Apr1

Knowledge Management

knowledge is powerIgnoring the fact that Australia is a very long way from the UK and that I have an intense fear of spiders, snakes and sharks, I recently took a trip Down Under.  My Aussie mates (actually mostly British ex-pats but all of whom have developed that distinct accent of turning every statement into a question) persuaded me I was due a visit. Admittedly, I hadn’t needed much convincing, with the reminder that the food is delicious, the beer is cold and the sun nearly always shines.

My first few days in Sydney were easily occupied with zipping around the city on the superb ferry network, photographing sharks in the impressive aquarium, and seizing the opportunity to swim in the ocean. Having left behind a rather soggy Britain, it was heavenly to be in the sunshine with flip-flops (or “thongs” to our Australia colleagues) on my feet and no need for a warm coat or an umbrella.

Midway through my trip, I had arranged to visit Ogilvy CommonHealth in Sydney to meet with Muriel Wang. Along with David Chapman, Muriel and I form a global team dedicated to the management of knowledge, called Global Knowledge Management.

What is knowledge management and why is it important? Knowledge is a key asset for any organisation, but in our knowledge-intensive world, it is necessary to be able to cut through the noise. Knowledge management is the process of capturing, organising, sharing and effectively using organisational knowledge.

Obviously the starting point for knowledge is data. Whilst data can be easily stored, knowledge, intelligence, learning and wisdom reside in the heads of people. A sustainable knowledge management strategy creates an organisational memory, reducing the loss of know-how.

The value of knowledge management is better and faster decisions; by tapping into the experience of your colleagues around the world, you can avoid their mistakes, apply their solutions and make the right decision the first time. This is evidenced in our support of new business efforts, and as Muriel explained, “This is particularly relevant in Asia Pac, where products often launch later than in the US and Europe. Being able to learn from the experience of our global colleagues helps us to get a leg up on our competition, so to speak.”

In addition to improved decisions from facilitated access to expertise, knowledge management reduces “reinventing the wheel” and prevents loss of knowledge from changes in organisational structure and staff turnover. Client, brand and therapy experience can easily be forgotten if not documented, and our capture of this data into databases is proving invaluable in responding quickly to internal and external requests.

Knowledge management requires a collaborative culture and a shift from “I know” and “knowledge is owned” to “we know” and “knowledge is shared.” Global Knowledge Management meets regularly to share insights from each of our regions, and taking a brief interlude from my trip to Oz to pop into the Sydney office and meet with Muriel will no doubt enhance our global knowledge management collaboration going forward.

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Oct5

Run Away With Me

The other day I sat in the pub after work. I’d left my keys on the kitchen table that morning and I was locked out. It seemed the sensible thing to go for a pint and read my book until my partner returned home from the office. Absently flicking through my personal emails whilst taking the first sip of my drink, I was suddenly struck by an admonishing subject line: How was your run today? 

Of course, I remembered, I was supposed to have run 8 km that day. Sadly, however, my running gear was ensconced somewhere in the recesses of my locked abode. And, after all, I’d started drinking now; why, I’d even managed to gulp down half the pint whilst considering the exercise in which I was now supposed to be partaking.

A few weeks ago, on this very blog, I took a pledge. I declared that I would road-test consumer health apps to investigate the ingredients required to make them successful, and to see if they ultimately made me a fitter, happier person. As a first step, I decided to test running apps. Whilst not exactly Usain Bolt, I have been known to go for a run around the park on a sunny morning. And, in what can only be described as a moment of insanity, I recently signed up to take part in a half-marathon with some seasoned runners from the Ogilvy Digital Health team. So it was with a modicum of verve and determination that I downloaded the Nike+ and MyAsics apps from the Apple Store.

Nike+

The Nike+ app is possibly the most expensive app I have ever downloaded. This is because, as well as the actual download, you also need to purchase a small pedometer device, which fits into a pouch that is threaded through your shoelaces. The app allows you to pre-program runs based on a variety of goals such as time, distance or how many calories you wish to burn. Whilst running you can listen to music on your iPhone, in the safe knowledge that at a simple touch of a button a cheery automated voice will tell you your current speed, distance, and how many darned miles you’ve got left to go.

