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The changing role of the expert in healthcare: challenges in customer centricity
Precision medicine and the changing role of the healthcare professional
Rise of the patient expert: an interview with Michael Seres
Influencer marketing: what can healthcare learn from other industries?
Smart connections with a human touch
Issu
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PERS
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Perspective – Issue 3 – January 20172
Welcome to the January 2017 issue of Perspective, the Blue Latitude Health magazine.
Blue Latitude Health is a creative marketing consultancy. We offer the vision of a consultancy with the creativity of an agency. Founded in 2003, our combination of heritage, approach and capability gives us a unique perspective in healthcare marketing. It means we’re ideally placed to unlock the potential in healthcare brands today through forward thinking.
At the heart of our work, we try to understand the changing behaviours and needs of all the stakeholders — healthcare professionals, patients, carers, payers, and regulators — within the healthcare ecosystem. We then design campaigns and services that genuinely engage these stakeholders, changing beliefs and behaviours to deliver better health outcomes.
At the beginning of each year, we take a look at the trends and key topics for healthcare and pharma for the year ahead. In 2017, rather than touch lightly on ‘top trends’ for the year, we’ve taken a deeper dive into an issue that is going to have a profound, lasting impact on the industry: the evolving role of the expert in healthcare.
In this edition, we explore how advances in technology are influencing the future of the expert-patient relationship and the role healthcare businesses can take in supporting and enhancing these interactions at the point of need.
In this issue, we’ll cover:
• How the role of healthcare professionals is affected by the advancement of artificial intelligence and supportive technologies
• The rise of the patient expert and the systematic barriers to innovation in healthcare• How influencer marketing can help healthcare and pharma organisations to better reach the right
customers in new ways• What the changing role of the expert relationship in healthcare means for patients and customer-centricity• How precision medicine is shaping the evolution of what it means to be a healthcare professional in the
21st century
We hope that the articles in this magazine provide thought-provoking insight around the changing dynamic between the patient and the expert. And if you would like to find out more about how Blue Latitude Health can help your brand reach and engage with your customers in innovative ways, please get in touch.
Simon YoungDirector and Head of Commercial, Blue Latitude Health
Letter from the Editor
Contact Blue Latitude Health:General enquiries: [email protected]: [email protected] you can give us a ring at +44 0 20 3328 1840.About Blue Latitude Health:Blue Latitude Health is a creative marketing consultancy. We offer the vision of a consultancy with the creativity of an agency.Founded in 2003, our combination of heritage, approach and capability gives us a unique perspective in healthcare marketing. It means we’re ideally placed to unlock the potential in healthcare brands today through forward thinking.Learn more about what we do at: http://bluelatitude.com
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Contents
Writers this issue
Smart connections with a human touch 4The changing role of the expert in healthcare: challenges in customer centricity 8Rise of the patient expert: an interview with Michael Seres 12Precision medicine and the changing role of the healthcare 15Influencer marketing: what can healthcare learn from other industries 18
Liz Inskip is the internal Content Marketing Manager at Blue Latitude Health.
She looks after our content strategy, how we use marketing automation as a business, and is the editor of our blog and Perspective magazine. She also supports the business development team through the creation of content and digital marketing campaigns.
Liz has over five years’ experience working in digital content creation and campaigns across a range of industries.
Simon Young is Head of Commercial at Blue Latitude Health.
His passion is identifying the needs of our clients and their organisations, and working collaboratively to design projects to solve those challenges. His expertise lies in strategy, driving multichannel transformation, and capability development in complex organisations.
Simon has partnered with a huge range of clients in over 30 markets in the last 10 years, developing a truly global view. He has been with BLH for 13 years.
Elisa del Galdo is Head of Customer Experience at Blue Latitude Health.
Her focus is on helping our clients’ projects benefit from the best in user-centred design practices and strategic customer experience thinking.
Elisa has over 20 years’ experience as a UX practitioner in over 20 countries working for clients such as Lilly, Nuffield Health, and GSK.
Ditte Funding is an Associate Consultant at Blue Latitude Health.
She supports our strategic consulting team in the development of tactical plans and recommendations for a rapidly evolving therapy area. She comes to BLH after obtaining a BSc in ‘Bioprocessing of New Medicines’ at University College London, where she gained expertise in the manufacturing of biologics and cell/gene therapies.
Corinna Grillo is an Account Director at Blue Latitude Health.
She is responsible for overseeing an immunotherapy oncology brand with an agency of record client, employing a uniquely proactive and collaborative approach to account direction.
Corinna has over six years of experience in the healthcare industry, gained in three countries, giving her an international view.
Perspective – Issue 3 – January 20174
Technology is changing the fabric of our society. The way we build, maintain and benefit from relationships is dramatically evolving through the emergence of new technologies. This has an enduring impact on how we seek information, guidance, and specifically, how we interact with those who influence our decision-making process. In healthcare, the connection between the patient and expert continues to be a pivotal part of the patient experience.
Simon Young, Director at Blue Latitude Health, discusses how advances in technology are influencing the future of the expert-patient relationship and why healthcare businesses must evaluate how best to support the future role of the expert.
