The climb to unicorn status: Experience innovation as the key to digital health adoption
In digital health, design emerges at the intersection of technology, people, and processes. As innovators work to make healthcare massively better, it is often the technology that is elevated. But hidden stories of design are revealed in products and services that populations are not using, that are not tailored to the realities of people’s lives and are not achieving outcomes or delivering value across health and wellbeing. The promise and failures of digital health are tied up in design.
There’s no perfect handbook for designing the experience of digital health solutions well, but here are five principles our team at Rock Health shares with digital health innovators who want to be thoughtful and build teams who prioritize experience design. Product and organizational leaders can apply these principles alongside existing design frameworks, working models, and guides.
1. Embed inclusive product design
How are you making your product inclusive by design?
Products and services sit on a continuum from representative to inclusive to equitable. Unfortunately, most design teams never get to inclusive, let alone equitable, because they design products with a singular persona in mind that is by default assumed to be applicable across an entire population. From digital health consumer adoption data, it can be inferred that products that lack inclusive design are not appealing across the market and underperform with a self-limited trajectory. So, the first step toward building successful digital health solutions is embedding inclusive product design into the process and obsessively learning how to meet the needs of multiple populations.
In Rock Health’s recent collaboration with a Big Tech player, the project stakeholders wanted to uncover ways to better build solutions for its next billion users. As the team took a look across the design process, there were widely-held principles of inclusion and equity across teams but the challenge came in translating that into the experience of the products. For example, there were examples of images of different body types and communities in the visual interfaces of products and in marketing assets, which was representation in design, but not inclusion or equity. The visual representation did not also carry over to culturally tuned content. There was an opportunity to reach more users with inclusive content. This focus on representation in product design without inclusion is fairly pervasive. And even when there is a focus on inclusion in UX design, user testing, and other practices, design teams tend to equate inclusion with equity.
Representation rarely addresses anything about how people interact with products. Representation, inclusion, and equity are all different things. To build for equity, teams need to not only be inclusive in the design of the product, but think about what people might need around the product (i.e. access to the product given the digital divide, education, or tailored communications). An example of a company doing this well is Carallel, which is moving beyond the intentional expansion of their team to reflect the communities they serve, to evolve their products and services in ways that are sensitive to a multitude of life contexts.
“Your customers are multifaceted, and your products must be built with that in mind.”
– Annie Jean-Baptiste, Director of Product Inclusion and Equity at Google and author of Building for Everyone
In short, how do you know you have something equitable? It’s when the product that has been built has created or contributed to an equitable health and wellbeing outcome. It’s rare that a single product can do this alone; instead it is often part of a larger solution set that makes it equitable.
2. Curate equitable services
How do you create services that fuel your product to move beyond niche markets?
The focus in digital health is often the technology, which holds this unique potential to transform healthcare. Yet traditional healthcare services carry the weight of being difficult to access and validated on a non-representative minority of the population. With over 1,900 U.S.-based digital health firms founded and raising venture capital since 2011, there is a proclivity to bet on companies that are big on the tech without taking a closer look at the services curated around the technology. A focus on availability, adoption, and most importantly, willingness to pay, powers growth and ensures that the innovative tech component reaches its serviceable market.
Building tech on top of services that are fundamentally inequitable, makes it impossible to build an equitable digital health solution. Leaders and design teams can always ask the intentional question, what services are we wrapping around this product to try to reach people and meet them where they are? Look at the way Violet is working with Galileo, Thirty Madison and others—their model shows the value of matching providers and patients that creates a more inclusive healthcare experience.
A valuable perspective on the intricate threads between services and innovation around the experience of a product comes from Byron Merritt, currently VP of Design and Creative at Amazon Music and former Vice President and Global Creative Director for Nike Digital. Merritt says, “A shoe isn’t just a shoe; it’s a shoe because of everything created by way of the experience.” In healthcare, a wearable isn’t just a wearable; it’s a wearable because of everything created by the experience of healthcare fluency morphing into wellbeing.
3. Craft mindful messaging and marketing
What are you doing to communicate to consumers and society at large about your offering and its value for their unique needs?
