Part 2 of our interview with Nearform’s Kurt Milam and Lefteris Paraskevas

Lefteris Paraskevas

“Usually, when we engage with clients we’re very product-focused and outcome-focused. We try to understand what they really want to achieve and to do that we hold a series of discovery workshops.

“We have a process called Ignite. With the client, we go through a series of workshops over days, over a week, over even multiple weeks. This helps us to really understand our client’s requirements and what they’re trying to solve, and then start framing a solution.

“I think our design expertise is really handy at this point. Our designers rapidly put together very high fidelity prototypes, without us building a line of code, and then the clients can start visualising what we were actually building.

“When you have a picture in front of you, it’s much easier to start solving questions like, ‘Do we need this button? What happens if we click here? What’s the process that we will trigger on the backend?’ That starts teasing out some of the technical requirements as well.

“The other thing we are trying to find out early in the process is any technical limitations. This is because not all our projects are greenfield, or not all our clients come to Nearform and say, ‘Here’s a blank canvas, just build something for us.’

“So we try to understand questions like, what systems will we integrate with? What are the key data sources? How are we going to get the data? What are the restrictions? And who are the key stakeholders?

“We feel as one team with our clients. We know who we need to talk to, how our ways of working will be formulated. Then we can start putting some actual delivery teams in place, to execute on the solution architecture or the technical roadmap that we came up with.”

Kurt Milam

“Another thing that’s incredibly important is that the domain is different from a lot of other non-medical domains.

“The doctors are thinking differently. The potential outcomes for failure are catastrophic, potentially leading up to harming a patient. And worst-case scenarios, you don’t even want to think about.

“Something I really appreciate about the teams I’ve worked with on medical projects here at Nearform is that the devs and the DevOps engineers, and the testing engineers we have are good at getting into and really understanding new domains.

“Everyone on the team is thinking together in the same direction. And they’re thinking like a doctor or they’re thinking like a patient. It means they’re helping to come up with suggestions for improving user experience, while keeping patients safe, and still complying with the important regulations.”

Lefteris

“The majority of our projects are very lean on process. They’re focused on agile delivery and working together with a client. We don’t like to operate in a way that the client gives us a list of requirements, then we disappear for three months and come back with a solution.

“We have potentially a domain expert from the client that keeps educating our developers. And we keep asking questions, even on a daily basis, to make sure that what we build is fit for purpose. We just don’t go based on, ‘Here’s a piece of paper. Here’s ten things you need to build. Put on these five buttons.’

“We really try to understand why we’re doing this, and even sometimes challenge the domain experts with some of our expertise. Which is, ‘I know you want to do steps one, two, and three to do this process, but this is not so user-friendly. Because we’ve seen this pattern work in another industry, what do you think about trying it?’

“This brings a first-person perspective into some of the clinical experts, or the doctors that utilise these platforms.”

Lefteris

“One project we were involved in is a global configurable platform for telemedicine, that would allow our client to potentially roll out their service into multiple countries. They can have a local presence in one country, but the underlying technology will be similar across multiple countries.

“As the platform we build keeps evolving, then all the countries of the client will start benefiting from this. So they don’t have to build bespoke custom solutions for telemedicines as they go into new markets.

“Of course, they will have to adjust and configure what we build, as we said, based on legal and other restrictions.

“What we delivered was mobile applications, to offer patients the ability to get telemedicine support. And then clinician applications, to help the clinicians actually access the data, do the consultations with their patients, subscribe medication, and make sure that they can offer top-notch healthcare.”

Developing a doctors portal for a biotechnology research company

Kurt

“We worked with a customer that combines biological markers from blood tests with answers to a questionnaire in order to generate input to feed into a machine learning model that responds with a forecast of how someone’s disease is likely to progress. This data lets doctors know what they should tell patients to do in order to avoid the worst-case scenario, if they’re headed in that direction.

“The customer has a medical device that’s approved by the National Health Agency in that country and they had been collecting information from doctors via paper forms. There were a couple of ways they would collect the data, but one channel was all paper.

“They wanted to switch that around and say, ‘Look, what we really need is a portal for the doctors. The doctors should be able to fill out a nice web form, where all of the input  is validated, and then it comes into the system.’ And they’re sending a refrigerated box to the doctor, that the doctor can put a blood sample in, and send it back to the lab, and all these kinds of things.

“That was a really interesting product we worked on. And we actually worked on the physician portal part of the product, where the doctors and their clinical staff could log into the product.

“They could check on the results of a test. They would get the results back on the platform to see what was necessary. They then had the data available to let them know if they should think about rescheduling tests for some patients. So they could test periodically, to keep an eye on a patient’s condition, to see whether they were getting better or worse over time.

“I’ve gotten some good feedback from the customer, six, eight, nine months down the road, that the portal is being used by doctors to help patients, and the doctors are happy with the portal.

“It’s a great feeling for me, because I know it means there are patients who are being helped by this product we worked on. There are patients who are being given the opportunity to make lifestyle changes that could have a major impact on their quality of life in the near future.

“If you can see that your work may be helping real people in significant ways, it’s a real motivator to do your best job.”

Lefteris

“We built a procurement platform that allows hospitals and other clinics to purchase equipment, especially for ambulances or emergency support.

“The key was the speed of the platform.

“An ambulance driver doesn’t have a load of time to actually go clicking around to shop for certain bandages or anything they need. They want to go to our platform and easily find the product that they know they want to purchase, because it’s usually a recurring purchase.

“They want to be sure they can finish this flow very fast, so they can go back to saving people, instead of spending time on a piece of software.”

Kurt

“Another big one is the contact tracing apps for COVID.

“We built a contact tracing app for one national health agency. That exploded into building customised versions of the app for multiple different countries, as well as for several states in the United States.

“The apps worked with a proximity detector. If you were close enough to someone who later tested positive, you would be notified and advised to go and get tested.”

Nearform

“Thanks so much to both of you for taking the time to talk to us. You’ve given us an amazing insight into what you do, why you do it, how you do it and the positive impact Nearform’s digital health expertise brings to our clients.”