# A decade into digital health, 7 key learnings for innovators _Date: 15-11-2023 , Tags:_ #digital-health, #entrepreneurship, #product-management, #innovation _15 November marks the 10th anniversary of the beginning of my journey into digital health innovation. Back then I was a 17-year-old nerd pitching my startup idea for a narrative medicine digital health platform._ ![[adryhealth-adriano-fontanari-startup-weekend-brescia.jpg|400]] _Startup Weekend (2013) - Brescia (IT)_ Over the next few years, I traveled to 8 countries and 2 continents. During that time, I studied and worked with different healthcare companies. These companies included startups, corporations, VC firms, healthcare providers, and non-profits. Every time was a humbling experience packed with valuable learnings. I outline the most significant ones in this blog post. --- ## My 7 key learnings for innovators **1) The things you do affect others' lives, and this effect isn't always measurable** _The story is the one of a cold winter day in which I was visiting a loved one. The palliative care nurse came for a routine care visit and started using the software I co-designed (she was not aware of it)._ In this situation what you want for your dear one is an efficient tool that reduces screen time and increases the the opportunity for direct communication between the nurse and the patient. No industry can offer an opportunity to improve people's lives like health care. At the same time, the quality of digital health software cannot be fully captured by a KPI, the only way to understand its real impact is to see how the software is used in the real world. **2) The Missing Chair (for the Patient)** ![[adryhealth-hospital.jpeg]] _SJD Barcelona Children's Hospital (2019) - Barcelona (ES)_ Jeff Bezos used to leave an empty chair in the meeting room. The chair symbolizes the customer not being present during decision-making. I feel like it should be the same in healthcare. Despite there has been uptake of user-centered design in everyday product development efforts, people tend to forget that the place where healthcare products are built is far from where healthcare happens. This is why having product management processes with several touch-points with patients across the continuum is paramount. Instead of showing wireframes and asking for feedback, product management teams should visit hospitals regularly, observing and talking with doctors, nurses, and other healthcare professionals. ![[adryhealth-blackboard.jpeg]] _(Biodesign) Need Finding Workshop - StarShip Health Innovation Fellowship @IESE Business School (2019) - Barcelona (ES)_ I believe It should be mandatory for people working on digital health solutions to have regular (and mandatory) visits to a GP or Hospital. **3) You should publish in peer-reviewed journals to work in Digital Health Care** This is a bit opinionated but I see it as a fundamental step to appreciate how evidence is generated. Working with senior research and publishing in peer-review journals, helped me understand the time it takes to generate good-quality research. Research has no deadlines. Conversely, startups by definition are meant to grow and can be acquired, merged, and dismantled even before the pilot paper of a technology has been published. **4) Best products do not (always) win...and most innovations are incremental (sorry for that)** Developing a 10x tech product does not set a company up for success. This is a harsh reality of health care than other industries. Getting Product-Market Fit in Digital Health means figuring out the stakeholder alignment. The payer may only see a valuable solution for a doctor as a cost. My recommendation here is two-fold: i. map out the whole user journey (and all stakeholders involved), ii. understand the culture and barriers to adoption, and connect the dots with a payer. Getting stakeholder alignment right is probably the most important thing to do in healthcare innovation. **5) You will soon realize data is the bottleneck of every digital health innovation** > "All roads lead to...the EMR Provider" - Every digital health innovator You may want to have quick access to longitudinal patient data. The reality is data is fragmented across different systems and providers and you will start learning about the importance of data interoperability. Not to mention data quality issues but this would be a topic for another discussion. My key takeaway is that existing data bottlenecks in health care are not a bug but a feature of the system. From the innovator's standpoint, I highlight the importance of making the solution interoperable by design. So that it will not create another "_data roach motel_,"[1] (data can enter but not leave the solution) but will make the innovation an integral part of the system. Native integrations with leading solutions and a fully interoperable platform are overlooked sources of competitive advantage. **6) A beginner's mindset, teamwork, and community are everything** ![[eit-innovatiors-community-adryhealth.jpg]] _EIT Health Innovators Community Meeting - Vienna 2022 - (GER)_ No matter your experience, each new digital health project feels like starting from scratch. Each innovation has its specific needs and requires different expertise to work together. Alongside the chair of the patient, innovators need to let empathy enter the meeting room and leave ego outside it. It is seldom the case a single individual has a full understanding of the all components of the solution. This is why effective digital health innovators need to speak different languages (here I mean the clinical, design, engineering, regulatory, business, and data ones). Indeed, Innovators are all part of the same big community, working tirelessly to build valuable solutions to improve people's lives. ![[digital-health-today-frontier-health-adryhealth.jpg]] _Digital Health Today Ambassadors @Frontiers Health (2019) - Berlin (GER)_ **7) Play only long-term games** > The days are long but the decades are short - Sam Altman No quotes can probably better summarise what it means to work in digital health. People working in this industry bear the burden that the impact of the solution may be seen one day, and that day can be far from today. Patience is a necessary skill to work in the industry, there are no shortcuts to building great digital health products. You get what you put in. The Startup Mantras (e.g. fake it until you make it; move fast and break things) do not work in the industry. Remember Theranos? Additionally, the SaaS exponential growth rat rate myth of the 2010s is over (and most likely it has never started in healthcare). This means embracing the reality. For instance, B2B Sales cycles are often long (at least 6-8 months) and tech will hardly disrupt healthcare to replace services. Conversely, I believe in the importance of a service component to ensure solutions are meaningfully bridged to the system. This can also be a key component to sustain the business (making money only from tech is hard). Playing long-term games means truly "caring" about the issues of the healthcare systems and embracing all the hurdles and struggles it takes to solve them. Startups may not make it but the potential impact on patients is worth the journey. ![[biodesign-digital-health-innovation-adryhealth.jpeg]] _Talk: "[[Innovation in Healthcare - From Tech Push to Need Pull]]" @Forum Sistema Salute (2019) - Florence (IT)_ ## After 10 years, what's next? Many things can be said about how I saw evolving digital health in the last decade. 10 years ago the US route was the only way to build a successful digital health business. Now that digital health become mainstream and an integral part of everyone's lives), Europe has also become a mature market to consider. I would like to close this reflection article by saying thank you to all the AMAZING people (colleagues, friends, mentors, leaders) who shared a part of the journey. What is next about me? I have always seen myself as an entrepreneur/intrapreneur. I will continue supporting companies building great digital health products and also giving back to the community my learnings. P.s. A final message to current and aspiring innovators: digital health innovation is fun! ![[mit-health-innovation-bootcamp-adryhealth.jpeg]] _MIT-HMS Healthcare Innovation Bootcamp (2019) - Boston (US)_ --- Are you interested in having a coffee chat to talk about **digital health or collaborate?** Or maybe just to **say hello?** <mark>Let's talk!</mark> <iframe src="https://calendly.com/adriano-fontanari?hide_gdpr_banner=1&background_color=242424&text_color=ffffff&primary_color=f5d70b" style="min-width:620px;height:300px"></iframe> --- ## References - [1]: Neff, Gina, and Dawn Nafus. _Self-Tracking_. The MIT Press Essential Knowledge Series. Cambridge, Massachusetts: The MIT Press, 2016. --- _Copyright © 2024 - Adriano Fontanari_