How to Choose a Health IT Technology Stack

Bogdan Blaga | April 12, 2019 | 10 Min Read

Making technology decisions can be challenging in an industry like healthcare where strict regulations apply, security standards are high and technology moves slowly. We've identified 7 core questions your product team should reflect on when choosing a technology stack in order to set your health IT product up for market success, both today and in the future.

Selecting a technology stack is no easy feat. It’s a decision that requires a lot of analysis and long-term thinking with regards to your software product, especially within the healthcare industry where technology adoption has been slow moving and regulation is strict.

We’ve identified 7 questions at the core of choosing a tech stack that will help your product team think about not only the technical requirements of today, but also where that technology is heading to help you integrate with other solutions and ensure long term market success.

1. What Are You Trying to Achieve With Your Product?

It might seem confusing to start a conversation about technology by not talking about technology, but any tech stack you decide to use can quickly become irrelevant if you haven’t properly identified the problem you’re trying to solve and the market you’re trying to address. Technology is never the solution, but rather a means to solve the problem. Try to keep this in mind as you’re making technology decisions; it will keep you humble and prevent you from falling victim to your own biases.

With this in mind, the first thing your team should do is articulate the main goal of your product initiative.

Possible goals of your solution could be to:

  • Optimize workflow within a clinical environment
  • Strengthen the relationship and communication between patient and physician
  • Empower patients with chronic illnesses to manage their conditions at home
  • Simplify the management of clinical trials

Decide on the goal you’re ultimately trying to achieve with your product and make sure it’s well communicated across the development team (so that all technology decisions made are helping move the team closer to achieving this goal) and across the rest of the organization (so that cross-functionally, everyone is aligned on the purpose and value of your work).

2. Who Are Your Users and What Do They Need?

After identifying the goal you’re trying to achieve with your health IT product, take the time to examine who exactly will be using it. Whether they’re patients, clinicians, researchers, or a combination of these, your team will need to learn more about how your users work on a day-to-day basis, the people and technologies they interact with, and where the current solutions they’re using are lacking. This will help you identify elements like:

  • Product features that would be most important to them (ie the ability to do X)
  • Interfaces they’d require or would prefer (desktop, mobile) and where they would prefer to use them
  • Modalities that would make interacting with your application more convenient/efficient (ie. voice)
  • If interface aesthetic or its functionality is most important (perhaps a healthcare consumer would be more engaged with a tool that was visually pleasing, but a clinician just cares if the job gets done)

There are various user experience research methods and techniques that we’d recommend your team use in order to accurately identify the wants and needs of your users. As you’re going through this process, make note of any user requirements you’ve identified that will influence the technologies you use in developing your solution. This step is important to narrow down the choices by eliminating from the get-go any technology that does not support what you want to achieve.

3. What Technologies Will Your Product Need to Integrate With?

As you research your users and recognize the technologies they use within their environment, you’ll be able to determine other systems or applications that exist on the market that your product will need to integrate with. These could include both legacy solutions and/or solutions that have more recently been adopted.

When developing software for healthcare, keep an eye out for any existing electronic medical record software, PACS system, medical devices or even any internal custom patient management software. These might be good candidates to integrate with in order to make it easier for your users to adopt your solution. The last thing you want is for your users to say “Oh, another program we need to use!?”.

How does this translate to your technology choices? You’ll want to consider if there are certain technology stacks that are more suited to help facilitate seamless integration with key technologies you encounter. An important rule of software architecture is to design around change and build abstractions that give you the flexibility to adapt in the future. Apply the same rule in your choice of technologies. Also, think about if the applications you’ll need to integrate with pose constraints that will limit your choice of technology stacks to use.

4. What Are Your Business Constraints?

When deciding on a tech stack, you’ll need to be cognizant of any major constraints within the context of developing healthcare IT solutions that your team may face.

From an industry perspective, healthcare presents a complex regulatory environment, so the tech stack and tools selected will have to allow your team to navigate constraints around HIPAA, GDPR, FDA and MDR. Is the data being transferred or collected within your application private and sensitive in nature (ie. PHI)? If so, your solution must meet the necessary security standards and the technology stack you choose must be able to support the security of that data.

When implementing healthcare software that directly impacts the lives of people, it’s imperative to choose a mature tech stack that allows your team to meet high security and compliance standards. Keep in mind that security and compliance are not always achieved just through technology (physical safeguards), but also through process (administrative safeguards). With that in mind, choose a technology stack that will make the administrative part easy for you. Some things that you’ll have to consider here are the number of packages to monitor for threats, source of libraries, or even availability of thorough documentation.

