Health Data Aggregator App

Market Analysis and Product Strategy

The Challenge

BUSINESS Goals

Potential Startup
 

The Hypothesis

User Research

Plus secondary research of additional subjects in online communities.

Use graphics, not photos

Survey - simple survey to identify potential users to interview

Conducted 11 User Interviews

Conducted 5 Health Care Provider Interviews

Secondary Research  - informed by themes from interviews

QUESTIONS - how they currently handle their health records, effect on their lives, what's important in their lives

User Personas

Who Needs Their Health Data?

Journey Map

What do users want to do with the data?

User Insights and Industry Realities
 

Loved ones care more for our health than we do ourselves

Electronic health data goes back a few years at most

Electronic data exists mostly for those who have seen a doctor regularly and recently

Productivity is the biggest pain point

There is no competitive app for kids' data

Target User
 

Competitive Landscape

What WE Learned About Users

Validation: an aggregated health record is not valuable for its own sake - it's not the data and procedures that matter - it's the personal story and - valuable only when it ENABLES the use of the data - it's valuable when it ENABLES productivity, management of care, or management of health - when it's complete - and when it's mobile.

Trust apps recommended by doctors
Want others to pay
Would pay "a lot"

The Opportunity

(The Challenge, Reframed)

How might we design a health data aggregation app that helps parents fill out their kids' activity forms?

Design Criteria

Ideation

Premium Concept: Foto Forms

Basic Concept: Quick Forms

Concept Process
 

Concept

This is the concept poster, the pitch. See WeWell slide that presents the 4 high points of WeWell.

The main concept is that your data is presented to you in a summary format after having been analyzed.

A mother with two kids would pay $30 - 40 for the basic service. The premium service really wowed them.

We Well - Kids Health Forms

Basic:
School Summary
Sports Sumary
Waiting Room Summary

Analyze Data by Age, Date, "Ever Had"
Include "Never Had"
Quick Views for School, Sports, and Doctor's Offices

Basic integration requires testing with a provider
Fastest to use SMART-on-FHIR stack and sandbox

PRocess: Key Assumptions to Test

Evaluate Ideas vs. Ideal Solution

Thought Experiments - Idea Screening and Evaluation - which to Prototype

Assumptions - does it need to be more than just an aggregator, does it need to engage - what if it's not even an aggregator yet, 

PRocess: Concept Development
Failed Concept
Use Blood Relatives' data

Why this is good for the business; Why it's a great competitive opportunity; Why it will work technically; Why users will want it

Key Assumptions to Test

Roadmap

Process: Prioritization

Importance / Difficulty Matrix
Bullseye Analysis
MoSCoW

Based on data, risk, assumption

Key assumptions to test

OTHER PROJECTS: Storyboard

Analytics Plan

Usage after second EHR integration

Usage before OCR integration

Roadmap Prioritization

Storyboard UI
Prioritize Feature Development
MVP - Test Key Assumptions
Analytics Strategy
KPIs - translate success criteria

Long-Term Strategy
 

Process Artifacts

Mind Maps

Appendices

THE CHALLENGE: DETAILS

Create consumer apps that aggregate electronic health records using open APIs.

The US Department of Health and Human Services (HHS) issued a challenge to aggregate data from electronic health records, to create apps that help consumers manage their health.

Requirements included using use new FHIR standardized APIs to aggregate data from multiple sources - primarily electronic health records (EHRs) from multiple EHR vendors and multiple health care providers, and potentially from personal devices and other apps. They offered prizes of $15k for concept and established partnerships with health care providers, and $50k prize for completed app and integrations. There was a companion challenge to create apps for use by health care providers.

Initial Research

Conducted research in 5 areas, discovering that EHR technology is so far from maturity that aggregation alone would not ~yet~ retain customers.

How did I find and recruit users?

SHARING THE DATA: MEET STEPHEN

Stephen injured his shoulder. His orthopedist took x-rays, then recommended physical therapy. Now Stephen has a problem. How will he share the x-ray with the physical therapist? The orthopedist told him he could order a copy on a CD for $20, that would be ready for pick-up in 2 weeks. That's when the orthopedist grabbed Stephen's camera and took a photo of the x-ray.

The Re-Frame

Re-framed the challenge.

The SOLUTION: WeWell App

WeWell is an app for collecting and sharing family health history with schools, camps, sports activities, doctors, and other family members. At launch it would rely on data provided by users. Subsequent releases would integrate with the EHR system of a sponsoring institutional healthcare provider such as a hospital. Eventually it would be integrated with several EHR systems via a health data aggregator platform. Providers would sponsor apps like this, at a discount if also licensed to other providers on the platform. Requires partners.

RESEARCH

Started by conducting research in 5 areas to look for user insights and to identify strategic opportunities. It's a juggling act, not a linear process!

User Insights
~
Secondary Research, Ethnographic Interviews

Conducted ethnographic interviews with potential users - survey respondents who had ranked their need to access health records above other topics. Rounded out the picture with insights from secondary research.

