The Clinical Decisions Hiding Inside Your Product
How to stop making clinical decisions by accident
This is Clinical Product Thinking đ§ , a weekly newsletter featuring practical tips, frameworks and strategies from the frontlines of clinical product.
Welcome, friends, this is issue No. 039 of Clinical Product Thinking. This week we're talking about clinical product, and why most health tech teams are still making clinical decisions by accident.
A couple of weeks ago Dani Brightman and I hosted a panel with Dr Anushka Mehrotra, Chief Medical Officer, Doctor Care Anywhere and Dr Yath Prem, Medical Advisor at Flo Health. The topic was how to build safe digital health products and how teams can stop making clinical decisions by accident.
The full conversation is below but the following are some top takeaways from the night:
The decisions that donât look clinical
An easy mistake is to assume clinical product means âthe bit where the clinician signs off.â It doesnât.
A clinical product is anything that meaningfully influences a clinical decision, a clinical workflow, or a patient outcome.
That definition is broader than people expect. It purposefully includes:
The copy on a triage screen
The default option on a dropdown
The order of fields in an intake form
The threshold at which an alert fires
The latency budget for an AI response
The colour ranges on a vital signs display
The reading age of patient-facing content
The fallback when a model returns low confidence
The hand-off between asynchronous and synchronous care
Often these donât read as clinical decisions to the people making them. They feel like product, design, or engineering decisions. But each one carries clinical weight. A colour scheme can indicate normal or abnormal physiological ranges. A default appointment length set for billing efficiency rather than complexity of presentation changes who gets seen properly. An AI response that gets faster but loses contextual qualifiers changes how clinicians act on it.
The role of clinical product is to make these decisions visible as clinical decisions, and to make sure the right expertise is present when they get made.
Why consultation models break
The dominant pattern in health tech is to consult clinicians at the start (requirements gathering) and at the end (sign-off). Everything between happens without them. The panellists were unanimous: this creates gaps where clinical decisions get made by people who donât know theyâre making clinical decisions, and surfaces them too late to do anything about it cheaply.
The alternative is embedded. A medical advisor sitting in cross-functional squads alongside product, design, engineering, and content. It stops being a question of âshould we check with the medical advisorâ because they are already in the room.
This is a cultural shift, not a process change. The test is simple: would a product manager describe the clinician as a member of the squad, or as a stakeholder?
This shift needs leadership to treat clinical product as a necessary function, like engineering or design, not an optional gate. In the companies that get this right, the friction is felt up front in design conversations, not after launch in incident reviews.
The shadow side of conventional metrics
Once the clinical view is embedded, the next problem surfaces fast. Traditional product metrics can pull clinical products in the wrong direction. There is a shadow side of conventional PM thinking in health tech:
Engagement optimisation can create dependency, especially in mental health and chronic care
Retention optimisation can keep patients in pathways or on treatments that no longer serve them
Speed optimisation can strip context from AI responses in ways that compromise safety
Activation optimisation can push patients past consent friction that exists for a reason
Churn reduction can mean discouraging the discharge that should happen
Clearly itâs not possible to run a healthcare product against the same scoreboard as a consumer app and reward the same behaviours.
Clinical product managers focus on different metrics, patient outcomes and clinical safety, alongside the business numbers. And speaking clinical in commercial terms is a key clinical product management skill weâll discuss next:
Learn to translate
Embedding clinical expertise only helps if it can reach the people making the decisions. That requires translation, in both directions.
For example the consequences of clinical risk can be non-obvious for non-clinical colleagues so being able to communicate the significance is a key skill, e.g.
âDouble doseâ â âmoderate harm leading to hospitalisationâ
âDiagnostic delayâ â âweeks of avoidable symptoms, escalating cost of treatmentâ
âInappropriate triageâ â âpatient sent home who needed admissionâ
The reverse translation matters just as much. To frame clinical concerns in commercial language, you have to know what the commercial team actually cares about and speak in their native language.
Accountability without authority
Translation gets you heard. It doesnât get you decisions.
Clinical product needs the authority to block unsafe decisions, because you cannot (or at least shouldnât) hold someone accountable without giving them that authority. If the clinical lead can be overruled by anyone with a louder voice in a launch meeting, then in practice they are an advisor, and the actual accountability sits with whoever made the call.
That doesnât mean clinical product spends its days blocking things. The better posture is pragmatic option-building:
Here are three ways we could do this
Here are the risk profiles of each option
Here is the route Iâd recommend and why
Here is what I would need to be comfortable with the other two
Veto is the backstop, not the default.
Where this is heading
The consensus across the panel is that clinical product is fast becoming a default role in health tech, the way product management itself became default over the last two decades. The companies that get this right now will have an enduring advantage when it comes to building great healthcare.
More in the full event recording below đ
Hiring Spotlight đ
Clinical Advisor at Bolus Health. Bolus is creating the future of diabetes care and Charlie, founder/CEO is looking for a clinician to help make his vision a reality.
Tara Lajumoke at Myora Health is hiring a fractional CMO/Clinical Product person to help create the first version of their product, supporting people with chronic diseases in underserved areas.
Clinical Lead at Eucalyptus. Euc are hiring a clinical lead for new products. This is an opportunity to take an inside look at consumer health done brilliantly.
Join the next clinical product panel đ€
The next clinical product panel on how to build safe, effective clinical AI is on 2nd June. đ Sign up here.
Thatâs all for this week. See you next time! đ
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Written by Dr Louise Rix, Head of Clinical Product, doctor and ex-VC. Passionate about all things healthcare, healthtech and clinical product (âŠobviously). Based in London. You can find me on Linkedin.
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The full 60-minute panel with Dr Anushka Mehrotra and Dr Yath Prem is below. We went deeper on metrics, CSO responsibilities, scaling clinical product as a function, and the human factors thread I couldnât fit into this post.
