Raise the Line: Help Medinas Fight COVID-19

Since the COVID-19 pandemic began spreading through the US, the Medinas team has been glued to our computers. If you’re anything like us, at this point you’ve read dozens of articles and earned your “amateur virologist” merit badge. You use terms like “social distancing,” “asymptomatic carrier,” and “transmission rate” on a daily basis. 

One term we’ve all learned over the past few weeks is “flatten the curve.” It’s usually accompanied by a graph like this: (1)

Flattening the Curve

The basic idea of “flatten the curve” is to slow down the spread of infection so that it doesn’t exceed existing healthcare system capacity, represented by the dotted line that cuts across the middle of the graphic. 

If we keep active cases below the capacity of our healthcare system, more people will survive. Exceed the system’s capacity and fatality rates increase.(2)

We’re all doing our part to flatten the curve by social distancing, washing our hands, and self-quarantining at home so that the virus spreads as slowly as possible.

But that’s not the only way to increase survival rates. At Medinas, we’re tackling the other part of the graphic: raising the dotted line. If we manage to increase healthcare system capacity, we make more space for the curve. Which will save lives.

Raising the Line

To grossly oversimplify an extremely complicated subject, healthcare system capacity to treat COVID-19 boils down to a handful of things:

  • Availability of skilled healthcare professionals to care for patients hospitalized as a result of COVID-19,
  • Hospital beds for everyone who should be hospitalized,
  • Ventilators and oxygen for those who can no longer breathe on their own,
  • Protective equipment such as masks to keep healthcare professionals safe, and
  • Patient monitors and other equipment needed to provide standard of care, slow transmission within hospitals, and ensure that patients receive the best treatment possible.

Increasing Access to Lifesaving Medical Equipment

We’re not a team of physicians, which means we can’t offset the medical manpower shortages we’re facing in this pandemic. But what we can do is increase access to the core tools medical professionals need to fight this fight.

That’s how we’re raising the line. 

Medinas is harnessing our network of suppliers in the primary and secondary market to procure desperately needed ventilators, masks, beds, and patient monitors and either make them available as rentals (many hospitals can’t afford to buy new equipment right now) or make them available at cost to capital-constrained hospitals. 

Equipment and supply availability is one of the biggest bottlenecks in the fight against COVID-19. Our hope is that by attacking this bottleneck, we can contribute to boosting the nation’s overall healthcare capacity in this time of crisis, and thereby improve survival rates.

To succeed, we need help

Raising the line is a monumental task. The amount of equipment that US hospitals need to combat this crisis is on a scale that hasn’t been seen in the modern era. If you’d like to help us raise the line, we’re looking for a few things:

  • New connections to add to our network of international suppliers of new and refurbished equipment (ventilators, beds, and monitors) and key supplies (masks, gloves, etc.),
  • Additional capital to boost our procurement capacity to import as much equipment as we can find, and
  • More international shipping partners to help expedite transit of equipment from point A to point B.

Please contact us at covidresponse@medinas.com if you think there is a way you can help.

Written by: Daniel Brian, Dir. Operations Medinas Health

1. Graphic Credit: Drew A Harris
2. https://www.washingtonpost.com/health/2020/03/15/coronavirus-rationing-us/ 


Partner Spotlight – Harmony Medical Solutions Medbays

The Spotlight Series

As part of our commitment to the environment, Medinas evaluates the environmental benefits of innovative healthcare products and services, particularly those that focus on equipment reuse. Our goal is to provide exposure for companies who are doing good in the world, in order to magnify their impact. We publish the results in our revolving environmental spotlight series

  • Spotlight No. 1 – Harmony Medical Solutions Medbays

    Harmony is helping people in disaster areas and developing countries by prefabricating diagnostic imaging suites inside of recycling containers with refurbished DI equipment. The potential human health and environmental benefits are enormous.
    When deployed at scale, Harmony Medbays have the potential to save millions of lives each year, while reducing manufacturing greenhouse gasses by up to 86%.

Medinas Health’s 2020 Company Values

Back in early 2018, the Medinas co-founders sat down and put together a set of values that we wanted to embody as a company. Every quarter the three founders will sit down and give ourselves a letter grade on how we were doing with each value, and it was a really effective tool for us to keep us accountable to our commitment. It’s nearly two years later, and we have a much larger team, so we decided it was time to take a fresh look at our company values and refine them into who we want to be as a company moving forward.

1. We seek the truth.

This remains our number one value because we feel it encapsulates everything we do, from finding the best candidate to figuring out what feature to build.  We try to focus on the truth so that we can make the right calls instead of giving in to ego or agenda.

2. Be frugal, but not stingy.

Spend what you need to do the job right, but avoid extravagances. Whether it’s investor money or profit, we don’t believe in unnecessary excess.

3. When it seems impossible, find another way.

Startups aren’t easy, and when you’re trailblazing a new path or working in a difficult industry like healthcare, it’s easy to get discouraged. We believe that there is always another way to get something done, and giving up isn’t an option.

4. Know the mission, know your metric, prioritize.

It’s easy to do work that feels productive, but doesn’t move the needle. When every team member knows their mission, how it fits into the bigger picture, and how to quantify its impact, they can focus on work that makes the biggest difference. At the end of the day, focus and execution are key.

5. We don’t make excuses.

It’s easy to make excuses when you’ve been pushing a rock uphill all day. But at the end of the day, success is doing the things you don’t want to do, and we’ve committed to holding ourselves 100% accountable for the results we reap.

