This is the fifth article in a series about the components that influence the value of a novel healthcare solution and how to address them.

The first article described the components that influence value (see the “value wheel” figure at the top of this article). The second and third articles talked about mapping the care pathway and exploring relevant perspectives, while the fourth article dove into the details of how to size the opportunity and potential value capture.

The last step is to identify potential barriers to adoption and sources of uncertainty regarding the value of your solution.

When I give talks on assessing value, I often start by showing the following two figures. To begin, I mention that when we think about the value of specific solution to an identified gap in care, we tend to think of it within a series of steps that look like this:

While in reality the situation is more likely to look like this:

Namely, there is a lot more going on than just the interactions that are directly relevant for the particular condition or care setting for the novel solution. That encounter, procedure, or activity is embedded within a larger, complex framework that involves multiple individuals making multiple decisions and having multiple interactions.

Therefore, it should be clear that to accurately assess and consider the value of that solution, we have to consider it within that larger context. Even after you perform the activities described in the previous articles (mapping the care pathway, exploring relevant perspectives, sizing the opportunity and potential capture), you must now identify all of the potential barriers and sources of uncertainty related to the “real-world” adoption of your solution.

Many start-ups fail to consider this step, and suffer because of it. If it sounds like an afterthought – it shouldn’t; the entire field of Implementation Science is devoted to finding strategies for how best to implement evidence-based solutions into real-world practice. Some in the field pull from other disciplines to leverage complexity theory and network analyses to determine how best to do so.

Depending on your solution and the patient population or setting it is relevant for, potential barriers or may related to:

  • Practicality (e.g., is it feasible to use within the current care pathway)

  • Regulatory (e.g., will it require additional training or add complexity to providers or facilities)

  • Technical (e.g., does it require a certain level of IT support, software, etc.)

  • Human (e.g., is it counter-intuitive, does it add steps or process, will it require a provider to change how they’ve always done things, etc.)

Essentially, these barriers reflect the level of disruption your solution would require to be implemented and adopted. This follows directly from your previous work to map the care pathway and understand who would be affected and where in the pathway.

Examples of potential sources of variability may include:

  • The level of precision of the estimates of the size of the opportunity in terms of number of patients affected, the associated cost or resource use, etc.

  • The accuracy of the estimates of the improvement you suggest your solution will confer.

  • The ability of users (clinicians, patients, caregivers) to effectively apply your solution as it is designed or intended.

There certainly can be others. But, whatever you identify, the next step will be to develop plans to overcome or mitigate barriers and uncertainty.  For example, if your solution will add several steps to what a front-line nurse needs to do to care for a specific type of patient, you will need to verify that it’s actually feasible (i.e., there’s time and opportunity given how busy that nurse already is) and determine how you are going to convince that nurse that it is “worth it” to do those extra steps. As another example, if there’s a low level of precision regarding the number of patients your solution will really be relevant for, you need to explore how “worst-case” and “best-case” scenarios will affect the value to the relevant perspectives you’ve previously identified.

Essentially, you need to put yourself into the shoes of those who will pay for, use, or receive care from your solution and think of all the reasons that could derail adoption, and then consider how to address those. It sounds straight-forward, but will likely take a lot of thought and effort. Simple, but not easy, so to speak.

 This will allow you to develop a more effective narrative when speaking to relevant audiences and decision-makers about your solution and its value.

Putting it all together

Once you have performed this final activity, after having mapped the care pathway, explored relevant perspectives, and sized the opportunity and potential value capture, you will have the following results:

  • You will fully understand the care pathway and flow of value

  • You will have confirmed demand from one or more perspectives

  • You will have identified one or more target audiences for your value message

  • You will have verified the value message(s) for those audiences

  • You will have quantified attributable monetary and non-monetary value

  • You will understand potential barriers and sources of uncertainty and have a plan to address them

This will allow you to identify the types of external materials you will likely need to develop to effectively communicate your value message(s) to those audiences, whether they are white papers, peer-reviewed papers, economic projections (ROI), value briefs, slide decks, infographics, or other. But, that’s a topic for another article…