Why Doctors Don’t Trust Technology
At Medigram, our hypothesis is that mobile digital medicine success can only be achieved through the successful bridging of two wildly different worlds, technology and medicine. This post is to help company stakeholders understand a common misunderstanding between the tech and medical worlds, and that involves knowing why doctors trust products and when they don’t. Without trust, they do not adopt. Notice I said digital medicine and purposefully did not say “digital health” which is in my mind, a lighter weight, frequently less consequential, direct to consumer “wellness” product. Why this specific title? Certainly doctors trust some technologies, they use them every day, CT scans are one example where they RELY on these brain images to differentiate between a stroke and a tumor. In this case, your relative comes into the hospital and exhibits symptoms indicative of either one which are similar; the doctor is initially unsure whether your relative has a stroke or a tumor. S/he needs to be able to rely on imaging to make the call. This CT scan has to be approved before the doctor is RELYING on it. CT imaging systems are regulated by the FDA under two statutes. The regulations implemented under these laws place controls or requirements on the manufacturers of the CT systems rather than on the users of the CT systems. Since doctors ordering CT scans know this, they will tend to “trust” any available CT scan. Acceptance of new medical products frequently comes after peer review of research. Peer review involves subjecting your work to outside experts in the same field. Whether it’s a health startup claiming its platform will save money or a biotech company claiming a new therapy can cure cancer or Alzheimer’s; those claims can and should be measured and quantified. In fact, companies legally cannot promote outside of approved claims and CRIMINAL penalties for false claims are career ending and can be enormous financially.
Notice that these doctors list “evidence-based treatment” as a selling point that they are quality doctors. Where does this evidence come from? It comes from what they consider to be esteemed scientific and medical journals.
How Do Doctors Learn?
Many doctors meet their closest colleagues by collaborating on patients; though they also deepen relationships with colleagues by writing together and reviewing each other’s work, including articles. The latter is referred to as peer review. We understand there is valid debate about this peer review system; though the focus on this article is to help technology investors primarily better understand how practicing doctors think and make decisions based on trust, even intuitively. What peer-reviewed means is that when a doctor or scientist submits findings to a journal for publication, then the journal asks established, appropriate and independent members of the scientific or medical community to evaluate the reported study findings. These reviewers help determine whether the study merits publication in said journal. Not all peer-reviewed scientific journals are the same, just like playing on the select soccer league in high school doesn’t necessarily make you Division 1 collegiate material. Competition to publish papers in respected peer-reviewed journals is high because the scientific community looks to these journals for the latest state-of-the art science that can be trusted. Failure to publish in peer-reviewed scientific journals is like saying, “I’m going to flout science and deny the best practice of proving whether my findings are right or not.” This is not how you develop trust with doctors who are essentially scientists. For example, by not publishing enough in peer-reviewed scientific journals, Theranos failed to accumulate evidence that their technology works and is actually useful.
What works in consumer or even B2B mainstream tech will not work in the healthcare industry for any use case that touches patient care. Safety is of paramount importance. An error in a Facebook, Google, or Apple, CRM app, file sync and sharing app or ERP app is not the same as an error in a patient lab test. Therefore, data sharing, collaboration, and debate with the broader scientific, medical and academic communities are of paramount importance in digital medicine. These communities cannot be ignored or sidelined “uber” stye. Real progress in digital medicine cannot be achieved without this in our view. At Medigram, we’ve subjected the earlier version of our technology to peer reviewed publication and review. We look forward to subjecting ourselves to continued, further scrutiny. We encourage others to do the same and allow their technologies to be measured in the clinical environment for reliability, efficacy, and time dependent metrics. Thank you to the Medigram executive team for inspiring this post and for your shared commitment to evidence based technology development and transparency in compliance and security management practices.
Sherri Douville is CEO and board member for Medigram, the modern, mobile communication platform and system for physicians. At Medigram, Sherri enjoys advising customer executives and their boards on how to tie their technology strategy to their financial and clinical quality goals. Sherri leads a world-class team of technology, healthcare, physician, and business executives in Medigram’s mission to eradicate the leading cause of preventable death, a delay in information. Sherri has been published and quoted 15 times in the last two years in healthcare IT, healthcare management, and IT media. She has 15 years of healthcare experience in executive management, product development, sales and marketing including with Johnson & Johnson, and as a health care product development and business consultant. She has a BioPhysics degree and has completed three certificates in electrical engineering and computer science through MIT. She serves on the board of the NorCal HIMSS (Health Information Management and Systems Society). She is also a member of the MIT Technology Review Global Panel. Active in health policy, Ms. Douville also serves on the board of the NorCal HiMSS (Health Information Management and Systems Society) as membership committee chair and in partnership with the top Ethics center in the nation and health system executives led the creation of the Code of Conduct and development of values guiding the organization. Sherri also advises Health IT, Medical Informatics, and genetics startup companies. Sherri and her husband, Dr. Art Douville volunteer together with a variety of NonProfits including as a member of the Board of Fellows for Santa Clara University. Ms. Douville deliberately allocates time to collaborating with and mentoring others including female leaders.