Technology as an enabler of change in the patient-expert interaction
The evolving health ecosystem is shifting the onus of healthcare from the expert to the individual. For some years now, there has been a growing emphasis placed on patient involvement in critical decisions about their treatment and in the provision of healthcare more broadly. Today, shared decision-making is becoming an intrinsic part of consultations, revolutionising the relationship between the healthcare professional (HCP) and patient. Furthermore, health and wellbeing are becoming an ever-closer union. Access to technology is improving our understanding of health, but can also enable us to monitor and adapt our own behaviour to achieve self-determined health goals. Greater visibility and control over our own health status is now driving an unprecedented level of individual accountability.
With greater democratisation of healthcare around the individual, there is a growing recognition of the patient as experts in their own right. This expertise reveals a much-needed perspective on the patient experience, offering vast potential to transform disease management and directly impact outcomes. The patient expert has emerged as a major influencer, not only within individual
treatment pathways, but also across the broader healthcare landscape.
It is more important than ever that HCPs are able to work together effectively to realise the benefits of increased patient involvement and participation. Integrated workflows should support individuals from diagnosis to decisions on treatment, through to ongoing management. Healthcare professional teams are multidisciplinary by design, however there remain significant challenges in establishing a truly integrated model. Nonetheless, with strong policy and technology drivers, professional groups are now driving more collaborative approaches to working across disciplines and across physical spaces.
These forces are mobilising healthcare provision closely around the individual with networked support from experts. There is no question that technology will continue to act as an enabler of change in the interaction between experts and patients. But to identify the biggest opportunities, we need to also understand how consumer behaviour is evolving in a technology-driven world and what impact this is likely to have on healthcare provision.
Consumer behaviour demands more connective, immersive, and personalised experiences.
The way in which data is consumed online is changing rapidly. The volume of rich content consumed on a daily basis is growing fast, firing across social networks at rapid speed. The time spent watching video content online
Simon Young, Blue Latitude Health
Smart connections with a human touch
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has exponentially grown between the first generation to grow up with the Internet and the millennial generation. Not only is consumption increasing, we share data far more readily as well. Sharing experiences, ideas and personal information has become a mainstay of our relationship with technology. But this comes with greater expectations. Whilst consumers are more comfortable with the idea of sharing their own data across networks, there is an increased understanding of the inherent value this holds for brands and technology providers. Sharing data is therefore just one part of a transaction. Consumers expect that improved services and experiences should result from this exchange.
With the growing sophistication of user interface (UI) design, technologies which cross both virtual and physical environments along with rapid and influential online interactions, there is growing demand to drive one’s own consumer journey. I can fully determine and drive my own consumer experience to meet personal goals using technology, where needed, to guide and support my interactions, decisions and actions. For healthcare, this includes access to the most pertinent information and guidance at critical points throughout the patient journey and decision-making process.
But what does this all mean for the role of the expert and, specifically, the relationship between the healthcare professional and patient?
The value of experts in healthcare is in providing
scientific and clinical understanding through a human connection. It is respect for their role and status that provides much of the credibility to the interaction beyond the pure science alone. Technology is already proving its ability to enhance and also extend this interaction to moments where a person-person interaction is not possible.
The big four: emerging technologies that could transform the role of the expert in healthcare
1. Smart supportThe use of artificial intelligence to provide
automated, intuitive support at the point of need has the potential to dramatically alter the expert-patient relationship. ‘Smart bots’, or conversational UI, is a text-based interaction where systems ask the user questions and learn to predict their needs, serving up the most relevant content in order to support desired actions. This technology is already receiving high levels of investment by leading tech providers. Google promotes a smart bot as a key feature within its new smartphone, Google Allo, and Facebook uses one to bolster its messenger service. Conversational UI aims to directly meet
But the real potential of emerging technologies is to provide real-time expert support at the point of need, delivered with scientific credibility through a humanised experience.
Perspective – Issue 3 – January 20176
an individual’s needs based on understanding the user through a history of interactions. But to be successful, the process needs to feel authentic. In other words, the connection must feel human.
Applying this technology to healthcare could be revolutionary. It could bring the expert directly to the point of need, extending consultation support outside of the clinical setting, delivered in a responsive and empathetic manner. Tone is absolutely critical in healthcare and any such service would need to mirror the credibility of the expert whilst providing the human touch. The first strides are beginning to be demonstrated within healthcare with the launch of Your.MD, an application-based service which asks questions around symptoms, determines probable disease areas and serves up the most relevant, clinically credible content direct to the user. The future of smart bots is to dramatically reduce our dependency on a screen interface altogether, relying instead on voice-activated support.
2. Immersive connectionsAugmented reality (AR) is already a highly
popular concept among smartphone users. As our physical and virtual worlds continue to merge, technology that helps us bridge the two will become increasingly important. Within days of launch, Pokémon Go had surpassed daily time usage of Facebook, SnapChat or Twitter by the average iOS smartphone user. Businesses across all industries are scrambling to determine ways in which this phenomenon can be used to meet consumer needs. In healthcare, AR is already proving to be highly valuable when it comes to patient education, helping individuals to explain symptoms better and improve overall communication during consultation. EyeDecide is an application, which has demonstrated this by simulating the impact of various eye conditions using the smartphone’s camera. Using this application within consultations has allowed ophthalmologists and patients to understand each other more effectively through visual means.