It’s a simple concept, but surprisingly effective. In days of yore, I would probably have attempted some overblown exercise involving maps and bits of string in order to work out a route for my run, and my two measurements of speed would have been the substantially less empirical: “slow” and “too fast, time to go home.” In this sense, Nike+ works in exactly the way a successful health app should: it does a bunch of the seemingly hard work for you so that you can concentrate on the real hard work that is the task in hand. It even has a feature that allows users to pick a motivational song that they can access with one click should they be flagging before they reach the finish line. I would tell you what my song is, but I fear it will lose its emotional power when you laugh in my face.

Over the past few weeks I have discovered that I can run a lot farther, and maybe even faster, with the knowledge that the app will inform me when I’m nearing my goal. Having said that, I have fallen firmly out of love with the cheery automated voice. The other day I am sure I noticed a malicious hint to her otherwise anodyne tone as she informed me I’d only reached the halfway point. It’s now got so bad that we’re not talking; or rather, I switched her off. But it’s ok, because I can just look at the screen for an update on my progress. I’ll let her back into my life when I’m ready.

MyAsics

The other running app that I downloaded, MyAsics, was free of charge. This app is linked to a website, myasics.co.uk, which you have to sign-up to in advance. The site allows you to develop a training plan based on your age, weight and previous running experience. In this sense it has been ideal for my half-marathon training. Once you have plugged in your details and downloaded the app, you get calendar reminders, emails, and a facility to map your runs by GPS.

In a perfect world I would be happy to declare that this app is the best thing to happen to me since Dynasty became available on DVD (only recently in the UK, in case you’re wondering).  However, as useful as it is to have a tailor-made running plan, it’s not worth the guilt you feel when you miss a run. Cue a barrage of push notifications, and passive-aggressive emails of the variety that hit me as I innocently sipped a beer in my local pub. Well I say guilt; that’s not what it feels like at first. Something crops up at work, or it’s a best friend’s birthday, and when the message pops up I think, oh well, I would be out running but I’m doing something ultimately more important. Then come the occasions when I have already got home, slipped on something more comfortable and snuggled under a blanket in front of some quality Joan Collins, when my phone angrily beeps with the now ubiquitous reminder: How was your run today?

There is so much I now hate about that question, notwithstanding the fact that generally I haven’t actually run that day. The way it rears its ugly head at approximately 1900 hours suggests it is fully aware that if you haven’t slugged your sorry ass out on the running track by that hour, there are still at least three precious hours open to you before the gym closes. That’s when I start to feel guilty, and this is a dangerous place to be because after guilt comes stubborn resistance. Namely, ”No, I haven’t been for a run today, and nor am I going to go for a run today, because I’m not going to let a pesky phone app rule my life.”

You’ve probably caught my drift by now: I’m not massively keen on the MyAsics app. The attributes that made the Nike+ app so successful, that allowed you to concentrate on the task at hand, were not present here. Instead the app, which should have me in fantastic shape by now, is like an old nag that I can’t wait to delete from my life.

The Verdict

When we create consumer health apps, it is important to remember that they should complement people’s lifestyles rather than complicating them. I’m never going to be the most dedicated exercise freak, so the Nike+ app worked perfectly for me as it allowed me to run as and when I wanted. With this level of control, I was more likely to run farther, longer and faster. Even if I decided to halt a run early, I could collect data on my performance without fear of chastisement. Through putting the user in the driving seat, Nike has created a positive, empowering app that encourages consumers to make positive changes to their lifestyle.

Whether we’re building apps for running, or to remind people when to take their medication, it’s never good to be chiding or annoying because sooner or later people will want to rebel, and it’s a whole lot easier to delete an app than it is to run for 10 miles without stopping.

Next time, I attempt to overhaul my diet….

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Also posted in Apps, behavior change, Digital, Great Ideas, Health & Wellness, Healthcare Communications, Technology | Tagged , , , , , | 2 Responses
Aug29

Communicating Value in Our Changing Healthcare System

Recently, the Supreme Court of the United States issued a 5-4 ruling essentially upholding the entirety of the 2010 Affordable Care Act (ACA). Many Americans, including the millions working in the healthcare industry, have questions about what the SCOTUS decision means. As many of the provisions of the law come on-line in 2014, the full long-term impact is not yet clear. What is certain however is the healthcare sector is changing, fast. The shift toward more patient-centered care and measurable quality-based healthcare outcomes started prior to the 2010 law, and this movement will continue regardless of the ultimate outcome of health reform.

