Telehealth Adoption

Healthcare Series Part 2. The Research: Collecting Facts

7 min readFeb 20, 2021

In my first post of the Healthcare series, I’ve reflected on four core problems in the healthcare system: 1. The historical lack of interoperability in EHR, 2. Private equity consolidates health practices while patients lose, 3. Limiting approaches and inconsistent definitions contribute to misdiagnoses, while continuing to encourage specialists to keep diagnosing new speculative conditions. 4. Problems in rural healthcare can be alleviated through telehealth solutions. I encourage you to call out if any of these facts are unreliable proxies.

If, after reading this post, you’re either very excited about building the future of healthcare or vehemently opposed to my approach and ideas on health tech, I encourage you to reach out to me at jacqueline@healthilymatch.ca for a fruitful discussion.

In the part 2 of this healthcare series, I’m going to cover:

The research that I’ve collected to verify the severity of these problems. Should we care about these problems? How many people are affected with this problem? What is the market opportunity?
The hypotheses of value creation for the ideal buyer and users who would like these problems to be solved.
I’m also going to discuss my approach to designing an experiment to test these hypotheses.

{This approach to tackling the customer problem is actually inspired from a project I did from MBA course called Social Innovation with a non-profit, creating hypotheses of the problems the customers have, generating insights from surveys and in-person customer interviews and finally providing a set of product feature recommendations — in other words, arriving at a prototype experiment to test whether the products solves these problems. }

Controversial quotes venture capitalists disagree with:

“ Execution is a dime a dozen. If you have an idea worth pursuing, then just make it.” — James Altcher

This quote is interesting because it suggests that with an abundance of products in the marketplace, the capability to differentiate your value proposition to an ever more targeted, defined audience is necessary. This type of expectation relieves the pressure of finding that — one unicorn idea — right away. Derivative ideas are everywhere and it’s difficult to differentiate between a feature, a product and your ability to execute on the very great idea. Isn’t this about testing whether your insight is valuable — and the challenge is to find enough users who can experience your applied insight in a tangible way?

If you believe in the credibility of Jungian psychology, more commonly known to be the MBTI, you’ll understand that there are at least sixteen types of ways of experiencing the world (and generating unique insights). Is your insight applicable to others?

▸ The Facts

$700M estimated cost savings on Canadian healthcare system for 1M telehealth consultations.
There are 4.8M Canadians who do not have a family doctor.
Alzheimer’s disease costs the healthcare system $1.1 T and $153B for America and Canada respectively.
Lifestyle choice-related diseases diabetes and obesity costs the American healthcare system $327B and 147B per year.
The income for the pharmaceutical industry exceeds $18B a year from sales in psychotropic medication. Growth rate of diagnosis since 1980s = 400%.
The number of people taking 5+ drugs have risen by 70%. We live in an anxiety-prone world.
6.8 M affected by GAD (Generalized Anxiety Disorder) in America.
Morbid obesity, diabetes, dementia (parkinson’s disease), pediatric asthma, and colorectal cancer are among the top conditions with the highest % of patients under-referred to medical specialists.
Cancer, cardiovascular diseases and infections are leading categories of harmful diagnostic errors in primary care, leading to costly $1.8B malpractice payouts
12M people are misdiagnosed every year.
It takes 4.6 years and an average number of 5 doctors a woman sees prior to receiving a correct diagnosis of an autoimmune condition, and women has a 50% higher chance of getting an initial incorrect diagnosis for heart disease.
41 M deaths globally from chronic diseases per year.

▸ Questions to Narrow the Target Audience

→ What is the customer’s approach to finding a medical specialist today? Are the urgent motivating factors behind these users and customers to seek a new solution today?

→ Do you have an advantage and unique insight into this particular audience segment you’re targeting?

▸ Defining the Hypotheses

Apparently at a startup, everything is turned into a hypotheses about value proposition. For now, these hypotheses should state the problem statements and the solutions that the customer require to solve these problems. The ultimate hypothesis here is, of course, that it is an idea worth pursuing. (It is an idea that can lead to revolutionizing the way we experience healthcare, yielding massive improvement in health outcomes and lower costs.

