Digital Transformation In Healthcare: Innovation Versus Regulation

By Mike Hughes, Principal Platform Evangelist, OutSystems

How do you innovate in an industry where heavy regulation seemingly rears its head at every corner? When you look at healthcare, one thing is clear: innovation refuses to be contained. According to CB Insights, the digital health industry hit a new investment high in 2015 with almost $6B invested. This peak is all the more impressive when you consider that 2014 already saw a 100 percent increase in funding.

You don’t have to look very far to see real world examples of the impact of innovation in healthcare. Take Frost & Sullivan’s recent study on consumer behavior towards digital health. According to the report, approximately 24 percent of consumers currently use mobile apps to track health and wellness, 16 percent use wearable sensors, and 29 percent use electronic personal health records. They expect this trend to continue with 47 percent of consumers considering using wearables in the near future. The market for wearables alone is expected to hit over $6B.

This growth is managing to occur in healthcare despite the fact that technology is evolving at a much faster pace than the corresponding regulations. The challenge is that this mismatch in pace is creating a regulatory context that imposes many rules that were designed for an analogue world. So, what does this mean for the technologists driving the innovation?

João Campos, director, UK at Truewind — an IT consultancy with a track record of helping healthcare organizations transform their businesses — says, “Transposing regulatory rules into a digital world is not trivial. On one hand, you want to comply with the regulations and convey trust to the users but, on the other, you don't want to cripple your solution, limiting the functionality further than what is required by the regulations. Ultimately, there is a need to understand the regulations and find the best compliant solution: one that fully complies with the regulations and still provides the best user experience.”

This balancing act when it comes to managing speed of innovation with regulation should not compromise the quality of the solutions being created. As Campos points out, user experience is as important as compliance. In order to manage this balance, organizations looking to innovate quickly should focus on continuous testing practices — automating the testing of applications to ensure coverage. But just as regulations struggle to keep up with innovation, it is difficult for test teams to ensure full test coverage for an application due to the time required to build and maintain the suite of automated tests. There must be collaboration between test teams and developers to figure out the right pace.

Continuous testing can actually help with compliance too. Gonçalo Borrega who heads up product management at OutSystems says, “At the end of the day, quality is being able to change without breaking anything. This can be achieved with a mix of abstraction, safe change patterns and automated testing for the business-critical actions. Automate regression testing for the compliance aspects of your applications to make sure you’re in control of the quality process.”

Both quality and quality perception are paramount. For example, more and more healthcare solutions aim to make sensitive patient records easily accessible, but in a way that ensures only authorized users can see them. Depending on the interpretation of the regulator, this may require the implementation of more authentication steps than the ones you'll find in your typical run-of-the-mill app. It is very important to explain why these extra validation steps are required and this is where quality perception comes into play. If the validations add extra steps for users, without conveying the purpose they may get frustrated, ultimately damaging adoption. After all, what good is innovation if it isn’t adopted?

Further, on the perception of quality, the experience has to be consistent across all channels. This includes digital, as well as analogue channels such as the telephone or even the reception desk. It shouldn't be any easier or harder (authentication-wise) to get a blood test result over the counter than it is using an app. If the user gets an inconsistent experience across channels that will only add confusion and damage the perception of quality. It can also call into question whether one experience or the other compromises compliance.

Another enabler for innovation is continuous delivery. Experimentation and observation of how new solutions enable new engagement models — between patients and doctors or between healthcare providers and the community — need to happen in a very iterative manner, so everything runs smoothly and there is minimal disruption to the engagement model currently used. Providers need to understand how their agents — practitioners and patients — react to a digital engagement as opposed to the traditionally very human engagement model.

At the end of the day, regulations may not keep up with innovation, but that’s no reason for the industry to slow down. As compliance regulations catch up, continuous delivery of new market solutions will allow for easy updates to ensure compliance with all the latest regulations and standards. If the healthcare industry takes this approach, it could see endless opportunities for continued innovation, growth and improvement.