Contrary to popular belief, Pink Floyd’s hit Another Brick in the Wall is not about students rebelling against the education system. The ‘Wall’ is apparently the self-isolating barrier we build for ourselves over the course of our lifetimes – and the ‘Bricks’ are the people or events that make us turn inward and away from others. So what’s this got to do with pharma?
Well it’s quite possible that, largely through regulatory fear, the industry has built a similarly isolating wall around itself that’s become a self-inflicted barrier to customer communications. And every new engagement solution that’s killed before birth due to unchallenged regulatory fears is just another brick in the wall.
But as the world moves on and healthcare stakeholders cry out for reliable health information, the wall needs to be knocked down. It’s time for pharma to have its Berlin moment. In 1979, perhaps we didn’t ‘need no education’. But almost forty years later, as communications channels proliferate and information overload prevails, people don’t just need education – they need advice on the best place to study and help understanding the curriculum.
Wall of noise
The current challenge of health education is being created by another wall – a wall of noise. Nowadays there’s just too much information within our reach. We don’t know what to discard and what to trust. Healthcare stakeholders, both professional and consumer, need reliable, credible and accessible information. Pharma has never enjoyed a reputation as a trusted source of information, but perhaps it could. Indeed perhaps health education could become a mechanism to drive levels of trust in pharma by solving the growing problem of ‘infoxication’. HCPs certainly believe it’s possible.
“There’s a common acceptance that we’d all benefit from having more and better quality educational resources for all stakeholders in healthcare,” says Tim Ringrose, CEO at M3 (EU). “Evidence shows that a strong majority of doctors believe pharma should be investing more in educational resources for patients and HCPs. One-to-one discussions with individual HCPs consolidate that view; physicians and consultants typically decry the bewildering amount of information that exists online, and bemoan how the patients they see are being misinformed by its variable quality. The take-home? There’s a growing need for a trusted repository of high-quality health education – and pharma should be a key player in delivering it. The benefits to patients, doctors and healthcare systems would be significant.”
So what’s stopping progress? For one, pharma is famously risk-averse. “There’s widespread fear within brand teams about what can (and can’t) be done, not only from a marketing perspective but also from an educational one,” says Tim. “ABPI and EFPIA guidelines are interpreted differently from company to company and too often compliance fears prevent teams from pushing forward with innovative solutions. However, there’s a realisation that investment in education may be a sensible move. We’re beginning to see companies shifting budget from marketing to education in an attempt to find new ways to engage customers.”
[Education] must be relevant and useful – for the patient and the HCP
Collaborate to educate
The drivers for change are clear. The urban dictionary tells us we’re all suffering from ‘infobesity’ – we’re growing fat on information. That’s certainly the case with health. Experts call it empowering patients, but that’s only the case if the information is credible. “We’re seeing the increased empowerment of patients able to monitor, interact with and self-manage their own health,” says Rhiannon Meaden, Head of Commercial Development, Complete HealthVizion. “They can instantly access a stream of personal data and education about their health. But health tech isn’t always created, validated or managed by clinical experts. While patients may embrace new technologies, HCPs question whether they’re accurate, reliable or supportive, and whether they take into account the idiosyncrasies of a disease and its treatments. It’s vital that clinical evidence sits alongside information generated via new technologies when developing any educational programme.
“The explosion in health tech is a positive for pharma. But it means we need to go beyond the pill and be present throughout the treatment journey. We need to work more closely with patient advocacy groups and societies, and include patients across the spectrum of activity – from clinical trial development through to the implementation of patient education. Patient, HCP and pharma co-creation of educational content should be our Nirvana.”
However, in terms of multi-stakeholder collaboration to build credible repositories of disease information, pharma’s risk-averse profile extends beyond regulation. “Pharmaceutical companies are notoriously reluctant to work with each other, says Tim. “Consequently, we end up with lots of different educational initiatives. They all contain high-value content – but the user experience is yet more confusion. The patient with diabetes, for example, doesn’t know which resource to go to – and the wall of noise just becomes louder. There’s a strong argument for EFPIA or the ABPI, in partnership with trusted publishers, to lead on education to ensure all appropriate stakeholders in a disease are working together to produce high quality resources, rather than everyone attempting their own separate initiatives.”
Customer experience
In the absence of cross-sector collaboration, how can pharma’s approach to education improve? “We need to focus not on the ‘disease’, not on the ‘patient’ – but on the ‘person’,” says Rhiannon. “The disease is just one part of a person’s life. Education needs to be aligned to truly meaningful outcomes and have behavioural change at its core. It must be relevant and useful – for the patient and the HCP. If we involve patients upfront and focus on what’s important to them, we’ll get it right at the outset and deliver more powerful change as a result.
“To understand the patient, we need to walk in their shoes, understand how they think, and how effective disease management and treatment will change their lives. If we don’t then our education won’t speak to the challenges they face because the emotional context will be missing. All too often we see situations where the tactic was the motivation rather than the outcome. If we ignore the patient context then education won’t resonate and technology won’t be used.”
Education could help improve treatment compliance
Another important area to explore is HCP-patient interaction. “The HCP is vital to patient education,” says Tim. “We know that when patients visit their doctor, there’s a huge amount they may have forgotten or misunderstood by the time they leave the consultation. This is simply the nature of communication within difficult time constraints. One thing that would help is if HCPs were able to deliver an ‘educational prescription’, whereby they recommend resources, contacts and materials that can help the patient once they get home. There’s little doubt pharma could help create these resources and, if produced independently and to a high standard, neither the patient nor the HCP would question their credibility.”
Supporting patient interaction at the point of care could also help drive medicines adherence. “Education centred on HCP-patient interaction could help improve treatment compliance, particularly in chronic disease where the dialogue is a longer-term partnership,” says Rhiannon. “We can also use technology to intelligently and proactively enhance the conversation when patients return for consultation. But there needs to be a greater focus on linguistics. We have to understand how HCPs talk to their patients and how patients talk about their own disease – before we can address barriers to effective communication with impactful medical education.
“To progress, pharma companies need to partner with experts that understand the complexities and can overcome them to create compelling, credible and accessible medical education. The best programmes will be underpinned by a clear strategy and have a firm grounding in behavioural science.”
Bricks in the wall
There’s no doubt that pharma has the knowledge and capability to develop educational programmes that can improve health outcomes. The challenge is to raze the self-built wall that historically has prevented pharma from joining the wider conversation – and start giving patients the trusted information they desperately need. “Pharma companies need to stop worrying that the world questions their reputation and motives – and realise that patients and HCPs want them involved in providing solutions for healthcare,” says Tim. “And if that involvement can be collaborative, the education that emerges will be so much more powerful.”
Greater collaboration would certainly be a step towards demolishing the barrier that has long isolated pharma from important stakeholders. Pink Floyd’s classic may not be about rebelling against the education system, but perhaps it’s time pharma rebelled against its own traditions and worked together for the common good. If it can’t, it’s allowing its propensity to be risk-averse to become just another brick in the wall.