This interdisciplinary course focuses on sustainable innovation, introducing entrepreneurial students to the realities of problem identification and solution design within the complex world of healthcare.
Business Models
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From the course by Duke University
Healthcare Innovation and Entrepreneurship
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From the lesson
Gaining Commitment
How do you gain commitment from your stakeholders? Do you have the tools to advocate for your proposal? Do you have a viable business model?
Meet the Instructors
Marilyn M. Lombardi, Ph.D.Associate Clinical Professor
School of Nursing
Bob Barnes, PhDInstructor
Biomedical Engineering
Well ladies and gentlemen this may be the last time that that you see me in this in
this role. and on behalf of myself and Marilyn
Lombardi we hope that this has been a good experience for you.
And of course we'll have one more coffee together.
But here we go in week six, this is session two.
Focusing on gaining commitment. Remember, up until now we've been putting
all these ideas together. We've been putting our need specification
together. And now, unless you're very different
from most people, you've discovered you don't either, you either don't have
enough time, you don't have the skills, you don't have the capability.
Or you don't have the money to actually implement your innovative idea?
So you're not only going to gain commitment from people that actually do
the work but, you've got to in some cases to gain commitment from people that will
provide you the money to support this and this means.
You're going to need a business model going forward from here.
This is a small part of this overall course.
But a major component of the work that we will do.
If you're going to market one of the first questions you should of asked a
long time ago. In fact you should of asked it back when
you had started the stakeholder assessment.
In terms of their must and wont's. Cause if you're going to go to market,
there's several things that you need to be thinking about.
if I'm going to market, what kind of income will we need to generate?
What kind of earnings will we have to generate in order to be able payback all
that capital we've. [UNKNOWN] How many employees and what
skill sets will we need? What competition will we face?
Will clinical trials be required and how much will they cost?
How much effort will we take? And how long will it take?
What about personal objectives here? What are some of the legal issues we need
to worry about? What is my personal role?
How much equipment will we need? What training will my sales force need?
What trianing will my service organization need?
What trianing will my customers need? Who will manage this?
How much will it cost? How long will it take to train them?
How will I protect my intellectual property?
How will I ensure that I am not impinging or infringing on someone else's
intellectual property? These are all kinds of questions that you
will have to answer for yourself and for perspective investors.
In order to go to market, we need some ideas of what kind of business models
we're going to be using. Earlier we talked about
In terms of distribution, direct sales and third party sales.
Direct sales, we've already talked about that, but we know that direct sales could
be very costly for us. But on the other hand, direct sales, once
we develop a relationship, sort of, and customers we have then in essence built a
barrier to entry for others. We could choose a sales model or business
model that looks like, what a number of, dentists do, we see dentists
participating in. If you've been to your dentist recently,
they may have talked to you about a special toothpaste.
Special toothbrushes, special teeth whitening, special electronic
toothbrushes that are sold through the dentist.
That's a sell through business model. Another model is service.
You don't really sell anything. You service other people's products, or
you service other people's processes. Or, maybe what you do, is that you give
or lease at a very low amount, your product, and then make your income by the
selling service to that product. Or is your strategy going, or is your
product going to be more like a capital piece of equipment, like an MRI machine,
or a CT scanner, or an anesthesiologist's evaporator, vaporizer?
Or are you going to be providing your service on a fee based basis?
That is, the, the best example of this is if you if you're running a company that
sells copy machines, we call it a per click cost, it is for so many minutes of
use for so many different utilizations. A fee for each use.
Is your product or service going to be reusable.
Or is it going to be disposable. Or is it going to be inplantable.
And if you think about it for a minute, you don't necessarily, if it's
implantable, you don't necessarily have to be the person who develops the
software or the or the component that's going to be actually utilized by the
body. But actually the system for the
implantation.These are eight different business models that deserve your
attention. And these are not things to be left until
the last step in your process, because when you were developing the concept,
that's when you should have been thinking about who are the key stakeholders in
terms of purchasing. How are these products or services that
I'm supporting in terms of healthcare device, product, or service, how are they
likely to be reimbursed? And based upon that that may strongly
influence my business model. Or, your business model might be designed
to provide a product or service that's similar to what's being offered in a
reusable format, now in a disposable format.
Or something that in the past has been used in a disposable format, but now
you'd like to offer as a reusable product or service.
These are strategic issues and strategic questions you need to address, if you're
going to take your well defined needs specification and develop it further into
the process. One of the things that an investor's
going to ask you about is a developer face especially.
How much risk are we beginning to take on?
Now, we talk about that product or service we can define risk and borrowing
from some very good work done by Shinhar and Dvir.
Back in the late 2000's, about 2007 I should say.
I'm sorry not 2000, not late but early 2000's, 2007.
Looking at different new part development processes.
What's the level of novelty? How fast would it have to be developed?
How complex is the product or service? And what are the technology implications.
