Running head: PANACEA BUSINESS PLAN 1

Panacea: Urgent Care Telehealth Business Plan

Steven Zhang

University of San Diego

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Executive Summary
Panacea offers a customized mobile telehealth technology solution for health care

organizations to improve patient access and care by modernizing advice nurse technology,

integrating urgent care centers with hospital emergency departments, and improving patient

experience.

Panacea will build a custom mobile application to fix the lack of access problem of after-

hours heath care. The application is a tool for advice nurses to have virtual video appointments

with patients and have access to their electronic medical records. Advice nurses can also

virtually check-in patients to available urgent care centers and emergency departments as

needed. This will reduce crowded emergency rooms and save hospitals millions of dollars each

year.

The telehealth industry is expected to reach $266.8 billion by 2026 (Fortune Business

Insights, 2020). The current Covid-19 pandemic has accelerated this industry and adaptation of

telehealth and telemedicine. The health care organizations are now looking for effective ways to

provide care to patients at their own home as 75% of consumers are now interested in telehealth

according to Mckinsey & Company (2020).

Panacea will be cash flow positive by the end of its second fiscal year. Based on current

market conditions Panacea predicts a sales growth of 25% by the third fiscal year. Initial startup

cost for Panacea will be $62,310 with a total first year expenditure to be $976,100. Panacea has

successfully secured funding for the first-year expenditure.

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Panacea: Urgent Care Telehealth Business Plan

It’s 3:00 a.m. Monday morning and a child is complaining of nausea, headache, and a

rash. The child’s primary care physician (PCP) is closed and is not available until the morning.

All nearby urgent care centers are also closed. You call the advice nurse hotline, but they are not

much help because they do not have your child’s electronic health records (EHRs) and cannot

see the rash on their phone system. Per the nurse’s recommendation, the parents head over to the

nearest emergency department (ED), which is crowded and uncomfortable. After a 6-hour wait,

the attending doctor prescribes over-the-counter medication for the child.

Panacea’s vision is to provide 24/7 access to health care, anywhere, anytime, and any

place for all individuals by improving access to health care during after-hours between 9:00 p.m.

to 9:00 a.m. and reducing unnecessary emergency department visits. Panacea’s purpose is to

build a smartphone app that allows patients to use modern telehealth technology to see a doctor.

Description of Activities

The Panacea application (app) will fill in the after-hours healthcare gap between 9:00

p.m. and 9:00 a.m. Using modern telehealth technology, clinicians will have the ability interact

with patients via video feeds. Clinicians will have access to real time health data, such as

heartrate and oxygen saturation. Additional health data can be made available for any medical

devices synced to the patient’s phone such as blood pressure. Most importantly, clinicians will

have access to your medical health records.

Patients, will have peace of mind knowing they have access to doctors and nurses on the

phone during late hours. If a visit to an urgent care or emergency room is needed, the app will

direct them to an urgent care or emergency room.

Target Population
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The target population for this product will be (a) young families, (b) parents with

advanced degrees each with an annual income of $150,000 a year, (c) early adopters of

technology, and (d) metro area residents on the west coast and east coast.

Panacea is important for three reasons:

1. This will help reduce emergency visits that are not actual emergencies.

2. This will improve the utilization of urgent care centers across the region.

3. Improve accessibility of patients to healthcare professionals during 9:00 p.m. to 9:00

a.m.

Business Description

The telehealth market is expected to reach $266.8 billion by 2026 (Fortuine Business

Insights, 2020). The sudden and rapid impact of the Coronavirus, a global pandemic that hit the

United States in March of 2020, and the subsequent shelter in place have push telehealth into the

spotlight. Even at a market share of just 1%, this equates an annual revenue of $26.6 million. We

believe this is an ideal time to help healthcare organizations to deliver high-quality care using

modern telehealth technology during after-hours. With Panacea, we are reimaging the late-night

advice nurse.

Panacea, the Greek goddess of universal health was chosen to be the name of our

company because it is in alignment of our company vision of quality health care access for all.

Rather than going to emergency rooms and enduring the long wait time with dozens of other sick

patients, patients can be seen within the comfort of their own home.

Currently, there is opportunity to capture the fragmented after-hours health care market.

The current pandemic has highlighted the effectiveness of tele-technology and now health care

organizations are investing in telehealth technology. Panacea wants to be the primer vendor to
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help health care organizations to incorporate telehealth technology into their current health care

system.

Current telehealth competitors offer similar service; however, there are two primary

difference between them and Panacea.

1. Current telehealth apps aim to replace the traditional PCP.

2. Current competitors require additional subscriptions and may not be covered by

traditional insurance.

