Ask YC: Profit: $25/user. Customers: satisfied. Competitors: none. Target market: huge. But... | Hacker News Reader

Ask YC: Profit: $25/user. Customers: satisfied. Competitors: none. Target market: huge. But...

30 pointstkiley56 comments

My startup's service:

http://www.inquickersmyrna.com/

Customers love the service, and they say it's worth the price of $25 per use.

The bad news: Right now we're only serving about 1-2 customers per day.

My goal is to move the site from 1-2 users per day to 10-15 users per day; I think if we could pass 10 users per day, it would be easy to persuade other hospitals and urgent care centers to participate, and it's all downhill from there.

How would you raise consumer awareness for a service like this? I've tried a few things (mostly offline), but none successful so far.

(If you're still reading: So far I'm the only person working on this business. I'm looking for a person with strong ui + graphic design, seo/sem, and/or copywriting skills to work with -- initially as a contractor, eventually as a co-founder. Interested? E-mail me.)

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Hmm. Interesting idea, but I see several extremely big problems.

First, you're relying on patients to triage themselves and determine if their condition is life-threatening. You do not emphasize that the service is for CLEARLY non-life-threatening problems. It should have a huge banner that lists some symptoms and says to call 911 or drive to the ER immediately. Maybe there should be a system for a triage nurse to monitor the "symptoms" of the people who sign up and call them if he/she thinks it's serious.

Second, if someone signs up and doesn't think their illness is life-threatening and then dies, you/your company can be potentially liable for that. I have a feeling insuring yourself against that will be expensive.

Third, the brand is really horrible and the site isn't exactly easy to navigate. But you mentioned you need a UI designer (I emailed you), so at least you seem to recognize that.

Fourth, I would not pay 25 dollars for this service. Maybe you can work out a deal with the hospital to pull this fee out of the flat ER cost. That would be awesome and you'd have tons and tons of people use the system, especially if it's well advertised at the hospital.

The idea is cool and for major trauma centers in metropolitan areas where the wait can be greater than 7-10 hours, it could be extremely valuable.

i dont think marketing to end users is the way to go. like someone said, no one cares about an emergency until they are in one.

market to hospitals. get integrated into their website. when someone calls their ER, make sure the nurse tells them to register on the website.

i think going white label is your best bet.

but yea, this is probably the best "Ask YC about my idea" i've seen since i've joined. you're not selling ER software. you're selling software that helps people wait in line.

think of other markets that could use these tools, and then sell it to them as well.

White label would be much easier, but that's shifting all the marketing effort (and most of the reward) to the hospital, which I'm not ready to do. Building a new unified brand is difficult, but I think it will be best for the company (and best for the users) in the long run.

For me, the $25/user is the endgame, profit-wise; for the hospital, the $200-$1k marginal profit from a new insured ER patient that would have otherwise gone to another hospital is the endgame. Marketing to their current patients is good, but not fantastic; the real benefit is in bringing in new patients.

Thanks for the ideas.

I think you might be a bit too ambitious.

1. Your target audience is difficult to reach (rich enough to pay $25, not rich enough to see a doctor, not willing to wait in line AND needing a visit to ER).

2. You're asking a lot from the hospitals (you collect patient data, you offer a no charge guarantee).

3. You're only getting $25 per successful transaction (needs to scale a lot).

On the other hand, you've already 'sold' your app as a white label. You have a reference and you can demonstrate that there's value for the hospitals.

Sell annual white-label licenses and you can built a very profitable company.

this is sage advice. it doesn't have to be entirely white label, but i dont feel like you're going to have much success marketing directly to end users.

if you're into branding though, remember, you are not making software for ERs, you're making software to help people wait in line, and your first market is ERs.

think about it.

I moonlight as an ER nurse as I finish my Software engineering degree next summer. I've worked in ER/Critical care for 15 years, and I've worked at over 25 hospitals as a contract nurse, and while your idea sounds good on paper, it's a medical/legal nightmare.

How fast you see a doctor in to an ER is not about being on a wait list. It's about how sick you are. If you're close to dying you get in right away. If you're not, we see you as soon as possible. Even then, it's not first-come first serve. And, if you're not here, you're not on the list, and there are no reservations.

And, I can't tell you how many people think they don't have something life-threatening and end up dead. And, there are many people who think that their illness is life threatening and it's not.

