Last month I participated in this EyeforPharma webinar along with Christian Isler, Global Head of Solution and Product Development, Pfizer Integrated Health and Mark Wilkinson, CEO of NHS Barnsley’s Clinical Commissioning Group.
If you missed it check out the following recording in which you’ll find some key insights into the ‘plus pill’ approach that’s being taken by the world’s largest research-based pharmaceutical brand, some perspectives from a NHS CCG that represents 38 GP practices and holds the responsibility for commissioning healthcare for the population of Barnsley, followed by my piece on how the pharma industry is rapidly converging to mobile (in ways that are similar to how consumer tech did in the last decade).
FYI My talk/slides starts at the 29 min mark and I participate in some of the discussions at the end.
What does your new customer want?
Your customer is facing difficult times. Patients need more than just a medicine to manage their disease. Time pressured doctors need more help to improve their relationship with patients. Budget constraints are forcing payers to thinking about optimising service delivery and innovative ways to improve health outcomes. Payers, physicians and patients are thinking of outcomes – now is the time to join your customer and move away from focusing purely on the product. Our webinar will give you three points of view of different ways to approach providing value beyond the pill.
Telephone: +44 207 375 7592
Transcript: (29min) I’m going to quickly explain our service. It enables members of the public to have documented mobile video consultations with registered Doctors. There’s an advance fee for this service of £35 per consultation. The process requires Patients to register on our secure website where they top up their account before sharing their personal healthcare record – or they can create this – and then they can use an interactive medical history questionnaire to share the important medical information they have with the remote Doctor before they meet.
That interactive medical history questionnaire has been developed over a period of some 20 years, is the most advanced in the world and is already used by big healthcare companies like Pfizer and after using that Patients also get the opportunity to share any additional information that they feel is important with the Doctor with whom they are going to meet. That can include photos, websites, YouTube videos – all the online content that we’re used to sharing in every other walk of life but here we’re giving you the opportunity to share it with Doctors. The doctor then reviews that information before conducting any necessary research before making a video call to their Patient. The video call itself normally takes no more than ten minutes and this is a time were the Doctor isn’t taking the history because the vast majority of that has already been provided so it’s time that really can be spent trying to guide that Patient. After the consultation the Patient is provided with a document that includes all the information they’ve shared and an action plan from the Doctor that will help ensure the next step the Patient makes is the right one. The service isn’t meant to be a replacement for a relationship with a Family Doctor and we always stress this as that is the best place for you to get your care and we’re not selling prescriptions. But we are providing Patients with information about the prescriptions that they might already be on or they might be considering changing. Our interaction with the Pharmacy normally comes from the report that we produce being shown by the Patient in a retail Pharmacy.
Today’s newspapers are full of this story that Patients would be emailing their Doctors but there’s no provision created in the health care system today – in the NHS particularly – for Patinets and Doctors to be effectively using email. It’s also quite exclusive as there’s not that many people with email in contrast to something like SMS that’s got almost complete penetration in the country. It’s also clear that GPs aren’t set up to be effectively managing an email workload.
It should be clear from companies like First Direct who are winning all the customer service awards for new banking services because they don’t have any face to face over the counter high street business models. We think that as we increasingly try to help Patients generate value from information there are similarly completely different ways to serve these needs and that will involve Doctors being remote, documented and always available to help Patients supplement the normal (office based) care they are receiving. We feel that this is much more preferable than the current efforts to force fit these new opportunities into existing workflows.
This iceberg graphic is something that I discuss at length in my eyeforpharma workshop and it helps us discuss the intricacies of how we’re shifting care. A lot of the work that mobile healthcare enables really will be very different from what we can do in clinics. Think about that the bottom of that iceberg where the big preventative opportunities lie and where by improving access we can begin to address these.
If you want to see where this is happening already look to the successful work being done by retail pharmacies like Walgreens.com. Already it’s causing lots of concern from AMA members who are now complaining that they feel Walgreens are now playing Doctor roles and doing family physician work but really what’s happening is that they are filling a gap because family care providers today don’t have the capacity to follow Patients and this really is a business that can be very well served when pharmaceutical products are extended into services which is really what this ‘beyond the pill’ is largely going to be about.
