Rebuilding healthcare with people, privacy & products
A few gems from the Talking HealthTech Autumn Summit
What dawns on me every day is just how damn disconnected our health & healthtech industries are. It’s easy to think it’s small, segmented, or simply dull and limiting.
Frankly, right now it is… And that’s what we need to fix.
But, finally, we’re starting to have more open collaborative conversations, like all those at last months Talking HealthTech Autumn Summit full of incredible Vets and inspirational individuals across all areas 🔥
Yes, I spent far too much time at virtual health events in March. But, can you blame me?
It’s beginning to bridge those gaps and bring to the forefront all that’s actually happening behind the scenes, but many of us are blind to.
A big takeaway from this jampacked day, was it feels like we’re trying to reverse the system created and we’ve complicity continued operating on for oh so long - Segmented, with mass production style output, always trying to achieve more with less and quantity > quality. But, it’s certainly nice to see this is trying to be undone.
Here’s just a touch of what was covered… (be warned, its a tad long)
👩⚕️What Do GPs Want From Healthtech?
Ft. Dr Karen Price, Dr Nathan Pinskier and Dr Todd Cameron
We have to remember we’re just at the beginning. There’s still a long way to go and we need to work out the best way to go forward ~ Karen Price, RACGP
So now, we have the opportunity to rejig & redesign what we want and need healthcare to be for both professionals and patients. Damn, that’s exciting.
We are just at the beginning and healthcare will change, but it just won’t tolerate shit.
💡 Key Insights From These Insiders on How We Can Shape a Better Future for Primary Healthcare Technology
1) Adopt an Experimental Mindset & Ask Quality Questions
The quality of products and outcomes are determined by the questions you ask and your willingness to change. As well as finding the key problems.
2) Codesign With Those Who Are Actually Going to Use the Product
Most software that currently exists is built by 1 GP, someone that did 1 focus group, or a group of techies who think they are going to change everything.
This is not the codesign - The key is constant feedback and reiteration.
Seamless integration is the name of the game, with people & workflows
3) UX & Easy Use = EVERYTHING (For Patients & Practitioners)
Patients love phone-based telehealth - they know what to do and it’s easy. That’s UX.
”If we (GPs) have to spend time trying to work out the software, it’s simply not going to happen”. In these environments, every extra thing is a barrier and will be scrapped if not essential or infinitely beneficial.
”Why is UX so shit?!” ~ Anonymous
4) Start With the End in Mind
Following the previous point, current products are not intuitive enough and change the patient-doctor dynamic in consults. To succeed, work backwards to design the optimal experience and outcome. And, don’t be afraid to try something new.
5) Place People (& Patients) At the Centre
Healthcare is complicated for a million reasons, but at the end of the day, the most complex and complicated component is the people.
Take a simple medication list - seems straight forward, right? But the reality is you must interrogate every single piece of data regularly, extracting it from the patient as you can’t ensure its correctness without it due to issues like compliance, changes and data capture. You need to go back to the person, placing them at the centre for true interoperability and successful supportive systems
6) Focus on Nailing One Thing
A lot of the software solutions that currently exist try to do it all, resulting in doing nothing really well. For success, like most startups, it better to do one thing really well, providing value and build on that than the other way around.
7) More Diversity in Groups of People Creating the Solutions
Dr Todd Cameron pointed out the sad reality that most of the “solutions” which exist are made by middle-aged white men who actually only represent a very narrow portion of target users and patients. We need more diversity, insights and involvement of all others to help create a better variety, standard and more appropriate solutions.
8) Take Into Account Remuneration, Markets and Systems
Unfortunately, the billing dynamic in GP land is very different to the hospital, with GPs facing far more constraints being paid based on procedures, time and outcomes. This needs to be considered when designing software and workflows, as most practices are just cobbling things together to make it work
9) Ensure Priorities of Both the Practitioner and the Patient Are Aligned and Integrated
The question of who has the onus on keeping data up to date and who exactly has the responsibility is tricky. And that’s why everyone needs to be involved and on the same page. “No decision about me without me” should be the go-to tagline for all healthcare
Other Top Tips for Anyone Trying to Tackling Clinical Software…
Don’t assume you have all the answers - At the end of the day, all that matters is implementation and the ability to bridge the technical and clinical concepts
Consider, perhaps the workflow should be derived from the technology rather than fitting into the current healthcare workflow
🍎Preventative & Value-Based Healthcare…The Buzzwords We’re Importing From the US
Ft. Edweana Wenkart, Ray Messom, Richard Alcock & Dr Kean-Seng Lim
It’s taken a long time, but preventative health is finally trending!
Ironic, it’s only now when 10-minute medicine and the mass production line is at its peak…but it’s time to go back to the beginning. And refocus on primary & preventative care, to stop people from getting so ill in the first place and keeping them out of hospitals. Not to mention the long-term economic argument can’t be faulted.
It’s good to have goals, and one integrated healthcare system is somewhat feasible says Dr Kean-Seng… but as a long term one.
To achieve this, we must set the right foundations first. If we build on an unstable base and don’t go back and address the instabilities, then eventually what we create, will never be as structurally sound as we hope. Sometimes, the best way forward is back.
Personalised Care + Population Health = ☯️
With the data revolution, it’s easy to see the endless possibilities. But the hard part is capturing it in a complete, cohesive and usable format. To do this, we can divide data into Macro - Meso - Micro levels to design and deliver care.
