/working · 2018 - 2023
DoctorPlan
cofounder · cto · hipaa
I cofounded DoctorPlan in 2018 and spent five years as its CTO, going from sole developer to running engineering teams in SF and India.
DoctorPlan is an app for managing patient health between doctor visits. Patients can record detailed information about their symptoms, conditions, and medications, so their doctor can be prepared for their upcoming appointment, and their care team sees structured data instead of self-reported recollections. I was the CTO and cofounder from 2018 to 2023.
DoctorPlan's value proposition to a clinic was that they could now reach their entire patient population with text messages and emails timed to each individual's upcoming care. Certain targeted communication could shift behavior across their patient population, allowing clinics to address revenue leakage and improve their bottom line.
Reminders are rare or off. Prep instructions get handed out at scheduling and forgotten, and about 9% of patients arrive unprepared for their colonoscopy.
A colonoscopy procedure can only be performed if the patient has finished their bowel prep (7 days of a liquid diet). At a typical clinic, around 9% of patients show up unprepared, each one representing a wasted revenue opportunity and a rescheduled commitment. Layering text and email reminders into the days before the procedure brought unprepared arrivals down to around 5%. The difference between 9% and 5% is millions of dollars of revenue leakage for a single clinic.
My first years at DoctorPlan#
I was initially responsible for the entire AWS infrastructure and TypeScript API. As we added customers, I hired and scaled a development team in SF and India, with my own work gradually shifting from writing code to product management. It was a great way to learn about giving away your Legos.
Some interesting technical challenges#
Some of the hardest technical problems involved DICOM images. We were using the DoctorPlan app to manage a clinical trial, which involved digitizing thousands of DICOM images that were mailed to us as CDs. I had to make an autoamted system that would automatically manage different DICOM formats and remove PII from images with burned-in text.
One of our core features was to generate PDF documents that would be inserted into the patient's medical record. After varying levels of success with open-source libraries, I ended up reading the PDF specification and figured out how to generate charts and visualizations writing directly against the native spec.
Changing behavior with text messages#
DoctorPlan was communication software: a clinic could reach its entire patient population, hundreds of thousands of people, with text messages and emails timed to each person's upcoming care. A clinic bought it to shift behavior across that population in ways that showed up in its finances.
Colonoscopies were the clearest example. The procedure only works if the patient finishes the bowel prep, and at a typical clinic about 9% of patients show up unprepared, each one a wasted procedure slot and a rescheduled patient. Layering text and email reminders into the days before the procedure brought unprepared arrivals down to about 5% at our clinics, which was worth real money at the volumes a GI practice runs.
What it did for me#
DoctorPlan is the work from those years I'm proudest of. It forced growth as a developer and as an entrepreneur at the same time, from proof-of-concept demos for investors to compliance reviews with hospital customers, and it was the first time I watched software I wrote change how patients were cared for.
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