All it takes is for you to place one person on a wait list who ends up dead, and you're having a number of long talks with a law-firm. I'm not trying to be a hater, or flame you. I'm the last one to discourage an entrepreneur, but I'm really concerned someone will end up dead, and you'll have a big mess on your hands.

Please, rethink your business idea.

haha, iamelgringo, you beat me to bring up these comments. let me add on a bit to what you've already said.

hospitals are not just run as businesses, but they also need to serve the public. as such, you also have ethical and social concerns. there are a several substantial problems with your idea:

-promotes inequality of care based on money. this will likely turn out to be a huge legal issue.

-the decision of something being life threatening should not be determined by patients, but by health professionals.

-substantial change to hospital behavior. the act of creating and incorporating reservations to the ER system will likely be a shock that hospital administrators will not appreciate. (just look at how long it took for doctors to move from beepers to PDA's and cell phones, and also look at the adoption of electronic medical records which is still less than 18% of all doctors) making hospital staff jump through new hoops will increase the resistance of using your technology.

please do not take these comments the wrong way. your idea could work, if you tweaked the business model around hospital constraints, and nothing specific is popping up right now. perhaps other areas where waiting in line is a pain that people will pay for?

Try to sell this service to government agencies where usually the wait times are ridiculous. Personally I would feel weird registering online for a visit to the ER. I'm either sick enough and I want to go there NOW or I'm not that sick and I can just see my regular physician when he has time.

> How would you raise consumer awareness for a service like this?

I'm not sure that "diluting" your message in the press will be very efficient. I may be wrong but I guess people don't really care about emergencies unless they need it.

I would instead spend a day (or a few days) in the emergency waiting room (or ask a doctor there) to see if there are "typical" cases of non-life threatening emergencies. Then I would directly bring the information to those people (e.g. skaters).

edit: your domain name really sucks. There's no way someone will remember this or even type this with a broken hand.

Great idea. I've done some limited research, and it seems that this site would appeal very well to people who have some type of infection that has worsened over a period of days. I've spent some dollars on adwords for "fever" and related terms, but that hasn't been terribly effective so far.

Right now I'm working on a plan to market the service to schools, hotels, amusement parks, retirement centers, sporting arenas -- basically any place large numbers of people are gathered. It seems promising so far (fingers crossed, nose to the grindstone :P)

Thanks for the input.

It might be also useful for parents with small kids. If you got a 104F fever on Saturday night you just take some pills and sleep over next day to see how it goes. If your kid get 104F you don't want to wait for your pediatrician to open their office on Monday. (Or, if your kids put a pill in his nose and it won't come out at 9pm; that happened to us).

If you can put your brochure in the "packet" the new parents receive from pediatricians or hospitals, that might help.

Seconded.

Don't remember the last time I went to the ER for myself. With 2 boys in the house (now 3 and 5) we had a stretch of 3 visits to the ER in one year.

You're probably already doing this, but make sure that you're using geotargeting with your adwords campaign so that the only people who see your ad are actually within driving distance.

You are 100% correct, the domain name is horrid. ;-) It was chosen at the insistence of the hospital; eventually, we want to promote the service nationally at www.inquicker.com. Is that one any better? :p

Much better!

What a great idea.

The way I see it, there are a couple ways to work with it.

1) You've found a size hospital that it works well for and you get resistance when trying to go to bigger hospitals? The forget the large hospitals and find hospitals that match this one's profile around the country. Interesting niche.

2) Use the technology and apply it to any place that you have to wait in line (for a table at a restaurant, public golf courses, etc...)

What else am I missing?

Agreed. Lines are a waste if you look at them from an economics point of view - people willing to wait for something would almost always be willing to pay more to have it right away. but businesses are throwing that opportunity away because they don't have the technology to fix it or they don't see the problem. It is cool to see someone solve the problem with software.

I wish I owned a grocery store, because I think it would be a neat experiment to post a different markup rate for each cash register, and see what would happen. For example, one cash register charges the advertised price (+0%), another +5%, another +10% up to 40%. At certain times the +0% line would be the obvious choice, but what would happen in the rush hours?

You are wrong with statement: "people willing to wait for something would almost always be willing to pay more to have it right away".

It depends on the price of their time. If the price of their time is high, they would be willing to pay more. If the price of their time is zero, they will always stay in the line, because they have nothint better to do. Google for "opportunity cost" term.

I disagree. I initially wrote that sentence without the almost, because everyone must have a non-zero value of their time. However, I can't prove that statement, so I added almost in order to not get into a debate about a theoretical person who's time is worthless.

