So, What Are We Really Solving in Health Innovation?

Insights from OHT Brighton’s October meetup

by Rose Bundock and Kate Prescott

The OHT Brighton meetup on 13 October brought together health innovators at The Walrus to tackle a question that should concern anyone building healthcare technology: are we actually solving the right problems?

Guest speaker Katherine Church, a Digital Health Strategist and former Chief Digital Officer for Surrey Heartlands ICS, came with an uncomfortable statistic: 80% of health innovation initiatives fail. Not because the technology is not good enough, but because innovators fall in love with their solutions before understanding the problem.

The Solution-First Trap

It’s easy to fall into. You have an idea for an app or platform, refine the features, maybe shape the data a little to fit your vision. Then you realise nobody actually needs what you’ve created.

This is the biggest risk facing health innovators today. The consequences go beyond wasted resources. Routes to market become unclear. You misjudge whether anyone will pay for it. And when things do not work out, there is often not enough reflection on what went wrong.

A Three-Step Process for Problem Definition

The session walked through a methodology for getting problem definition right, starting with the Einstein principle: spend 55 minutes defining a problem and only five minutes solving it.

Deep Discovery  

This should take three to four times longer than expected. It means talking to as many people as possible, including detractors who are doing the opposite of what you’re proposing. The goal is understanding context, not just evidence. Key questions include: Who is your economic buyer? What happens if you do nothing? Is the cost of inaction compelling enough to drive change?

Crystallise the Solution  

Only after thorough problem understanding should you start building. When you do, show the evidence, demonstrate clear research on competition, and be honest about where you fit in the landscape.

Positioning  

Be realistic about market penetration timelines. Be clear about who you are solving for. Prepare for counterarguments. Avoid hockey stick growth projections - they do not impress people who work in healthcare. And be careful about overstating cost savings, which often reveals a poor understanding of the system.

Understanding NHS Culture

The discussion highlighted that you cannot innovate in UK health without understanding NHS culture. Most private healthcare leaders are ex-NHS and bring that culture with them.

While the NHS 10-year plan headlines are right (community-focused, preventative, digital) there is no funding or clear strategy to support them. The system suffers from “pilot-itis”, where things get tested but never scale. Task groups meet endlessly without finishing. Repetition is common, but reflection on failure is rare.

Examples: What Works and What Doesn’t

The session included several real-world examples that illustrated the principles:

Fragmented Digital Systems  

People with multiple conditions might need separate apps from different hospitals and surgeries. Someone managing diabetes, heart disease and arthritis could be juggling five or more portals. Many don’t use any of them. Or worse, they think they’re being monitored when their GP has never seen the data because nothing is integrated.

The case was made for a small number of core federated apps at the centre, with primary care as the digital front door.

Lloyd George Digitisation  

This was presented as an example of poor problem framing. The issue wasn’t that patients didn’t want digitised records. It was that the data wasn’t written for patients to view or understand—full of medical jargon and abbreviations. The framing was wrong from the start.

Dementia Care  

In dementia care, the technology won’t necessarily be used by patients themselves. Carers are the actual users. Design for the wrong user and you end up serving nobody.

Success Stories  

Accuryx Telehealth was highlighted as getting it right: simple solution, easy integration, easy adoption. They understood GP workflows, made the tool free initially to build trust, then started charging once they’d proven value.

Blood pressure monitoring at home for elderly populations is another example. Automated tools that relieve burden on GP time while giving patients autonomy. Simple, effective, widely adopted.

The Data Challenge

Discussion around data sharing touched on why it remains so difficult in healthcare:

Technical challenges: Cybersecurity risks, integration nightmares across systems, bias in AI trained on biased data.

Trust challenges: Patient trust is fragile. Shared health records sound good in principle, but who sees what? How is it governed?

Equity challenges: Who gets left behind when we rush to digitise? Some people will never be digital—have we designed systems for them too?

The point was made that places like the Nordics, Israel, and Estonia have made progress, but they’re smaller and less complex. The NHS is a 75-year-old institution trying to retrofit itself for the 21st century.

Should Healthtech Work for Everyone?

This question sparked one of the most thought-provoking moments of the evening. 

The discussion leaned towards no, perhaps it shouldn’t. And that would not be a failure of equity, but a recognition of reality.

Health innovation should be designed for those who want it and can benefit from it. The real equity win is using that innovation to free up capacity so that people who will never engage digitally, or for those it is not suitable for, can access high-quality care too.

Trying to make one solution work for everyone often means it works well for no one. The balance is about giving people genuine choice about digital engagement, designing systems that serve the majority well, and using the efficiency gains to improve care for those who need different approaches.

Women’s Health and Current Opportunities

Observations from the recent HETT show noted that while some specific applications are impressive - like national lung screening programmes - there’s still too much virtue signalling and not enough real collaboration.

For women’s health specifically, the framing of problems still needs work. But there’s growing reason for optimism: powerful networks of clinicians are emerging, women are becoming more demanding consumers, and there’s a ground swell of change within systems. The view was that now is the moment to advocate from clinicians’ perspectives.

Practical Workshop

The evening concluded with a menopause-focused workshop tied to Menopause Awareness Week. Participants worked on better framing problems using the principles discussed: human-centred focus, understanding wider context, identifying economic buyers, thinking about equity and inclusion, and considering system integration.

Key Takeaways

Several lessons emerged for innovators:

• Spend three to four times longer on problem definition than expected

• Actively seek out people who disagree with you

• Identify your economic buyer early

• Design for actual end users, not imagined ones

• Show deep understanding of NHS culture

• Be ready for counterarguments

• Avoid unrealistic growth projections

For the healthcare system itself, the message was about moving from pilot-itis to actual scale, prioritising a small number of core apps over proliferation, and addressing digital inequalities with intention.

Final Thoughts

The core insight: the hardest part of finding the right leverage point is seeing the problem whole, not just the parts.

In a field where 80% of initiatives fail, the ones that succeed take time to deeply understand context, culture and consequences before falling in love with a solution. It takes longer than you want and it’s less exciting than building a prototype. But it’s what separates initiatives that scale from those that don’t.

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Thanks to Katherine Church for sharing her insights with the OHT Brighton community.