Monday, August 8, 2016

Joining the ACE group if putting up hospital

Innovation in health care in many ways

Ateneo Professional School
Makati City

The field trip to Pateros Medical Center of the ACE group was a revelation.  There are now 20 in the Philippines.  They cover the entire Philippines.  They boast of their superiority in numbers, economies of scale, connection at Land Bank and huge credit lines (in billions) generous terms, wealth of experience in running a hospital, and more.

There are at least 6 med entrep students who run their own hospital.  One thinks of putting up a hospital soon.   For northern Luzon where there is a little ACE presence, I suggest that you are better off to make things easier for you, to join the ACE group or follow their business model.   The three who are currently running their own hospital may wish to level up and benchmark what they saw. The minimum that Dra Vi and Dra Jane can do is to link them to LBP and their suppliers of reagents and other top of the line equipment.

This way, we can really help make superior health care become accessible to everyone in remote areas of the Philippines.

The next step is to look at the prepaid health card services tied up with ACE (From where I am coming from, that is the next opportunity)

Sunday, August 7, 2016

Almost fanatical adherence to the ACE vision and core values

Innovation in health care in many ways

Rizal  Philippines
August 7, 2016

From the stories of Dra Jane, I and I have not seen the man on top, Dr Ace himself (the boyish looking Oxford Cardio Thoracic surgeon who is the inspiration behind the Pateros hospital) I could sense that the driver the entrepreneur, the visionary behind the hospital is right in our class room amongst us.  That Dra Jane encouraged Dr ACE to be the head so that the group can save money is entrepreneurial leadership at its best.  To have the idea that instead of leasing the lot they all contributed for to build a hospital GO FOR THE HOSPITAL BUILDING TAKES A LOT OF COURAGE  and entrepreneurial gumption.  Between taking on debt of P400 million and raising P200 million in equity is quantum leap an act of faith.  That is why she is the medical director.  She has to make the whole thing work, deliver value to the patients and above all to Land Bank and hundreds of other investors   MD and non MD

I could guess that after observing that instead of posting CLAYGO (clean as you go) Dr. Jane had the ACE (Always Clean after Eating) means that probably the ACE in the vision that means Altruism, Compassion and Ethics could have come from the medical director and not the Oxford guy.

Kudos, Bravo Zulu. Keep this up

Field trip to Ace Group Pateros Medical Center

Innovation in health care in many ways

Rizal Philippines
August 7, 2016


Part of the syllabus specified a field trip to any establishment.  We decided that we will visit the Pateros Medical Center which is nearby at Pateros.  Its medical director is Dra. Jane Panaligan. We would also conduct the last 4 Special Report in their auditorium

Prior to yesterday, I requested that a presentation in the business plan format be prepared by the ACE group composed of Dra. Hazel Carandang, Dra Vi Beltran and Dra. Jane Panaligan

Thus I took a trip to Pasig and Pateros yesterday and went to the ACE Hospital at 12:45, well ahead of the class.

We had lunch (thank you Dra Vi, the head of marketing) and then the SR and then the guided tour to all of the 7 floors.

The total cap ex for the hospital is P600 million due to the extra cost of P60 million due to the foundation.  The soil is soft so they had to have pile foundation of 38 meters which took about a year to complete.  The hospital construction if funded by equity (30:70) and Land Bank of the Philippines loan.

Having a group according to Dra Vi creates synergy and leverage:  they have connections at DOH, Land Bank and can get the best terms for their equipment because they buy in bulk (Economies of scale)



                                                        A sumptuous lunch. Thank you Dra Jane Vi

                                               Our host, guide;   write your checks now!

Friday, August 5, 2016

Feedback on the business plan draft submitted

Innovation in health care in many ways

These are my comments regarding the business plan draft submitted last Saturday.  Thank to all those who did their best to comply.