I am not saying that everyone is willing to pay 5-40% more to go in a slightly faster line, but I bet if you go anywhere that a line is formed there is some nonzero price which everyone in the line would be willing to pay to skip to the front.. Even if it is measured in cents.

Your right, it is about opportunity cost. And opportunity cost is rarely zero.

I have no data, but let me make some off-the-cuff predictions about your plan to create "premium" supermarket checkouts:

Customers who understand your novel scheme will tend to queue up in the line which has the lowest prices, because people do not consciously understand what their time is worth.

Then other customers will see the long line at the discount aisle and subconsciously decide to leave your store without buying, because the lines are too long.

Or perhaps, instead of abandoning their attempt to buy anything, frustrated customers will notice an apparently empty checkout line with a cashier standing there. They'll approach that line, and be told that that it's a "premium lane" which will cost them an extra 5%. Then they will become enraged. Nobody wants to pay extra for a service that they're accustomed to get for free. And when they're told that they can always stand in the long, less expensive line, they will continue to be enraged at the sight of one or more cashiers standing around idle in the premium lane, waiting for premium customers, when those lazy cashiers could be helping out in the discount aisles! What do we pay those bums minimum wage for, anyway?

Inevitably, unless you are on-site breathing down their necks, your cashiers will give in to popular pressure and go to work in the discount lanes. At which point the premium lanes will have no cashiers, and nobody will use them.

Of course, if grocery stores were more like emergency rooms -- scarce, high-margin businesses which routinely force you to wait two to eighteen hours for service -- things might be different.

For info on shopper behavior from a guy who actually does have data, I recommend Paco Underhill's Why We Buy: The Science Of Shopping.

UPDATE: I have the answer! You could invent a scheme where customers who want to avoid waiting in line can trade their own labor for a shorter wait -- by scanning and bagging their own groceries at an automated kiosk. Suddenly, via a series of psychological tricks, your idea works well. I should patent this amazingly original variation of your idea. :)

So re-label it as a discount line. People who are willing to shop at odd hours or are willing to wait during peak times can save 5-10%. Meanwhile mark the rest of your stuff up 5-10%.

Not sure whether people pay enough attention to their grocery bills to tell a 5% increase, but I hear grocery store margins are terrible (like 2-3%) so maybe they would. It's tough to tell without some data.

Good idea though.

I agree that the initial response would be something like that, but it is the long-term behavior that I would be interested in.. Do people rationally value their time? Probably not. But I will bet you that some people would be willing to shop in the premium isles.

An automatic kiosk is a way to get around this, except you do extra work instead of paying more. But that misses the whole point of this - it isn't a solution to the lineup problem, it is a social experiment. You could potentially find out how much people value their time, in dollars and cents.

Thanks for the book recommendation.

Interesting comments!

I thought I'd post again, because I wasn't so clear the first time. Let's try again.

1) You DO have competition. Almost nobody has NO competition. Competition #1 would be "do nothing". There are other competitors.

2) This has probably been done before -- many times in many venues. You should find out where and why it did/didn't work out.

3) I hear you say you want to generalize to all kinds of things: doctors, grocery stores, banks, etc. Take a pill on some of that. If this has been tried before and failed, then you're going to need to grow organically inside one vertical -- then spin out. Waiting in line at an ER is just a different problem (both business and technical) than waiting in line at a car wash or something. Learn how to sell into one market well, first. Dreams are grandeur are probably a little premature. Mind your knitting.

Hope that helps some.

"Do nothing" is not called a competitor, it's called a barrier of entry.

"Barrier to entry" of a market is the cost in time and money it takes to become a possible source of a solution in a customer's mind. "Do Nothing" and "Do it yourself" are still very viable options for consumers even for competitors who have successfully managed to enter a market.

There is a distinction between competitors and alternatives; "do nothing" is the latter. I'm not foolish enough to think there are no alternatives, but I do believe there are no competitors to my service right now.

Look, I'm not trying to argue with you. I've been in a spot with ideas that didn't have competitors too. First thing I was told was that there's always competition.

Now you can look at it as alternatives, but if you are competing with these other alternatives in the mind of the prospect, guess what? They're your competitors. Alternatives that people have to doing your thing is called your competition, even though it might not have a logo and an office.

