Medstro, an online community site for physicians, medical students, and healthcare innovators recently announced passing the milestone of 100,000 registered users – less than three years since it was founded by CEO, Dr. Jennifer Joe, MD and co-founder and COO, James Ryan. This self-funded Boston-based startup has grown impressively given its organic, “grass-roots” expansion since its official launch in April 2014.
This online community is not only an innovative platform of its kind, but offers its users the possibility of interfacing and collaborating with other experts and community members interested in medical and healthcare technologies. In fact, Medstro’s interactive online groups have offered such unique opportunities that several major industry players, including Google and Boston Scientific, as well as well-known medical societies in the country, have given their support to this platform through sponsorship and other resources.
We are very excited to bring you this exclusive interview with Dr. Joe and Mr. Ryan.
Alice Ferng, Medgadget: What inspired you to create Medstro?
Dr. Joe: We all go to medical school with a mission to serve patients, build a community, help the greater good, and those who are underserved. I grew up in MS, which is the poorest state in the country, so I grew up around poverty and a lot of injustices related to poverty. I was very passionate about these things, and going through medical school, residency, and fellowship — each time I was thinking that there were so many things I could be doing better to meet that mission. I think physicians and the entire medical team feels that way. As a physician-in-training a couple years back, I thought that maybe getting more power and authority when I finished my training would help things get changed, but I discovered that they don’t because there are just so many emerging issues within medicine to fix. Things and times have changed; there’s less time to communicate with patients and less ways to communicate with other physicians and colleagues for various reasons. Physicians used to communicate more with each other because it was a different time and they had more time. Now people are working more hours and are more physically tired as a result. There used to be more time to meet face-to-face with colleagues and patients, but due to the hectic times we live in now, we aren’t able to have as many of those important conversations about our profession and patient care to really address the things that need to be addressed.
When I finished fellowship it really hit me that I was waiting for a “fix” that just wasn’t there and that we weren’t adequately communicating about these issues. That’s when I decided to create Medstro.
Medgadget: Many social networks for doctors have been operational for years, how is Medstro different from other networks such as Sermo or Doximity?
Dr. Joe: I wanted to create a platform where physicians could have meaningful discussions about medicine, whether that was about the latest scientific literature and what the literature means to the practice of medicine, or what heart failure medicines are best under what circumstances or what isn’t working, or how policies affect coverage for our patients, etc. It’s like that story when a patient who has lost health coverage comes through the Emergency Room, and then you see this case happen over and over again. You really feel this firsthand. That’s the point at which Medstro was founded, and because of this vision and mission, we have been very careful about making our technology decisions and for creating spaces that enable others to come up with various solutions. We have been super successful in doing that, and creating the right alliances. Our goal is to be a communications platform. Our goal is not to replace natural physician’s communities. Communities, conversations, and relationships have to happen the old-fashioned way, and we are just hoping to provide the tools.
I think some of our most successful examples have been the NEJM forums, which is essentially a journal club that is open to students, residents, physicians, and anyone who wants to communicate across the nation and world that gives them access to directly speak with experts about their latest research. This really gives people an opportunity to ask questions about the research and data that has happened on the ground level, and to talk about the biases that may have occurred, and other similar scientific inquiries. We also bring experts around the country within these fields to help contribute and discuss experiences and research from their perspectives, which is incredibly powerful.
My hope would be to that this journal discussion platform can take something that has been recently published, on a new medication for example, and to move along these newer findings and have them be implemented sooner in hospitals and communities rather than waiting a decade for these findings to be utilized or for “best practices” to be created.