From a patient consumer experience, often patients will use a telehealth app only during

an urgent medical situation, frantically downloading the app, use its services, pay service fees

needed to speak with a clinician, and drive to an urgent care or an emergency room. Most apps

do not have access to patient’s electronic medical records. What we wish to accomplish is to

embed our services with healthcare organizations and uses one app for all patient related needs.

Our service is unique because our platform will be connected to the patient’s traditional

health care organization. From the patient’s perspective, our services will be covered by their

current health insurance policies. The Panacea app will act as the mobile urgent care center when

traditional avenues are not available. Patients will simply log into the app and tap on the service

they need. Different user interfaces will be designed for patients with various technology

skillsets. The app will also default to their preferred language. A live clinician will be available

to triage the situation and build a plan of care for the patient requesting service (e.g., at home

remedies, urgent care, emergency room, ambulance). Any bills incurred during the virtual visit

will be billed to their insurance company.

As part of their residency and internship, doctors, nurses, nurse practitioners, and

physicians’ assistants (clinicians) are required to work a certain number of hours. Dedicated
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virtual clinicians will be added to the app services once demand of the service increases.

Clinicians will have access to the patient’s EMR just as they would for an in-person visit. Virtual

clinicians would also have ability to write prescriptions and refer patients to urgent cares or

emergency rooms and offer virtual check-ins. In the event of an emergency clinicians will also

have an option to contact 911 for an ambulance.

Key Participants for This Endeavor

Technology developers and cybersecurity experts will design the application and ensure

its safety. A project manager can communicate both the technology side of the app as well as the

intricacies of a health care organization. Additionally, we need stakeholders within the healthcare

organizations to buy into the idea and allow this add on into their current healthcare app. We will

also need representation from the union to develop new job responsibility up to a new dedicated

virtual position to ensure proper coverage. We would also need a participate representing the

medical school and build this into their internship curriculum.

Our strategy to convince the Federal Drug Administration (FDA) and other governmental

agency about the safety and legality of this issue is bolstered by the current pandemic. As

schools and other institutions go virtual, we can use the data collected and demonstrate patient

care done via telehealth is safe and protected. Hire a professional consultant who is familiar with

the FDA process will be critical to ensure federal regulations are met and approved. We will

ensure our telehealth technology meets both Health Information Portability & Accountability Act

(HIPAA) and Health Information Technology for Economic and Clinical Health Act (HITECH)

regulations.

As the healthcare organization will be our customers, the basic price model will be a base

fee plus of charge per usage. This pricing model may be ideal for health care organization that
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expects low perceived usage. Another pricing model would be base price plus total patient within

their healthcare organization, in which the health care organization is charged a base fee plus a

charge for every patient they have on their system. This pricing model may be ideal for health

care organizations that experience high usage and may be more cost effective in the long run.

Using a perpetuity license and subscription model, Panacea expects sales revenue ranging from

$100,000 to $15,000,000 depending on the size of the health care system.

Market Analysis

The potential market opportunity for this service can be nationwide as our primary

customers are health care organizations. As an initial proof of concept, we will limit our market

to members of Kaiser Permanente of Northern California which includes 4.5 million people.

Using the percentage standard of the diffusion of innovation, we can expect roughly 2.5% of the

Kaiser members will adopt this technology, which equates to about 112,500 members.

According to the statistics provided by the California Health Care Foundation (2020), there are

371 ER visits per 1,000 residents per year which equates to 37% of the population. Therefore, of

those 112,500 members, we can predict 42,188 Kaiser members will use this app in an urgent or

emergency event.

Market Segmentation

The San Francisco Bay area will continue to rise 30% by 2040 according to Metropolitan

Transportation Commission (2020), and in turn, we can expect Kaiser Permanente’s membership

to increase as well. Since our business model will be a base fee (based on total Kaiser members

within the area) plus a usage fee, we can expect an increase in revenue of our product. The ideal

customers we will be targeting have the following characteristics:

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Behavioral
Purchase: Very comfortable using both computer and mobile technology
Consumption: Medium to high spending.
Educated and informed
Reliance on customer reviews to make decisions

Psychographic
Active lifestyle- pursues a well-balanced life
Fun, loving, caring people. Concerned about environmental and political rights
Works in job with meaning and purpose

Geographic
San Francisco Bay area

Competition

There are three groups of competition within this market: emergency rooms, urgent care

centers, and private online telehealth apps.

Emergency Rooms

In the Bay Area, the four major health care systems are University of San Francisco

Health System, Stanford Health, Sutter Health, and Kaiser Permanente. These emergency rooms

operate 24 hours a day.

Urgent Care Centers

There are urgent care centers throughout the San Francisco Bay Area. All urgent care

facilities typically operate between the hours of 9:00 a.m. to 9:00 p.m.

