If You Aren’t Ready to Embrace the Complexity, Stay Away from Healthcare
HealthTech is a sexy space for entrepreneurs and investors. According to Rock Health, by mid-year 2017, digital health funding was on a record-setting pace. KPCB partner Beth Seidenberg has stated that “Healthcare is really the last industry to be disrupted.”
So the new gold rush. Investors, entrepreneurs and technologists are running into a space that has defied all previous attempts at disruption, and with the infusion of new blood, new thinking and new technologies, fix healthcare for good. “Uber for healthcare”, here we come…
Not so fast. The impregnability of the walls of healthcare to disruption comes from its unique mixture of regulation, government involvement, large number of ecosystem partners and information asymmetry. I believe it is this last point that is the hardest to tackle as it is baked into the system, for reasons good and bad. As a physician, I took a pledge…in Latin. Primum non nocere. You can’t get more rarified than using a dead language. And, from there followed years of highly specialized training with its own rich vocabulary and context that defied attempts at oversimplification. But…as one learns during this journey, the need for this complexity is inherent in health; human biological processes cannot be reduced to a two-sided marketplace with a buyer and seller.
So there are very good reasons why complexity exists in healthcare. I think that is the first fundamental flaw of healthtech visionaries who decide to disregard the nuances of healthcare and rush in with models that are poorly designed to meet the various demands of patients and physicians. Dave Chase published a great article on this point in Why 98% of Digital Health Startups Are Zombies and What They Can Do About It where he states “the most common failure scenario we see is a founding team that is made up of smart technologists who are blind to or dismissive of the idiosyncrasies of healthcare.”
I fundamentally feel that the way to disrupt healthcare is to do so from the inside, and that means being able to respect the complexity of healthcare while at the same time focusing on how technology can help drive patient and provider satisfaction and productivity. You don’t do that by throwing out the entire model; you do that by focusing on the gaps in the system and providing bridges and connectors to help drive efficiency gains.
A big part of that comes from the “bad” type of information asymmetry, which is the current failure of most health systems to have clinically cohesive care coordination models, particularly in the outpatient space. As physicians we are told to “treat the person, not the disease” but the minute patients leave the hospital, they are by and large left to their own devices, and are driven to access care in bite sized chunks, all delivered by well meaning providers that are focusing only on their small piece of the pie. In the absence of a holistic approach, patients are increasingly turning to self diagnosis (Google being the largest disseminator of healthcare information in the world) but without the training and context that they need to make informed decisions. Little wonder that rates of medical adherence, follow-up on chronic diseases and overall patient engagement stay stubbornly low.
This is where technology can play a critical role working with the providers of care to reduce ‘bad’ information asymmetry. Creating novel systems of care coordination, healthtech companies can help bring together the fragmented care ecosystem to provide a holistic framework for care. Technology, if applied correctly, should be letting physicians treat the person, and not the disease, by taking into account the great number of variables that help separate successful interventions from failures. Further, rather than creating additional silos (which the first versions of hospital health information systems did) technology solutions must be able to connect with each other, with interoperability and data sharing an absolute given requirement.
All of these things take time and require an intimate understanding of local healthcare systems to be successful. I am confident that as long as healthtech entrepreneurs embrace the complexity of healthcare to make the user experience simple, there will be meaningful impact on this space, the final frontier.
Authored by: Dr Snehal Patel
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