We spent a day at the Texas Medical Center Accelerator (TMCx), one of the top healthcare startup accelerators in the country, talking to very talented healthcare entrepreneurs about how to build stellar products.
Healthcare is hard — but many of the TMCx alumni are now successfully navigating the healthcare space, and we wanted to take a look at how good startups approach the beast that is the healthcare industry.
Rule 1: Know Thy Stakeholder(s)
Most healthcare organizations are deeply layered and extremely complex. When entering a working relationship in the healthcare industry it’s imperative to understand the different layers of stakeholders in order to have a successful engagement. To build a mutually beneficial relationship, you must understand who each stakeholder is, where their priorities lie, where they see risk and what success looks like to them. You’ll find, as with all large organizations, that stakeholder priorities are not always aligned, meaning that you need to be willing to take the lead and help them align with one another.
When it comes to financial stakeholders the key objective will (obviously) always be focused on cost to the company and ROI. However, it is important to remember that each finance department, for each healthcare entity, has a different structure and therefore it’s necessary to understand which KPI’s are important to them before engaging. IT stakeholders, on the other hand, may be motivated by implementation requirements or security vulnerabilities. Often times, technical architecture is specific to an organization, and as most health organizations tend to be more complicated, a successful partnership relies heavily on open lines of communication and a full understanding of their existing systems. Satisfy those driving the business case, along with those who will actually use the product can also have conflicting goals. Stakeholders can also be silent or non-obvious. Even if a CIO makes the final call on decisions, it may be the case that she may heavily defer to her IT team, whom she deeply trusts. If all of these factors are lined up and healthy, the relationship stands a strong chance of being successful.
Rule 2: Map The Ripple Effect
The installation of any new practice or technology within an organization is bound to cause a myriad of changes to workflow, and not always in ways that are expected. In a healthcare organization, it’s likely that a new technology will cause a significantly greater ripple effect. Before installing a new product, or perhaps even before installing a new partner, such as a startup, it’s necessary for healthcare organizations to understand how these incoming changes will reshape their working structure and practices. As a startup partner, it’s important for you to ask questions to get the organization thinking about the consequences of introducing your product. If this is not mapped out at the beginning of the relationship, you risk problems in the design and development phase if you’re going to require the involvement of internal stakeholders to build the product. Worst, you could find issues at the level of rollout — and that’s a nightmare to deal with. Think carefully about the ripple effect of your product beyond its immediate use — on patients, on family members, on ancillary staff. It may seem like a no-brainer, but carefully mapping out how a change in one department will affect the success and workflow of other departments is a key to a successful partnership.
Rule 3: Start with KPIs and work backward
In considering these KPIs and metrics, it’s also important for organizations and startups alike to keep the patient and end-user experience as their guiding light. A clear metric for both sides will always be user adoption. Without this, the healthcare organization can’t justify continued investment and the startup loses the partnership. Do your due diligence when it comes to researching the target user and give them the prototype before it is integrated into the organization. This allows for a foundational tentpole within strategic engagements so that all success metrics and OKRs are tied back to the user. Forgetting about the patient experience is detrimental to any engagement.
However, you shouldn’t stop there. Yes, the workflow you’re solving for might be very suboptimal and painful — but in highly complex organizations, inconvenience and pain to the end-user are one dimension of a problem and they might be very specific to a single institution — remember that in a large organization, inertia can reign supreme. If your users are telling you that they’re suffering from a problem you’re trying to solve but the institution hasn’t figured out a solution yet — it’s a pretty good sign that the inconvenience of your users on its own wasn’t enough to drive change forward. If you want to craft a narrative that stretches beyond a few pilots and keep winning stakeholders over, you’re going to have to dig into the KPIs that are going to be improved by your product. Sometimes, the best way to do this is to keep digging during your customer research phase until you find the KPIs that really matter — then work backward from there.
Every company has hard metrics they need to attain in order to determine a product investment is a success. “What results are we trying to drive from this engagement?” should be a common question that all stakeholders ask before shaking hands. Thinking of the end goals of the product or partnership allow organizations to be strategic about defining their KPIs and success metrics. At Sidebench for example, HEDIS measures are one of the many metrics that we look to when making product decisions because one of our clients is a managed Medicaid provider.
Conclusion
Healthcare is hard — and that’s why it’s worth trying to create products that have an impact on the industry. While consumer-facing digital health products are attractive to build, the truth is that most digital health startups will end up selling to other businesses, including complex healthcare organizations — you will inevitably have to face the beast. Go forth and arm yourselves with these best practices!