AR also has the potential to support self-management and self-administration of treatment. While Google Glass itself was abandoned as a product, its development led to a large number of trials using the technology. In one such case,
a company known as Small World in collaboration with the Australian Breastfeeding Association successfully trialled Google Glass to support new mothers breastfeeding their infants. When it comes to decision-making, using AR can improve the way in which patients understand treatment options, how they work, and potential outcomes. In fact, AR changes the conversation altogether — supporting expert-patient consultations by creating a common language, a way of understanding, that can be shared and thereby strengthen the relationship.
3. Crowd powerEarly adopters are becoming a thing of the
past. Rapid sharing through the connectivity of online communities and social networks means distribution and adoption of new ideas and experiences occurs at lightning speed. These highly networked groups are generating huge amounts of data, and within them emerge organically grown peer influencers. Such communities have already proven to be powerful in healthcare. Health Unlocked is a UK-based social network for health providing peer-to-peer support across a large number of disease areas. The platform enables even niche groups to easily form an online community to talk about their experiences of conditions, symptoms, treatments, and health services.
These types of communities have been significant in amplifying the voice of the patient and driving forward the notion of the patient expert. The value of these communities to healthcare businesses is enormous — both in proactively and intuitively harnessing insight, as well as testing concepts with those who have direct experience. Within the power of these networks, there is also a unique opportunity to bring together peer influencers and experts to organically grow and sustain healthcare knowledge within communities.
4. Industrialised analyticsAnalytics has long been a focus in technology,
and forms the building blocks to improving customer experience. As Christina Ho, Deputy Assistant Secretary at the US Department of the Treasury stated recently, “data is the only resource we’re getting more of every day.” Obtaining large volumes of high quality data is now a reality. However, for many businesses, turning raw information
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into practical insight remains a challenge. Across all emerging technologies, there is vast potential to draw rich data about behaviours, attitudes, and experiences. To fully exploit this potential, businesses must first revisit their current data practices and look to evolve these through building internal capability and developing new governance, infrastructure and models. Advanced methods of interpreting data — including visualisation, machine learning and cognitive techniques — can also help identify hidden patterns and relationships, where the true value of insight is found.
The expert-patient relationship is changing — creating an opportunity for healthcare businesses
Emerging technologies have the potential to strengthen the relationship between the expert and the patient, facilitating ubiquitous access to the interaction, irrespective of space, time and context. For healthcare businesses, the opportunities are vast, but selecting which technologies to invest in can be challenging. Agreeing shared principles, both cross-functionally and at board level, is critical to guide internal decision-making. At the forefront should be the desire to remain technology agnostic whilst laying the foundations for innovation.
This includes consolidating core capabilities within the business — including skills, infrastructure, and experience. The goals of the selected technologies should focus on eliminating the biggest pain points in current patient experience. Finally, investing time upfront in designing effective processes, which enable all stakeholders to experiment and learn quickly, will ensure that any financial investment will not be wasted.
Information and social connectivity remain at the heart of our technology-based needs. This means finding innovative ways to bring personal support and guidance, in a human connection, to where you are, when you need it. It includes harnessing the power of a network of experts across disciplines and geographies to provide scientifically credible and holistic insight. Importantly, it means leveraging experts to grow knowledge and capability organically within communities, driving constant improvement in our understanding of our own health.
At Blue Latitude Health, we have a deep understanding of how to map and leverage the experts that matter to you. Get in touch at [email protected] to discuss how we can help. ■
Keep it human: can technology replace the human touch? Corinna Grillo, Blue Latitude Health
In recent years, the temptation has been to say that the interaction between physicians and patients is critical, that the expert-patient relationship should always stay ‘human’. However, we’ve already seen a dramatic change with the introduction of digital companions like Jibo or Buddy, who are designed to support patients in a variety of ways. They can remind a patient to complete a list of tasks or take their medication, or make it possible for someone with mobility-restricting health conditions to virtually visit with family via video call.
Another example is a robot called Pepper, who is placed at the reception of
a Belgian hospital. Pepper understands different languages and is able to detect if it is speaking to an adult or child. It can also accompany the patient to the right place in the hospital, which is surely a huge help for some patients.
And with integrated technologies like video calls, we are replacing in-person interaction with virtual interaction to improve efficiency and give patients better access to healthcare professionals. We carry experts in our pockets now with smartphone apps like Babylon Health and Vitality GP.
While a virtual presence might be the right fit for routine catch-ups and
minor consultations, patients still have a need for human interaction where tests and treatments are concerned. So there is certainly still a place for in-person interactions with healthcare professionals — and we should aim to keep them.
The use of supportive, ‘human-like’ technology, where the aim is to assist patients in the completion of everyday tasks, is going to grow significantly. This will mean replacing humans with technology in some cases, but only where it is most efficient to do so and where we think the ‘human’ interaction (being helpful, compassionate, and intuitive) is still preserved through technology.
