How to switch from the ‘death by pilot’ drama to a ‘beyond pilots’ happy ending

I think this is the beginning of a beautiful friendship is not only a famous line from ‘Casablanca’ but also a statement that most of the companies working in a pilot project would love to hear from the healthcare organisations. Not only that, but also most heads of innovation would love to say to the companies. But, if you have any experience with digital health pilots, then you already know the end of this film. The lovely woman leaves the country even though she loves the protagonist, and the company leaves its bright future options even though the pilot is doing well. Yeah, this film is kind of a drama and it’s called ‘death by pilot’.

It is not that I am here to be pessimistic, but let’s be honest: many things need to be changed if we want a happy ending. Though it seems that in the US the situation is improving, what I perceive in Europe is that we still have many pain points and roadblocks. Especially when the pilot is co-funded by a public grant from European, national or regional innovation support programmes.

I have participated myself in a project where 5 out of 7 digital health tested pilots were considered successful. How many do you think got adopted (meaning procured)? Only one, and it didn’t extend beyond the piloting clinical department to the other regional hospitals. So here’s the plot of our film: even if the tested innovation is successful and the end users love it, there’s a high rate of ‘death by pilot’. If those that co-created the solution do not procure, who will?

The villain of our story

Every film has a bad guy, so this one has it too. In my opinion, there is much more money for research and innovation projects than for procuring the successful solutions coming out of them. Furthermore, the people in charge do different tasks in different units and have different priorities. Sometimes they do not even talk to each other before applying or launching the pilot.

Besides, I usually have the impression that participating in research pilots is a business on itself for the hospital unit that runs it. Its main interest is not to put in value the successful outcomes of the pilot, but rather get the next round of funding for yet another futureless pilot.

Not incorporating a piloted solution that has proved to be successful is a waste for those that have invested their time, money and enthusiasm. It makes healthcare personnel sceptical about participating in future innovation activities. And it also carries an expensive opportunity cost tag for the expenditure of public money in supporting innovation.

Three proposals for a happy ending

If we manage to increase the rate of adoption of successful pilots, the economic impact for European vendors will increase and help them to become global champions. That is why pilots are meant to be the first phase of a larger partnership. Let me share with you three proposals focused on our three main characters: funding programs, digital health companies and healthcare organisations.

Funding programs to ask for adoption commitment. For example, funders could specifically request for organisational commitment to the health partners participating in proposals, and grant those with the most credibility. That would force communication and alignment between research, procurement and top management from the very beginning.

Startups to understand and negotiate what success means (e.g. KPIs) and what would happen if it is achieved. What the escalation plans if everything goes well. Because if the start-up first wants the customer to fall in love with the innovation and then ask them to procure, chances are it will not survive the valley of death. Especially when the unmet need is dictated by the external source of funding and not directly by the health organisation.

Vendors to think about scalability inside their customer organisations. Healthcare managers tell me they take for granted that most pilots will be successful. That the real challenge is that the pilot has to smoothly scale outside the testing unit. To address this, not only should vendors should focus on technological excellence and clinical or economic value, but also pay much more attention to assure that the innovation will be adopted by the rest of the organisation.

No more play it again, Sam

These insights I’ve just shared with you are meant to be the starting point of an open international dialogue. We don’t want to listen to the same sad music anymore. If you feel like you want to know more or you fancy sharing your point of view about how to improve pilots in Health, then your next step is to attend the HIMSS Europe & Health 2.0 Europe Conference in Sitges (Barcelona). Join the conversation on Tuesday 29th in the workshop: ‘Moving Digital Health Beyond Pilots – Leading Change Toward Future-Proof Health Systems’.

A bunch of experts in the field of digital health will be there to play their part for a happy ending. Because this could be the beginning of a beautiful friendship.