Mr. Ryan: We started this company because we had a mission, and we really wanted to improve the lives of physicians and to improve healthcare. We funded ourselves completely, and have never taken an outside investment or VC money, which is really huge. I’ve been in startups for 25 years and every time you get a VC-funded startup, they start pressuring you to make bad short-term decisions in order to deliver revenue every quarter and to hit your revenue targets. We didn’t want any VC’s telling us to spill our user data, or to hire sales people to go after pharma ads. Many other sites such as Doximity, Facebook, and Twitter use the sales of user data or display of various ads to help generate revenue. We pride ourselves in not having advertising, and in having physicians trust us with their data. We don’t sell their data, rent it out, or let anyone else use it and it will always stay this way. These are the reasons we have been able to build trust in our platform. So even though it may have taken us a lot longer than a platform like Doximity to grow the number of users, and even though we didn’t have the monetary investments to market the way others have, it’s all been organic growth. Our #1 goal is for the users to have a good experience and not to satisfy the advertisers.
Medgadget: Networks such as Sermo have had issues such as verification of credentialed doctors – how does Medstro avoid similar issues?
Mr. Ryan: I understand why Sermo does that. Their business model is to provide market research for the pharmaceutical industry. The pharma companies therefore get to hear just what doctors have to say. Again, this is not our business model, so we require that people are physicians or medical students to join the main part of the site or any groups that have this restriction of them. People can create groups on our platform that restrict the members to physicians and students only, but there are also public discussion groups and online challenge platforms that are open to the community. We haven’t really found the need to have people fax their medical license over or to jump through hoops to prove their credentials as on other platforms since we are not a HIPAA compliant platform, and our users do not use it to talk about their patients. People could pretend to be a doctor to join the site, but there really is no reason or benefit to doing that since they can join in on discussions. If someone tries to join as a fake doctor and advertise a product, the community itself is pretty good at reporting this and this is immediately stopped.
Medgadget: What were the most difficult challenges to overcome when you first started Medstro? How did you find support for revenue and development of the platform and business?
Mr. Ryan: There were a lot of challenges. The first challenge was to figure out how to make enough money to pay for all of our developers. We developed everything in-house, and did not outsource anything. In fact, we have the same team now that we had when we first started, almost 4 years ago now, which is amazing for a startup. We really try to make sure we make Medstro is a great place to work, and we also have a policy that our workforce has to be 50% female. Another big challenge is to hire talented people at a startup where we can’t afford to pay Google rates. But I think that we have been able to do that because we have been able to make Medstro a great place to work.
Dr. Joe: At Medstro, we also work very hard to listen and be responsive to our partners, such as the New England Journal of Medicine, and always go the extra mile whenever we can. We saw a real need in the technology space, and have really tried to build the med tech community in Boston. We have participated in creating a lot of our own events because when you’re building an online community you really need to understand yourself what is being communicated. What we saw were a lot of clinicians, innovators, scientists, and designers who were really trying to come up with great solutions for the medical community but they didn’t necessarily have a place to gather and to find each other and share what was happening. This was one of the reasons that we started our online challenges more often than not culminate in a live event where these people meet in person.
Mr. Ryan: We were lucky to find a business model that allowed us to fund our growth since we weren’t looking for venture returns. We really just want to sustain our company and grow the network. That was true working with NEJM and providing a platform to host their discussions, and working with other partners such as Google, who we run challenges with. Providing exciting and interesting content, and getting paid to do this without having to resort to selling user data or showing ads was really hard initially, but we have overcome this now and actually made a slight profit last year, which allowed us to give our employees slight bonuses for the first time since we began.
Medgadget: How is Medstro better than other platforms at connecting the community and in engaging the community to interact? Are these interactions sustained over time (e.g., do members maintain a certain level of activity once they join?)?
Mr. Ryan: I think we have 2 types of users – one type comes on board for a specific discussion or event, and the other type that pokes around Medstro that maybe gets involved in an online challenge or starts a user group similar to Facebook groups. Some get really engaged in various ways on the platform, and those tend to stay around, and others are just around for a discussion or two. The level of engagement really depends on what the user is coming on board for and what they are interested in.
Dr. Joe: I think things have really worked out well because we have been on the ground talking to people on a personal level to really build trust in Medstro. It is important that we truly understand physicians’ needs and to participate in that. That is one of the reasons I have remained a practicing physician in different settings. I manage medical students, nurses, PAs, and other trainees. I also belong to multiple communities, which helps me stay engaged and to network with people in all walks of life.
