Friday 19 October 2018,
by Andy Stafford

All pharma companies have now proudly labelled themselves ‘patient-centric’, or ‘patient-centred’, or some other variation of this value that recognises the fundamental importance of the end-user, or ‘customer’ in any other universe, but are they, really?

I went to EyeForPharma, London to find out…

If you don’t work at a pharma company you are probably wondering why this is even a point of discussion? You are probably wondering how they could be anything but patient-centred? And you would have a point, but this is not something that all pharma companies wholeheartedly embrace yet, not by a long shot. That a more holistic (medicine together with valuable services) offering must be provided is, I think, a given, but the full transition to a patient-centered mindset has been slow.

Consequently, patient-centredness is a claim that for some rings a little hollow. One pharma company presented the challenge as one of thirds, where one-third of the company believe it, one-third think it sounds good but practically is a huge challenge (“we can’t talk to patients!”, I hear them cry), and the remaining third that it is just hype!

But, whilst there are challenges, distilling the two days at the Patient Summit to a singular aspiration from those working on all sides is actually pretty straight forward. It’s simply to work together, with a shared purpose, in order to bridge the gap to healthier lives.

Expanding that out a little, I have some key takeaways and recommendations for pharma. The recommendations are also relevant to other organisations with health as a focus. In fact, if you look at this macro scale it applies to organisations, their employees and customers, so the themes whilst specific in places, have a degree of wider relevance I believe- just swap the collective nouns around!

1. Accept, and then embrace that the balance of power is shifting towards the patient.
2. Enable internal change and structure to orientate around the patient.
3. Involve the patient right from the start of the drug discovery process.
4. Think of the patient as a person, not just as a patient.
5. Co-design and co-create the services and solutions that they need.
6. Think patient experience first, not patient engagement.
7. Make it easier for patients to connect with you.

Accept that the balance of power is shifting to the patient

Just like the with the customer in FMCG, the power of social media and other forces is slowly gravitating away from the product, and towards the patient. The power still flows from pharma to HCP, to patient group and finally to the patient, but this is becoming much less rigid.

As the pressure to transition to more outcome based payments for pharma is applied then perhaps patients become the king, as they are front and centre for the industry? Some believe a failure to listen to them will result in poor outcomes and potentially financial penalties. So, instead, embrace this change and listen and learn from patients and strive to meet their needs to create solutions that genuinely improve their lives.

Enable internal change and structure to orientate around the patient

Okay, easily said, but not so easily done. This requires organisational change, which the big consultancies would love to help with, of course, but I believe can be accomplished organically as well as with less financially burdensome solutions. There were some great ideas here to start shifting employee’s perspectives that I’ve listed out below with increasing challenge and complexity:

1. Add a ‘red chair’ to meeting rooms where someone must speak in the interest of the patient.
2. Enable patient advocate ‘missionaries’ at every level and discipline of the business whose job it is to evangelise the patient’s perspective.
3. Bring patients into every part of the business and listen to them; consult them right from the start (see below).
4. Break down silos by creating cross-functional participation in patient work.
5. Implement patient value KPIs at the very top of the business.
6. Consider frameworks, SOPs, policies and standards and operational models that help to guide at every level.
7. …and last but by no means least, ensure/hope/pray that the CEO and leadership are fully bought in. If not, it might be time to organise a petition, or maybe a revolt?

Involve the patient right from the start of drug trials

There are now many examples of companies involving patients right from the outset of drug discovery, bringing them in to help with every element of the design and delivery of the trial. The patient, it is believed, should be able to critique every element of the interaction to make it better for them. Remember, that they will probably be spoilt for choice in some of the big therapeutic areas, so nothing should be off the table for discussion. Apart from the drug itself, of course; this is not a marketing exercise.

Think of the patient as a person with a condition, not just as patient

This was a recurring theme, a constant throughout the two days. Patients are people first and foremost. In fact we all are, or will be, patients or carers or more probably both in our lifetime. We want respect, support, care and love, and not to feel that we’re in an unbalanced relationship, or in one where we might be being exploited. The contracts used in patient interactions were mentioned as just one such bugbear. Patients are not waiting around for your call, they are trying to live their lives, and if you want their input and to produce better solutions for them you will need to take into consideration them and their needs. Further, patients don’t measure their outcomes clinically, they simply care about their ability to live their life. Oh, and obviously, use common language that can be understood by everyone…

Co-design and co-create the services and solutions that they need

This applies to all industries now really. This is about taking a ‘design-thinking’ approach to providing services and solutions. Simply put, if you don’t know what the ‘user’ wants or which of their problems you are trying to solve, you can’t hope to provide solutions that they will actually want to use.

