With our partners Previsior and Igenci, we often talk about the challenges inherent in building great products that change patients’ lives. Unfortunately, in our experience, we’ve often found that the final solution falls well short of the intent or potential, frustrating all stakeholders in the process - but no one more than the patients themselves.

The expectations of patients everywhere are set high by the array of great products in the consumer space - everything from banking mobile apps, to eCommerce platforms, to services like Uber and Airtasker - satisfaction is just a tap or two away. So why, when it comes to the healthcare space, do so many products come up short?

From our perspective, there are four main challenges that need to be overcome to create great products that change people’s lives.

Complex systems

Starting with the most obvious one, the healthcare system is a set of complex, interconnected organisations with legacy rules, and infrastructure designed to reduce risk and thus become resistant to change. The perceived risk and effort of making improvements is often seen, by default, as being greater than the downside of the status quo, especially by those whose careers depend on maintaining it. When there is eventually sufficient appetite for change, the search begins for someone who can offer solutions, and the door opens for consultants and technology vendors claiming that they can overcome the challenge. More often than not, they end up adding yet another system on top of the rest, and the problem is amplified by adding yet another set of stakeholders to an already complex landscape. This sets the scene for a protracted and expensive engagement. The patient experience gets lost in the fog.

Siloed organisations

Due to the way medicine has evolved, we have inadvertently created two distinct issues here - silos within organisations and disconnections between organisations. Given most healthcare challenges involve multiple layers and organisations (each with their own priorities, constraints and politics), getting things organised can be painful. For example, in a previous project, one of our partners was helping with child protection issues that involved nearly a dozen organisations including schools, police, local GPs, hospitals, charities, and more - not to mention the general public. There was no shortage of passion and talent at our disposal all aligned to a powerful shared goal. However, when we brought the stakeholders together, it became quickly apparent that many of them had never spoken to each other, even when they worked for the same organisation. In the final wrap-up, several were heard saying to each other “we should do this more often” - an unfortunately common refrain.

Unsustainable change

Our third common challenge relates to setting things up for the long haul. Many healthcare initiatives are built on a business case with an identified and quantified current issue which needs to be addressed. But while systems are set up to capture this data at a particular point in time, measurement and management of continuous improvement requires commitment over many years or decades…or potentially generations. The issue here is that success is measured from the health agency perspective, rather than the patient perspective. Take obesity for example - Government initiatives may operate at scale, by informing patients about the benefits of diet and exercise, then hoping to have an impact. Yet, when we think about the best digital engagements in this space, especially those which drive sustainable and measurable benefit, they seem to come primarily from the private sector (e.g. Apple Fitness+, Lifesum, Smoke Free) which can lock the data away beyond the reach of the public healthcare system. It’s unfortunate that the government, with the potential for significant and sustained funding, isn’t in a position to leverage this data for the greater good (potentially a sign of the lack of long-term mandate).

Digital ‘tacked on’

The healthcare industry generally doesn’t recruit from outside its own industry, which is unfortunate because considerable digital talent lies elsewhere. Hard-won lessons about the best way to approach projects (broadly: strategic, agile, user-centred) have still not been embraced wholesale in the healthcare industry. Unfortunately, we’ve seen a fair amount of management by committee, and a reluctance to empower those who bring diverse (i.e. non-clinical) perspectives. When it comes to designing digital aspects, many decisions have already been set (including budget, timing, and, unfortunately often, platform choices). Pity the poor patient who’ll be the unwitting recipient of an app based on countless unvalidated assumptions, monolithic legacy systems and inconsiderate user-experience design.

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While all of this might be cause for depression (there’s a lot of work to be done), there is also cause for optimism. There are now many people and organisations who recognise these challenges, which is the first step to resolving them.

The single greatest step we can take is to acknowledge that the “disenfranchised patient” shouldn’t simply be a passenger in their own care journey. By placing them at the heart of any initiative designed to help, we can change the trajectory of engagement. Focus on empowering the patient to take ownership of their health, doing the hard work to align multiple stakeholders in support of this goal. Make sure the patient has a voice throughout the project, and treat their feedback as a gift. Determine what long-term, sustained success looks like from their perspective, and build this into the plan. Undertake efforts to understand their digital life from the outset, and design by applying these learnings.

Or, put another way, we can aspire to perform collaboratively so that the solutions we co-create with clients and patients will compliment existing patient behaviours rather than fighting them, all in pursuit of the ultimate goal - patient empowerment in their own journey.

This post was written in collaboration with Adam Wardell of Previsior and Tracy Whybrow of Igenci.