HealthTech 2021: Back to Business

This month Atrómitos participated in the 2021 GIANT digital technology conference in London. GIANT (Global Innovation and New Technology) is a forum for health technology innovation in Europe. This was the first in-person conference that our team had attended since the beginning of the pandemic. There were some differences – lining up outside the Business Design Center for vaccination (or negative test) verification being the first and biggest difference that comes to mind. But, for the most part, circulating throughout the event I was struck by how little has changed, particularly as it relates to how digital health technology platforms and services are conceived, presented, and (by extension) implemented. 

Let me back up and explain. Over the last two years, the experience and exigencies of the pandemic have underscored how central technology is to the (safe, effective, and reliable) delivery of health services. Consider how overnight the world needed to pivot to enable expanded delivery of telehealth or telemedicine services. Or how the barrage of ransomware attacks on health systems and first responder services impacted the availability of services and health records across communities already under the stress of responding to COVID. 

Despite this, for the most part, while speaking with exhibitors or listening to the various presenters and panel discussions, I was struck by how so many of the speaking points could have been the same as those offered in December 2019. Yes, there was an increased focus on mental health access and management, and patient risk stratification for limited hospital-based resources (the waiting lines for surgical procedures under the National Health Services is a real problem – and has presented an opportunity to validate important predictive analytics solutions). But for the most part, it felt like business as usual: health technology solutions were presented as discrete and additive solutions to specific health management issues; as something that can be operated along parallel tracks to current operations, and with the common assurance of no or minimal integration (and thus disruption).

And why is that a problem? I propose that this is a problem because it (continues) to perpetuate the perception that health technology is an added-on bell and whistle (and sometimes a deeply resented addition) to operations, as opposed to a foundation upon which all health operations depend. As an additive feature – as opposed to mission-critical infrastructure – it is something where investment in and integration of information security leadership “at the table” is something that can be deferred or siloed off to the IT department. Similarly, as an enhancer or accessory one can go about collecting component parts, (something in every color!) as opposed to harmonizing and simplifying existing infrastructure.

At the end of the day (or at the very least at the end of 400 odd words in this article), if there is an ask or a call to action, it is this: our health care system is excessively complex. And we are (all of us – it’s a pretty human impulse) looking for the next new thing, a shiny silver bullet, or the better mousetrap. But sometimes, (as articulated in Kim Bellard’s excellent article, To Add is Human, to Subtract, Design) what we need is to “do simple better,” to take away some degree of complexity by refusing to add on. And we can accomplish that in the healthtech space by more intentionally approaching our information technology and digital health systems with a more holistic and integrative approach.

This is a big ask, and it goes against every (very American) additive impulse. I suggest, however, that the degree to which we can shift the framework to harmonizing technology operations, the more effective (and efficient) we will be.

To do this, I offer the following recommendations:

• Take inventory of your existing technology inventory. Understand how the various platforms and solutions work together (or don’t) and how the clinical workflows intersect and where there is room for improvement. Begin with what you have and understand your gaps.
• Iterate, Iterate, Iterate. After investing in a technology solution and undergoing implementation (always painful) do not shy away from continuing to evaluate how that solution is actually utilized in practice. When evaluating, keep in mind that often the best solution may not be a technical one. Don’t rely on a technology solution to (wholly) address what may be a different kind of problem (whether it be people, processes, or other resources).   
• Be a Savvy Consumer. This means two things. First, never shop hungry or without a “grocery” list: When selecting a technology platform or solution, do so with specific, weighted criteria in mind. The hard truth is that you are not (in general) going to get a single turnkey solution. No one technology solution is going to do all things for all people. (And if they say that they do – be particularly wary). What population are you targeting and what is the outcome that you are looking for within that population? The best partnerships – the best interventions – often start small, but you also need to have the capacity to scale that solution across operations. Secondly, when contracting for a technology solution, demand relevant Service Level Agreements as part of the contract. The gap between the sales team and the technology side of a potential vendor can be …. vast. Do not rely on sales assurances; if a functionality isn’t in the contract (with a correlating, enforceable service level standard) it doesn’t exist.
• Invest in both Information Security and Availability. This tops my personal list of what is needed when integrating technology across an organization. As stated before, information systems and digital solutions create compounded complexity. You need to have someone with the expertise, authority, and capacity to serve as the center point. 

 We live in a complex, interconnected, and digital world. Complexity is inevitable; however, the structures that you put in place in your own organization to filter through the noise present an opportunity for reducing unnecessary complexity for a more elegant design.