Understanding the patient problems and opportunities requires deep understanding in order to really contextualise the patient’s life; we’re not just talking about the medical aspect, but their personal circumstances, and the broader psychosocial environment. This can all (okay, well, mostly) be accomplished through interviews, workshops, diary studies, observation, and other techniques such as analysis of structured and unstructured data. Capturing the subconscious is admittedly trickier but that is why building a solution should be an iterative, ‘build, test, learn’ process that continually improves satisfaction through collaboration (see my colleague Jules’ post on Growth Driven Design for more).

Note on adherence

If you are thinking of designing a service for patients, adherence is never far from mind here, but be warned you will need to do more than simply engage them briefly to get the information that you need. You will need to have awareness of all of a person’s life, provide support for behaviour change (adapt a solution to the person rather than expect the person to adapt to your solution) and design for the provision of ongoing support. An analogy that was used here was that ‘a dog is for life, not just for Christmas’- a longer term view must be sought.

Consider the wider ecosystem of assets and services that you can provide, and partners that you can work with to provide best in class digital and non-digital services. Awesome digital is, unfortunately, also a bit like a dog, as it needs continual attention!

Think patient experience, not patient engagement

Both these terms sound a little ‘buzz-wordy’ but if you are thinking about how you should be engaging patients, that is good, but it shouldn’t be a one-off. Instead, you should consider how you can design the patient experience. Patient engagement has a sense that it is perhaps not being done for the patient’s benefit, or that it is tokenistic whereas your committing to create an awesome patient experience is a win-win. Be human, demonstrate value, treat with compassion, dignity and respect, listen, give a voice, give control, provide support, and work hard to develop trust.

Make it easier for patients to connect with you

This came up a great deal. Patients want to share the good experiences as well as the bad with pharma, but where can they do it? Where can they go? It’s unclear to them because, well, it is very difficult to get in touch, because pharma has made it difficult. Okay, to be fair, the regulations have made it difficult, but regardless, there is a clear desire from patients but a wall between you. What can be done? What about one place for all patient feedback, staffed by trained medical staff or with live chat (of even A.I. deployed at the frontline)? What about helping patients to connect with other patients? I am not naive enough to think that this is easy, but if the demand is there, and it’s in the patient’s interest, what is really stopping you?

So, it seems, things are moving in the right direction. After spending two days at the patient track at EyeForPharma, you could sense the appetite for change and collaboration in the air.

What is clear, is that companies that fail to adopt a patient-centred mindset will be left behind. And the consequences in a world of rising healthcare costs, personalised care, barely differentiated product, and digitally connected stakeholders, probably don’t bear thinking about.

If you’re just not seeing the benefit of a more patient-centred approach, what about considering the following?

1. Better patient solutions, delivered more quickly will mean more patients accessing value-adding services -quicker!
2. Which means more patients managing their condition and taking their medication, with less burden on front line services.
3. Which in turn means more doctors thinking about your solution for their patients- and patients talking to other patients too (about the value-added services, that hopefully, you have designed for patients like them).
4. Which also means the acquisition of data, learning, collaboration and continual improvement.
5. And a whole lot of love to go around.

I listened and chatted to some amazing people; with patients and carers talking about their experience, their hopes and aspirations, and absorbed all I could from them together with the all the other presentations and discussions, from industry to patient and everything in between. I’m fired up and keen to also help us transition towards a more patient-centred company too.

Working in the healthcare space we see the problems, and get out of bed in the morning to do what we can to help improve lives. Our purpose at Nitro is literally ‘bridging the gap to healthier lives’ which we accomplish by, for instance, closing the gap between Pharma/industry and HCPs, HCPs and patients, and pharma/industry and patients. Working collaboratively with our clients for shared positive long term outcomes we look to create a win, win, win for the patient, for our client and for us.

If you’re looking to see how you can build a path to future health for people why not get in touch with us?


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