What is driving the digital underpinning of healthcare?
All aspects of our lives have been radically changed by the ability to interact in a digital world: the way we learn, shop, travel, are entertained, make friends. In medicine, innovation has enabled Real World Evidence collection, but the transition to personal interactions in clinical trials and between patients and physicians has been slower. However, as summarised by a McKinsey report on Medical Affairs (December 2018), digitisation offers enormous opportunities to drive rapid evidence generation, clearly articulate clinical and economic value, upgrade patient decision making and, by better understanding stakeholders, steer more effectively the direction of healthcare organisations.
Access to such information speeds everything up. The COVID-19 pandemic has demonstrated what free access to thousands of research papers can do in leading to better educated patients and to physicians being able to rapidly assimilate vast amounts of data, in turn transforming stakeholder engagement throughout the healthcare value chain. Pharma companies can now more easily and directly listen to, and respond to, the needs of patients and physicians alike, rather than being solely dependent on market research to get feedback.
What is the downside?
The volume of data involved tends either to drive a rapid Facebook and Twitter type communication, which can lead to information being dumbed down to the lowest common denominator or, at the opposite extreme, being transformed into complex and detailed evidence-based guidance documents. The answer, says McKinsey in their “Vision for Medical Affairs in 2025”, is to follow five approaches:
- Embrace the power of technology to provide new AI (artificial intelligence), analytics, and datasets
- Constantly review how organisations perform digitally to drive excellence
- Directly address patient needs using engagement and new tools to understand their medical journey
- Use better ways to collaborate building project leadership and understanding, resulting in improved efficiency
- Seek out ways for the industry to collaborate through professional organisations
So how has the COVID-19 pandemic catalysed the process?
Travel limitations have meant face-to-face meetings, considered the norm in the past, have become almost universally virtual. This includes patient-doctor as well as Pharma-doctor interactions.
While online interactions will not replace face-to-face meetings altogether, they are now widely accepted as being just as productive, easier to schedule and better attended than face-to-face ones.
In order to make the most of this wave of virtual tools, users should have a positive online experience, and developers must ensure that the information relayed is succinct and on message.
Conferences have been moving inexorably towards online formats as Pharma and physicians have increasing constraints on travel. Virtual versions of scientific and educational sessions and satellite symposia, whether live streaming, pre-recorded or hybrid, have become commonplace. Some online meetings have allowed links to company websites, but a true virtual exhibition experience has been rare, and event organisers have enticed Pharma companies to have large stands for experiential learning and discussions.
During the COVID-19 pandemic, however, the “hard” exhibition space is not there as conferences for the first 9 months of 2020 have relinquished their physician presence and gone “online”. Organisers have reduced the registration fees, but correspondingly more people may attend; however, the lucrative fees from the exhibition halls are not being paid and will likely leave a large void in organisers’ budgets.
Meanwhile, attendees may prefer the new format as they “drop in and out” as needed around other work commitments, rather than blocking out several days from their busy schedules. However, they may miss the networking. Overall, there may be more attendees than at a static conference.
In order to improve attendees’ experience and conference organisers’ budgets, virtual simulations of medical conference exhibition halls have been developed alongside virtual poster halls. The conference organiser can then sell slots for Pharma to display their medical information in a simulated way. This “virtual exhibition booth slot” offers live presentations, interactive timed webinar audience sessions, pre-recorded video clips, and all the conventional materials of engaging exhibition booths.
Companies are rethinking their approaches to virtual booths for 2020. Once simulations are developed they can, if required, be used again beyond the intended conference.
The “live campus” central core
Online learning facility
Online elements have been used in education for many years but adding more sophisticated simulations makes learning more engaging and allows bespoke modules. E-learning materials can be developed by Opinion Leaders with support from Medical Affairs personnel, patient experiences can be utilised, and live Q&A sessions can be set up. The online approach allows users to learn at their own pace and to focus on areas of greatest relevance. In some simulations that have been used, the learning module comes in the form of a learning campus, with lecture halls, libraries and examination rooms for remote invigilation and certification.
Medical information in the “live campus”
The “live campus” concept can hold medical information in a single simulated facility accessed at different levels and languages around the globe, allowing company personnel and healthcare professionals to visit it for specific information or request live interactions with medical science or medical information liaisons. The “campus” can act as the main source of information for different products, and disease information can be provided from a friendly user interface with fewer concerns about user interpretation.
AI and real-world evidence (RWE) providing information to the “campus”
Regulatory global source in the campus
In Regulatory Affairs, industrialisation of Artificial Intelligence/Machine Learning-enabled Intelligent Content Authoring (extraction, modularization, classification, re-purpose) assists with regulatory submissions and product labelling.
Pharmacovigilance activities can make use of developing technology such as Intelligent Safety Suite (ISS), featuring natural language processing (NLP)-based Independent Case Study Report processing, advanced signal detection and aggregate reporting.
Virtual Advisory Boards, webinars, and networking
Facilitating Advisory Boards can be a challenge at the best of times, requiring preparation and skills to manage and access valuable information from Key Opinion Leaders (KOLs). Remote meetings are no different but with visual interaction and clever use of webinar technology, the objectives can be achieved almost as effectively as in a face-to-face meeting. Webinars can easily take place: smaller ones with network interactions, even Virtual Coffee sessions! Collaboration must be more disciplined and prepared, and this form of meeting will surely outlive the current COVID-19 pandemic.
Research – market or clinical
Digital market research, including surveys, regional clinical guidance, and product usage information are all widely available, but during the COVID-19 pandemic companies started sharing such information. Companies are even collaborating on clinical trials that test each of their active products against a single comparator. Clinical trial conduct, Regulatory Affairs and document management have all gone largely digital. The use of video-linked informed consent and conferencing for patient visits have been enforced by the COVID-19 pandemic, but patient-physician feedback to date suggests that this will improve the patients’ trial experience. Some patients travel long distances to be in a trial, and a Skype meeting might make the difference between participating or not.
Is COVID-19 accelerating us toward our goals?
Do we measure up to McKinsey’s view of 2025? Have we accelerated our journey? Undoubtedly, we are using better ways to work together and collaborate, building project leadership understanding. Companies are seeking out ways to collaborate through other professional organisations. Analytics, AI, and data sets are powering information in “live campuses”, which are used to drive excellence through education and transparency. The last, but probably most important, benefit is directly addressing patient needs using new tools to understand their medical journey, and, by listening to patients, carers and health professionals, providing them with what they want, rather than defining messages that we want them to hear.