This is the part 1 of a series about how health technologies impact our lives and seek to change the way patients interact with the healthcare system. In this post, we explore the question: Should good HealthTech make itself redundant?
Can a business’ mission be to eradicate its business?
Many years ago, upon seeing Novo Nordisk’s mission statement printed on a messenger bag, I got into a discussion with the person carrying it. Back then, the statement read something along the lines of “Defeat diabetes”. My question to him was: How committed could a company be to erasing the sole purpose of its very existence?
Since then, diabetes has only manifested its pandemic-like rise but interestingly, Novo has also rephrased its mission statement to “Changing diabetes”.
A similar question could be posed to an increasing amount of HealthTech: How committed should and can those technologies (and the products and companies behind) be to making themselves redundant?
Is success to become useless?
Try to think of one of the earliest inventions to assist us for health reasons: the crutch. It’s a brilliant example of a health tool becoming successful through redundancy. On one hand, a person with a broken leg would be completely immobile without it but on the other hand, it’s such an annoying tool to rely on. You hate walking with it and being dependent on it to perform even the most basic everyday tasks, and its design and functionality really hasn’t evolved radically over the past centuries — maybe for the reason that it would have long-term negative consequences if you kept relying on it. The crutch is simply designed to make itself redundant. But what about healthtech?
For the annual High Tech Summit at the Technical University of Denmark, I had a conversation on stage with a person living with a chronic skin condition who used to be a user of the Imagine skin tracking app we develop here in LEO Innovation Lab.
He was 20 years old when he first discovered that something was awry with his skin. A year passed before he went to the doctor and received his diagnosis: psoriasis.
Throughout our talk, he shared how using the app to document the development of his psoriasis through photos and then comparing them had helped him becoming more self-aware. However, once he had derived that benefit from the app, he stopped using it.
Part of me felt like we had failed. Our app hadn’t provided the necessary value for him to keep using it to document his flares over longer periods, so we could eventually automate even more helpful insights. He was another drop in our measure of retention.
And yet, as we continued to talk, I came to appreciate his point: The app had helped him manage his condition on his own. It had empowered him to strengthen his coping mechanism and identify his primary trigger: stress. It had been successful and as a consequence had made itself redundant.
Can redundancy be an aim for all HealthTech?
The WHO defines Health Technology as “the application of organised knowledge and skills in the form of medicines, medical devices, vaccines, procedures and systems developed to solve a health problem and improve quality of life.”
Medicine, especially in the areas of long-term conditions, is mainly focused on alleviating the symptoms in lack of available cures, the main advances of medicine are aiming to make it more effective, less costly, more accessible — and of course to cover more diseases. In the US alone, an estimated 30 million people are affected by about 7,000 rare diseases. 80% of these diseases are thought to be genetic in origin but only 5% have treatments available.
So healthtech in the form of medicines isn’t really looking at making itself redundant anytime soon.
Vaccines are probably one of the most vigorously debated topics in the past years. Just when we thought the vaccines for polio and measles were so successful they had made themselves almost redundant, outbreaks reminded us that it likely takes a global, coordinated and well-timed effort if we want to eradicate those diseases as successfully as smallpox. Such important vaccines are here to stay.
Medical devices have until recently mostly taken the form of hardware with varying degrees of complexity and with or without integrated software. Think of your fever thermometer but also x-ray scanners, blood pressure monitors or Novo’s insulin pen.
However, following the “software is eating the world” megatrend, a magnitude of procedures and systems are already software-based and digitised. Medical devices are also more and more purely software-based. We’re even seeing the first digital therapeutics clinically validated and approved by regulators.
Smartphone-based healthtech apps have made enormous inroads the past years. In 2017, 325,000 mobile health, fitness, and medical apps were available for download on Android or iOS. However, only a tiny fraction of those can point to solid, science-backed proof such as having gone through randomised controlled trials.
And given an increasing body of research around the negative effects of smartphone usage (exposure to blue light, behavioural changes, etc.), combined with a dominant mindset of many technology companies to make products as addictive as possible, the question here becomes even more relevant: Should good HealthTech make itself redundant?
“You’re spending a lot of time trying to make your products as addictive as possible – Sean Parker on why he left consumer tech for health
One example of health apps that defy the purpose of becoming redundant is also one of the most widespread: meditation apps.
In this category, you’ll find more than 1000 apps. From a product, design, and branding perspective, I personally find Headspace extremely inspiring. But is the criticism valid that this app exploits a weakness in people making them dependent on the app?
There is a growing body of scientific research pointing to positive effects of using the app. Headspace itself claims 65+ independent research studies to be in progress. From current studies, smartphone-based mindfulness intervention has shown a number of benefits including stress reduction, improvements in wellbeing, and increases in psychological, social, and environmental quality of life to mention a few. One study even showed a measurable impact on blood pressure reactivity and cortisol levels.
For meditation purposes, these apps are strictly speaking unnecessary. People have been meditating for thousands of years to achieve clarity of mind and improve mental wellbeing — and all you really need is yourself. But what these apps offer is convenience and insight as they meet you where you are — with your smartphone. Research suggests that self-monitoring has a positive impact on your health behaviours promoting awareness and self-efficacy — and potentially improving objective clinical evaluations and boosting one’s immune. Where the problems arise is when you can’t manage your health without an app and depend on it to understand yourself.
Developing towards HealthTech making itself redundant
So where does this leave us? Should good HealthTech make itself redundant?
Dependency is never a good thing in the long run — neither for development aid nor for HealthTech. When I talked to a psoriasis patient during High Tech Summit, he expressed:
“Technology can teach you a lot of useful things but you want to be able to absorb it and make it part of yourself rather than becoming dependent on an app.”
I believe that technology can play a strong initiating and facilitating role, lowering access barriers and increasing self-awareness. I also believe technology should empower people to use it as an enabler and catalyst; however, without becoming dependent on it. Therefore, technology should remember to consider itself a temporary crutch and make itself redundant. And where this cannot be the case, technology has to become non-intrusive and almost invisible — and only surface when it truly is needed and can make a difference.
By Adrian Young-San Roessler, Head of Imagine