Moving from volume to value

In the healthcare delivery system of the past, providers were paid to treat problems, not prevent them; financial incentives were based on volume versus outcomes and multiple providers with little coordination delivered care. All of which contributed to healthcare costs rising at an unsustainable pace. Now, however, a paradigm shift is upon us.

In the idealized healthcare delivery system of tomorrow, providers are incentivized to increase quality and improve outcomes across their respective populations, infrastructure and processes are used to reduce variations and better coordinate care, and healthcare spending becomes a purposeful investment in value. Indeed, almost three-quarters (73%) of C-suite healthcare executives in a recent survey by Forbes Insights and Allscripts agreed that providers need to begin shifting their focus from “volume to value” immediately.1

The changing definition of “value”

But what does “value” mean in our brave new healthcare world? Value is one of those buzzwords flying around that has been absorbed and redefined by different stakeholders.  For patients, value means improved access to healthcare, high-quality patient-centric care, and improved patient engagement including better patient-provider communication.  For providers, value means ensuring patients receive high-quality accountable care based on best practices, including improved coordination across provider types and sites of care. Additionally, value for providers can mean receiving fair compensation—something that novel delivery systems and payment methods, including patient-centered medical homes and bundled payment schemes seek to address. For administrators, value means ensuring a sustainable healthcare system by placing particular emphasis on reducing waste, errors and redundancy.  The meaning of value in pharmaceuticals is changing as well. Now, not only are safety and efficacy evaluated, but effectiveness and appropriateness of treatment are also considered, while quality of reimbursement is downplayed. Wired health tools, such as electronic health records, are used to support treatment decisions, improve collaboration and measure behavior and outcomes.

How to communicate value now

With greater alignment across audiences, tomorrow’s healthcare delivery system demands more integrated value messages. New ways of communicating with patients and establishing value for the healthcare provider may become even more important. For example, development of safer drugs requiring less counseling, less paperwork, and drugs that have easier access to brand information could become important criteria of differentiation. Information and messages could be tailored to various HCPs and distributed in a less vertically structured environment. Outcomes research may help inform patient-centered value perspective in messages. Also, in the increasingly collaborative provider environment, the patient, her advocates, caregivers, and multidisciplinary HCP teams (social workers, MDs, RNs, NPs) may become even more important audiences to consider. This is especially true for serious diseases where care typically crosses into different disciplines and healthcare settings.

The US healthcare system is changing at a rapid pace. Still, however, the innovative delivery systems that seek to balance quality, cost and access are still in their early phases of implementation. Staying on top of these developments to identify strategic opportunity and translating insights into value-driven communication is more important now than ever before. Proactivity and adaptability will be the defining characteristics of winners on the changing healthcare landscape.

1   http://images.forbes.com/forbesinsights/StudyPDFs/AllscriptsVolumetoValue.pdf

Also posted in Access, behavior change, Healthcare Communications, Patient Communications, Physician Communications, Reimbursement, Strategy | Tagged , , , , , , , , , , | Leave a comment
Aug23

Speed That Belies Size

The interwebs sparks all sorts of great stories. Cat videos are awesome. Only boutique agencies “get” digital. And big agencies are only good for bloat.

We can all agree on the first. The latter two—well, as “Mortal Kombat” used to kick off its matches: Fight! Which is not to say there aren’t odd days in the quagmire week where machinery gets in the way. But more often, the potential of having a great many top folk in one place is its own advantage.

Rapid response can be assembled in short order. Properly motivated and target-focused, this is a critical mass of strategy, planning, creative, coders, UX, and more that can more than handle itself in the ring. And as in all good moments of fission, that time to reaction can really cook.

Just this last week the mobile group put together a 2-day hackathon. Thirty or so pros, many meeting for the first time, split into 5 teams across an equal number of brands.

Two days to learn about multiple capabilities in a new software development kit (SDK) from a leading telecomm vendor; conjure that fresh knowledge into a mobile app concept; push pixels and punch words to fit an appropriate number of screens, menus and assets; and program it out into a working prototype that had to impress a showcase session at the end of the second day.

