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QEC Business Plan 25 October 2013
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Table of Contents
I. Executive Summary
II. Mission
III. Relevant Objectives
IV. The Product
V. Market Analysis
VI. Marketing Strategy by Market Segment
VII. Competitor Analysis
VIII. SWOT Analysis
IX. Financial Forecast
X. Management Team
XI. Appendices
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I. Executive Summary
AEGLI Inc. is a healthcare IT solution venture based in Kingston, Ontario, offering browser-
based technology that allows healthcare providers to create and customize electronic
forms for information collection from patients. AEGLI forms solve a number of problems
present in patient care today, by reducing the amount of human errors and thereby the
costs of maintaining an efficient healthcare practice. Initially, AEGLI will sell to medical
researchers, general practitioners, and specialists to build out the required platform for
accurate patient information collection. AEGLI will then move towards more risk-averse
markets of walk-in clinics and hospitals. With low start-up costs and a dedicated team,
AEGLI anticipates achieving positive cash flow immediately.
The Problem
The majority of mistakes that occur in clinical settings are caused by human error and
delivery inconsistencies. These mistakes are costly in terms of losing patient capacity,
correcting errors, and insurance and regulation fees. These human errors are made by both
patients, doctors, and the miscommunication between the two. With the transition between
paper to electronic forms, doctors are finding it difficult to bring patient data online. By
striving to standardize quality of care, AEGLI is also helping to reduce long wait times
experienced by patients, empower patient-centric care, and improve clinical efficiencies.
The Product
AEGLI empowers clinicians and medical researchers to design and customize electronic
structured information gathering tools that meet their specific needs. The platform's
specialized healthcare context allows for providing easy access to more advanced domain-
specific form elements not offered by other general questionnaire creation services. While
sophisticated patient questionnaires can easily be created from scratch, the platform also
offers a Form Bank that encourages users to browse, use, modify, and re-share
questionnaires with others. This allows care providers to quickly create or gain access to
highly context- and patient- specific follow-up tools, and enables specialists to download or
design forms uniquely suited for their area of expertise.
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Current Customer Traction
AEGLI has recently partnered with LIBERATE, a start-up that works to ensure that what
the doctor has communicated is understood by the patient. Together, AEGLI and LIBERATE
completes a full circle of patient and doctor communications. LIBERATE anticipates a
launch in over 500 offices within the next 4 months, taking AEGLI into these doctor offices
as well.
AEGLI has been validated by a number of healthcare professionals and industry specialists.
We have interest from a full range of healthcare practitioners waiting to trial our product
from the SVP, Easter Health who runs the hospital system of Newfoundland and Labrador
to MD of Cancer Care Specialist. AEGLI is currently trialling and customizing the follow-up
form system for a Rheumatologist practicing in Kingston Ontario.
Business Model
AEGLI’s business model will be to operate on a subscription based model based model.
Revenues will be acquired through the option of an all-inclusive monthly or annual fee or a
pay-per-form method. Our direct start-up costs only include server hosting.
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II. Mission
At AEGLI we develop systems to enable more open and efficient patient-clinician
communications, harnessing emerging technologies while prioritizing simple integration
with existing healthcare IT solutions. The value that AEGLI delivers to the healthcare
market is the ability to dramatically improve the accuracy, sensitivity, and timeliness of
patient information and the quality of patient-centric care. AEGLI technology enables easier
integration into online patient records that will meet the increasing demand of remote care.
We are committed to providing software solutions for an advancing industry to help
healthcare providers to what they do best, provide better care to more patients worldwide.
III. Relevant Objectives
1. Increase the adoption of EMR systems by making it easier to collect patient
information online
2. Become the leading technology for both healthcare providers and researchers to
collect information from patients
3. Reach 3000 healthcare practitioners and hit revenues of $2M by the year end 2015
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IV. The Product
We are all patients and have all experienced at some point, either first hand or through a
loved one, the hours spent waiting in line at the doctor’s office or the frustration of being
unable to express your medical condition or history. The majority of mistakes that occur in
clinical settings are caused by human error and delivery inconsistencies. In solving this
problem, AEGLI satisfies the needs of three important stakeholders:
I. The Patient: Patients experience what is known as “White-Coat Syndrome” that
cause patients to get confused and forget their own symptoms, illnesses, purpose
when put on the spot in front of the doctor. Patients, especially elderly patients,
come unprepared to appointments, for example, without medication lists. AEGLI
helps empower patients to strive for better outcomes through improved point of
care condition and treatment by answering the doctor’s questions on AEGLI
forms before the appointment. Patients will also be able to receive better remote
care with AEGLI’s follow-up forms.
