How 4G Clinical get $200m by Goldman Sachs

4G Clinical, which develops software to manage clinical trials, raises $200M led by Goldman Sachs

(Emma Betuel/TechCrunch)

What is a CTMS? – Clinical Trial Management System

The Clinical Trial Management System is the essential set of tools to effectively plan, manage and track your clinical study portfolio.

What Is 4G Clinical?

4G Clinical is a leader in randomization and trial supply management (RTSM) for the global life sciences industry, offering the only fully cloud-based, 100% configurable and flexible solution utilizing natural language processing (NLP) and integrated supply forecasting.

Where is 4G Clinical’s headquarters?

  • 4G Clinical is located in Wellesley, Massachusetts, United States.

What is DRG grouper software?

The grouper is a computer software system that classifies a patient’s hospital stay into an established DRG based on the diagnosis and procedures provided to the patient.


Section 1886(d) of the Act specifies that the Secretary shall establish a classification system (referred to as DRGs) for inpatient discharges and adjust payments under the IPPS based on appropriate weighting factors assigned to each DRG.  Therefore, under the IPPS, we pay for inpatient hospital services on a rate per discharge basis that varies according to the DRG to which a beneficiary’s stay is assigned. The formula used to calculate payment for a specific case multiplies an individual hospital’s payment rate per case by the weight of the DRG to which the case is assigned.  Each DRG weight represents the average resources required to care for cases in that particular DRG, relative to the average resources used to treat cases in all DRGs.

Currently, cases are classified into Medicare Severity Diagnosis Related Groups (MS-DRGs) for payment under the IPPS based on the following information reported by the hospital: the principal diagnosis, up to 24 additional diagnoses, and up to 25 procedures performed during the stay.

What is the difference between DRG and MS-DRG?

DRG stands for diagnosis-related group. Medicare’s DRG system is called the Medicare severity diagnosis-related group, or MS-DRG, which is used to determine hospital payments under the inpatient prospective payment system (IPPS).

What are the pros and cons of DRG?

The advantages of the DRG payment system are reflected in the increased efficiency and transparency and reduced average length of stay. The disadvantage of DRG is creating financial incentives toward earlier hospital discharges. Occasionally, such polices are not in full accordance with the clinical benefit priorities.

Guide to Build HIPAA-compliant Software – Medical App Development

Statista and Global Market Insights predict that by 2021 the mHealth market will reach 100 billion dollars, which is a five-fold increase compared to 2019. The range of areas in the healthcare industry that need digitalization is broad and new solutions are needed.

Categories and Components in Digitizing the Healthcare Industry

During the COVID-19 pandemic in 2020, healthcare companies that employed medical app developers to adapt to a new reality have prospered.

The Challenges You Can Resolve with Medical App

This type of apps provides solutions that help to reduce costs, time, and a number of medical errors while providing enhanced services, removing bureaucracy, and so on.

Key Benefits of Starting with Medical App Creation

The benefits of medical apps are as follows:

1. Assistance with medical insurance
Apps like Epocrates check if a patient’s insurance plan covers the provided services and prescribed medications.

Epocrates Medical App Functionality

2. Documentation storage

3. Improvement of workflow

Any app in the mHealth domain intends to improve a workflow; currently, the best example is Medscape.

4. Simplified billing workflow

5. Exchange of experience and knowledge

6. Medication tracking

An essential part of the recovery progress is timely medication intake. Medical health apps, like the MLSDev product Healixir, helps patients take the homeopathic product used for surgical recovery.

Healixir App for Timely Medication Intake

7. Better decision-making and support

MLSDev helped to implement the Idana software to improve the process of communication between patients and doctors.

Screens of Medical Software — Idana

8. Communication and care coordination

Doctorate App Screens

For example, a product by MLSDev, the Doctorate that allows patients to rate and review their experience with physicians. Based on patient feedback, the app builds recommendations for helping patients choose the right doctor.

