Patient-Centricity and Health Tech Development
I feel really lucky and privileged every day to have fallen in to a career that I love. My biggest passion is developing assets, tools and services that help and meet our patients, carers and HCPs needs. When you are completing user testing with patients and HCPs and they are telling you that the thing you and your team have spent hours, days and months sweating over to get right is going to make a real difference to their life with a condition: it’s such an unquantifiable high.
However, listening to my mum (NHS rehab centre) and her friend (community nurse) talk over lunch about the internal systems at their respective places of work and the implementation of already outdated patient management technology that does not help, but hinders their everyday, reinforced to me that unless we are all involved in genuinely putting entire healthcare ecosystems in to consideration in the development of our assets, patient centricity is bound to fail.
It may sound obvious but if HCPs are spending inordinate amounts of time being forced to use outdated systems that don’t talk to each other, take 3 times as long to ‘request bloods’ than traditional methods and often don’t have the functions required for the different HCPs to perform differing tasks, aren’t we fast putting bureaucracy and cost-saving at the centre of everything we do and not the patient? Moreover, with systems like this in place, it isn’t really a mystery why HCPs are skeptical of our Pharma-produced, health-tech solutions intended to improve their patients lives.
I believe patient centricity is without any doubt an aspiration in terms of a vision statement, but it’s easy to see how difficult it can be for us to remain truly patient-centred in the real-world environments our HCPs are operating in. For example, the biggest frustration for my mum (aside from the archaic/new computer system) was that all the nurses had been banned from using a specific kitchen as someone had left crumbs in there! So now it takes 2 nurses to conduct a tea round… is that decision patient-centric? Having two nurses off an already understaffed ward at any one time so one can open doors for the other? And all because of some crumbs!
Clearly technology can’t solve the above problem (although iBeacons to sense approach of authorised staff and automatically open doors….) but it does highlight one: not all aspects of patient-centricity are considered when decisions are made, and although best of intentions are at heart these incremental changes can have a huge impact.
It Sounds Obvious But…
When we are developing something as crucial as a support programme for patients and HCPs, no matter what kind of support, it is absolutely imperative that we take the time to really consider the smallest needs and requirements before specifying any kind of solution or functionality. This takes patience and a willingness to invest in observational ‘discovery’ time.
In our haste to deliver assets to the market we forget that they need to be truly useful and applicable to the worlds that our patients, carers and HCPs live in. Taking the time to get under the skin of your users, develop personas and shadowing them to see for yourself their frustrations and the life that they live in will pay dividends in the successful scoping, build and delivery of your project.
Test, Iterate, Retest and Yep…Iterate Again
It’s a small detail, but its so important. In no other industry would we develop tools or services without running user experience testing with the end users. For example my dad designs the implementation of bespoke technology for helicopters; during this process he does not design something, fit it, present it to the client and say ‘taa-daa, ready to fly…’. He works with the pilots, engineers, clients and aviation regulation to ensure the design and fitting is right, compliant, useful and ultimately meets the clients requirements and the pilots need. This process includes rounds of beta testing prior to fitting, then operational testing, prior to completion – no one wants a helicopter to fall out of the sky at the hands of a freshly fitted sound system!
In healthcare this approach is not always adopted. Take for example an app designed to help a patient manage their condition and medication. This application has been built in partnership with the pharma company (so meets their objectives clearly – happy client) and with the agency in around 6 months. The application has been certified as a medical device and launched on the App Store. All brilliant, however, not one patient has been involved in the testing of this application leading to a swift uptake of downloads thanks to the promotional campaign that sits behind it, and an even swifter ditching of the application when patients find it over-engineered and the interface confusing. All elements that should have been tested and iterated upon at the design and beta stage.
Work with your users to understand how they interact with technology and mould your design, features and processes to them. It’ll secure the long term success and adoption of your asset, throughout its lifecycle.
Plan for the end
It’s sad but true that all good things must come to an end. There’s nothing wrong with planning for the end at the beginning, in fact its responsible health-tech management. Patients, their carers and the health care team could be relying on your technology to manage their disease and associated treatments.
Developing an exit plan upfront can build relationships and confidence in your asset that there is a plan for its ongoing maintenance moving forward. HCPs have seen pharma develop assets before and then not continue to finance and maintain them when a marketing director moves on or brand plans change. The business, in partnership with their agency, needs to plan for the maintenance of an asset across a pre-determined life-cycle with an exit plan drafted. Obviously this doesn’t need to be set in stone and should change over time as the environment changes, but the fact that it exists will mean that when the time comes, the business maintains integrity and reputation through the smooth transition of the asset shut-down or hand off.
Overall patient-centricity is not something we should say we do, but challenge ourselves to implement at all stages throughout all our processes; from infection control protocol through to the development of patient support assets. It’s a win-win for everyone with investment and time not being wasted on bureaucracy and assets that won’t deliver on the commercial objectives of the company and that won’t enhance the healthcare landscape. We can develop and create less ’stuff’ and focus on valuable ‘assets’ that mean something to the people using them.