Organizing for Digital Health Success

How to align your organizational structure with your digital health strategy.

In our last article, we spoke about what made pharma a case for psychotherapy when they weren’t able to deliver on the promise of digital health. This month, we will look at what pharma can do to avoid ending up on the therapist’s couch again.

When deciding how to organize to deliver digital health, there are two questions companies should ask themselves about their intent and strategy in this area.  These will determine how far removed from the core business any innovation should happen.

These questions are:

1.      Does the company want to use digital tools to influence patient health behavior and/or clinical decision making with the goal of improving outcomes?

2.      If the company wants to directly influence outcomes do they want to focus on a product or a therapeutic category?


Answering no to the first question, or not asking it, is the default approach of the pharma industry. If this is the case, then it is likely to result in the kind of Bolt-On, product-centric services that exist today  – simple apps, support tools and other digital marketing efforts. Yes, pharma are moving HCP and patient communication to new channels but the relationships are not fundamentally changing.  Many of the apps that focus on brand equity and disease awareness are also not widely adopted by the target users.1

The good news is, however, that the quality of these tools is improving and pharma organizations have learnt to source and incorporate them into brand strategies. The company can improve their return on investment by involving patients and HCPs in the design process but they shouldn’t expect miracles!

 Beyond the pill

Our approach to integrated care will vary by therapeutic area and the needs of the healthcare system.  In some therapeutic areas, we will adopt a bolt-on approach, but in areas like diabetes, where we have strong expertise and the needs of the patient and healthcare system are huge, we see the need for complete solutions including services and technology beyond drugs" - Francois Nicolas, Sanofi.  

When companies answer “yes” to directly influencing outcomes with a tool or service then they most likely enter into regulated space.2 If so, this requires development that is in compliance with medical device requirements and standards. This is what we call genuine “Beyond the pill”.  It is a step far enough from the core that it requires extra support. This broader, wrap-around strategy requires a new regulatory approach, another business model, as well as a new technology skillset. It will also increasingly need a plan for reimbursement based on outcomes rather than just giving away products for free. This isn’t just business as usual with an app on the app-store.

Sanofi is one company that has dealt with the move from bolt-on to genuine beyond the pill.

“Our approach to integrated care will vary by therapeutic area and the needs of the healthcare system.  In some therapeutic areas, we will adopt a bolt-on approach, but in areas like diabetes, where we have strong expertise, and the needs of the patient and healthcare system are huge, we see the need for complete solutions including services and technology beyond drugs.  We have recently significantly enhanced our own internal capabilities to enable this shift and remain open to external partnerships,” said Francois Nicolas, Vice President in charge of Integrated Care for Sanofi diabetes business.

Bayer, similarly, solve for this by starting initiatives within the existing commercial group and passing them over to a beyond the pill team as needed. Groups like these centres of excellence, act as part incubator and part support function to give the initiatives room to grow and also source external experts.  This function will be necessary for companies who choose this approach until it becomes business as usual.

Standalone group

When companies want to develop patient-centric, product-agnostic solutions then groups responsible for their development and delivery should be further away from the core business. Ideally, they should reside in a standalone group that is independent from the day-to-day pharma organization.  If these organizations don’t have an independent structure and focused leadership they will fall victim to governance, processes and priorities focused on developing and commercializing drugs.  This was covered in more detail in our last article here. Operational freedom is, however, not enough. They will also need the same beyond the pill capabilities plus further business building skills to develop stand-alone solutions.

So far, there have been limited product-agnostic initiatives launched as standalone structures. AstraZeneca is a potential candidate in COPD and Sanofi’s Integrated Care Group might also consider a similar move in future.

An alternative example of the standalone approach is J&J who created the Janssen Healthcare Innovation group.  This is the group responsible for Care4Today, the master brand for the company’s outcomes focused multi-disease platform.  It is important to note, however, that J&J are uniquely positioned to offer such a multi-disease platform due to their broad experience across the consumer, health solution, medical device and pharmaceutical spaces. The jury is out whether they will succeed but a separate organization has at least given them the right kind of jumping-off point.  

Success in digital health will depend on leadership, skill, hard work and good luck but if companies work to match their organizational structure to their desired degree of innovation they significantly improve their chances of success.

We hope that we have provided some ideas on how to approach the organizational stresses of trying to deliver digital health. We’ll be looking at some of the practical aspects of implementing digital health in our next article - "Digital for the sake of digital".

2. FDA definition of “device”: When the intended use of a mobile app is for the diagnosis of disease or other conditions, or the cure, mitigation, treatment, or prevention of disease, or is intended to affect the structure or any function of the body of man, the mobile app is a device

A trained engineer and avowed gadget geek, Tina Boggiano has over 20 years of commercial pharma experience, with the past five years spent in commercial and product development roles in digital health initiatives. Tina understands both the technical as well as the human sides of digital health design and she possesses unique insight into the challenges pharma companies face when trying to innovate in this promising and evolving space.

Doug Haggstrom, a trained chemist and engineer, worked in Drug Development before venturing into a career in Strategy, Media and IT development. He has worked within and advised companies ranging from multinationals to startups. He has most recently been advising a developer of patient tools and supplier to the Pharma industry. He is able to bring influences from outside the industry and translate them into a pharma context.

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