The most frequently discussed elements determining digital health adoption are reimbursement, interoperability, leadership, infrastructure, and digital skills. What do you think is the invisible part of this iceberg?
People are the most important element. They impact all the other elements simply because humans can be innovative, strategic, and resistant to change and often have the power because of their positions to block new ideas, slow the consideration of new solutions, and insist on long-drawn-out procurement processes. Besides, there is, especially in the public sector, an aversion to risk-taking and the often-heard comment “we are dealing with public money here,” which is accurate but misleading and can be an excuse for doing nothing.
What are the key lessons for digital health companies that you’ve learned as a chair of the ECHAlliance, a leading community that gathers over 750 member organizations from 78 countries?
Probably too many to mention in this short interview! As we all know, common sense is not that common. On a positive note, I have learned to listen. When you actually listen to understand the concerns, the ideas, and the contribution that the vast majority want to make, it reveals the obstacles. We have a saying within the ECHAlliance, “Lead with the Need.” We help identify the real needs—whether in a country, a region, or a city, we have created multistakeholder communities across many countries, languages, cultures. Over ten years, we have realized the power of that intelligence network. We constantly find a need in one place and a solution in another—our role as the connector is in demand. It is rewarding when we make our communities aware of successes and failures, and the trust and respect we have built-in that role is very rewarding.
The COVID-19 pandemic has accelerated the implementation of telecare and telemedicine. Individuals are increasingly using mobile health apps. What can be done not to waste this potential?
We spend a lot of time spreading the word on what has worked and what hasn’t. There are so many advances, either in innovations or the acceptance of solutions, which have been around for years.
The pandemic has enabled governments to set aside many time-wasting procurement processes. More importantly, in my view, is the focus on deployment and implementation, rather than pilots and then more pilots. Now the consumer has had a taste of the convenience of a virtual call with their GP; they liked it and will not want to go back to the “old” days of waiting to be told “the doctor can see you now.” In addition, the consumer has become much more aware of their need to manage their own health and find help through apps for prevention, well-being, and mental health issues.
So far, digital processes and solutions are embedded in existing health systems. It’s a bit like adding new parts to an old mechanism. If health systems were created under a new digital model, what should they look like?
We all have opinions on what is wrong with the present systems, but there is no consensus on what we should move towards. There is no “we,” which makes it all more complicated. Many big names have a vested interest in keeping as much of the status quo as possible. Suppose you owned, say, 100 hospitals, and you are shown digital solutions that will dramatically reduce the number of patients to your hospitals. Do you embrace those solutions, perhaps even buy them? These are fundamental questions facing every player, including governments, payers, providers, solution vendors, etc. As we move to what I believe is inevitable, a sector having to provide the citizen with what they want, when they want, where they want, and at a price they want. As has happened in so many other sectors, consumer power is already changing this sector. I believe this offers significant opportunities, but there will be a disruption for many.
What prerequisites must be in place to harness the power of digitization in health care?
Trust is the biggest. The citizen/consumer has to trust the providers, and that trust has to be earned. One question is and will be key: Who do I trust with my data? Governments? Big Data companies? Private groups? I am not concerned all about finding the technical solutions—many already exist. This is a huge topic and I worry that it is being addressed often in many silos, but the dots are not being connected.
What frameworks do you use personally to evaluate the value of digital health solutions?
Obviously, we look at existing EU or global standards—our members, of course, spend lots of resources complying. My personal framework is again common sense. I have had a lot of start-ups myself, so I have the mistakes, lessons, and scars to prove that! My question, having listened to the pitch, is always “What need are you addressing ?” I am often asked what do you mean? They then tell me how incredibly innovative their idea is, and I have to repeat my question. Many ideas are created by much smarter people than me, but if they don’t satisfy an identified need, they are likely to fail.
Can you please give three tips for investing wisely in technology innovation?
It depends on who you are. As a private investor, I have my own criteria because I am taking the risk. My main tip, and I think this applies to any investor: the people are what matters, not the idea or technology. If the people are investable, you can move forward, and you can change the technology, probably not the people. Governments, hospital groups, etc., have to add lots of necessary processes and we encourage them to interact with and understand what is available in the market. Too often, they don’t have the systems which allow this, but that is changing.