Given that they live in an industry based on the scientific method, you’d think that healthcare organizations might have a better attitude about failure. You might expect some lab-based pep talks, invoking names such as Lister, Pasteur and maybe even Thomas Edison (“I have not failed 10,000 times — I’ve successfully found 10,000 ways that will not work”).
After all, everyone knows failure is baked into healthcare. A recent study of clinical success rates finds that only 9.6% of drugs that enter Phase I clinical testing reach the market. Venture-backed Silicon Valley startups have a slightly better batting average, with about 75% failing.
Put it this way: If new life-science ideas were a baseball player, the poor kid would never make the junior varsity squad. Yet, instead of cheering for wins, watching other companies fail has become its own kind of spectator sport.
To that point, MM+M asked innovation all-stars not just to explain what makes other peoples’ failures so inherently fascinating, but also to reassess some notorious missteps and flops.
It turns out there are dueling storylines. First, there’s the love of all things sci-fi. As any kid who watched The Jetsons can tell you, we want to see jet packs and flying cars, says Sara Holoubek, CEO and founder of Luminary Labs.
But there’s also the The Emperor Has No Clothes complication, offering smug satisfaction in spotting another person’s train wreck before it happens. The Great Google Glass Gaffe of 2015 is a great example. “The design was horrendous,” says Carmine Jichetti, VP and head of the innovation lab at Ogilvy Health. “Who did they think was going to wear that?”
Holoubek recalls wearing her Google Glass and thinking how hot it felt on her forehead before she put the device back in the box for good. “This is so close to my brain,” she remembers thinking. “This can’t be good.”
Still, for those working in the innovation trenches, the concept of failure doesn’t have the same stench it does for everyone else in business. Most see it very differently: Because failing is learning, there’s plenty to take away from every disaster. In other words, we haven’t seen the last of the Google Glass concept.
“I still love the idea of an overlay,” Jichetti says.
Holoubek insists that failure — even expensive, calamitous failure — can be the grist for the success mill. By way of example, she points to Apple’s Newton, a disastrous personal digital assistant from the 1990s.
No, it didn’t catch on. “But what Apple learned led to other inventions and ultimately, maybe even the iPhone,” Holoubek suggests. “Many inventions fail in the first round or just haven’t found the right use cases yet, but innovation is a really long game.”
The pandemic has offered plenty of proof, rebranding previous fails as made-for-the-moment breakthroughs.
Back in 2012, the Pfizer REMOTE study wound down early for failure to enroll, recalls Craig Lipset, founder of Clinical Innovation Partners and former head of clinical innovation at Pfizer, who designed the effort. “It was the very first fully at-home clinical trial,” he says. But thanks to COVID-19, “the decentralized trial movement is now unstoppable.”
QR codes, almost laughed out of existence some years ago, have become popular again. “That’s because of the obvious need for more contactless communication,” says Holoubek. “Do any of us expect restaurants to print menus these days? And QR codes are easier now that we all have smartphones with cameras.”
Other failures stem less from bad ideation than misaligned or overmatched stewardship. After college, Jichetti spent some time in minor league baseball, where he briefly fell for red contact lenses.
“The idea was that it enhanced the contrast between the red seams and the white of the baseball,” he says. “I got a pair and thought they were pretty cool.”
But replenishing them was a problem. “They were made by some fly-by-night apparel company, not a reputable lens maker — and that happens often,” Jichetti continues. “It’s not surprising when companies such as Nike and Under Armour make tech products that don’t do well. It doesn’t mean they were bad ideas, just that the company bit off more than it could chew.”
Here are our experts’ favorite failures— and the successes they may have anticipated.
The letdown: Glucose monitoring contact lenses
“Having worked in new product development for medical devices that supported people with diabetes, I was intrigued by an announcement in 2014 that Google submitted a patent application for a high-tech contact lens that, among other things, measured blood glucose from tears,” says Joe Shields, president and cofounder of Health Accelerators and a former innovation exec at AstraZeneca. “I had high hopes to see this on the market in a few years. Unfortunately, there were significant problems with both the accuracy of the glucose readings and the ability to manufacture the lenses, so the program was scrapped in 2018.”
The lesson: Demand for non-invasive continuous glucose monitoring is growing. Why? Among other reasons, finger sticks still hurt. A new report from Jefferies predicts that more than 50% of type 2 diabetes patients in the U.S. may use a CGM in the next three years, up from 30% today.
