Pilotitis, a term commonly used in digital health to describe the tendency to launch numerous small-scale pilot projects without committing to or scaling pilots to full scale implementations. As someone who has worked in digital health for 11+ years I have had significant exposure to Pilotitis. Although I have built a strong immune system at this point.
Pilotitis is often criticized as a waste of resources and time. I take a bit of contrarian view to this. But first let me begin by acknowledging the abundance of pilots and/or tech innovations / solutions busily seeking out problems to solve.
It is critical to be crystal clear on problem definition and validation, solution prototyping, co-design with stakeholders (patients, clinicians, technology partners) and seeking first principles related to necessary clinical and commercial prioritization. Understanding the prevailing and pressing priorities of a pilot host organization (see what I did there?) and designing/addressing those priorities can improve odds of success in terms of scaling innovation learnings and pilots to larger success.
The digital health world is littered with the wreckage of failed pilots, startups, discarded pet projects that never gained traction whether because of lack of clinical/administrative/business/patient buy-in, inadequate scaling resources, poor planning, poor feasibility analyses…the list goes on and continues to do so. Given the potential for catastrophic consequences for start-ups and innovators, we affirm that this phenomenon can only maximize benefit and minimize risk for all stakeholders if approached correctly.
Firstly, pilot projects continue to provide a low-risk opportunity to test new ideas and technologies before fully investing in them. This allows organizations, clinicians, and academics to gather data, validate efficacy and viability of a solution, as well as identify potential challenges and make improvements before scaling. This is kind of the point of a pilot. This does however assume a framework for evaluation, resources for change-management, adoption acceleration (and learning) and that someone did some actual simple math to see that a solution makes sense in theory and at scale!
In the digital health field, where innovation does (and needs to) take place (with peer-review, validation, regulatory and security/privacy considerations), pilot projects can help organizations improve clinical and business outcomes (revenues, cost-savings) by learning from and experimenting with automation, virtual care, machine learning and AI.
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.
Pilots need to adhere to principles of evidence-informed care, inclusive and empathy informed codesign, health equity, workflow (and technology) integration and clinical efficacy/outcomes improvements. This offers an opportunity to build processes around rapid (repeatable) operationalization, evaluation and learning for future pilots and experiments. Learning is critical. You know the famous Peter Drucker saying, “If you can’t measure it, you can’t manage it.” But also remember, if you can measure it, you can also game it (that one’s mine) so watch out for that one.
Immunity building from Pilotitis allows for critical patient, clinician and stakeholder connection, engagement and feedback, empathy and relationship building. This allows for innovators, clinicians, entrepreneurs, and systems/organizations to build new nodes of collaboration and gain deeper understanding of the needs and challenges faced by those they serve. This can lead to more meaningful and impactful solutions that are better tailored to the needs of the people they aim to help. Metcalfes law still applies: The value of a network is increased by the number of connected nodes. Building networks of innovative clinical innovators, organizations and ideas allow for learnings in piloting, integrations and (on occasion) scaling of innovations into clinical and commercial workflows to ultimately improve outcomes.
Working through Pilotitis offers a unique opportunity to gather data and evaluate the effectiveness of different solutions and refine the processes needed to do so. This informs future investments and helps organizations de-risk and de-cide.
Yes it is true…logic does not always prevail. In fact, logic often falls victim to politics, resource inequities, administrative BS, and the realities of things like market forces.
In the digital health field, where evidence-based decision making is crucial, pilot projects can help organizations learn how to make more informed decisions about which innovations and tech are likely to be successful and have the greatest impact.
By providing a platform for organizations to test and validate new ideas, Pilotitis can inspire organizations to pursue similar initiatives and drive the development of new solutions internally and/or externally. Pilotitis can help inform build vs. buy vs. rent decision making processes. Pilotitis creates a more challenging and dynamic and painful ecosystem. Guess what, progress can be painful. Digital health can be like an endurance sport and anyone who has trained understands that endurance sports don’t get easier over time, you just get faster.
I will quit while I’m ahead with my analogy of immunity building with Pilotitis, the point is, while painful for many (startups, innovators, innovation departments etc.) it can also be a valuable tool for organizations in digital health, digital engagement, virtual health, and digital therapeutics for:
- Improving business outcomes
- Optimizing innovation lifecycles
- Strengthening innovation networks
- Making informed decisions
By providing a lower risk environment with a framework for measuring success, process for experimentation and collaboration, the experience of Pilotitis can help organizations validate new ideas, build organizational resilience, build a culture of quantifying success, learn how to activate data, and actually improve clinical, organizational and innovation-related outcomes.
Photo: Witthaya Prasongsin, Getty Images