1. The drafts are still work in progress. Most are only 30 to only 40% done.  A lot more work has to be done to put flesh into the business plan. As we say that MDs are scientific and evidence based, the BP has to be buttressed with more information (clearer information) that the concept will work

2.  There are those who subscribe to other BP formats. There are about several thousand business plan formats. But for our purposes, the business plan format that shall be graded only shall subscribe to this format and which was published in the web site:

Notes on business plan submission

3.  Required parts of the business plan and their weights/points system of grading:


Contents of a business plan and their weights in grading

1. Business concept and business model                                             10 points
2.  Executive Summary                                                                        5 points
3. Business Objectives -  VMOKRAPI                                                  10 points
4.  Organization  Technical, Financial and Middle Management                 5 points
5.  External Environment:  Macro and Micro Market                               10 points
6.  Product Customer                                                                            5 points
7.  Sales projection                                                                              10 points
8.  Operations (how to produce the product or service                            10 points
9.  Strategy         SPATRES    (enterprise delivery system                     20 points
10   Financial Projections                                                                   10 points
11. Compliance with regulations and exit strategy                                  5 points 

Saturday, July 30, 2016

Guest Entrepreneneurs: Dr. Eloy Marcelo -father of Telehealth in the Philippines and Dr. Rommel Bautista - founder owner of Fino fine leathercraft

Innovation in health care in many ways

Ateneo Profeesional Schools
Makati City
July 30, 2016


                                                    Tarpaulin for Telemedicine

                                      He was the SVP of Philhealth, the author of e PhilHealth reimbursement,                                                       needing just somebody's Ok for implementation
                                            Following the Shoptalk Format

                                 Complex problems in business can make you a psycho case?


Today marks the 2nd batch of entrepreneurs presentation by Groups which is 25 points of the grade of the group. Todays guests were Dr Eloy Marcelo, classmate of Dr. June2 Serrano at UP PGH a surgeon and father of telehealth in the Philippines and Dr. Rommel  Bautista, an ophthalmologist and owner of Fino fine leathergoods.

Dr. Eloy Marcelo Father of Telehealth in the Philippines

His real passion was to be in computer.  But his parent who are both doctors wanted him to be a doctor.  So he passed the Med School and wanted to be in a different specialist until he met someone who told him it is best to be surgeon.  So he trained for surgery at PGH.  While he was there he noticed that only the Surgery Dept had computers and decided to use this for data base encoding of the surgical cases for census and stats.

He was able to convince their department when he learned that there is such a training for medical informatics.  He trained for 2 years in US and was thereafter a telemedicine man.

His mission is how to integrate the very dis aggregated health care services.  It is a fee based each dr to his own paper based patient records;  the pharmacy, the hospital each with its own set of records, even with the use of comptuers

1. Definition of terms:

   1. e health  -  umbrella of health information;  telehealth

   2.  telemedicine -  delivery of health services over a distance

   Both has its own set of problems.  E health has privacy issues and competition issues

   Telemedicine  is low yield transaction and even exposes the inquirer to being branded as incompetent for not knowing how do a procedure better, it is anonymous, makes one like a call center agent.

  Dr. Marcelo found it the hard way.  He was able to get a funding for P40 million, spent half of it to get only 8 referrals because of the above concerns.

  The only thing that is workable for telemedicine would be a ecosystem where there would be no diseases, a preventive health care;  a self directed health system where you can order laboratory, medicine, nursing health (not telemedicine as we would like to understand it)

2.  E health would work only to overcome the competition issues, if this would be tied up to Philhealth, ie the e claims system. Only those who would  have connected to t he PHIE, or would be using the eleectronic format for claims would get reimbursed:

It  would be fast:  the membership can be verified online and the payee can track their claims. The eclaim system was authored by the good doctor while he was SVP of Philhealth under Dr. Banzon  (Politics?)


Wednesday, July 27, 2016

Writing my own business plan draft for turning around a regional unit bank

Innovation in health care in many ways

Ateneo Professional School
Makati City
July 27, 2016

I tried doing a bp myself. I am doing this for a rural bank which was just acquired and I was asked for advice on how to turn this around.  The BSP requires a BP too:

I started getting the inputs Monday, I attended their informal meeting yesterday. I started working on this this morning and was done by 12:30

3 days from input to output of a draft   5 hours to draft  What am trying to say:   You can do it YOU CAN SUBMIT THE DRAFT

I  Background:

The San Francisco bank  was recently acquired from its former owners recently, (March)   It was established on December 11, 1959 as the 235th rural bank to serve then the growing QC area area.  It has because of its managementand owners  kept up with the times.  It stopped lending for a time, has only about 1.300 depositors

It has been acquired by CBC group headed by dynamic business woman CBC who is engaged in construction, real estate, luxury goods trading and lending investor.

