Last week, Rock Health, the San Francisco digital health accelerator for very early-stage companies, published an intriguing letter from someone it calls a "newly minted M.D. training in emergency medicine."
The letter from Jae Won Joh is addressed to health entrepreneurs and offers a kind of broad road map into what kind of devices, products and apps can make a meaningful difference in the clinical world. As well as what devices may grab headlines but are ultimately useless in the medical setting.
Build Products that are "Compelling" Not Cool
If you are trying to get the attention of clinicians, the word "cool" should be ditched for "clinically compelling" in terms of product development, Joh recommends. If it is so, the clinician may ignore the price tag. Joh points to the Withings scale, the smart weighing machine with a related app that can help people track heart and rate and fitness level and send that information to their smartphones for analysis, as falling in that clinically compelling category.
But Withings is not the only device that has got it right. Joh also singles out Sanofi's iBGStar and the Runkeeper app for praise. The iBGStar, is a glucose-monitoring device that connects to an iPhone or iPod, to help people manage diabetes on the go. The Runkeeper app, as the name explains, is a running app that can track your activity but with the added twist of enabling GPS tracking so that workouts can be social.
Test, Test and Do More Testing
Recently, futurist Jim Carroll told an audience of medical device manufacturers and suppliers that Silicon Valley has its sights on the device industry. He was referring to the intent of the industry to bring disruptive innovation to the industry.
Joh appears to be a little wary of this attitude. In his letter he says:
The “move fast and break things” motto that worked for Facebook does not apply to healthcare. “Be deliberate and test everything” is probably more appropriate.
In fact simply saying that the device or app is rigorously tested is not going to suffice. Joh recommends that product manufacturers and entrepreneurs have the data to back up their claims. Especially with respect to error rates. Joh candidly declares:
Call me OCD, call me conservative, call me whatever you want, but if you want me to use something new, it needs to have an error rate at least equal to, if not significantly better than, the status quo, preferably with data to back up that assertion.
Find a Pressing Clinical Need And Address It
Health entrepreneurs need to develop products to address a clinical need instead of build a product just because they can. In fact Joh takes on a product that has received a lot of attention lately - the Scanadu Scout. He writes:
It’s admittedly quite nifty that for under two benjamins we can now create a device that measures my heart rate, temperature, and oxygen saturation in 10 seconds by putting it to my forehead. Clinically, I couldn’t care less, and I don’t think the vast majority of patients should either. Anyone can get their heart rate in 15 seconds for free by putting two fingers on their wrist/neck while looking at a clock and doing some basic math. They can get their temperature at the same time with a $10 thermometer from Walgreen’s. If they don’t have a lung condition and they feel ok, their oxygen saturation is almost guaranteed to be 98-100%. Even being in the low 90s generally feels incredibly uncomfortable, and healthy adults don’t go that low without serious problems, so if someone feels this way, it would be wiser to just call 911 instead of wasting time seeing what a device says, particularly since an O2 monitor can be fooled by emergent conditions such as carbon monoxide poisoning.
Joh provides some thoughtful and provocative suggestions sure to ruffle some feathers, but companies that deal with physicians in emergency medicine or in the OR will recognize a persistent theme: that these busy clinicians have a protocol that works for them and is aimed at keeping people alive. The bar to change that behavior - which must happen in order for a new product introduction - is, not surprisingly, set very very high.
[Photo Credit: iStockPhoto.com user DragonImages]
-- By Arundhati Parmar, Senior Editor, MD+DI