II. The Physician: Not only providing a user-friendly interface for healthcare
practitioners and researchers to collect and sort through patient information,
AEGLI also solves the three major problems that all healthcare providers
experience.
Time: AEGLI helps reduce time spent on interviewing and documentation that
can be done before the appointment and collect follow-up information, such as
wound management, so that a second appointment will only be made if
necessary.
Quality of Care: Through timely and accurate collection of information, AEGLI
helps providers focus on treatment and care.
Consistency of Care: In clinical setting, AEGLI ensures that the same questions
are being asked by each provider for each patient and there are no variations in
quality of care between different doctors or nurses.
III. Healthcare of Canada: AEGLI offers a simple solution that allows healthcare
institutions to transition easily into patient-centric care. Healthcare institutions
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are undergoing the difficult task of transitioning all patient records online and
each institution has different rates when adopting new software. AEGLI is
compatible with any EMR system. With a user-friendly interface, AEGLI focuses
on data collection and analysis and having this information easily accessible to
doctors and for doctors to export to whatever software or EMR system they are
currently comfortable with using. We have the ability to grow and change with
the technology in a doctor's office as healthcare industry begins to take on
patient-centric methods of healthcare.
Specific Features
Form Creation and deployment
Upon creating a new form, users can choose between starting from a blank slate, and
downloading an existing template from the platform's Form Bank repository of AEGLI-
supplied or user-generated content. An intuitive point/click/drag interface allows users to
add, rearrange, and remove a wide range of form elements as required, customizing the
digital form to their own needs. Forms can easily be edited after creation as well.
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Practitioner Editing View
To share the form with a patient, the user can post a public link to the questionnaire (for
example, in a waiting room or on a clinic web site). Alternatively, they can send the form to
any patient for whom they have created a profile on the platform. In that case, the patient
receives an email containing a customized link. Following this link and completing the form
automatically associates the patient's response with their profile in the system, allowing
the clinician to easily find the response in the future.
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Patient View
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Practitioner View of Submitted Forms
Submission Management
After a patient submits a questionnaire, the completed response appears immediately to
the clinician in a form submission inbox. Selecting a completed form displays the questions
and patient responses. Forms submitted anonymously through a public link can be
manually associated with a patient profile, if desired. Form data can be exported as plain
text (for copy/pasting into a clinician's electronic medical record system), or downloaded
and saved in multiple file formats including PDF and CSV.
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Practitioner View of Patient Responses
Patient Profile
Clinicians are able to create profiles for specific patients, associating a patient name or
custom identifier with an email address for sending custom form links to patients (either
manually or on a predefined schedule). The clinician can then quickly review the patient's
form response history and track changes over time.
Patient Security
Legal Security Requirements
AEGLI’s predominant legal concern is the federal Personal Information Protection and
Electronic Documents Act (“PIPEDA”), given that AEGLI will be collecting personally
identifiable information through commercial means. Fortunately, PIPEDA does not restrict
the collection of data or impede AEGLI’s operations - it is a set of recommended guidelines
to which AEGLI’s data collection practices abide by.
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Other than PIPEDA, legal research has shown that medical data must be stored in Canada
as to avoid foreign monitoring. Although server hosting is cheaper in other countries, for
example, AEGLI is restricted to hosting data on physical servers within Canada – even if it is
still a cloud-based system.
Back-End Security
Following extensive research into the legal requirements as listed above, AEGLI developed
a security system to maximize accessibility while minimizing the potential for issues to
arise. AEGLI implements a two-server, UNIX system, separating the front- and back-ends to
ensure data cannot be inappropriately accessed. Given the heavy regulation of the
healthcare industry and confidential nature of the data, an impenetrable information
system has been planned out for use.
The first server, the ‘front-end’ server, only stores the forms for doctors and patients to use.
The first server will implement a Linux or UNIX operating system due their superior ability
to manage user access, and efficient memory management. As the front-end server does
not contain restricted information, the server is restricted from being overwritten and
changed, but anyone with a link can read and access the forms. When a form is accessed
and information is submitted on it, internet-standard SSL encryption is used to submit it to
the first server. As the first server does not store patient data, it is then immediately
transferred to the second, ‘back-end’ server. Each time this transfer is initiated, the client is
authenticated using a client certificate before a transfer is allowed – allowing access only
from the front-end server’s IP address.
