4 minute read
Why digital health interventions fail
Healthcare World’s Data Correspondent Simon Swift speaks to Dr Steve Hajioff about the shortcomings of digital health innovations, and how their failures can be corrected
Digital health, as a concept, has one purpose - to help people. Not just clinicians, not just healthcare workers or management, but everyone. It’s a noble idea - and absolutely fantastic when it works. However, all too o en, we see digital health innovations turn out to be a complete dud. Sometimes they just don’t work; sometimes they try to solve a problem which isn’t there. Sometimes they even identify a problem but the solution provided is poor and doesn’t solve it. This makes many digital health ventures low impact or even entirely useless - they act as a detriment to higher quality, higher value, personalised, healthcare.
I spoke to Dr Steve Hajio , CMO of Sana Life Sciences and Consultant in Health Policy and Technology, about the issues which o en arise within digital health models and solutions - and what can be done throughout the process to ensure that interventions identify solutions accurately, provide benefits e ectively, improving outcomes and delivering better value healthcare.
The seven points of failure
Steve has seen a wide range of system failures within digital health and has identified one of a set of seven points of failure each and every time.
1. The Deus Ex Machina
The belief that data, and data alone, holds the power to solve problems, without any thought or process applied to managing or understanding what to do with the data itself. 2. The User Experience Catastrophe
When a project is designed and built to specification, without thought put into the experience of the people who will have to use it on a day to day basis. A building built without an architect. 3. Good Idea, Bad Approach
When the best intentions exist to solve a problem but insu icient user consultation, poor planning and
research, and lack of focus lands the project in no man’s land, with a team who have no idea which direction they actually want to take it in. 4. My idea is right, but the world is wrong
The classic enthusiast’s tale of tunnel vision, failing to realise that what you believe is correct may not be applicable to, or even possible, in the world at large - or even your target audience. 5. If you build it, they will come
A lack of proactive consultation and user engagement. Projects and products need to have a pull, a reason for customers, patients, and organisations to make the jump towards you and engage with your idea. 6. They won’t mind
The failure to correctly identify the needs and desires at the end-user level, rather than the C-Suite level. Again, a lack of consultation. 7. We’ve got the solution, now what do we fix?
The problem where a project develops a great solution for… something? By failing to identify a key target issue, perhaps due to the scope of a project - they actually fail to solve any real world issue at all, but not for want of trying.
This isn’t an exhaustive list but it includes some of the major flaws that can occur in the development of a digital healthcare project – and can ultimately lead to why they fail. So how can we prevent this?
Understanding change
To understand where solutions fail, a large part rests on the inability to change behaviours - the simplest of concepts, but one of the most di icult to manage. The lack of solutions, or the failure to utilise them properly, is a failure to recognise the benefit, or the belief that the benefit is one thing when it is not.
A viable solution is not simply a system which puts out data for the sake of it, but rather engages with it, understanding how to use it in a day-to-day basis and in a long term strategy; and crucially, the support it requires in order to make it work.
“It’s about having an a priori understanding of how people change their behaviours and why systems change the way that they behave. For instance, everyone has known that smoking is detrimental for over half a century, yet people still struggle to stop doing it and we still can’t stop people from taking it up,” says Steve. “So we started implementing tools to help them change their behaviour - for nicotine cravings, smoking cessation tools, or therapeutic services. However, these were delivered in a piecemeal approach, and for a long while we failed to see a great deal of change in attitudes towards smoking,”
“However, we then saw systemic change - the smoking and advertising bans, higher rates of taxation and health risk mandates. As a result, tobacco usage plummeted because we knew how to use the data, and how to a ect the change on a systemic level. This is the same in any behavioural or organisational change pattern. It’s about understanding the drivers of behaviour - data is only one of them, but if we can use it properly, we can bring about massive change.”
As such, the reason digital health interventions fail is multifaceted. Problems can arise at any point in development but the crux of the issue is change itself. If we cannot guide people to understand the benefits of solutions to them, and ensure that they are utilised and able to be used in an e ective manner, then we cannot begin to start using them for the better. People must understand and agree with the need to change before we can see digital solutions thrive.
Dr Steve Hajioff CMO Sana Life Sciences
Contact Information
simon.swift@methods.co.uk