The relentless pace of technological innovation in healthcare means we’re seeing a rapid rise in the number of connected medical devices. Electronic patient health records are becoming the norm. Interaction is moving beyond the computer and phone into voice-activated services like Amazon’s Alexa. Artificial intelligence and big data are set to revolutionise the way we diagnose, manage and treat conditions. Record amounts of funding are pouring into start-ups and established players alike.
But it seems there’s a widening gulf between the promise of healthcare technology innovation and how the industry harnesses it to improve people’s lives today. That’s especially true for those managing long-term or chronic conditions.
So-called ‘beyond the pill’ services often provide a thin veneer of patient utility by focusing almost exclusively on drug-related support programmes, rather than services that use technology and data to give patients an understanding of, and some control over, their condition.
These pharma services have traditionally been added to an existing product to help market it, rather than developed as a core component of the product itself. The internet is cluttered with pharmaceutical ‘support programmes’ named after drugs and offering similar ‘one-size-fits-all’ features: access to phone lines, online resources and tips, medication reminder apps, mindfulness tools, help with pre-screening/application processes and financing, savings cards, and even daily crossword puzzles and games.
This isn’t altogether surprising. Historically, pharmaceutical companies have been poorly suited to developing user-centred services. Their businesses are geared to lengthy R&D-driven scientific product development processes, not creative, agile service design methodologies.
So far, data and digitally-enabled service design from traditional healthcare providers, medical device manufacturers, pharma and health insurers has largely led to isolated islands of innovation. For the average patient, they’re unconnected. Virtual consultations, repeat online prescription deliveries, online health assessments, app-enabled medical devices and mail-order blood tests are all available. But separately.
Patients with long-term conditions will only get usefulness and utility when these services are joined up. But joining growing amounts of disparate data, collected by ever more devices and services across ever more outdated systems, is becoming harder and harder.
Let’s imagine a patient having a common surgical procedure in a private hospital. Afterwards, they’re prescribed drugs and physiotherapy. The combination is the most effective in aiding recovery, but over- or under-exercising in the first six weeks after the procedure undermines outcomes.
Tracking their activity with a device and sending them an alert when it’s under or over recommended levels should be relatively straightforward.
Yet these types of data-enabled feedback loops aren’t commonly available. The design can be simple, but initiating, funding, developing and managing it is staggeringly difficult.
In our example, the health insurer, private hospital, operating surgeon, pharma company, physiotherapist and patient all have a vested interest in improving and tracking the patient’s outcome. Deploying a simple technology-enabled service to do so should be a no-brainer for all of them.
But why would an insurer or pharma company develop a solution that would need to be administered and monitored by a physiotherapist? How would that even work? Which systems would they use? Which other systems would they need to integrate with? Where would the data be stored? Who would own it? Who’d be able to access it and when, and under what circumstances? Who’d be responsible for it? Who’d own the patient relationship? How would revenue or costs be shared? The list of reasons why it’s not going to get off the drawing board goes on and on.
Even in our basic example, we’re not designing around the patient. We’re skirting around the issue. And as an industry, pharma will keep doing that unless it can truly focus on giving patients meaningful data they can use to change their behaviour or manage their environment. Our example uses a simple fitness tracker. But the range of data-enabled medical devices currently and soon-to-be available is quite staggering.
Gathering, storing, sharing, analysing and using all the data these devices produce will be difficult. But that’s what’s needed to ensure the technology improves services for patients and achieves better outcomes.
Organisations close to, or representing, people with long-term conditions already know this, as Janet Allen, Director of Research at Cystic Fibrosis Trust, told us:
“Empowerment is a central tenet of remote monitoring, and indeed every aspect of the research we do. It’s about providing people with cystic fibrosis the tools they need as individuals to manage their condition. Those needs will vary from person to person, but a variety of tools should be available to help people manage their condition to the best of their ability.”
The industry must understand and respond to the fact that improving patient outcomes means negotiating a very complex data ecosystem.
Within this ecosystem, modern service design approaches are far more likely to succeed when offering solutions that integrate with other organisations’ service platforms.
Pharma will need to define the data-sharing and integration protocols and standards to join up services for health and wellbeing, care pathways, connected devices, condition management, insurance funding and healthcare logistics. This is a service platform approach, with pharma taking a leading role in defining the standards for data and technology interoperability.
All that means a fundamental shift in perspective and capability – to developing services with the expectation that you’ll need to develop and share collaboration standards.
The winners will be the collaborators, the true patient-centred designers – the ones who light the way in developing standards of cross-industry protocols, governance and revenue sharing.