The back-end server restricts access through two main features. First, the servers are
installed with firewalls in place, restricting all external access, restricting ports from
unknown IP addresses. Even the front-end server will be blacklisted to ensure no-one is
able to access the back-end server through the unrestricted front-end server. Secondly, in
the case of a physical security breach or unlikely electronic breach, the data is encrypted
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with a 128 bit encryption. At this level of encryption, even a computer checking a
quintillion possibilities per second would take 1013 years to crack the encryption, and
without doing so, the data is useless. The only people able to access the back-end server to
retrieve client data are the doctors and clinic administrators, who would be set up with
access certificates.
Furthermore, the servers run applications which continuously monitor the accessing of
data. Therefore, if an unauthorized party did manage to access the data, the server hosts
would be e-mailed and the servers would be temporarily shut down.
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V. Market Analysis
Healthcare IT Industry
Applications of information technology to the clinical health care sector are numerous and
growing, both in demand from institutions and individual practitioners, as well as in
diversity and capability of offerings from software vendors. Global industry revenue
estimates were $11.6 billion in 2009, with expected growth at 12.4% annually to 25.6
billion in 2016.1
Software as a Service (SaaS) is expected to play an important role in future healthcare IT
investments, providing centralized, flexible, and scalable solutions that can be implemented
incrementally and with minimal initial infrastructure investment.
Business Environment Analysis
An unprecedented convergence of demographic trends, medical culture shifts, and
incentivized technology adoption is creating an ideal – and time limited – environment and
market for the product AEGLI provides. As patient-doctor communication becomes
increasingly valued, health care systems increasingly stressed, and IT solutions spread into
wide clinical usage through government subsidy (and while EMR vendors continue to
struggle to meet baseline eligibility requirements for those subsidies), the ideal
opportunity to create value as a third-party IT solutions provider through accessible,
electronic patient-doctor communication is now.
Demographic and Cultural Trends
As collaborative and patient-centered concepts gain traction in medical care delivery,
frequent and meaningful doctor-patient communication is becoming increasingly
important2. However, growing demands on healthcare systems, spurred by aging
1 GlobalData Market Report, 2010 2 OMA Policy Paper - Patient Centered Care - Ontario Medical Review, June 2010 (https://www.oma.org/Resources/Documents/Patient-CentredCare,2010.pdf)
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populations and physician supply-demand imbalances, have resulted in doctors having less
time to spend with individual patients. In the face of such conflicting trends, improving the
efficiency with which patients and clinicians communicate becomes vital. Offloading
objective information gathering from the examination room into the waiting room or
privacy of a patient's home allows patients and doctors to spend face-to-face time on
meaningful consultation and analysis a patient's condition, rather than simply collecting
data on it.
Regulatory Considerations
Given the sensitive nature of personally-identifiable health care information, health
information custodians and their agents (including third-party IT organisations handling
patient data) are required to comply with provincial and federal privacy regulations
(PHIPA and PIPEDA) governing the collection, use, and disclosure of all personal
information collected3.
Compliance with such regulations involves establishing formal policies justifying the
purpose of collection of personally identifiable information, demonstrating transparency
and patient consent in collecting such information, and describing information access
controls as well as physical, organisational, and technological safeguards.
Financial Incentives for Digitization
Publicly-funded incentives to digitize health care data are a core driver of industry growth
trends, as governments seek to promote IT solutions adoption in order to leverage the
demonstrated quality-of-care increases, clinical efficiencies, and cost savings associated
with such technologies4.
3 PHIPA: http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_04p03_e.htm, PIPEDA:
http://laws-lois.justice.gc.ca/eng/acts/P-8.6/ 4 Kalorama Market Information - Electronic Medical Records, 2013
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In Ontario, eHealth Ontario subsidizes physician EMR adoption. For a product to be eligible
for such subsidy, the EMR vendor must meet functionality specifications as set by
OntarioMD and updated on a regular basis5.
Technical Opportunities Arising
As EMR market penetration continues to climb (to the 100% targeted by government
funding agencies), healthcare providers naturally develop repositories of digitized patient
data that becomes available for enhancement complemented by third-party solutions
providers6. A network effect encourages further IT investment as digitizing specific aspects
of the healthcare delivery workflow encourages the adoption of compatible systems in
other areas, while integrating with traditional analog systems can become more expensive
or time consuming such as printing or scanning paper, manual data entry and the like.
