Contributor: Anish Sebastian
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Look behind any successful person, scratch the surface of any profitable venture, and you’ll find the same thing: a network, a community, a group of collaborators that are at the heart of the successes. It’s the founding premise of Darwin’s evolutionary theory: over history, “those who learned to collaborate and improvise most effectively have prevailed.”
The healthcare space has been slow to learn that 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. Healthcare is the established player and tech is — well, the disrupter. And the establishment does not respond well to disruption.
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 are 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 start-ups are called “unicorns”). Many tech start-ups achieve their success 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.
Yet the healthcare industry is overripe for disruption from the tech world. Take maternity care, for example: it’s no secret the United States has the highest rate of maternal mortality in the developed world (especially in African American women, who have a mortality rate that is 3 - 4x higher than their white counterparts), and the rates are rising. And yet prenatal and postpartum care is still being delivered through the same one-size-fits-all approach — a model that was recommended by the Institute of Medicine nearly 50 years ago.
This was the starting point for Babyscripts: we saw an outdated model of care that has no efficiencies in place for the individual needs of patients and the potential for tech to fill the gaps. But we also recognized that without clinical input on our solution, we could just be adding more unactionable data to the preexisting pile; and with no understanding of clinical workflows, our “efficiencies” could create more work for providers already stretched thin.
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 patient-provider relationship is at the heart of healthcare decisions, and that means the needs of the provider as well as the patient have to be the guiding principle for change.
Our collaboration with Penn Medicine is a perfect example. It’s not simply about the technology, it’s about improving the management of care. We’re actually 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. Working in close alignment with clinicians from Penn and implementing the lessons from their research ensures we are creating effective solutions that will respond to the needs of providers as well as patients.
As the digital health market matures, it will be these kinds of collaborative models that overcome the traditional obstacles to tech integration in healthcare. xealth 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.
Regardless of origin, it takes 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.
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 and setting aside their competitive differences is the path forward to better outcomes.
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