Digital health is here, but is it making a difference to patients?

The concept of 'digital health' has been with us for around 10 years now, but is it really starting to make a difference to patients?

A half-day conference, Digital Works II, held by the PM Society in London this week, attempted to answer this question, and brought together a broad range of people doing pioneering work in the field.

The answer was unanimous – yes, digital health is beginning to make a difference, and has huge potential to improve health in the 21st century – but there are plenty of obstacles left to overcome.

Among the speakers at the event were Kai Gait, GlaxoSmithKline's (GSK) global digital director, and Guy Shauli, AstraZeneca's digital strategy director, two digital evangelists leading innovation from within pharma.

Joining them was Martin Moth of NHS Choices, a government website aimed at encouraging the public to take a more active role in managing their own health, and Barnaby Poulton of Proteus Digital Health, a company pioneering the world's first 'digital pill'.

Also speaking were Alex Butler, David Hunt, Dominic Marchant and Louise Benson from the agency side, who are digital leaders setting the pace for a sector which remains conservative about digital health.

Beyond the hype

It's true to say digital health has been held back by hype, technical limitations and products which simply don't serve a user need.

Many health apps remain the most obvious example – they are easy to create and usually free to download, but most fail to provide real benefits, and the overwhelming majority are rapidly abandoned by users.

Kai Gait says that's because most mobile health solutions aren't designed to solve the underlying problem. GSK has now gone back to 'first principles' to make a new updated 'My Asthma' app that truly helps patients and doctors keep on top of the condition.

Gait and his team have collaborated with a leading academic centre and a very well known 'fruit-based' technology giant (which insists on not being named) on developing the app.

GSK has now gone to the trouble of making the app a Class 1 medical device – something which has added complexity to its development, but which Gait believes will pay off for users.

Apple's ResearchKit

Alex Butler, managing director of EarthWorks spoke about the huge potential of Apple's newly launched ResearchKit, saying it was already transforming the clinical trial landscape.

As everybody in pharma knows, clinical trials are the most expensive part of the R&D process, with many inefficiencies, with 80 per cent of trials failing to meet their enrolment deadlines.

Launched in March this year, ResearchKit is aimed at turning the iPhone into a powerful tool for medical research, by allowing users to participate in clinical trials. The pool of potential recruits is huge: around 700 million people use an iPhone worldwide, a 'captive audience' who could help revolutionise how research is done.

The first five apps built into the ResearchKit focus on key areas: breast cancer, asthma, Parkinson's disease, diabetes and cardiovascular disease, and each of these has been created in collaboration with a leading academic or charity health research institute.

A smartphone's built-in sensors, such as microphone, camera and motion sensor, can all help collect data digitally. Butler was particularly enthusiastic about mPower, a ResearchKit app created to aid research into Parkinson's disease. The app captures data on a person's voice, gait, balance and manual dexterity which, over time and across thousands of patients, can build up a valuable dataset. (Click here for video.)

ResearchKit has proven to be an instant success in recruiting trial volunteers: Stanford University said that within the first 24 hours of its launch, 11,000 iPhone owners signed up to its heart health study via the MyHeart Counts app, a feat which would have taken a year for a multi-centre trial to achieve.

Butler acknowledged that there are a number of obvious limitations to ResearchKit – trials which require a blood sample would not be achievable of course – but said the technology would continue to evolve, and would allow rapid progress in some areas of research.

One further advantage was that people viewed this clinical research as different to pharma-led research.

"In clinical trials, people think they are being exploited by pharma companies, whereas with this, they think they are helping other people," he explained.

Butler also urged pharma to be brave in leading tech innovation, in order to meet the challenges of healthcare and ageing head-on.

The first digital pill

Next to speak was Barnaby Poulton, head of customer partnering at Proteus Digital Health, a company developing the world's first digital pill.

The technology involves an ingestible sensor being embedded into a medicine capsule, allowing medicines compliance, as well as physiological response to the drug, to be tracked. Data from the swallowed pill is picked up by a special sensor worn as a plaster on the patient's arm, which can then be shared with healthcare professionals.

Proteus has just had its first filing accepted by the US FDA: a collaboration with Otsuka on a digital pill version of its antipsychotic drug Abilify.

Exciting news for the UK is that Proteus is working closely with the NHS on researching its technology in real-life conditions. Poulton said a study in uncontrolled hypertension found one third of patients could get their condition under control with better compliance – a massively helpful insight to inform and improve clinical management.

Poulton said the technology would help shift healthcare towards a more patient-led, model: moving away from 'What's the matter with you?' to 'What matters to you?'

Who are pharma's 'perceptual competitors'?

David Hunt, chief executive of Havas Lynx, and Guy Shauli presented together on closed loop marketing (CLM).

While CLM might sound like just another three-letter acronym, Shauli and Hunt said it was the method by which the world's best companies were learning more about customers and refining their products and services.

They said pharma should look beyond its industry peers to 'perceptual competitors' to provide an outstanding service to customers. Among the most impressive 'disruptive innovators' were digitally-based companies such as Airbnb and Uber, said Shauli.

He cited online video company Netflix as a leader in using data to understand its customers' viewing habits, and tailor services accordingly, including the commissioning of a whole new series, House of Cards.

"They're a data company, now, not an entertainment company," he said.

David Hunt said these lessons could be applied to pharma's digital work. "Doctors won't say 'I'm going to prescribe because your iPad presentation looked so impressive'. But when you look at the data and then tailor your discussions with them, that will make a difference."

Hunt concluded by urging pharma to work in a more agile way, and abandon the linear processes which slow work down, switching instead to a bolder, more iterative approach.

Influencing behaviour with web-based tools

Next to speak was Martin Moth, Tools Lead at NHS Choices. He said this government-funded website is now engaging the public beyond the level of simple health 'pop quizzes' in order to influence behaviour. He said NHS Choices was also collecting user data so it can analyse if its efforts are working – but must be careful to follow good practice in data management and protection.

He showcased an interactive online tool which allows the general public to calculate their 'heart age'. He said the tool was deliberately provocative – aimed at shocking people into addressing their health, particularly those who would otherwise ignore such issues – typically middle-aged men who wouldn't visit a doctor.

Moth said by understanding how modern digital media works, the online tool went viral, thanks to coverage by The Daily Telegraph and the Daily Mail Online and others.

He said the site has now gathered data from 670,000 users, which it will analyse to inform future work. He reported that the site is already seeing an increase in users who 'know their numbers' in blood pressure and cholesterol, a sign of greater engagement in their health.

Creativity in digital health

Finally Dominic Marchant, managing director of DJM Unlimited and Louise Benson, festival director of Lions Health, spoke about the role of creativity in digital health.

They said that supporting creativity would help pharma break away from its old approaches, and ultimately help patients.

Marchant said companies like Samsung, Nokia and Microsoft were moving into healthcare, and forcing pharma and other incumbents to raise their game.

He echoed the sentiment among many of the agency-side leaders, who emphasised that brave and ambitious thinking was required from pharma in digital health.

A judge at last year's Lions Health awards, Marchant said the most impressive work had come from outside the traditional US and Europe regions, with Latin America and Asia producing the best quality projects.

"We were blown away by the quality of the work – and it made me think we can do better. If clients can think that way too, we'd be on to something."

About the author:

Andrew McConaghie is pharmaphorum's Managing Editor, Feature Media.

Andrew can be contacted via: andrew@pharmaphorum.com

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