Digital is impacting pharma—big time. But just as the industry becomes comfortable in social and better at data collection, new trends and players are emerging as tech giants such as Google and Apple dip their toes into healthcare. PM360 asked 13 experts about the latest, most important trends in digital, the impact of tech companies entering the space, and how digital can solve healthcare’s most pressing needs.
Today, we stand at a true inflection point in human history. The technological advances in medicine and science combined with the social imperatives that loom large across the globe will transform human civilization. No, it’s not an activity tracker. It’s not a sexy app that fosters a marginally higher level of patient engagement. And it’s not another gimmick that sells yesterday’s technology redesigned in a fancy digital form.
It’s the emergence of Big Data that provides a new view of humanity that is akin to the profound and disruptive changes of the microscope. It’s the emergence of nanotechnology that vigilantly searches and destroys cancer prior to systemic invasion. It’s -omics—from genomics to proteomics—that will map our physiologic world and provide the template for treatment and a path for longevity.
And today, this theory is moving into clinical practice. For example, the joint venture between MC10 and UCB takes the conventional activity tracker and advances it to the next level. The reinvention of the tracker as a dermal patch combined with advanced motion analysis allows a new and innovative way to monitor gate abnormalities and tremor associated with Parkinson’s disease. These data combined with sensor-based dosage modulation allow for superior disease management and quality of life.
Digital health is moving from an “athletic option” to a “clinical imperative” as technology empowers citizens and scientists alike to leverage the vast resources of digital connectivity, human need and robust technology. It’s been said that the next 100 years will see technological advances that will eclipse the last 20,000 years of human history. And with the life expectancy of some girls born today exceeding 100 years, humanity will see disruptive changes that no longer live in the vague future of science fiction, but in the simple span of one human lifetime.
One of the most exciting areas today is telemedicine. With the growth of mobile- and video-based conversation, telemedicine has started to move into the mainstream for acute primary care. It can be leveraged for rapid triage, remote follow-up and expanded post-event education—offering new opportunities for customer value. It also creates a new comfort level for real-time video conferencing to provide patients with information and support.
Behavior-based digital health and wellness support is also a transformative opportunity. A behavior-based framework driven through digital engagement will impact more than just lifestyles—marketers can use it to provide content and services beyond prescriptions.
Another trend to watch: Miniaturization will have a significant impact on how we capture and deliver information. This trend is already driving reductions in blood volume needed for tests and has application for expanded home health diagnostics. For marketers, smaller devices, sensors and screens create new challenges for health literacy while generating opportunities for digital experience delivery.
Digital’s New Role in Healthcare
Digital will play a key role in keeping aging patients in the comfort of their own homes for longer periods—whether through remote digital education, health monitoring or social support experiences. Digital medicine initiatives are also expanding the types and volume of data that can be used to measure patient and population health outcomes. For example, digital sensors are able to provide granular data by tracking motion, anxiety levels and vital signs, providing an increased level of intelligence on remote patients living with chronic and comorbid conditions. This level of data can help drive more personal intervention and be used to engineer innovative services and support solutions.
Consumers today spend more time with digital media than with any other media format. Even more striking, half of the time spent with digital now occurs on a mobile device. No industry is immune from mobile’s impact, including healthcare. In fact, Pew Research shows that 62% of smartphone owners have used their device to research health information in the past year. Furthermore, we are already seeing half of healthcare searches coming from mobile devices.
The average consumer checks his or her phone more than 150 times per day. This constant access to information has resulted in a demand for instant gratification. Doctors no longer have to wait for sales reps to learn about proper dosing and consumers no longer have to wonder what their symptoms might mean—all of these questions can be addressed instantaneously in the palm of their hand. But as quickly as consumers demand information, they are even quicker to swipe it away if it does not provide value.
Providing Value With Mobile
Mobile has created a new challenge (and opportunity) for marketers. Not only must brands be present at the moment when consumers are looking for information, they must also provide value to gain the consumer’s attention—an increasingly scarce resource.
We have seen brands successfully provide value in three ways: Connecting with emotion, education and inspiration. Similac’s “Sisterhood of Motherhood” campaign (bit.ly/1GCgDZZ) pulled at the heartstrings of more than eight million people, and Invokana’s informational treatment video (bit.ly/1BcJ2yK) engaged more than 20 million people in just a few months, while Galderma’s “Band Together Project” (bit.ly/1c5AxyQ) provided inspiration to stand up against bullies. Healthcare brands are starting to realize that being there for consumers is only the first step. Looking forward, the most successful healthcare marketers will be the ones that create easily accessible and valuable consumer experiences.
Technology is evolving faster than the industry is capable of adapting. And as the entire industry attempts to interface with physician and pharmacy technology, the greatest challenge is developing standards that will allow convenient access to services in the provider’s work flow.
