This year has been an incredible time to be a health technologist. For decades prior to March 2020, innovators had been knocking uselessly on institutional doors, whilst frontline clinicians were forced to brave it out — archaic IT systems, bleeps and paper records to contend with. Every so often a promise was uttered (“purge the pager”, “axe the fax!”), but on the shop floor technological advances were made at a snail’s pace.
But as the pandemic swept across the continent during the early months of 2020, the tools propping up our frontline heroes took centre stage. Suddenly, everything had to change. Staff were redeployed, services went remote, and new hospitals were built. Healthtech companies piled in to help with these exceptional challenges, and were met with unusually open arms.
Long procurement processes were scrapped and new tools rapidly adopted. Innovators were able to take the lungful of oxygen they needed and finally get their products into the market: GP and specialist appointments went remote; critical communication networks were established; treatments were triaged via AI.
But now, as our feet ease off the accelerator, we’re starting to evaluate what has and hasn’t worked during the last six months — which companies and products deserve to be adopted for the long-term and which need to be ditched, quickly.
Failure is a good sign
This is a seminal time for healthtech, as we determine how we want the future of our health systems to look and who we want to be part of it. Rapid adoption and trial of new ideas doesn’t, and shouldn’t, always lead to success. Failures will be rife when you act with the speed that was required as Covid-19 hit Europe, decimating all 'non-urgent' healthcare services and forcing every single staff member to work differently.
Failures will be rife when you act with the speed that was required as Covid-19 hit Europe.
Already, we’re seeing examples of things that didn’t work out. These include the NHS contract with remote consulting tool Attend Anywhere, which has not been renewed. Elsewhere, mobile health company Now Healthcare Group shocked staff when it announced in May that it was to shut up shop following a critical CQC report and the loss of a lucrative contract. In June, a group of North London hospitals axed the use of the Health Help Now app (which was designed to signpost users to relevant local healthcare services) after it failed to meet clinical and governance standards. And across Europe, contract tracing apps — such as France’s StopCovid app — are attracting ire on everything from bugs to budgets (and let’s not even mention the UK’s attempts to date).
Poor performances on the ground are often used to incite public rancour, but for me, this is encouraging evidence that new ideas are being trialled and assessed at the speed we’ve long called for.
Systems and software must be tested, and that’s exactly what is finally happening within healthcare. We wouldn’t expect every new drug or treatment to work, so why would we expect every new technical solution to weave seamlessly into the complex environment of a hospital?
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We wouldn’t expect every new drug or treatment to work, so why would we expect every new technical solution to weave seamlessly into the complex environment of a hospital?
Yes, the stakes are high in healthcare, and some standards are simply fundamental (confidentiality and data security, for example), but if an innovation looks like it has a chance of making a difference — well, we can’t afford not to try it. Healthcare’s plate is overflowing and a second European wave is looking ever more likely — so it needs all the help it can get.
For the products that work well and the companies who are truly committed to the cause, healthcare organisations are making space to integrate them for long-term use. Those that don’t or aren’t should be permitted a graceful exit.
Let’s not go back to the old ways
My big fear is that following this period of rapid adoption, the pace will start to slow and organisations will revert to the old ways of making decisions — heavily avoidant of risk and the unknown. The NHS’s recent deal with Microsoft (reportedly worth hundreds of millions and designed to give staff access to Microsoft 365 digital tools) is a stark warning to startups and small businesses; they may have got a look-in when the stakes were high, but the big money is still headed in the direction of the massive corporates. SMEs and smaller companies, often founded by those who have stronger, more direct experience of the problem they’re trying to solve and more innovative solutions, may be once again left out in the cold.
2020 has laid the foundations for technologically enabled health systems of the future. It has breathed life into the ecosystem for the first time since the sector’s emergence. But we need this blueprint, this mindset, to continue. In order to make progress, we need to remember how to experiment, succeed, fail and emerge from the iterative process with stronger products that are better suited to clinicians and ultimately to patients. And, with the bar raised, new market entrants will have to raise their game accordingly.
As health services brace for whatever comes next, we must consign anachronistic systems to history and embrace technology that will bolster our response to whatever biology throws at our species next. And we’ll do that better, and faster, by being unafraid to try and unafraid to fail.
Dr Lydia Yarlott is cofounder of Pando and an NHS paediatrician.