Every one of us relies on the healthcare system, to both prevent disease and look after us when we are sick. Health data and digital technology have infinite capacity to make this system better and ultimately improve our lives. With so much efficiency to gain from better healthcare experiences that give back time to staff and patients, why aren’t we seeing industry-level progress in our healthcare services today? 

We met with one of our brilliant clients Elliott Engers, Co-founder of Infinity Health, to talk about some of the major challenges facing the healthcare sector right now, how Infinity Health is making a difference, and how Ostmodern contributed to their success.

—

Interview date:
24th April 2024

Participants:
Elliott Engers - Founder of Infinity Health
Katerina Christou - Lead User Experience Architect, Ostmodern

—

Ostmodern: I'm Kat Christou, Lead UX Designer here at Ostmodern and I'm with Elliott Engers from Infinity Health as part of our Q&A series. We're here to talk about the product that you run and the wider health care industry as a whole.

So, Elliott, would you introduce yourself and talk a little bit about Infinity Health and what the product does?

Elliott: Hi Kat, I’m Elliott Engers, Co-founder of Infinity Health.

I describe Infinity today as a task management solution that's used by front line care teams that coordinate care for patients. Infinity supports them to do that and so we build tools that make things safer and more efficient for front line staff.

How is Infinity Health used in hospitals?

Ostmodern: Could you give an example of the kind of scenario that the product’s used in, in the hospital?

Elliott: Sure. So at the beginning and end of every shift, clinicians exchange the most sort of important information about their patients, and they would do it in the most brittle way.

So they were doing it with excel spreadsheets or handwritten notes, or the back of a glove, or on a phone.

Ostmodern: We had some pictures of that!

Elliott: Yeah. So that really is the case and there's endless data breaches that happen because of that. But it's also really unsafe, and it's hugely inefficient. So we effectively just digitised that process wherever we could.

So it manifests as a list of tasks that you have to do for you and your teams. You can accept those tasks. You can create new tasks and assign them to people, [then] they get notifications. In the back end, we fill out this sort of large infrastructure for deeply integrating [the data] into existing clinical systems because we're moving things around.

We have an automation engine, so “when this thing happens over here”, we can create a task and “assign it to this team over here”.

What has the journey been like?

Ostmodern: What has the journey been like?

Elliott: We always had this vision that we'd sort of, like bring about a product that would get used by people on the front line of healthcare, and they say really nice things about it. And you know, that dream came true and many times over.

So the product is now regularly used by front line teams, and it's integral to the way that they do deliver care for patients, and that's really rewarding.

How did you begin to develop the product?

Ostmodern: Did you have to like, go in and study what they were doing to try and teach them how to use it before you actually launched the product? So they were prepared?

Elliott: The very early work we did with Ostmodern, we knew that this was a design problem that we were solving, so we kind of worked with the best. We went to the best UX team we could find at the time that would say yes to us, and that was Ostmodern.

We did some really early work that basically said, if you want to change the way anything happens in healthcare, you're gonna have to change the way staff work. So that means you're gonna have to really observe them. You have, like two ears, one mouth so we spent much more time watching and listening than we did sort of being opinionated about what we would put out there.

Then we put something out there in the world after having prototyped it and tested it and everyone telling us that it was going to work. Then it goes live with 500 people on day one and if it doesn't work, there are 300 patient transfers that aren't gonna go well.

And it works and it's great. It's such a great feeling.

Ostmodern: That's wonderful to hear that.

How has your team evolved over time?

Ostmodern: How has the shape of your team evolved?

Elliott: We ebbed and flowed quite a lot as we went, investing quite a lot in product, at one time trying to get a build out. But I think what really changed is we kind of built out really good delivery teams. So we really understand clients needs, what they're currently doing, and then how we can augment that with our tool to then bring about a benefit that they're seeking. And we got really good at that.

What are the biggest challenges facing the healthcare industry at the moment?

Ostmodern: How have things changed, and what do you think are the biggest challenges facing the industry at the moment?

Elliott: There was this perception during COVID that we were having this huge digital health revolution, and suddenly all of the barriers to adoption were falling because of the necessity. That was true for about six weeks, where we rolled out video consultations because people couldn't see their GPs. And now the use of video has dropped off considerably.