Consumer Attitudes after Covid. The lack of insight into potential healthcare costs for regular check ups and testing continue make it difficult for the everyday consumer create a budget for healthcare. We know that hospitalization is the costliest and people, especially those without a primary care physician, at especially at risk. What if there is a standardized approach to intervene at earlier stages? Do people develop depressive symptoms easier because of external circumstances, or could it be a nutritional problem?
People are aware that preventive care is prioritized because (1) there is a pervasive lack of trust in doctors and medical specialists from particular segments of society: minorities, people with language, geographical and cultural barriers, (2) going to the doctor is expensive in America if you require seeing multiple medical specialists, and (3) lifestyle changes require sustained effort and are the root causes of many early onset of chronic conditions. This can be enabled with technology with convenience from the person’s pocket. People also want to realize the value they capture from healthcare services to ensure the prescribed medication or treatment is actually effective.
The problem of misdiagnosis, late and under-diagnosis can partially be solved if healthcare solutions can be personalized to the individual’s health objective and status. If an individual’s condition is complex, it would require seeing multiple medical specialists before getting to the right diagnosis. While having a primary care physician is historically considered to be the first point of contact, convenience of walk-in clinics and the low supply of primary care physicians have rendered this unnecessary and impossible.
If people can experience pleasure and moments of joy (much like when they’re completing an online purchase!) in their healthcare journey, then they would actually care, participate and be proactive in making changes about their lifestyle, targeting health goals. There are intersection moments in a doctor’s life when using the product that can both provide joy (a sense of relief) and a measurable positive health outcome for the patient. Where are these moments within the users’ life? Do these moments coincide with recognizing the value they can capture from using the product?

▸ Prototype Experiment Design — can we turn this into a Machiavellian Social Game?

I’ve been inspired by the latest content on Netflix. Gamification is a proven technique on the mobile platform. What does it mean if we want to deploy gamification principles to sustain user interest in the platform? Do we make completing health goals as addictive as possible?

What is the expected outcome in concrete measurable terms from the experiment that would make it successful? Do they have to sign up for a subscriber list? Do they have to make specific, meaningful interaction with the product? Do they have to join a specific social media community such as Slack? Setting clear definitions of what exactly the action brings and doesn’t bring.
What are the conditions that must be true for this prototype to work well? For example, patients must already have a mobile phone and are willing to use a mobile app. Both the doctor and the patient recognize the necessity of effective communication: the tracking of symptoms and the effects of medication. Did it shorten the timeline to get to diagnosis or a second referral appointment to a specialist?
De-risking the assumptions would mean getting users (whether they’re medical specialists or patients) onboard with the vision of the product. What are the most obvious obstacles that can deter the user from successfully taking the action to In an overproduced world, are there competitors solving part of these problems in a novel way? What are they getting right and what are they getting wrong?

What available concoction of online properties can I use to validate the user value hypotheses quickly? Personally, this is where I was struggling because there are multitudes of different things online that can possibly validate any of these hypotheses. To begin, I’m just unfamiliar with all the choices and their available features to deploy. The other point to remind myself is that there must be a differentiation from other solutions in the healthcare market.
What is the timeline of this experiment? How much data do you need to confirm these hyptheses? The answer is that we need to confirm this hypothesis as soon as possible.

Prioritization

What is the result we’re trying to validate here? We want physicians to confirm that they see the value in using technology, and these technologies can help their everyday life. What are the activities that can most effectively and quickly bring about this result?

Observations

Physicians are notoriously against using LinkedIn for networking purposes. It is also known that they’re quite difficult to find because the internet returns limited results. Unless their profiles are on RateMDs, you will find limited information and even if you do, it could be difficult to get them on the phone to schedule an appointment (or pre-assessment). Testimonials are everywhere — aggressive product and market expansion only works if the user target is in the mindset (realize the necessity of change) to adopt a new behaviour.

Variables

The equation could look like this: effective outreach to medical specialists (early adopter) + awareness the change is required today + willingness to go through pre-assessment and on-boarding = [Call to Action + Delivery of Value] * Secret Sauce

Call to actions would be signing up to have your independent clinic featured, booking an appointment to chat with the founder, and should indicate sufficient interest to follow through with either an onboarding session (a demo) or provide a letter of intent to purchase the product in advance (best case scenario).