Shubs Upadhyay, NHS Clinical Entrepreneur and Clinical Lead at AI-powered health platform Ada Health has had to think in a totally different way when working with a start-up. And it’s done him the world of good…
As digital technology becomes increasingly central to healthcare, more and more clinicians are choosing to work in the world of digital health, either instead of – or in addition to their work in practice. At the same time, the role that doctors should play in the development of new health technologies is an increasingly hot topic within government and healthcare.
As a practicing GP who also works for a digital health company, I can tell you that this is a very welcome development. Tech companies need front-line clinical experience if they are to create safe and successful products and if, as doctors, we believe this technology can be a force of positive change, then we should put ourselves at the forefront of shaping it.
You don’t need to be an evangelist who thinks tech is going to solve every problem to work in digital health. In fact, it often helps to be a healthy sceptic. After all, rigorous analysis and oversight from clinicians will be integral to moving us past the hype cycle that has at times dominated the debate over medtech. There’s also the fact that it is a highly exciting, dynamic environment to work in, and a real accelerator for personal growth.
So, have I convinced you that you should work for a healthtech company? Great. Here are some tips to help you hit the ground running:
In my experience, one of the key differences between the clinical environment and a start-up is in how they approach change. In the clinical environment, it can be difficult to change even the smallest thing, because change tends to always come from the top down. This can too often result in change that is slow, ineffectual, and/or counter-productive. In a start-up, change is the norm; everything changes all the time, and organisations are typically dominated by an attitude that questions everything and continually looks for ways to transform things for the better.
With this fluidity comes increased agency. As a doctor, it’s often easy to feel like changes to systems or processes just ‘happen’ to you – and so change that meaningfully impacts the user happens much more slowly. But start-ups, which often rely on smaller teams and utilise a flatter hierarchy, give clinicians the opportunity to lead change themselves. This can be disorientating at first, but also incredibly empowering.
The trick is to embrace rapid change while keeping your clinical cap on.
Those clinicians who find a way to let creativity bloom while ensuring a patient-centric, and an evidence-based approach, will be invaluable to innovative healthtech companies.
You are likely to be working closely with engineers if you make the move into tech, which is an education in itself! One thing clinicians and engineers have in common is that they love solving problems, but how they think about problems is another matter. As healthtech relies on cross-disciplinary work, combining their two differing approaches is something that clinicians will be used to doing.
How do they differ? Where clinicians are trained to focus on the individual patient, engineers and product designers are typically trained to think more about the total user experience and to adopt a Design Thinking approach – utilising things like experimentation and prototyping to arrive at solutions that are emotionally meaningful as well as functional. In a start-up, I have found that you are encouraged to adjust to thinking much more about the overall user journey, across every touchpoint and interaction.
My advice is to lean into this Design Thinking approach and make the most of every opportunity to collaborate. Seeing problems from a different angle can be liberating and it will also help you to think laterally and find solutions that wouldn’t have been obvious by taking a purely medical approach.
Another similarity between tech and medicine? They’re both jargon-heavy disciplines. In the clinical environment, this is intended to ensure clear, efficient communication and there’s generally a common language whether you’re speaking to a nurse, doctor, or a paramedic. Of course, this jargon differs massively from that used by engineers, and so when the two come together in healthtech it’s easy to encounter minor misunderstandings that can quickly lead to frustration, wasted time and, most importantly, poorer outcomes.
To tackle this, we work hard to make sure everyone on our team is operating from the same frame of reference. One of the first things that struck me when I started working in a start-up was how many words we use interchangeably. One person might say ‘visit’, while someone else might say ‘consultation’, which may differ, depending on context. So before beginning any new project or collaboration, we take the time to define our terms. This also forces us to keep things simple – and sticking to first principles helps us to find the most straightforward solutions.
Of course, it helps that we clinicians are typically well-versed in adapting our communication style to suit the context – ie patients from different cultures versus the many multi-disciplined professionals we work with. But you should be prepared to really test out these softer skills when you first enter the world of tech. It takes time and effort but being able to see each other’s viewpoint is vital to combining both disciplines effectively.
Without the close involvement of medics, clinicians, and patients, the innovations of tomorrow will always struggle to meet the most rigorous standards of testing and real-world usage. We therefore need to influence every stage of the development if these new technologies are to win the trust of clinicians at large – otherwise the idea of tech just ‘happening’ to doctors will simply be perpetuated. Moreover, getting closer to the front line, and becoming intimate with the problem, is the only way to develop a solution that truly makes a difference in the real world.
If you’re looking to get into tech, there are lots of things you can try as a first step: get involved in things like pilots, trials, partnerships, and research. The most important thing is to stay open to things and be ready to share your views and expertise: we all have something to bring to the table. More and more companies are recruiting clinical expertise, so keep your finger on the pulse and be ready for when opportunity comes knocking.
And you will be a better doctor for it. I take lots that I’ve learnt from my work at Ada back into my practice as a GP, and I can feel the difference it makes to my day-to-day interactions with patients.
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