PHARMA GEEK

[hopital.fr] Première cause d'hospitalisation pour les patients de plus de 65 ans, l’insuffisance cardiaque touche un million de personnes en France et se caractérise par une importante gêne dans la vie quotidienne.

le marketing classique de Kotler & Dubois a lui aussi été balayé pour mieux installer les nouveaux préceptes du marketeur à l'ère digitale: Présent, Pertinent, Patient, Performant.

With the proliferation of mHealth apps, it was only a matter of time before healthcare providers would start prescribing apps as soon as apps proved to be as or more effective than prescription drugs. Happtique, a mobile health application store and app management solution startup will launch a trial of mRx™, the first program to enable physicians to prescribe mHealth apps to patients. You could call it an “app formulary” that complements (and competes) with a traditional drug formulary. Anecdotal evidence has circulated that some apps have been more effective at addressing some chronic conditions than drugs. As more hard data is available, this represents a major threat to lucrative drug franchises. Pharma Looking Like a Cross Between Railroads and Newspapers

As I outlined in IBM’s Reinvention Should Inspire Flat Pharma Businesses, pharma faces a grim future if they don’t take action. A program such as Happtique’s can be either a huge opportunity or a huge threat depending on how they handle it. Over the last several months, I have had many meetings with leaders of pharma companies that are eerily reminiscent of meetings I had in the latter half of the 90′s with newspaper executives.

Pharma execs will often share that when they gather as an industry, they all commiserate with their industry colleagues that their business is in their words “effed”. However, when they return to their office “innovation” is little more than incremental tweaks to existing business models. Like the newspaper execs I observed, the vast majority either seem to not fully believe the consensus about the future or they are simply unable to marshal the ability to drive change within their organizations. In either case, they are lulled into complacency as they remain hugely profitable and face the reality of dealing with the short-term thinking of Wall Street. I’m afraid most of them will have a final chapter of their career that reads the same as newspaper execs of that era. The chapter title will be “He/she couldn’t read the handwriting on the wall.” I have yet to see a pharma CEO like John Paton who is one of the few newspaper CEOs to fully take advantage of the changed media landscape.

In fairness, John Paton took over a bankrupt newspaper chain so it’s relatively easier to make drastic change when an organization is that close to extinction. It is instructive to know that IBM swung from their most profitable year to losing $16 billion in just three years. The lesson is that change looms out there for awhile and then hits like a freight train. The question is whether pharma will have to wait until they near death or if they can make bold changes before they are in a death spiral like the newspaper companies before them.

Smart Pharma Will Get Out of the Stands and Onto the Field

There have been a proliferation of “app challenges” that have been sponsored by pharma. While the challenges are a step in the right direction, they are doing the equivalent of providing polite applause from the stands and giving the gladiators (aka startups) some modest rewards for their efforts. When I am asked for my advice by pharma execs regarding how to drive change and innovation, my primary piece of advice is to get out of the stands and onto the playing field. They can put more skin in the game (both money and people), however it need not be at the same scale as their venture arms. In fact, they could probably get involved with ten companies for the cost of one of their venture investments in biotech.

Consider the learning they could get from the program Happtique is running. One of the benefits of participating in a program like this is pharma would get out of their industry bubble. For the program trial, Happtique is recruiting physician prescribers who treat heart disease, diabetes, and musculoskeletal conditions, as well as physical therapists and trainers to test the technology with health and fitness apps. After a training program, Happtique will track both prescribing processes and patient mRx™ downloads through early summer. “Mobile app prescribing will add an entirely new dimension to my ability to care for patients,” said Steven Magid, M.D. of New York-based Hospital for Special Surgery. “The use of Happtique’s mRx™ will ultimately improve patients’ health.”

Another Forbes contributor, Dr. David Shayvitz, comments in Pills Still Matter; So Does Biology — Managing Expectations About Digital Health about the combination of pills and apps likely being the most effective combination. I agree. Another sage industry commentator, John Moore of Chilmark Research, has interesting analysis in a piece mHealth: There When You Need It. He debunks the myth that lower income people won’t engage with mHealth apps, however two key attributes need to be present. First, physicians reimbursement needs to be aligned with outcomes (and thus the transition from fee-for-service to fee-for-value that is underway). Second, patients consistently engage if there is someone they are interacting with via the tool such as a nurse.

