Hacking Healthcare: Will It Help the Patient?
Up until recently, the word “hacking” conjured up nefarious deeds, in particular using a computer to gain unauthorized access to data in a system. But the word also has a secondary definition — “a clever or creative solution to a tricky problem” — that gains relevance to healthcare in the context of exploratory programming.
Hackathons originated as group software development sessions within IT groups. What distinguished them from simple collaborative sessions was the inclusion of participants with disparate skill sets from outside the IT world. A hackathon to develop an online banking application would include bankers, accountants, and potential users of the application, for example, but also software engineers, programmers, and graphic designers. Hackathons are typically focused on solving a specific problem and may last anywhere from several hours to several days.
Other industries have appropriated the term, and it has entered the mainstream lexicon. In the healthcare arena, organizations such as MIT, the Cleveland Clinic, Baylor College of Medicine, Tufts University School of Medicine, and Massachusetts General Hospital have all sponsored hackathons within the last two years.
Hackathon events involve a range of participants looking to solve individual problems who “pitch” the problem to people in the room. After hearing all the pitches, participants settle on a problem upon which to focus. Sometimes everyone in the room works on different aspects of a single challenge; other times there are a host of challenges that individual groups put their heads together to solve.
The groups are small — usually three to five people, each with a specific skill set and very different perspectives. They labor under compressed time frames, with a clear mandate to solve unmet clinical needs. In a room with a range of problems to be solved, one group's solutions may apply to another group's, so there's plenty of cross-pollination.
For years pharma marketers have been tackling adherence and compliance with limited success. So one might logically ask (and reply), as Elizabeth Bailey, director of the Consortium for Affordable Medical Technologies at Mass General Hospital's Center for Global Health, did in Wired: “What can 250 people in a room for two days really do to solve challenges that experts over decades have been unable to address? A lot, it turns out. They can break down walls to develop real solutions that save lives.”
WHY THEY WORK
The 2016 MIT Hacking Medicine hackathon awarded winners in categories, including connected health, healthcare at home, and chronic conditions.
At a recent event I attended — MIT's Grand Hack in Boston — several participants pitched what sounded like interesting problems. One dealt with how to save babies in incubators in third-world countries, where power regularly goes out. Another focused on how to get a life-saving drug to patients in Africa, where corruption and lawlessness prevent delivery. Another surveyed how to encourage adherence and compliance among patients with type 1 diabetes.
The beauty of breaking down tricky problems in groups like this —with a range of people with different skill sets putting their minds together — is that you hear all aspects of the issue. Working with patients is especially useful, since they can offer immediate feedback in terms of physical and emotional factors that are affecting them. This, plus entertaining viewpoints from the other participants in your group, allows you to attack a problem from all sides. You develop a deep understanding and appreciation of the physical, emotional, and psychological issues of suffering from a health condition.
Hackathons also allow participants to get at the essential core of a problem. Although it may at first appear simple and solvable, it can actually be a compound issue. Thus the first step is to break down the issue, answering questions like, “What is the problem and what are the underlying elements creating this problem?” By sharing your orientation with others and hearing their points of view, you come to understand why and how this situation affects a patient, how it makes her feel and whether the solution is internal or external (i.e., whether it's a problem the patient herself has to deal with or whether it's something beyond the patient's control that needs to be addressed).
For example, a patient may have unrealistic expectations about her treatment, expecting a feeling of relief within a week of starting a particular regimen, when in actuality relief normally takes a month. When relief doesn't come within the timeframe she expects, she becomes discouraged and stops treatment, thereby assuring failure. In that case, she may need to be educated so that she better understands the realistic time frame and recognizes that her progress is normal and on track — thus encouraging her to resume treatment. We might also see if there's a way to shorten the timeline without compromising the quality of the treatment.
Another solution might involve the addition of outside support. Rather than expecting a frightened patient to give herself a weekly injection, it may be necessary to have a nurse come to her home to give it to her.
Where hackathons excel is in their ability to help uncover solutions to problems in areas where you may not expect them to be. Perhaps, for example, you think a patient simply needs another app or tool at her disposal. But maybe another widget wouldn't begin to address the patient's real need — which may simply be help or companionship in navigating through her treatment journey, rather than having to navigate it alone. Or maybe, if she feels that what she's going through is “awful,” preparing her for what she will experience and helping her understand that what she's going through is absolutely normal, will alter her perceptions of the journey.
WHAT IT ALL MEANS
The collaborative experience of a group problem-solvers from diverse backgrounds can be transformative, allowing patients and providers to work together to solve complex problems and identify unmet needs. And, it's worth noting, solutions for one problem plant the seeds for solving other problems for other audiences at other points in the patient journey. As Bailey pointed out, “Customers (healthcare providers and patients, in this case) should help define the problems that drive technology innovation, not the other way around.”
Hackathons reduce the barriers between the patient and the system by reinforcing the recognition that healthcare solutions are human experiences. Patients have traditionally felt at the mercy of those guiding their health; hackathons change the paradigm, elevating the patient and her experience from “research participant” to “authority” and “partner.”
The power of hackathons is now magnified because of the power of the internet and social media, giving both patients and healthcare professionals a global platform for their voices. This platform goes beyond a print page, personal presentation or TV and radio wave, reaching millions of potential customers faster than ever before. Aligning this reach with the ability to tap into an audience of diverse minds and skills — all of whom want to find solutions to unmet needs — offers the power of convergence, of possibilities, opportunities, and solutions.
Erica Rivera is senior manager of engagement strategy at AbelsonTaylor.