Types and Examples of Medical Apps for Patients&Doctors

Most Popular Types of Medical Apps
  • Treatment monitoring apps

Examples: Cerner Physician Express II, Cerner Millennium, Epic Haiku

  • Patient engagement apps

Examples: AdviceCoach, Practice Fusion

  • Telemedicine apps (telehealth apps)

Examples: KRY, Ada, Doctor On Demand, MyDoctor, Telemedicine IntelliCare

Telemedicine Apps Statistics in 2020
  • Medication management and e-prescription apps

Examples: iPrescribe

  • Medical reference apps

Examples: Medscape, Epocrates, Visual DX

  • Electronic healthcare record (EHR) apps

Examples: eClinicalWorks, Allscripts, PrognoCIS EHR

  • Chronic disease management apps

Example: Medisafe, Fooducate, Pain Diary, My Medical Info

  • Professional networking apps

Example: Daily Rounds, Figure 1, Doximity

  • Patient healthcare tracking apps

Example: VitalHub, Chart

  • Medical appointment booking apps

Examples: Zocdoc, Doc Aid

  • Medical calculator apps

Example: MDCalc, Calculate by QxMD, Easy Drug Dose Calculator, Nursing Calculator

  • Educational apps

Examples:QxMD Read, Docphin, Case

  • Mental health apps

Examples: Moodfit, Modmission, Talkspace, Sanvello, Headspace, Happily

  • Wellness apps

Examples: 8Fit, Samsung Health, Wellness, BetterMe, Google Fit

Most Promising Areas for Medical Apps

Based on the set of features, your app can belong to one or several categories. Based on CB Insights research, clinical intelligence and enablement is a top area with tools that help to make clinical decisions to deliver care more effectively and efficiently.

Features for Custom Medical Apps

  • Video conferencing feature
Medical App: Online Conferencing Functionality (Source: Dribbble)
  • Speech recognition (SR)

For the technical implementation of these features, refer to:

  • Web Speech Specification API — text-to-speech functionality
  • Web Speech API — voice recognition
  • Google Cloud Speech API — transcription
  • HPE Haven OnDemand Speech Recognition API — speech-to-text functionality
  • Patient and doctor profiles
  • Search functionality
  • Listing functionality
  • Offline access
  • Booking feature
Doctor Booking Functionality Sample (Source: Dribbble)
  • E-prescription feature
  • Activity feed
  • Health dashboard

The Samsung Health app provides a great example of a user-friendly mHealth dashboard.

Samsung Health Dashboard Example
  • Progress tracking and sharing feature
  • Medical records and calculation feature
  • Symptom checker
  • Messaging functionality
  • Custom notifications and reminders
  • Wearable connection
  • Cloud integration
  • Payment processing
  • CRM, Analytics, & Reporting

When building an analytics and reporting feature, it is necessary to note what sorts of reports will be used.

Medical Dashboard Example

The described features may be used within different categories of apps.

How to Create a Medical App: Step-by-Step Process

So, how does one develop a medical app?

Let’s review each of these steps more closely.

1. Learning the needs of your target audience

The methodology to work with the target audience is simple and consists of three actions:

  • Divide them into groups and define your customer profile
  • Collect their thoughts, needs, problems, and similar data (through polls, questionnaires, and interviews)
  • Identify your early adopters (potential customers)

2. Document Your Medical App Requirements

After going through the steps above, you should have the following takeaways:

  • Concept for medical app project
  • Defined customer portrait
  • List of expectations and requests from your target audience
  • Competitor and market research

3. Compose Your Unique Value Proposition

For example:

  • Zocdoc: Find the right doctor right now with Zocdoc
  • Medscape: Your one-stop resource for medical news, clinical reference, and education
  • iPrescribe: Prescribing made painless
  • Practice Fusion: Meet the EHR that helps independent practices thrive

Your UVP should answer 3 questions: “What?,” “Who?,” and “How?”

For example: (What?) iPrescribe app — helps (Who?) doctors write prescriptions — (How?) by automating procedures.
Here is the table that provides VP examples for different category of users.