There have been no major advances, in my view, into the way that we do business fundamentally. That said, the demand is huge now, and the workforce is as depleted as ever. So the conditions for change have never been more needed. And typically, when the health service reaches a tipping point, it sort of rises to the occasion.

'There have been no major advances, into the way that the healthcare industry does business fundamentally. The demand is huge now, and the workforce is as depleted as ever. So the conditions for change have never been more needed. And typically, when the health service reaches a tipping point, it sort of rises to the occasion.'

How are you getting user feedback?

Ostmodern: How are you getting user feedback at the moment?

Elliott: We still do lots of user testing, proposition testing before anything goes live, but the best user feedback we get is when we put something live. We have sessions with actual real users. Quarterly we meet with our customers, we try to understand what's going well, what's not going well.

The other way we get user feedback is that we actually go and do real world evaluation of what we do. We'll do a qualitative analysis where we'll put out some sort of survey to users and do “before and after”.

They'll say to us, “we think we take this amount of time doing this task, this task” and then post Infinity we’ll ask them the same question. And then you do a time in motion study to kind of verify that. That’s the best user feedback you can ever get. So you actually know how much time you're saving.

As it turns out, people's perception of the amount of time that's being saved is pretty accurate. Always.

Ostmodern: Really?

Elliott: Yeah. How many portering requests do you think are failing? “About half of them”. 42% is what it turned out to be.

How much time do you think you're saving? “Oh, about an hour and a half per shift”. 91 minutes is what we found out. Like they know! Everyone's acutely aware of their time in healthcare I think.

How did Ostmodern help Infinity Health?

Ostmodern: How did Ostmodern play a part in Infinity Health's journey?

Elliott: Going back to just before we met Ostmodern; internally, we kind of had a realisation that there was an opportunity to solve a front line problem. This is a design problem. A start up could solve it, but it's a design problem. So, let's go and get some money to build a proof of concept and then shop that around the best UX companies in London. And everyone just said yes to me, so I just kept moving up the ladder towards the best.  

I was a huge fan of what had been done with the BBC iPlayer and what was being done with VoD. I had a conversation with Tom and Jody, where I had read about how Channel Four were trying to get 1.2 people watching a show instead of 0.9, and the A/B testing that was being done on the player to determine what would get eyeballs on the next show, and the evidence based approach to product design for products that people wanted to use.

Could you apply that same thinking of “get 1.2 eyeballs on the next show” to getting people out of hospital half a day sooner? The opportunity there for waiting times to go down in A&E. If you can just move the needle by 5% here, you can, like, get tens of thousands of hours back every year. It translates to millions of pounds saved. It's a massive opportunity.

'If you can just move the needle by 5% here, you can get tens of thousands of hours back every year. It translates to millions of pounds saved. It's a massive opportunity.'

That felt like the recipe I wanted in the DNA for Infinity. Everyone realised it was just the best way to build a product that has a meaningful impact. So that's where that's where it began.

Then we thought we understood how to do user centred research until some people at Ostmodern really showed us how to do it; and really looked at touch points, really looked at the way teams were structured and the different hierarchies that exist, and the different ways in which touch points were used. That was super interesting.

'Then we thought we understood how to do user centred research until some people at Ostmodern really showed us how to do it…'

What does the future hold for Infinity Health?

Ostmodern: So what do the next few years look like for Infinity Health? What are the obstacles that you see that might prevent you from being successful?

Elliott: Infinity relies on being able to plug into the health record system and the patient platform and the app you're using and a BI system to move things around and get things done. We would love that to be moving faster, but everything we want to do is doable. It's just much harder than it needs to be or it's more brittle than it needs to be.

As a country, we spend a lot of money on R&D, deploying well over a billion pounds every year on research and development. Very little of that, in my view, goes on adoption of anything that shows benefit. So we spend all of this money showing proof of concept and then nothing to support the adoption of it, just hoping that the innovation on its own will do that. So what typically happens is they either die, these innovations, or they go abroad.

'As a country, we spend a lot of money on R&D, deploying well over a billion pounds every year on research and development. Very little of that, in my view, goes on adoption of anything that shows benefit. So we spend all of this money showing proof of concept and then nothing to support the adoption of it, just hoping that the innovation on its own will do that. So what typically happens is they either die, these innovations, or they go abroad.'

