“Patient Centricity” is a byproduct of business schools who taught Pharmaceutical clients about how customer centricity changed the retail business over the last twenty years and how it should be applied to the healthcare world. In the transition from retail to pharma, the tools like journey mapping and Voice of The Customer migrated. However, the implementation and interpretation of these tools were not tailored to healthcare to help understand people with a disease (or patients as we most often but inaccurately call them). Innovation is a second word that has suffered from it’s meaning becoming lost in the transition from the Pharmaceutical world to the world of people’s healthcare.
Let’s start by looking at with patient centricity. The common understanding of this phrase by consultants, business schools, and Pharma executives is to bring the patient to the center of their business. For most this seems obvious and quite often this is visualized by drawing the patient at the heart of choices and decisions of other stakeholders. While this picture makes sense that a Pharmaceutical company helps its employees to see the people the products and services are aimed at, it missed a couple of reality checks. While the simplicity of the patient-centric model is appealing, in fact, the situation is more complicated on several fronts. Firstly patients are not at the center of all decision and choices about their healthcare. Also, many people do not want to have to make all the decisions themselves even if they could. Secondly, many companies view of patient centricity is overly focused on how a patient should choose a single companies products and services. There is nothing wrong with that as a process for a company to follow however to is misleading to call this patient centricity.
The issues become clearer when discussing another misused word, Innovation. For Pharmaceuticals, Innovation, like patient centricity, is focused on making better products that excerpt greater effect on biochemical pathways and cellular control of a disease. However, when thinking about creating change in health outcomes for people with a disease, the concept of Patient-Led innovation leads people to think more broadly about factors that cause disease and support both positive and negative health outcomes. Patient-Led design takes the person and their environment into consideration. In short, Pharma innovation is just a part of healthcare innovation. When we look at the investment in healthcare innovation, a disproportional amount is focused on the pharma innovation model. The phrase “Patient Centricity” feels wrong to many because in reality, it reflects only one pharmaceutical companies view of the choices a patient should be able to make to get better after becoming sick. I would propose Patient-Led Healthcare design is better as it looks at the holistic, complicated nature of wellness and sickness. It looks at health outcomes from a humanistic perspective irrespective of the technology or companies involved in achieving it.
When you start to look at improving health outcomes through a Patient-Led lens you start to see that the millions of actions that surround health decline and are also involved in stabilizing or improving health after a disease or condition is discovered. It’s clear from this view healthcare goes beyond pharmaceutical companies current business. In fact, it explains why there needs to be a different model for innovation in healthcare. Physicians, their hospitals, and pharmaceutical companies have provided almost all of the substantial advances in medical care through innovation like hygiene, vaccination, surgery and anti-infective compounds over the last 150 years. It is expected that the next wave of transformative health innovation will be in the fields of innuno-oncology and gene editing. Both coming from the pharma world of innovation. However, there is a growing feeling that existing disease could be avoided and during treatment outcomes could be more positive than those of today by taking a Patient-Led design approach.
Patient-Led design looks at the patient as a whole. More than a pure focus on molecules and cells, it captures the elements of human behavior and attempts to understand people’s choices and how the environment affects those decisions. There are great underlying processes affecting human choice including memory and response to the past and present environment. Heuristics capture the little automatic controlling stories we use to make the everyday choice easy for ourselves. These heuristics affect the way we approach important life activities like diet, exercise, getting disease diagnosed and following medical advice. By understanding how these aspects, along with the effect of pharmacotherapy on the disease, real and sustainable healthcare changes might be achieved.
If we are going to start looking at these more behavioral aspects of health and our human narrative as diagnostic, we will need different tools that enable us to make a change. It is the recent change in technology that allows us to start working more precisely and proactively in this part of healthcare. We are learning through the acceptance of the quantified self that we can measure many more parameters that were possible before. The changes in cognitive computation and artificial intelligence have made the ability to spot patterns in the millions of actions we perform on a daily basis, and now we have the possibility for real-time feedback and decision making based on those patterns that might be able to guide us towards better health. If real-time feedback is one part of the new advance in healthcare, data visualization and their place and temporal nature of the feedback is another. Different aspects of our lives need on-time feedback or just in time feedback other need aggregation and consolidation of information to give deeper thoughtful feedback. Our understanding of this is just beginning, and it needs to be Patient–led or it will not follow the humanist need and will subject to slow or low changes in health outcomes.
The consumer giants have learned that people make purchasing decisions for all sorts of irrational reasons. Many of these are interwoven with health choices. So it is no surprise that people fail to follow rational medical advice and outcomes based on non-real world tested pathways will yield poor results. Understand human behavior is, therefore, an important activity for anyone looking to create change in health outcomes. It’s is that work that will give people the insights into products and services that will make the pharma innovation model work.
Patient Centricity is a useful phrase and model for Pharmaceutical companies, but Patient-Led design is much better if you are aiming to improve health outcomes for society.