

‘Make something people want’ — Paul Graham, Y Combinator

Avoid wasting too much time trying to change the ‘stuck’ middle who don’t want to innovate because they are very good at using the current system. Are your people your assets or your problem?

Before building your business ask: What problem would someone else solve for me?

Another thought: The number of secrets in the world is roughly equivalent to the number of startups we need.

How did the companies that are currently successful scale. When you scale big you win even if your product is inferior. Unless you can bring 10* value you are unlikely to be able to displace an incumbent. (As per Peter Thiel).

Design Thinking

He would thoroughly recommend doing Stanford’s online course on design thinking (8–10 hours). Emphasise, define, ideate, prototype, test. Do it in groups if you can, it will radically transform your thinking.

‘Kick Ass’ products have evidence that they solve a customers problem in a big market. Focus on the early adopters. People you can beta test with. Commit 5 people. They need to know they are aren’t buying a perfect solution.

They are trying to find a home made solution. They want you to succeed, they will give you their time and honest feedback and you have a relationship of trust. Your mum is not one of these first customers!

Do you know the demographic? Needs and goals? Problems that need solving, Present behaviours? How do they go about solving those problems? Reference group? The behaviours and the psychology are key.

Behaviour Change

BJ Fogg. Head of behavioural theory at Stanford. B=mat. B=behaviours, m=motivation, a=pre-acquired ability, t=triggers (we are all contextual. We need external triggers to get us to change our behaviour. Every product is a behaviour change. Activation threshold affected by these three things, the triggers have to be enough to get them over the threshold.

Source: B.Fogg (Stanford) Site as per diagram.

Can you make something better than it already is? make something simpler? In an ideal world how would this problem be solved? Better, Simpler or emerging methods?

He suggests we build 5 actual profiles of 5 potential customers (actual people) . The more specific the better: Motivation, Habit , Income, Age, Location, Status, Backstory. Become intimately acquainted with there problems.

Then understand the full use-case lifecycle.

Source: @capenterprise — John Spindler

What do these personas do when ‘triggered?’

Entrepreneurship is a career. Startups are risky experiments. You don’t have to experiment full time. Start today with what you have.

Do you invest in startups who don’t use lean methodology? Yes but its rarer. Sometimes people just get damn lucky and hit a home run of first base but its the exception rather than the rule and it might not be repeatable.

Then he talked about financing and how ‘founders fit’ and how investors look at these things. Do you have someone resourceful, someone who can do x and y. The team you build now might well not be the team that takes it to the next level. Identify the task in hand and see if the team members can get you there.

Funders and investors must fit. An investor should never distort the function of the startup because this is your task. You have the hands on the controls. They are investing in you!

Suggested reading: Moms test by Rob Fitzpatrick, Running Lean by Ash Maurya and Lean Startup by Eric Ries.

This article came out of notes I took on a talk by @capenterprise at the first NHS clinical entrepreneurs pit stop – The beginning of a new journey. Or see my medium blog

Finally: My two favourites from Expo 2016

My Clinical Outcomes

As someone who was the first doctorpreneur I ever discovered and who is a genuine and honest guy. Tim Williams has helped me more than he realises at an early stage on my doctorpreneur journey. What he is doing with @myclinoutcomes is great and we need more of it. It’s only by measuring the metrics of health that we can feed back into the learning cycle and make sure we don’t waste effort (ie. think lean) but more importantly patients will be protected from harm. (Tim to the left). Lorie his analyst and Joe Mcdonald chair of the clinical CCIO network are to the right.

I want great care

In the middle is Neil Bacon. I had heard of Neil before and have even once for some reason been asked if I had founded doctors.org.uk! (apparently many have claimed to be the founder. If you are one of the other founders I would love to hear from you…)

Talking to Neil was like talking to an even more vivacious and talkative me! His passion for what he is doing shines through and I have to say what he is doing with Iwantgreatcare.org is fantastic. I signed up straight away and so should all doctors. What you might think is just a ‘trip advisor’ or ‘checkatrade’ for Healthcare is actually a powerful feedback and analytics platform that enhances patient safety and outcomes. If you use it you WILL be helping your patients!!!

That’s it from me from NHS EXPO 2016. It’s been a great conference. Next up GIANT health con November!

Matt

An Indian Legend

​Dr Nageshwar Reddy of Hyderabad. This guy is a legend. Gave the best talk I’ve ever seen on innovation in endoscopy today at #BSG2016. Lots of challenges but many lessons can be learned. Endo live hyderabad seems very interesting. 

Goodbye to Ian Forgacs

Bye Ian. You’ve done a great job