I think the biggest opportunity in the UK is for there to be a shift in how we kind of spend money on R&D and innovate. Things like Infinity showed real promise very early on in proof of concept. It could have been given a push.

There's no money in the UK in the health service right now, that's creating a huge vacuum. I think systemically it needs to take a completely different approach to innovation. It needs to industrialise it in some way, test things out, really understand them, and then adopt them broadly. And support UK businesses or all international businesses that solve problems for the NHS. That's great.

What does it take for healthcare products to get to market?

Ostmodern: Let's talk about some of the successes that make it to use. What’s unique about those things that we can learn from?

Elliott: Oh, there's yeah, some very, very clear things. So they're essential. 

There's been very few, but the product-led successes have focused on video consultation at the very beginning of the pandemic. Then they focused on vaccine booking, and they executed really well. They published their road map in a digestible format for their users, so they knew what was coming. They demonstrated huge velocity in delivering features. They prioritised around “what are the biggest pain points for our users?” and “let's solve those now”. It built an enormous amount of trust with their end users. They had fanatical support.

These are the things, like being genuinely user centred, that have led to the biggest successes and the most meaningful changes in the way healthcare is done. To make change in health care you're going to have to really understand the staff, or the patients, or the interaction between them, and then solve for that and in a very complex system. I think that's a design problem and all of the approaches to distilling down user behaviours, and then measuring the impact you have, was very foundational.

 It really was very foundational with the work we did at Ostmodern for Infinity.

How will data impact the healthcare industry moving forward?

Ostmodern: How will data impact the healthcare industry moving forward do you think?

Elliott: The problem we have in the UK is that all of our data is in silos, right? We think that the NHS has our data, but they don't. A GP practice, a computer, hardware, metal has your data on it in one GP practice and a hospital might have a bit of another record over here. Very little of this has been connected.

'The problem we have in the UK is that all of our data is in silos.'

There is a big initiative with something called the Federated Data Platform, the vision is that it will get adopted and will be able to monitor where everybody is in their care pathway. And then off that you'd be able to hang things like Infinity that can then get some tasks done.

What we're going to do with data, is we're going to be getting much better at predicting population health. So the needs of any given population, for a given region, will allow you to do a smoking outreach campaign here or increased breast screening over here for whatever reason because of the density of a type of population. So you can really do great population health management with good data and good prediction. Then the dream of data in health care is the individualised precision medicine, AI generated drugs just for you, Kat, to make you better, because it understands you and your biome and whatever else. That seems a little further off in my view.

I think the more mundane uses of data are much more interesting to me. Kind of like knowing, because you've been admitted for this particular thing, I know that you need a sepsis assessment, or a VTE [venous thromboembolism] assessment done in this amount of time, so I can create a task. And I can make sure that happens 96% of the time instead of 82% of the time, which might be once every three years to save a [patient from] DVT [deep vein thrombosis].

Takeaway - Risks of risk aversion

Product design and development in healthcare has inherent risk. The key challenge is about weighing it up. Risk is either genuine or perceived and impacts different areas of the healthcare service differently: patient risk, operational risk, security risk or staff risk, some of which have very real and very serious consequences if something goes wrong. 

Current shortfalls in public healthcare such as delays in urgent treatment, discrepancies in the quality of regional care and poor staff working conditions leading to burn out, pose very immediate and very serious risks to patients. 

Better digital products in healthcare like Infinity Health, can work to decrease risk, by reducing staff time spent on administrative tasks, increasing data sharing to improve and standardise treatment, or even personalise treatment based on individual needs. 

Risks in healthcare need to be taken seriously, but there is a compromise that needs to happen in order to address the very active risks in services right now.

Healthcare industries need to invest more in the trial and implementation of digital product solutions beyond R&D, where there is massive scope and opportunity to improve (saving lives and money). They must accept that some short-term issues may come from digital change, but these can be managed and will likely outweigh the harm caused by doing nothing.

Product teams must ensure they quantify service impact to staff and patients, as well as to the overall business (time and money saved). They need to follow an iterative process to manage risk incrementally and be evidence-based, so that staff and patients are central to all product decisions.