4. Test your app’s assumptions

Based on the collected critical points from respondents, it is necessary to finalize your idea and adjust the medical app’s functionality.

5. Create a medical app sketch

Tip: You may use tools like Figma,, Marvel, Balsamiq, and UXPin to create an initial medical app sketch.

Hospital Management System Prototype

6. Find Professional Medical App Developers

There are a plethora of outsourcing destinations in the world. The most reliable in terms of quality and pricing — and that is Eastern Europe.

The prices for software development in Eastern Europe, mainly in Ukraine, are considerably lower than those in Western Europe and the USA. The average rates in EE for software development range from $30 to $40 per hour.

Check out the diagram below for a visual presentation of how to outsource app development.

Detailed Process to Outsource App Development

7. Build a Solid Medical App

The process starts with the initial discussion of your business idea and ends up with our ongoing support and maintenance of the completed product.

Discovery Stage

Here’s a brief breakdown of the Discovery stage deliverables:

  • Business analysis (functional specifications, product backlog)
  • Design (UX/UI design)
  • Project architecture (architecture vision)
  • Market & Competitor analysis (on-demand)

Development Stage

During the Development stage, our medical app developers bring your idea for a medical app to life. During this stage, we develop the back- and front-end functionality and test your product.

Many teams end collaboration with a client at this stage, but we offer ongoing support and product development in response to the ongoing, changing needs of the market.

Example of Workflow Scheme

8. Launch Your Service Correctly

The best way to introduce the app to the market is to start with the early adopters. This tactic has a huge benefit, since this segment of your audience already has expectations about your app and will be generous with feedback.

9. Market Your Medical App

Here are a couple of ways to do it:

  • Use social media marketing to announce the app
  • Use paid ads (on Facebook, Google)
  • Content marketing
  • Build a referral network (let other resources, like bloggers, talk up your app)
  • Finally, ask your first clients for referrals

The whole process can be finalized in a product strategy presented in the form of a Business Model Canvas and the forces influencing its creation.

Business Model Canvas for Medical App

Usage of Emerging Technologies

The following emerging technologies find their appliance in a range of fields, including medical apps.

  • AI & ML integration

Integration with AI and ML solutions boosts the domain of digital diagnosing.

For example, during the COVID-19 pandemic, an AI-powered British health app Babylon helped to diagnose a high risk of infection in 15,000 users, out of the 31,000 that tried it, before they actually visited a hospital.

  • Blockchain integration

The use of blockchain technology is a response to the elevated demand in highly secure solutions, as the amount of sensitive data to be stored grows exponentially.

  • VR-based functionality

VR-based solutions have various applications in medicine. From a better way to visualize an issue in medical studies, to use for its therapeutic effect, doctors have no plans to stop experimenting with VR.

  • IoT

Integration with connected devices expands the reach of mHealth solutions.

Robotic cameras help with remote examinations, and fitness trackers allow users to monitor essential health indicators 24/7.

Innovations in Healthcare Industry

Crucial Aspects of Any Medical App

The crucial aspects of medical apps involve compliance with privacy regulations, interoperability standards, and encryption.

1. Compliance with regulations

HIPAA Compliance and Data Protection

HIPAA regulations set the standards for managing sensitive data and when it comes to medical application development for the US market.

Aside from regional regulations, there are international standards:

  1. IEC 62304
  2. The ISO/IEC 27000
  3. SOC Type 2

2. Improving interoperability

To maintain the interoperability of medical services, the US Office of the National Coordinator for Health Information Technology has created a nationwide interoperability roadmap.

3. Data protection and encryption

Sensitive medical information should be protected from malicious attacks. It is possible to achieve this protection through data encryption and the use of safe protocols like HTTPS and TLS/SSL.

Cost of Medical Apps

The following table will help to make a preliminary calculation of the medical app cost – $60 000~$230 000:

Note: the prices are based on the average hourly rate of medical software developers in Ukraine, which is USD 40/hour.