Every group delivered sit-up-and-take-notice work. The results were a wowza gathering of mobile goodness across luxury and consumer packaged goods, financial and communication services—and from our corner, healthcare adherence.

Building on the tools offered by the SDK, the Ogilvy CommonHealth Worldwide team concepted an app that tracks a person’s pattern of behavior, uses location to assess health-positive and health-negative activities, and then provides the right level/tone of support to make sure they’re properly managing their condition through treatment.

These weren’t blue sky exercises. They are real apps, based on real insights, and they will be leveraged for real next steps with their respective brands.

Not bad for 16 hours. And more common than “big agency” is often credited with. Edgy and current is critical to digital thinking. But that’s not the sole province of “small & scrappy.” Mass can equal more talent, more discipline, more expertise and experience to kick into gear and kick it up a notch. On your next journey into digital, consider all your options.

But whatever else—trust me on the cat vids.

Also posted in adherence, agency life, Apps, behavior change, Creativity, Design, Digital, Great Ideas, Health & Wellness, Healthcare Communications, Marketing, Strategy, Technology | Tagged , , , , , , , , , , | Leave a comment
Jul31

Affordability of Medicines—the New Kid on the Block

You know the feeling: you pop into the shop and see something you want to buy, but times are tight and you simply can’t afford it. You want the best, but you feel compelled to consider all your spending priorities and choose to go for the less expensive brand—it’s a question of affordability.

In today’s environment, this is a challenge facing healthcare systems throughout the world. Coupled with this, more healthcare resources are being consumed as people are living longer with increasingly complex health problems. Add to this the increased complexity of how national health systems are assessing a medicine’s value, and you have the perfect storm.

Indeed, just as you weigh up whether you can afford to pay for something, those who pay for medicines (termed “payers”) all have affordability at the forefront of their minds. Governments are addressing the issue by driving further healthcare reforms, while payers are aggressively managing costs, limiting therapy choice, and shifting more of the cost burden to consumers.

However, if industry is to effectively support payers in their informed decision-making, it is important that they are viewed as investors in their community’s health and not simply gatekeepers of the budget.

As investors in health, payers deploy a variety of instruments to support medicines’ cost control. These can be broadly divided into supply-side and demand-side approaches.

Demand-side instruments include:

  • National-level price negotiations/price cuts
  • Reference pricing systems–using the cost of other similar drugs to set the price
  • Health technology assessments–assessing the value of a medicine using a range of tools including cost- and comparative-effectiveness
  • Promoting generic medicines and parallel imports–parallel imports refer to the practice of importing a medicine from another market where the medicine is cheaper

Supply-side instruments include:

  • Patient co-payments–this is the practice where patients will pay a certain percentage of the medicine’s cost
  • Reimbursement restrictions–restricting the money paid for a particular drug
  • Delisting–removing a product from a list of drugs that will be paid for
  • Prescribing budgets–setting financial budgets for the prescribing of medicines
  • Formularies and guidelines–a list of medicines that have been approved to be prescribed, or their incorporation within guidelines that should be adhered to

To date, the pharmaceutical industry has focused predominantly on communicating about cost and cost-effectiveness to secure optimal pricing and reimbursement for their brands at a market level. Arguably, more needs to be done to demonstrate the true benefit of treatment to patients, the communities in which they live, and society at large.

Some solutions to help demonstrate the true value of a treatment include:

  • Evaluating and demonstrating the longer-term patient outcomes
  • Demonstrating and communicating the economic value across all stages of a product lifecycle
  • Supporting payers to identify which patient segments would benefit most from treatment
  • Relating the outcomes demonstrated through clinical trials to local demographics

There is no doubt that the industry continues to go through a challenging time, while the economic crisis faced by many countries is only likely to get worse. In this environment, the issue of affordability is higher up on governments’ and payers’ agendas. However, by understanding and meeting the needs of payers and their communities, the industry will be better placed to ensure patient access to their medicines.

 

 

Also posted in Access, adherence, Clients, clinical trials, Health & Wellness, Healthcare Communications, Managed Care, Marketing, medical affairs, Reimbursement | Tagged , , , , , , , , | Leave a comment
Jul19

A “Credit Score” for Medication Adherence?

