Patient engagement: Breaking through in digital
The pandemic is serving as an accelerated lesson in the possibilities of digital engagement. Now pharma must work out how to harness its full potential
Face-to-face engagement restrictions during the pandemic made remote engagement the only game in town for pharma and healthcare providers.
The speed at which both have risen to the challenge and adopted digital tools to solve urgent patient care and support needs has been striking. Most pharma players will have relaxed pre-pandemic standard operating procedures to get drugs and treatment advice to patients by any means.
And in a new Reuters Events Pharma survey, almost two thirds (63.2%) of respondents say their patient support programmes are able to meet current remote access conditions.
Now that the initial pressure on the healthcare ecosystem has eased, it is a good opportunity to consider unleashing the full potential of digital engagement. The pandemic has underscored the profound value of well thought through and well delivered digital engagement, says Peter Said, Head of Patient Engagement APAC at Bayer Australia.
“We have a big role to play not just around drugs and adherence but also supporting them through times of low mood, that may be impacted by social isolation, offering someone to talk to, helping work out how to get medications and so on,” he says.
“People are becoming more connected via digital, which allows the exchange of information in a rapid fashion. We are able to engage with patients more with more agility, especially those connected patients in younger demographics.”
Overcoming the tyranny of distance
Remote and digital engagement is already proving its worth in terms of better use of time as consultations can be completed in less time. It is also overcoming the challenges of distance, says Nicole Millis CEO, of patient group Rare Voices Australia.
And it seems unlikely that things will go back to how they were before when the pandemic restrictions ease, adds Millis. “It is likely people will reassess what is considered the best use of their time and resources moving forward. People may feel less inclined to travel interstate for a meeting they may be able to conduct over Zoom.”
It is clear that there has been a significant shift in attitudes to digital. “There is much more emphasis on digital now and much more acceptance from people for that,” says Jonny Duder, CEO of Atlantis Healthcare, which designs and develops patient solutions.
He cites injection training as a good example of a traditionally in-person activity that is rapidly finding acceptance in a digital setting. “A lot of our injection training has gone remote now, including the psycho-social training around it,” says Duder. “We can offer it to more patients. HCPs are coming to grips with that as well.”
Digital engagement’s scalability is a significant factor here. It is a hugely valuable quality for health services facing ever more demand but limited by relatively fixed human capability and budgetary capacity.
The potential from hereon in is vast. The full promise of truly reactive, two-way engagement using well-designed digital tools that drive ever better outcomes is now more than the distant possibility it was before 2020.
Agile and predictive
The prizes of breakthroughs in digital engagement will include far-reaching improvements in meeting patient needs, better outcomes and adherence, not to mention better value for payers.
Truly predictive engagement could pick up on patients who are falling through the gaps and rapidly get them back on track, for example. “With real time data you can start to make predictions around where people will have behavioural challenges and adjust in real time to address someone falling off treatment,” says Duder.
Having seen the rapid adoption of digital in just a few months, the idea of creating this next generation of tools to drive rapid improvements via agile feedback and analysis of real time data should no longer seem like the ambitious long-term endeavour it might have only a few months ago.
What will this next generation of digital engagement look like and how will it be created? One thing is clear: It will have to be smartphone friendly and it will need to be highly flexible.
The best digital engagement programmes and tools of this near future will share some common features, says Duder. They will be designed to benefit all stakeholders and will be adaptable to each user.
They must also meet our expectations as consumers of convenient and intuitive digital services, says Duder. “A lot of people are engaging in digital health via apps on their phones and those experiences set the standard now.
“There is a shift in what people expect. So if you enrol in a digital patient support programme, you expect a level of interactivity, of digital quality. A website with some wellbeing content on it and some information around your treatment is not going to cut it. That is not a personalised support service, that is a content portal.”
Risk v reward
While everyone in the healthcare sector is seeing what can be done to engage digitally, it is also fair to say that caution remains. Perceptions of risk ranging from pharmacovigilance to data privacy could slow the speed of progress from here.
Atlantis is successfully pursing digital engagement with patient communities on behalf of pharma clients and is proving that the benefits outweigh the risks, but others have yet to engage, says Duder. "Some clients won’t go near them because the risk is too high, yet we have been running programmes like this for years. The compliance burden is not much worse than when you talk to people on the phone. There are challenges but it is doable.”
Compliance and safety concerns are not the only thing slowing pharma’s journey into digital engagement. A lack of digital, data and analytical capabilities is a well flagged issue pharma generally and for many will be lacking in the teams tasked with furthering digital engagement.
The risk is that pharma will lose the current momentum for change, says Said: “We did not have the skill sets and talent internally and we are quite risk averse. We have not looked to the entrepreneurs who are playing in this field. But the pandemic has opened my eyes, seeing how the world has changed. We have to change because of it.”
An appreciation from HCPs of the existence and benefits of digital engagement tools is also essential to their successful dissemination and application, yet historically this awareness has often been lacking.
Telling the service story
Part of the reason for this is the heavy product focus of many pharma sales teams. “Often at launch, the focus is on the product story and the reps don’t have the time to sell the story of the service that comes with it,” says Duder.
Giving HCPs an overview of the digital engagement service and showing them what the experience is for a patient and the various touch points they encounter is important, adds Duder.
Said agrees. “We do tend to be product focused. We need to think more broadly, and look at what we offer patients in terms of that suite of solutions that are supporting health behaviours.”
Funding, in many cases likely to be in shorter supply post pandemic, is another potential impediment to the rapid expansion of digital engagement. “Although building a meaningful support service around treatment is becoming an increasing priority, what I think potentially makes it more difficult is delays around funding. These services take time if you are going to co-design them,” says Duder. “But are you going to get funding in the local market?”
As well as recognising and allowing for the financial constraints that may limit the extent of pharma’s ability to engage digitally, pharma should also recognise the practical ones. Access to digital services cannot be assumed to be universal, nor necessarily always desirable.
Not everyone can engage on equal terms digitally, says Millis. “People living with a rare disease often feel isolated and misunderstood and the pandemic can exacerbate these feelings. People experiencing socio-economic disadvantage cannot necessarily access and maintain engagement with digital-only services. Many people also struggle with technology.”
And there will always be instances where the personal and the face-to-face are the most appropriate solution in any case, adds Millis. “One of the biggest downsides of digital engagement alone is the loss of social connection and lack of community that face-to-face contact and support provides.”
Said agrees, adding that age is another important factor to consider. “We have seen 73% in Australia of 65-70 year olds own a smart phone. So they are socially connected but that does not mean they are using health apps. There is still a way to go.”
Expanding into digital engagement, while offering huge value, should not come at the cost of patient choice, he adds. “It is not about providing a one-stop shop, it is about providing options for patients. Digital is another element in the armoury. If you are really patient centric, you give the patient a choice.”