Trevor van Mierlo
Most of us know the story of the T-model – but what is often overlooked is how it works for other industries, especially digital health. Let’s revisit:
In the early 1900s, cars were custom-made. You meet with consultants, design the car, place an order, and wait for delivery for several months. Once your car is shipped, it is difficult to operate. Many owners hired drivers because at the time the car needed technical knowledge, ongoing maintenance and quite a bit of power (not reaching power steering for decades).
Then there was the 1908 T Model T, which led to Ford’s development of his assembly line in 1913. He recognized the problems in the industry and saw opportunities. He saw the opportunity of scale:
- standardization: “Any color, as long as it is black“
- Mass production = affordability: Prices dropped from $850 in 1908 to $300 in a decade
- Access to ownership: Anyone can Walk Enter the Ford dealership, drive leave
Starting in August 2000, to the right of the picture above is a cutting-edge digital health plan. I know it very well – because I helped it. Since then, I have been engaged in over 100 digital health interventions. Approximately 200. This is the fact: there has not been much change within it. Behavioral science won’t move anytime soon (Although my recent work in AI is changing).
Yes – digital interventions look better, easier to navigate, and coding languages have evolved – but in reality, digital health is still making custom cars, not Model TS. That’s why tens of millions can’t open a browser and get the help you need.
What’s the T Model T moment that’s hindering digital health?
1. Corporate sales (pipeline death): Most digital health tools are sold through corporate channels: RFP, procurement department, tendering, security reviews and legal teams. The average sales cycle is 6-18 months. It’s a $5 million contract, which is OK, but it’s deadly for a $50,000 contract. The problem is not the product – it is the process.
2. The disappearing champion: I’ve been through dozens of times and took a deep breath in the webinar: a digital health company demonstrated their solutions with the client champion. Transfer of priorities. The champion leaves. Reference item death. Most contracts don’t lose the advantage – they’re lost turnover.
3. Medical pricing ≠ Software pricing: Most patient-oriented tools are priced like services, not products. This is a symptom of a business sales trap. Suppliers charge annual fees regardless of usage. Customers expect these custom products to be handheld. Pricing needs to reflect modern SaaS models – free value-added, layered access, billed per user.
4. Static products in the dynamic world: Consumer software is updated weekly – sometimes daily. Digital health tools? They launch, and then stand. The feedback loop is weak. There is no iterative culture, nor expectation of continuous improvement.
5. No one sells to users: If no one uses them, designing the best tool fails. Lack of participation is a systematic problembut many programs don’t have onboarding programs, email campaigns, and even pre-written content Tiktok or Instagram. Users don’t know what the tool is, why they receive access, how to access it or how to adapt to its care. This is not a product problem, but a marketing failure.
We need to build systems, not just tools
Henry Ford did not invent the car, but was remembered because he built a system. He surpassed the engine, chassis and tires. He focuses on standardization,,,,, distributeand Right to use.
Digital health needs the same. Currently, too many solutions are trapped in the loop – customized, with no realistic approach to scale for small populations sold through enterprise channels.
Good news? We’re very close
Cloud infrastructure, AI and behavioral intelligence platforms have finally caught up. Now we can personalize at scale, launch immediately, track engagement in real time and iterate quickly. But to get there, we have to let go of the custom carriage mindset and embrace assembly line. This is not a trade-off in quality, but a commitment achieved.
- We don’t need more pilots – we need platforms.
- We don’t need more custom builds – we need scale.
Digital Health No technology Question – It has a Delivery issues.
Before we achieve this, we are just making better carriages and the whole world is waiting for its model.
Dr. Trevor Van Mierlo has established mental health and patient support products for more than two decades and is CEO of Evolution Health