Realizing that industry standards take generally a half of a decade to evolve, we need to adapt technology to accommodate everyone’s needs. The phrase “you can’t be all things to all people” is not relevant in the new environment. Fewer sales representatives and more technology seems to be the current trend.
The Latest Patient Engagement Solutions
Pharmaceutical marketing solutions companies are now at the forefront of the patient experience with collaborative patient engagement solutions, including electronic benefit verification (eBV), electronic prior authorization, direct-to-patient prescription home delivery, e-sampling and e-copay savings offers available to the physician during the patient’s in-office experience. The latest, however, is the eBV integrated into the physicians’ prescribing flow.
Even though some practices have visibility into formulary information, they are still unable to accurately determine what the patient’s out of pocket expense will be when he/she arrives at the pharmacy. An eBV service can provide a real-time view of the patient’s co-pay or deductible amount and suggest the appropriate available offer.
With direct-to-patient home delivery options in the work flow, the physician may have the ability to prescribe a treatment and have it arrive at the patient’s front door immediately following the visit. This is just the beginning of a slow evolution in healthcare with an endpoint that relates to the ability to completely engage patients and physicians—and collaborate with payers to jointly obtain successful and measureable health outcomes.
Data has never been in short supply for our industry and pharma has indeed gotten better at collecting and compiling its own “Big Data” from clinical trials, sales and marketing activities. However, the exponential proliferation of new sensors, wearables, apps and devices are creating an explosion of consumer-driven data that pharma hasn’t quite yet figured out how to integrate and leverage in our highly regulated industry.
Along with data analytics, a true fundamental comfort with being customer- and data-driven, and welcoming any and all new sources of data openly, is becoming central to winning in the digital health movement. Having access to data is the first step, but having dedicated, robust analytical capabilities to translate that raw data into insights is the second. Thirdly, and most importantly, is an organizational willingness and ability to act upon those insights orchestrated across all channels and activities in as close to real time as possible.
Lessons Learned From Consumer Tech
No one digital offering will solve all our biggest challenges. Instead it’s using the power of digital foundationally to advance the merging of technology, data and science to transform customer experience and improve patient lives. Digital is at the core of how Uber became a leading car service without actually owning vehicles, how Facebook and Twitter became leading news sources without creating any content themselves, and how Airbnb became the world’s biggest hotelier without owning any real estate. When healthcare companies, and pharma in particular, truly embrace digital and make it part of their DNA to impact all aspects of their business—that’s when true disruption will occur. Customers, be they patients or prescribers, do not “do digital” separately from simply going about their daily lives in a digital world, nor should our industry.
Mobile will finally come to pass in a big, meaningful way—not for the obvious uses in marketing, but for monitoring and to drive better health outcomes. The next generation of mobile monitoring doesn’t look like a phone, a Fitbit or even an Apple Watch. Typically, you won’t see it. It could be a sensor the size of a pinhead inside a pill, as is the case with Proteus’ ingestible pill sensor technology. Or a smart patch that delivers the right dose of Parkinson’s medication when it detects muscle tremors. Or temporary tattoos with embedded sensors that monitor heart, muscle function and brain activity through miniaturized transistors, diodes and resistors, fashioned into wires just a few nanometers thick, each bent into the shape of a tiny meandering river. All these technologies exist today. The question is: How do we best apply them to modern life?
Improving Patient Outcomes Digitally
The central focus in driving down systemic costs of managing highly prevalent chronic disease conditions such as blood pressure, diabetes, COPD, cardiovascular and cholesterol, arthritis, depression or chronic kidney disease is on driving up compliance rates (since they’re mostly generic markets and it’s the cost of disease progression, not the drug that is expensive). The per capita spend on a patient with high cholesterol, blood pressure and heart disease (which is the most common triad found in about 33% of patients with any of these) is around $20,000. When multiplied by the patient population, it’s a huge cost, unsustainable in the years to come. The key lies in addressing compliance and daily lifestyle management for chronic conditions, and early detection of acute onset situations—and miniaturized health monitoring technology happens to excel at both.
One of the biggest issues currently in healthcare is the difficulty of sharing information between healthcare stakeholders. Tantamount to this struggle has been the inability to establish a centralized, connected platform in which all healthcare participants can easily and securely exchange information relevant to patient care.
As local, server-based systems are replaced by cloud-based electronic health record (EHR) platforms, the improved flow of information between providers, patients, payers and pharma will facilitate a dramatic shift in improving health outcomes and lowering costs. With real-time, actionable data available at the point of care, providers are armed with an array of features and initiatives to help them improve outcomes and save lives.
