Innovation in Healthcare: 5-part Series

Series of short articles published for Bloom Partners in December 2021. Findings are based on interviews with healthtech experts and doctors.

DAY 1

PATIENT CENTRICITY & PATIENT EMPOWERMENT

This week, we will explore 5 key challenges facing the healthcare industry.

In our expert interviews, one overarching theme was apparent – although modern patients are used to a high standard of customer-centricity in their everyday lives, healthcare often relies on outdated, poorly-designed systems which do not prioritise patient centricity.

Patients may feel disempowered, or complain of being treated like objects to be acted upon, rather than leaders in their own healthcare journey.

We identified 3 key challenge areas:

POORLY DESIGNED SYSTEMS: Systems are designed to treat enormous numbers of patient at the most efficient cost. The patient journey, comfort, and ease-of-use is often sidelined.

NO PATIENT EMPOWERMENT: Patients often do not have full access to their own health records and are not empowered to lead their own healthcare journey. 80-90% of patient wellbeing is related to everyday life outside of the clinic. (src)
PREVENTION IS BETTER THAN CURE: Patients are rarely empowered or facilitated in gaining a holistic view of their health. Simple preventive measures like gene tests or monitoring eating habits could help prevent conditions – better for patients, and the under-pressure system.

Let’s take a look at some potential approaches which could help.

DESIGN THINKING: Empathy and inclusive design are key in designing better, more equal systems. Small examples: larger windows to make hospital rooms more light-filled, healing gardens, social space for patients. SRC

ACCESS TO OWN RECORDS: Plugging into an API/open access will increase patient autonomy and allow easy access to their records – as well as prevent info getting lost between appointments.
PATIENT CENTRICITY: Meet patients where they are and embrace solutions which help them self-manage. Prioritise preventive, personalised interventions. An example: support diabetes self-management for patients. French startup app Tilak gamifies monitoring chronic eye diseases.

These are just some strategic changes which could revolutionize healthcare. How would you change healthcare for the better?

Join us tomorrow for part 2: data mismanagement.

DAY 2

LACK OF DATA

Today, we explore another mammoth challenge in healthcare – data mismanagement!

A whopping 30% of the world’s data volume is generated by the health care industry (Capital Markets).

However, lack of data integration and connectivity means information is fragmented and difficult to access. A Forbes article called the lack of data sharing in healthcare “a medical tragedy of underappreciated dimension.”

Samir Khan, CEO of Lighthouse Innovations believes “data is the glue, the thing to motivate everyone to come together and collaborate”.

So, what are the key challenges?

SILO MENTALITY: Data is not shared between healthcare systems, hospitals, or even departments. HCPs may be unaware of trends or similar problems (and solutions!) developing in other places.
EPISODIC VS HOLISTIC DIAGNOSIS: Information walls between specialists means patients with complex systemic conditions fly under the radar. Many diabetes patients are completely unaware that they are at a higher risk of CVD, because diagnostic processes focus on the most pronounced symptoms relevant to that specialist only.
LOST OPPORTUNITY FOR INNOVATION: The massive amount of data “walled” in by individual hospitals or governments prevents innovators or clinical trials from identifying and researching solutions which may help patients.

Let’s take a look at some potential approaches which could help.

CENTRAL PATIENT DATA BANKS: These produce replicable, credible data for clinical trials. Techniques such as homomorphic encryption (a cryptosystem that encrypts data with a public key) and differential privacy (a system leveraging information about a group without revealing details about individuals) allow data centralization while ensuring patient privacy.
BI & DATA ANALYSIS: Data could help identify issues – for example, a small number of patients account for up to 28% of emergency room visits. Data can help analyse their conditions and create preventive plans which can be shared with similar patients to reduce emergency room visits.
DIGITISING PATIENT ONBOARDING: HIPAA compliant digital forms integrate patient paperwork and consent to an EHR, meaning easy access for different doctors or departments who followup with the patient. (HIT)

These are just some strategic changes which could revolutionize healthcare. How would you change healthcare for the better?

Join us tomorrow for part 3: misincentives.

DAY 3

MISINCENTIVES

Today, we explore one of the most frustrating aspects of healthcare – HCPs are swamped with bureaucracy and forced to follow misguided practices.

The large scale of the healthcare system means bureaucracy and misaligned incentives distract time from patient care.

“We need a system that motivates HCPs to ensure patients become truly healthy”. Dr Oliver Eidel

So, what are the key challenges?

