Giant Steps in Health Innovation

Illness. Money. Business models. Incentives and experiences.  Just a few barriers to health tech innovation thrown up when Upstart's Dominic Pride joined a recent Giant Health panel show on Disrupt Live Tv. Watch the full episode here or read the highlights below.

Giant Health is an international community improving healthcare by supporting innovation and promoting entrepreneurship. Founder Barry Shrier hosted the second episode of Giant Health Innovators with four participants providing radically different views on innovation in healthcare. Here we summarise their comments and points of view.

The guests, their businesses and view of future health

Naveed Parvez: CEO of Andiamo: we create custom fitted orthoses by taking 3D body data and turning it into 3d printed devices designed for a purpose- such as an orthopaedic boot which enables a young girl to dance again.

I think that the vision and the reason why we started this company is there are two major interrelated problems. One is empathy and how clinicians are trained out of empathy but actually we believe empathy leads to better decision.

Fundamentally the system design is broken. It's based on the industrial age not the networked reality of today. It's about better decision making and we believe it's about augmenting empathy.

Jenny Thomas: I run an accelerator programme, Digital Health.London. We help 30 startups a year to refine what they're doing and scale it across London's health and care system.

We help healthcare businesses to understand how the health and care system works in London. We connect companies with the right people so that they can test their solutions with people looking to solve problems.

Dr Gyles Morrison:  I work as a Clinical UX specialist which specifically relates to the experiences people have with anything that's been designed.

From my medical background I try to observe what tasks are present in healthcare user experience and see how to make the process as usable, accessible and as fun as possible.

Dominic Pride: I run Upstart, we do something called Breakthrough Strategy - we take the tools and techniques which breakthrough product companies use to develop products and apply it to strategy.

Disruptive technologies are knocking on the door of every single industry, so what we're doing is we're collapsing the timelines to strategy for from sometimes years into two months and occasionally weeks.

Getting Better Or Worse?

Barry: Addressing a fundamental issue, is it getting better? Is it changing compared to the way things we're perhaps ten years ago?

Gyles: Because digital health is such a massive industry now there's so many players there's so many projects that are not working so well, the problem has shifted but it's gotten bigger. Health care is very unique challenge with time and financial pressures and [people] even not knowing how things could be different. Because of that people are resistant to change..

You could be going to technology not a clinician. This needs to be driven by the clinician, so my work is about training up clinicians to understand user experience and work on digital health projects.

Jenny: Money is the constraint. It’s about trying to understand what are the levers so that so it becomes an opportunity for technology as opposed to a challenge.

Barry: In my understanding is that the promise of tech innovation is the  potential to deliver better outcomes in the future for less money.

Naveed: There's a disconnection between money cost and value. We don't necessarily have models that exist to deliver the value that people see into monetary value. Within healthcare there's no way of one department recognising the saving for another. I think that the user experience problem is due to the system having been designed for efficiency, but what have we made efficient? What people now want and what people now value is very different.

New Business Models from Abundance

Naveed: An example of that is communication - it used to be based on the amount of time that you were on a phone call and per minute was cost X amount.

It's now a fraction of a penny to run that service, so when you start talking about healthcare and you move it from being a human cost of X to a computer cycle of Y that's a whole new model.

We don't know what to do with that yet, The company doesn't know hasn't got a way of monetising it. Everyone know this important and but health care system doesn't have a way of buying it.

Dominic: I also think it's about it's about business model, how do you present [a health proposition] to the person that's buying the healthcare - whether it's a hospital system in the United States or here in the UK or even the individual?  To what degree is the individual prepared to pay directly in a monetary model or indirectly with attention?

Barry: It doesn't sound realistic for there to be one model in healthcare, bearing in mind the complexity of the situation and the national differences versus the international capability of providers.

Gyles: [we're moving towards ] creating something new from something that already exists so your needs change. To do that  there's a lot of dependencies, I think first and foremost you need to access things that already exists.

The next problem is that you think create something you know is great but actually how do you get someone to use it?  

There are times when knowledge is a barrier, there's so much training that's involved or you need to have a whole lot from the clinician’s perspective.

There's a lot of people problems, how do they fit in the bigger picture? Then you look at the physical problems of the technological side. Things are completely different across the whole NHS and it gets worse when you just look on an international basis.

Where do you start to innovate, where do you start to see the problem? If you go too high there's so many problems, lower down there's too much complexity or the you're not addressing the coal face problems.

Jenny: We don't give companies money in exchange for equity, we help them to navigate the system. It's really about helping them to unpack this complexity and  know who to talk to.

Gyles: Naveed’s product was designed so a little girl could dance again. Healthcare doesn't pay for that and the difference for that young girl is almost immeasurable - technology makes that possible.

Dominic: I think there's there's a way of measuring value-add which at the moment isn't there. For example, we can look at patient reported outcomes, at mood, and those kind of things where there are already clinically-validated scales.

Naveed: We need to find a way of valuing that in the system, it's not the device-we've got to be able to procure the outcome.

It's not the focus on the clinical outcome, it's is on that person and their families outcome.

Gyles A lot of what we're talking about is, to do what is actually going to be best for your user and improve life quality. The money comes if you actually solve problems so we need that freedom to think about the problems people are solving so that we can make someone's life better.

What Can We Learn - And What Can We Do?

Healthcare system needs innovation from different aspects to create multiple business models that can be applied to bring about a better user experiences.

Key problems within systems are

1. Money

2. Incentives

3. Measuring the value of a better healthcare experience

4. How to tackle problems with such a complex system already in place.

Rather than working in isolation the system needs to be looked at by practitioners from multiple backgrounds and expertise, addressing the problems together.