Private Online Telehealth Apps

Currently, there are over a dozen telehealth applications available to consumers. Of the

dozen or so mobile apps out there, only four apps have more than half a million downloads:

 Doctor on Demand: Over 1 million downloads with 35,875 reviews at 4.5 stars.

 Teladoc: Over 1 million downloads and 32,000+ reviews at 4.7 stars.

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 K Health | Telehealth & AI Symptom Checker: Over 1 million downloads at 8,884

reviews at 4 stars.

 Amwell: Doctor Visits 24/7: Over 500,000 downloads at 4.2 stars.

Medical Application Analysis

The four medical apps selected have their own in-house physicians and are available 24

hours a day through patients’ smartphones. Although some do take insurance, others require a

subscription and pay-per-visit fees. Although they offer 24-hour access, these medical apps do

not offer urgent care services and primarily act as a replacement to your PCP. These medical

apps do not have full access to your EHR compared to urgent care centers and emergency rooms.

SWOT Analysis of Panacea

The goal of our product is to help current healthcare systems to increase access to

healthcare and have better patient outcomes during the hours between 9:00 p.m. and 9:00 a.m.

By working with healthcare systems to expand their late-night services through telehealth urgent

care, not only will this reduce the number of nonemergency cases in the emergency department

(ED), it will also improve the patient experience as they no longer need to wait hours to be seen.

Figure 1 SWOT analysis shows a SWOT analysis of our product.

STRENGTHS WEAKNESSES
• Full access to patient • Healthcare bidding process
EHR means safer and more is tedious and complicated
accurate diagnosis • High regulations HIPPA,
compared to current HITECH, Sarbanes–Oxley
telehealth apps. Act (SOX)
• Fills in critical gap in • New operational processes
health coverage between SWOT will need to be implemented
9pm to 9AM that Urgent within the health system.
Care Centers does not fill • Long bureaucratic process
• Shorter wait times means • Reimbursement process
better patient experience may be slow- causing strain
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and outcome to cash flow.

• Financial model is billed • Single steam of income-
through the health systems healthcare system
rather than from patients
• Ability to write
prescriptions and direct
patients to physical
locations
• No additional
subscriptions necessary
OPPORTUNITIES THREATS
• Process can be replicated • Local, state, and federal
quickly across multiple regulations
healthcare organizations • More urgent care adopting
• Help healthcare 24-hour telehealth service.
organizations capture lost • Cybersecurity—hackers
revenue due to urgent care • Malicious patients
centers • Market demand
• Telehealth is gaining
popularity due to current
global pandemic
• New services can be
provided upon successful
telehealth urgent care
launch
Figure 1. SWOT Analysis

The current pandemic has shined a spotlight of telecommunication and telehealth. Due to

the current shelter-in-place in the state of California, citizens have accepted the concept of tele

technology. With the help of our current target customer (Kaiser), we can launch a mobile

campaign to encourage patients to use this app for late night urgent needs in place of the

traditional nurse helpline. Once the early adopters (i.e., 25-30-year-old patients, families with

small children) recognize and appreciate the benefits of this app, peer reviews and strategic

campaigns will add in the dissemination of Panacea.

Financial Analysis
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The initial start-up cost will be the purchase of computer equipment and the creation of

the website. Anticipated costs for furniture and computer hardware have a lower projection due

to employees already owning personal equipment needed for a home office as well as high-end

computer systems. There is no cost for office space rental fee as Panacea have decided to work

primarily from home with meetings once or twice a week at the local library. The projected

onetime start-up cost for Panacea would be $76,160. Table 1 shows the breakdown of Panacea’s

budgeted and actual start-up cost.

Table 1

Initial Start-up Cost

Initial Start-up Cost

COST ITEMS DATE DUE BUDGET ACTUAL OVER/UNDER
 
ADMINISTRATIVE/GENERAL
Licenses/Registration $500 $375 Under $125
Permits $300 $175 Under $125
Insurance $3000 $3000
Legal $500 $600 Over $100
Business Consultant $3000 $3000
Software (General) $5000 $4000 Under $1000
Miscellaneous $1000 $300
LOCATION/OFFICE
$360
Telephone Set up & Annual Cost $360
($4,320)
Furniture $2,000 $0 Under $2000
Hardware $30,000 $15,000 Under $15,000
Installation Fees $500 $500
Miscellaneous $500 $0
MARKETING
Logo, branding, website $25,000 $35,000 Over $10,000
ESTIMATED START-UP BUDGET   $76,160  $62,310 Under $13,850

Funding

The start-up funding will be a combination of various investors (i.e. self-funding, friends,

family, private investors) in addition to traditional bank and credit union business loans. There

are over a dozen start-up incubator and accelerator programs throughout Silicon Valley which
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offer both funding and mentorship and Panacea can apply for, such as 500 Start-up and Rock

Health. Additionally, Panacea can compete in start-up competition hosted by investors firms

such as SF Angels group and Silicon Valley Forum and win additional investments and

mentorship start-ups. Panacea’s goal is to be ready for Series-A funding by Year 5 of business

through a successful track record revenue.