Perspective – Issue 3 – January 20178
However, when we talk about customers as experts in healthcare, what we’re really talking about are clinicians. Experts in diagnosis, treatment and clinical care (HCPs) and experts as those who experience the medical condition in their own personal context (patients). Both of these groups are vitally important to getting treatment right for the condition and context of each individual patient. This represents a shift in how we view ‘experts’ in healthcare and, indeed, the required shift in the system that services them.
Head of Customer Experience Elisa del Galdo talks through how the evolution of the relationship between HCPs and patients is changing the role of the expert in healthcare.
Mismatched expectations: the flawed HCP/patient relationship
Through our own work with patients and HCPs, we know that there is a mismatch between what physicians are trained to do (treat a condition), and the sum of what patients are seeking from their physicians. Not only does a patient expect to be treated for their aliment, but they also crave a relationship with their HCPs to better understand their condition. They also want to know what they can contribute to their wellbeing, and feel that it is a collaborative relationship. They want to feel
empowered and informed. From the HCP perspective, their role is to
understand the symptoms, diagnose the problem, and treat the patient for a specific condition (or set of conditions) to the best of their ability. Once a diagnosis has been handed down, and a treatment plan decided upon, and the patient is cured or monitored, their job is finished. For a patient, this process can make them feel as if they are a condition with a patient attached, with no needs outside of treatment, and no opportunities to contribute nor have a say.
However, the Internet has provided an easily accessible way for patients to become better informed about their condition and treatment options. It has increased patients’ appetite for more and higher quality information about conditions, treatments, and the actions that they can take to support their treatment. Patients’ access to the Internet not only provides a wealth of information, but is a game-changer in that it gives easy access to people just like them — connecting patient groups via forums and chat rooms to share their problems, concerns, experiences and advice. Here, their personal context is taken into consideration, and they are more than a condition, but without the ability to know which information (or person) is relevant and credible.
The changing role of the expert in healthcare: challenges in customer centricityElisa del Galdo, Blue Latitude Health
Putting the customer at the centre of care has been the topic of many conversations in healthcare for a few years now. From bringing the healthcare professionals who make critical decisions about treatment and care into focus to empowering patients to be more proactive in their care, and implementing organisational change to support it – customer-centricity is here to stay.
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What this mismatch leads to is an inherent conflict in the relationship between patient and HCP; the patient may come armed with information about their condition that the HCP has not seen, and which the HCP cannot verify as credible. This makes the HCP resistant to let the patient into the process, alienating them from their own care. The patient may also ask them questions about alternative remedies, complementary treatments, changes in lifestyle, etc., but this is usually an area that the physician has not been trained in and is not able to consult on. The physician may also be prescribing treatments that, due to a patient’s personal needs or wishes, makes it difficult for them to adhere to. Both situations can result in a less engaged patient.
The rise of the ‘patient expert’: putting conditions into context to enable more personalised care
As patients have access to more and more information about medical conditions, they become a layperson expert not just about their condition, but also how that condition manifests itself within their own context. However, for HCPs, the problem becomes one of credibility and relevance. For example, a cancer patient may come to their oncologist demanding to know
more about a new treatment currently in clinical trials, which has recently been in the news and is showing promising results. The treatment may not be right for the patient, but what is being demonstrated is a willingness to be involved in clinical trials of treatments, about which the physician may know very little.
While this scenario can be frustrating for physicians, and perhaps puts them slightly on the back foot, it can be reframed as the patient engaging in their care and a willingness to be more involved and perhaps adventurous — something that has been documented to deliver better outcomes. And while the patient is not an expert in understanding medical studies and data sets, they are an expert in their condition in their own context, and can contribute to developing a more tailored, personalised approach to treating their specific disease. A collaborative approach to delivering customer-centric care is the future of patient care — but it isn’t without problems.
Barriers to innovation: overcoming the challenges of introducing new treatments and services
As a heavily regulated industry, healthcare is highly averse to risk, and innovation feels risky. How do we provide the best service within a
system that meets the needs of all participants — HCP, patient, care provider and healthcare provider — all while mitigating risk? And how do we best make use of the HCP-patient partnership to leverage the experience of both HCPs and patients?
Part of the solution is developing a deeper understanding in the industry of user experience — how it works, its benefits, and what being truly customer-centric means to an organisation. A truly customer-centric approach includes input from actual customers firsthand (patients and HCPs) rather than opinion, anecdotal information, or assumed input from individuals who are once removed. Incorporating patients as contributing experts, whilst also bringing the diagnostic and technical expertise of the HCP forward is an approach that can enable the innovation of healthcare delivery, treatment administration,
and the tools and services that will deliver better outcomes for patients, healthcare professionals, and healthcare providers alike.
