There has been a proliferation of digital patient solutions over recent years, but average user numbers and overall adoption rates are often low.
In a recent survey of more than 1,000 UK clinicians, just 36% said their patients are currently using digital products like diabetes management systems and health-tracking wearables.
However, the NHS staff themselves were overwhelmingly in favour of more use of data-driven technology, with 76% saying they thought it would lead to more accurate monitoring of symptoms and better management of conditions.
Meanwhile, patients are embracing new technology where they perceive it to offer clear value in their care, as can be seen in the general support for video consultations with doctors for minor ailments and ongoing conditions.
So, what’s holding digital patient solutions back? S3 Connected Health’s head of consulting David Mulligan says that a focus on user experience (UX) and user interface (UI), while necessary, has come at the expense of analysing what drives acceptance by the key stakeholders and motivates them to adopt the solution.
“It’s important for life science companies to understand who the users and stakeholders of their solution are, be they HCPs, patients, payors or providers, and analyse those factors that will influence them to adopt a solution,” he adds.
One of the reasons why this may not have been done to date is due to a certain amount of confusion around the term ‘adoption’ and what aspect of it pharmaceutical companies should focus on.
There are two sides to adoption. Firstly, there’s a solution’s initial acceptance and uptake, and then there’s sustaining its usage and patient engagement over time.
Speaking to Mulligan, it’s clear that these different elements have different problems that come at different time points within development and require different analysis.
This article will define adoption as the initial acceptance and uptake of a digital patient solution, acknowledging that ongoing engagement and sustained use is a different problem which needs to be examined separately.
Looked at from this perspective, Mulligan says it’s entirely possible for pharmaceutical companies to understand, analyse and successfully plan for the adoption of a new digital patient solution.
“Leveraging behavioural science and analysing a user’s capability to use a digital solution, the motivations they may have to use it, and the external opportunities that can influence whether it is available to them, can lead to solutions that not only drive adoption but have an impact on care delivery and healthcare outcomes,” he says.
But it would be a mistake to assume that the process of securing adoption for a digital patient solution starts at its launch; it has to be planned for throughout the design and development process.
To do this, companies need to define the health behaviour challenge they face and identify a high-level solution that could address it. From there it is essential to analyse the factors that could affect a solution’s adoption, an understanding of which requires the application of behavioural science principles, says Sinéad Ní Mhurchadha, senior consultant in behavioural science at S3 Connected Health.
COM-B stands for Capability, Opportunity, Motivation and Behaviour. Applying the COM-B model to a healthcare professional’s adoption of a solution from the outset, could identify that:
If these types of barriers are not addressed when designing and launching the solution, they can present considerable barriers to adoption of the solution.
The model can also be used to address the factors that may impact a patient’s adoption of a solution; identified through patient experience mapping techniques.
“Patients must also perceive value in the solution and see that it addresses a need, and they must have the health literacy skills to adopt the solution. They may also need to consider whether they can afford it, if it’s self-funded and if it’s reimbursed by the healthcare system or even accessible,” Ní Mhurchadha says.
Once pharmaceutical companies have solid plans in place, ensuring adoption of a digital patient solution still requires many other considerations to be taken into account, as Ni Mhurchadha explains.
In addition to embedding behavioural science techniques into the overall design process, companies should also decide upon the ‘core adoptable solution’ they can produce. Mulligan explains this idea as “the true intrinsic piece of value that a solution will deliver to make a difference”. It is the core of a solution, upon which future iterations can be built and scaled.
With those two aspects addressed, companies can look to solve further adoption problems that users and other stakeholders may experience by designing enrolment, training and ongoing support strategies.
“To do this, companies must engage with users and stakeholders early, and often, to truly understand the factors that are affecting adoption, and then follow through with the same early adopter users to test the propositions being designed and remove any barriers to adoption that are identified,” Mulligan says.
Digital patient solutions have often suffered in the past from a blind spot when it comes to adoption, partly because it’s an undoubtedly complicated challenge to address, but also because it’s easy to lean on assumptions about what drives behaviour, rather than applying academic theory to it.
To truly bring about change, pharmaceutical companies need to focus on both patients’ needs and those of HCPs. Only by considering both of these perspectives can firms understand what will have an impact on the likelihood of adoption for any new digital patient solution.
It is all too easy for digital patient solutions to be designed and launched without paying due attention to the very real adoption challenges they will face. Though these are by no means insurmountable, they require pharmaceutical companies to have a clear focus on a solution’s initial acceptance and uptake, addressing the different drivers and barriers they will face, and underpinning their efforts with an appropriate use of behavioural science principles.
Sinéad Ní Mhurchadha a senior consultant in behavioural science at S3 Connected Health and a chartered psychologist with the British Psychological Society and the Psychological Society of Ireland. She completed a BA in psychology at University College Dublin, an MSc in health psychology at University College London and a PhD in psychology at Dublin City University.
With extensive experience in the health and pharmaceutical industry, Sinéad has successfully led the research, design and creation of many global, regional and local patient-support solutions and healthcare-professional initiatives across a range of conditions. Her work includes primary research, patient experience mapping and solution design. Sinéad is driven to support patients living with chronic illness and to make real-world, long lasting changes that benefit their lives.
David Mulligan is head of consulting at S3 Connected Health. He and his team use behavioural analysis, patient journey mapping and data-driven insights to understand the needs of patients, clinicians and providers to inform the conception, design and delivery of tailor-made digital health solutions.
With a strong background in hardware and software development, David has worked for Philips and ResMed in scientific hardware and software R&D and was previously director of consumer product development for Europe at Microsoft. In recent years his focus has moved towards improving patient outcomes through patient engagement and empowerment, leveraging the opportunities which mobile, device and cloud technologies offer. David has a passion for developing creative and innovative solutions to large challenging problems.
S3 Connected Health provide digital therapy management and patient engagement solutions that empower patient self-management and provide real-world evidence to support access, reimbursement and value-based care.
Using behavioural analysis, patient journey mapping and data-driven insights, their multi-disciplinary team understands the needs of patients, clinicians and providers to create, launch and operate scalable, secure and regulatory compliant digital health solutions.
With over 17 years’ experience, they have delivered award-winning solutions in over 50 countries across 20 therapy areas, including neurology, immunology, endocrinology, dermatology, respiratory, cardiology and oncology.