In June of 2011, FICO—originator of the credit score in 1956—introduced a medication adherence score model that predicts patient adherence to prescription medications. Approximately 3 million Americans were to have an adherence score by the end of 2011 and an additional 10 million are expected to have one by 2012.  If proven a predictor of adherence, this new score has the potential to revolutionize prescription drug marketing and may have sweeping implications for the insurance industry.

Most Americans are familiar with credit scores—often referred to as FICO scores. The FICO scoring system was created by Fair Isaac and Company and is used to predict the likelihood of a consumer to repay a loan. The lower the FICO score of the consumer, the greater the risk of default to the lender.

Years ago FICO scores became a key tool for banks and financial institutions in marketing credit cards and loans. What quickly became apparent was that the consumers with the lowest scores were generally the most responsive to credit offers.

The FICO score revolutionized credit by enabling lenders to reach a balance between risk and an acceptable cost to acquire new customers. The score eliminates the time and expense of marketing to potentially inappropriate consumers or to those unlikely to respond. It also short-cut the amount of information needed for lending decisions, spawning “instant credit” and rapid approval of auto loans. In a similar way, a medication adherence score could alert a healthcare provider immediately if a patient is at risk of being nonadherent, so appropriate steps to improve their adherence can start early.

Medication adherence is a major issue for patients, employers, managed care and pharmaceutical companies and is a multibillion-dollar problem in the US. A score that predicts medication adherence can help pharmaceutical companies in two key ways:

  • For brands with medication adherence programs, they can target the programs to patients who actually need help with medication to more efficiently produce better healthcare outcomes
  • New patients can be acquired who are more likely to be adherent to medications

This is all good. But where banks and financial institutions found that the FICO credit score became a predictor of responsiveness to direct marketing, it is not yet known if the medication adherence score will have a similar predictive quality with respect to direct marketing. It is also to be determined whether a medication adherence program delivered to patients who have a score is more effective at increasing medication adherence vs. traditional programs delivered to patients without a score.

In managed care, there is continual pressure to make patients more accountable for their health and well-being, and the adherence score has the potential to stratify insurance pricing based on adherence. It could be used to exclude patients from coverage much like credit scores are used in underwriting property and casualty insurance, and also has the potential to impact how life insurance is underwritten.

Early adopters will be the first organizations to start reaping the benefits of medication adherence scores to improve patient healthcare outcomes and strengthen their brands. When it comes to medication adherence scores, is your company making things happen or watching what happens?

Also posted in Access, adherence, advertising, Direct-to-Consumer, Health & Wellness, Healthcare Communications, Marketing, Patient Communications | Tagged , , , , , , | Leave a comment
Jul12

Mum, Dad, Reading Glasses, Arthritis and…iPhones?

“Pass me my reading glasses, will you? I can’t see the screen.”

For those of us working in the healthcare communications industry, words like apps, social media, digital, mhealth and self-management are part of everyday life. But what words make up the everyday life of our parents and grandparents? Well I don’t know about you, but my parents often struggle to even see the screen let alone have the confidence to use online and technologically advanced tools to look after their health. They’ve just about learned how to call me on Skype but setting up a Facebook account to keep up to date with my latest holiday snaps is way beyond their comfort zone. But this isn’t to say they can’t do it.

The ageing population is one of the key challenges and opportunities du jour for the healthcare industry. We can’t deny that the population is getting older, just as we can’t deny that digital and technological advancements are getting bolder. The question is: how do we make this oxymoronic marriage one made in heaven?

“I see next door have bought a nice new car.” For our parents and grandparents, it’s all about keeping up with the Joneses. For us, it’s all about influencing, motivating and supporting the Joneses to help them make positive decisions for their health.

According to a US-based survey, 40% of doctors believe that using mobile health technologies that monitor fitness and eating habits can reduce doctor visits, and 88% support patients monitoring their health at home. Combine these insights with the 10,000+ health apps available on iTunes and the math kind of speaks for itself.  But how do we apply these stats to an ageing Mr. and Mrs. Jones?