5 OntarioMD EMR Specs: https://www.ontariomd.ca/portal/server.pt/community/emr_specification/spec_4_1_requirements/ 6 Frost - Electronic Medical Records, 2011
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VI. Marketing Strategy by Market Segmentation
Researchers
Researchers represent a profitable market for AEGLI since the platform can be used to
conduct research. The system’s forms can be specifically tailored to a researcher’s needs
and AEGLI’s export functions will generate condensed spreadsheets of the research results.
There are an estimated 130 institutions funded by the federal government, which
represents over 14,000 researchers each receiving a grant ranging from $1,000 to over a
million in size (Exhibits 11 and 12).7 At a usage rate of just 10% amongst funded Canadian
researchers alone, AEGLI is expected to generate revenues of over $3 million when
charging researchers upwards of $2000 a year.
AEGLI will target researchers through individual medical institutions. There are numerous
academic research portals, networks, and papers that connect researchers together. Each
university have Directors in Industry Partnerships that link the research community with
companies that require academic research conducted. Connecting through the Industry
Partnerships wing of a university to gain exposure to researchers have proved extremely
successful.
General Practitioners
51% of all healthcare practitioners in Ontario are Family Physicians (Exhibit 10). These
general practitioners run their own practices or work at clinics with typically under seven
general practitioners.
AEGLI will tap the general practitioner market through the partnership with LIBERATE.
LIBERATE is sponsored by pharmaceuticals and is free for all practitioners and patients
making it extremely attractive for general practitioners. Through partnering with
LIBERATE, we are further enhancing their platform and value for general practitioners and
7 "2013 Funding Decisions Notifications." Government of Canada, Canadian Institutes of Health Research,
Research and Knowledge Translation,. N.p., n.d. Web. 27 Oct. 2013.
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we will be able to penetrate the market with them. We will generate revenue through a
pay-per-form method paid for by LIBERATE.
Specialists
Both MD Specialists and Non-MD Specialists (Chiropractors, Psychologists, and Mental
Health Teams) require a better method of tracking information over time, collecting
information remotely, and analyzing that data. AEGLI will allow specialists to minimize
unnecessary appointments through secure information transfer in remote care and track
progress to know what went wrong and when. Currently, when any form involving
confidential patient information is submitted, it must be submitted in person or done
through fax since e-mail is not secure enough. AEGLI can save specialists time and energy
with our secure form portal.
Many specialists are professors or researchers at medical institutions. Each specialist chain
also has an online network, such as the College of Psychologists, where specialists connect
and share the most recent news of the practices, including what Healthcare IT solution to
use. AEGLI will enter the market through the connections at universities and expand
through the power of word of mouth.
Walk-in Clinics
In 2010, 4.4 million (15.2%) of Canadians aged 12 and older reported that they did not
have a regular medical doctor8. These are the people that are crowding walk-in clinics and
build up the six hour wait times. This, coupled with the fact that Canada boasts some of the
longest wait times to receive medical treatment in the developed world9, makes AEGLI an
ideal product to implement at health care facilities across the country. By saving 3 minutes
per patient on documentation and interviewing time through having patient information
filled out before the appointment, doctors can see over 200 more patients every month.
8 2010 Statistics Canada 9 "Canada Could Shorten Health-care Wait times by Building ‘market-based Policies’ into System,
Author says." National Post News Canada Could Shorten Healthcare Wait times by Building
Marketbased Policies into System Authorsays Comments. N.p., n.d. Web. 27 Oct. 2013.
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With the average walk-in appointment revenue of $60 per patient, that is $1200 more
revenue for the doctor every month.
We will target walk-in physicians after many white paper clinical papers that support our
credibility and results. Walk-in clinics are very risk averse and fear that a new technology
will make practices less efficient. A doctor’s time is the most valuable asset to a walk-in
clinic and a solution that will allow doctors to see more patients has sparked the interest of
every clinic manager AEGLI has proposed to.
Hospitals
Emergency departments are high risk, high stress environments. When patient capacity is
exceeded, there are heightened opportunities for error; quality of care is compromised
when patients experience long wait times to see a physician. Walk-ins, ER, and Urgent Care
Centres also lose revenue because of the temporary inabilities to meet the high patient
demand. Patients are being turned away hours before the clinic closes at walk-in clinics and
patients are walking away due to long wait times at Emergency Rooms and Urgent Care
Centres. This loss of revenues is detrimental for the institutions. Furthermore, high re-
admission rates are a considerable expense for healthcare institutions.
