Paul Scrase, head of user experience at Precipice Design, explains the role that an increasingly digital market can have on healthcare and medical device markets.
You would think that when it comes to our health, life or death, symptom-free or regular exacerbations, that we would all be actively engaged with our wellbeing? But strangely we’re not.
I remember being shocked working with people with prostate cancer when I discovered they didn’t regularly take a daily pill to help them live longer. The client’s initial hypothesis was that these people were forgetful, but I quickly discovered this wasn’t the case. They were actively choosing not to take their medication because of how the drug targeted their cancer and how this made them feel about themselves and their masculinity.
In other healthcare research projects I have learnt that some people choose not to wear hearing aids not because they are too big, too uncomfortable or wax up too easily. It’s because we live in a world where we are constantly told to fight the signs of ageing. Wearing hearing aids is like sticking a big label on your chest with OLD written on it.
So, if people aren’t prepared to take one pill a day to survive, or would rather be deprived of their hearing than made to feel old, how do we encourage them to integrate complex transformative digital healthcare technology into their lives?
Provide solutions in two directions
The COPD and Asthma Devices Market is expected to reach $34.3 billion globally by 2020. Imagine the data that could be collected with the widespread use of smart inhalers?
We would benefit from such a rich understanding of when and where people use their inhalers, how frequently and how much. Pharmaceutical companies and healthcare providers would be able to accurately automate prescription renewals and identify when patients require health reviews. We could even understand the effect of pollution, pollen and weather systems on populations by overlaying smart inhaler data with meteorology data. Enabling new discoveries and improved understanding of the causes and best treatments for respiratory conditions.
However, the biggest challenge to smart inhaler success is that they only provide a one-direction solution – for pharmaceutical companies and healthcare providers. Where is the user value? Why would they want to use a smart inhaler? What is actually in it for them? Especially when the inhaler will probably be bigger, require batteries, a data connection to harvest data and probably cost more. Let’s give them an app that reminds them to take their medication I regularly hear pharma companies cry! But a digital reminder is not compelling, every smartphone comes with calendars and alarms already installed, and we know forgetfulness is often not the main cause of missed doses. Lack of meaningful patient-user value is where current smart inhaler concepts fail. We must find a way of reframing them to provide solutions in two directions. A tangible benefit to those using the devices.
Flip the ownership of outcomes to people
In 2017 9% of the global population had type 2 diabetes. By 2045 it is estimated to rise to 12%: over 1.1 billion people
Currently the NHS spends £14 billion a year on diabetes, which is about 10% of its budget. To help manage the increasing financial burden, digital transformation has an important role to play.
Currently there is a smorgasbord of smart connected blood glucose meters, insulin pens, pumps and diabetes apps available to people with diabetes. But the problem with each and every one of them is that they just focus on a single function: tracking blood glucose, or insulin titration. Just single pieces of an incredibly complex puzzle, they don’t consider the aggregated picture required for successful diabetes management, nor the meaningful connections people need to integrate these tools in their lives.
There are two challenges with getting people with diabetes to successfully use digital tools. First, you need to encourage them to input an awful lot of data. Secondly, and most importantly, you need to make the data useful and actionable for them AND for their clinicians. Only by doing this can they take ownership of their diabetes management.
For a type 1 to better understand their diabetes they may need to consider four core data streams;
- Their blood glucose throughout the day
- Insulin doses,
- Carbohydrate intake
- Activity levels.
Some people are using the latest connected blood glucose meters, insulin pens and pumps. They may well also use food tracking apps and an activity monitor, but there is no solution that aggregates data streams into a single location.
Many diabetics are also using ‘dumb’ unconnected devices. These people need to manually enter all the data. But sadly, there is no solution that seamlessly integrates this data entry into daily life. Currently if someone has been diligent enough to enter data into an app, the best they can currently expect to see is a data table or line graph of sporadic historic values. Unless you really love data or are a trained HCP, it is almost impossible to discover any trends and understand what to do next. So, what’s the point?
People need meaningful insight for their own lives; Maybe they are trying to get fit, want to start a family, are trying to lose weight, adore food or just need to be told everything is ok. These are all hooks that can be used to engage and help them own their diabetes management.
New methods and approaches are needed
There is no doubt that we are living in a world of digital health transformation. More things are getting smarter, more things are talking to one another, and more data is being collected. Transforming digital healthcare is a huge challenge, especially as healthcare organisations are not savvy consumer tech companies, so need to learn new skills in an evolving category, whilst navigating complex regulatory constraints.
We need to think about emerging healthcare technologies for the good of the world. We need to stop thinking about ‘things’ talking to other ‘things’ and consider the people at the heart of these smart ecosystems. We need to think beyond the traditional focuses of human-centred design and frictionless user experiences. We need to better understand the complex layers that make up how people create meanings and connections to the ‘things’ around them.
It is not easy to get ideas to market, but companies make the future based on the products they create. If we can think about that better, if we can execute ideas better, then we can create a better future for companies, and a better future for patients, payers and global healthcare.