A pirate’s bounty

Pirate ship sailing on the sea

Turning the promise of digital healthcare technologies into real business value

Avast ye matey! As we enter the fourth industrial revolution, I was wondering how best we harness the benefits of ‘digital healthcare technologies’ - defined in the Topol Review as ‘genomics, digital medicine, artificial intelligence (AI) and robotics’.

The Topol review is a positive endorsement for how new technology can address the big healthcare challenges of the 21st century. However, whilst we all know innovation is a good thing, we also know that there’s inertia around making the step-change technological leaps that are needed to unlock the real bounty that lies ahead.

This got me thinking on two fronts:

  1. Why do we struggle to adopt innovation?

  2. What can NHS organisations do to embrace and take forward technologies that unlock healthcare opportunities in their organisations?

Amara’s law and the hype cycle

On the first question, maybe our concerns (perhaps rightly so) about how we innovate and adopt new technologies at pace could lie in past experiences, failures of projects or programmes, which then subconsciously impact our thinking and appetite to take risk?

Author and corporate innovation commentator Tendayi Viki suggests a lot of the innovators tend to be impatient people, just wanting to jump in and get started. Such approaches could easily concern Executive boards who will be wary of living up to hype and worrying about failure at a time when health and care budgets are more stretched than ever before.  This is perfectly illustrated by the phrase “Amara’s law”, coined by the American scientist Roy Amara.  

Amara’s law states ‘that people tend to overestimate the impact of a technology in the short run, yet underestimate it in the long run’ (Cox, 2017)

Gartner’s hype cycle (Gartner, Inc. 2019) is one of the modern applications of Amara’s law. This five stage model is an excellent guideline to estimate the different phases new technology moves through before longer-term benefits are realised.

Hype diagram

The hype cycle.
(Adapted from: Gartner, Inc., 2019)

Understanding the steps in a model like this helps to mitigate risk and ensure we’re not working on just any project but the right project. Starting somewhere doesn’t mean anywhere.

Introducing MELDS components
In my search for a framework to help create the right conditions to become successful with AI I came across MELDS.

MELDS was invented and put together by Daugherty and Wilson in their book “Human + Machine” (Reimagining work in the age of AI).

MELDS is an abbreviation for the five components: Mind, Experimentation, Leadership, Data, and Skills (review here https://2021.ai/melds-5-components-ai-implementation/)

These key components are invented for management purposes and should be considered when embarking on an AI journey. However, I believe MELDS can also be a very valuable tool, helping organisations reimagine their business and become more successful when deploying innovative digital healthcare technologies.

In my next blog, I will begin to explore each of the five components with a few additional key pointers for consideration to help you on your own innovation journey.


We know our emerging health systems can’t continue doing the same, with rising chronic and complex demand and budget squeezes. Our Healthcare delivery is built, and generally remains centred, on the treatment of single diseases.  With the number of people in England with 4+ conditions (multi-morbidity) is predicted to double between 2015 and 2035.

As Multi-morbidity increases the likelihood of hospital admission, length of stay and readmission, raises healthcare costs, reduces quality of life, and increases dependency, polypharmacy and mortality our single disease-focused model of healthcare becomes unsuitable. The Lancet (December, 2019)

However, just like The Great Horse Manure Crisis of 1894 where in the late 1800s, large cities all around the world were “drowning in horse manure”, due to their dependence on thousands of horses for the transport of both people and goods. London, for example, had a staggering total of over 50,000 horses transporting people around the city each day. The manure on London’s streets also attracted huge numbers of flies which then spread typhoid fever and other diseases, creating a significant health problem for the population

However by 1912, this seemingly insurmountable problem had been resolved; in cities all around the globe, horses had been replaced with motorised vehicles becoming the main source of transport and carriage. With necessity as the mother of invention the petrol engine saved the day. I believe that the innovative application of digital healthcare technologies - genomics, digital medicine, artificial intelligence (AI), data and analytics and robotics - will save the day for health and care, helping us to creatively respond to the future multi-morbidity challenge our health and care systems face.

Yes, we often overestimate the impact of a technology in the short run and underestimate it in the long run which causes problems and hampers innovation. But following models like the MELDS framework can help smooth out the ‘hype cycle’ peaks and troughs and ensure buy-in from the outset from executives and other key stakeholders.

Finally, in case you are wondering why I used the ‘pirate’ analogy in the introduction: if you are seriously looking to explore and exploit innovation I would highly recommend a recent read called ‘Pirates In The Navy’: How Innovators Lead Transformation by Tendayi Viki  (May 2020). I’ve quoted Viki in this blog for good reason. His brilliant book shows how ‘Intrapreneurs’ can help organisations transform.



Avast ye matey (pay attention or listen) pirates

Deloitte. 2018. The Fourth Industrial Revolution is here – are you ready? Available: https://www2.deloitte.com/content/dam/Deloitte/za/Documents/Consumer_Industrial_Products/za_Global_Industry4-0_Are-you-ready_Report_ZAFinal.pdf [2020, Sept 14].

The Topol Review - Preparing the healthcare workforce to deliver the digital future
https://topol.hee.nhs.uk/ [2020, Sept 14].

Cox, L. 2017. At a glance – Amara’s law. Available: https://disruptionhub.com/glance-amaras-law/ [2020, Sept 14].

Gartner, Inc. 2019. Gartner hype cycle. Available: https://www.gartner.com/en/research/methodologies/gartner-hype-cycle [2020, Sept 14].

Daugherty, Paul, R. Wilson, H, James. Human + Machine – Reimaging work in the Age of AI. Harvard Business Review Press. 2018
https://2021.ai/melds-5-components-ai-implementation/?ref=Welcome.AI [2020, Sept 14].

Viki, Tendayi. Pirates In The Navy: How Innovators Lead Transformation.  Unbound. May 2020 [2020, Sept 14].

Multimorbidity—a defining challenge for health systems https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(19)30222-1/fulltext

The Great Horse Manure Crisis of 1894 [2020, Sept 14].

Intrapreneurs – employees who work on entrepreneurial ideas inside of an established organisation

Director of Business Intelligence