Managing the Barriers to Customer Adoption- Presentation by Lisa Prasad, Managing Director, International, Henry Ford Innovation Institute at the Henry Ford Health System. Background about Provider efforts toward innovation, including status of Digital Transformation, impediments and barriers to adoption, persuading doctors / health care professionals, workflow challenges, activation constraints, procurement cycles, costs, IT integration and security, role of incumbents and practitioners, validation plans, payer inefficiencies,

1. Communications Strategies to Raise
Capital and Attract Customers
Lisa Prasad
Managing Director, Global Innovation
Henry Ford Health System
Managing the Barriers to Customer
Adoption

2. Poised for Digital Transformation
• Healthcare in need of change and digital innovation takes advantage
of capital efficiency trend; cost to get software product to market is in
constant decline and much lower than a device or drug
• Analytics and Ai can reduce/eliminate errors that cost lives and
money; >$17 billion spent on measurable medical errors annually in
US
• IT can reduce the absurd 25% of healthcare costs that are based on
back-office administration

3. So Why So Slow to Adopt?

4. Simply, a strong “Yes”
2016 American Medical Association survey yielded high interest and enthusiasm for
digital health tools. 85% want them.
But, it has to:
• Improve work efficiency
• Increase diagnostic ability
• Not reduce face to face time with patient
• Pay them for time spent using the tool
Are Doctors Interested?

5. Workflows
Noise In the System
Procurement Cycle
Costs
IT Issues
Self Interests
Value Proposition
Validation Plan
Payer Inefficiencies
Adoption Barriers

6. Hurdle 1: Workflows
• Safety and efficacy are requisites, but not sole needs. Practical fit of solution into
existing care path is critical.
• Who has to be trained, hired? How do I purchase, dispose, respond?
• “I’ll gladly take $1 dollar today over $2 tomorrow” and “Do no harm” are
prevailing mentalities

7. Hurdle 2: Activation Energy
• New products require energy to activate
• Traditionally, regulatory navigation provided more time for activation
• With emerging digital health, need time to test and implement new solutions
• There are simply too many emerging patient engagement platforms and decision
support algorithms to consider
• And many have over-promised

8. Hurdle 3: Procurement Cycle
• The sales cycle in hospitals is both, long and disintegrated.
• Health systems are a mosaic of individual hospitals, and hospitals a mosaic of
departments
• While integrated care is the target, most purchasing is made unit by unit.
• Ref CareTrail path

9. Hurdle 4: Costs
• Theoretical cost savings are rarely considered. Rather “accounted” costs
dominate.
• Accordingly, preventive value propositions (reduction of errors or downstream
costs) not valued as much as they should be.
• Volume-based care still dominates thinking and economics, while value-based
care remains the aspiration

10. Hurdle 5: IT integration and security
• Once digital solution is viewed as warranting adoption, practical
issues of IT administration, redundancy and security are paramount
• Bugs or system failings are death-knells
• Perceived security risks are critical detriments to young firms.

11. Hurdle 6: Incumbent self-interests
• The existing corporate players do not want disruption
• Lack of interoperability intentional
• High costs to integrate limit adoption (ref Epic)

12. Hurdle 7: Practitioner Self-interests
• Automation eliminates jobs in all sectors; not lost of clinicians
• AI for radiology and digital pathology works, but resistance is clear (and logical)
• Automation of triage needed and practical, but it will be fought
• So, “decision support” reigns and this may add costs
• Also, positive self-interest can add features and costs that are not conserved by
the decision makers

13. Hurdle 8: Lack of value proposition
• Digital firms don’t usually “miss the target”, rather, they do not know what the target
is.
• What are you selling, why would we buy?
• Is it proven to not cause harm to a patient?
• Does it solve a real problem we have today?
• Does it work within our ”system”? (no new protocols, equipment, integration, etc)
• What is the cost / benefit relationship?

14. • Tech-based firms often underestimate validation protocols
• Definition of “Proof of Concept”
• Lack of understanding risk, cost and current pathways erodes “legitimacy”
• Leads to absurd economic expectations: remember healthcare “profit” is about 2-
3%
Hurdle 9: Lack of validation plan

15. Hurdle 10: Payer Inefficiencies
• 3rd party Payer System is inefficient in that it adds another hurdle that is a “black
box”
• A “Chicken and an Egg” paradigm ensues
• Payers may cover once utility is demonstrated; coverage and adoption are
needed in order to prove utility.

16. What Can We Do to Alleviate?
With respect to hospitals
• Partner early
• Align to major current problems
• Focus on system, not product

17. What Can We Do to Alleviate?
Internally
• Buildout diverse teams
• Utilize retrospective data modeling to reduce costs and conduct
scenario analysis
• Set appropriate expectations internally for time and costs (and garner
investment appropriately)

18. "If you want to disrupt an
industry [like healthcare],
you have to do it in a non-
disruptive way."
– Sami Inkinen
Thank You!