Lessons from Microsoft for Pharma

I’m the first to say I’m not an expert in pharma. However, I can see pattern recognition and have seen how one of the few organizations to spend as much on R&D as pharma (Microsoft) can be both a cautionary tale and a guiding light. Over the last 15 years, Microsoft has spent tens of billions on R&D. I would argue there are only two true stand-alone successes that have emerged out of that massive investment — Xbox and Expedia. In both cases, Microsoft physically and culturally separated them from the mothership. In Expedia’s case, it also made the most sense to separate them financially. It wasn’t that the Xbox and Expedia teams had people who were any smarter or hard-working than other teams at Microsoft. The key was they were unshackled and unfettered.

Via Chaturika Jayadewa

With recent statistics showing Kenya’s maternal mortality ratio at 488 per 1000 live births, a new monitoring system for expectant mothers is set to ease the number of deaths during childbirth. The app ensures the health workers, midwives and the pregnant mothers share health information and care tips using SMS and prepaid calls.
Via Alex Butler, dbtmobile

With the close of the American Telemedicine Association's 2012 Conference and Exposition this week, I have seen a number of articles regarding the confluence of tele and mobile health in care delivery innovation.
Via Bernard Strée

As AT&T continues to expand its services into the telehealth market, the company has signed an agreement with Valued Relationships Inc. (VRI) to deliver a remote patient monitoring service to more effectively manage chronic diseases and help reduce hospital readmissions. The end-to-end managed service is scheduled to launch in the third quarter of 2012.
Officials at AT&T said the target customers for the service are physician practices, hospitals, and payers (e.g., employers and insurance companies). It is up to the targeted customers to identify and create a list of patients. AT&T will then recruit from this list for the service, on the customers' behalf. Under the agreement, equipment will be installed in the patient's home that connects to VRI's nurse-staffed telemonitoring center to monitor patients around the clock who suffer from a number of chronic illnesses, including asthma, chronic obstructive pulmonary disorder, coronary heart disease, congestive heart failure, and diabetes.
The system will capture data from wirelessly connected personal health devices, such as blood pressure cuffs, weight scales, and pulse oximeters. Patients then upload the information through AT&T's network to VRI's care representatives. VRI's advanced analytics tools and reporting capabilities can read patients' vital signs and indicate whether intervention is required. If patients require intervention, care representatives call them to check that the technology is working properly and being used according to clinical protocols, and then arrange the necessary treatment.
Andy Schoonover, CEO of VRI, said the service will help providers and payers manage clinical information and monitor the alerts gathered by the telehealth devices.
"Health plans and hospitals will no longer have to actively monitor the information because VRI's call center will monitor it for them. VRI will only contact them in a case in which a clinician is needed to give the care required to keep them from being hospitalized," Schoonover told InformationWeek Healthcare.
Eleanor Chye, executive director for mobility healthcare and pharma at AT&T Business and Home Solutions, did not give specific pricing details, but she did say the cost for the remote patient monitoring service will depend on the type of service requested.
"The pricing structure for chronic disease management includes a monthly service fee per patient, patient site dispatch fee, and professional services fees," Chye told InformationWeek Healthcare. "The pricing structure for acute care management (hospital readmissions) includes a 30 or 60 day flat fee per patient, patient site dispatch fee, and professional services fees."
Irene Berlinsky, IDC's senior analyst covering multiplay services, said there is a lot riding on this new service. "If this partnership succeeds, AT&T has a new product it can shop around anywhere in its wireless network--which is most of the U.S. VRI gains exposure and gets to be a part of a managed, end-to-end solution rather than a piece of a 1,000 piece jigsaw puzzle," Berlinsky said.
The new managed service is being introduced at a time when telecommunications companies are aggressively looking for new opportunities to serve the healthcare industry, which is applying new technology to its evolving business model.
At the same time, hospitals are seeking to reduce readmission rates as a way to lower healthcare costs. Research that examined the re-hospitalization rates of Medicare beneficiaries indicates that nearly 20% of Medicare patients are re-hospitalized within 30 days after discharge, at an annual cost of $17 billion.
"Hospital readmissions carry huge costs for hospitals and add greatly to the cost of healthcare. Remote patient monitoring has the potential to prevent many such readmissions," Berlinsky said.
If the AT&T/VRI partnership hopes to succeed in reducing hospital readmissions, they'll have to provide a platform with software that accurately interprets a patient's vital signs.
"The quality of the solution depends on the software used to analyze patient data. If it inaccurately flags problems--or worse, misses them--hospitals may not see the expected savings materialize," Berlinsky added.

Via Chaturika Jayadewa

To support the 1 Mission 1 Million global campaign, Boehringer Ingelheim provided €1 million to support projects chosen by the public that aim to educate abo... (Why does 1Mission 1Million have such a strong support base?