In the triage process, nurses can be provided a form that the patient fills out and will be
able to add more questions, notes, and annotations during their personal evaluations of the
patient. Not only do these customizable forms help nurses follow a consistent procedure in
the triage process, ensuring that patients are receiving the same level of care throughout
the organization, but it also allows the nurses to see more patients by saving time on
interviewing and documentation. These forms can be then seen again through the system
by the doctor in the ER, altogether allowing the through time and flow rate of patients in
the department to be much faster.
After the ER, Urgent Care or Walk-in visit, hospitals can work on reducing re-admission
rates through and preventative measures with the AEGLI follow-up features. AEGLI allows
healthcare providers to create customized individual forms for patients to fill to keep up
with discharge instructions (e.g. taking medications as prescribed, following appropriate
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diets, and utilizing any in-home monitoring equipment), tracking of symptoms before they
escalate, tracking follow-up appointments, and collecting information on quality of care
feedback.
Hospital systems will be AEGLI’s final target. A hospital system is made up of multiple
departments including researchers, specialists, general practitioners, and an ER that will
need to see previous results and successful cases in similar settings. AEGLI does not plan to
enter this market in the first two years. In order to target this market, we will need to rely
heavily on word of mouth reputation and build up a strong healthcare IT sales force that
have been in hospitals before.
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VII. Competitor Analysis
AEGLI does not have any direct competitors. Multiple questionnaire-creation products or
information-collection services exist, but are either a) unspecialized and not suitable for
use in a clinical health care setting; b) overly specialized and not flexible or generalizable to
custom healthcare contexts; or, c) customizable and health-care specific, but difficult or
impossible to generate and modify spontaneously and on-demand, or d) customizable and
health-care specific, but not directly accessible to patients, as well as difficult to generate
and modify spontaneously and on-demand.
General survey tools
SurveyMonkey, Qualtrics, etc. offer general questionnaire-creation services, targeted
primarily at survey- and poll-style information gathering, with a focus on collecting
aggregate summary statistics. Collaboration and sharing of created forms between users is
not a focus, nor is referencing individual responses and results. Such services are also not
generally compliant with personal health information regulations and so are not
appropriate for collecting use in a clinical context.
Condition-specific tools
Doctor-patient communications platforms often offer suites of pre-set patient information
collection tools related to specific common medical conditions, usually for ongoing
monitoring of chronic conditions. Such products cannot be customized to meet the needs of
specific doctors or extended for use by specialists. These services are also generally not
useable for gathering patient information in advance of an initial visit as they require
setting up a patient with an account.
Custom questionnaire hosting
A small number of companies offer online hosting for custom medical forms. Users are
often charged on a per-form basis and form creation and customization work is done
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manually by a company developer for a fee, de-incentivizing doctors from creating forms as
needed to collect specific information or for use with specific patients.
EMR-integrated custom forms
Select Electronic Medical Record systems (EMRs) allow doctors to import custom form
templates, and associate the completed forms with patients. However, the form creation
process requires by minimum a basic familiarity with web development technologies,
dissuading many users from building their own forms and restricting access to using more
sophisticated questionnaire elements. Most critically, such forms are only accessible
through the EMR and are not available for a patient for complete on his or her own.
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VIII. SWOT Analysis
Strengths
AEGLI’s focus on enabling individual health care practitioners to create or customize
existing forms broadens the potential market beyond any single specialization or category
of health care. The ease with which created questionnaires can be modified and re-shared
also promotes an iterative and collaborative process, giving all users access to pre-built
content that they can use immediately in their own practise.
The ability for clinicians to automate form submission requests to patients and build
custom solutions to meet a specific patient or patient demographics needs provides
significant value to patients who would otherwise only be able to share information on an
infrequent basis, without placing additional time constraints on the health care provider.
Weaknesses
While the platforms allows for data export in a variety of standard and open formats,
integration with specific proprietary EMRs and other software products is non-trivial given
the fragmented EMR landscape, making cross-platform data integration generally
infeasible without specific corporate partnerships.
Opportunities
An in-progress cultural shift towards patient-centred care will bring focus onto
personalized treatments and increased patient-doctor communication. At the same time,
individual healthcare providers lack the technical expertise to create and leverage tools for
connecting electronically with patients without compromising data privacy or security.
Established EMR and other healthcare IT software vendors are focused primarily on
developing core products and keeping up with government-mandated requirements for
subsidy eligibility, and few focus on non-traditional / value-added / extension functionality.
