OPINION: Healthcare’s pilot culture is holding back HealthTech innovation

HealthTech startups in Europe are developing innovative technologies to enhance patient care, relieve healthcare burdens, and optimize resource utilization. However, many of these promising solutions face challenges moving from the pilot phase to long-term adoption. This issue is not novel; companies working with large public healthcare organizations, such as the UK’s National Health Service (NHS) or Ireland’s Health Service Executive (HSE), are familiar with the hurdles of new technology implementation.

These institutions operate on a large scale, with intricate responsibilities and stringent obligations concerning patient safety and public spending. The caution, while understandable, raises concerns regarding whether the current processes are tailored to foster innovation or hinder healthcare progress.

Pilots serve a crucial function in healthcare innovation, enabling clinicians to evaluate a technology's practical effectiveness, patient responses, and necessary adjustments before wider implementation. Nevertheless, they often serve as the final step, rather than a stepping stone to mass adoption. Widespread adoption of successful pilots can encounter numerous obstacles: determining budget ownership, assignment of implementation responsibilities, compatibility with existing systems, and provision of training and support.

These critical questions are frequently addressed too late, resulting in adoption being halted prematurely. Additionally, clinicians championing pilots, who are often enthusiastic about new technologies, may not be representative of their colleagues' priorities or interests. Consequently, a technology that thrives in one department may encounter resistance when implemented across other departments.

Procurement poses another significant hurdle for promising HealthTech companies. Healthcare procurement is a critical function that involves significant responsibility in spending public funds. Procurement teams must choose suppliers that are financially stable, with products that meet clinical, technical, and regulatory requirements.

They must have complete confidence in their selections. Young, unestablished HealthTech companies may not garner this confidence, despite the effectiveness of their solutions. Moreover, procurement processes often prioritize cost, making it difficult for innovative solutions with higher immediate costs to secure approval. This creates a vicious cycle where a company needs a contract to establish its track record, but requires the contract to build its reputation.

Furthermore, procurement decisions are often driven by price, potentially favoring established suppliers with proven track records, even when smaller companies offer superior approaches to clinical problems.

Healthcare providers must ensure that any offered technology is backed by robust evidence and accountability, leading to an unintentional culture that prioritizes caution over clinical outcomes. This caution can inadvertently hinder the adoption of beneficial technologies, negatively impacting patients, clinicians, public finances, and European businesses.

HealthTech startups must generate revenue, build sustainable businesses, and invest in further development. If the transition from pilot to procurement remains uncertain, companies may struggle to plan growth or attract necessary investment. To avoid losing access to homegrown innovations and missing global opportunities, European companies risk relocating to more predictable markets.

To improve the path from pilot to adoption, healthcare systems should involve implementation and procurement teams early on. Establishing clear success criteria, designing pilots with scalability in mind, and balancing procurement requirements to consider long-term benefits are essential. Moreover, learning from both successful and unsuccessful pilots can help minimize duplication and improve decision-making for future pilots.