- Mission Statement
- Pitch
- Problem
- Solution
- Product
- Market
- Clients
- Vendors
- References
- startup school
- start-up school pitch
Clarity is a software project that aims to mitigate the burden of chronic disease in America by applying an intermediary layer of computation behind every food and drug-related transaction made by all individuals in our economy today. We believe that software can and should be capable of changing behavior for the better and we believe that a new paradigm of healthcare prevention software can realize that belief system.
Clarity is the first healthcare prevention and health management software B2B2C company that allows physicians and insurance providers to see what their patients' consume in real-time.
An apple a day keeps the doctor away
- Most deaths in the U.S. are preventable and are related to our nutrition.
- Less than 8% of healthcare in the U.S. is preventative.
- Physicians do not have access to any of their patients food & drug-related consumption data.
- The cost of healthcare in the next 50 years will rise from 20% of GDP to 50% of GDP.
- Why is there a current lack of healthcare prevention software? We have a healthcare system that is focused on illness rather than wellness. Healthcare prevention is bad business because a healthy person is a non-existent patient.
- The American Healthcare Crisis is not a healthcare-based problem, it’s a market-based problem. That requires a market-based solution.
In 2009 a board of physicians at the institute of medicine discovered that ~30% of all health care spending is waste.
The cost of healthcare to the U.S. economy is ~4 trillion dollars per year.
-
The United States spent approximately twice as much as other developed countries on medical care, yet utilization rates in the United States were largely similar to those in other nations.
-
Total health care spending consumes about 20% of the gross domestic product (GDP) and as costs are projected to rise up to 50% by year 2050. Rising healthcare costs present a challenge not only for the federal government but also for private payers, however an innovative implementation of effective measures to eliminate economic waste represents an opportunity reduce the continued increases in US health care expenditures.
-
If we help insurance providers in reducing the economic waste we can pass the savings on to the consumer and reduce the cost of healthcare in the U.S.
-
“Despite efforts to reduce overtreatment, improve care, and address overpayment, it is likely that substantial waste in US health care spending remains.”
-
In a 2009 review a board of physicians at the national institute of medicine discovered that ~30% of all health care spending is wasted. Estimates that the U.S. loses some $935 billion annually to medical fraud, inefficiencies, and other siphons in the health-care system.
-
Failure of care delivery, $102.4 billion to $165.7 billion
-
Failure of care coordination, $27.2 billion to $78.2 billion
-
Overtreatment of care, $75.7 billion to $101.2 billion
-
Pricing failure, $230.7 billion to $240.5 billion
-
Fraud and abuse, $58.5 billion to $83.9 billion
-
Administrative complexity, $265.6 billion
In comparison, the Defense Department budget $757.8 billion for the war in Iraq over the eight years it was there. Despite efforts to reduce overtreatment, improve care, and address overpayment, it is likely that substantial waste in US health care spending remains. Health insurers underwriting margins could be better optimized if they had nutritional data on their entitlement populations. If insurers had access to a patients food and drug related spending they could in turn better assessing, underwriting, and price risk.
How do we address the administrative costs / complexity waste?
Clarity
The United States has a voluntary private employer-based and individual-based system. Private insurance as the primary form of insurance is highest in the United States at 55.3%
Shrank, William H et al. “Waste in the US Healthcare System: Estimated Costs and Potential for Savings.” JAMA vol. 322,15 (2019): 1501-1509. doi:10.1001/jama.2019.13978
“There may be no such thing as dying from old age. From a study of more than forty-two thousand consecutive autopsies, centenarians—those who live past one hundred—were found to have succumbed to diseases in 100 percent of the cases examined. Though most were perceived, even by their physicians, to have been healthy just prior to death, not one “died of old age.” Until recently, advanced age had been considered to be a disease itself,2 but people don’t die as a consequence of maturing. They die from disease, most commonly heart attacks. Most deaths in the United States are preventable, and they are related to what we eat. Our diet is the number-one cause of premature death and the number-one cause of disability.
How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease Greger, Michael, MD
Clarity is the first healthcare prevention software that provides nutritional data on transactions made for an insurance provider's entitlement population as well as a healthcare provider's patient population. In doing so we increase diagnostic accuracy, and we help reduce the rates of risk
// define key metrics to optimize for Insurance Provider?