It’s also quite common in the healthcare space for solutions to be developed partially using a waterfall methodology. This involves identifying all requirements and features as a design input before development starts. However, teams often discover features that should be added to the product or new requirements that should be fulfilled in the midst of development. Keeping that in mind, the technology stack you choose should allow for an architecture that facilitates your team’s ability to go back and make adjustments in order to save time and money. Also, look for the same flexibility in the tools around that particular technology stack.

Because of the strict regulations surrounding health IT and pre-existing organizational processes, time-to-market tends to be a concern. Many stakeholders are usually involved in the development of these solutions, and there’s usually a lengthy process that a new health IT product must pass through before it’s approved (from both a regulatory standpoint and organizational standpoint). These factors often lead to time-to-market being drawn out. Reflect on tech stack options that address your business constraints and have the potential to accelerate your time to market.

5. What Are Your Team Constraints?

Evaluate your team’s strengths and identify where potential talent gaps exist. In some cases, comparable technologies will all get the job done, regardless of which one you pick. When this is the case, it’s best to play off your teams strengths and select the technology they’re most experienced in.

Be bluntly honest with your team’s capabilities. Look at past successful product development initiatives to see what technology stacks were used. This might be a good indicator of where you can start the analysis. That being said, if the outcome of your analysis (based on the questions we address above) shows that you should be using a technology stack which your team doesn’t have extensive experience in, consider looking for development partners that can assist you.

While you are searching for partners, try looking for companies that have worked in healthcare, have navigated the regulatory environment and can appreciate the thoroughness you need in order to build software that touches patient lives. Finding a highly skilled pool of talent to dip into can actually be an opportunity rather than a constraint.

Aside from talent, does your team have the resources to develop and deploy a highly secure solution that potentially must scale, adapt, and be resilient to different sorts of events? Think of the entire picture when making your technology choices, as you will likely need to meet extensive, enterprise-grade requirements as your solution evolves and expands its client reach. The more users your solution has and the more people it touches, the more important it becomes to have a dedicated IT support team to handle issues that may come up after product launch.

6. Where is Technology Moving Within Your Industry?

Of course, when selecting a tech stack for your healthcare solution, you need to understand the technology trends that exist within the healthcare industry and also be aware of where tech is heading in general.

Considering the shift towards IoT and the digitization of services, your team will need to reflect on what tech stacks are going to compliment this shift. Consider selecting technologies that go hand-in-hand with cloud connectivity and enable the development of a mobile-friendly solution.

You’ll also want to be on the watch for new government regulations with regards to healthcare technology. Make sure you’re regularly testing your software to demonstrate it’s compliant and meets industry standards.

A significant shift in the healthcare industry is the notion of care customization. In this respect, collecting and transforming patient data into actionable information to personalize their care is something that providers and pharmaceutical companies desire in order to comply with value-based care model and improve the patient experience.

Machine Learning and Artificial Intelligence play a large role in enabling healthcare customization and personalization. Does your tech stack support AI and ML? Most modern technologies have evolved SDKs and libraries that are going to help you with the integration of deep tech in your platform, but if that is a key differentiator for you, make sure you opt for the technology that gives you the most out of the box.

Think holistically about which software technologies are starting to fade out, which are growing in adoption and which are the mature technologies with a large enough ecosystem and strong proof points. You don’t want to choose a tech stack that is so novel that it poses risk; lean toward something that has been deemed “tried-and-true” and is trustworthy. However, this doesn’t mean you have to go with some old legacy technology. There are great options out there for mature frameworks and technologies that are trending and have a vibrant development community.

7. What is the Impact of Your Technology Decision Across the Organization?

Although it’s clear that once you make a fundamental technology choice, it will impact other parts of your organization, it’s not always top of mind. Even if, depending on how each company is structured, the impact will be large or small, it’s worth consulting with your peers from other departments and bringing their perspectives into the mix.

Think of how the technology stack you choose will affect integration with other departments (ie billing, customer service). Ask your colleagues to find holes in your decision and your thinking. This will make sure that you haven’t missed a critical factor before deciding, plus it will prevent you from falling in the trap of the overconfidence bias.

Don’t Forget to Reassess

Making such a decision can be overwhelming, but with the right framework in place, you can gain confidence and increase your chances of success. In today’s fast-paced technological environment, circumstances can change relatively quickly and as you push forward and develop your product, you might find better tech stacks to address new development challenges. That is why it’s important to periodically measure the outcomes, revisit the questions we’ve outlined today, and be prepared to pivot if needed.

Download the Guide to Developing Engaging Digital Health Software

This 90+ page guide focuses on the intersection of your user, technology choices, and the regulatory environment you face that will play a critical role in the success of your application.

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