Population Health Management
One such initiative is population health management, which can facilitate clinical decision support interventions when a patient’s care does not meet evidence-based clinical guidelines. These initiatives can also provide unique insights into entire populations of patients, allowing providers to actively track and quantify their clinical decisions. One example would be helping providers identify potentially at-risk asthma or COPD patients, which allows them to discuss treatment compliance.
Additional features to help providers improve care include patient adherence tools and educational materials, prescription reminders, clinical trial recruitment programs and electronic prior authorizations. The versatility and accessibility of cloud-based systems allows for the rapid adoption of new technologies to aid providers.
For patients, increased access to their health records through a patient portal instills ownership in their own health as they are able to review their health information and have a more open dialogue with providers. With the continued adoption of cloud-based EHR systems, the barrier of inaccessible patient health information for both providers and patients will be removed, leading to the ultimate goal of one patient—one chart.
Big Data and digital platforms are transforming the industry as both can be leveraged to help patients, providers, payers and marketers achieve better outcomes and measure results. However, each of these constituents has unique challenges, which require unique solutions.
1. Patients: Patients want to manage their health conditions more effectively. A data-driven digital platform can deliver relevant, customized content to drive behavioral change. This level of engagement drives lifestyle changes and improves medication adherence.
2. Providers: Faced with increasing reimbursement pressure, providers must acquire new patients and increase throughput and utilization. Digital enables hospitals and other healthcare providers to achieve unprecedented targeting and minimize the waste associated with traditional media channels such as radio and billboards. For instance, working with hospitals on patient acquisition campaigns focused on specific service lines.
3. Payers: In light of rising costs and increased regulation, payers need to improve outcomes and reduce medical expenses. A smart digital platform can help insurers and ACOs identify plan members, stratify risk and engage patients during specific health episodes. For example, working with payers to help identify high-risk pregnancies early and intervening to prevent preterm births and prolonged hospital stays. Given that premature births consume roughly 60% of all neonatal healthcare dollars, preventing these adverse outcomes has significant economic impact for payers and employers.
4. Marketers: Lastly, marketers have long wanted to better understand patient journeys and measure the financial impact of their advertising spend. Advances in data science and digital technology are illuminating conversion pathways and enabling offline sales measurement. This type of attribution modeling is taking the guess work out of advertising and helping marketers finally understand ROI. John Wanamaker would have approved.
Until recently, technology was lacking for pharma reps to readily and easily share “live” or dynamic “on demand” national thought leader content with their docs. Pharma reps had to rely on flat detail aids and journal articles to promote therapeutic benefits and risks.
Today, the pharma segment leads most industries in taking advantage of the power of live broadcasts to share critical information with doctors and re-inforce rep relationships. Brand teams recognize the power of experiential marketing through content rich sharing of the latest data and trends and keeping docs and reps local. For instance, by using in-place, high-definition broadcast technology in private dining rooms across the country or leveraging “Green screen” on-demand video productions, teams can improve the attention and engagement of HCPs with dynamic and animated slides.
Pharma reps sit side-by-side with docs and together react to live broadcasts and submit their questions for responses. Live streaming technologies to laptops and mobile devices have dramatically improved, and the production quality of the programs is akin to watching professionally produced television news programs.
Improved Lunch and Learn Programs
This dramatic improvement in broadcast and Internet bandwidth technology has also made “lunch and learn” programs and dinner events with live broadcasts commonplace. In fact, some brand teams offer one or two live broadcasts per month with varying thought leader panels. This could be anything from hosting 20 or more doctors in a private dining room or just sitting with a few doctors and sharing a live broadcast in an office setting on a laptop or mobile device.
Additionally, pharma training departments are also recognizing they can accomplish sales rep training at the local level with similar setups at nearby venues. Not only are savings in hotel and air travel quite substantial, but reps also spend less time away from the field.
The explosion in rich media and digital channels is creating great shifts in the historically conservative marketing ecosystem of the life science industry. Even with the industry-specific compliance, transparency and traceability requirements, digital is unquestionably beginning to displace traditional marketing tactics, with the strategic priority moving to the re-use and dynamic assembly of web content and mobile assets for multichannel distribution.
However, the need to adhere to global Codes of Practice significantly impacts time to market for healthcare products, and this is exacerbated as digital content becomes more complex, sophisticated and much more expensive to produce. It takes a lot longer to verify a website or mobile app than a good old-fashioned e-Detail aid! It is essential that companies seriously re-engineer their processes to facilitate this shift to digital and create a new infrastructure which enables better conversations and collaboration to deliver tactics to the various web, social, mobile and print channels.