Population health management software. Data Collection and Platform Infrastructure
- Clarity collects an individual’s food & drug-related transactions.
- Parse and generates a patient profile nutritional data structure from those transactions.
- Integrate and pipeline that data into pre-existing legacy software to reduce onboarding expenses.
We provide entitlement's nutritional intake behavioral patterns, by providing food and drug-related transactional metadata for insurers.
By providing nutritional data on transactions made for an insurance provider's entitlement population we help reduce waste.
How do we reduce waste? We provide entitlement data for insurance providers to more accurately...
- Assess Risk
- Underwrite Risk
- Price Risk
Insurance companies run on underwriting margin. Insurance companies will not be creatively destroyed. Health Insurance companies have two things that maintain their status... Their capital, and they are at the center of all the data.
What we think we know about healthcare is wrong by Luke Williams
| Cliche | Hypothesis |
|---|---|
| Healthcare costs always go up | What if we keep healthcare costs flat or even lower them? |
| Healthy people are a better risk than sick people | What if the sickest populations were the best kind of risk? |
| Waste in the healthcare system is unavoidable | What if we could pay for the uninsured by reducing waste? What if we could pay back half the nation's debt by fixing this problem? |
Pipeline that data structure in pre-existing web-based EMS portal. (EMS - electronic medical records systems).
[
{
"timestamp": "yyyy-mm-ddThh:mn:ssZ",
"transaction": [
{
"location": "",
"vendor": "",
"vendor-id": ""
}
],
"general": [
{
// Barcode of the product
"code": "200-EAN-13",
// URL of the product page
"url": "https://xxx.com",
// Date that the product was added (UNIX timestamp format)
"created_t": "yyyy-mm-ddThh:mn:ssZ",
// Date that the product was last modified (UNIX timestamp format)
"last_modified_t": "yyyy-mm-ddThh:mn:ssZ",
// Name of the product
"product_name": "cherios",
// Generic name of the product
"generic_name": "cereal",
// Field that designates quantity and unit size
"quantity": _100g
}
],
"tags" : [
{
"packaging": shape, material,
"packaging_tags": "",
"brands": "",
"brand_tags": "",
"categories": "",
"categories_fr": "",
"origins": "origins of ingredients",
"origintags": "",
// Locations where manufactured or transformed
"manufacturing_places": "",
"manufacturing_places_atgs": "",
"labels": "",
"labels_tags": "",
"emb_codes": "",
"emb_code_tags": "",
// Coordinates corresponding to the first packaging code indicated
"first_packaging_code_geo": "",
"cities": "",
"cities_tags": "",
"purchase_places": "",
"stores": "",
// List of countries where the product is sold
"countries": "",
"countries_tags": ""
}
],
"ingredients" : [
{
"ingreidents_text": "",
"traces": "",
"traces_tags": ""
}
],
"misc_data" : [
{
// Serving size in g
"serving_side": ...,
// Indicates if the nutrition facts are indicated on the food label
"no_nutrients": ...,
"additives": ...,
"additives_tags": ...,
"ingredients_from_palm_oil_n": ...,
"ingreidents_from_palm_oil": ...,
"ingreidents_from_palm_oil_tags": ...,
"ingreidents_that_may_be_from_palm_oil_n": ...,
"ingreidents_that_may_be_from_palm_oil_tags": ...,
// Nutrition grade ('a' to 'e')
// Reference: https://fr.openfoodfacts.org/nutriscore
"nutrition_grade_fr": "a",
"main_category": ...,
}
],
"nutrition_facts": [
{
"energy_100g": ...,
"energy-kj_100g": ...,
...