You can split hairs and try to call it something else, but that's the way I was taught. And I don't think splitting hairs will help much. You are in competition with the status quo, with inertia, with the tried-and-true. Your main goal is to get people to try something new. As far as I know this is a well-established piece of sales and marketing knowledge.

http://ezinearticles.com/?Sell-More,-Make-More-by-Knowing-Yo...

http://www.businessknowhow.com/marketing/knowcomp.htm

http://opinionatedmarketers.blogspot.com/2006/12/other-day-f...

I think you've got a good idea. Good luck with the implementation.

Interesting. I'm starting to see a lot of business-related terms that mean different things to different people in different fields (for instance, "securities" means "bonds" to a tax accountant, but "stocks+bonds+etc" to a financier). I'll certainly be careful with such distinctions when talking with investors, clients, etc.

Thanks for the input.

Yeah it's a biz term.

Perhaps non-intuitive, but the point is that you have to figure out how you are getting customers, whether that is changing their mind from "option X" to your service, or changing their mind from "doing nothing" to your service.

Some businesses don't bother to do that work, instead just saying "I have no competition" -- I'm sure you know that you don't want to go there.

As a side note, I'm really curious as to why I was down-modded up above there. I was simply trying to share stuff I know. Don't know why it would tick anybody off. People are welcome to have different opinions, and I'd like to hear about them instead of getting down-modded. If I'm wrong, I want to know about it! (That's kinda the point of commenting to begin with)

Get an add for it on the automated answering machine at the hospital, clinic, and or local physician offices.

i think the best way to do this is, via negotiations with ppo groups, hmo groups, and insurance companies. I could see someone like Allstate being interested in this, in regards to their current ad campaign about safe driving. Insurance is a really competitive market place, and I could see this as a feature add on sell, for a monthly fee. say 10$ a month to auto fill your paperwork, when you arrive in the emergency room.

you also need to consider that information is so often filled in wrong, and it makes the billing process hell for doctors and hospitals. if you could validate someones payment options before they arrived, then the hospital/ doctor might pay for that service just to get more accurate billing info.

medical health care billing is a dirty business and doctors get paid less than 1/2 the time. increase their payment percentage and they will jump at it.

when someone calls in, they will be given the option to fill in the data on the web via a website.

I can't find anything about it online, but going from the word of my adviser while I was studying in China, there was a woman there who did something similar to this and is now very wealthy. IIRC, she paid people to wait around in lobbies and sell their spots when they got called, so people could bypass the rest of the line. What you are doing, I would say, is more ethical because instead of skipping the line a customer is just reserving a spot. I wish I could find some news article about this, but I have nothing. Either my adviser was lying to me or my web search skills are diminishing. Anyway, good luck, I think it's a good service.

Go after the big city hospitals where there tends to be a really long wait time, like Chicago, New York, and LA. Also, try to work in text message notifications for 15 minutes before the scheduled time.

They have that for housing in China too. Usually when a new building of condos is for sale, only the first 100 (or however many there are) customers can buy it, so a few days before they open the office, a lot of people would line up and sell their spots to real potential condo buyers.

This is an absolutely brilliant idea, and I'd certainly use it if it were offered at a hospital near me and I needed it. (I hope I don't, for obvious reasons.)

I'd try two things to raise awareness. One is a local news story, as mentioned elsewhere on this thread. The other is to work with the emergency room staff at the offering hospital - I'd imagine they appreciate something like this too, since it means fewer frustrated patients when they finally do see them. Have flyers available for emergency room visitors - they'll be frustrated from the long wait time, which is the perfect time to offer them a solution. Put up posters around the waiting room. Try and get on the offering hospital's website.

You're right -- the ER staff love the service, because patients are in a noticably better mood when they haven't been cooling their heels in the waiting room for 3 hours.

The hospital's web site has a link to us on its front page, but this hospital hasn't invested much in developing their web presence. I'd like our next partner hospital to be one that has a stronger, more high-visibility web site.

If we could get on the first page of google for "<metro> hospitals" or "<metro> emergency room" that would be huge, I'd think. (But again, it's a local service, so getting link-fu is difficult right now)

Flyers & posters. Have the triage staff hand out a flyer along with the visit forms. It's the kind of thing that people will take note of and use later, and they may even tell their friends.

There is a lot of potential for really clever marketing. I'm thinking something like bus billboards that read "Hit by a bus?" :-)

I'd definitely use this if it were available in my area.