6. No job is beneath us.

We want to foster a service-based culture within our company.  Sometimes that means doing unpleasant tasks that ensure everyone else is unblocked.  From writing code to taking out the trash, we do what it takes to make sure we’re always moving forward.

7. Don’t be a jerk.

We believe you can be innovative, analytical, and efficient, without being a jerk. We focus on hiring high-performers who don’t need to make other people feel shitty to prove their prowess.


How Medinas is using serverless to tackle a $765 billion problem

Originally published on the AWS Startups Blog

If you were to walk into any surplus medical supply donation center in the U.S., you would immediately notice how much stuff lines the walls. Perfectly usable items like adhesive dressings, bandages, syringes, and surgical masks sit waiting to be donated to remote healthcare clinics and hospitals around the world simply because they will expire in a matter of months — and in some cases, even years. For hospitals, the penalties for being caught with expired supplies are too steep to keep such surplus around. Even more surprisingly, these donated supplies are a drop in the bucket when compared to the hundreds of billions of dollars worth of supplies that are simply thrown away by the U.S. healthcare system every year. This is wasted capital that could be used to save lives. Since 2010, at least 79 rural hospitals have closed, and nearly 700 more are at risk of closing, leaving thousands of Americans scrambling to find other healthcare centers that are potentially hours away from where they live.

We first learned about this situation through an acquaintance who had first-hand experience starting a donation-based non-profit that was trying to make a dent in the yearly amount of wasted medical surplus. We couldn’t believe how big of a problem this really was and how it had gotten so bad. More importantly, we wanted to know why anything hadn’t been done about it. With some research, we learned that the surplus problem is so big, all previous attempts to solve it haven’t reached the size necessary to really see progress. In the absence of a scaleable answer, we started Medinas in early 2017 to make sure every unit of medical supplies in the U.S. gets a second chance at being used before it expires. Our solution involves allowing medical facilities to sell their unused surpluses to other medical practices who can then put them to use. By algorithmically matching surpluses to existing demand on a custom marketplace, we create cost savings for all parties and simultaneously reduce the volume of supplies going to waste.

But starting off in a challenging space isn’t easy. Luckily, our recent win at the Forbes Under 30 Summit’s $500k Global Change the World For-Profit Competition has provided us some runway as we build both healthcare partnerships and our minimum viable product. Next, on top of finding people with domain expertise in healthcare supply chain procurement, we also have to solve the problem of marketplace liquidity. To do this, we’re first focusing on one side of the marketplace: the buyers. It’s easy for us to create the supply through affiliate partnerships and then attract buyers by creating a value-add layer of service to their procurement/buying experience. At the point that we’ve seeded initial liquidity, we will have a value to underpin our pitch to larger hospital systems to begin building the seller side of our marketplace.

Enter: API Gateway and Lambda

As we develop our MVP, we want our tech to be as streamlined as possible. Having had prior experience building marketplaces from scratch, we’re able to bring unique insights into the creation of this new double-sided marketplace. As a company that’s focused on a problem of cost reduction, we also need to be vigilant about frugality within our own organization.

That’s where API Gateway and Lambda (Serverless) become key to our strategy. Their unique out-of-the-box scalability, pricing model, and decreased requirement for hands-on management allow us to focus on our core goals rather than being concerned about ballooning tech costs.

Questions of scale are difficult to answer when first starting up. How much traffic will we be receiving on launch? Will it be consistent or in bursts? How long will elevated traffic levels last? What will average traffic loads look like after launch? What will costs look like at six months given the way we’re building? What about a year? It’s a maddening amount of uncertainty. But we still need some sort of answer.
Under normal server or container-based circumstances, we’d make an estimate based on the amount of press we’ll be receiving, promotion to our target users, some margin for other visitors, and a whole host of other variables in order to model some sort of rough expected traffic pattern. However, even the best of these models tend to be wildly inaccurate.

But with Serverless, none of that matters. Complexity is all abstracted away, and we can now focus on the important part: getting the code right, on time, and on budget. AWS handles scaling Lambda in a way that’s completely transparent. API Gateway has a default, adjustable maximum of 10,000 requests per second, with Lambda being limited to a maximum of 1,000 simultaneous requests. When request runtimes are measured in the low hundred-milliseconds, we start to approach a theoretical maximum territory that’s far beyond anything Medinas will need for the foreseeable future.

Which brings us to the question of price. How do we make sure we’re ready for our anticipated traffic loads at a cost that is affordable? Under server-based assumptions, the key optimization is around server uptime. But the Serverless pricing methodology flips this idea on its head. Rather than worrying about uptime, we pay for only what we use on a by-request basis. Our cost-savings strategy then becomes focusing on making request process times as short as possible in order to reduce our cost. And as an added benefit, the AWS free tier allows us to operate cheaply until we reach a much larger scale.

Security is another aspect that we need to worry about. Ensuring your own code’s security is difficult enough, especially when first starting out. But making sure to keep the infrastructure that your code runs on up-to-date with the latest and greatest security patches quickly becomes a second full-time job. Serverless is liberating in that there is no infrastructure to maintain. AWS does that automatically. Code “just runs” with no update outages or downtimes. This decreases the time and/or human capital cost of needing an additional person to handle these worries.

While we’ve got our work cut out for us, advancements in cloud computing are providing us with peace of mind, helping us to focus on the core problem. We’re excited to tackle something so big that it touches every life in one way or another. If you want to learn more about us, or have some way to help, reach out to hello@medinas.co! We’d love to hear from you