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The numbers are huge. Pharma companies are losing an estimated $637 billion each year because of medication non-adherence, according to a report by consulting firm Capgemini and medication adherence company HealthPrize Technologies. And improved adherence to diabetes medication programmes alone could avert 699,000 emergency department visits and 341,000 hospitalisations annually – saving $4.7 billion in healthcare costs. So there’s a lot at stake.

Adherence matters, quality of adherence matters – and outcomes matter. Logic demands that, over time, therapies with poorer outcomes will be prescribed less often. So maximising adherence – and thus outcomes – will contribute significantly to ensuring future market share.

In today’s world where digital solutions are transforming whole industries, this is a great example of an unmet need that provides a major opportunity for innovation. So how could technology address the adherence challenge?

For a start, it can measure it. There are many early steps being taken already, mainly by recording dosing. That’s great, and serves the initial need – but is it thinking far enough ahead? Is the time and day of a dose enough to influence the outcome?

Consider the example of inhaled medications. By monitoring airflow in addition to just actuation, we can gather significant insight into how well an inhaler user is taking their medication. This gives deeper insight into adherence – if a patient is taking their medication but taking it poorly, then efficacy is reduced. But it also opens the door to extra services like automated in-home training – enabling patients to improve their technique at their own pace, and reducing the training burden on medical professionals.

We can also go further and explore other sources of information – building towards a more holistic model of the patient’s condition rather than just focusing on their actions. A small biometric monitor, for example, can be embodied in a low-cost device to monitor and report breathing rate and heart rate in real time. Linking this kind of capability with patient records, adherence monitoring helps us to create a more accurate understanding of a patient’s condition and the effect of medication in the long term, ultimately improving health outcomes.

So where to start?

It’s easy to jump into the digital world and propose an ‘all-singing, all-dancing’ connected system just because it’s technically possible. But is this really innovation?

The challenge is finding the most commercially exciting solution when almost anything is possible at one price or another. This is where the ‘technology-led’ innovation approach has to give way to a ‘market-led’ one.

We use the increasingly influential ‘jobs-to-be-done’ methodology to guide our innovation thinking.  It’s a particularly effective technique when there is a complex ecosystem of stakeholders that influence success. It’s a great way of getting ‘under the hood’ of customers and stakeholders to understand what will really drive their future actions and choices. In situations when a proposed innovation will disrupt a complex care pathway and industry, it provides an evidence-based framework not only to inspire and guide innovation but to measure a solution’s value and predict choices. When considering how to innovate, this allows your strategy to be developed based on data analysis, rather than supposition.

It starts with an understanding of the stakeholders and the challenges they face. The theory says these people have ‘jobs’ that arise regularly that must be addressed – and they look around for products or services to get them done. To put it simply, a patient does not want to take medication per se – they want to feel better, and their insurance company wants to maximise profits in the medium term, and so on throughout the ecosystem. It concludes by identifying the best opportunities to enter the innovation pipeline.

But can you make it real?

There are examples of a well-targeted connected product changing a whole industry sector. Often these products have changed from just a physical tool that the customer can buy and use to a source of data that is valuable at an individual level, and even more valuable when aggregated across groups.

From a technical perspective, a device is usually a collection of sensors, actuators, power supplies, communications protocols, regulatory approvals, data security systems, networks, data storage and processing systems, data analysis algorithms, clinical research, statistical analysis, and finally commercialisation and monetisation strategies. Success lies in adapting the technology to meet a set of valuable unmet needs across all the stakeholders involved.

Let’s get digital

The digital age is upon us – and industry after industry is exploiting these new opportunities. Patient adherence is just one of many applications where digital solutions can potentially create dramatic changes.

At Cambridge Design Partnership we have the expertise to identify opportunities, develop strategies and create new products that exploit the new digital world. Where to go from here? Let’s start the conversation via hello@cambridge-design.co.uk.

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