“15% of all diagnosis of life threatening diseases is actually misdiagnosis. This means that per year, there are around half a million of patients worldwide who could have been saved, had they been correctly diagnosed,” Dr. Jama Nateqi shares a sobering statistic, which forms the background to the young doctor’s main project: Symptoma, a medical search engine. He has more figures to prove his case: “Only 3% of physicians are satisfied with the current professional and medical research options; 97% aren’t. Unfortunately, they don’t have the proper tools and resources to check differential diagnoses efficiently.”
No doubt, as “a Google for physicians” Symptoma, which Jama and his team have been developing for more than four years has set out to solve a serious problem. But how does one doctor make the leap from dealing with uncomfortable statistics to actually finding viable solutions for preventive care – and at the same time maintaining a profitable web business?
The beginnings: building up a community
For the Salzburg-based German with Afghan roots, the foundation for what would later become his main trade – running the click for knowledge GmbH as CEO – was already laid in his teens. Driven by his inquisitive nature and a desire to provide free access to knowledge, 16-year old Jama started an online platform offering math tutorials – Matheboard.de – with his self-taught IT skills in 1999. With an impressive 25.000 visitors per day, the website did rather well. But Jama recognised that “the traffic stream can be gone in a day if the sources dry out”. Initially acting alone by gathering and sharing information, he set up a chat service to communicate with his users. After more than three years of running the site and joined by his friend and later co-founder Thomas Lutz (27) in 2002, he realised, he had to go further, “I wanted to build something sustainable and it occurred to me that with something like Matheboard, you can build up a community; then even if your sources of traffic dry out, you still have your community and you can revitalise your project at any time.”
Changing the concept to an information-sharing platform encouraging discussion rather than providing all the answers seems to have been a wise decision. To this day, Matheboard is operating without losses. Since 2004, ten free access educational online portals have been added to the portfolio with over 2 million monthly visitors and a community of around a hundred teachers and students working on the platforms on a volunteer basis. In this early motivation for transparency, accessibility and community, appears to lie the germ of the idea for Symptoma.
“It’s absolutely impossible and it’s not going to work”
As a medical student striving for excellence and thoroughness, Jama, who wanted to become a doctor since the age of six, would search the web if the lecturers at the Paracelsus Medical University of Salzburg were not up to scratch. But the information available to him was hardly satisfactory. Out of this discontent arose the idea of fusing his IT and medical skills to build up an online database of diseases.
Initially, Jama’s professors were skeptical of the concept. One professor he consulted for an opinion told him, “It’s absolutely impossible and it’s not going to work.” Indeed, with more than 20.000 diseases, which have different symptoms and effects on each individual patient, the project seemed difficult to accomplish. Besides, there had been efforts to build up a similar database for diseases since the 1970s, as Jama knows. But none had succeeded in providing a viable solution.
Jama took this challenge and together with his partner Thomas, who has a background in nanostructure technology, he convinced the Business Creation Center Salzburg (BCCS) of their idea. With the help of the BCCS, which provided them with a grant “because they trusted us”, they embarked on the research and development of Symptoma in 2007. One first success was when the very same professor who had originally opposed Symptoma, wanted to co-operate and even signed a letter of intent after talking to Jama in person.
“Europeans tend to focus on their own work”
Just as Jama and Thomas received funding for Symptoma in 2007, the dedicated medical student got the chance to study at Yale School of Medicine for a semester. With these major opportunities running concurrently, he certainly had his work cut out for him. Nevertheless, he balanced the two and returned to Salzburg to continue heading the startup, motivated by his US experience. “When I talked about Symptoma in Europe, the first impression was usually ‘No, it’s too big to be accomplished’ whereas in the US it was more like ‘Wow, what a great idea, if you accomplish it, it would have a huge effect on medicine and also if I could support you in any way like give you contacts to whatever you need.’”
Reflecting on his studies at Yale, Jama clarifies that he had already been confident about his project before going to the US. “Confidence comes with practice,” he refers to his more than 12 years of experience as an entrepreneur. But he also detects a downside when it comes to driving innovation in Europe versus the US: “Europeans tend to focus on their own work, this distracts them somewhat from something new, it’s a disadvantage for some startups.”
Re-investing the revenue
In 2009, the year of Jama’s graduation, he founded click for knowledge GmbH with Thomas to incorporate Symptoma, as well as Matheboard and their additional portals. Since its establishment, click for knowledge has increased its revenue by a multiple of nine every year. Instead of burning the cash, being dependent on venture capital or a high percentage bank loan, Jama and Thomas have been re-investing it into the growth of the enterprise.
After more than four years of intensive research and development with a team of 24 physicians, medical students, developers and marketers, Symptoma was launched in public beta in July 2012. During this time, Jama had carefully considered all the insights, observations and statistics regarding preventive medicine, outlining a project whose functionality would be both revolutionary and easy to grasp. Thus, through a continuously updated web platform, his goal was to reduce the chances of misdiagnosis by offering doctors access to a wide array of symptoms about as many medical conditions as possible.
By entering a symptom, the year of birth and gender of the patient, doctors can find possible causes for differential diagnosisAlthough Symptoma was designed to function as an enterprise from the start, its social roots make it so that everybody wins: the doctors who, through peer group fuelled interaction, have a better chance at placing the right diagnosis, and thus perfecting their practice; the patients, who receive better healthcare; and Jama and his team, whose dream to transform the medical knowledge management system slowly takes shape. But Symptoma’s social reach goes well beyond a mere win/win strategy; what it aims is to offer a simple to use web tool for researching and confirming diagnosis, keeping in mind the contribution it can have for doctors in far-out areas like the Middle East or Africa, where access to knowledge is more scarce. Jama emphasises that the NGO Doctors without Borders/Medicins Sans Frontieres (MSF) plays an important part in Symptoma’s roll-out strategy.
Failure was not an option
As for advice to other startups, Jama believes, “it depends on what your goals are”. There is a thoughtful pause before he continues, “If it’s to get rich quick, then follow the media and get investors on board and burn as much venture capital money as possible”. He quickly re-articulates the click for knowledge model: “What we have done is to find proof of market before you develop too much, because then you can improve it. [With Symptoma] We had a minimum viable product, and we sold it before we had a website, and a name”. He takes a reflective pause the length of a nano-second and continues, “Look out to meet the expected revenue goals. Failure is not an option. Don’t spend money you don’t have”.
Bringing education and technology together is certainly the new cutting edge of medicine today, but Jama doesn’t seem to be a stranger to doing things the unconventional way. On our way back from a startup round table at CoWorking Salzburg, we start talking about films and he recommends the cult film “Harold and Maude”. He draws a parallel between the film and his own company, as he says that it is possible to achieve a lot with a small amount of funds. But you must help people solve a social problem and you also must execute very well. For the astute and committed doctor/entrepreneur it seems to have been as simple as that.
Interview, research and source material by Jessica White
A German version of this article has been published by our media partner, derStandard.at, at: http://derstandard.at/1361240437760/Mediziner-Jama-Nateqi-entwickelt-Google-fuer-Aerzte