This allows us to look at the greater population, smaller subgroups, and individuals, and use each of these, individually and collectively to inform both systemic and individual solutions, providing optimal care. The magic is in the mixture.
Reviving Continuity of Relationships, Data, Care & Visibility
Apparently, we’ve realised (again) that creating sustained patient engagement and strong relationships is extremely valuable in health. Crazy.
In the future, “professionals and providers must walk alongside patients” (Michael Greco) as opposed to leading - Finally.
Patients are getting some of the power and it’s our duty to empower them more. Including using the right tool and measures to do so, like the Western Sydney Primary Health Network (PHN) is with the “Patient Activation Measure (PAM). Unfortunately, there just hasn’t been sufficient financial incentives for systems or individuals to make this mainstream … yet.
Data collection and consistency is still another large hurdle in the public health system, as is privacy, but it’s come a long way and hopefully headed in the right direction, with 2/3rd of GPs in Sydney feeding data into the PHNs.
🔐 The True Front Line of Health - Privacy, Policy & Security
ft. Emma Hossack, Robert Grenfell, Larissa Briedis, Melanie Marks & Daniel Muchow
The Misinformation Pandemic & Empowering the Public
Following on with patient empowerment, it’s clear people are taking their health into their own hands. We’ve seen it in google search results, self-diagnosis, and by “the public tuning in at 11 am every day on tv during covid - they want fast access to good information” ~ Larrissa Bredis.
But, we don’t have the systems in place to sufficiently provide, filter or collect the required information in a safe (both clinically accurate & security-wise) or scaleable manner. It’s really hard to access good sources of information or transmit things.
Why is this? Systems, security, and trust.
🦸 Cyber Security: The Superheroes We Desperately Need
During Covid in 2020 there was a 660% rise in covid themed phishing attacks, making very visible the underlying holes that were always there.
The main problems?
Again, it comes back to people. Human error remains the biggest point of compromise and issues in healthtech security. Showing the need for better basic cyber hygiene practices and small business training to plug many of the small but simply fixed gaps.
Then there’s the Systems… Less is more, but currently, we lack simple frameworks for managing data and communicating. Resulting in suboptimal behaviours for managing and communicating patient data. I.e. the much used but never mentioned use of WhatsApp, email and texting in healthcare.
So, What Does Good Privacy and What Does Implementation Look Like?
”Only collect what you need, know the purposes, be transparent with what’s going on, and keep it securely”.
You can only do this effectively with the trust & understanding of the public and patients. Two things we’re currently low in (oops)…
In Australia, privacy is a serious concern for many. We gladly sell our souls to Facebook, Apple and Google. But when it comes to health it’s a different story. With horror stories like the US where any/all information can be used against you and constant lack of understanding for all parties involved, on purpose, it’s no wonder why.
And we’re yet to see good examples of why we should trust institution or system.
Trust is hard-won and easily lost.
How Can We Help Fix This?
Follow the money - Create incentives to get people on board, motivated and compliant with cybersecurity practices ❤️ Love those positive reinforcement loops
Create clarity around who is actually responsible for security - Its currently far from clear, so we all get lost in the blame game & different standards of practice
“More carrot, less stick” - Target smaller changes at the human level and not technologically difficult. Focus on that human element and put a carrot in there to incentivise it
Use the 3 Ps to protect where data is sitting - Passwords, patching systems and preparation. Simple yet somehow still lacking
Create a “Right to be forgotten” for people with their records and data - Provide an “opt-out” to patients as an emergency button, to help break down those trust barriers, and reinstate control and confidence
⚡BONUS RIDDLE - Who Owns the Data?⚡
Now isn’t this a fun little problem… still with no answer
The experts say it’s a discussion that needs to be had between the patient, hospital, provider and government. We need proper frameworks to be established about how data is actually created & shared etc. As well as fixing data asymmetry - patients need to be in the mix and the room with the data.
💰 Commercialisation - The Real Struggle
Ft. Robert Buehrig, Bronwyn Le Grice, Marcus Tan & Sam Lanyon
Now, this topic is everywhere at the moment, but I loved the panels spin on the somehow often overlooked basics.
Viability = Market, Not Your Product
Here it is again, it doesn’t matter how good your solution, tech or product if no one is able or willing to pay for it, you’re dead before you even begin.
You need to understand the health dollar flow and the market you’re trying to get into.
Once you’ve got this down, get creative, come up with a good business model and find out what price will make an impact. And ensure you anchor your pricing it to something.
Focus on the Problem - Not the Idea or Product
So many of us are in love with our solution and idea, failing to see the blind spots.
It’s basic first principles, but just because your solution is good doesn’t mean it’s the most appropriate or viable.
Sticking with the less is more theme, we don’t always need to over complicate it -
Sometimes the best and cheapest option is just a pen and paper.
“You Don’t Know What You Don’t Know”
Talk to as many people as possible and get as much info on markets as you can. It’s complicated, so each data point you get and things you decipher will be of benefit.
Make sure you find people from IN the systems to give advice and mentor. NOT what someone thinks they think. Go directly to the source, and stop the chain of Chinese whispers. Including speculations about specific markets (*cough* - US).
🍁 Want to Listen to All 12 Talks From the Autumn Summit?
Ok, now, I promise to stop with event summaries and get back to other insights.
But as always, I’d love to know any thoughts you have or things you’ve come across on these topics!
See you soon