Things I’ve Learned From Healthcare: Building Products in a Complex Space
RL has been honored to work in the niche of Patient Safety over 20 years. As a PM, I am constantly reading about methodologies that can help us become a stronger team and create more valuable outputs to help our customers. No matter how many meetups, conferences, or blog posts I review, very little of the findings can be applied back to my role in in a B2B healthcare software company with products that are stable in their product lifecycle.
Now that SaaS, Agile, and Analytics are here to stay, the tech boom is causing growth at an exponential rate. Many startups are building healthcare apps that are meant to fit nicely into patient and provider lives, but there is a lot to consider before taking the leap into the healthcare space.
Below you will find some of my learnings from navigating the complex landscape of healthcare software.
1. There is no one-size-fits-all in healthcare. Lack of standardization and regulation in the healthcare industry causes a huge number of setbacks for tech. It’s understood that hospitals in different countries need to comply with different standards, but those same challenges can exist between hospitals within one state or even between departments of a single organization. The silo culture is caused by a number of factors and must be taken into consideration when building a taxonomy or best practice for several healthcare organizations.
2. Scalability and flexibility need to be prioritized in healthcare. Healthcare organizations are massive and are always in flux. Sixty-three percent of our clients are large organizations (>500 FTEs) and 60 have more than 10,000 FTEs. The industry is also infamous for its M&A activity, which is expected to continue indefinitely, with 70% of healthcare companies expecting to undertake M&A activity within the next 3 years (Source). “The number one driver is financial pressure, which, in turn, drives the need for scale,” says Ann Huston, chief strategy officer at the Cleveland Clinic, a globally renowned U.S.-based health care provider.
Any health app needs to account for the constantly changing environment by allowing it to grow, shrink, merge and evolve. Whether its about on-boarding new sites, divesting old ones, or re-branding all of them, the system needs to be prepared for constant overhauls.
3. Relationships can mean everything. When dealing with niche products in the healthcare market, sometimes standing out from the competition is more than just about having more features. Customers want to know that they will be heard by their vendor. Taking on a new system that will be integral to your role is scary. Sometimes it’s about knowing that they will be supported and that can only be shown with building relationships at the beginning and displaying that throughout the contract. At RL, we love our clients and our colleagues so much. When a customer signs on to be with us, they are not only purchasing a new product, they are joining our family.
4. “Tried and true” product methodologies should be taken with a grain of salt. Whether it’s a prioritization matrix, an experimental process, or PM Venn Diagram, it will likely not fit nicely into the healthcare niche you’re developing for. It’s great to have a strong community of product managers to share ideas with and to learn from each other’s’ experiences, but whether it is in healthcare or not, concepts often cannot be blindly applied into your organization.
5. Safety training and measures that have been a fail-safe for high risk industries are hard to adopt in healthcare.
a. Simulation training. Let’s look at the airline industry, for example, which resulted in 324 death in 2016 for the entire world source. Before you become a pilot, and throughout your career as a pilot, it is mandatory to perform regular simulation training to prepare yourself for major events that can endanger the lives of yourself and of passengers. Now lets look at Healthcare. In the US alone medical errors are responsible for at least 440,000 preventable deaths per year source. Compared with 324 deaths for the entire world in 2016. Even with the staggering numbers, simulation training is something healthcare is only starting to adopt now. Boston Medical Center has a state of the art simulation training facility, but it was extremely difficult for them to get that up and running, and they are still one of the only high fidelity training centers in north America. There are some clear gaps in healthcare safety that need to be addressed, and its not all just about technology adoption.
b. Other industries need to be highly reliable in terms of their safety data. For example, on a construction project, you are likely to see a “Safety First” sign that clearly displays how many days it’s been since the last accident.
But High reliability Organizations (HRO) is only becoming a trend in healthcare now. New initiatives like safety huddles and zero tolerance for high severity events are new, but hopefully here to stay!
6. Balancing pie-in-the-sky desires with reality. As much as we’d love to build the latest and greatest technology on the latest languages and browsers available, the reality is that healthcare systems cannot always support it. Our clients often have to maintain legacy systems that only function on older hardware and older browsers. The majority of our users are still accessing our web pages on IE7 and IE8 so that they can run their other web applications to complete their daily tasks. With constraints like these, it can be a balancing act to stay relevant in the market while ensuring our customers will be able to benefit from new technology and innovations.
7. Stickiness of software is important. Healthcare systems are becoming more budget-conscious. With that in mind, if a client spend a lot of time and money implementing your product, it will be more compelling for them to continue to grow with you as a vendor than for them to start fresh. On a related note, if the product touches more areas of the organization’s needs, it will be a linchpin and will be more sticky in their purchasing decisions.
8. Interoperability is key. This isn’t news to everyone. With smaller budgets and more options to choose from the market, the products that can easily integrate with others are a major bonus. Hospitals have complex databases and feeds all over their organization. If you’re not willing to make the effort to connect with those systems, you will not get very far in healthcare.
9. Domain expertise needs to live with the vendor, not just the user. Healthcare is complex, and the pieces need to be well understood in order to build solutions to solve their problems. It’s not enough to offer a generic taxonomy that might fit into their workflow, it involves deliberate planning, and often user coaching to ensure policies are being followed properly. It may be a lofty task to take on, but it’s necessary if you want to get your product right the first time.