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Threats
With little potential for formal intellectual property protection, a larger player could build a
similar product and leverage their existing customer base and distribution networks as a
competitive advantage. In particular, a competing product developed by an established
EMR vendor could integrate natively with that vendor's EMR software, providing a more
compelling product for their existing user base.
Competitive Advantages
There are no direct competitors pursuing our highly unique approach. The sustainable
competitive advantage that AEGLI commands include:
Our focus on delivering the best customizable forms in the most user-friendly
interface
Our platform-agnostic technology and open data export, allowing for use with any
EMR system or Healthcare IT software already in use by a physician
Our partnership with healthcare IT start-up LIBERATE has allowed us to form a
complete package in patient communication technology. With over 500 offices that
have pre-ordered our package, AEGLI has the first-mover advantage in electronic
patient forms
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IX. Financial Forecast
AEGLI will be pursuing two different financial models. When targeting General
Practitioners, AEGLI will be paid for by LIBERATE to enhance the LIBERATE platform.
AEGLI will charge 5 cents for every form that a patient under the LIBERATE platform fills
out. When charging specialists and researchers, AEGLI will charge an average of
$150/month or charge a fee that varies per project. We anticipate each negotiation will be
different varying between $1000 to $5000 for each research project and up to $2000 a year
for healthcare providers. This price has been validated by a specialist that has been billed
$3000 and in previous pricing discussion before beta.
Exhibits 1 and 2 show the revenue projections AEGLI expects over the next four years.
AEGLI hopes to acquire 100 specialists and researchers that will subscribe annually in
2014. With this reoccurring revenue model, AEGLI will pass $2M in revenue with 1200
healthcare provider subscriptions on board by the end of 2017. When partnering with
LIBERATE, a start-up that has a lot of initial scale, we will be charging on a pay-per-form
basis. Assuming that a doctor will use a form for 70% of patients every day, 20 days a
month, AEGLI will charge five cents a form and reach revenues of $1.8M by the end of 2015.
With low operational costs, AEGLI has the flexibility to adjust pricing to accommodate
clients of all sizes. Our only consistent cost is hosting servers. Before moving towards
hospitals that would like to host servers behind their own firewall, we will be expending
the following costs on server hosting. Note that these are estimates and the real amounts
will depend on specific needs.
1. 2-server security in the cloud with no redundancy: $60/month
2. 2-server security in the cloud with redundancy for a total of 4 servers:
$120/month
3. 2-server security with physical servers but no redundancy: $200/month
4. 2-server security with physical servers and redundancy for a total of 4 servers:
$400/month
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See Exhibit 4 for Income Statement details. Although initial penetration may be slower than
predicted, such as we are not able to meet targets by the end of 2015, we are confident that
AEGLI will hit all sales goals by 2017. We hope to be in 10% of Canadian doctor offices by
the end of 2017 and begin to expand into the United States. Since we do not need to cover
server costs until clients require them, we have no costs except in sales acquisition. The
first customers will be acquired through connections with medical schools, LIBERATE, and
networks. After initial trials have been completed and successful, we will build a sales force
then to reach a wider customer base. These costs will not be incurred until necessary to
expand and revenue is already generated.
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X. Management Summary
Co-Founder & Chief Executive Officer – Ivy
Ivy is a third year business student with a passion for improving healthcare efficiencies.
AEGLI was an idea that spun from her time waiting in walk-in clinics. She has had
numerous experiences consulting in high level strategy for local businesses in her
community and interned at the world’s largest HR consulting firm, Mercer, in the Health
and Benefits Department. Ivy is a member of the global Healthcare Information and
Management Systems Society (HIMSS), consistently keeping up with the efforts to optimize
health engagements and care outcomes using information technology.
In the past, Ivy has co-founded a children’s rights organization, Children for One Another
(CFOA) that raised over $150,000 in for children’s aid around the world. Her work with
CFOA has been recognized and awarded through the Algonquin Youth Entrepreneur Award
and the Coalition of the Rights of a Child Canadian National Award.
Ivy deals with building business relationships with clients, partners, and mentors and
continuously developing and updating AEGLI’s long term strategy. She strives to break
down all obstacles so that her team can perform at fullest potential.
Co-Founder & Chief Operating Officer - Gord
Gord is an Engineering Physics 2013 graduate who has always chosen to dedicate his life to
social businesses. Gord has an extensive background in web programming and experience
in front and back end web design, development, and maintenance services. He has also
worked with a SaaS social-purpose business based out of Ghana that provides an
international mobile polling and broadcast platform for NGOs. He is a sole proprietor in his
digital media consultant business performing digital image acquisition and video editing
services for non-profit, education, and narrative film making projects.