The second half of the solution is to understand that there is no longer a single ‘expert’ in healthcare. Instead, we have a partnership of experts, each with different perspectives, but all driving toward the same desired outcomes:
• Better HCP-patient partnerships
• More time for HCPs to dedicate to patients not systems
• More engaged and informed patients
• Efficient and effective services, tools, and processes
• Reduced strain on HCPs
• Lower costs to deliver healthcare
• Greater disease prevention
• Better outcomes for patients
At Blue Latitude Health, we have interviewed hundreds of patients and HCPs in the development of innovative services to improve patient outcomes and deliver efficiency to healthcare providers. To learn more about how we can help your organisation leverage the partnership between patient and HCP to improve patient outcomes, get in touch with us at [email protected]. ■
Technology as a partner in healthcare: AI and big data for HCPs Corinna Grillo, Blue Latitude Health
Big data and super computers already support several fields within healthcare from drug development to diagnosis. This support is completely reshaping the relationship between humans and technology. For example, when cancer diagnoses by physicians were compared with IBM’s Watson computer, the computer had a 90% success rate where the physicians scored only 50%. This significant improvement allows HCPs to save valuable time to get accurate results and they can concentrate
on the treatment options available for their patients. This is also a good example of how technology can efficiently support an HCP’s decision-making process without affecting the relationship between the HCP and patient.
When looking at the relationship between HCP and patient, it’s important to remember that technology increasingly plays an important role in improving outcomes for both partners.
10 Perspective – Issue 3 – January 2017
Perspective – Issue 3 – January 201712
Rise of the patient expert: an interview with Michael Seres
This issue of Perspective magazine focuses on the changing role of the expert in healthcare, and what that evolution means for the industry. 11 Health is a connected medical device company currently working to change the lives of patients using stoma bags. Founded by Michael Seres in 2011, the ostom-i was developed as a direct response to Michael’s own desire for a better stoma bag.
Content Marketing Manager Liz Inskip interviews Michael about his company, how patients are changing the role of the expert in healthcare, and the systematic barriers to innovation in healthcare.
You’re the founder of 11 Health, a company your website describes as “born in the hospital ward” — can you explain what you mean by that, what drove you to form the company?
11 Health never started as a company, it was a hack to solve a problem I was facing in the hospital ward. I was the 11th person in the UK to undergo a small bowel transplant, and was given an ileostomy as part of the surgery. So when I woke up, I had a stoma bag, and it needs to be emptied regularly to report output to the doctors and nurses. Too much output could mean kidney problems or dehydration, too little could indicate a blockage.
The problem was that the task was incredibly unpleasant; the bags leak and spill. Emptying the bag manually was also time consuming and difficult. My goal was to solve the issue I was having, to test the solution on myself, and show healthcare providers how it could help others.
This issue of Perspective magazine is about the changing role of the expert in healthcare. 11 Health is technology developed by the patient
and for the patient. How has the role of the patient as healthcare expert changed in recent years?
Healthcare is traditionally very paternalistic. It’s the way they’ve been trained — they operate on you, they give you meds, and off you go. It has changed, and the role of the expert has changed as a result of the Internet and the ability for patients to become more knowledgeable about their conditions. It’s not always good, but it’s driving change. You can see this in the e-patient
movement (‘e’ for empowered, enabled, and engaged). It was started by patients as a way
to take more control over their data and healthcare.
This is especially true for patients with long-term conditions; they’re becoming partners in healthcare. It’s now a relationship between the patient and wider healthcare team. I’m a partner in
my healthcare. I’m not more important than my team, but I am of equal value.
There is a movement now toward mutual respect, empathy, trust, and
value. Everyone’s function is treated equally — I will never operate on myself, but the decision to go into surgery is something that I would discuss with my doctor and we would take that decision together. At the moment, I’m having a problem with my anti-rejection meds. I had a three-way conversation about my options with my two
Liz Inskip, Blue Latitude Health
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surgeons, and we decided on a way forward together. That is the changing role in healthcare: patient partnership.
Equal value and equal importance is the future of healthcare.
In your talk at UCD16, you described how difficult the process of getting the ostom-i into British patients’ hands has been. And you’re still not there yet! Can you tell us about what the challenges have been in getting your product to patients?
At the moment, we’re able to conduct trials and have been well supported through our clinical trials. The nightmare is how technology is scaled and paid for. There’s no issue with patients and clinicians — they want the ostom-i — the issue is the overly bureaucratic system, which doesn’t lend itself to scaling technology at pace (getting it out to as many people as possible). There’s no clarity of process. The NHS is riddled with acronyms and departments, but there’s no guide with the rules of the game to tell you what you need to do and who you need to speak to in order to get your innovation into hospitals.
For example, we’ve spoken to Clinical Commissioning Groups (CCGs), Academic Health Science Networks (AHSNs), NHS England, Drug and Technology Tariff, GP networks — and no one can advise how to scale technology that works across primary, secondary and social care. No one understands what the rules of the game are, or how to activate them.
The bottom line is that money matters. Who is going to pay for your innovation, and how is it paid for? We can’t give away our product for nothing, but we do understand that there’s a balance. Cost-benefit analysis is, understandably, a key metric for the NHS. However, there is no route to information around how to demonstrate cost-benefit metrics or what the NHS is looking for in the current system.
We’ve raised investment money in the US, and they (the investors) were dismissive of the UK healthcare system because of the lengthy, complicated processes. I’m not dismissive, I want to make it work here. I was born here, and the idea was born here. It’s hard graft, and we are at least another year away from real progress — we will be able to demonstrate some small wins and gains in
2017, but it will be at least another full year before we can adopt at scale.