>How would you raise consumer awareness for a service like this? I've tried a few things (mostly offline), but none successful so far.

This is the kind of thing with huge mainstream appeal which means you need to market to the mainstream. PR is the best, do you know any reporters at local newspapers? If you raise some money or have some money, you can also buy advertisements in newspapers or magazines or hire a true PR firm to get you press hits.

Market the damn thing! Buy advertising! I'd definitely use this service, but there's no way I'd know to go looking for it.

This is a great service. I do not have much advices as I do not know about your industry but I can clearly see the value. Too bad I just moved from Smyrna ( I lived on Paces Ferry & Cumberland) or I would use it. Good luck, It's always nice to see startups from the ATL

I like it. Keep bootstrapping.

I wonder about scaling past that first hospital, though. Kind of a catch-22 situation -- the hospital has to be small enough to not care about having part of its records online yet large enough to support a growing business.

Good point. We've had to do some interesting data gymnastics to satisfy the lawyers at our first hospital, and the bigger hospitals we've talked with seem even more concerned.

I think it needs to be a compelling service from a financial perspective in order to get the hospital's legal and financial departments to approve. If we were able to move 10-15 patients per day to a partner hospital, it could be adding $1 million/yr in profit to the hospital, easily. Hence the need for volume before we can partner with more hospitals.

Thanks for the comments.

Perhaps do a little thinking about who your customers are. Just guessing, but I would think they are people with a) not a immediately threatening problem, but one they want to see a doc about, b) have $25 or a credit card or something and are willing to use it to prevent waiting around, and c) are internet savvy.

So I'd go looking for a hospital that has a lot of these folks that use their ER and see if you can't set up a partnership based on the work you are currently doing with this hospital. Better yet, get a list of 50 such hospitals and work your way down :) With a high-enough density target market, you can move to things like radio, doorhangers, or newspaper ads. The interesting question is whether or not to use SEO, because of the geographical limitations.

Neat idea. I was just talking with a guy a couple of weeks ago about this exact thing, except for doctor's offices.

"Competitors: none" won't last.

This seems like a situation where raising tons of funding and scaling like hell is your best move. Settle questions of legality in different cities/states now, before you have competition.

rev split with hospitals + terminal in the waiting room. Get biz dev and sign up hospitals. I'm sure that someone is saying this already in the comments, but don't have time to read all.

Find the person in the hospital that is having pain (figurative), whoever deals with the ER scheduling. Start by giving offering the hospital 15-25 %

It is a unique story, try pitching it to the local news, worst they can do is say no.

Good idea, I'll give that a whirl.

PG and others tend to talk a lot about how PR firms and offline marketing are irrelevant to online startups -- I think this may be one particular instance where that's not true. In a way, this is a very web1.0 idea, but hey, it's something people seem to want, so I'm running with it.

Thanks for the thoughts.

The fact that you have a hospital willing to do this is something huge. If you can make it work with them you could go to other hospitals to do the same.

It is a tough one to figure out though. I would think you would need to try to inform everyone in a 6 mile radius of this service. If it is densly populated you might try door hangers.

"Our startup spent its entire marketing budget on PR: at a time when we were assembling our own computers to save money, we were paying a PR firm $16,000 a month. And they were worth it. PR is the news equivalent of search engine optimization; instead of buying ads, which readers ignore, you get yourself inserted directly into the stories."

http://www.paulgraham.com/submarine.html

What story could you possibly make this into except, "Rich fucks pay to get ahead of poor sick people in emergency rooms?"

Users of this service aren't allowed to "get ahead of" anyone. This service only allows people to wait at home rather than waiting in the ER; the wait time is still the same, it's only a bit more comfortable.

Thanks for your input. ;-)

Users of this service aren't allowed to "get ahead of" anyone

That is rather clearly the whole point, but I'm not going to argue with you--I'm just alterting you to the fact that the public response to this will be overwhelmingly anti-elitist. As such, any advertising should probably be targeted.

Yes that is the story. Everyone wants to be rich and the guy who gets into the emergency room first. Kind of like those people who go to the front of the line at Disneyland.

You mean the people who are smart enough to buy Fastpasses?

Actually, you don't pay anything for those fast passes. If you have a ticket you just get them for free next to the ride. Everyone can do that.

http://news.ycombinator.com/item?id=65100

"Keep away from people who try to belittle your ambitions. Small people always do that, but the really great make you feel that you, too, can become great"

- Twain

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