Each one of these can be further subdivided into novelty, this is
derivative. This is incremental.
Or is it breakthrough, something no one's ever thought about before?
Well, maybe you're taking something in the past that has been done or been
accomplished through pharmaceuticals and you found a way to do it electro
chemically. Or you found a way to address the issue
or the problem mechanically. In terms of pace, regular within the
industry. Or is it going to resemble a blitz?
Must be done extremely fast in order to beat your competition market or to take
advantage of a special situation. And are you thinking about something that
is a simple assembly or is this a system of systems, an array?
In terms of technology. A low tech.
A tongue depressor versus a super high technology.
And I would put MRI devices in the category of super high technology to some
extent. So your job in term of risk is be able to
along these four dimensions to share with yourself and with your partners and with
the vendors that make pardon me, with venture capitalists that may be
interested in investing in your device, in your product or service.
How much risk you're about to take I would recommend that you take something
that's comparable to yours, show it on this set of axes, and then for your
product or service, give your best estimate of how it maps out.
If you like more detail, more direction for this, take a look at the reference
that we've provided here. The devil is in the details.
Simple not easy. Well now that you know the, how you're
going to market, now that you've identified, you've identified how much
risk. You should be asking, how much is this
going to cost to get through the development phase, not delivery but to
just get through the development phase? So just [INAUDIBLE] here's just a simple
little diagram of how to begin this process.
Ask yourself; now that I have a concept identified, I've got a preliminary design
that has preliminary specifications. I've identified the market.
I know that it's reimbursable, I have a strategy for that.
The obvious question now is, how much is it going to cost and what skills, what
capabilities are going to be needed? So on the left here you see just a very
simple column in an Excel spreadsheet. Now if I define here all the people that
might be involved. Oh by the way, you probably also want to
include some information here about tools and facilities, etcetera equipment.
Disposable, so those just don't show up here, I'm just showing you the labor
component. Now this is only going on for twelve
weeks, this oh, but it continues. And you may be doing this for three,or
four or five years. One of the real problems in terms of
entrepreneurism is, people have great ideas because they're creative and very
innovative. But the hard thing for them to recognize
is the more capability you include in your prompt to service.
More than likely, the more it's going to cost to develop and the longer it's going
to take. What we're showing in this graphic.
On this chart is for each one of these different positions.
When we're going to need them and how many equivalent persons are going to be
required. So, if you take a look at the MD, one
means one full time equivalent person. A half is obviously a half, and if you
look down at technicians, you'll see it runs from four to six.
Where do these numbers come from? Do you have to estimate them?
Do you have to monitor what you're actually doing and modify your plan or
your expense plan and your cost plan accordingly.
And this continues over the entire time that you're in development.
This is one of the reasons that some inventors, not entrepreneurs or
innovators necessarily, choose to invent patent and then license the development
of their device. As you begin to look at this, this begins
to look a tremendously tremendously like a lot of effort in terms of accounting
and day to day nuts and bolts managment. The bottom line is we want to be able to
compare what our costs are and the cumulative savings or the cumulative
revenue. Cumulative savings, if you're doing this
as an intrapreneur revenue, if you're doing this as an entrepreneur.
And this shows that the payback period [COUGH] would occur in about period ten,
at a cost of, and notice that we haven't done dimension, the vertical axis, very
vigorously at about 2700 units. Now whether that's 2700 thousands or
$2700 I'm not specifying here but this is one of the diagrams that your investors
are going to want to see and you should want to see as this should begin to tell
you whether you have perserverence. You think that you can actually build and
deliver the product or service in the time frame that may be available to you
in the marketplace. So remember, when we talked about the,
the. Deal flow, we've been focusing primarily
on discovery. Then we ta, if we take from discovery, we
vet that. And we have our, our conceptual design.
And that has to go through this full blown design and prototype testing.
Then we can move, once we get through the prototype to the development such that we
have a product or service that can be manufactured and or delivered on a
regualr production volume basis. And then we can move to deployment.
And this is where serious investment begins.
Ladies and gentlemen, as I indicated, this is our last session together, prior
to our last coffee. I hope this gives you some idea, of the
complexity of the work that has to be done.
I hope this also reflects on something I said back in the beginning of week five.
The fun at the beginning of week five for some people is over.
Because week five we would begin design. Is fun in terms of coming up with
conceptually what might work, but from that point forward life gets very
serious. Innovator entrepreneur, especially in
healthcare. Because from that point forward, we are
building detailed business plans to take us through the design, the development,
and the delivery phases. Hopefully, we've given you enough
information, together with the references, that you can begin to see
whether A, you're very interested in being an innovative entrepreneur or not,
and or B, if you are, how to proceed. Factually, effectively, and efficiently
to bring your new products, services, and processes to the market.
On behalf of Dr Marilyn Mino, Lombardi and myself, thank you very much for your
attention over these six weeks together I wish you the very best of luck.
Goodbye.
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