A long-time Apple employee, who was most recently involved in the company’s special health projects has written a piece which was published today by CNBC. It takes a look at why Apple and other tech companies can’t employ the same approach to developing health tech as they do with all their other products.
Robin Goldstein was an Apple employee for 22 years, most recently serving as senior manager of special health projects. In a comment piece, Goldstein argues that Silicon Valley can’t use the ‘fast fail’ approach that has become so popular when it comes to health technology products.
The Cube didn’t kill Apple. The Fire Phone didn’t kill Amazon. The Nexus Player didn’t kill Google.
This is the mindset Silicon Valley has brought to every space it enters: A bad product or poor user experience doesn’t have any ramifications beyond that particular product or experience, and they can always wipe the slate clean and start again.
Goldstein believes that there are three primary reasons why the ‘fast fail’ strategy won’t work when it comes to innovating in the health tech space.
Maybe most importantly, this is the first time products’ stakes are actually “life and death.”
Unlike other consumer products, digital health products connect users to their own mortality. Although we refer to them as “health” products, the current crop is primarily focused on diagnosing, screening and managing illness and disease. Unless you have a specific need, most people would rather “get busy living” than “get busy dying.” In other words, the ultimate stakes for current digital health products are, by design, life and death. This differentiates them from all other products these companies design and sell.
Next, Goldstein brings up that it’s not just consumers that tech companies are selling to.
Digital health products require buy-in from both the user and their health care provider. Simply using a health-related device or app is not enough. A user must close the loop with a clinician before any meaningful action can take place. So if a patient uses a digital health product but their health care provider won’t accept and incorporate the results into their treatment, it’s a fail. And if a primary care doc recommends a device, but the consumer doesn’t use it as “prescribed” (for any of a number of reasons) it’s also a fail.
Goldstein’s last point is that with healthcare, first impressions are crucial.
The old adage, “You don’t get a second chance to make a first impression” is especially true in healthcare. This is because when adopting new technologies, the marketplace performs a kind of calculus that evaluates perceived benefit, perceived risk, cost, maturity and history. Or for the poets, how much good will let us put up with the possibility of bad; how bad is bad enough before it outweighs the possible good; what’s the track record of those making claims about the possibilities of good and bad so we don’t get fooled (again); and what does it all cost? With health, a bad outcome can be truly disastrous.
With these three factors in mind, Goldstein notes that risks are higher than ever for companies working on health technology.
Taking a look at Apple’s rumored plans in health tech, and how far off some of them seems gives some perspective on how cautiously the company is approaching innovation in this space. For example, we heard about Apple’s diabetes tracking and treatment efforts over a year ago, and a launch is still rumored to be years away. Notably, Tim Cook has been said to be testing out the noninvasive glucose tracking tech.
Meanwhile, Apple is steadily working on building momentum on the software side by developing partnerships with healthcare systems via its Health Records.
We’ve seen more progress from smaller third-parties in many respects, like AliveCor’s EKG KardiaBand for Apple Watch. But the factors shared by Goldstein and the long-natured process of gaining regulatory approval will likely change the pace of product launches when it comes to health tech as we move forward.