As the global costs of healthcare rise, startups might soon find themselves answering one question over all others: “How does this reduce costs?”
It is an important question; one that certainly becomes compelling as startups develop business plans. But when a startup is developing a product, it is also important to think beyond the bottom-line costs. Considering the ecosystem into which you are developing is key to move the conversation out of a one-note cost discussion. It is also the most important way to ensure that your product is addressing real needs in the market.
Cost is just one part of your story. Improving outcomes is another, says Bill Evans, SVP of Bridge Design, a Ximedica company based in San Francisco. He recently spoke in an Medical Design and Outsourcing webcast on defining value in the digital age of medical devices. As Evans says, “Hopefully you are doing this while improving the quality of life of patients and, of course, the quality of life for busy healthcare professionals, too.”
For Evans, the ecosystem is more than the “oft-quoted virtuous duet of reduced costs and improved outcomes.” A third important point for industry is that health solutions must offer the best overall outcome and cost, not necessarily the best individual therapy or diagnostic.
Emphasis on this overall outcome rests on intrinsically understanding how to get patients and healthcare professionals to embrace the technology and use it at “the moment of need” – the moment when a technology can transition from a healthcare solution to an essential part of the care environment.
Getting to that moment is the essential challenge of medtech development, “whether you are a startup, a conglomerate, or anywhere in between,” Evans says. And the only way to get that is to probe. He offers some ideas on how to get there:
- Research the people part of the system by digging deeply into the needs of the various stakeholders, such as patients, providers, and payers. Understand the medical condition in the broadest context and look for opportunities to smooth the journey from illness to wellness, lowering overall cost and improving outcomes.
- Determine the most valuable place for your stakeholders to get information or use the device. Don’t assume it’s an app or a wearable. It might be presenting data through an existing electronic health record. It might be a text to a nurse or a patient. Or, you might be using GPS tracking to take into account the context of where the patient is. Your supporting devices might be wall- or bed-mounted. It’s got nothing to do with how cool the technology is, or how much information you can throw at people. It’s all about relevance.
- Cut through the hype of engagement and adherence and use evidence-based research. You’ve got to ask, “Will my users use it?” not simply, “Can they use it?” Research into human nature indicates that we’re most successful when we meet people where they are, not where we might want them to be. We’ve got to move away from the finger-wagging of yesterday’s healthcare. Instead of making the path you’d like them to go down, come round to the same side of the boulder to understand their needs and what drives them to be receptive to change and use those insights to help them push the boulder in a better general direction. And it’s not just the patients who have adherence issues. Doctors, nurses, and family caregivers will need to be cajoled and helped just as much as chronically ill patients.
- Use behavioral psychology and behavioral economics to understand the obstacles to making the best health choices and then figure out how to reduce those obstacles. Know what rewards are most likely to work and when. It’s important to understand the value people place on familiarity. You might improve the chances of adoption by using a look and feel that borrows from existing technology. It doesn’t follow that new and different is always best.
- Make technology and design the slave to getting your products used and useful again. Think beyond the craze of wearable bands, for example. We’re just scratching the surface of what wearable means. Your team may be focused on what you feel is alluring that’s new and interesting, but your user might be very worried about how large the product’s going to be. They might prefer you dumb it down a little and trade off to a minimal display so it doesn’t show as much beneath their clothes. This will make them more willing to wear the product all the time, which is how it’s going to be most effective in treatment.
- Look critically at your technology and your team’s skill set, and figure out which piece of the jigsaw puzzle you’re missing, and then how you can incorporate those into your company and your structure of developing products. This may mean finding different kinds of partners, not just those you’re most familiar with.
- Understand how the FDA and the broader regulatory system affect your ecosystem offering. You be tempted to avoid having some of your developments be regulated, but most solutions to the really substantial healthcare problems we’re trying to tackle will probably require Class II and above types of approval. This may not always be true for all informatics and wearables. Remember the FDA is your partner and a key stakeholder; work with them closely right from the start to ensure that you’re one of those that gets quickly approved.
- Create road maps for an ecosystem roll out that initially can give you a chance to put your toe in the water with less regulated offerings such as Class I informatics. Carefully select partners and systems that can grow into the regulated world and understand that their plans also need to be fluid because, of course, once a product actually hits the market and competitors respond as things change.