Adam Goodman, product manager at eConsult Health outlines why he thinks the disruption of legacy finance can be a blueprint for the future of digital healthcare in the UK.
The fintech revolution has been nothing short of explosive. The total value of digital payments grew from $4.1 trillion in 2019 to $5.2 trillion in 2020 and as of 2021 there are nine unicorn fintech companies around the world.
The speed and scale at which fintechs have disrupted a powerful, heavily regulated sector is particularly impressive. Little wonder that 88% of financial institutions believe part of their business will be lost to standalone fintech companies in the next five years, according to a recent PwC study.
In the last 12 months, COVID-19 has ignited a revolution in the provision of digital health services that has a lot of the same characteristics I experienced in fintech in the last few years.
Pre-pandemic, 90% of GP consultations took place face-to-face. Just two months into the first national lockdown, 90% were done remotely. The digital triage service provided by my employer has seen a 290% increase in eConsults since the pandemic.
I have spent my career working across both sectors and see strong parallels between the two. As a result, I believe there is much that the burgeoning healthtech industry can learn from the successes and failures of fintechs over the last decade.
1. Find the friction
A defining characteristic of successful digital disruptors is finding the friction in existing processes – the problems and the gaps – and eliminating them. Monzo built its success on a simple insight: people hate waiting in line at the bank on their lunch break. By creating a branchless bank and providing 24/7 customer services, it built a service that attracted busy, digitally native millennials in droves.
The most successful healthtech players have also single-mindedly targeted a legacy process. Like Monzo, many healthtechs are focussed on replacing a trip to the GP with a video experience in order to increase accessibility and cut down on travel times. eConsult allows for consultations to be sent into GPs remotely, reducing in-bound phone calls and ultimately increasing patient access to their GP.
2. Obsess about the user
Jeff Bezos pioneered the notion of customer obsession and it has been another attribute of the best disruptors. Perhaps the biggest failure of traditional banks prior to the fintech revolution was a focus on the process at the expense of the customer experience.
In a sense, the failure was understandable. It is a heavily regulated sector and the average bank has ageing processes and large siloed departments across huge teams. However, the subsequent lack of focus on the user experience (UX) has cost banks dearly.
A well-shared study from UX consultancy Built for Mars worked out that it took just 24 clicks to open a bank account with Revolut, five times fewer than First Direct. The same study showed that it took just two days to open an active account with Starling Bank compared with a whopping 36 at HSBC.
Similarly, the health sector is flourishing through patient centricity. The telemedicine services that have emerged during the pandemic have made it easier for patients of all ages and in all corners of the UK to access health services on the device of their choice at a time of their choosing.
It is also important to remember that the ‘user’ in healthcare isn’t always the patient. Some of the most impactful innovations on the market today are focused on making the lives of hard-working GPs, receptionists, A&E nurses and doctors easier, either through smarter design, process improvement or new delivery models.
3. Embrace your value chain
Revolut originally targeted foreign exchange only which enabled it to build a large, loyal customer base. From this strong platform the company was able to ‘land and expand’, growing and extending its services beyond foreign exchange but from a differentiated starting point. Similarly, eConsult focussed exclusively on primary care - developing its core product and growing its reach – for seven years before diversifying into urgent and emergency care.
4. Harness emerging technologies
Any student of Gartner’s ubiquitous Hype Cycle knows that new, breakthrough technologies are emerging every year and slowly making their way up the Peak of Inflated Expectations before hitting the Trough of Disillusionment then (hopefully) the Slope of Enlightenment.
In the last few years, fintechs have leveraged the technologies that have successfully run this gauntlet - cloud, big data and AI - to gain an advantage over traditional players with legacy IT environments.
Similarly, AI in particular is growing in prominence in healthcare across a range of different areas from diagnostics through to surgery. The true scale of the impact is yet to be understood - but is certainly an exciting space to watch.
However, it may be the less ‘sexy’ technologies that will ultimately have the biggest impact. For example, true interoperability (the ability for different systems to talk to each other) will play a critical role in developing more personalised, patient centric healthcare industry and could truly revolutionise the NHS. The work NHS Digital is doing to support this through the implementation of FHIR standards is often overlooked but is absolutely crucial.
5. Be responsible
Perhaps the single-biggest failing of the fintechs has been their tendency to fall foul of regulation and invite controversy, lending credence to Big Finance’s accusations that “they can’t be trusted with your money”.
Negative headlines like the demise of Wirecard as a result of a fraud scandal, scrutiny on Klarna and Clearpay for their Buy Now Pay Later (BNPL) business model or Tide pulling out of the Bounceback Loan Scheme undermine confidence in the whole sector.
Healthtechs are also facing a series of challenging issues including patient safety and privacy. For example, over a third (38%) of GPs are worried about the safety of platforms that solely rely on free text boxes to triage patients. First-class clinical governance and medical indemnity are critical safeguards for any digital player with aspirations in this space.
Privacy stirs difficult questions too: how much patient information should be collected, how long it should be stored for and for what future purpose? Many of the VCs invested in healthtech are eyeing this data as a treasure trove of potential value but are underestimating just how controversial a step that would be.
In summary, there is much to admire about the ascent of fintech but also cautionary tales to learn from its current challenges. Digital health professionals would do well to follow the category with interest.
