Bumps Along the Digital Health Innovation Road
Arlen Meyers, MD, MBA
President and CEO, Society of Physician Entrepreneurs, another lousy golfer, terrible cook, friction fixer
Digital health describes the use of information and communications technologies to exchange medical information to reduce sick care or health care costs and to improve the quality of outcomes and population health as well as enhance the doctor and patient experience.
Digital health means different things to different people. Here's how I slice and dice the industry:
- Remote sensing, wearables. patient reported outcomes measurement information systems and data input technologies that are part of the internet of things
- Telemedicine
- Data analytics and intelligence, predictive modeling and artificial intelligence
- Health and wellness behavior modification tools
- Bioinformatics tools (-omics)
- Medical social media
- Digitized health record platforms
- Patient -physician patient portals
- DIY diagnostics, compliance and treatments
- Decision support systems
When it comes to digital health, there are some unique challenges when compared to other software development, since errors can cause harm to patients. Here are some bumps in the digital health innovation highway:
1. Reimbursement and revenue models
2. Intellectual property protection when using agile development techniques and lean startup methodologies
3. Using unreliable patient early evangelists to test and develop your product
4. Medical marketing is different from other consumer marketing
5. Failing to address the reasons why non-sick care entrepreneurs fail as sick-care entrepreneurs
6. Defining and delivering value
7. Innovating instead of tinkering
9. Technosceptics are rampant and there are major barriers to adoption and penetration in sickcare.
10. There comes a point when high tech displaces high touch too much and yields diminishing returns.
12. Long sales and decision cycles
13. IT objections to integrating a proposed solution into legacy EMR and other IT systems
14. Unwillingness of providers to pilot or engage in proof of concept trials
15. Medical staff objections to workflow disruption
16. Non-physician support staff objections to systems disruption and integration
17. Revenue sharing and equity participation conflicts
18. Human subject design and IRB approval and costs
19. Cybersecurity
20. Applying pilot data to a more generalizeable population or using the results to scale the solution.
21. Usability-the extent to which technology can be used efficiently, effectively and satisfactorily
For digital health entrepreneurs, the main obstacles are:
- Difficulty finding clinicians with an entrepreneurial mindset who are willing to forgo the opportunity costs of practice to contribute to a startup
- The lack of a digital health eCRO to clinically validate an idea that is cheaper, faster and better than drug or device trials
- Difficulty finding provider partners, even in so called "innovation centers"
- Lack of seed stage capital
- Barriers to legacy EMR integration at end user facilities
- Barriers to patient and physician dissemination and implementation bridging the digital divide and using technology to help underserved patients
- Intellectual property issues
- Regulatory barriers
- Finding doctors with the knowledge, skills, abilities, and competencies to add value as an advisor, consultant or member of the leadership team
- Digital health cluster member segmentation and lack of integration
Take smart watches and other wearables, for example:
Here is a recent report from Stanford highlighting some of these barriers.
The digital health innovation roadmap has many distractions and confusing road signs. The wary traveler should be well prepared and forewarned.
Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Twitter@ArlenMD and advisor at MI10
Physician at JDH, LLC
9yArlen, I agree with you regarding the portion of the physicians and patients who consume the majority of Healthcare Resources. There needs to occur a quantum change in the "culture" underlying the current Healthcare System. Unfortunately, the impediments are not (IMHO) bumps in the road; those can be visualized and navigated. What we are dealing with are truly "mobile chicanes". Sets of rules/guidelines which seemingly change with the wind.
President and CEO, Society of Physician Entrepreneurs, another lousy golfer, terrible cook, friction fixer
9yMke: THanks. I agree and have been pushing The Big Fix: Moving from Sickcare to Heathcare. However,the target needs to be the 20% of doctors and patients who consume the 80% of resources, not the 1% who spend the 80% on spandex, joga pants and Patagonia sweaters.
Strategic Advisor | Fractional Product Management | 2X Founder | AI/ML | Growth/Scale | Enterprise Digital Transformation
9yAgain a great segmentation of the industry. Each area has opportunities and requires skills or insights that are specific to innovate a solution
Retired with interests in University of Washington and CoMotion start-up team mentoring, animal rescue, cycling, and swimming.
9yDr. Meyers, I always enjoy reading your publications....... I agree with you on the medical practice side but I do think that at the very least, the digital products available serve to engage more people around the concept of wellness and that alone will be a huge positive for personal healthcare. Given that over time, I think we'll all pay more out of pocket for care, this is a good start.