The World Health Organization has also been pondering this very topic. By 2050, nearly one in every four people will be over the age of 60. WHO believes that innovative technologies can help maintain the independence and physical health of older people. Mobile devices can now connect HCPs to seniors to family like never before, helping older patients remember to take their medication and stick to diet and fitness plans.  Devices now also have the ability to monitor health patterns and alert doctors when there are signs of trouble.  Older people no longer need to feel isolated in their daily healthcare needs.

In the healthcare communications industry, we need to carefully consider how we can use these technologies to assist potentially reluctant people like our parents—we must ensure that we listen to our audience, giving them what they need rather than what we think they need, finding out what they are comfortable with using, finding out if it is more appropriate to assist the caregiver over the patient, and taking a multi-generational approach. My mum and dad might not know how to use this app, but I do.

So it is up to us then. It is up to us as children and grandchildren to show the older generation they have our support and to pass on positive attitudes about using new technologies for healthy living. It is up to us as healthcare communicators to develop carefully designed and targeted tools, and to highlight the health value of using these, to help the ageing population embrace the technological revolution as much as we do. It is up to us to do this in a way that inspires, motivates and, above all, drives people to the sustainable action of taking control of their health. If we can make Mr. and Mrs. Jones next door embrace this, our parents will embrace it too.

 

 

 

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Mar1

Apples and Oranges?

Biosimilars: The Sophistication of Generics

Biologics—therapeutics derived from living cells—remain complex to produce…and reproduce.  Due to the molecular and structural complexity of large (relatively speaking) biologic proteins, a generic biologic equivalent can only be made “similar,” not identical, to the original, hence the industry term “biosimilar”—this is unlike small-molecule drugs, whose chemical structures can be completely characterized.

With all of the technology at our disposal, why is this the case? Alas, while companies striving to manufacture a biosimilar have access to the commercial biologic drug they wish to replicate, they do not have access to the same biologic cell line used by the innovator or direct knowledge of the manufacturing process nuances involved in bringing the biologic drug to market in the first place. This lack of “inside” information and inherent biologic complexity accounts to a large extent for the tremendous time and effort currently associated with manufacturing a biosimilar.

But let’s make no mistake, biosimilars are coming, as evidenced by companies like technology giant Samsung with little or no experience in pharma/biologic development. Samsung is currently devoting the equivalent of 25% of the Korean GDP toward a commitment to healthcare—including. and in particular, biosimilars. Wow!

Layer on that,the innovators’ competitive response to biosimilars looming on the horizon. In the case of biologics, the competitive race is on within the halls of large and small pharma alike to discover new ways to advance their therapeutic platforms while driving down the costs of production, sales, and distribution.

And the reason all of this is important to pharma, clinicians, patients, and the healthcare system as a whole? Safety, efficacy, and outcomes—key factors that payers and HCPs consider when selecting and reimbursing for a drug. Despite biosimilars having the same “biologic” protein structure as the innovator, small differences resulting from the heterogeneity of biological processes and environmental conditions used (ie, formulation, light, temperature, moisture, packaging materials, container closure systems, and delivery device materials) affect safety, purity and potency—important and key differences that can negatively impact product performance. Additionally, process-related impurities may increase the likelihood and/or severity of an adverse immune response to a protein product.

Contrast this competitive biosimilar hurdle to market entry with that of the public health objectives promoted by the Hatch-Waxman Act, which “waxed” the new drug application pathway for generics over three decades ago, eliminating the need for preclinical and clinical studies for “bioequivalent” drugs, resulting in a tsunami of generics, as the process was straightforward (and state, federal and private payers looked to reduce drug costs). With the immense and increased pressure to reduce the cost of healthcare, how long before the FDA will be able to approve biosimilars (apples) as a cost-saving alternative to reference biologics with the same relative ease associated with licensing a generic (oranges)?

With several biosimilar drugs already licensed in Europe, there are several companies working feverously to submit biosimilar applications under the Health Care Reform Act in the US—navigating an abbreviated approval for which the strength of evidence required for biosimilar registration approval is currently unclear. While it may be a bit longer before a biosimilar is approved in the US, it is particularly crucial, given some of the high-profile large- and small-molecule drug shortages of late, that an agency have an integrated team of scientists, marketers, and reimbursement experts…with a deep and thorough understanding of biologics and the complexities of these potentially life-extending drugs.

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