Healthcare business ideas someone should build

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Go forth and build

We announced our upcoming hackathon with Deerfield Management (with $250K+ in non-dilutive grants!!!). Since then I’ve had quite a few people hit me up to spitball ideas to potentially build, and a few others who don’t know how to read text on a website.

I thought it could be fun to source ideas from newsletter readers and give a few of my own. Respond back with an idea you think should exist in healthcare and I’ll put my favorite ones in the next issue. Maybe someone will reach out to be your teammate? Maybe someone will bring it to life? We have an opportunity to bring fresh ideas to the space, let’s be collaborative!

Below are some healthcare companies I think could exist and I might do if I wasn’t converting shitposts into currency. Likely not VC scale businesses, but could actually make money which is a foreign concept to a lot of the startups reading.

P.S. don’t forget we have our upcoming AI agents in Ops course next week - it’s free. Come through.

DME recycling marketplace

I think the concept of recycling waste in healthcare is interesting. An enormous amount of stuff that isn’t even used is discarded simply because there are no entities to check if it’s still usable. Currently redistribution is already happening in shady gray markets via facebook/whatsapp groups with no oversight, or through non-profits that are relatively limited.

The dollar amount in drugs is non-trivial. Medicare alone is close to $1B in discarded drugs, and since 2023 manufacturers have to refund CMS if more than 10% of units are discarded.

I’m an investor in a company called Medicircle. It takes unused medications from patients that would normally be thrown out, certifies that they’re still good to be used, and then gives it to patients who need it for free. Plans reimburse them for less than they would normally pay for the drug. It’s a win all around! No one is a jerk, which is why they’re not called Medicirclejerk.

There are other areas you see recycling too, like surgery supplies. WestCMR, XS supply, RevMed, Hospital Overstock seem to do this by acquiring excess inventory from hospitals and then re-selling it. There’s also a program for pacemakers called My Heart Your Heart to recondition pacemakers from recently deceased patients.

I wonder if there are more places where this business model can exist. Durable medical equipment is an area that comes to mind. This happens with diabetes supplies - you’ll see these shady ass flyers posted around NY or weird Craigslist ads.

Could a company come in to provide more legit third-party re-certification for other forms of durable medical equipment like CPAP machines, power wheelchairs, unopened diabetes supplies, 60 walkers ordered to a patient in a South Florida fraud ring, etc.? Maybe slightly darker but what about implants?

I think re-certification marketplaces can be brought to more parts of healthcare - re-using materials is much more common in other countries. Maybe there’s an ideological conversation about whether patients should be allowed to try these recertified products at lower cost and absorb the risk themselves.

World's Fair for healthcare

There used to be the World’s Fair which would allow people to see and experience a lot of advances in consumer technology (electronics, transportation, etc.). More recently there were the humanoid olympics in China for robots, a great way to have some fun seeing what robots can do.

I think one of healthcare’s big issues is that people aren’t amazed and excited by healthcare technology. Have you watched a robotic surgeon do their work? Or seen what happens in the NICU to save a child? Or seen how the cutting edge physics of the MRI are used? They used to have premature babies in chicken incubators at the Coney Island fair to show how they could survive, which must have seemed amazing at the time.

There’s a big opportunity to create a new World’s Fair to show people all the advances in healthcare. Imagine seeing a person with a Neuralink implant live, or using one of these Wandercraft exoskeletons, or see a Trilobio automated lab in action, or see the internal medicine resident speedrun using dot phrases in Epic.

More than anything I think it would actually give people optimism and positivity of what’s possible in healthcare. And if you’re building robots in healthcare...that’s one of our hackathon’s request for startups.

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Instinct for healthcare workers

I use Instinct constantly. It’s a personal AI assistant that has fundamentally changed the way I work and get things done. It hooks into all of your systems, has its own virtual computer that can click around, gets context about everything, and takes actions you need to get done. Like any successful company, I have no affiliations here I just enjoy the product.

Importantly Instinct requires virtually no complex setup, it just lives in your iMessage and you text it things. It will ask you to add it to various systems and ask follow up questions. But the form factor is so easy to use - even my non-tech friends that I’ve sent it to use it all the time now.

It’s clear to me that people are going to try to use this to do things at their job. Does your job require you to get data from different places and fill out a lot of forms? Or send a lot of follow up emails, etc.? Or make updates to various google docs where you lowkey don’t know where that doc even lives? This tool is EXTREMELY tempting to use for that because it’s excellent at that.

However this is also a security and privacy nightmare. These personal AI tools can basically mimic you as they go through your systems which is what makes them useful but also very scary. It even knows to switch to a YouTube short for like 10 seconds before switching back to the task at hand. So any company that touches PHI, or sensitive data has to watch out because these tools will find it and accidentally expose it.

But again because it’s such a useful tool for employees you are 100% going to have people trying to use it for work at healthcare companies. So your options are:

1. Do your best to fight it and put in internal security that watches for actions that look bot-ish. However that takes internal resources and will always be an arms race against the personal AI tools that find workarounds.
2. Create compliant paths/tools that work like personal AI tools but have the appropriate security/privacy guardrails.

There’s probably opportunity in both of these buckets, but I’m more interested in the second. Something like an agent that gets its own login and virtual desktop on the org’s network instead of impersonating with cached passwords, the brain can be a cloud model under a BAA, memory is maintained locally, etc. Each employee’s agent gets different permissions/requirements of human-in-the-loop depending on their role.

There are some seedlings of companies attempting to do this. Contxt is one for regular enterprises, Heidi’s new agent is more healthcare specific. But there is a lot more to be done here and probably could be more specific to different roles in healthcare (e.g. Instinct for clinical research coordinators).

Parting thoughts + call for ideas

You might be wondering why I don’t just go and build these if I think they’re such good ideas. Because Out-Of-Pocket is a real company it turns out and I have to run that.

Send me an idea you think should be built! I’ll put my favorite responses in the next newsletter, it can be a fun creative brainstorm. Don’t worry too much about whether the idea already exists or not, maybe all the options out there are not good.

And if you know someone who’s working on an idea in healthcare that’s really early, you should tell them to apply to our hackathon with Deerfield Management by 11/19. IT’S NON-DILUTIVE GRANTS!!! Who doesn’t want that!

Thinkboi out,

Nikhil aka. “Ideas are the hard part right?”

Twitter: @nikillinit

LinkedIn: Nikhil Krishnan

IG: @outofpockethealth