Its management team and Board of Directors:  include:

1.  Mr. AG   President and Director former head of a chemical petrochem plant, and now heads the first solar manufacturing plant in the PHL


2.   Mr EV  - VP and Director, formerly from from two large commercial bank

3,  Mr. EMR -  Manager of Operations, formerly cluster head and Senior Manager at a Universal Bank

Its financial is as follows (as of June 30, 2016)  

  Total Assets:   101,071549

   Total Loan Portfolio  net                 54, 630,154

Total Deposit                                     67,601,975

Total Stockholders Equity                31,447,315

PNL for the first 6 months of 2016

Income                                               4,788,013

Expenses                                          5,072,846

 Income/Loss                                        264,883

II  Opportunity Scanning:

Macro:

1.   Increasing Philippine Population 

     This will be the driver for increased consumption (salary loan) and other businesses

2.  Political  (more peace and order)

    The new President is intent on crushing drugs and criminality, and corruption.  The peace and order will usher in more investments and business activity.

    The govt wants to lift the poor from poverty (we can not legislate that you get out of poverty.  You have to work yourself  - Duterte)

3.  Social

    The poorest of the poor about 70% of the population, the CDE segment are short of cash.  They get financing from Bombay, and pawnshops where they get 2 to 4% rate per month on the average.

   This segment of population need micro insurance, microfinance and other services.

    Consumerism is on the rise and even the poor want to have aspirational products and gadget

4.  Environmental  (business)

    1.  Many banks have closed  due to various financial crisis further upping the demand for financial services

    2.  Most U Banks and Kbanks are serving the upper and middle market and neglecting the lower market.   They have neglected and left out the small lower market being not cost effective.

(We cant quantify these yet)


Saturday, July 23, 2016

Financial Accounting Practice Set

Innovation in health care in many ways

Let us review our Finacc learning

Make your journal entries T accounts/excel  time limit 30 minutes per group

A doctor decided she will be dispensing physician  because of profits involved and convenience for her patients.  The drugs she is prescribing  is difficult to procure at the the popular drugstore. It is more convenient for the patient to have the injection right there and then (say anti ___ drug)

1.  She invested P10,000 for the venture cash  July 1

2.  She initially bought 10 items of the drugs for P700.00 each cash, She could sell the drugs for P1,200 each. At the popular drugstores the drugs sell for P1,500, quite a savings for her patient    July 5

3.  For the period July 1 to 15, she was able to sell 5 units at P1,200. She was paid in cash

4.  She again ;procured 10 units of the drug  for P500.00 this time on 30 day credit

5.  She was again able to sell 7 units for P1,200 for the period July 18 to 22 cash

6.  She decided she will pay her Sun Cellular telephone bill for P500.00 cash  July 22 2016

7.  She gave a pakuwenselo to her medsec nurse and gave her P1,000.

Compute for cash flow

Income statement

Balance sheet.

May I have the outputs from the groups sent to this post as comments or hard  copy this Saturday?

Wednesday, July 20, 2016

Business Plan Draft - Hoobrah by Entrepreneur Dr Dominic Velasco


Hoobrah a Telehealth Company for Diabetic Patients
By: Dominic N. Velasco, MD

I.               BUSINESS CONCEPT
Hoobrah is a telehealth concept that gives consultations to patients diagnosed with insulin dependent or non-insulin dependent diabetes mellitus 24/7. A smartphone app is the line of communication between patient and healthcare provider. Patients can use a messenger app embedded in the software or interact via video call directly to the health care professional through voice over internet protocol which is also available on the app. They can also log in their blood test results and daily blood sugar monitoring for assessment. A healthcare professional - nurse, diabetologist or endocrinologist will be by their side 24/7.
Hoobrah is also an online pharmaceutical retailer of important hypoglycemic agents that is necessary for these patients. It will ensure cost effective and readily accessible anti-diabetes drugs to its customers.

