Designing healthcare systems of the future

Harvard Business School’s Transforming Health Care Delivery course focuses on the global transformation taking place in the health care industry, with the aim of addressing the fundamental challenge of providing optimal clinical outcomes while keeping costs as low as possible. Course leader Professor Ariel Stern explains the central role technologies like Proximie will play in this transformation.

“The Transforming Health Care Delivery course teaches students about the most compelling business models that we see in health care today, along with how to deploy those in practice to improve the quality and patient-centricity of health care. There’s so much great technology out there, and too much marvelling at how cool it is without thinking about the best strategies for getting it into the hands of clinicians and patients.”

The health care industry has inherited a set of institutions from the last century that were not set up with some of today’s most compelling technologies in mind – and therein lies a managerial problem. How do we get new products and technologies into the field that have real potential to meaningfully improve health care for a lot of people, when our institutions for regulation, payment and health care delivery are not optimally set up for these technologies?

Part of this depends on how thoughtful we can be about policy making and identifying the most appropriate ways of paying for and integrating these tools into our health care delivery systems. Digital tools like Proximie are playing a major role in helping us bring expertise to places that it doesn’t otherwise exist, improving the quality of care for a large number of patients wherever they are. My own research has explored the massive variations we see in quality and outcomes in health care both across regions of individual countries and worldwide. I’ve spent a lot of time thinking about how tools can help us ensure that patients’ locations – even within a developed country and health care system – doesn’t determine their access to high quality surgical procedures. There is tremendous potential in this regard, and my hope is that Proximie and technologies like it will play a significantly larger role in the medium term, and certainly in the long term.

Proximie is a case study in the second module of the course, focusing on digital tools and their potential to improve and transform health care delivery. Digital tools lend themselves to personalisation in a way that is simply not true of physical devices. We see this in everything from Proximie to things like apps for chronic disease management, for example, where we can start to use best practices from the tech world around AB testing and customer engagement to ensure that patients are being provided with the health content that is most likely to work for them. The final module of the course is around personalised and precision medicine, and tools that can help move from broad strokes approaches to caring for patients towards more targeted care – whether that be targeted cancer therapies, or even just better diagnosis of bacterial infections, for example.

Something I found very compelling when learning about Proximie early on is the fact that it’s a software company – because any time you’re trying to physically replace objects that are already in a hospital, you’re fighting an uphill battle. This isn’t the case for Proximie, because the software can integrate with any digital devices already present in the operating room – it’s hardware agnostic. The DaVinci Robot, for example, has a viewfinder on it, a digital display, and it can all be seamlessly integrated into what Proximie is doing. This obviously lowers the barrier to entry for bringing Proximie into operating rooms, because you’re not asking your surgeons to swap out an existing device or technology for something new; you’re saying this is an add-on that layers onto the system, it’s quick to set up, it’s interoperable and will integrate seamlessly with what you’re already doing. So it’s a very light lift in terms of operations and deployment, which is vital for getting the solution out there and into the field.

At Harvard Business School, we work very closely with companies when developing case studies about them. We interview multiple members of the leadership team several times, gathering hours of recordings to make sure that we’ve really got under the hood of the company and understand their business model. My colleague Alpana co-authored the case study with me, and we spent a lot of time at various points over the pandemic talking to members of the Proximie leadership team over Zoom, going off and writing the case and then going back to Proximie to make sure we’ve got all the details right – that we’ve correctly captured the business model and included their input in a way that reflects the spirit of their thinking about the way this technology is headed.

What’s then really wonderful is that when we discuss the case study with students, we can invite company leadership into the classroom to join those conversations. So we had Nadine [Hachach-Haram, Proximie founder] and Bryn [Davies, Chief of Strategic Execution] with us at Harvard Business School, talking directly with students about what they’ve figured out and navigated, which things they wanted to openly challenge, and what they’re thinking about for the future. It was inspiring to see the class engaging with Nadine, asking thoughtful questions about Proximie and getting to grips with the business model.

We want our students to be constantly on the look-out for innovation and technology that could transform the health care industry for the better, and to be armed with the managerial skills to deploy these tools. We get students with really deep health care expertise; about a third in the class are actually medical doctors, while others have experience working for hospitals or health systems and are quite close to having boots on the ground. These are the people who will be shaping the future of health care, and we’re preparing them to rethink the inherited health systems of the past with the high-potential technologies we have available to us today. Immersing them in the power of digital technologies like Proximie today, can show them what’s possible in the health care systems of tomorrow.

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