Comparing the UK healthcare system to the US system — how has the journey of getting the product into patients’ hands been different abroad?
The big difference was that the rules of the game are laid out clearly in the US. The steps to get FDA approval are clear, and once you’ve worked with Medicare and the commercial insurance companies to define reimbursement, things run smoothly. Commercial payers in the US take their lead from Medicare for the most part, which mitigates the effect of having different state regulations. They use the federal government lead, so if Medicare will reimburse, it’s a good starting point. There are hundreds and hundreds of different plans, so each patient’s co-pay will differ, but getting reimbursement is the key thing.
We achieved reimbursement agreements with both Medicare and commercial payers because the rules were clear, and now we can scale the product and roll-out. Now, our constraints are our manpower and ability to get it out at speed.
Additionally, the FDA is becoming far more open and willing to talk to small, start-up companies about products before they come to market. Whereas, in the UK, you have no idea who to talk to because there are so many bodies in so many places, and no one can give you a decision independently of the others.
A good example of this problem is the recent innovation and technology tariff. A great idea, but the requirements were never published. How technology was evaluated was also not published, so you ended up with scissors being included on a tariff that was presented as something solely for technology.
And finally, you mentioned a movement in your UCD16 talk — #WeAreNotWaiting — what is the impact of a patient movement like this when we talk about how the changing role of the expert in healthcare?
I think what it’s doing is bringing innovation to market at a greater speed than healthcare companies and traditional medical companies can. We (patients) cannot afford to wait.
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I’m the second person to survive five years with my type of transplant. I didn’t have time to wait for medicine to innovate for me. We have to speed up innovation today.
Patient movements are changing the way companies and the system think about solutions. I think people are now starting to think about a solution from an end user’s perspective first. You can see that in Obama’s precision medicine initiative. Personalised medicine is the future, and
it’s based on outcomes. You have to engage the end user to know which outcomes are important to them, and the movement is part of that shift.
Many thanks to Michael for taking the time to talk with us! You can read more about his work on the 11 Health website.
To hear more about how Blue Latitude Health works to drive patient and customer centricity and engagement, get in touch at [email protected]. ■
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How does this change the role of the healthcare professional (HCP) in the patient journey? Associate Consultant Ditte Funding discusses the challenges and opportunities facing HCPs as this new approach continues to take shape.
Moving away from a one-size-fits-all approachHistorically, healthcare professionals have
taken a broad approach to treating the patient population, and most medicines are currently prescribed empirically. In some cases, such as with anti-inflammatory drugs for pain relief, most patients respond positively to these treatments. For other therapeutic classes, such as antidepressants, responses are variable and each patient will respond differently. At present, the treatment approach is to try a number of agents until a satisfactory response is achieved.
Precision medicine is an individualised approach to healthcare that tailors the treatment of each patient through appreciating variability in the genes, environment, and lifestyle of each person. It involves identifying patients who are likely to respond well to a particular agent, both in terms of efficacy and safety.
With precision medicine, the HCP’s role and influence in the patient journey will change. The HCP will be exposed to a much more complex approach to treating patients, greater patient empowerment, and the need to adapt to many new technologies and players entering the medical space. Patients will be stratified based on their differences, and HCPs will be able to predict much more clearly which patients will respond well to which medicines.
However, its success is entirely dependent on HCPs adapting to this influx of change and complexity, and other stakeholders working collaboratively with them in order to enable and prepare them for this new treatment environment.
The rise of big dataA key component of precision medicine is data,
and, in some ways, data can be considered the new currency in healthcare. Big data is what enables this personalised approach to healthcare. It’s through collecting large volumes of data that the potential
impact of gene variability, environment, and lifestyle have on the success of a certain treatment can be tracked. However, in order for it to be useful, HCPs will be required to handle multi-parametric data and possess some ability to decipher “-omics” data.
In the past, medical degrees have not included genetics and deciphering “-omics” data as core modules in the curriculum. This means that HCPs may not be able to correctly read this kind of data and use it to drive positive patient outcomes. We are able to sequence a patient’s genome for less than
Precision medicine and the changing role of the healthcare professional Ditte Funding, Blue Latitude Health
With the introduction of precision medicine comes a fundamentally new way of treating patients. It introduces a new paradigm for disease classification, diagnosis, and treatment. The growth of precision medicine introduces a shift away from treating the population as a whole, to treating each patient as an individual.
Precision medicine’s success is dependent on healthcare professionals adapting to an influx of change, and other stakeholders collaborating with them to enable them for this new treatment environment
How precision medicine impacts the whole treatment pathway
TREATMENT
Precision medicine ensures the right patient is given the right treatment at the
right time.
DIAGNOSIS
Diagnostic tools, such as genomic sequencing tests,
allow HCPs to correctly diagnose patients.
PATIENT MONITORING + DISEASE MANAGEMENT
Remote patient monitoring and wearable tech allow the
HCP to constantly gather data and monitor the patient’s
response to treatment.
PRE-DIAGNOSIS
Through the rise of big data and advanced analytics, at-risk patients can be
identified and monitored.