<rationale for choosing this: passion, economic engine or competency>

II.              BUSINESS MODEL
Hoobrah_Business Model Canvass.jpg
<where is the innovation?>
  1. EXECUTIVE SUMMARY

  1. VMOKRAPI


Vision: In 2022,  grow Hoobrah into  a leading telemedicine service provider and retailer of hypoglycemic agents for diabetic patients in Central Luzon  with an annual sales of P60,000,000.

Mission: Hoobra will provide diabetic patients in the Philippines accessible and affordable telehealth care via advanced electronic communications and telecommunication technologies and medicines as a means to provide profit to its business partners.

Objectives
  1. To be the Philippines' leading telemedicine service provider for diabetic patients.
    1. To provide diabetic patients accessible, and cost effective diabetic care.
    2. To deliver affordable hypoglycemic agents to patients.
  2. To have happy customers and realize the value of Telemedicine with high quality medical consultations.
  3. To make a profit for its owners.
  4. To make Hoobrah's employees feel that Hoobrah is the best company to work for.

Key Result Areas / Performance Indicators

KRA
PI

2017
2018
2022
1.a. Number of diabetic patients users nationwide.

10,824
12,989
18,714
1.b. Sales volume of medical consultations.
P19,899,792
P26,267,625
P59,876,460
1.d. Market share Nationwide.
0.10%
0.12%
0.18%
2.a. Survey ratings from customers.
2.5/5.0
3.5/5.0
4.0/5.0
2.b. Percentage of repeat customers.
35%
50%
65%
2.c. Percentage of controlled diabetes mellitus patients.
60%
80%
99%
2.d. Percentage of customer morbidity secondary to diabetes mellitus after availing of service.
19%
15%
10%
2.e. Percentage of mortality secondary to diabetes mellitus after availing of service.
25%
22%
15%
3.a. Amount of net profits for the next 5 years.
(P85,208)
P3,638,487
P23,420,928
3.b. Payback Period
3.21 years
3.c. Return on equity.
(1.42%)
60.6%
390%
3.d. Return on Investment.
(0.47%)
18.6%
88.7%
4.a. Employee turnover rate.
5 out of 20 per year
4 out of 20 per year
1 out of 20 per year
4.b. Compensation and benefits are above par.
5% above industry standard
8% above industry standard
15% above industry Standard
4.c. Number of job applicants.
10% more job applicants
20% more job applicants
30% more job applicants

Understanding financial statements - a review

Innovation in health care in many ways

Ateneo Professional Schools
Makati City
July 20, 2016

Understanding financial statement:

1.  From Slideshare





2. Genesis of an enterprise

MATERIAL
LABOR
LAND
MACHINERY
SUPPLIER
CASH
STOCKHOLDER
LENDER
GOODS IN
PROCESS
FGI
SALES
ACCOUNTS
RECEIVABLES
LIABILITIES...

See how the circles become part of Financial Statement

3.  Basic Equation:

   1.  Sales - Cost =  GP

   2.  Assets  = Liabilities + Stockholders Equity

        Equity =   Assets -  Liabilities

  3.   Debit  -   Increases in Assets, Decrease in Liability,    Uses of Funds

        Credit -    Decreases in Assets,  Increases in Liability   Sources of Funds

 4.  Nominal  Accounts  -   Income Statement

      Real Accounts   -    Balance Sheet Account

5   Presentation of  Balance Sheet items are in order of liquidity and priority

6.  Order of Preparation:

     Income Statement

     Cash Flow

     Balance Sheet




7.  GAAP



Sunday, July 17, 2016

Resource speaker for TeleMedicine. Entrep, MBA-H on Telemedicine

Good morning Prof. George,

Is it ok to have our resource speaker for Telemedicine on July 30?

How much time will we allot for the talk?

Thank you Sir!

Regards,
Junjun Serrano  <Great. Please have his CV sent. Kung gumawa tayo ng forum featuring Dr. Catan and Telemedicine, OKs na Oks sana>

Sent from my iPhone

Presumptive DOH officials were in the class yesterday?

