Digital health & tech is big business. In 2017, the global digital health and tech market is valued at $135.9 billion USD1, of which $24 billion USD is for the mobile health market alone1. Secretary of Health, Jeremy Hunt announced in early 2016 that £4.2 billion was going to be set aside to push further towards a “paperless” NHS. There is huge scope for companies to earn some serious money! But are we always going to get best outcomes in healthcare if the focus is on money?
As a doctor, I have had to sit though many hours of mandatory training to use the Electronic Patient Record (EPR) systems in the numerous hospitals in which I’ve worked. However, I was left confused, frustrated and generally disappointed after using the systems. In one hospital I had to write out a new patient’s history on a proforma, only to type everything up into a digital system moments later. That’s assuming I could access an available computer of course.
But what does it matter? I still did my job. So it’s fine, right?
As a Clinical UX Specialist, I have worked on numerous projects to create mobile apps and websites. They came with lengthy business plans detailing 10 year financial projections going into the millions, with equally millions being required in the budget and an intricate project plan. Yet there was no time set aside for meaningful (if any) user research or user testing before going live. Time and money would then get wasted as avoidable mistakes were walked, fallen – if not jumped – into.
But what does it matter? I still did my job. So it’s fine, right?
Well no actually, it certainly is not fine.
Great healthcare is a basic human right
Digital health, spanning mHealth, health IT, wearables, telehealth and telemedicine, is the natural evolution of modern medicine. 2 Modern medicine is a means to optimise the physical and mental health and wellbeing of all. All decent governments are expected to do this and the Human Rights Act is a means to ensure governments do. Very often, however, governments and their health systems cannot do this completely on their own. There is a need for essential skills and resources which exist outside of these institutions. So in order to do what is best for the people, a variety of providers “provide” products and solutions, including digital ones, to satisfy the needs of the people.
But are really giving the people what they want?
Cherry pie, not apple pie.
I like pie. If I asked you to get me pie, you may get me an apple pie. You could choose to go to a supermarket or a well known fast food restaurant beginning with Mc. You might even bake me a pie. Ultimately though, I would be disappointed because I like cherry pie, not apple pie. What’s worse, I’m trying to eat healthily at the minute and would prefer you gave me something to support that endeavour. Your apple pie is not making me happy, and actually I am now having a bad experience.
Maybe you spent a lot of time and money on that pie. It could have been grandma’s recipe.
You did your job, but it really matters that you didn’t show any care or gain direction from my needs, because I was not included in your thought processes. In fact, we didn’t even have an (imaginary) conversation before you went off and got me my (imaginary) pie.
If only my needs were at the centre of your decision making. My needs could have been discovered by asking me, or teased out by having a lovely chat with me. Doing this one thing suggests you care about my needs. (Don’t make assumptions though, as we all know what happens to those that do). I know myself, so don’t guess when you can be certain by asking.
Give me what I need, not what I want
If we are ever to make medicine truly modern, the same attention must be given to needs when dealing with digital health. And specifically needs, not wants.
“If I had asked people what they wanted, they would have said faster horses.”
Henry Ford, Founder of the Ford Motor Company
A person may know what they want, but that does not mean they are experts in health. That’s ok, as someone can be an expert about themselves without knowing everything about health. It’s important that their personal expertise is incorporated into thinking about needs when it comes to developing new digital health solutions. We do this through conducting user research where interview, observe and test people. We discover why they do what do, what tasks beyond the immediate one they are trying to achieve, and what really matters them.
People will always have a reaction to something when they have an experience with it, which is not always the case when they think of how they might react to something. Someone may not always know how to articulate that reaction, yet there are experts (user researchers we call them) who can discover that. The design of new digital health products and services, and indeed the evolution of existing ones, can be optimised by understanding the experiences people have with them.
No more delayed and expensive MVPs; Mediocre Vexing Products. No more “right enough”. Instead we can make something right first time, within budget and keep everyone happy.
Great digital health deployments require an optimisation of usability, accessibility and pleasure. Solutions should do what they are meant to do, for all people who need them, and should leave users feeling positive. To do this, understand business needs, get excited about the impact you can make, even consider your own needs and those of your colleagues: But always keep the needs of humans at the centre of everything you are doing in healthcare, especially when it comes to digital health.