The health care industry loses about $150 billion each year due to no-shows for doctors' and dentists' appointments. A number of factors, such as a lack of insurance, inability to take time off of work or difficulty affording care, may prevent patients from going for their checkups. On the provider side, inefficiencies in systems and staffing can compound the problem.

Whatever the reason, the result remains: Patients do not get the care they need. And one patient missing an appointment wastes a block of time that could have been used by someone else in need of care.

Vinodh Subramanian, who graduated from the University of Arizona in 2019 with a master's degree from the Department of Systems and Industrial Engineering has been studying the many factors that make people keep or forego visits to health care providers. In collaboration with his adviser, Robert Lepore, director of the engineering management  graduate program and instructor at the UArizona College of Engineering, Subramanian has developed a deep understanding of the problem, along with a solution to reduce appointment no-shows in medical practices using systems thinking principles.

"Our goal is to encourage patients to get the care they need, when they need it, at their own comfort, without needing to wait, travel or take off from their work," Subramanian said. Based on his research, an algorithm is allowing Subramanian and his colleagues to envision and build "products that will bring patients and the providers much closer by eliminating any human and system inefficiencies."

While the work served as the basis for Subramanian's graduate thesis, he is now taking it a step further.

"Our first goal is to build an enterprise telemedicine platform we're calling Consultation that will help patients self-schedule their appointments with their preferred care providers," he said. "Once they've booked their appointment, patients can choose to get their consultation over live video with the providers, or they can choose to visit the provider in person, based on their comfort."

He said that the system, which will initially be focused on the dental field, will help patients show up for their appointments by alleviating fear through introductory video consultations. The technology seamlessly integrates all the key components – from patient recruitment to video consultations to appointment reminders – providing a complete solution for health care practitioners, as opposed to cobbling together multiple disconnected services. 

Subramanian has worked with Tech Launch Arizona, the commercialization arm of the university, to create a strategic plan and license the invention to his startup, Hipokratiz LLC.

"The algorithm they developed minimizes no-shows, and they've already got a business model and people are using it," said Bob Sleeper, senior licensing manager for Tech Launch Arizona.

Tech Launch helped Subramanian through the entire commercialization process, and he took advantage of two of the many free programs available for UArizona startup teams: mentors-in-residence and I-Corps, a short series of classes that help entrepreneurial inventors better understand their customers.

"I-Corps was one the best resources available to us as a research-based startup," Subramanian said. "Oftentimes, as researchers, we develop bias towards our own findings and solutions and never pay heed to what the customer or the market wants. I-Corps was very helpful in eliminating this bias, and it forced us to get out of the lab and classroom and made us talk to our customers to understand their perspectives."

He also was matched with Tech Launch Arizona Mentor-in-Residence Barry Glick, who Subramanian said was instrumental in helping him shape Hipokratiz as a company.

"Vinodh (Subramanian) is well-positioned to be at the forefront of medical care, taking full advantage of the spectrum of digital software-based tools," Glick said. "It's been a pleasure for me to help guide Vinodh though the initial phases of startup development."

Glick said the integrated services Hipokratiz is commercializing will benefit both providers and patients; increase provider revenue while decreasing cost and inefficiency; and provide patients with a more convenient, less intimidating approach to getting needed care.

"As a scientist, Barry was able to understand our research, and as an entrepreneur, he was quickly able to visualize the market potential of the invention and guide us on how we should approach our commercialization plans," Subramanian said. "Most importantly, he pushes his mentees to think outside of the box, and he never lets us settle for mediocrity nor take things for granted."