Broadly speaking, mindful messaging covers all of the ways you help users learn about your product and what you believe it can do for them. More than simply “marketing”, it’s about communication: being thoughtful about what you say, how you say it, and how you attempt to reach people, and then listening to how people respond (or not). Mindful messaging includes not only how a person learns about a product, but given that it’s healthcare, how that journey is deeply tied to a person’s health information fluency.
This is why engaging consumers (whether patients, informal caregivers, or providers) in ways that account for behavioral elements is key to good design. In the healthcare field, knowledge, attitudes, and behaviors are important factors, so it’s important to be intentional about approaching and thoughtfully segmenting populations as they are nudged to use new products and services that can bring value to their lived experiences. Without being intentional around this element, it’s difficult to penetrate the market and deliver on the promise of access at scale. At Rock Health, we are taking note of companies like Samesky Health, who are scaling health information fluency to engage and improve outcomes across populations with a specific focus on health plans.
4. Enable accessible consumer spaces
How are you creating opportunities for wellbeing across physical and digital spaces?
Healthcare decisions are not only made at the consumer level, but are heavily influenced by the choices of payers and purchasers. With each new digital health product, purchasers have to ask: Is it realistic in this organization, environment, and community? Is it feasible? If not, what can be done to address that? Health and wellbeing are not just a single episode of care, rather healthcare is an ongoing service that is forgotten until needed. It may seem counterintuitive in digital health to consider the spaces where consumers connect with care, but if there’s anything learned from the COVID pandemic, it’s that valuable care can happen as seamlessly in a parking lot drive-through as a phone.
While it is now common sense that good design crosses the digital divide, it is time to invest more in the process element of connecting virtual to brick and mortar and consider how hybrid care has an opportunity to make access the baseline and equity in outcomes the innovation. Too often, digital health innovators think about digital without brick and mortar, and healthcare leaders in brick and mortar institutions translate physical barriers into digital workflows and experiences. For leaders and design teams, the frontier of experience innovation is thinking about how patients move across physical and digital spaces. In terms of physical spaces, Rosarium Health1 is reimagining connected healthcare at home while Hazel Health is bringing virtual health to schools. AI-driven solutions like Olla2 are building bridges across patient data silos to create seamless experiences across virtual, hybrid, and in-person settings.
5. Leverage new market insights based on publicly available public health data
Are you looking at population health data to understand the market?
Most digital health solutions are sold to purchasers who are in charge of a heterogeneous population. The largest of these customers, whether insurers or employers, manage populations that cut across the continuum of income, demographics, and identity. For payers and large employers, there is a litmus test question for good design: Have you designed for the lived experience of the diverse members whose outcomes and costs of care the business supports? Other questions leaders should ask include: Is the product stack inclusive of diverse lived experiences? Does the technology enable high quality services across populations? What populations were not considered in design?
Simply put, you can’t design for the $4.3T healthcare market without the perspective of people and communities. If you want to meet a large population’s needs, deep understanding of the population’s knowledge, attitudes, and behaviors is essential. This is public health in its truest form, and there is freely available data that offers insights into the knowledge, attitudes, and behaviors of different populations in detail. Everything from health services research to political and technological determinants of health as well as trends around trust and how to utilize different channels to optimally reach populations are available as building blocks for design. The most exciting digital health innovations are marrying a consumer obsession with a public health lens and tracking different populations’ knowledge, attitudes, behaviors—from Recursion pushing the envelope on biopharmaceuticals to Friendslearn pioneering the field of digital vaccines.
Population health clarifies market opportunities because it’s all about understanding knowledge, attitudes, and behaviors. Build on this to design inclusive products around services that accelerate health and wellbeing across lived experiences, with a clear intentionality around health information fluency and accessible consumer spaces. Iteratively, that becomes good design.
Good design improves lives—and is pushing us at RockHealth.org to reimagine how opportunity and innovation is fueled; galvanize healthcare leaders to design new ways of building solutions; and celebrate and support a community of game-changing innovators. Learn more about our work in building a more equitable future at RockHealth.org.
Footnotes
1Rosarium is a portfolio company of Rock Health Capital.
2Olla is cofounded by the author, Dr. Monique Smith.