VetPronto (YC W15) Brings Veterinary House Calls to San Francisco

> ...as almost no medical decisions are not made by me individually. We actually have a board of veterinarians meeting weekly to ensure our standards of care are the very best as peered review practices are generally the gold standard. I do not know the exact number of years experience combined we have, but it is greater than any individual veterinarian. I'm not sure what you're trying to say. It's great that you have established practices for the vets in your network in an effort to ensure a high standard of care,

I'm glad you appreciate that we practice a high standard of care.

>but what makes you think that other vets don't adopt best practices?

I am not individually responsible for other vets and don't make that assumption. I am just focused on the quality of our own medicine.

>Just because you assemble a team ("board") of vets with, say, 70 years of combined experience doesn't mean a lot to me. I could pull 10 software engineers with 40 years of combined experience into a room and it wouldn't mean that I have access to more expertise than a single engineer with 20 years of experience.

Good point, but just as paired programming can oftentimes help make a solid product, peer reviewing cases is a great way to achieve better results than an individual might be able to.

>As for "almost no medical decisions are not made by me individually," this is confusing to me. Let's say you palpate a dog on a house call and feel a mass. Are you not going to make certain decisions on the spot? Is every decision or recommendation a vet in your network makes reviewed by a team whose members may not have actually had the opportunity to physically evaluate the pet?

I meant that I don't make the standards of care myself. It is true that vets must make decisions on their own, and getting rid of human error is something that has not been accomplished at any clinic human or veterinary medicine . However, all of our vets are very experienced and excellent clinicians as our reviews can support this as well.

> There is a lot of issues regarding the management of pet health care that has not been worked out. Luckily we don't have the same amount of regulation that makes it difficult to create software readily, but it is also not a lucrative business to just make veterinary software. There are also currently no veterinary practices built around technology that I am aware of either which means most record systems actually decrease a veterinarians efficiency rather than improving it and are primarily designed to track billing and inventory. Our software is being built from the ground up ensuring that it allows vets to focus on what they do best, practice medicine. >This is all very non-specific. Again, I'll use my experience as an example. I have received high-quality, cost-effective service from my mobile vet. She arrives on time, is responsive and very cost-effective. In short, she has taken great care of my pet, access to special software or not. When she identified an issue that demanded the expertise of a specialist, a referral was made to one of the best specialty centers in Northern California. All of my pet's records were transferred within hours.

I think I would agree with Joe's previous comment addressed this pretty well, but please let me know if it needs more elaboration.

>With all due respect, it is absolutely not true that there are "no veterinary practices built around technology." The specialty center I was referred to, which is staffed by board certified vets, makes extensive use of technology. Is a practice with everything from an on-site CT scan to one of newest linear accelerators available for radiation therapy in pets not "built around technology"?

This sounds like a very technologically advanced clinic and I don't know what software they run so can't really give specifics on what may or may not be great about their systems.

However, I am fairly passionate about medical records in general so will dig in a bit. Unfortunatley these days, picking veterinary practice management software gives you the options of bad or worse so am skeptical of any third parties assumption that any clinic is built on a great platform. This is a problem I tried to solve directly initially in and out of vet school, but veterinary clinicians generally do not care about having great technology drive their practice as they were trained to practice medicine and view the computers as getting in the way of that. Unless they see direct results to their profit right away They are not interested in adopting new technologies. This is why most practice management software just focuses on inventory. Many practices are still largely paper based even if they have a practice management software solution.

This is slowly changing though. I've been active with the Association of Veterinary Informatics, performed collaborative research between human and veterinary medicine on natural language processing of medical records with amount Sinai and worked with Trupanion pet insurance in trying to pull meaningful data from clinics trying to find ways to solve this.

I hope VetPronto can eventually help define some of the medical record standards to help more seamless integration occur between practices, but for now we are focused on delivering a great service to as many pets as possible.

>In short, you seem to believe that custom practice management software with a mobile booking app makes you a technology-based veterinary practice. While I see nothing wrong with the nature of your service and wish you the best of luck, I would simply suggest that you're underestimating what the word "technology" means in modern veterinary medicine. Of course, this "wrap a mobile app around a service business and call it a technology business" approach is widespread today and not exclusive to your industry, so anything that I wrote here which might be construed as criticism applies to many startups.

I am a bit confused with this. Is a veterinary specialty center your definition of a technology based veterinary practice? If so, I think I answered this but please let me know.

>Finally, for "but it is also not a lucrative business to just make veterinary software," you might want to look at http://www.henryschein.com, a Fortune 500 company that did hundreds of millions of dollars in sales of dental, medical and vet practice management software in 2013.

Henry Schien is a drug distributor that bought out one of the largest practice management software services (AVImark) to sell more product to clients and get their foot in the door of more clinics. AVIMark was likely easy to buyout because making practice management software because it wasn't very lucrative. I can't speak for the other markets and practice management software outside of veterinary medicine.