Ensuring Digital Compliance
This re-engineering can be swiftly accomplished using modern cloud-based software platforms when combined with specialized industry expertise in managing digital assets along the digital supply chain. In doing this, life science companies can ensure quality and compliance are achieved seamlessly within an approved operating model, resulting in faster time to market, far greater traceability and significant re-use and re-purposing of content around the world, delivering easily quantifiable cost savings.
As the landscape changes to focus on digital delivery methods, a shift towards a collaborative and open working ethos can offer life science companies the potential to reshape their conversation with customers, healthcare professionals and stakeholders at the same time as transforming their own productivity.
Physicians are proactively seeking clinical content online1, presenting an opportunity for pharma to facilitate engagement at the point of care. By providing educational info that’s valuable, within their workflow, or advertising on platforms that do so, companies can evolve into a helpful or even trusted resource. This targeted approach reaches HCPs when and where they are open to engaging with pharma, soothing the sting of restricted rep access. Pharma companies are employing this strategy through both branded tools that assist with the administration of a specific product and unbranded resources that support care for a therapeutic category.
Digital Solutions From Pharma
Brands can help improve medication adherence and patient outcomes while promoting their brand through mobile apps. These tools empower patients to take charge of their health. An example is Sanofi-Aventis’ GoMeals which includes tools for eating healthy, staying active and tracking blood glucose levels. Simultaneously, these apps allow physicians to track patient compliance and behavior to improve care. Other apps such as Merck Medicus provide physicians with access to medical news and resources. Pharma can also engage with physicians on assessment tools that assist with clinical decision-making at the point of care.
Both providers and patients use multiple media formats on a daily basis. Leveraging digital to solve today’s healthcare issues requires pharma brands to use integrated channels that are available on demand when these audiences are seeking information. Brands that can determine which variety of channels will have the greatest value and can balance new technologies with traditional mediums will be ahead of the competition.
1. comScore, New Study on Physician Online Behaviors Shows Health Care Professional Sites Reach 4 out of 5 Physicians, While Electronic Medical Records Show Highest Engagement, 2012. http://bit.ly/1LilgHB.
According to data from the Pew Research Center, 7 in 10 U.S adults track at least one health indicator, and one-fourth of this group used technology to do so. Expect these numbers to skyrocket as mHealth and their respective platforms such as Google Fit and Apple’s HealthKit mature.
As this data deluge is being tracked, monitored and analyzed, it’s providing unprecedented opportunities for biomedical research and drug development. This is particularly true of Apple’s ResearchKit, which already powers Stanford’s MyHeart Counts, an app which allows its end users to better understand their own health data. But its value doesn’t stop there. The app also provides a goldmine of data and access to future studies to medical researchers.
“There’s a new movement in academic research called participatory research, where patients are part of the groups that should be asking: ‘What questions are interesting? What should we test?’” Ida Sim, MD, PhD, Professor of Medicine at University of California, San Francisco, said in a recent Huffington Post article (http://huff.to/1MsOnZO). She added, “the public could start seeing research as something that isn’t imposed on [them], but as an activity that we all do together so that we can learn together.”
In fact, such collaboration may revolutionize the healthcare industry. According to a new survey by Research Now, 46% of clinicians believe mHealth apps will improve the clinician-patient relationship. The survey also found that 96% of consumers believe mHealth apps have the potential to improve their quality of care.
A number of hurdles, however, still remain. The primary concern is mobile security and user privacy. It is of critical importance that data is secure—preventing the threat of cyber-attacks and data theft. Thus, developers must find ways to keep user’s sensitive and personal information safe in order to avoid any friction in the industry’s growth.
Technology has had an enormous impact on the quantity of data collected and with acute, personalized detail. Big Data is not new. But until now, the conversation has largely focused on “BIG” as being the operative word in the term. In order to make an impact, we must shift the focus of the conversation to how the data is curated to create a meaningful effect on pharma sales and marketing efforts. Big Data certainly helps us identify larger trends in any market. However, in pharma, we often focus on very niche audiences. Having the right filters in place is imperative in order to turn Big Data into Focused Data.
Focused Data, Not Big Data
Focused Data allows companies to create smaller, hyper-targeted segments across key condition categories, with much greater relevance. These smaller slices of data allow pharma brands to connect with the right individual to have the right conversation at the most appropriate time, and deliver the most engaging experiences possible. In return, this leads to greater marketing efficiencies and a heightened user experience.
The amount of data available in healthcare will only continue to grow in coming years, especially with companies such as Google and Apple increasing their focus on healthcare. This makes it imperative that companies have a dedicated focus on turning Big Data into Focused Data. The data must have meaningful filters in order to make an impact. For instance, by normalizing data down to approximately 400 data points, you can focus on one condition and/or targeting parameter to reach the most meaningful segments, which is particularly helpful if you are trying to connect with extremely niche audiences.