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Perspective – Issue 3 – January 201717
$1000, and the crucial problem is no longer being able to gather this kind of genetic and “-omics” data, the problem is now that HCPs need to be able to analyse it and action it when presented with it.
Not only will HCPs be required to understand data to identify different patient sub-types, they will also need to adapt to new disease taxonomy. There are constantly new sub-classes of diseases being identified, for example in breast cancer, and how each disease is classified is frequently evolving.
In the space of precision medicine, the HCP needs to stay up-to-date with substantially more data, and they may be ill-equipped to deal with the anticipated complexity and volume of new information.
The rise of patient empowermentIn order for precision medicine to have the
greatest impact on improving patient outcomes, the patient will need to become much more involved in their treatment journey. For example, with the use of wearable technology, patients will be able to closely monitor and manage their disease and gather reams of data for researchers to analyse. This leads to patients being much more aware and having a greater impact on the treatment they receive.
The impact on the healthcare professional is that they have to adapt to a more empowered and active patient. The HCP will no longer have as much autonomy on the final prescription or treatment choice for patients. Precision medicine necessitates a new era of collaboration in medicine, where empowered patients, researchers, providers, and HCPs work together in order to identify personalised treatments that target the right patient at the right time.
The rise of technologyPrecision medicine will also mean an increased
use of technology in the treatment of patients. Technology will be used throughout the patient journey from diagnostics to treatment. In diagnostics, technology will help the HCP to
identify the correct treatment for each patient. For example, using high-throughput sequencing to uncover a patient’s genome. However, occasionally there will be a different diagnostic tool for each treatment or therapy. The result of this is increasing complexity further for the HCP and requiring them to be aware of each of these diagnostic tools, and when and how to use them correctly.
Technology will also play an increasing role in patient monitoring through wearable technology and remote patient monitoring. One example where this is becoming very important is the treatment of patients with diabetes and heart disease. The HCP needs to adapt and be willing and able to adopt these new technologies into their standard of care, in order to leverage the benefits they present.
Precision medicine presents a new paradigm for disease classification, diagnosis, and treatment. It introduces new types of players into the patient journey, and the HCP will have to adapt to a new way of practicing medicine. In order for HCPs to effectively perform precision medicine, they will need a strong knowledge base about the disease, a strong base of real world data for tracking patient outcomes, and the analytical skills to correctly interpret these two bases to match each patient to the correct treatment.
Not only will HCPs need to adapt, but healthcare systems must also adapt to help prepare HCPs for the oncoming change and equip them with the necessary tools to succeed.
Precision medicine comes with the promise of improving the treatment experience for both the HCP and the patient, but only if the needs of the HCP are fully understood. It’s crucial the healthcare industry and pharma remember who their customers are, and help empower them if precision medicine is to become a reality.
To hear more about how Blue Latitude Health can help your organisation to better understand the needs of your customers and the systems they work in, get in touch at [email protected]. ■
bluelatitude.com 18
Content Marketing Manager Liz Inskip interviewed Founder and CEO Pete Longhurst about the rise of influencer marketing and social platforms in other industries, and discussed its possible impact on healthcare sector.
Before we get stuck in, can you tell me a bit more about the work The 7th Chamber do?
The 7th Chamber is a new breed of advertising agency with deep expertise in influencer marketing. The influencer marketplace is still immature but
growing at a frantic pace. As it continues to grow and evolve, the message back from brands is consistent:
1 How do I partner with the right influencers and ambassadors?
2 How do I ensure I am getting return on investment?
Accordingly, we’ve embraced market demands by crafting a rigorous strategic and scientific approach for our clients. This encompasses our
Influencer marketing: what can healthcare learn from other industries?Liz Inskip, Blue Latitude Health
This issue of Perspective magazine focuses on the changing role of the expert in healthcare, and what that evolution means for the industry. The 7th Chamber is a performance-based global influencer agency founded in 2003. The 7th Chamber combines art and science to leverage a powerful network of social influencers across industries and platforms.
19 Perspective – Issue 3 – January 2017
Audience Intelligence Platform which uses social listening and deep data insights to identify target audiences, the most influential brand advocates, and topics that resonate with them.
Our creative teams work with brands to formulate a consolidated campaign activation and content production plan that leverages how selected influencers will engage their audiences, and a distribution plan that optimises across social channels with tailored content.
We then remove commercial risk by guaranteeing campaign KPIs. Rather than paying for individual influencers or content pieces, the client pays for the desired results.
When you look at how influencer marketing and social platforms have transformed the way consumers make decisions, what kinds of changes have you seen, and how can brands leverage those changes?
The advent of social media and rise of influencers has radically changed the path to purchase for all age groups — Baby Boomers through to Millennials. There are so many statistics about consumer trust and how it has evolved. Peer recommendations, word-of-mouth, and reviews from peer experts are all considered more trustworthy than advertising now — and that’s true across all industries. A staggering 81% of marketers who have used influencer marketing judged it to be an effective tactic.
Another less obvious benefit of influencer created content is how people discover it through search engines. This is another real game-changer and a tick in the box for us. Ultimately, consumers invest significant time to research before making a purchase — for FMCG products like shampoo, right through to high ticket items like cars — they trawl multiple reviews, read blogs, and watch an unhealthy amount of user-generated content.