Also an entrepreneur at a young age, Gord was awarded the Spirit of the Capital Young
Entrepreneurship Award by Child and Youth Friendly Ottawa.
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Gord works on front end design and user interface for AEGLI. He works with healthcare
practitioners to determine specific needs for the product and maintains the up-to-date
product while building better features to improve user experience.
Chief Technology Officer - Trevor
Trevor is the first member to join AEGLI’s management team. We were blown away by his
advanced technical skills and experience with user security. He is proficient in python
application development and scripting, SQL databases with SQLAlchemy, Web
development with Flask, and Linux server management amongst many other coding
languages. He has worked at multiple start-ups and large corporations such as IBM in
software development.
Trevor also runs his own enterprise application development consulting business where he
has engineered systems that process over $3M per year in e-commerce transactions and
$2M per year in cellular renewals. He has developed customer-facing and internal web
applications to interact with complex backend systems and maintained security to protect
sensitive customer information.
Trevor’s past experiences directly apply to his role as CTO at AEGLI. Trevor has built and
now manages the back-end servers and the connections to front-end applications. Patient
security and confidentiality is a priority for the healthcare industry and AEGLI. Trevor will
be dedicated to mitigate risks and provide immediate response in case any security
problems arise.
Business Analysts
AEGLI currently employs three business student analysts. These students work part-time
and deal with sales and client acquisition. The analysts approach new leads, reach out to
potential healthcare practitioners, and manage beta trials.
Company Ownership
AEGLI was incorporated in August 2013 and the shares were allocated between the three
managing directors. There are currently no investors or external shareholders.
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XI. Appendices
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Exhibit 1 – Sales Projections in Independent Sales
Exhibit 2 – Sales Projections in Partnership with LIBERATE
2014 2015 2016 2017
General Practitioners 1000 3000 6000 8000
Number of Forms Used 6000000 36000000 72000000 96000000
Price/Form 0.05 0.05 0.05 0.05
Total Revenue $ 300,000.00
$ 1,800,000.00
$ 3,600,000.00
$ 4,800,000.00
Exhibit 3 – Combined Revenue
$0.00
$1,000,000.00
$2,000,000.00
$3,000,000.00
$4,000,000.00
$5,000,000.00
$6,000,000.00
$7,000,000.00
$8,000,000.00
2014 2015 2016 2017
Revenue Projections
2014 2015 2016 2017
Practitioners and Researchers 100 300 450 700 Retained Practitioners and Researchers
101 293 503
Total Subscriptions 100 401 743 1203
Price $ 1,800.00
$ 1,800.00
$ 1,800.00
$ 1,800.00
Total Revenue $ 73,748.23
$ 721,800.00
$ 1,337,877.00
$ 2,165,470.65
31
Exhibit 4 – Income Statement
2014 2015 2016 2017
Revenue
$ 373,748.23 $ 2,521,800.00 $ 4,937,877.00 $ 6,965,470.65
Variable Server Costs
$ 36,000.00
$ 114,060.00
$ 224,595.90
$ 312,182.36
Variable Sales Acquisition Costs
$ 37,374.82
$ 252,180.00
$ 493,787.70
$ 696,547.07
Total Variable Costs
$ 73,374.82
$ 366,240.00
$ 718,383.60 $ 1,008,729.42
Contribution Margin
$ 300,373.40 $ 2,155,560.00 $ 4,219,493.40 $ 5,956,741.23
80% 85% 85% 86%
Fixed Costs
Server Costs
$ 4,000.00
$ 4,000.00
$ 4,000.00
$ 4,000.00
Business Travel Costs
$ 2,000.00
$ 3,000.00
$ 5,000.00
$ 7,000.00
Payroll
$ 65,000.00
$ 97,500.00
$ 146,250.00
$ 219,375.00
Business Admin and Miscellaneous
$ 1,000.00
$ 1,000.00
$ 1,000.00
$ 1,000.00
Total Fixed Costs
$ 72,000.00
$ 105,500.00
$ 156,250.00
$ 231,375.00
Net Profit
$ 228,373.40 $ 2,050,060.00 $ 4,063,243.40 $ 5,725,366.23
32
Exhibit 5- Use Case: Walk-In Clinic
John wakes up feeling nauseous and realizes he is ill. He phones in sick to his workplace
and decides he needs to be seen by a physician. As he does not have a family doctor, he
searches online for the closest walk-in clinic. He browses its website and notes a link to an
online pre-visit form.
