Last week I had dinner with investors in a startup I work with. Coming from finance, the investors struggled to understand why the digital health application development startup wasn’t moving faster. The product had demonstrated technical feasibility in a lab and clinical setting, producing “big data” on fragile patients. Let’s go to
I explained to the group two barriers I see all the time:
1. Are digital health applications viable in the real world?
2. How are these digital health applications adopted to commercialization?
Big data are meaningless until meaning is created and even then, a new parameter or analytic must be integrated in day-to-day operations and workflow – be it in a clinic or home situation. Dumping an app or dashboard on clinicians, staff or caregivers adds to the burden rather than removes a problem.
So the best thing a digital health investor can do is to understand the puzzle, resolve to solve it, and hand healthcare something valuable and usable beyond a cloud of data. How?
Application Development Should Add Meaning and Value
Big data are meaningless unless some pattern emerges or you create meaning by tying the data to clinically relevant outcomes. Things like falls, events that are costly to treat and that are associated with poor health outcomes, such as death. If you predict and prevent such events, value is created on multiple levels. Right now, healthcare is all about improving outcomes. It drives revenue, and is good for the patient. Satisfaction scores go up, which drives revenue and census (occupancy). Patient outcomes are a win-win business.
The trick is to find the outcomes that are relevant in the setting you’re in. Falls are big across the continuum of care. Hospital readmissions. Cognitive decline. Pressure ulcers. Chronic wounds. Urinary tract infections (UTIs). All very unpleasant, and costly, which is exactly why they are a focal point of value-based care. If you manage these events and conditions well, or prevent them, you’re a winner. If you increase them, you lose. Makes sense when you think about it.
Finding out what is valuable and meets a need starts with talking to stakeholders. Sit down with administrators, care staff, caregivers, the patients, family members. What is important to them? What causes problems? What solves problems? What would they value and pay for, if need be, out-of-pocket?
The next thing to understand is how events are captured and logged. If they are, those logs can be used to document what happened when and tied to your analytics. If you’re lucky, an association emerges between the metric(s) you create and the health outcomes that are of interest and value.
Needless to say, this takes time. In a facility I visited recently, a fall had not occurred for 9 months. Great achievement, but a problem if you’re looking for falls to validate or tune your analytics. No matter how big the data cloud going into your analytics, if there is nothing to compare it against, your data do not speak.
Seamless Integration and Use of Top Digital Health Applications and Their Practical Application
Assuming a valuable metric has been identified and validated, how do you present it to end-users? What is the best point of integration? A desktop application, a mobile app, a simple alert or notification? Furthermore, how does it interface with existing digital health applications? Does it have to be opened separately? Does it read data from and to other applications, such as an electronic medical record?
Interoperability is a big problem in healthcare and not something unique to medical devices. I have a patient portal for each of my health care providers, sometimes multiple for the same provider. It is supposed to make things easier, but for whom? I personally do not perceive a benefit and find patient portals a nuisance I prefer to avoid.
What’s more, clinicians and caregivers – paid or unpaid, tend to be extremely pressed for time, whether in a professional care setting or in the home. Words cannot describe the stress, pressure and chaos that are part of everyday healthcare and chronic disease management. Not because these people are clueless and inefficient. But much of healthcare and health is unpredictable and fluid. Many caregivers spend their days putting out fires.
New digital health application development and ‘solutions’, therefore, need to seamlessly fit in the flow of everyday life and practice, or they simply will be tossed aside and ignored. Uptake and use, I explained to the investors, requires a careful understanding of how and when to present the end-user with data. This, in turn, takes time.
Healthcare is not for the faint of heart. It requires the art of the long view. Many investors, as well as tech developers and entrepreneurs, are not prepared for this. Indeed, as Henrik Molin of Physitrack told MobiHealthNews last week, “The pressures of venture capital […] all too often become a roadblock for ideas that need a little more time to germinate.”
Chantal Kerssens understands how people think, make decisions, and behave. And she knows how people interact with new health technologies. Contact Chantal for all of your digital health application needs.