Instead of just building apps that people may or may not use, healthcare innovators have started taking lessons from counterparts in other industries by testing their ideas first.
“Calls for innovation can sound hollow to practicing clinicians, who know that when it comes to intractable challenges like patients repeatedly admitted with heart failure, there’s no app for that,” Executive Director Dr. David Asch and Chief Innovation Officer Roy Rosin of the Center for Health Care Innovation at the University of Pennsylvania wrote in a New England Journal of Medicine article.
“But lately, the innovation field has shifted its focus from the generation of ideas to rapid methods of running experiments to test them,” they added.
One method is what Asch and Rosin called the “vapor test,” discerning whether there is a market for something before that something even is a something. “When you select a product from a retail website and get an ‘out of stock’ message, often the truth is that it never existed. Retailers post believable descriptions or computer-generated images of items that might interest customers, to see whether anyone will try to buy them,” they explained.
However, professional standards in healthcare make this strategy a risk. The Penn pair said that they were approached by a medical student who suggested allowing the emergency department to place intrauterine contraceptive devices rather than requiring women to make an appointment.
“Before investing in such a program, we could test demand by asking patients, ‘We may not be able to do it today, but if I can arrange it, would you like the IUD inserted before you leave?’ This ‘fake it ’til you make it’ approach, despite its subterfuge, may do more good than harm by accelerating important changes and conserving resources,” Asch and Rosin noted.
Those in health innovation sometimes also try building a “fake front end” or “fake back end” of products. For example, they said, the Children’s Hospital of Philadelphia recently employed a fake front end for youngsters with sickle cell disease but low risk for bacterial infection who showed up at the ED.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
“As part of their routine workflow, physicians were asked to identify which children could safely be sent home,” the authors said, but noted hat all patients were still admitted to the hospital. “The data gathered resolved the debate over feasibility, and now 27 percent of these children are no longer admitted.”
An example of a fake back end was a smartphone-based pedometer system to convince sedentary people to start walking regularly. The fake back end was for collecting data.
“A mini-pilot revealed that our design inadvertently motivated active people to walk even more — but demotivated the target population, who felt defeated when they lagged on leaderboards,” the authors wrote. Still, the researchers noticed “potent social dynamics” to allow for different kinds of comparisons that helped get sedentary people off the couch.