BUREAUCRATIC SWAMP: 60% of HCPs in Germany spend three hours or more per day on bureaucratic tasks (Marburger Bund). 35% spend 4+ hours. SRC
TREATMENT FOCUS: Success is measured in numbers of treatments prescribed rather than patient outcome. The fee-for-service payment scheme encourages over prescription or preference for specified treatments – which aren’t necessarily the best for patients.
PATIENT OUTCOMES RARELY CONSIDERED: The rare studies on patient outcome focus on “worst cases” such as death rates, rather than patient quality of life. SRC For example – patient cases are considered “successful” once cataract surgery has been performed. While this improves patient’s vision, some patients suffered reduced “short-sighted vision” and felt worse overall. Lack of followup meant they fell off the radar. SRC

Let’s take a look at some potential approaches which could help.

ORGANIZATIONAL AMBIDEXTERITY: As the population ages and strain on the healthcare systems increases, digitising bureaucratic processes and freeing up HCP time becomes an imperative.

OUTCOME-BASED PAYMENT MODELS (OBPMs): This could encourage HCPs to focus on more personalised treatment plans and incorporate newer, “beyond the pill” solutions if desired.
CAPITATION-BASED REIMBURSEMENT: Linking payment with quality of patient health care will encourage HCPs to consider long-term effects on the patient rather than resorting to legacy behaviour “quick fixes” preferred by the system.

These are just some strategic changes which could revolutionize healthcare. How would you change healthcare for the better?

Join us tomorrow for part 4: underleveraged technology.

DAY 4

TECH IS UNDERLEVERAGED

Today, we explore a highly interesting challenge for those of us in digital – the lack of tech solutions in healthcare!

Some HCPs are reluctant to accept digital solutions. The difference is particularly striking between older more conservative HCPS and their younger, tech savvy colleagues.

Different practices among HCPs means fragmented experiences for patients, and lost potential.

Dr. Moritz Behm; strategy and digital transformation expert, distinguishes between “doctors that accept digital solutions as complimentary in increasing treatment quality” and “the doctors who believe they know best, and reject solutions that are brought by from “nonmedical laypeople”.

So, what are the key challenges?

HCP RELUCTANCE: Some HCPs may see technology as management interference in their work. However, patients are generally enthusiastic about technology and associate it with more control over their treatment. (Center for Connected Health Care UG) src
DIFFICULT TO INTEGRATE: Some EHR systems date back to the 1960s and are ill-equipped to process modern data. Any new apps or software must easily connect with the provider’s EHR platform – some of these date from the 1960s! This integration would require massive effort from providers.
SYSTEMS RELIANT ON OLD-FASHIONED TECH: Doctors preferring outdated technology: Doctors receive more money for sending a fax than for sending an electronic discharge letter. This had held back digital transformation. src

Let’s take a look at some potential approaches which could help.

LEARN FROM AGILE MENTALITY: A US-based healthcare provider successfully introduced a 15-minute huddle system to quickly transfer and escalate important knowledge. SRC
EMBRACE NEW TECHNOLOGIES: Advanced diagnostics and robot-assisted surgery are just some of the possibilities. Scientists at Weill Cornell Medicine and New York-Presbyterian developed an AI-powered computer program that examined more than 13,000 pathology images of various cancers and distinguished each type of cancer with 100% accuracy.
GO BEYOND THE PILL: More digital solutions such as healthcare apps or Virtual Reality treatments could revolutionise care. German health insurance providers will soon begin reimbursing prescriptions for some apps! src

These are just some strategic changes which could revolutionize healthcare. How would you change healthcare for the better?

Join us tomorrow for part 2: entry barriers to innovation.

DAY 5

EXTERNAL BARRIERS

We have already explored 4 challenges within the healthcare system. What about external entry barriers for innovators outside the system?

Healthcare is one of the most stringently controlled industries – and for good reason! However, tightly-organised systems and numerous roadblocks often stifle innovation.

“innovating here is not inviting. There are too many legal walls. Big business, expert VCs avoid healthtech, and those who work with smaller start-ups can sometimes lack a cultivated understanding of healthcare processes.” Nadeem Sarwar, CEO of UK-based online pharmacy Phlo

So, what are the key challenges?

HIGH RISK: Healthtech is a risky venture with high initial costs! Health IT failure-rate estimates range from 40%-70%, and it is difficult to attract qualified, specialist talent.
INVESTOR PATTERNS: Investors stick to predictable patterns and invest in familiar initiatives. FemTech, or digital women’s health, receives only 3% of all Healthtech funding!
DISTRIBUTORS: In Germany specifically – getting a new solution approved for “reimbursement” from health insurance companies may prove challenging.

Let’s take a look at some potential approaches which could help.

LEARN FROM OTHERS: Healthtech startups should welcome advisory boards and outside experts on topics such as UX and business models to replicate success.
DIVERSE INVESTORS: VCs must make diversity a hiring priority. More women, ethnic minorities, and thus with non-VC backgrounds better represent the target market and will lean toward new initiatives.
GOVERNMENT SUPPORT: Germany’s new Digital Health Act will allow insurance companies to reimburse apps prescribed for treatment. Increased public awareness will motivate governments to embrace healthtech.