By Deborah Borfitz

February 14, 2022 | Novartis has plans to develop one or more “connected health” solutions—a universe that includes connected devices, wearables, and software as medical devices (SaMD)—to be part of its drug program over the next five years. Its fledging digital health platform will be putting those tools in the hands of clinicians, patients, and researchers to improve the overall healthcare experience and access to trials, according to Justin Wright, Ph.D., vice president of connected health, in his keynote at last week’s Summit for Clinical Ops Executives (SCOPE).

Novartis is a “bit scrappy” when it comes to connected health, says Wright, noting that the company last year established the dedicated development unit. It signals leadership’s commitment to producing evidence substantiating long-held claims that connected health can drive efficiencies and positive outcomes.

As he sees it, connected health represents the fusion of the high-tech digital and low-tech physical worlds to quantify health with a longitudinal composite measurement system. “If you shift too far one way or the other, you’re going to miss out.”

Connected health shouldn’t be thought of in a linear, discrete way or applicable only in the clinic, Wright says. The question is how to integrate app-enabled sensor technology, be it medical or consumer grade, into the daily rhythm of life and “decode” the experience.

The healthcare value continuum has evolved over time to include more than safety and efficacy, says Wright. The additions began with convenience (e.g., pre-filled syringes) followed by adherence (correct use of interventions), engagement, good outcomes, and—today especially—a positive experience when using health-enhancing products.

A good experience has even become a regulatory expectation, Wright notes, and needs to be quantified. “As an industry… we’re still quite in the early days.” To become more sophisticated, companies might consider borrowing ideas from sectors with highly regarded brands but, he adds, “the DNA of experiences are not universal across industries.”

The basic formula is to measure a value, or key performance indicator (KPI), by considering the corresponding friction (e.g., How will our data be used?), says Wright. The main goal is to quantify trust, but other KPIs will rely on measures of how individuals engage with the company’s solutions, such as an out-of-the-box experience or app utilization.

A satisfying user experience must address the pain points, says Adama Ibrahim, EMBA, the company’s director of digital solutions. Digital health is “fragmented and burdensome” and Novartis wants to help harmonize the experience, and part of that is not recreating apps (e.g., scheduling calendar) that consumers are already routinely using.

Many New Players

Investment in digital health technologies has been accelerating over the past decade, Wright says. Funding of U.S.-based startups last year topping $29.1 billion across 729 deals and the average deal size nearly doubled.

Much can be learned from online pharmacy PillPack and telehealth giant Teladoc Health, he adds. PillPack, which was acquired in 2018 by Amazon, improved the pharmacy experience by creating a single, easy-to-use platform for people on multiple medications to reduce the complexity of polypharmacy. Teladoc last year acquired diabetes management company Livongo and began aggregating data to offer whole-person care on a virtual platform.

The most advanced connected health innovations in pharma are being driven by the diabetes market, Wright says. But the growing number of startups are targeting a variety of conditions and big-tech players are heating up the competitive landscape. His advice is to look across disciplines, functions, and industries for unconsidered opportunities.

Much effort is required for a new technology to displace the incumbent and his theory is that healthcare workers are what digital health solutions will be supplanting. Artificial intelligence, composite metrics, and the ability to provide actionable insights to patients and caregivers is “where we’re headed.”

‘Friction Equation’

To properly quantify the patient experience requires knowing the “friction equation” that is acceptable to them, says Wright. “We’re not [yet] sophisticated enough to understand that” even if the collection of experience data is now a regulatory expectation.

Novartis is actively thinking through how connected health might move the needle (e.g., improve adherence or provide clinical decision support) and ways players in the ecosystem can meaningfully work together when patients have a need to create a new value stream for the company, he continues. Currently, “there are a lot of shiny widgets” that aren’t working in sync.

Like other industry players, a key strategy at Novartis is to build a digital health platform to help achieve the desired efficiencies, scale, and interoperability, which Wright terms a “huge first step.” A brief overview of the enterprise-scale platform was provided by Ibrahim.

Creation of the multi-tenant digital health platform has been a two-year journey, says Ibrahim, and will enable the collection of big data for secondary use. It comprises three layers: a consumer and clinical solution where different vendors allow data entry, platform services for the management of data with existing infrastructure, and underlying cloud infrastructure for data sharing.

Identified use cases for the platform are medical imaging, digital endpoints and eVitals, SaMD (e.g., digital therapeutics), and others such as social networking and electronic health records, she says.

Separate strategies will be needed for the collection of thick and contextual data, Wright adds, as well as microsystems around discrete patient populations.