For example, let’s say the product is an over-the-counter medicated shampoo, and it’s been positioned with a few high-impact and relevant influencers. These influencers would create different types of content (vlogs, reviews, written blog posts, social media posts) which usually attract high levels of engagement from their followers in the form of comments, shares, retweets, views, and likes. The search engine algorithms cannot ignore it, especially
YouTube content. Where appropriately optimised using logical, relevant words and phrases, the content and brand conversation is positioned in the prime real estate of the results; directly in the eyeline of your target audience, at a key point in their decision making process.
Something that’s important to remember, though — influencer marketing isn’t all about working with the disproportionately and insanely popular big hitters like Zoella and PewDiePie. Far from it. We favour and rank relevance over reach any day of the week. In other words, we’d recommend a portfolio of small and mid-sized influencers with a more relevant audience for your brand, rather than one person with millions of followers with different interests.
Moreover, research has been conducted which concludes that the level of audience engagement actually decreases with larger influencers. This is why we regularly work with so-called ‘micro-influencers’ who typically have a following of up to 100,000 people. They tend to have a much closer relationship with their fans and followers. They engage in conversations with people who ask questions, they respond to feedback, and they often have a more targeted audience with common interests.
This is important when talking about products that have a more niche target audience. Take the aforementioned medicated shampoo as an example — while a placement with a heavy hitter might reach hundreds of thousands of people from a wide variety of backgrounds, a placement with a more niche micro-influencer will direct tens of thousands of people with a relevant interest to your brand.
Healthcare and pharma companies are still focused on the age-old Key Opinion Leader cascade marketing approach. How do you think healthcare and pharma companies can leverage the huge strides made in other industries with influencer marketing?
All of our clients have been moving away from small, round table panels of peer experts. They are leveraging the power of influencers and turning advocates into ambassadors to share knowledge with a much wider, more targeted audience. Of course, pre social media this would never have been possible, but today, we live a very different world.
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To further reinforce this, the six degrees of separation on planet earth is reduced to only 3.57 on Facebook.
In healthcare, it’s unlikely that you’ll have someone in a professional position of authority (like a physician) who is also a social media maven, but imagine the impact of pairing a professional physician with an influencer. Rather than treating them as the same, it’s a 1+1=3 scenario. The power and credibility of the healthcare professional paired with the social currency of an influencer will get you greater results than either of those experts individually.
For example, you might have a health and wellbeing vlogger with around 80,000 subscribers. Their videos are a mix of interviews with experts in healthcare and wellbeing and reviews of products and topical books. They could be paired with a physician to do an interview about a condition (for example, eczema) to talk about the facts and lifestyle elements involved.
The ROI on KOL/expert cascade marketing is often difficult to measure. How do you think the new age of influencer marketing can change this?
This is a feature that we are actively seeking to address, to put that final piece in the puzzle that is particularly relevant to agencies and brands alike. Our Audience Intelligence Platform can track the consumers who have actively engaged with influencer content so, essentially, we can identify and follow anyone who has developed an emotional connection with the content and brand, through the pipeline and all the way to purchase.
Of course there are still limitations. The example of the over-the-counter medicated shampoo is a
good one, as it’s virtually impossible to accurately draw any attribution from someone seeing a piece of content on YouTube who then drops a bottle in their basket on a trip to Sainsbury’s at the weekend.
But the argument is the same for many forms of advertising in both the traditional and new digital world.
What should healthcare and pharmaceutical companies be thinking about for 2017 when it comes to leveraging influencers and experts in their markets?
It’s naïve to think that people won’t already be talking about your brand or products. They are. Consumers and experts will already be engaging with your brand and telling stories about their experiences.
There is a strong likelihood you already have fans or advocates. Find them and bring them closer to your brand. Engage with them and they will engage with you. The clear benefit of this approach is building the solid and authentic foundations of your relationship, and the results will be genuine.
We’re going from an era where brands used to be judged by how they described themselves to one where they are defined by how others describe them. By branching out into influencer marketing, there is a strong opportunity to be involved in that conversation.
Many thanks to Pete for taking the time to chat with us! You can read more about his work on the 7th Chamber website.
To find out more about how Blue Latitude Health can help your brand leverage experts through social network mapping, get in touch at [email protected]. ■
B R A N D S T R A T E G Y C U S T O M E R E N G A G E M E N T O R G A N I S A T I O N A L C H A N G E FORWARD THINKING
Logic & Magic.Blue Latitude Health is a new kind of creative marketing consultancy. We combine the vision of a consultancy with the creativity of an agency.
Founded in 2003, our unusual blend of heritage, approach and capability gives us a unique perspective in healthcare marketing. It means we’re ideally placed to help unlock the potential in products and services that save and transform lives.
Based in London and New York, we are proud to work with some of the most exciting healthcare brands, redefining expectations of excellence and effectiveness with our innovative work.
If you want to shape the future of healthcare, email: Simon Young, Head of Commercial, at [email protected] or find out more at www.bluelatitude.com