Upon arriving at the clinic, he is reminded that he has the option to fill out the pre-visit
questionnaire. He uses his smartphone to access the form while he sits in the waiting room.
He uses his time waiting to carefully think though his symptoms, medication profile, and
medical history, submitting each via the form as requested, along with his name for
identification.
When the clinic's walk-in physician meets John, she pulls up his form submission on the
computer terminal in the exam room using his name, and scans through his responses. John
has never visited the clinic before and so has a blank file in the EMR system, so the
physician copies his form responses into his file, appreciating the thorough yet concise
background information she is able to obtain in a matter of seconds.
The physician spends the remainder of the visit diving deeper into John's symptoms and
asking questions that build on the base information she has already been provided. She is
able to quickly confirm the details of John's current medication profile before issuing a
prescription.
John leaves the appointment, appreciative that he wasn't put on the spot to remember
details of his medical history and satisfied that the doctor fully understood his situation.
33
Exhibit 6 - Use Case: Specialist Intake and Follow-Up
Elsa suffers from rheumatoid arthritis and visits a specialist on a bi-monthly basis. For the
past six months, she has been receiving an automated bi-weekly email from the
rheumatologist with a link to a questionnaire about her joint swelling and tenderness, and
her level of comfort and mobility. With one click she can access the form and easily input
her responses.
During her visits, the rheumatologist is able to consult the history of Elsa's responses,
noting trends and areas of no change over time. He uses her responses and reported
progress to make a decision on whether or not to change her medication or dosage
prescription. While doing this, he saves her response history into her EMR file.
After a visit, the rheumatologist easily customizes a questionnaire for Elsa based on her
specific situation and conditions as discussed during their last encounter. He then sets the
questionnaire to be sent out on a bi-weekly basis, replacing the last version of the form he
had Elsa fill in. He knows that as Elsa responds to this questionnaire over time, he'll be able
to track her answers and compare them with her answers to the questionnaires he had her
answer prior to this latest visit as well.
34
Exhibit 7 – Canadian Healthcare Spending
National Expenditure Database, Quickstats
Exhibit 8 – Canadian Healthcare Spending
National Expenditure Database, Quickstats
$150B
$170B
$190B
$210B
$230B
$250B
2009 2010 2011 2012 2013 2014 2015
Administration 3% Capital
5%
Drugs 16%
Hospitals 29%
Other Health Spending
6%
Other Institutions 11%
Other Professionals 11%
Physicians 14%
Public Health 5%
35
Exhibit 9 – Number of Physicians in Canada
National Expenditure Database, Quickstats
Exhibit 10 – Physicians in Ontario by Specialty
2011 Statistics Canada
60000
62000
64000
66000
68000
70000
72000
74000
76000
2011 2012 2013
Family Medicine
51%
Emergency Medicine
4%
Specialty Medicine
23%
Internal Medicine
16%
Pediatrics 6%
36
Exhibit 11 – Canada Foundation for Innovation Funding in Health
Research Infrastructure
Funding Program Number of Level of
Projects Funding ($)
Canada Research Chairs Infrastructure Fund 241 37,269,336
CFI Career Awards 3 1,239,066
College Research Development Fund 3 864,584
Exceptional Opportunities 0 0
Innovation Fund 161 529,024,410
International Access Fund 0 0
International Joint Venture Fund 0 0
Leaders Opportunity Fund (with CRCs) 0 0
Leaders Opportunity Fund (with federal funding agencies)
Leaders Opportunity Fund (CFI alone) 0 0
Leading Edge Fund 20 3,276,092
National Platforms Fund 0 0
National Initiatives Fund 0 0
New Initiatives Fund 0 0
New Opportunities Fund 0 0
Research Development Fund 400 64,350,837
Research Hospital Fund 3 1,036,705
10 48,920,674
TOTAL 841 685,981,704
37
Exhibit 12 – Distribution of Health Research
Funding Source Percentage
Distribution
Granting Agencies:
Canadian Institutes of Health Research(*) 58.9
Natural Sciences and Engineering Research Council 7.5
Social Sciences and Humanities Research Council 1.2
Departments and Agencies:
Health Canada 4.8
National Research Council 5.9
Canadian Institute for Health Information 0.2
Foundations:
Canada Foundation for Innovation 9
Genome Canada 4.7
Canadian Health Services Research Foundation 0.8
Indirect Costs Program 6.8
Total 100