A view from The Hill
4 December 2017
Digital health & innovation Health Services Research
Sociologist Alex Rushforth from the Nuffield Department of Primary Care Health Sciences, recently attended Oxford’s annual digital health pitching event, The Hill, for the first time. Here’s what he made of it.
Last month, a crowd composed largely of medical technology enthusiasts in the Oxfordshire area converged on Oxford University's Andrew Wiles Building for the annual digital health technology showcase, The Hill.
For those of you who are unfamiliar, the format of The Hill is reminiscent of TV shows like X-Factor and (especially) Dragon’s Den. 30 presenters each have only one minute and one slide to pitch a health app or device they have been developing (as individuals or part of a team). Following each presentation, the floor is opened to cross-examination by judges selected from sectors including universities, NHS, and industry. At the end of it all, the audience is invited to vote online for the winner. Those voted in the top-three are awarded prizes of £1000, as well as a period of one-to-one feedback from local technology consultants.
The Hill provides a fascinating insight into the multiple dimensions which can make early stage medical technologies interesting and attractive to investors.
One of the first things to say about the event is that I had a lot of fun – not a word one would always instantly associate with medical technology events. Like Dragon’s Den, The Hill turns entrepreneurship into a spectacle: spotting future talents and game-changing products becomes a game in which we in the audience are actively encouraged to participate by voting the winners. Aside from having a good time, as a sociologist interested in the (often failed) promises of medical technologies, I was struck by how effective the format of this event was in laying bear common problems and pitfalls of early stage medical innovations.
So what lessons might participants in The Hill 2017 have taken away about the qualities needed to make it as a med tech entrepreneur, and conversely, the factors that can leave so many promising ideas rooted in the starting blocks?
Lesson one: med tech entrepreneurship is an unforgivingly competitive world
The fact that the event was structured as a competition, clearly feeds into the popular culture image of entrepreneurship as a game of winners and losers. In a world awash with digital devices and apps, few will make it into practice and fewer still can expect to become mainstreamed in health systems like the NHS. Thus in a way the entire theatre of The Hill is all about simulating the pressured environment of technology entrepreneurship – where ideas routinely fall at the first hurdle. This was echoed in the closing gambit by head of the judging panel, Professor Sir John Bell, who recommended presenters “always be realistic”.
Lesson two: communication is vitally important
The stringency of one-minute time slots demands clarity and simplicity from presenters. A good “elevator pitch” with a straightforward and potent “value proposition” for the product is essential. In many cases, the strict presentation format made visible another common (unsuccessful) trope of the aspiring entrepreneur, as figures too immersed in technical details to articulate to non-specialists what makes their product stand out. In other words, nerdiness alone won’t cut it.
Lesson three: Attention to detail and carefully thought through business plans are a must
Rhetorical skills are clearly important in this arena, however, the role of judges is to cut beneath slick sales patter and to help voters in the audience think about the viability of the product being pitched. As with Dragon’s Den, the judges directed blunt, probing questions at presenters (“how is this different from existing products?” “how far developed is this?” “what problems does this actually solve?” “who would pay for this?”). In the face of such scrutiny, the individual presenter must demonstrate an eye for detail and a competent business plan, not to mention an ability to think on their feet.
The Hill provides a fascinating insight into the multiple dimensions which can make early stage medical technologies interesting and attractive to investors. Whereas some of these archetypes of the successful entrepreneur may of course be exaggerated and amplified in such an artificial setting, the event nonetheless provided telling insights into challenges of medical tech entrepreneurship which individuals and organisations must learn to navigate effectively to stand any chance of success with their product. Presentations covered an enormously diverse range of apps and devices – from devices helping parents to administer correct dosages of paracetamol to babies, to electronic data support systems for multi-disciplinary team meetings in cancer clinics, to recording devices to help relatives communicate with family members suffering with dementia. This made picking a winner difficult, but for my money some of the more impressive presentations were those which had demonstrated efforts to enrol end-users (e.g. medical professionals, patients or patient families) into co-designing the technologies.
One of the three winners which stood out on the night for me was Forward Clinical, a ground-up innovation offering smartphone-based secure-messaging services for clinicians and patients interacting in the NHS. By collaborating with NHS Digital, the start-up had sought to ensure compliance with the multitude of guidelines governing use of patient data in the NHS. Unfortunately, too many pitches appeared to have neglected co-design principles. Following a largely “technology-push” model, these ended-up offering rather technocratic-looking solutions to complex multi-dimensional problems.
Finally, The Hill offered a useful opportunity for those charged with supporting medical innovation in the Oxfordshire region to reflect on some of the challenges associated with supporting early-stage start-ups. Speaking with various practitioners from the audience afterwards – including patent attorneys, technology transfer officers, and philanthropists – the event clearly flagged and reinforced for them some of the problems with digital health technology pitches that they routinely encounter in their respective trades, with many presenters apparently approaching as “mere afterthoughts” some of the vitally important steps, including how to go about securing venture capital funds and how to approach scaling-up technologies into real-world NHS settings.
As such, one of the questions events like The Hill prompts for intermediaries within the Oxfordshire regional innovation system is how they can continue to support entrepreneurs to “fail better” at developing digital health technologies in the future.