Reflection | Karina Moreno Bueno

Blogpost: Day 1— March 13th

Upon arriving in Washington D.C, we had meetings lined up all day that Wednesday. We met with Senator Burr’s office, Congressman Price’s office, Congressman Hudson’s office, and attended the AHIP conference that was taking place at the time. A lot was gathered throughout the day. One of the most surprising things that day was to learn that the problems arising with broadband in rural areas for healthcare had become a high topic of conversation on The Hill recently. It was surprising to learn that because many times the rural areas are overlooked, especially when it comes to healthcare, hence, the shortage of medical providers in those areas. We got some perspective from the policy-maker side for the view on task-shifting down colposcopy. One of the greatest concerns was whether or not a general provider would be able to catch the same diagnoses in time and the effects off reflecting on the patient. Again, it was brought up that due to the current lack of broadband, if the telemedicine part were to be paired with the Pocket, there would have to be measures in place to compensate for the lack thereof. Furthermore, a possible location for the niche was suggested. We learned that the department of Defense invests large amounts of money into telemedicine for military use, making it a possible niche for the Pocket. We also learned that if we need more guidance with our work with the Pocket abroad, we may want to refer to Global Health Policy under Title 3. One of the biggest takeaways from this day was the emphasis of how important our upcoming meeting with CMS is. Because many private insurers tend to follow what CMS covers, it is important that we get ask the correct questions at CMS and get the answers that we need in order to properly bring in our device into the coding part of the industry. Lastly, it was brought up how our team needs to look more into the possible bypassing of medical practice across state lines. The day was very long and tiring but extremely productive. It was my first time talking to people in congress and thus, was a great first day for my learning experience. It definitely gave me more confidence for talking to people on The Hill and set me up for the rest of the trip.

Blogpost: Day 2— March 14th

Our second day started very early in the morning which was quite hard considering that our previous day was really long. Our Bass team met with representatives from Connected Health, America’s Health Insurance Plans (AHIP), Centers for Medicare and Medicaid Services (CMS), and Winifred Carson-Smith, a nurse practitioner activist and lawyer. One of the greatest takeaways from the second day was that in order for the Pocket to be delivered and to be used with its original intentions, we need to realize money is the driver of the entire project. If we cannot get providers paid, they will not want to do it. Since telemedicine is intended to be used with our device, we learned that it is best if we focus on the following three questions keeping medical providers in mind: Will they get paid? Will they get sued? Does the device work for them? It was definitely something that came as a surprise. Originally, we just thought that medical providers would have a more altruistic motive to helping implement the device. But if they cannot figure out a way to get paid — code for can the device and service be coded — then they will not want to use and promote the device. We also learned that depending on how the device is coded, whether preventative or diagnostic, the patient may have to pay a fee for service. It was very important to learn that money will determine whether or not our device will be successful in the medical industry.

Later that day we learned that colposcopies are usually coded as diagnostic, meaning that the patient would have to pay at least a copay payment. We also learned that if two different medical providers are working together to both take the image with the Pocket and analyze — whether its from different locations or the same location — both providers cannot code the same code because it is illegal. They would have to devise some agreement as to how the specialist analyzing the image would get paid. We were given the example of how many doctors make those agreements with radiologists, which indicates that those agreements should not be too hard to come by.

Blogpost: Day 3— March 15th

The last day was just as productive as the last two days. Although we only had two meetings lined up, we still gathered a lot of pertinent information for our project. Our Bass team met with the Prevent Cancer Foundation and with a Former FDA Employee. We definitely made some important connections that day and were invited to attend The Dialogue for Action conference that focuses a lot on different cancer initiatives. This would be a great conference for some team members to attend to further make other connections with other important people in the industry to get our word out. We also learned that our product is ahead of Mobile ODT in the sense that its more acceptable for patients. Our device looks more like a medical device whereas the Mobile ODT looks more like a personal phone and can make patients more uncomfortable. We also learned that our device needs to really focus on the risk-management side for labeling in terms of getting it through the FDA. It is very important that we do so in order to mitigate the possible harms that may from using our device improperly. Overall for this day, we definitely need to make sure that our device gets it marketing right with the messages being sent and need to make sure that it will not harm the patient if used incorrectly.

From the commercialization and costing standpoint, since it is not clear if all providers like PAs and NPs can use and code for the Pocket. There needs to be more research on who is “competent” to do so by law. Once we figure this out, we will need to remodel our beachhead markets, TAM size, and our potential top customers. Hopefully not too many buyers will be taken out so that our final business model and pricing framework is not changed to much. Lastly, if the coding situation is not integrated with the extra business agreements among providers, our device cannot be properly costed. Our team can look more into possibly conducting interviews with physicians to determine if they would be willing to arrange business agreements to guarantee the payment for primary care and the specialist.

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