Profit and Loss Statement

The profit and loss statement below is Panacea’s estimated projection of our first 3 years

(the first year is broken down by months). Our target goal is to build a functioning product by the

end of the first year, aggressively market the product by Year 2, and win a contract by Year 3.

Depending on the size of the health system, each contract should be worth anywhere between $2

and $10 million. A small business version is available for private clinics and urgent care centers

for additional revenue stream. The profit and loss statements (see Tables 2, 3, and 4) show the

first 12 months and the first 3 years of Panacea.

Table 2

Profit and Loss Sheet Monthly Jan- June

Table 3
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Profit and Loss Sheet Monthly June- December

Table 4

Profit and Loss Statement Years 1-3

Operating Plan
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Panacea’s 3-year timeline and rollout are in alignment with its three-year financial plan.

Panacea will have a deliverable product by the end of the first fiscal year. The primary goal of

the mobile app will streamline after-hour care. The Panacea app will enable clinicians the ability

to view patient medical records when they call in. Advice nurses will also be able to video chat

with patients. Third, advice nurses will have the ability to refer patients to open urgent care

centers or emergency rooms and check-in virtually.

Panacea’s next release, (target by end of Fiscal Year 2) will allow interconnectivity

between Panacea and other third-party healthcare applications that store patient vitals and other

health information. The goal of this feature is the ability to for advice nurses to take patient

heartrate, blood pressure, and other data in real time.

The third and final planned release will expand Panacea’s functionality to allow patients

the ability to have virtual doctors’ appointments with their primary care physicians and other

specialists. Convenient features like appointment scheduling, viewing medical records, and

reviewing medication history are now available for patients to use at no charge.

Technology

The key technology used in the Panacea app is the connectivity between the Panacea

App, electronic protected health records (ePHI), ePHI databases within health care organizations,

urgent care centers, and third-party health monitoring mobile apps. Due to the sensitivity of the

ePHI, no personal ePHI data will be stored on patients’ physical cellphones, and all data

transmissions will be done over secured networks.

Stakeholders

The major stakeholders in addition to Panacea, the makers of the mobile application will be the

stakeholders within each health care organization. Health care organization as a whole is
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interested in the cost savings by reduction of patients unnecessarily overcrowding emergency

rooms. Potential income generator as more patients will seek out telehealth services prior to

going to urgent care. Within the health care organization umbrella are patients themselves, who

wants easier, faster, and affordable health care 24 hours a day. Finally, there are

Emergency Clinicians and other hospital staff, who are concerned about heavy workloads and

safe working conditions.

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Key Employees and Organization

The key employees of Panacea will have an executive team as in any business. The Chief

Executive Officer (CEO) will be responsible for the overall direction and vision of the business

as well as relationship building to secure additional funding. The Chief Financial Officer (CFO)

will be Responsible for the financial aspect of the business. Its main goal is to monitor the

financial health of the company. CFO’s primary objective is to ensure accurate financial

information to the CEO. The role of the Chief Technology/ Operations Officer (CTO/COO) will

be a combined role responsible for the operational effectiveness of the business. Since Panacea is

a technology company, it is important the COO have a technology background to ensure the

business is operating efficiently. The Backbone of Panacea will be the team of developers who

will be designing the Panacea mobile application. The team comprise of App developers

(building the main code of the app)and User Interface Designers who will design how users

interact with the app. Cyber Security Expert will ensure that the app is protected and safe from

hackers and other variabilities that may compromise patient information. Finally there are

Product and Project managers who oversees the successful completion of the app on time and on

budget.

Figure 2 offers a hierarchical view of Panacea’s organizational structure.

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Figure 2. Organizational chart.

Facilities

Panacea will allow all current staff to work from home indefinitely. All business

activities can be done online using teleconferencing tools such as Zoom and Microsoft teams.

Once the pandemic is over and it is safe to travel, the team will meet once or twice a week for in-

person meetings to strengthened relations and address the needs of the business in person.

Conclusion

Panacea will modernize the after-hour access to health care through the use of modern

telehealth technology. By connecting video conferencing technology, access to patient health

records, and virtually checking in patients to urgent care centers or emergency rooms, Panacea

will save health care organizations millions of dollars each year while improving patient access

to high quality care.

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