Babylon Health

OVERVIEW
As a digital first health care platform, Babylon Health’s mission is to make high-quality healthcare accessible and affordable to everyone on Earth.  In my role as Principal Product Manager,  I was responsible for lowering the average per member cost  by improving  individuals management of their own health.  I defined the strategy, built the teams and was responsible for execution and executive evangelism. 

SETTING THE SCENE

DEVELOPING A WINNING STRATEGY

I rapidly iterate through each area refining the working output and making adjustments to the others areas. I run through the process making refinements as many times as needed until a clear measurable hypothesis for success can be defined. 

DEFINE THE PROBLEMS
HOW DO YOU GET PEOPLE TO IMPROVE THEIR HEALTH THROUGH BEHAVIOR CHANGES?

To answer this complex question, I broke the problem down into simpler questions and then orgnaized them into categories. Some of those quesitons included things like:

• How much can we influence individuals’ willingness to change their health behavior and what techniques work?

• How do we segment and prioritize members who are at the greatest health risks and thus potentially the most expensive?

• What healthcare concerns/areas where the greatest health and financial impact can be made by changing behaviors. 

• What programs, devices and apps had the greatest success at sustaining health behavior in the past and why? What has been tried and failed?

• What technology considerations need to be taken into account for any solution built within the Babylon ecosystem?

• What business timelines/financial goals will impact solution delivery?

GET ANSWERS - RESEARCH & ANALYSIS PHASE
With the initial questions identified I expanded my research to include areas that would impact my strategic approach.
The areas of research fell into 4 general areas:

1. Psychology of Behavior Change & Effective Models

2. Patient Risk Stratification & Condition Priortization Aimed at Cost Reduction

3.  Business Considerations (technology, fiscal and strategic goals)

4. Market Differentiation, Best Practices & Partnerships

PSYCHOLOGY OF BEHAVIOR CHANGE
To answer the question of influencing changes in behavior, I worked hand in hand with a behavioral psychologist at Babylon. Together we reviewed dozens of academic research articles on the subject and pulled what we felt were the most effective elements from top behavioral science models to form our own Babylon behavior change model. This model became the foundation of how the product and UX teams approached  the experience and product design. This process also uncovered a fundamental flaw in the way Babylon was thinking about digital healthcare as it relates to people in the US.

PATIENT RISK STRATIFICATION  & CONDITION PRIORITIZATION AIMED AT COST REDUCTION
Though our applied science team was working on a patient’s risk score based on a member’s current known health conditions, there was a crucial missing piece as it related to behavior. We could not determine which members were likely to manage their conditions on their own and which weren’t. For this I turned to our Chief Medical Officer and his vast experience managing care teams and he had a suggestion. As it turned out, I was not the first to ask this question. The University of Oregon had spent a good amount of time answering this same question. They had built a program that was not only able to accurately segment patients into four categories based on a person’s skills, knowledge and confidence to manage their health, but also provided appropriate behavior goals based on condition. The University of Oregon’s program was very similar to what I knew we needed. The next question then was do we buy their program, try building our own, or look for partnership opportunities?

BUSINESS CONSIDERATIONS
1. FISCAL, BUSINESS & INDIVIDUAL GOAL ALIGNMENT
Even if I came up with the perfect solution to my business problem, if it didn't help advance the all up business strategy and contribute to the short and long term fiscal goals then the solution would be a failure. As part of this alignment process I met with the executive teams, head of product departments and sales to get their understanding of their take on business strategy/fiscal goals and how their part contributed. This gave me invaluable insight not only into my stated objective, but it allowed me to understand where misalignments in the company existed and where potential strong partnership may be forged. 