Medgadget: How do you come up with the topics of your online healthcare challenges? Do you propose them to companies, or do they come to you?
Mr. Ryan: We did the first one — and it was Jennifer’s idea — and it took off from there. Jennifer noticed some physicians that she knew at Boston Children’s and Brigham & Women’s hospitals that were really excited about the Google Glass that had just come out at that time. They were doing very interesting things such as hacking into the Glass and making them more secure with encrypted WiFi, and so forth. One doctor even managed to get patients’ electronic health records to display on the Glass. We therefore created a challenge for using Google Glass targeted for any clinician to come up with any idea to use the Glass in their clinical work and got around 55 submissions. We didn’t even ask Google for help, but after a while we got so much press that Google actually approached us and offered to invite the 10 top ideas and groups to come present their ideas in a “Shark Tank” pitch-off competition at Google’s facility in Cambridge, MA.
After we had done this Google Glass challenge within our first year, we really starting noticing that there were many clinicians, physicians, patients, and community members with lots of ideas on how to improve healthcare. We decided at that point to build an electronic platform on Medstro that could help facilitate this process of innovation in 2014. Our next challenge was with the Harvard Medical School Center for Primary Care, Costs of Care, and the American College of Physicians in an event we called the “Primary Care Innovation Challenge.” We had another Shark Tank style event at Harvard after that, and since then we have really spread via word of mouth. People who thought one event was great will approach us and ask if we could do something similar for them. Since then, we have done many events. We do an online event every year with Google now, with Boston Scientific, Philips Healthcare, Partners HealthCare Connected Health, AARP, and many other groups.
Medgadget: What kinds of demographic populations are you targeting with these online innovation challenges, and who do you allow to submit projects or participate? Do you exclude those without an MD?
Dr. Joe: We are a technology platform, and we really piloted the idea to create these types of online innovation challenges, although we don’t really come up with the challenge topics as often now. We really wanted to increase the transparency of the thought process that goes into this type of innovation. And also to allow people from different walks of life to collaborate with each other and to really engage the community at large in terms of big problems that the healthcare system sees because there is a lot of criticism around the healthcare community even though there are a lot of people doing good things.
There are some challenges that are hospital specific that are closed to a specific community. It’s been great having these open platforms to show the transparency of what problems are identified by patients and to watch how healthcare workers then take this information and drive healthcare innovation with this input.
Mr. Ryan: We made these challenges very collaborative from the beginning so that you didn’t just submit your idea and have it go to some black box and then have 3 months go by before you receive an email saying you won or lost. The idea goes onto the site and others can look at it, give you feedback, or ask to collaborate with you. We have a “teaming” feature where people can ask to join your team. There are also online mentors who read all the submissions and help out. These mentors are picked from a variety of backgrounds so that people can submit their ideas and learn from each other instead of just compete, and have the opportunity to make their ideas better.
Dr. Joe: Having this opportunity to collaborate and work together just expedites the whole process of scientific discovery and makes it more meaningful. The questions being asked are very complicated, and we hope by connecting the right people who are interested, we can help facilitate healthcare innovations and solutions.
Medgadget: How does Medstro plan to expand, and what exciting new ventures are on the horizon?
Mr. Ryan: We are not looking to be the next Facebook or to beat Mark Zuckerberg. We aren’t trying to double our revenue or please shareholders. The goal is to continue growing the company and to fund ourselves and staff with reasonable salaries. There is enough demand with the online challenges that we will be able to continue to grow just based on that. We have also just created a template based off of Medstro with similar features that others can adopt that are white-labeled and branded as something else, so you don’t know you are on Medstro. An example of this is a platform hosted for NEJM called Resident 360 (https://resident360.nejm.org). This is a community for residents that provides study guides for all of the rotations internal medicine residents go through, discussions, and blogs.