Key Finding - Less than 50% of available information is used to make health care decisions
- not increasing as fast as you might think
- increased cost
- decreased quality of care

Key Insight - People take better care of others than themselves

Personas - Soccer Mom (target), Elderly, Caregiver, Chronically Ill, Acutely Ill, Busy Professional

Pain Points and Opportunities
~
Journey Map

Identified opportunities to increase value to users and reduce friction during onboarding and frustration with bad.

TECHNOLOGY Challenges
~
Ecosystem Diagram

Identified reasons why there have been few successful health data aggregation efforts.

Technical Considerations

Integrate via SMART-on-FHIR Platform

Integration Speed

2 Developers, 1 Year - integration with a single EHR system

API Integration - black box testing in each system - takes a long time

Credentials - ability of user to log in to provider instance - security step - manual or oauth - easier on those who see health care providers more often

INDUSTRY REALITIES

Where's the Beef: EHRs are Sparse

Providers have only recently adopted enough modules to create meaningful records. Most still store xrays and other images in separate systems. 5 years ago, only 25% had EHRs. Only patients who have seen doctors recently and regularly have electronic data. The rest is still on paper. Who has data? The elderly, children, and those managing chronic conditions.

Interoperability: EHR Systems are starting to share data

Practitioners are being incentivized to reduce costs, so they are starting to favor EHR systems that help them collaborate and share data to improve outcomes and avoid duplicate testing and imaging.

Competitive Analysis

How did I find these apps?

iBlueButton was first to market, is mentioned on HSS website

Prime came up in a search of the iTunes App Store

Swellbox - was listed on the FHIR initiative website

iShare - was listed as a partner to one of the EHRs

OneRecord - I found while researching potential names for the app

Downloaded and used the array of competitive apps, plus several EHR-portal mobile and desktop apps.  Identified advantages and disadvantages, looking for opportunities to differentiate our product.  

Hole in the market - intersection of added value, sustainable technology (defensible advantage), and target market

Initial feature matrix - only aggregators - look at their features

Ecosystem of EHR vendors, providers, platforms, apps, payers

Competitive Landscape

iBlueButton - XML - Medicare and VA

Prime - direct integration - took forever - concierge credentialing - 

Swellbox - adoption before integration complete - no engagement - FOUND EMOTIONAL JOB TO BE DONE unrelated to health care, but related to target users - Response to Peer Pressure

iShare - 

OneRecord - 

Ones I signed up for and used - screen shots - feature matrix (now or later - after ideation to translate insights into features)
Competitive Apps: Prime, Swellbox, Medfusion Aggregator
EHR Portals: Athena, MyChart, Medfusion Provider

Market Size

Evaluate Ourselves
~
SWOT Analysis

asdfasdf

Strategy
~
Design Brief, Re-frame the Challenge

Wrote design brief to communicate strategy based on synthesis of the research, reframing the problem to be solved and defining the criteria for a great solution.

1) Problem statement: reframed based on research
2) Insight: users care more for the health of their loved ones than for their own
3) Opportunity: feature to obtain EHR credentials in-app

Business Model

 Used business model canvas to identify the need for a key partner in order to deliver.

Partner: an institutional health care provider, like a hospital, that is already uses at least one EHR and can sponsor the development of specialized apps

System Partner: a technical platform that speeds up integration with multiple EHRs and makes apps accessible for licensing by other providers

Market Size

Concept

Selected a primary persona to serve. Selected competitive opportunities to pursue. Ideated and developed concepts to meet design criteria.

"more likely to care for the health of loved ones than themselves"
Competitors

Features

Prioritized user problems we could address and translated them into features.

Family Health History
Sharing
Credentialing

Prototypes & Testing

Created rapid prototypes and tested with users, iterating through cycles of learning and validation. (Way to test remotely - usertesting.com)

Interactive Prototype

Video a validation test session.

Key Assumptions & MVP

Created a plan to test key assumptions using a minimum viable product in order to test and observe actual user behavior.

Roadmap

Subject to change

Recommendation

In order to access aggregated data to drive care management and health management apps, need to integrate with many ERH systems. FHIR Ecosystem challenges - EHRs support FHIR to different extents or not at all

Have to become a platform or use a platform that already has multiple integrations in order to access data needed to drive app functionality. 

Currently 3 options, all works in progress

Provider installs platform supported by EHR - APIGEE
Work with Apple only - GLIIMPSE
Create a platform

(SMART on FHIR is a tech stack, not a platform - yet)
(Soso web services instead of FHIR marketinginteroperability, not apps - yet)

Late-breaking developments - Soso web services, FHIR platforms, Apple Gliimpse, 

Next Steps

Build MVP, Create Marketing Plan, Conduct Customer Development, Measure User Behavior, Update Roadmap and Iterate

Copyright 2016 Colette Brown