}
],
"nutrition_facts" : [
{
"energy-kcal_100g": ...,
"proteins_100g": ...,
"casein_100g": ...,
"serum-proteins_100g": ...,
"nucleotides_100g": ...,
"carbohydrates_100g": ...,
"sugars_100g": ...,
"sucrose_100g": ...,
"glucose_100g": ...,
"fructose_100g": ...,
"lactose_100g": ...,
"maltose_100g": ...,
"maltodextrins_100g": ...,
"starch_100g": ...,
"polyols_100g": ...,
"fat_100g": ...,
"saturated-fat_100g": ...,
"butyric-acid_100g": ...,
"caproic-acid_100g": ...,
"caprylic-acid_100g": ...,
"lauric-acid_100g": ...,
"myristic-acid_100g": ...,
"palmitic-acid_100g": ...,
"stearic-acid_100g": ...,
"arachidic-acid_100g": ...,
"behenic-acid_100g": ...,
"lignoceric-acid_100g": ...,
"cerotic-acid_100g": ...,
"motanic-acid_100g": ...,
"melissic-acid_100g": ...,
"monounsaturated-fat_100g": ...,
"polyunsaturated-fat_100g": ...,
"omega_3-fat_100g": ...,
"alpha-linolenic-acid_100g": ...,
"eicosapentaenoic-acid_100g": ...,
"docosahexaenoic-acid_100g": ...,
"omega_6-fat_100g": ...,
"linoleic-acid_100g": ...,
"arachidonic-acid_100g": ...,
"gamma-linolenic-acid_100g": ...,
"dihomo-gamma-linolenic-acid_100g": ...,
"omega_9-fat_100g": ...,
"oleic-acid_100g": ...,
"elaidic-acid_100g": ...,
"gondoic-acid_100g": ...,
"mead-acid_100g": ...,
"erucic-acid_100g": ...,
"nervonic-acid_100g": ...,
"trans-fat_100g": ...,
"cholesterol_100g": ...,
"fiber_100g": ...,
"sodium_100g": ...,
// % vol of alcohol
"alcohol_100g": ...,
"vitamin-a_100g": ...,
"vitamin-d_100g": ...,
"vitamin-e_100g": ...,
"vitamin-c_100g": ...,
"vitamin-b1_100g": ...,
"vitamin-b2_100g": ...,
"vitamin-pp_100g": ...,
"vitamin-b6_100g": ...,
"vitamin-b9_100g": ...,
"vitamin-b12_100g": ...,
// Also known as vitamine b8
"biotin_100g": ...,
"pantothenic-acid_100g": ...,
"silica_100g": ...,
"bicarbonate_100g": ...,
"chloride_100g": ...,
"calcium_100g": ...,
"phosphorus_100g": ...,
"iron_100g": ...,
"magnesium_100g": ...,
"zinc_100g": ...,
"copper_100g": ...,
"manganeses_100g": ...,
"fluoride_100g": ...,
"selenium_100g": ...,
"chromium_100g": ...,
"molybdenum_100g": ...,
"iodine_100g": ...,
"caffeine_100gtaurine_100g": ...,
// pH (no unit)
"ph_100g": ...,
// % of fruits, vegetables, and nuts (excluding potatoes, yams, manioc)
"fruits-vegetables-nuts_100g": ...,
}
],
// Nutri-Score
// Nutrition score derived from the UK FSA score and adapted for the French market (formula defined by the team of Professor Hercberg)
"nutrition-score-fr_100g" : "a",
// Nutrition score defined by the UK Food Standards Administration (FSA)
"nutrition-score-uk_100g": "a",
}
]
Utilizing the following,
aetna’s Interoperability API Developer Portal uber api stripes api
The total addressable market size in the United States. Adoption for Key Clients
5,654 Health Insurance Companies 784,626 Healthcare Providers 330 Million Americans / Define total smartphone users.
BlueCross BlueShield Aetna Humana McKesson United Healthcare CVSHealth AmerisourceBergen
Aetna’s Interoperability API Developer Portal
actuary's at Health Insurance Companies
Open Banking would make it easier to get the transaction history. Will be good to look out for that in the coming years.
- https://en.wikipedia.org/wiki/Payment_Services_Directive#Revised_Directive_on_Payment_Services_(PSD2)
- https://www.scribd.com/doc/298569302/The-Open-Banking-Standard
- https://en.wikipedia.org/wiki/Open_banking
- https://www.mckinsey.com/industries/financial-services/our-insights/data-sharing-and-open-banking
- https://www.linkedin.com/pulse/apple-opens-up-open-banking-sanjeev-kumar/
Need to look into whether any health insurance company has already integrated with HealthKit to get activity, VO2max and ECG data.
