Better Outcomes for Patients will Provide Better Business Outcomes
AstraZeneca's John McCarthy on how to make the buzzword of patient centricity more concrete.
It will not have escaped your attention that ‘patient centricity’ has become something of a catchphrase in the last couple of years: mission statements and company announcements are full of it. Cynics have yet to be convinced, but some believers in pharma are working to win them over.
John McCarthy, VP Global Commercial Excellence at AstraZeneca, thinks he has the tools to make the idea something more concrete. The international team he leads has a daunting remit: to build and deliver capabilities to drive commercial success, transform the healthcare experience and improve the lives of millions of patients.
Measuring the journey
In short, he is leading the charge to make AstraZeneca a patient-centric organization. To know you are achieving this broad and ambitious set of aims requires a laser-like focus on outcomes, and McCarthy believes it is vital to build in measurement from the start. However, there may be a limit to the usefulness of traditional KPIs in this environment. “There are many ways to measure along this journey,” McCarthy says. “We’re probably not measuring patient centricity at a corporate level just yet, but if you’re doing journey mapping and understand the problems, that is probably a measure. KPIs too often bring you back to the business outcome only.”
Instead, he suggests, you need to look for evidence that you are solving a problem for patients. The $64 million question which follows on from this – and it is one that pharma seems to be dancing around a little at present – concerns the return on investment from patient centricity: is there, perhaps, something slightly distasteful here? Does talk of ROI actually miss the point entirely?
“You need to be asking the right questions and then measuring the outcome,” McCarthy begins carefully. “The direct line to business is more difficult. Once someone’s a patient, they have been prescribed a medicine – so the question then is about whether we are meeting their expectations in their therapy as in other areas of their life.”
He cites the way that Uber has revolutionized the way that people hire taxis and suggests that pharma must look for ways of providing its own customers with convenient solutions. “That’s a better measure for us,” he explains. “We’re trying to create services alongside our medicines rather than replacing medicines.”
We follow the science, and when you’re talking about strategy, that deeper understanding of the patient journey is important. Can we create interventions and services along that pathway which can improve customer experience.
Patient journey mapping, offering insight into where pharma might make additional interventions in patients’ lives, is another area where AstraZeneca is looking to make a difference. “We’ve looked at how you train your commercial-facing roles,” he says. “We’re doing that by looking at the journey map to better understand how a medicine we introduce can fit into that journey.”
Like most pharma companies, AstraZeneca talks about putting the patient first as part of its corporate strategy. But McCarthy adds: “We follow the science, and when you’re talking about strategy, that deeper understanding of the patient journey is important. Can we create interventions and services along that pathway which can improve customer experience (CX)?”
Need for change
CX has not necessarily been something which pharma has majored in over the years; patients bring with them ideas of how service – in whatever the sector – should look based on their experiences in more consumer-focused areas. For example, as well as using a smartphone app to hail a cab, people are able to book holidays or buy groceries online at whatever time they choose. Much of what happens in healthcare seems rather ponderous by comparison. This situation will have to change, McCarthy says.
“We need to recognize that patients’ expectations of us are changing,” he insists. “It’s dangerous to assume we don’t have to meet those. Science will always win the day in our industry but there are other factors we have to take into account: how do we bring those things alongside the science to improve the experience?”
One of the most potentially exciting things about the drive towards patient centricity is the engendering of a spirit of openness in the industry – and McCarthy is happy to acknowledge the efforts of others.
He praises Babylon’s ‘doctor in your pocket’ app, which lets patients book virtual appointments with GPs, receive prescriptions at convenient pharmacies and monitor their health on an ongoing basis. “Ali Parsa has great vision and is democratizing healthcare delivery,” McCarthy enthuses. The service has the potential to be a major player, he believes.
Michael Seres, founder of UK-based connected medical device company 11Health, is also cited as someone from whom pharma can learn. Seres is a bowel transplant recipient and cancer patient who has developed social media programs and online communities focusing on patient-to-patient and patient-to-doctor interaction.
“He has taught himself social media skills and is sharing his experience,” McCarthy says. “He has several products on the market. We talk about patient centricity – and he has lived it. He is leading in health and delivering in the business community, and the expectations for us are being shaped by these other leaders.”
What links these start-ups is the way that the patient is enmeshed in the operation and AstraZeneca is applying some of this approach to co-creating programs with patients. In 2015, AstraZeneca introduced LVNG With (pronounced “Living With”), which centers on activating a community of people living with lung cancer and their loved ones, who share their emotional journeys and everyday experiences with each other. “Patients told us that connecting with others makes all the difference in helping them get back to living their lives, but now with their lung cancer,” he says.
The company is not making claims for improved patient outcomes but hopes that those who have been diagnosed will find hope from hearing about how others have coped, as well as practical assistance. It was co-developed by AstraZeneca and three leading lung cancer advocacy organizations: Bonnie J. Addario Lung Cancer Foundation, Free to Breathe and Lung Cancer Alliance and has included live events in three cities.
“The opportunity to work with the US leadership in oncology with LVNG With has been inspiring,” McCarthy continues. “To see the survivor community and how some of these patients are still thriving is an awesome experience. Hearing some of them talk about how fulfilling their life has been since diagnosis is a humbling thing.”
The older one gets, the greater the likelihood of being affected in some way by serious health issues. McCarthy’s father died from lung cancer two decades ago. “It was a short fight,” he recalls. “But that personal experience has a very lasting effect.”
Things have come even closer to home since then for McCarthy. About six years ago, he found himself undergoing tests in hospital after suffering from chest pain. After stents were fitted, McCarthy went back to work “practically the next day”. But it is clear that his first-hand experience of the healthcare system has given him a new understanding of his professional work. “I feel very fortunate,” he says. “But making changes was an important part of that too.”
Providing better outcomes for patients will provide better business outcomes.
Attempting to live more healthily is the crux of another AstraZeneca launch, in conjunction with Vida Health: Day-By-Day is an app which includes a live digital coaching service to help US heart attack patients and their caregivers. “The patient’s journey starts with a lot of changes,” McCarthy says. “This is a coaching system to help them get on the right path. It’s therapy-agnostic but it is an interesting service to run alongside our medicines.”
As well as getting patients to come to terms with what has happened and adhere to their new drug regime, the initiative is designed to equip them with knowledge and tools to make and sustain healthy lifestyle changes. Educational resources include videos, food diaries and articles on various subjects. Patient Activation Measure (PAM) scores will be key here: the company does not yet know whether Day-By-Day will help improve outcomes, although data from a trial program at Duke University is expected soon.
All of this feeds into McCarthy’s view that co-creation with patients is vital if pharma is to move forward – and he believes that the commercial rewards will naturally follow. “Providing better outcomes for patients will provide better business outcomes,” he concludes. “And the industry is beginning to do that.”
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