Negativity. Sadly, that seems to be the single word to describe the popular view of Pharma and healthcare delivery. In a Gallup Poll from September 2023, the pharmaceutical industry had the lowest positivity ranking by the US public in a Business and Industry survey. The Healthcare Industry was not far behind. The US Federal Government ranked higher than Pharma! How can this be? Is it real? A false perception? I believe it is a bit of both. And the responsibility for both lies squarely at the feet of industry leaders who do not accept the reality and remain mired in old ways of working.
The result: folks are becoming disheartened from within and outside of industry. I would encourage us to honestly accept this challenge with an approach that engages the difficulties as opportunities to be addressed with optimism and hope. The solution requires true disruption.
Disruptive innovation, as described by Clayton Christianson, is not about randomness. Instead, it is about a steady prescriptive process that has the potential to change an industry. Patient Centricity is the next disruptor in the Pharma/Healthcare sector, and the impact will be revolutionary. Now is the time and Patient Centricity is the path forward.
This concept is far from new; other industries have embraced their customers in the development of new products. Would a car manufacturer dare to release a new model without asking customers their perspective on electronic interfaces, seat configuration, and color options? Or would a beverage company launch a new flavor of soft drink without testing it with consumers to determine its acceptability and whether this new option is likely to alter their purchasing behavior?
If they are successful companies, the answer is, of course, absolutely not. Yet we have been resistant in drug development and healthcare delivery to lean into our customers – our patients and often their caregivers – during the most critical portions of the research, development, and delivery process. We instead pursue innovation in the vacuum of omnipotence believing our work is so unique and complex that the end user could not meaningfully contribute. This belief and in that of the existence of Big Foot are equally ridiculous.
The result: failed product launches, large investments squandered, commercial teams wondering what it is they have been handed from development and – most importantly – lost time for our patients anxiously waiting for solutions. There is a better way.
As I explain through vignettes in my book, A Bandana and A Bluebird, patients and caregivers have a lot to teach us about their condition and journey. They provide, to those willing to listen, a Masterclass in need and value, an understanding of their challenges with care in their real-world setting and clarity about behaviors that promote or interfere with care.
Our job: create processes and capabilities to capture these critical insights and make them actionable. To change for the better how we develop and deliver innovative solutions for and with patients.
Over the past decade, it has been a privilege to play a role in driving much needed change in our industry, and it is indisputable that implementing patient centricity processes into the R&D and delivery framework has a meaningful and measurable impact on decision-making, portfolio investments, timelines, and effective resource allocation. Of course, there remains work to be done; intelligent evolution is part of any successful disruption. However, there are critical elements that every organization should implement to align with their customers on what the next generation of treatments should look like. The time is now!
There are 4 components that will make this evolution possible.
First, develop methods to engage and collaborate with our customers – our patients. These relationships should be dialogues not monologues, long-term and bi-directionally beneficial.
Second, create the internal teams and capabilities to make our learnings actionable in every decision. This requires highly specialized teams to support the different internal functions. Research and Discovery teams require different types of information than do later stage development teams. Understanding this and supporting the function with proper capabilities is critical.
Third, measure the impact and continue to evolve, paying close attention to internal team needs to enhance their ability to execute effectively and more efficiently. This work cannot be effective if done in a vacuum. Listen-Learn-Evolve should be the operating principle. While this work is very “human,” it must also be recognized it is being done in the context of a business. As such, measurement of impact is important and must always be a component of the model.
Fourth, focus on culture – it is the foundation of any sustainable change. In fact, I would argue that none of this is possible without an active program to create/strengthen a patient centered culture.
To be clear, everything suggested has been done, has had a positive impact and can be implemented in a cost-effective manner.
In over 30 years working within the healthcare system what I’ve learned is that this basic understanding of the end-users’ desires and needs – the patients and caregivers – is often assumed, and therefore not accurately captured throughout the patient journey. Not only as it applies to therapeutics, but also to devices, to clinical protocols, even to medical education and nurturing of a basic bedside manner.
Reflecting on my time as a young medical resident, I realize now (but did not have the time for such reflection then) that we received outstanding education on how to effectively treat illness, but not a great deal of formal education on effectively caring for the individual. Over time, it became clear to me there was a huge difference between treatment and care. Treatment being the delivery of the correct medicine or device; care the appropriate treatment along with the touch, the listening, the understanding that can only be captured with intention. Those learnings would come through observation – working with experienced physicians and nurses who had “the right stuff.”
Successfully implementing patient-centered discovery, development and delivery requires both top-down endorsement and bottom-up partnerships.
First, gaining organizational and leadership alignment on the need and benefits of a patient centricity capability is necessary. This can be an arduous task in some settings; not so difficult in others. However, it is needed to obtain resources required to get started. Implementing the capability requires deliberate operational changes. A truly patient-centric model includes key operational elements to enable the actionable integration of the patient perspective into decision-making of all new solutions. Most organizations have an established process for evaluating whether a new program should progress, but does that process require researchers, for example, to include the input of end-users? Project scorecards can be created clearly showing how the patient, caregiver or provider perspective informed the ultimate recommendation. The point here is that collaborative efforts between and among team members is critical in creating new processes that evolve from old. How does this process expand within organizations? User experience. Share the analyses, measure the impact, and create advocates for the function…and it will grow.
As mentioned above, perhaps nothing is more important to setting patient centricity as an organization’s foundation to innovation than the role of culture. Yes, you need leadership endorsement and cross-functional partnerships, and operational implementation, but without a conscious awareness of the patient in all activities, of every employee, every day in every role across the world, long-term success is unlikely. This is best achieved by what I refer to as the Head-Heart-Hands approach.
Understanding, believing, and acting in a Patient Centric way. It is often a sequential approach, with each step more difficult than the previous, but more permanent in its impact. Programs can be designed to move culture from a passive slogan to an active process.
Patient Centricity is not only possible and impactful but essential if we are to thrive as an industry and if we are to benefit patients, remembering always, we will all be patients one day. Now is the time. What are we waiting for?