The letdown: IBM Watson
Remember when this Jeopardy! champion was going to KO cancer? After its much-ballyhooed collaboration with MD Anderson Cancer Center fizzled, many wrote off the pioneering artificial-intelligence product.
Jichetti recalls how frustrating that period was. “Watson was the one-word answer to every tactic a client needed,” he says. “It was very frustrating to explain to everybody that you don’t just go to the supermarket, pick up a box of Watson and open it.”
AI, as we’ve learned, needs to be trained. “People need to understand it takes a lot to get the answers you want — and you can get wrong answers too,” Jichetti adds.
The lesson: Machine learning is here to stay
“It was a mistake to market IBM Watson as a simple solution, and maybe a mistake to aim it at an industry as complex as oncology,”Jichetti says. “Companies just need to make sure they are willing to invest time and money in training it right.”
The letdown: Wearables as a clinical powerhouse
Wearables, from the Apple Watch to trendy Ōura sleep rings, continue to be a hot category for consumers. But despite the theoretical arguments in their favor, there’s not much data to prove they are effective as health aids.
Early adopter Holoubek became frustrated early on by measurement discrepancies between one device and the next. Indeed, recent research confirms inaccuracies still exist, overestimating calorie burn by as much as 50%. Out-and-out failures include Jawbone and Nike’s FuelBand. And don’t forget that Fitbit was struggling until Google acquired it earlier this year.
The lesson: People love gadgets for a reason
While bona fide clinical connections are still elusive, people want to use devices to get healthier — and boosters say they can be highly motivating tools for behavioral change. “For someone like my mom, who has high blood pressure, they are a very successful piece of technology,” Jichetti notes.
The letdown: Home DNA testing
Led by 23andMe and Ancestry.com, testing companies promised to turn the world’s spit swabs into a trove of health data, generating new drugs, treatments and interventions along the way. The reality? That the category is running out of early adopters.
Sales have declined, with layoffs throughout the industry. Earlier this year, Ancestry.com yanked its health testing kit off the market, saying it would focus on its family-tree business. Finally, privacy concerns have surged, fueled at least partly by publicity surrounding the dramatic 2018 capture of the Golden State Killer, which tapped genetic information.
The lesson: Be patient
In its first quarterly report as a publicly traded company, 23andMe reports an increase in revenue. In addition, its partnership with GlaxoSmithKline has fueled an immuno-oncology program, currently in a Phase I clinical study.
The letdown: Facebook patient groups
Andrea Downing, a breast-cancer advocate and moderator of a Facebook support group for 10,000 people with BRCA mutations, dug into Facebook’s privacy policies in the wake of the Cambridge Analytica data breach. After she enlisted cybersecurity experts, she discovered that a Chrome plug-in was harvesting personal patient data. In other words, many of Facebook’s “closed” groups were anything but.
“Online support groups are a great idea and this group didn’t fail. Facebook’s privacy policies did,” Lipset stresses. While Facebook closed the loophole, trust in the social giant remains underwater, likely discouraging an untold number of patients from seeking valuable online support.
The lesson: Listen to the privacy crusaders
While Facebook makes for an easy villain in this story, marketers buying data obtained through opaque means are the real culprits. Brands that respect and protect patients will win; companies that exploit them won’t.
The letdown: Theranos
Our experts still aren’t sure whether this blood-testing dumpster fire should be labeled a failure or merely a fraud. But they agree that it’s a textbook example of how easy it is for people, even the smartest and most successful people, to let their love for an idea blind them to reality.
The lesson: Beware the hype machine
“We never seem to learn from this cycle of media hype, then watching the hyped company fail,” says Holoubek. Alas, in the case of Theranos, there may be little encouragement for the next blood-testing startup: The mess left in its wake means the idea is untouchable, at least for now. “Nobody wants to be associated with that technology, and that’s unfortunate,” she adds.
Furthermore, Holoubek argues that the way funding works now, failure is more likely than it needs to be. The intensely competitive nature of Big Tech chews through innovations that are full of promise.
“The nature of a venture-backed innovation is that you have a very short window. If you can’t prove that it’s possible in that time, there is no more funding,” she explains. “That can be to the detriment of the digital health sector and the detriment of humanity.”
That is why governmental approaches, like collaborations with groups such as BARDA (the Biomedical Advanced Research and Development Authority), can be better at stimulating high-risk, high-reward investments. “Anybody can build a website in a day. That doesn’t mean that a digital intervention or hardware should be built in a year,” Holoubek says.
From the November 01, 2021 Issue of MM+M - Medical Marketing and Media
