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Challenge Cup

Winner Spotlight: Medxnote Brings Hospitals into the 21st Century with Mobile Messaging

Dena Levitz Headshot

Dena Levitz

Challenge Cup Reporting Fellow, 1776

Pagers might seem like relics of another, pre-smartphone era, but they’re still a big part of medical professionals’ workflow and communications.

Niall Rafferty is out to change that with Medxnote, a secure mobile-messaging app for hospitals and their staff.

As of last week, the Dublin-based company became one of four People’s Choice Award winners, earning a chance to pitch as a Challenge Festival health semifinalist. In the wake of that vote, Rafferty, founder and CEO of Medxnote, explained why he became frustrated enough to start a company around healthcare communications and what makes his startup’s application superior to WhatsApp and other messaging tools out there.

You emphasized during your Challenge Cup pitch that you want to take hospitals out of the 1980s and 1990s and replace pagers. Hospitals are really still reliant on pagers these days? And why is this problematic?

Medxnote solves two problems. The first is the hospitals and their outdated communication tools like pagers. The second is, because of the limitations, doctors are using non secure consumer messaging apps like WhatsApp to text patient information to each other, which is not safe.

What we have is safe and secure to use in a hospital. We can replace pagers and give doctors a secure alternative and w can also handle medical alerts. So a doctor can know when the message is opened, and we’re building in an acknowledgment system, which is important.

And going back to the issue of pagers: Yes, hospitals are still using pagers. At one of our pilot sites they have 600 pagers. And why are they still using them? I don’t know. It’s not even that it’s fully healthcare’s problem. The IT departments of the hospitals are providing pagers, and doctors know they’re inefficient so they’re going out and getting their own (devices). So effectively we have legacy systems and the doctors have also done a work-around. Doctors have moved on but the hospitals haven’t caught up.

So then, on the safety and security angle, what do you do that makes messaging via Medxnote more effective and secure?

When we were developing this we looked at the United States and HIPAA, so we’re already HIPAA compliant. It’s safe and secure and password-protected and meets all of the security requirements.

How did you come up with the idea for this?

It was borne out of my own frustration working in a hospital. Most health care workers are mobile. They’re moving around all the time. Communication is the height of what’s wrong in health care, in my opinion. People aren’t connected and in their own little silos of what’s going on.

I was in charge of the radiology system for storing x-rays. And if I knew the system was going down between 3 a.m. and 5 a.m., I couldn’t get a message to the doctors. I’d have to print out posters and walk around the hospital and stick them on the walls. I just thought that was frustrating. If we wanted to get an x-ray result out to a doctor it was very difficult. If I wanted to do a training session with new doctors I was paging them and no one was answering and I couldn’t wait loads of time for them to respond

And the big thing that happened, which really made me passionate about fixing this, was we could see the breakdown in communication had affected patient care. A doctor just didn’t get the message and the person’s treatment was delayed. And I thought there has to be a better way. Everyone has a smartphone. We can use technology better.

How is your solution different than other healthcare-related messaging tools?

With a lot of other apps, a medical professional might take a picture of a wound and text it to a doctor to decide whether to give antibiotics. But this is happening outside of any official electronic record for the patient, and a lot of them delete the message after it’s received.

What we want to do is to have all of our conversation part of the electronic health record. So it’s stored in such a way so that it can be moved and included in the record.

We also have alerts. We want users to be able to see if and when the doctor opened the message.

(Our team has) been involved in medical data for a long time and we also did a lot of research to figure this out. And what we use is structured messaging templates. All of the conversations are built around the patients. So it’s patient-centric. You have them all identified and then can export the information into patients’ records.

How and when did Medxnote become a business?

It actually was in June 2013 at Startup Weekend hosted by Google. That was kind of huge. I had all this frustration at work and was thinking about immigrating and leaving Ireland.

(At the event), it was 60-seconds on stage. I got through the first round and ended up winning by talking about the basics of the problem and that healthcare was stuck in the 80s and 90s. There wasn’t a product yet, just the idea. This was on the top floor of Google and “Shark Tank” pitch style.

From there we went to Launch Pad at the NDRC (National Digital Research Centre). We’ve gotten some investments. I just made the decision after Startup Weekend to keep going. It was a once-in-a-lifetime opportunity to build on that momentum.

You were one of the People’s Choice winners for Challenge Festival. How did you manage to drum up support to get the necessary votes? And what does it mean to you to be at Challenge Festival?

We asked everyone to vote. We went crazy on Twitter, but we don’t have that many followers. NDRC does, so we got them to retweet and get their followers to vote. We put it out there, used, too.

Actually I pitched at Challenge Cup in London last year. The company was only a few weeks old. We had just incorporated. I did the 60-second pitch, but it didn’t go so well. I thought, “What a waste,” because I had come all the way to London. I enjoyed it and met some people, but it wasn’t a good result. Then, I ended up sitting next to (Irish investor) Ian Lucey on the plane ride home. We’re now closing a seed round and hoping to get our own office.

So, in a funny way, 1776 has been very pivotal for us in our progress.

What’s been your experience like as a startup in Ireland?

One of the big things, when I was going to leave Ireland, I (came into contact with) the startup community. There’s an energy, positivity. I saw products that could change the world—and it changed my life. Suddenly there was a whole positivity I didn’t know anything about. I just loved it and wanted to be a part of it.

In Dublin there also are European headquarters for all of these companies. It’s just quite a connected country. You can have a coffee with almost anybody. It was that positivity that we tapped into as well to get all of those votes.

At the same time, Ireland’s a good test bed. I suppose as a nation we’re really forward-thinking. But you still have to think internationally from day one. That’s where all the potential is.

Dena Levitz Headshot

Dena Levitz

Challenge Cup Reporting Fellow, 1776

Dena Levitz is traveling to almost all of the Challenge Cup cities to cover the competition and analyze startup ecosystems around the globe. Dena joins 1776 after finishing the first…