As I explored in last week’s article, clinicians of all specialties and ages are exploring the viability and process of launching a virtual clinic to offer their clinical expertise from the comfort of their home…or their Air BnB on the beach or in the mountains.
While it is a tempting idea, starting an internet-based service business, especially in the heavily regulated healthcare industry, is not to be taken lightly. Fortunately there are a number of strategic, business, financial, legal, and marketing experts that can assist a motivated clinician in the journey of creating a new way of freedom.
Last week, we asked nine essential questions to help clinicians decide whether they should start a telehealth clinic. This week’s article picks up where that one left off: you’ve confirmed you’re ready — and now you want to know how to do it.
You’ll find no single recipe or one-size-fits-all playbook here. But this four-phase framework — BEFORE, SET UP, LAUNCH, and RUN & OPTIMIZE — offers some practical “food for thought” to organize your thinking, your time, and your progress.
Enjoy the process of reviewing the critical decisions, deliverables, and tasks you will have to complete as you are moving toward the launch of a sustainable telehealth clinic.
BEFORE
If the questions you answered last week were about gaining initial clarity, the assignments below take us to the next level, using some of the information you prepared by answering those initial questions.
This phase is about creating clarity. There is inherent risk in a venture like this and you would not want to waste your time and your money on “putting the cart before the horse” spending money on a logo, or a brand, a website, or a lawyer.
So here we go – BEFORE you launch your Telehealth Clinic, here are six areas to ponder.
(1) Define Your Target Market: Who do you want to serve? Beyond the clinical conditions that reflect your expertise, consider demographics (such as gender, age, education level, income, net worth), geography (especially at the state level), payor type (if you think you will take insurance vs. cash pay). Since in a virtual environment patients will have to take initiative to reach out and book an appointment, also consider exploring the intrinsic and extrinsic motivation of the patient to seek care.
(2) Clarify Your Value Proposition: Defining what will make your clinic uniquely helpful to these patients is crucial? Think beyond clinical expertise and include the obvious aspects of telehealth, such as accessibility and convenience. But also explore how you can differentiate yourself from the “brick and mortar” competition (maybe it is same day appointments?) but also from the hundreds of other “virtual clinics” that are available to your targeted patients with the click of their mouse.
(3) Sketch a Simple Business Model: There will be a need for a more formal business model that considers the various aspects of a telehealth clinic, but for now one of the key decisions to make are these: Will you be direct-to-consumer or business-to-business? Taking insurance, cash-for-service or a subscription model? A solo practice or group model? There are many options to choose from and to evaluate the most likely ones will take some time.
(4) Estimate Revenue and Costs: Many clinicians are going into this direction because they want to earn additional income or replace their income from their day job. Therefore it is prudent to early on create a rough but realistic pro forma. What would you need to charge? What will startup and operating costs look like?
(5) Set Your Success Metrics: Similar to one of the questions from last week, knowing what success looks like will save you a lot of missteps. Many treat it like “I’ll know it when I see it”, but being clear what “success” you are working towards can shave off months if not years of the launch. So ask yourself: what does “working” look like — financially, emotionally, or operationally? How will you measure success beyond the profit?
(6) Gauge Your Risk Tolerance: Just like good financial advisors (and plenty of online tools) frequently ask you, you need to know your risk tolerance. Launching and growing a business is not for the faint of heart, though when it works it is immensely rewarding. How long can you (and your family) tolerate losing money before you give up? What cushion can you use to support you through the initial months?
The collection of answers to these six assignments should give you confidence to proceed. If all lights are still “green”, it’s now time to go back and formalize some of the early drafts. Key deliverables out of this phase include:
-
A Value Proposition Canvas (along with multiple patient personas)
-
A Business Model Canvas
-
A Pro Forma
-
A Business Plan (but not the 50 page version)
-
A Pitch (or pitch deck) if you want to raise money
SET UP
Once you’ve considered and confirmed all the questions above, it is time to pull the trigger. Armed with cash to pay your (existing) bills and with money set aside to pay for the startup costs, you can now build the foundation of your future business.
