MiMedication: a niche Personal Health Record strategy
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Frank Boermeester Frank Boermeester - January 31 2012

Health Startup Interview with Mitchell Silva, founder of MiMedication

MiMedication is a new online personal health record for tracking medication and health parameters.  Nothing new you might argue, given the number of personal health record offerings out there already, so what’s special about Mitchell Silva’s creation? Focus could make the difference. Mitchell is targeting people with chronic lung disease and he’s focusing on the Belgian market first, exploring potential revenue streams from patients, government and insurance companies.  Even given that focus, the market isn’t to be sniffed at.  In Belgium alone it is estimated that there are 1 million people (out of a population of 10 million) suffering from asthma or chronic obstructive pulmonary disease. Every COPD patient is costing the social security system 4250 Euros per year. Mitchell has some pretty handy experience too—he conducts research in the field and he happens to be a lung patient himself. In this HealthStartup interview, we asked Mitchell how he intends to make a success of his product in the Belgian/European market.

How did you come up with the idea? What led to you starting this business?

I have a personal incentive. Three years ago I was diagnosed with a very rare lung disease requiring daily doses of cortisone.  Sometimes I take a high dose to combat symptoms but afterwards I always have to gradually reduce the daily dose.  I found that process of managing my doses and symptoms really challenging so I started using an Excel spreadsheet to log these parameters on a systematic basis. I found Excel too cumbersome to use, however, so I decided to develop my own tool.  Professionally, I also happened to be involved in the field of Pneumology so that helps too.  I’m a bio-engineer graduate from Leuven University and for my PhD thesis I conducted research with asthma  and COPD patients.  My thesis entailed the analysis of coughing acoustics to see if it could serve as a disease indicator.

And the tool works for you?

Yes definitely, it has a significant impact because I was able to detect clear patterns in the way my symptoms and medication doses interact. My doctor and I use that data to fine-tune the daily doses with good result. Basically the tool allows you to see much earlier whether a specific medication and dose is right for you. I’m now talking to Pneumologists at the university hospital to see if we can organize a clinical trial to more formally determine the benefits of the tool.

Where do you stand today with the company?

I had the tool developed approximately a year ago.  The site is live and available on a subscription basis to patients, although I haven’t done any marketing yet.  At this point I’m trying to test the service and build the right business model.  The key question is: will patients be prepared to pay for this? The answer is probably ‘no’ for a generalist service. The plug was pulled on Google Health because people seem to lack discipline or interest in logging their own symptoms—and their service was free.  That’s why I want to focus on a specific chronic illness—lung disease—because then there is a real motivation to track your symptoms.  This doesn’t mean that the market is small. In Belgium alone (population approx. 10 million) there are approximately 1 million people suffering from a chronic lung disease such as asthma or chronic obstructive pulmonary disease.  The question still is, will people—even chronically ill people—be prepared to pay.  In the United States a survey showed that 20% of people are prepared to pay a small subscription fee for a medical record service.  But in the U.S. people are accustomed to paying for medical care; not here. As a result I’m also talking to insurance companies and the sickness funds (mutuals) to see if they could reimburse patients for utilizing the service.  That’s why research is important—I have to show them that it can save on healthcare costs.

Are you optimistic? Is Belgium the right place for starting this type of business?

Sometimes I do think that the US would be a better place because people there are more likely to pay for this type of service themselves. On the other hand, if I can convince a key stakeholder in the healthcare system here to back the service I’ll gain traction much faster.  It comes down to lobby work. Furthermore, Belgium is well known for its research on COPD patients and has clearly documented the financial impact of this disease on the health care system. We also have some of the world’s most recognized COPD specialists here in Belgium supporting my application, so in that sense Belgium is a good starting point.

One of the potential barriers to your type of initiative is the complexity of regulation governing privacy and healthcare data, especially in Europe.  Is Europe ready for this type of initiative?

Time will tell.  Clearly we need to move towards a more bottom’s up approach where patients take more responsibility for their own medical information.  In the current top-down system where every country has its own e-health regulation it won’t be easy, granted.

What are some of the key trends in the field that you’re keeping track of?

I’m particularly interested in two trends.  Firstly, the connection between wifi-enabled devices and online records making automated data collection possible.  I’ll definitely be integrating devices into my solution.

Secondly, the trend toward personalized medication. There is increasing awareness that a more personalized approach to disease management and medication is important. That requires far more intense tracking of symptoms and health parameters—which is exactly what I’m trying to do with my solution. Also, if the data can somehow be aggregated in a safe and anonymous way then it should become possible to improve the intelligence of the tool by for example using predictive models and early warning alerts.

Do you have any tips for other entrepreneurs in the digital health space?

Firstly, surround yourself with experienced people. I’m alone in this project and have found that difficult.  That’s why I seek out help from various networks and platforms. For example, I attended the Microsoft Bootcamp programme which was really useful for connecting with mentors.

Secondly, action, action, action.  Even if you don’t know what the outcome of a particular initiative will be, just do it, you’ll learn soon enough.  Things move so fast in this field that you cannot afford to wait. You have to keep moving and learning.

Any requests for our readers?

Yes, I’m looking for partners, especially medical professionals and developers. Please do get in touch if you think we could work together somehow.




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