Essentially the challenge arises because what if you had a generic drug and an app. Would that be better than a branded product without an app? A lot of the nutraceutical and generic companies are leading the innovative efforts in this space and I think that’s going to drive a lot of the key brands to act.
We’re also seeing at Walgreens a focus on being “Happy and Healthy” driving better adherence through a points based reward system and I think again this shows that the services based around bricks and mortar clinical practice set ups aren’t always desirable.
It’s also key to appreciate that essentially everything that should be connected will be. So here’s a smoke/CO monitor – a sensor that you should all have in your home – but now think about what happens when that device is connected. Well it can now tell you if the battery is low (and needs replacement), it can tell you if the battery has been removed, it can tell you that the smoke alarm has been triggered. It could also be set up to automatically inform your local Fire station so that they know there is a problem before the home owners/occupants have even had the chance to raise an alarm by picking up a phone.
If you extend that model to every touch point in healthcare services you quickly realise that devices like weighing scales, blood pressure monitors (eg. these very beautifully designed products by Withings that are selling in record setting volumes through Apple retail stores across the world) and you start realising what these patients are getting is more data, more touch points, more interactions but also with the custom-built apps that are integrated with these devices there’s a whole new opportunity for new touch points with patients.
This is another product which you must check out. It’s the Alivecor ECG case for the iPhone. It literally uses your smartphone to read your ECG! Imagine the opportunities there when you’re trying to monitor Patients with heart conditions. We’ve already shown how it can be used to interrogate the battery and on/off status of an implanted medical device. Normally this would require a Patient to have to travel to a clinic to get tethered to an expensive ECG machine but it’s now happening just in the palms of your hands…
It’s also fascinating to look at the disruption that happens when you start with a read/write approach to Electronic Health Records. Check out ePatient Dave and the work he’s done around his “Gimme My Damm Data!” call for action. What happens if we take a completely different approach and let the Patient create a lot of the information that’s in the EHR?
Patient expectations have changed. This is key discussion point at many of the EyeforPharma events and it’s fascinating to think about what we are doing when we go (as Patients) to the clinic. How are we spending our time? It’s clear that the healthcare experience is very different to the customer experience in other sectors that have been quicker to adopt consumer tech.
Another product that’s well worth checking out is from Telcare. This is enabling new services that are generating some incredibly positive feedback from Patients and Carers and it’s happening because the company have managed to converge a mobile phone and a high quality glucometer. For a Parent with a child with diabetes who heads off to school with very little real incentive to be testing their blood glucose levels there’s a new situation in which readings taken with the device are immediately shared with their Parent. This can transform the way we care because that Parent now doesn’t need to ever call or text their child to remind them to test or to check on their readings. Instead we now have the opportunity to leverage the communication opportunity for much more positive and productive things, for example incentives for the child to regularly test and that can be reward based – for example think of mums sending their child Smurfberries!
As you apply the way these reward based systems work to the wider pharmaceutical world you realise the potential to turn any and all interactions into data and this will inevitably greatly expand the value of remote carers who are experienced in generating value from data.
(…46 min) Lanre Ibitoye: So question for you David, so Pharma is looking to create a Value Added Service for Doctors or Patients using mHealth, do you feel that they can create this by themselves using their own capabilities or do they need to partner?
…I think it’s obviously a disruptive opportunity so a lot of people looked critically at Steve Jobs when he started with the iPhone because they thought it wold destroy iPod sales. While recognising that an iPod in a phone would disrupt the stand alone iPod it was key to see that it could also open up much bigger new opportunities and that’s the key to disruptive opportunities. It’s key to be able to see the future as a bigger opportunity than where you operate today because it’s likely you’ll run the risk of jeopardising your existing product lines. If something has become key to the structure of your business it’s time to do it yourself but not every company can do that. Some companies are already doing this – Pfizer for example have acquired products like MDVIP and Christian (Isler, Global Head of Product and Solution Development at Pfizer Integrated Health) can obviously tell you more about their plans there. Can it be done? Of course but success is determined by your capacity to grasp the disruptive opportunity or if you need a partner to help you do that… …look forward 10 years and we’ll have fallen off the patent cliff and the service opportunity will be key because no one has so far worked out how to continue to bring new drugs to market at anything like the pace enjoyed in the past”