By TREVOR VAN MIERLO
Most of us know the story of the Mannequin T – however what’s typically ignored is the way it applies to different industries, particularly digital well being. Let’s revisit:
Within the early 1900s automobiles had been {custom} constructed. You’d meet with a advisor, design the automobile, place your order, and await months for supply. As soon as your automobile was delivered, it was troublesome to function. Many house owners employed chauffeurs as a result of on the time, automobiles required technical know-how, fixed upkeep, and a good bit of energy (energy steering wouldn’t arrive for many years).
Then got here the Mannequin T in 1908, which led to Ford growing his meeting line in 1913. He acknowledged an issue within the trade and noticed a possibility. He noticed the chance for scale:
- Standardization: “Any coloration, so long as it’s black“
- Mass manufacturing = affordability: Costs dropped from $850 in 1908 to $300 inside a decade
- Accessible possession: anybody might stroll right into a Ford dealership and drive away
On the correct aspect of the above picture is a cutting-edge digital well being program from August 2000. I do know it properly – as a result of I helped construct it. Since then, I’ve labored on properly over 100 digital well being interventions. Most likely nearer to 200. Right here’s the factor: what’s inside hasn’t modified very a lot. Behavioral science doesn’t transfer that rapidly (although my recent work in AI is changing that).
And sure – digital interventions look higher, are simpler to navigate, and coding languages have developed – however virtually, digital well being continues to be constructing {custom} automobiles – not Mannequin Ts. That’s why tens of tens of millions can’t open a browser and get the assistance they want.
What’s Blocking Digital Well being’s Mannequin T Second?
1. Enterprise Gross sales (Dying by Pipeline): Most digital well being instruments are bought via enterprise channels: RFPs, procurement departments, tenders, safety opinions, and authorized groups. The common gross sales cycle is 6-18 months. That’s fantastic for a $5M contract, nevertheless it’s deadly for a $50,000 contract. The issue isn’t the product – it’s the method.
2. The Vanishing Champion: I’ve skilled this dozens of occasions, and I’ve taken deep breaths watching it unfold on webinars: a digital well being firm demos their answer alongside a consumer champion. Priorities shift. The champion leaves. The reference challenge dies. Most contracts aren’t misplaced on benefit – they’re misplaced to turnover.
3. Healthcare Pricing ≠ Software program Pricing: Most patient-facing instruments are priced like providers, not merchandise. That’s a symptom of the enterprise gross sales entice. Distributors cost annual charges no matter utilization. Shoppers count on hand-holding for these {custom} merchandise. Pricing must replicate trendy SaaS fashions – freemium, tiered entry, per-user billing.
4. Static Merchandise in a Dynamic World: Client software program updates weekly – typically day by day. Digital well being instruments? They launch, then stall. Suggestions loops are weak. There’s no tradition of iteration, and no expectation of steady enchancment.
5. No one Markets to the Person: The very best-designed instruments fail if nobody makes use of them. Lack of engagement is a systemic issue, but many applications are launched with out onboarding plans, e mail campaigns, and even prewritten content material for TikTok or Instagram. Customers don’t know what the instrument is, why they acquired entry to it, how they entry it, or the way it suits into their care. That’s not a product situation – it’s a advertising and marketing failure.
We Have to Construct the Programs, Not Simply the Software
Henry Ford didn’t invent the car, however he’s remembered as a result of he constructed a system. He regarded past the engine, the chassis, and the tires. He targeted on standardization, distribution, and entry.
Digital well being wants the identical. Proper now, too many options are trapped in a loop – custom-built for small populations, bought via enterprise channels, with no sensible path to scale.
The Good Information? We’re Shut
Cloud infrastructure, AI, and behaviorally clever platforms are lastly catching up. We are able to now personalize at scale, launch immediately, monitor engagement in actual time, and iterate quick. However to get there, we’ve got to let go of the custom-built carriage mindset and embrace the meeting line. That’s not a compromise in high quality – it’s a dedication to achieve.
- We don’t want extra pilots – we’d like platforms.
- We don’t want extra bespoke builds – we’d like scale.
Digital well being doesn’t have a expertise drawback – it has a supply drawback.
Till we obtain that, we’re simply making nicer carriages – whereas the world waits for its Mannequin T.
Dr. Trevor van Mierlo has constructed psychological well being and affected person help merchandise for greater than 20 years and is the CEO of Evolution Health
