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Reduce friction, not point solutions – A lesson from HLTH Europe

By Hassan Chaudhury, Expert in Residence, London Institute for Healthcare Engineering (LIHE) and member of the Silver Buck Advisory Board

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HLTH Europe was memorable for many reasons, but it specifically marked a distinct break away from ‘point solutions’, towards platforms, marketplaces, tech-enabled services, and towards more ‘picks and shovels’ plays.

I wasn’t the only one to notice, and it was the subject of a lot of discussion on the conference floor.

I agree that there has been a shift, but argue that this is not yet a conceptual one.

I have long maintained that the biggest single reason why digital health companies struggle is that they make digital products which are difficult (or full of friction) for buyers to adopt into an enterprise.

By adoption, I mean the whole gamut from finding the right pot of money, writing the business case, commissioning the product, contracting, deploying and integrating the product, to generating the real world data for evaluating the product.

Importantly, it also includes downstream transformation efforts with our people like modelling the workflow from the as-is to the preferred state in preparation for deployment, training users, or supporting people to adapt how they work to truly leverage the product.

This is true across both the public or private sectors, and each of the elements above can be described as points of adoption friction.

Challenger banks like Monzo and N26, and the experience of setting up a new Apple device are well-known examples of how to reduce consumption friction, so this all sounds crazy to friends outside our sector (retail, finance etc.) since one of the key advantages of digital is that it makes deployment and adoption easier, but that has never been the case in health and care.

The human factors at the heart of digital health innovation are vital as it’s never a case of ‘fire and forget’.

The potential friction of a deployment has to be modelled for and mitigated, and the responsibility for thinking about this must lie with the vendor.

One reason for this occurring so often is that founders often don’t think deeply about general entrepreneurial principles from a typical MBA to apply them appropriately for digital health.

For example, the business guru Ash Maurya is correct to state that ‘the top reason why new products fail is building something nobody wants’.

However, in digital health, the primary reason for the failure of a new product is a subtle variation on the above.

In our sector, the top reason why new products fail is building something nobody can easily adopt.

The buyer might want the product but how the hell can they get it bought and into their enterprise?

How will the product interact and integrate with other solutions? How will users react?

Will it be a White Elephant, underutilised, unloved?

My advice to founders on this is simple; to escape this, just think about how potential adoption friction could kill a sale downstream and then (re)engineer your business model and process to avoid it consistently.

The shift away from ‘point solutions’ has been evident for some time, but it felt more abrupt and distinct at HLTH Europe.

While it’s certainly positive, it still feels more like a reaction to how tough the market has been for vendors, large or small, over the last few years and not as a product of deep thinking and reflection.

I argue this because when you examine these solutions, some level of friction often remains inherent despite a move away from a point solution to a different model, if not adding more friction back in as a result of the change.

It is as if many of these founders have been told the conclusion of the thought process (point solutions are bad), but not been briefed on the thought process itself (friction is bad).

The shift is therefore typically without nuance, without sophistication and without imagination.

To be clear, I wouldn’t mind a ‘point solution’ if there was no friction. It’s the resulting friction that I mind, not the point solution itself.

Furthermore, platforms and marketplaces do not always mean we end friction.

I can see a potential problem in the near future where we have adopted too many competing proprietary platforms that attempt to lock us in and refusing to work together.

We will inevitably find ourselves wishing we had been more thoughtful about open standards (OpenEHR, FHIR etc.).

The key here therefore is to think deeply about what to do and not to merely stumble from one paradigm to another.

We will only really see progress when we see digital health founders embrace the concept of minimising adoption friction so buyers can adopt solutions more easily, and for adopters of innovation to consider the ramifications of each move carefully.

For now, I would happily settle for more founders to think deeply and deliberately to end friction in their business models.

Until then it is just papering over the cracks.

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