...a recent survey of 900 Americans showed that almost 60% would be more willing to buy a fitness tracker if it meant they could pay less for health insurance
-
https://www.forbes.com/sites/parmyolson/2014/06/19/wearable-tech-health-insurance/?sh=10f78e8018bd
-
https://technologyadvice.com/blog/healthcare/study-wearable-technology-preventative-healthcare/
-
https://www.humana.com/manage-your-health/achieving-health-goals/go-365
TLDR: Humana appears to be pioneering using data from your fitness trackers and using incentives to affect insurance premiums
-
https://www.cultofmac.com/292319/apple-met-unitedhealth-talk-health-initiatives/
-
https://www.fiercehealthcare.com/mobile/14-hospitals-piloting-apple-s-healthkit-platform
-
https://www.engadget.com/the-engadget-guide-to-the-best-midrange-smartphones-120050366.html
Tech entrepreneurs in the health space say insurance companies are currently figuring how to best access the data generated by today’s fitness trackers.
Source: https://www.forbes.com/sites/parmyolson/2014/06/19/wearable-tech-health-insurance/
Additionally, Apple Research is a very interesting application of HealthKit. Apple partners with research institutions and allows iPhone and Apple Watch users to enroll in scientific studies and share all of their health and activity data.
Read about legality of "discriminating" against people based based on their personal habits.
It looks like discriminating based on race/sex/religion is not allowed, but the law did not catch up yet on the usage of fitness trackers and payments history to affect insurance premiums.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5227931/#:~:text=Section%201557%20prohibits%20discrimination%20based,and%20Human%20Services%20(HHS).
- https://nwlc.org/resource/nondiscrimination-protection-affordable-care-act-section-1557/
- https://www.forbes.com/sites/erikamorphy/2014/06/22/as-google-apple-get-ready-to-change-mobile-health-some-advertisers-could-find-the-fda-barring-the-way
Measuring blood glucose levels using a wearable device is becoming easier. This would give us a good way to track healthy/unhealthy food hobbits.
Apple has been researching this since 2014 and the feature may come in a future Apple Watch.
DexCom the manufacturer of glucose monitoring systems and UnitedHealthcare partnered to track time-time data on their patients with diabetes. DexCom's devices are intended to help members reduce their use of perscription drug medication and in turn reduce permiums.
Since users can get lower insurance premiums by eating healthy food & etc, some computer-savvy users could "hack" our program to report data that would be beneficial for lowering their insurance premiums.
Similarly, malicious actors might benefit from getting access to Clarity's data.
Need to research relevant security standards and implications (i.e, HIPAA)
Even if the consumer does in fact “cheat” meaning one of the following options for a single transaction may occur: Clarity. Clarity recognizes transaction, consumer consumes ALL items Clarity recognizes transaction, consumer consumes SOME of the items. Clarity recognizes transaction, consumer consumes NONE of the items.
| clarity % in transaction recognization | user % consumption of transactions.items[ALL] |
|---|---|
| ✓ 100% | 100% |
| ✓ 100% | < 50% |
| ✓ 100% | 0% |
| ✓ < 50% | ? |
| 0% | ? |
Total Federal Spending for Medicare and Medicaid Under Assumptions About the Health Cost Growth Differential. The health cost growth differential refers to the number of percentage points by which the growth of annual health care spending per beneficiary is assumed to exceed the growth of nominal gross domestic product per capita, after an adjustment for the growth and aging of the Medicare and Medicaid populations. This study presents CBO’s projections of federal spending on Medicare and Medicaid and health care spending generally over the next 75 years. Despite the substantial uncertainties surrounding projections over that long a period, particularly ones involving the growth of health care costs, such a horizon is useful for illustrating the long-term fiscal challenges that this country faces.
Shrank WH, Rogstad TL, Parekh N. Waste in the US Health Care System: Estimated Costs and Potential for Savings. JAMA. 2019 Oct 15;322(15):1501-1509. doi: 10.1001/jama.2019.13978. PMID: 31589283.
United Healthcare Student Resources
Waste in the US Health Care System: Estimated Costs and Potential for Savings