Global start-up success stories have invoked parallel comparisons to David’s encounter with his oversized adversary, albeit with a lack of appreciation for the intricacies in the scripture.

Countries in Southeast Asia too are buying in, and embracing radical ideas of hoodie-sporting technologists with besuited investors in hand.

The past decade has seen a surge of these partners venturing into more traditional industries such as healthcare. However, difficulties in retaining users borrowed through free trials and discounts has led to poor performance following an initial hype.

Few incumbents provide convincing case studies of the coveted “lean start-up methodology”. It is challenging in medicine to go lean while producing sustainable solutions that integrate with a heterogeneous health systems.

The result is bleeding investors have taken a step back and survey the situation, confused as to  the apparent impotence of tried-and-tested strategies from other industries. Although healthcare is riddled with inefficiencies and opportunities for innovation, it has numerous barriers to adoption and propagation.

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This article highlights 3 recurring problems encountered by aspiring innovators in healthcare and users of their solutions.

The Human touch: a cornerstone of any health intervention

The relationship between a patient and their healthcare worker is a key component of health interventions. Proponents of the notion that clinic visits can be replaced by a robot fail to appreciate this therapeutic relationship.

It builds upon the trust of patients, provides solace to individuals incapacitated by illnesses, and encourages perseverance in the management of a possibly decades-long chronic diseases.

Medtech companies would do well to respect the value of the human touch, and build their innovations to enhance rather than bypass.

The latter approach may also result in a diminishing impact in the long-term, undermining sustainability of interventions. Ultimately, healthcare is not ripe for disruption, but poised for digital empowerment.

Medtech without a doctor is an airport without a control tower

Med-tech innovators are often under pressure from investors to quickly demonstrate returns after fundraising.

Armed with a prototype or ”minimum viability product (MVP)”, they splurge on marketing and yet have difficulty acquiring users. This is due to the staggering levels of information asymmetry between patients and health providers — unlike any other industry.

Patient-users may not adopt medical technologies based on a viral video or discount promotion. Instead they often first approach their physicians for advice, physicians whose confidence will not be inspired by a Frankenstein prototype of hardware jolted alive with rudimentary software.

Respectable physicians simply will not have their patients turned into guinea pigs without proper procedures in place. 

You are the doctor, shouldn’t you decide what I need?

This is an all too common response practicing doctors in Singapore receive from patients, after listing the risks and benefits of their treatment options.

Although patients have begun to appreciate the premise behind informed consent, this dialogue perfectly illustrates a dependent relationship. Digital health enthusiasts argue that the information age will rid patients of this reliance on doctors.

However, this could not be further from the truth. The onslaught of information from wearables and questionable sources online is instead confusing the public. Counselling regarding a diagnosis that ordinarily takes 10 minutes may double in duration today due to time spent dispelling such misconceptions.

A preemptive solution would be to engage with physicians early in the process. Being able to clearly demonstrate enhanced patient education or outcomes through this is an investment of time that will greatly facilitate adoption.

Healthcare does not need “uberisation” but rather a commitment to working with stakeholders to enhance their capabilities. A case in point would be Doctorbell which builds customisable patient management systems for doctors to educate patients, build closer relationships with patients, and enhance follow-up processes through telehealth technology.

Such empowerment of existing providers brings solutions more likely to be adopted in today’s complexed health systems.

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The next point is the context of healthcare. It is a dominion of heterogeneous corporate behemoths over end users that are highly trained professionals and patients enslaved by the shackles of licensing and inelastic demand.

The bureaucratic processes, checks and balances of health systems are crucial for safety, but may cause tunnel vision where innovation is concerned because it distances leaders from users and innovators.

Fortunately, collaborations between technologists and healthcare workers have given rise to a surge in new medical research evidence that empowers stakeholders and innovators to reach decision makers directly.

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In conclusion, disruptive methodologies that blasted corporate culture and enabled a generation of digital nomads in other industries will not bypass barriers of health systems. Instead, collaboration and purposeful partnership is more likely the way forward.

I hope that all innovators in healthcare succeed in addressing these issues, so that our patients ultimately benefit from successful solutions to the growing complexity and costs of our health systems.

Abstract:

Dr. Dinesh Visva Gunasekeran provides insight into 3 key and poorly understood problems encountered by medical technology innovators in Southeast Asia (SEA), along with potential corresponding solutions. He is a medical doctor from Singapore with years of experience in big data clinical research and advising several med-tech start-ups in Southeast Asia, such as Doctorbell. Dr. Dinesh has over 10 scientific publications and book chapters to his name, and has been invited to speak at international medical conferences on his scientific research and at innovation forums about iterating health IT solutions for complexed health systems. He is optimistic about the potential for the passion and creativity of the new generation to produce silver-bullet solutions to the bureaucratic inefficiencies that plague modern systems.

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