2.TECHNOLOGY CAPABILITIES & SDLC ADHERENCE
Next I needed to learn the Babylon platform, its strengths, weaknesses, and  flexibility as well as domain ownership.  I also needed to understand adherence to SDLC processes and where the development org was in its maturity cycle. Understanding the technology side of Babylon provided rough answers:

• Average time to release features - this can be a high level proxy to answer many of the above areas. As it turned out, Babylon had a very long development cycle due to code and domain silos, an overly protracted safety and security review process, as well as a new CTO and VP of technology who were still ramping up on all the issues themselves. This would factor into my build/buy/partner decisions.

• Capacity and capabilities of the current team and an understanding of where the gap exists - The technology team had a large number of open positions  and a very slow recruitment process. This had a significant negative impact on the new product and development teams I was hired to help build.

• Current tech roadmap -this helped me understand the company’s top priority items. This knowledge allowed me to either  tie my  initiative into the planned work or  evangelize items that I felt were of equal importance.  It also helped me understand technology's perspective on the product and how our various platforms did or did not work together.

• Executive alignment - knowing all of this I could test the perception with the rest of the executive team to gauge their awareness and alignment on the obstacles that would significantly impact the roadmap strategy.  Any misalignment would mean I would need to incorporate a level of education into my executive strategy proposal.

MARKET DIFFERENTIATION & BEST PRACTICES
Working with the team - we identified the 15 apps and programs that sought to solve similar problems in healthcare.  The UX team answered the questions of what was and was not working  from a usability perspective and feature set. I focused on the health industry as a whole and analyzed other health care behavioral change programs.

Through this work I had a clear understanding of what had been tried in the industry and which initiative had more or less success and why. When paired with our current app usage, and executive product priorities, I uncovered a critical misalignment, one that would prove fatal if not addressed. It showed that the current product strategy addressed less than 1% of the  population we were presently serving and even further, of  that small cohort, the majority were not the members we should be focusing on for cost reduction.

Finally, I looked at the healthcare industry as a whole, where we currently fit into the ecosystem and where we were hoping to go. With $1 in every $5 healthcare dollars coming from medicare and making up 90% of our present US contracts, legislation would have a major impact on Babylon and potentially the prioritization of features.

DREAM BIG
With an understanding of some of the biggest areas where we could make an impact, it was time to pull the constraints off and dream big. Through a series of collaboration sessions made up of health practitioners, artificial intelligence engineers, UX designers, product and compliance leaders, we worked together to reimagine what healthcare could look like in an ideal future as well as identify solutions for the short term. Working this way allows me to ensure that while  I am solving for immediate  problems everything we build is positioning the company to significantly impact the field going forward.

CREATE A STRATEGIC FRAMEWORK
With opportunites identified and enough of the questions answered, I was now armed with information and understanding to put together a framework made of strategic goals and guiding principles that would inform my product strategy and roadmap.

Primary Business Goal: Lower overall per member cost through improved patient overall health.

Team Missions: Create programs/features that lower average per member cost by increasing overall patients health care self efficacy which positively impacts detection time, preventative illness, and utilization of cost.

Guiding Principles

• Product Guiding Principles

  • Deliver customer and business value every quarter

  • Where others do it best partner or buy and learn from them  so we can do it better in the future

  • Plan for short, medium and long  term impact

• UX Guidelines

  • Personalization and relevance is crucial to success

  • If it’s not easy, it won’t work

• Technical Guidelines

  • Solutions should be built to extend the company’s nascent saas offerings

  • Solutions should be built to create a seamless integration between patients and care provider platforms

  • Solutions should leverage machine learning and artificial intelligence in order to create highly personalized digital  experiences which continuously evolve

  • Digital solutions should Integrates with most common EMR ( Electronic medical records)

  • Stay compliant

DEFINE STRATEGY
With a solid foundation of information and aspiration in place, the strategy almost wrote itself. Through a mix of partnerships, purchased solutions and new feature development, I defined the 1, 3 and 5 year strategy with cost savings projections estimated at an initial 54.2 million/100,00 members year over year.
The strategy was embraced by both the product and healthcare teams. Together we immediately set to work turning the plan into reality.