Innovation in health care in many ways

Ateneo Professional Schools
Makati City
July 17, 2016

The post tried to make the discussion interesting and level up responses by having a role playing.  The reporters and the discussants were to be officials of DOH since the reports were policy issues of the health sector.

The first to report was Dr. Elle Lim who presented the overview of the External Factors (drivers) of the health sector. He was interested in the "laylayan" (periphery) of the society.  They never see a doctor or who have access to health care facilities. They even do no have NCSO birth certificate.  Since he is aligned with the political leaning of Pres Digong (left of center) Dr. Elle would fit in theshoes of presumptive health secretary.  Hence. he would render his opinion on his report as a New Health Secretary (kind of difficult to answer?)

Then Mikee Junsay reported on (who reports direct to the current Sec of Health) on Complementary and Alternative Medicine.  Would he be an Asec for this concern?

Then the others were asked who would be Directors for Mindanao -  Dr. June2 Serrano, a kababayan of Pres Digong, Dra Donato for Region III.  

Dr. June2 (Papa June) Serrano reported on Ayurvedic Medicine (a sub specialty of the report of Mikee)  He distributed various flavors of food (we had PM snacks)

 The most exciting and interesting report was that of Dr. Nanette Bernal on Dr. Shetty.  He focussed on Operational Innovation like Wheel and Spoke, Task Shifting etc (I hope she distributes her report which is illuminating and very educational)  She mentions telemedicine and social business aspect of the work of Dr. Devi Shetty (who was the MD of Mother Teresa.  Did Mother Teresa influence Dr. Devi)  The Secretary of Health was asked to comment on Dr. Shetty's work.

He report introduced the topic of business process improvement and EDS which is in the MiCO case.

If our govt officials think and acted the way our classmates acted yesterday, the health care situation in the country would be much much better. I think the role playing motivated and awakened the class

Friday, July 15, 2016

Taping session at ANC Shoptalk for Disaster Preparedness business with Rizza Tanjuatco - Trillo

Innovation in health care in many ways



These are the pictures of the pre airing/taping session yesterday at Studio 6 of ABS CBN for the Shop Talk with hostess  Rizza Tanjuatco- Trillo.

The professor helped guide the discussion with his question focussing on how  to do business plan.  The analysis was ala Pranav.  The businesses are about Go Bags of Prepper + and Pilipinas 911, frontiers of business spawned by disaster preparedness plans and disasters that frolic in the country

My contribution to propagating Entrepreneurial Revolution in the Philippines.

                    Biboy Castanares of Prepper Plus

                         Allan Gruenberg of Pilipinas 911




Ideas solicited by Rheeza Candelaria, intern of Shoptalk, seen way in last night's airing of Shop Talk

Innovation in health care in many ways

Makati Professional School
Makati City
July 15, 2016

Several weeks ago I got text messages and email from someone named Rheeza Candelaria who claimed to be an intern at ANC Shoptalk. She had questions which I readily answered via email, although I did not confirm or investigate who she was.  And then I forgot about them.  Last night, I found advice flashed at the ANC shop talk:

I hope you get some inspirations and more ideas from our conversation


Several weeks ago I got text messages and email from someone named Rheeza Candelaria who claimed to be an intern at ANC Shoptalk. She had questions which I readily answered via email, although I did not confirm or investigate who she was.  And then I forgot about them.  Last night, I found advice flashed at the ANC shop talk:

I hope you get some inspirations and more ideas from our conversation

What I mentioned in my test are formal institutions where an aspiring entrepreneur may obtain furnding:

1.  Micro finance instituions may be rural banks or institutions that are micro finance companies whose main purpose is to lend amounts of not exceeding P150,000.   They may be collateralized or non collateralized.  They are patterned after the Grameen Bank established by Mohammad Yunus.   They are usually clean loan, secured by joint and several commitment of a group of borrowers and paid regularly (weekly very much like the 5/6 of Bombay)  The group members undertake to collect from the members of a group.

2.  Cooperatives -  refer to credit cooperatives.  From what I know, one can borrow up to 2x your contribution to the cooperative.  Thus if your equity in the credit cooperative is P1,000, you can borrow up to P2,000   This encourages thrift, capital formation (that can help other cooperative members)   And the arrangement doubles the amount available for starting a venture.