(1) Develop Your Marketing Plan: Most Telehealth Clinics that are aiming to serve the direct-to-consumer market will be primarily in the marketing business, not the healthcare business. Delivering care is the easy part. Finding patients, however, can be quite tricky. A good marketing plan that builds on the patient personas, value proposition canvas, and business model canvas will cover your key messaging, refine your target audience (and where to find them) and identify (and price) your specific marketing techniques that will enable you to find your first patients.
If your business model will be highly dependent on the success of your marketing approach, it would be prudent to spend a good amount of time on the marketing plan and to validate your assumptions before spending money on the steps.
(2) Choose Your Legal Entity: Most clinics will want to operate as a pair of a managed services organization (MSO) and a friendly professional corporation (PC), due to the legal limitations in the US of who can provide healthcare. But there are then also other things to be considered – LLC vs. Corporation vs. sole proprietor. This is the time to tap into the expertise of lawyers and accountants to ensure that the entity is off to a solid start.
(3) Register and License: This step is obviously next to establish your business entity. Other tasks in this step include getting your EIN (for tax filings), and the uniquely healthcare aspects of a business: secure malpractice coverage, and establishing licensure in all the states that your patients could be contacting you from.
(4) Pick Your Tech Stack: Running a telehealth clinic obviously requires an investment into a video visit platform that is user friendly for both the clinician and the patient. Other tech tools include an EHR, patient intake software, patient messaging system, payment processors, etc., just to get you started. For the not so tech savvy clinicians, teaming up with an expert in this field to spec, acquire, install, configure and train you on may be another good investment to keep down the headaches and nightmares.
(5) Set Up Financial Operations: Here a part-time bookkeeper and accountant will be valuable to assist in opening business accounts, setting up the bookkeeping and determining how you’ll collect and track payments.
(6) Draft Policies and Paperwork: Another round with a good, experienced lawyer will yield solid policies that every business should have, especially when they are publicly very visible on the web. These include terms of service, privacy policies, intake forms, consent documents —get these ready before your first visit.
(7) Define Your Clinical and Admin Workflows: The delivery of care is a series of processes from making appointments and communicating with the team to visiting with the clinician and paying the bill. Many clinicians only see “the tip of the iceberg” and are often oblivious to all the behind-the-scenes processes that exist to get the patient into front of the clinician (and back). In addition to the patient-facing workflows you will also want to define all the operational processes related to finances, human resources, technology, etc.
(8) Decide on Your Support Team: As may be already obvious by now, delivering care at a distance is not simply jumping into a virtual waiting room and letting the patient in. There is more — a lot more — to it. So you have to decide whether you will start solo or bring in virtual assistants, billers, a bookkeeper or schedulers. Other considerations include engaging part-time leaders in strategy and operations, if those are not your forté.
(9) Design Your Brand Presence: In our brand-conscious world this is where many people love to start investing time and money. But I put this action purposefully last in this section, as you should only invest in your brand if you have utmost confidence that you can be successful based on the research and answer in the previous questions. A brand includes a name, logo, tagline, standard colors and fonts and, eventually, a website (which is also part of your marketing strategy).
Ready for Launching and Running your Clinic
With those preparations we are now ready to actually launch the clinic.
We’ll continue our “blueprint” in next week’s article, where we cover the actions in the remaining two phases.
Building a telehealth clinic is bold work. Yet it’s also entirely possible. Would you like to talk through those questions or explore how our team could be of assistance to getting closer to realizing your vision of establishing your own telehealth clinic? Then text me at (657) 464-3648 to set up a call or connect with me through my other channels.
To receive articles like these in your Inbox every week, you can subscribe to Christian’s Telehealth Tuesday Newsletter.
Christian Milaster and his team optimize Telehealth Services for health systems and physician practices. Christian is the Founder and President of Ingenium Digital Health Advisors where he and his expert consortium partner with healthcare leaders to enable the delivery of extraordinary care.
Contact Christian by phone or text at 657-464-3648, via email, or video chat.
