1. Design for behavior change

In almost all healthcare systems today, payers increasingly only pay for health outcomes. As such, designing behavioral interventions for better adherence and outcomes has become a way for new entrants to disrupt the market. Start-ups like Omada Health for example design new, comparatively low investment behavioral interventions that significantly improve patient outcomes for chronic, preventable diseases. Such programs combine behavior change around diet, coaching and digital connectivity. In some cases, patients already diagnosed with diabetes can reverse their diagnosis and avoid insulin therapy, thereby also saving payer systems exponentially. Designing for behaviour change at a variety of touch points is a specialty of ours. 


What are you doing about design for behavior change?

2. The business of personal data control

Most developed countries have highly evolved laws and protections on sharing health data. However in the $238M, much hyped industry of wearable fitness trackers, there is growing disillusionment with who controls personal data. Recently the Quantified Self community initiated measures to force companies to allow users to reclaim the personal data that they have generated themselves (calories, steps, sleep patterns etc.) It is surprisingly difficult to determine how such data is currently used by such companies. New start-ups such as Human API and TicTrac are developing API's and services respectively to enable people to integrate and control all of their personal health data that might have been collected across a variety of platforms.


How are you empowering users with their own data?

3. No more blockbusters

Innovation in pharma is increasingly coming from service propositions around compounds, which also serve as important brand extensions. New, innovative services are often aimed at other agents in the ecosystem of care besides patients and physicians  - like nurses or family members - who have been traditionally unaddressed, but who have significant impact on outcomes. While nothing can save traditional blockbusters from falling off the proverbial patent cliff, new services around compounds add more stickiness, higher value and better outcomes to branded offerings.

What are you doing about designing new services?

4. New commercial models

Established single-payer systems, like those in northern Europe, only pay for measurable patient outcomes. Even the US has moved toward a single-payer system. For big companies, designing for patient outcomes in a single-payer environment will be the most significant commercial challenge for years to come. We see big companies going with leaner sales staffs of key account managers, who will use sales budgets to build interventions in collaboration with their single-payer customers. We have even seen some companies cut outcome-based risk-sharing deals with governments in order to maintain pricing. We have helped our clients build innovative commercial propositions.

What are you doing about designing innovative commercial models across different markets?

5. Different doctors treat risk differently

Marketing to patients through doctors is often pointless because such efforts typically ignore real doctor behavior. We have found that there are basically two types of doctors: those who perceive the most risk in new, unproven therapies and those who perceive the most risk in a disease spreading without aggressive intervention from the newest therapy. Having spent a lot of time talking to doctors, all of them fall somewhere on this continuum of professional risk assessment. There are opportunities within the design of new commercial models and actual interventions that acknowledge the fundamental behavioral differences between real physicians.

What are you doing about designing for real physician behavior?

6. Challenging the throughput model

Most doctors practice medicine under a model that requires them to see a patient every 1-2 minutes. Both doctors and patients are unsatisfied with this system and aspire to a much more meaningful doctor patient interaction than simply sprinting through protocols and treatment algorithms. The internet of things offers ways to capture and visualize data related to patient behaviors and vitals between visits to make time for higher quality, more meaningful doctor-patient interactions in the future. Other innovations include practice management, automation of repetitive tasks demanded of physicians from new services like hellohealth.com, or patient support from services like patientslikeme.com. We are only at the beginning of creating new possibilities for a more human care. 

What are you doing about challenging the throughput model?

7. More life, less stigma

As the developed world ages, baby boomers are recasting “illness” into degrees of “wellness.” The normalisation of diabetes, which continues to rise, could be socially perceived in the future as something more akin to having freckles. This normalisation has also resulted in a glut of smart phone apps for blood glucose measurement that look and feel more like lifestyle accessories than traditional medical equipment. At the point of care, the lines between healthcare and lifestyle are also already blurring. There are new resort/hospital hybrids all over Europe and the Middle East. There are travel companies who, targeting wealthier ageing clientele, include traveling physicians as part of their holiday tours. We see a growing proliferation of more elegant and less intrusive “medical” interventions everywhere. 

How are you designing interventions that fit into patients' lifestyles?

8. Designing for personalized medicine

The emerging field of molecular diagnostics in the future promises tests that will determine which treatment is most suitable for “my body” and “my particular form of illness.” Such tests, while somewhat primitive now, are rapidly gaining in sophistication. Such predictive measures promise to disrupt current treatment algorithms in the future. Under such a scenario, molecular diagnostics is poised to become the engine room of personalized medicine. As such tests emerge, there is a need to design clear propositions, packaging and details around these tests.

What are you doing about designing for personalized medicine?

9. Jugaad. Learning from the B.O.P

There are some brilliant, low cost interventions in the developing world that could affect how costlier interventions will be delivered in the developed world. In the book, Jugaad Innovation: “Think Frugal, Be Flexible, Generate Breakthrough Growth,” Jugaad is a Hindi word that roughly translates as “overcoming harsh constraints by improvising an effective solution using limited resources.”

What are you doing about using Jugaad to inspire lean, disruptive innovation?

10. Competing on pain management

Propositions around pain free treatment have become differentiators in private care. Pain and anxiety reduction in patients will be an important competitive choice criteria for an increasingly selective, ageing baby-boomer patient population. This is felt particularly in managing chronic diseases. However, we have seen the consequences in recent years of the random, over-prescription of opiates – particularly in the US. This has resulted in addiction and provided gateways into black market opiates, even among affluent patient populations.

How might we responsibly balance the need for pain management with the physical realities of dopamine?