3.  Grants -  There are foundations that gives grants to foundations and religious groups to fund projects of cooperatives neighborhood associations  I know of a priest who was able to obtain a grant from a Canadian donor in the amount of $1 million (P40 million) over a five year period. for Aetas in Tarlac.  They are to be used for schools, markets and livelihood project.   I learned from an MBA student, a Japanese expatriate working at ADB who said that ADB through him lent $5 million to DTI who in turn to Small Business Corp lent it to entrepreneurs.   through Tulong sa Tao page 28. Please further various govt programs for micro credit by various govt agencies

4.  Angel Investors  

      They are few and as luck would have it, SM was said to be have benefited from such angel investor:  the M is Mr. Senen Mendiola who gave assistance to Henry Sy early on, and the large fast food chain was helped by a furniture manufacturer in Cubao when he started .   Apple was helped by angel investor when such an angel lent Steve Jobs cash and credit in the amount of $200,000 total to start Apple.  They failed to get financing from a bank.  

     Dennis Mendiola founder of Chika got a boost from Oscar Reyes, former chief of Pilipinas Shell. Angel investors who are retired or semi retired business executives and entrepreneurs lend not only money but their expertise and network to t he business. But they demand higher than ordinary returns.

    We heard news that there seems to be a movement for growing number of angel investors


x-x-x-x-x-x-x-x-x-x-x-x-x-x
Hi  Rheza:

From Entrepreneur - 10 ways to fund a start up

Answers to your follow up questions:

1.  Crowd funding is inviting possible lenders, investors, donors via the net. You present your offering business plan, as to banks or venture capitalists;  you make your pitch via the web (there could be apps or website for this) and try to get funders, lenders investors become interested in your project/product.  There are many ventures abroad that were financed/funded via crowd funding.  So parang inbound ang procedure (as in inbound marketing) Rather than outbound, you actively search for funders.


Those that are available are:






2.  Donation and grants for start ups

Multilateral agencies and NGOs donates, gives to communities and individuals (and other NGOs charitable institutions too) seed capital for starting business that are to be paid forward, or paid soft interest especially in devastated areas by calamities or catastrophes or that are impoverished.

You can get donations and grants via crowdfunding too.



Grants gov in the US -  How to obtain grants from Federal Agencies

Items to be taken up tomorrow July 16, 2016

Innovation in health care in many ways

Ateneo Professional School
Makati City
July 15, 2016

I plan to take up the following with the class on Medical Entrepreneurship the following:

1.  Report/feedback on learning on last Saturday's Medical Innovation fourm:
     1.  medical science and technology
     2. innovation
     3.  entrepreneurship and strategy

2.  Final 4 weeks schedule

3.  Report by group leaders on progress of member's business plan

4.   Missing parts:

       A.   Product and customers

      1.  Product  - relate to the main value proposition

      2.  Features especially the unique features, advantages

      3.  Price Delivery Quality

      4.  Competitive analysis   (say in relation to #3)

      5.  Brief description of:

           Parts, bill of materials

           How to produce this

      6.  Customers   -   (PTM)

           Demographics

           Pyschographics

           Profile

     8.  Customer bond and link

          Link:   channel, placement, promotions media

          Bond - customer service, crm, advocacies

Tuesday, July 12, 2016

Revised Schedule for MBAH Entrep (Medical Entrepreneurship class)

Innovation in health care in many ways

Ateneo Professional School
Makati City
July 12, 2016

This is the revised schedule

Session                    Date                     Case              Lecture                                      SR  

    8                      7/16                 Mico                Strategy Process/EDS                        4

    9                      7/23              Victoria Court       FS     Exit/Regulations                    4

   10                      7/30           Entrep Presentation      Draft Submission                       4
                                                                                     Mind mapping Exercise

 11                        8/7                              - Field/Food Trip                   Consultation                          

   12                     8/13                          Submission of Paper               Closing Ceremony/Awards  

For comments and suggestion      

Note:  Dra Burgos texted me as to whether the group's entrepreneur can be accommodated on July 23.  Definitely yest.  We have to make some adjustment on the SR?