Barriers to Rapid Improvement in Healthcare IT
There is a lot of talk in the healthcare IT industry about bringing successful product development strategies from B2C companies such as the Agile software development and Lean Startup methodology. Agile focuses on rapid development of software based on iterative and incremental improvements, while Lean Startup implements a fast to fail mentality.
Innovation in Healthcare IT can have its own unique challenges. A high regulatory burden forces companies to implement quality systems and put software though standardized validation and verification processes. And while few would argue that software that could be used to treat patients should be well tested and documented, it introduces a significant barrier for rapid innovation.
Both Agile and Lean Startup emphasize being flexible and learning quickly from your customers. However, institutional customers are naturally risk-adverse and not prone to test new products. This makes testing the market and validation with customer feedback challenging to say the least. Combine this with the increased regulatory costs, a long sales cycle of 6+ months, a U.S. market that is less than 6000 registered hospitals; it can be cost prohibitive for smaller companies to develop and test new products in the marketplace. Vendors face an uphill battle to deliver new or improved products to their customers.
To see rapid improvement in the quality of healthcare IT, two changes in behavior and communication are needed from healthcare institutions and healthcare IT vendors.
- Healthcare Institutions must change their behavior in adoption of new and improved technology. They should consider working with smaller, more agile vendors and be open to collaboration with these vendors. It takes two to make any relationship work and both parties have to be willing to put the time and resources into building relationships and openly discussing how to improve products.
- Institutions can provide incentives to work and support those vendors that go above and beyond in the areas of service and product development. This can include providing access to information, clinical expertise, and specialized facilities such as simulation labs to test improved products. In order to see products rapidly evolve to fit the needs of an institution, it is absolutely critical to build partnerships with vendors and collaborate on win-win contracts that build long-term relationships.
- Vendors must also change their behavior in working with healthcare institutions and in the way they develop their products internally. Vendors need to actively listen to their customers on multiple levels across the organization and integrate feedback mechanisms into their product development processes.
- Vendors can improve software development turnaround time by adapting Agile processes for their software development teams and automating quality system reporting requirements. In addition, building stronger internal communication between product management, sales, and software development groups can help re-focus product priorities to customer needs.
Methodologies like Agile and Lean Startup can provide insight into how to improve healthcare software companies. Agile promotes active planning, the use of cross-functional teams, and encourages rapid and flexible response to change. Lean Startup teaches us to accelerate the feedback loop with our customers: learning faster, coding faster, and measuring faster. These practices, to be effective in healthcare must be adapted to fit the unique challenges of a highly regulated, slow to change industry.