• Becky Sarson

For F**ks Sake – Do Your Homework

For innovation to be successful we need to deeply understand the problems we are trying to solve first, and not try and fit a problem around some cookie-cut product we have created. This is fairly common sense but why is this archaic, product-focussed approach still being bought by pharma and sold by agencies?


Imagine walking in to the doctors surgery and before you have even opened your mouth the doctor says…


‘shhhhh…. here’s what you need’ and writes you a script….


‘but you haven’t even heard what’s wrong…’ you respond tentatively


‘I don’t need to, I already know, just try this, see how you get on, it’ll be fine…’


Another analogy, you take your car to the garage, and the foreman says to you as you get out of the car, ‘give us the keys love, we’ll fix it..’ But you haven’t even had a moment to explain what could possibly be wrong, in fact, you’re just picking someone up who has just dropped their car off…


So, not only are both of the characters in these examples deeply arrogant assuming they know what is wrong before anyone has been given an opportunity to express the problem, they have also diagnosed, and believe they have fixed the problem without consultation with the end user. This means that the likelihood of the solution being prescribed, being correct, is infinitesimal.


Granted, these are unlikely scenarios, but sadly, it is almost the modus operandi in our industry. I see Pharma and agencies decide they know how to fix the problem, and then proceed to either develop new products, or worse attempt to retrofit pre-developed interventions in to practise without ever consulting the end users of the product, or gaining an insight in to the environments in which they are to be used. Its crazy! This methodology would never be adopted in the discovery and drug development process. So why is it so common at the marketing and patient support stage?


The agency

The traditional agency model is to just simply answer the brief from the client with as bigger margin as possible. If the client wants to spend the money developing the solution, then by god, develop it. This makes no sense to me at all. Why hire experts as delivery houses? Let’s face it these solutions can be developed at lower cost elsewhere, heck, hire a freelancer.


Agencies have a responsibility to ensure they are helping their clients to do the right thing, and that budget is being spent effectively, because ultimately it will be you being asked: ‘why are we doing it this way again?’ Your answer should never be: ‘because you told us to’, if it is, chances are the client never needed you in the first place.


It is also the responsibility of the agency to ask questions, do your homework! Do not just lazily answer a client brief, but understand the problem at large first. What are the tools and services that are really required by HCPs and patients to improve their lives? how does that overlay with the commercial objectives of the company? Hang on, doesn’t the patient organisation already have that?? If there is no value to the end user, or the need is being met elsewhere, there is no value to the company to create it. The intervention will be lost in the noise, drowned, and never used, ever.


Lastly, unless you are buying a CLM platform or something of a similar ilk, NEVER waste your money buying off-the-shelf solutions from agencies to fit your need. This product will have been sold to multiple brands in multiple therapy areas. It will not differentiate your brand or you in the therapy area and as such, is likely to add little value to your end users. In short, there is little commercial value to your customers, patients or pharma in this approach, but a maximum margin for an agency.


This may seem a bit odd coming from a commercial agency person, but I see this as a no-win for all parties. If products that are being handed over to the client from the agency are not of value to the end users, they are not something that any reputable agency should be proud of. Profit margins are not a good enough reason to be delivering these ‘productised’ solutions for pharma, their customers and the patients. I would argue it’s actually unethical.


Product first, problem second

There is a drive and a focus to implement health technology in to clinical practise, but starting from the technology first will never work.


If we really want to change patient’s care through the use of technology the rationale to implement needs to be backed up by co-design, continuous evaluation/testing and iteration, as well as a willingness from the users to change clinical practise and accommodate new ways of working.


There are multiple examples of interventions being designed and developed with the best of intentions but in splendid isolation of the people who are going to be using them, or the environments in which they are going to be implemented.


For example, “In North East London, community pharmacists were piloting the use of a device, Kardia Mobile, in conjunction with a smartphone to screen for atrial fibrillation. Pharmacy staff were trained to use the device (even if they had no clinical training) and during the pilot 1,400 people were referred to their GP for further screening. Through a process of constant feedback from evaluation partners in UCL, it became clear that while the technology was working, the pathway was not. Patients were being referred to their GP who would then do the same test again. This needlessly extended the time between initial screening and treatment”

https://www.kingsfund.org.uk/publications/getting-most-technology-requires-pathway-redesign


This example does not stand alone. I have sat with many clients asking me to evaluate the products they have built and help them to understand why they were simply not being used. But looking at the end product is not the answer. We need to start from the beginning and re-look at the research, design and development process. We need to begin to place users at the centre of the motivation to design and implement, not pharma or their agencies.


Can we fix it?

Absolutely.


As agencies we need to re-evaluate what it is we are offering to our clients, and help our clients to not only answer the brief, but ensure our proposed solutions are solving a real problem for their customers/patients/carers/PAGs.


Agencies should be helping to add real value to the healthcare landscape in the same way our clients medicines do: through the development of value-added products and services. SPOILER ALERT: it wont be through product websites – Wikipedia has you covered!


Helping our clients to employ user-centered design methodology in to the product development processes used by agencies, will help us to understand and evaluate the feasibility of the product before any kind of production begins. 


Working with the right agencies will ensure this doesn’t need to be a huge departure from current development processes, but it does need to start with understanding who our customers/proposed users are. We need to identify and empathise with our users, understand what are their motivations? What could the tasks and goals of the product be (aligned to the commercial objectives and the objectives of our users)? Is there even a need for the proposed product in the first place? This process might push timelines upfront by a couple of weeks, but will pay dividends to the design, development, testing and implementation process in the long run.


By truly putting the user first and not just paying lip service to the process, will mean we will be producing valuable services that work for the users and can be implemented with less friction in to practise. We will be spending budget more effectively by not investing in products that wont be adopted or used; and investing instead in the development of products/services that hold mutual value between product sponsors and their users.


The process of design, testing and constant iteration throughout the design and build phase is a departure from the traditional development and approval methodologies within Pharma. Elements that have been previously approved are still subject to change throughout the process which can feel uneasy.


However, if a mutual approach can be agreed upfront, product development can work out more efficient in the long run. For example, the practise of rolling out all design screens: previously a costly ‘must’ for approval processes (usually 2nd round Zinc review, post-copy) and the bane of an agencies life, becomes almost redundant. A feature-approval process can be used to get to the same approval result in Zinc, but with less pain for all parties and a better overall final product.


With careful project management and a thorough on-boarding of all internal teams (both Pharma and agency side) I believe the adoption of true user-centered design processes will inevitably lead to: much more aligned products of mutual value being developed, less budget wastage and the faster adoption of appropriate (and maintainable) health technology in to mainstream clinical practise. This can only be a good thing.

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