Summer 2017 Newsletter - Questions for Hospital Executives to Ask to Avoid Bad Mobile Technology Advice

By Sherri Douville, CEO for Medigram, Inc, @SherriDouville

I was inspired to write this for all of the amusing and bad technology advice for which health system customers are perplexed. To one vendor, one health system executive said, "I need you to send your suits and khakis home and return with technical people to tell my team exactly why this is not working in our environment." The purpose of this article is to assist healthcare executives to filter which solutions to consider beyond following the crowd.

Why Bad Technical Advice Gets Out: If you have worked with engineers closely, you know that programming languages and other tools and skills are almost like religions. Therefore, whatever they are good at is what they want to promote, really this is human nature. At least in a startup, a big part of the CEO's job is to impose a technology BS filter. One thing we cannot accept is the choice of a tool without a complete explanation for the purpose and rationale as applied to the targeted outcome. This is pertinent in healthcare, where we should be wanting to help clinicians and serve patients or go into a different vertical. To do this effectively, we need to examine the technology being advised and to filter that advice.

If It is a Buzzword, Beware: I was inspired to write this based on musing and reflecting on all of the bad technical advice we have been given. Sometimes tools that are marketed as "plug and play" type Lego pieces or solutions for software do not work well together in the healthcare environment. This is especially true for mobile in healthcare, in which there is a high interference environment with low connectivity. Bad news is when 80% of an app's performance is based on its own networking infrastructure. (This is unrelated to environmental wifi networking, which is also important.) There may have been traditionally consumer oriented or web technology leadership who have no real understanding for the use case and challenges of the environment we are all tackling.

Questions to Drive Mutually Respectful Dialogue: Without discouraging technologists from their interest in healthcare, asking some specific questions can help open their eyes to how much they need to learn. Below are some examples of how you can open the the conversation.

1) Pick Vendors Who You Can Learn From: Say - Walk me through your technology stack. Let's put it on a whiteboard. Tell me how you chose each element. Let's look at the networking, storage, database, and application layers. Since my board is asking for my digital strategy, I'm asking this to learn for myself too. They're digging into the technology, and I’m just requesting from you no unpleasant surprises. One vendor tried to sell us something, and when we reviewed the stack, one element came up with the words "hacked over 40K times".

Image Credit: kullabs

2) How a Health System CxO Can Coach The Vendor Into Reality: Our board has decided to follow NIST guidelines because security in healthcare is important. When systems are hacked or taken offline, patients get delayed or diverted, which is harmful to patients and hurts our bottom line. Walk me through how you implemented NIST guidelines in your development in a way that I can present to my board. If it is for mobile, can you explain your mobile security recommendations?

3) Make Them Explain How They Have Considered Your Specific Environment: We have connectivity challenges and network drops that are increasing throughout our campus. The problem is from radiation and MRI machines interfering, and when you add more towers for connectivity, they interfere with themselves. Walk me through how your team has taken this into account.

4) Make Them Explain How They Understand Your Requirements: Our high value medical specialists have contracts that stipulate that they answer a call and be in the hospital within ten minutes of that emergency. At least half the consumer smartphones that physicians use do not provide notification guarantees for apps. Help me understand why this is irrelevant in the use case you are proposing and why it does not matter if the physician gets your notification or not.

5) Make Them Explain That They Understand Your Business: We are very busy reorganizing and responding to mandates, who on my team is going to manage this project and why.

6) For Mobile Apps, Make Them Show You That They Know For Themselves What a Mobile App Does: Show me your phone, I am going to also check in with my teenage son about this since he advises me on mobile tech. He i's always teaching me new stuff and poking fun at me. To help me open the discussion with him, what mobile apps do you use that I can compare to yours that my son might be familiar with? Walk me through how it is similar or different and why. It would be great to do this in a way he will understand.

To assist hospital executives further, I also wrote about how to help identify stakeholder priorities as they relate to digital.

I wrote this piece in response to #mastersofscale and anyone passionate about actually improving healthcare.