"There are no bad ideas, just bad timing..."
There are no bad ideas, just bad timing! Here are a couple of ideas that many great founders have tried but just may not have had their moment yet…
Referral Management
100M+ specialist referrals occur every year (source); many are sent to the wrong type of specialist the first time, involve months-long lags for appointments, and/or result in patients showing up at the specialist office without the appropriate documentation and insurance requirements. Money and time are wasted, appropriate care is delayed, and physicians and patients have a terrible experience.
It's one of the most enticing problem spaces out there (the potential for a specialist marketplace! analytics on physician performance and availability! network effects!), but multiple generations of companies (including mine) have tried and failed to get to scale in addressing this business opportunity, and referral processes still suck.
Navigation companies have certainly proliferated, but they are really a superficial bandaid in the form of concierge services and read-only steerage apps, versus something that should be embedded into real-time, point-of-care workflows. With the rise in risk-bearing primary groups who are financially on the hook for wasted or higher-than-necessary specialist spend, and better infrastructure for interoperability, summarization, and routing, will the stars finally align for someone to build an important company in this space?
Modern EHR (see "The Six Stages of Health Tech Grief", by Nikhil Krishnan)
There have been countless attempts to build modern EHRs targeting traditional outpatient clinics, virtual care providers, and value-based care groups, but we've yet to see any company get to venture scale in the last couple of decades. And how many VC dollars are spent by early stage care delivery companies rolling their own EHRs because they can’t find a great off-the-shelf option? (hint: way too many) Few founders (none?) are masochistic enough to attempt to build a platform that sells against Epic, but imagine if hospitals had at least one other solid option out there to choose from...
But now, the Meaningful Use halo effect has dissipated, the fundamental business and operating model of healthcare is changing in a way that will soon make legacy EHRs obsolete, and AI advancements now allow for the fundamental rethinking of how humans interact with and leverage technology. Might we finally see a hyper ambitious founder, with an AI-native technology strategy that addresses both the outpatient AND inpatient opportunity, and a clever but aggressive go-to-market motion (e.g. starting in a severely underserved segment of the market that *isn't* dominated by Epic today, and then moving upmarket from there) build THE dominant, next generation EHR? It would require a lot of patience, capital, patience, luck, patience, and grit… but If I don't see a new entrant give Epic a real run for its money in my lifetime, I will die a discontented woman."