In Healthcare Technology, Black Turtlenecks Are Just a Symptom: The Sickness is The Lack of Evidence and Research
Digital health risks repeating mistakes of the past unless it commits to leveraging data to deliver more evidence of efficacy and publishing more research.
This week I’ll be in Boston, a city I love and loathe. Loathe — because I’m a prototypical Philly sports fan who is generally resentful of the success enjoyed by the most wicked awesome collection of pro sports teams over the past 15 years. Love — because Boston is the mecca of healthcare technology, an industry I’m passionate about and fortunate enough to have spent the last decade and a half building alongside many of its leaders.
The occasion of this week’s trip is a conference focused on the marketing of healthcare technology (#HITMC). Like other high growth markets, healthcare technology — aka digital health — benefits from the talents of people who are good at explaining how new things work and why they matter to you — whether you happen to be a doctor, a patient, a payer, a provider, a regulator or an investor.
But simply communicating a message effectively is no longer enough. The old adage of “show, don’t tell” is true, and for #healthtech marketers today, this means leveraging data and research. And my colleagues and I take this to heart — our agency is branded “120/80 MKTG” and our tagline is “Prove your outcomes.” Taken together, these serve as a reminder to ourselves and our clients: If we’re not citing data and using it to prove the case for what we do, then we’re off message.
Beware of the Black Turtlenecks
By now, most of us in healthcare tech have read John Carreyrou’s “Bad Blood” or watched the HBO Documentary “The Inventor” — both inspired by Elizabeth Holmes, the founder of Theranos. It’s an incredible tale and hard to believe that a “breakthrough technology” positioned to disrupt something as fundamental to our healthcare system as lab tests was given a pass on proving efficacy by so many for so long.
The key question is — what can we learn from this? Researcher John P. A. Ioannidis and his colleagues from Stanford and NYU Medical School had an insightful take in their paper “Stealth research: Lack of peer ‐ reviewed evidence from healthcare unicorns”. He argues and I would agree that focusing on the fraud and bizarre behavior misses the larger issue: a lack of peer reviewed research. While not as colorful as an obsession with building black boxes, dressing in black turtlenecks and associating with former secretaries of state, a continuation of this behavior could lead to our collective undoing in digital health.
The Why: Money, Culture and Competition
There are many factors contributing to the lack of evidence. I would offer up three for consideration:
Money - the obvious and boring answer, but we can’t skip over it. The massive growth in investment in digital health has raised the stakes for CEOs and entrepreneurs, in particular. This translates directly to a need to prove the business model and get to revenue as soon as humanly possible. That, in turn, leads to a rational but disproportionate focus on customers and growth. As a result, production of evidence suffers and public disclosure of data and research falls victim to the drive for speed to market.
Tech Culture - For those of us who have worked in tech, the-fake-it-til-you-make-it philosophy and hyper-aggressive marketing tactics are real. We’ve all experienced it and, at some point, probably contributed to it. But in tech, the stakes don’t typically involve someone getting the wrong result from a lab test for HIV or lost time during cancer treatment. In the past several years, healthcare technology has been the beneficiary of a migration of CEOs and management teams from the world of traditional tech. And while this has many benefits, I don’t think I’m lobbing bombs when I suggest there is less appreciation for the role of clinical evidence and published research, much less peer review. Proving outcomes is part of the tech sales model, but not always core to the company business strategy or product adoption.
Competition - as the market for healthcare technology has grown, so has competition. The more companies, the harder it is to make a name for yourself. The default response of most CEOs and their boards is to hire a PR firm and begin to build out a marketing team. Both sensible business decisions, but not to the exclusion of a data and research program and a commitment to demonstrating meaningful clinical and economic outcomes. Done correctly, the results of these efforts should become the lead message and primary wellspring of content for both PR firm and the marketing team.
Priorities in a Post-Theranos Era
As we all enter the post-Theranos era (hopefully a bit wiser), the question remains — what do we do about it? Here is my initial advice to CEOs, particularly those leading startups who are in the best position to change the trend.
Prioritize - Make the decision and make it known to your organization that creating a data and research program is mission critical. Move something else down the list if you must. Take the initiative and reap the reward ahead of your competitors from investors, customers, regulators and recruits looking to do business with a company that gets it and proves its products and services have real value.
Pilot and Scale - Just as you do with your product or service offering, start small with a pilot, learn and scale over time. This discipline must be part of your DNA. The concept of minimum viable product does not always have a place when lives are at stake.
Ask for Help - If a lack of free resources and internal inertia is preventing you from moving forward, then don’t go it alone. Source business partners who not only understand data, research and peer review, but the overall business value that comes from publishing, presenting and promoting how your work delivers meaningful outcomes.