The Graveyard of Digital Health

Collaboration is at the heart of successes over history — in Darwin’s words, “those who learn to collaborate and improvise most effectively have prevailed.” Yet the healthcare space has been slow to learn the lesson. Far from functioning as a team focused on a single goal, healthcare stakeholders operate on a fractured playing field, each one trying to get to the goal on their own. From that perspective, everyone becomes a competitor — and the ability to reach the goal line becomes nearly impossible. Nowhere is the tension more obvious than in the struggle to integrate technology and healthcare. On the surface, they are unlikely partners. Healthcare isn’t exactly a profession for risk-taking, and rightfully so — in every decision, the safety of a patient is at stake. A new drug or tool has to run the gamut of regulatory burdens and clinical validation before it gets anywhere close to adoption. Adoption and implementation is arguably even more challenging, including everything from integrating new solutions into legacy systems, convincing practices to abandon the sunk cost of preexisting solutions or overcoming the lack of financial incentives — without practice reimbursement, the challenge of adoption becomes that much more daunting. Technology, on the other hand, is a high-risk, high-reward market (there’s a reason that billion-dollar-valuation startups are called “unicorns”). Many tech startups succeed by delivering direct-to-consumer solutions, cutting out the middleman and individualizing experiences for the user. It’s a formula that doesn’t map well onto the healthcare field, where the success of patient care and outcomes relies on a web of relationships. And tech companies that have tried to take these formulas from Silicon Valley and apply them to healthcare learn that really quickly. The graveyard of digital health tools is littered with companies trying to sidestep the problems of the healthcare system by dealing with the patient directly, and removing the care provider from the equation. The crash-and-burn rate of tech entrepreneurs trying to break into healthcare is so notorious that GV, Google’s venture capital arm, set up a program to teach the ins and outs of the healthcare industry to aspiring crossovers from Silicon Valley. Despite this, the healthcare industry is overripe for disruption from the tech world, yet the process of working with healthcare providers is not easy, for all the reasons stated above. The rate of change is slower, the challenges to adoption more widespread. But the provider is an essential player in the provider/patient relationship that is at the heart of healthcare decisions, and that means that the needs of the provider as well as the patient have to be the guiding principle for change. See also: Putting Digital Health to Work   As the digital health market matures, it will be collaborative models that break down the barriers between stakeholders, and consequently will break down the traditional obstacles to tech integration in healthcare. Xhealth is one such example: A platform that connects innovators, healthcare teams and patients; it streamlines the integration of tech through an online marketplace that makes ordering and prescribing digital health tools as easy as traditional medications. Some of the most successful of these models are incubated by health systems themselves, like Mightier, a spinout of Boston Children’s Hospital (BCH). With an intimate understanding of their own workflows and the needs of their young patients, health providers at BCH created the app to help children with emotional and behavioral needs overcome daily challenges through bioresponsive games, and the Mightier system has since become available to children outside the BCH. At Babyscripts, we employ a collaborative model between clinician and innovator to develop and enhance our solution for pregnancy care. Our recent partnership with Penn Medicine focuses on taking the care protocols and results developed through Penn’s Heart Safe Motherhood program and automating and scaling those accomplishments into a technology solution for postpartum hypertension. Regardless of origin, a solution must have an awareness of different perspectives to build products that respond to diverse needs and configure to the right business model — and this awareness comes from a deep understanding of the needs of all the players on the field. See also: The Science That Is Reinventing Healthcare   Of course, providers and patients are not the sole stakeholders in the healthcare continuum, and, until we can get all of the stakeholders on board, then we’re still only responding to some of the needs. It’s necessary to expand the vision for collaboration beyond patients and providers: to nurses, payers, social workers, caregivers, community leaders, family members and others who play a role in patient health. Bringing these various stakeholders into dialogue, setting aside their competitive differences, is the path to better outcomes.