Mobile Health Destined to FailFor many, mobile health is the future. But as a “semi-pro” and keen observer of the healthcare and pharmaceutical industry, I think mobile health is a tale told by and for “idiots”:  full of sound and fury, signifying nothing.

Sales in the healthcare and pharmaceutical industry often involve organizational (and therefore complex selling).  Under the Exchange Behavior framework developed by Sheng Peng, the most important aspect of the purchase process is to convince key persons and core opinion leaders. Key persons and core opinion leaders are defined as those who have a say in regard to the purchasing decision; their influence may be resource related, product related, or process related.

Each key person and core opinion leader has a different view on criteria, which means that when they are making a decision, they are looking at different selecting points and selecting rationale. For example, the resource related key person may be most interested in the cost effectiveness of the purchase, whereas the process related key person may want the purchase process to be as simple as possible.

Because key persons and core opinion leaders have different self interests, they necessarily differ in how they perceive a new offering. This means that organizational purchase is inherently complex in nature. In addition, because organizational purchasing decisions are rarely made on an individual basis by an autocratic “decider”, consensus among several key persons and core opinion leaders are required. This means that key persons and core opinion leaders, in addition to consider their narrow self interest (or “buying points”), have to consider how their words would sound to others and how to convince and influence others’ decisions (or “selling points”).

The best sales pitch, then, would necessarily have to appeal to ALL key persons and core opinion leaders, for one negative opinion, obstinate enough, would be able to derail the whole thing.  The sales pitch not only has to have buying points that appeal to everyone’s self interest, but must also contain valid selling points so that it could be used by them to convince their peers.

In addition to the sales pitch, deliverability is also important to key persons and core opinion leaders. Everyone could talk a good game, but the key persons championing a new offering must also make sure the talk is backed up; otherwise the whole enterprise may collapse right in front of their eyes.

If we analyze healthcare startups in this framework, then we can see why their futures are almost unanimously pessimistic. First of all, the startups usually have a very technological appeal: that is, the startups usually claim their offering provide efficiency. This may very well be true, but the efficiency alone cannot convince key persons; many of them may be beneficiaries of the current inefficiencies.

From the way startups are marketing themselves, it’s unlikely they even know the identity of the key persons. Some startups have founders who are doctors, but even doctors only see a small part of the picture. Chinese healthcare industry is complex to the extreme. A doctor may understand what is going on in his department, but his grasp of the mechanism of other departments is probably faulty, let alone how various governmental agencies, logistics companies, and pharmaceutical companies work and how different organizations interact.

Because of such complexity, crafting a message with something for everyone is extremely difficult. There is also a degree of uncertainty associated with new offerings. Sometimes their promises are great, but result meager, as it’s the case with electronic health records in the U.S..

An ideal healthcare startup (and one with the greatest hope of success) would have an impeccable product or service (that is truly more efficient). The team running the startup would be well versed in every facet of the industry, with contacts in the government agencies, pharmaceutical companies, logistic firms, hospitals, as well as other key players.  This will help them understand every key person and core opinion leader’s need, and shape their messages accordingly. But even this ideal situation has holes in it: what is this awesome team doing with a startup?

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