The Journal of mHealth talks to Tim Davis, Vice President, Digital Patient, ERT, about the evolution of digital health programs – how do today’s programs compare to those of a few years ago, what lessons have been learned and what are the biggest barriers still to be overcome?
Pharma have been investing in digital health programs in recent years. What do they hope to achieve, and has anything changed in the past decade?
With the growing burden of rising healthcare costs, Pharma has been looking at ways to move beyond their role as manufacturers of medication toward becoming healthcare service providers. Digital advances have provided an ideal platform for this, meaning Pharma has been developing digital health strategies with two over-arching aims. Firstly, and always at the heart of what Pharma does, is the goal of improving health outcomes for patients. However, to create a viable, sustainable model for pharma these programs commonly focus on a specific brand with the goal of increasing – or protecting – market share.
Despite almost a decade of trying, a model of ‘successful’ digital health programs is not yet proven. Early programs, for example those focused on simple adherence reminders, have experienced difficulties in providing sufficient value for patients over extended durations. Therefore, the industry has come to realize that to provide treatment optimization, it must improve insights into marketed products, patients’ use of them and the challenges these patients face.
This need is driving a change in the type of solutions we now see, moving away from simple reminder services toward richer, more personalized, patient support programs.
This change is also driven in part by the 21st Century Cures Act, which, for the next 5 years focuses on patient experience and feedback, pushing Pharma to build insight into real-world patient experience to provide better informed research and drive more effective medicines and treatments in the future.
What does pharma need to consider when developing effective patient support programs?
The digital health market is still relatively new, meaning there are no ‘standard methods’ or program types when it comes to developing effective patient support programs. This poses challenges for an industry that traditionally needs to provide a clear return on investment for new initiatives. As a result, programs can stall in concept or in early development phases as stakeholders struggle to agree on clear objectives for these initiatives.
To overcome this, it is important for program stakeholders to identify specific, measurable objectives ― for both the patient population and the organization ― at the outset. Only then can they evaluate possible approaches to meet these objectives and have the greatest impact on health outcomes.
Similarly, it is important to manage the initial scope of the program to limit development timelines and prevent endless cycles of review and refinement. Pharma is increasingly moving towards a minimum viable product (MVP) approach, whereby initial development focuses only on the core requirements of the program. This expedites the route to market launch, saving time and money, and critically, it allows Pharma to gain insights to program usage and impact on objectives that can drive refinements in additional functionalities and subsequent version releases.
There are so many advances in technology: New ideas are being developed on an almost daily basis. How do you determine which technology to incorporate into programs?
By following the process outlined above, Pharma will have identified actionable needs and objectives for their programs. The next step is to identify technologies that could address these challenges. The breadth of technology available is phenomenal, and this presents the opportunity to integrate all kinds of different options – not just medical devices or sensors, but many consumer technologies like voice assistance and smart products for the home e.g., HiveHome can build a richer experience for patients. The key is to focus on how such technologies can address specific patient challenges – Pharma must consider what patients need, not just the actions they want patients to take – so that they remain engaged throughout the program. Finding technology that the patient is familiar with and that fits in with their lifestyle is absolutely key.
What are the biggest challenges Pharma faces when developing patient support programs?
Beyond the complexity of defining patient support program requirements based on specific, value-based objectives, perhaps one of the biggest challenges Pharma will face when developing an effective digital health program is how to scale from small regional programs to large, multi-territory programs in line with regulatory and data privacy requirements.
Early programs used attractive yet very simple apps to test a concept in a specific region, but quickly found that this approach does not scale. There are varied and complex regulations across territories, as well as differing patient requirements for the precise type and form of digital technology to be applied. To standardize programs across different territories requires one single solution, rather than multiple solutions to support and maintain. This necessitates highly adaptable technology, built on scalable foundations that not only manage data in accordance with local standards, but can also incorporate different elements such as regional settings and differences in grammar, punctuation, and date formats.
It’s true that Pharma is currently investing heavily in digital health programs, but in order to develop effective patient support programs, they must take a step back, identify patients’ needs and challenges, and define their programs before they even begin the development process.