Patients First! - The Oversimplified Playbook for Success in Patient-Facing Healthcare
TLDR: clear vision, aligned incentives and model, constrained focus, full-stack, modularization of tech / processes, emphasis on patient relationships, expansion => success!
Note: in this series, by “patient-facing healthcare”, I am referring to all elements of healthcare where patient interaction is significant, inclusive of both direct-to-consumer models and B2B2C models. Excluded in this definition are solutions that are purely B2B intended on solving problems for just organizations or care providers, with patients as a lesser priority.
Opinions expressed here are my own.
Intro:
Building anything in healthcare is hard. Just ask Nikhil Krishnan (Why It’s Almost Impossible to Build a Health Care Startup That Works). Or Halle Tecco, Rock Health’s Co-Founder, on the common pitfalls in digital health. Or Jay Parkinson on his many stabs at dragging primary care to the present. Or Kyle Hill building in home care with HomeHero. Or Jamie Campbell on the complexities of medical data portability. Or …
Building in patient-facing healthcare is even harder. At least when you’re building products centered around healthcare’s incumbents, there have been success stories (EHRs like Epic / Cerner / Athena, Veeva, Flatiron, etc.). Why is this the case? Among a million reasons, some of the most critical ones are:
- Incentives: At the macro scale, decisions and money primarily flows through larger incumbent players like payers and providers, with patients commanding little leverage. With essentially no incentive to build strictly for the patient, considering the patient experience isn’t mission-critical, it’s charity. Good luck convincing thin-margin incumbents to spend a proactive dime for patient-centered innovation.
- Building: Building and maintaining software that’s consistently compliant with regulation while overcoming the healthcare data bottleneck presents massive hurdles prior to even developing a core product. (Side note: check out my other series where I dive into healthcare’s data problems) Then comes the problems with actually creating a solution: finding the right balance between tech and human interaction, accommodating healthcare’s complexities, optimizing for scale, etc.
- Opacity: The conspicuous difficulty of this arena deters inflow of talent and new perspectives. This deterrence reduced the amount of precedent for the critical problems of building a business (figuring out product, pricing, selling, etc.). This, combined with the long feedback loops, meant that new entrants had less data points to work with compared to other industries. Essentially, throwing darts blindfolded.
For patients then, healthcare is complex, expensive, ineffective, and impersonal, but nobody wants to solve their problems. That’s messed up.
However, times have changed. Recent economic and regulatory trends in healthcare point to a crucial development: patients are steadily becoming both where the money and the data reside.
Now, it’s no longer just good will, it’s opportunity. Incentives are slowly aligning in healthcare so that, finally, success in healthcare necessitates actually solving problems for the patient. The historic neglect of prioritization of the patient means that delivering an improved patient experience can creates disruptive levels of differentiation. It’s almost exciting. (What a weird thing to say in healthcare!)
So then let’s take that earlier statement, and flip it on its head. If healthcare is complex, expensive, ineffective, and impersonal for the patient, how can you create an experience in healthcare that’s convenient, affordable, outcome-driven, and personal?
Luckily, there’s precedent to follow. I dove into the paths of high trajectory patient-facing healthcare companies, namely Capsule, Cedar, Maven, Oscar, Ro, and TrialSpark. Though operating on very different pieces of the healthcare pie, these organizations’ paths to success have a lot of thematic overlap. Some themes apply to all startups, more to HC companies, and all to patient-facing companies.
I’ve distilled these into a three step playbook:
- Vision —Identify a broken patient experience that speaks to deeper complexities and misaligned incentives in healthcare, then connect this to a bolder vision of healthcare’s future.
- Build — Succeed in building a full-stack experience that strives for scalability while emphasizing a relationship with the patient.
- Scale — Utilize your scale-optimized components and established brand to reach the full potential of your product, then extend beyond it towards your greater vision.
Building is your problem to solve, and incentives are slowly aligning. Here’s my stab at breaking open the black box of building in healthcare and reducing the opacity. Let’s break this down.
