most disruptive innovationsTop 10

in eHealth for Pharma

Iam currently in the early stages of producing our eHealthForum 2015 (co-located with our Big Data in ClinicalDevelopment event) and what struck me was that there is a

massive enthusiasm in the pharmaceutical industry for theapplication of these technologies – for their clinical pipelines,improving patient care, and even as a platform for discovery –but when searching for real-world examples; examples whichshow proven success between these manufacturers and thehealthcare systems, it can be a little thin on the ground. This is adisruptive technology for the pharma market and we are justreaching the Tipping Point. This is not just about mobile apps,this is about how eHealth will fundamentally change the drugsindustry and the drug industry knows it.

Top 10 most disruptive innovations in eHealth for Pharma

The US eHealth Initiative quotes 4 key themesor “treatments” of ehealth within the clinic.

EHealth drivers in the USincluding monetary incentivespaid to providers for

compliance with IT “meaningfuluse”. The larger health reformlegislation wraps around this ITprogram.

Within the pharma business model,these themes are inevitably leadingto some unique implications. I’llbegin with a 2008 paper todemonstrate this year’s ‘Open-Play’in eHealth and the industry’s owngrowing ambition. “Opportunities forelectronic health record data tosupport business functions in thepharmaceutical industry-a casestudy” – was published by Pfizer todescribe how the healthcareinformatics team had interviewed 35senior company leaders (Pfizer) toassess why they had a desire forelectronic health records access(EHR – those real-time, patient-

centered records providing detailsof care and a fundamental part of‘eHealth’). The top responses hadbeen for “Drug Safety &Surveilliance”, “Clinical TrialRecruitment” and “SupportRegulatory Approval”. As shown byour above ‘healthcare themes’, thesubsequent years have seen anexpansion of the role of eHealth inprovider systems and this haspotential for application into thedrugmakers business model:

• Drug discovery direction includingfrom real-world observations

• Clinical research [eg. EURECA,Linked2Safety (EHRinterconnection), GRANATUM(“Facebook for biomedicalresearchers”, Salus Project,SemanticHealthNet, TRANSFoRm(“rapid learning healthcaresystem”)]

• Repurposing of drugs, theapplication of the “Internet ofThings” (IoT – wifi in portabletechnology such as transplants) inmedical devices and itsinteraction with therapeutics, HTAevidence portfolios, chronicdisease management, medicineadherence and improved patientoutcomes, the list goes on.

And so, to illustrate how eHealth isdisrupting how we approachpatient care – and inevitably thefocus of Big Pharma within this – Ihave put together a top 10.

Note – Ranking is in relation totechnologies which have anestablished record, probability ofsuccess, eventual goals ofparticular projects and theramifications of a run-away success.It also weights the rankingfavourably towards what areas willcause a fundamental change inhow the drug industry “works” andimpact on public health.

• Digitization of health information (HIS, EMR, PACS adoption)• Longitudinal HER (sharing data between existing systems)• Chronic disease management (home health, devices, etc)• Consumer empowerment (personally controlled electronichealth records, online scheduling and prescriptions, etc)

“Patients. Herebe Big Data.”

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10Top 10 most disruptive innovations in eHealth for Pharma

Smart watches have moved on; as mentioned inthis article ‘Google’s Smartwatch to Be Fueled ByGoogle Now, “In Late-Stage Development”’

10.Wearable technology,it’s in the blood.

As the worldwide eagerlyawaits Google Glass 2.0 (andits application in changing

the way we view the world), Googlehas filed a patent application withthe World Intellectual PropertyOrganization (WIPO) for a wrist-worndevice that could destroy cancercells in the blood. The patentapplication, which has the name"Nanoparticle Phoresis", describes awearable device that "canautomatically modify or destroy oneor more targets in the blood thathave an adverse health effect".These targets could includeenzymes, hormones, proteins, cellsor other molecules that, whenpresent in the blood, may affect amedical condition or the health ofthe person wearing the device. Thewearable device is designed tomodify or destroy the cells bytransmitting energy into the blood

vessels. The transmitted energycould be a radio frequency pulse [acutting edge, area of medicalresearch – March 2015 paper –‘Radio frequency responsive nano-biomaterials in cancer therapy’], atime-varying magnetic field, anacoustic pulse, an infrared or visiblelight signal. Google used theexample of proteins implicated as apartial cause of Parkinson's disease.

"As a further example, the targetcould be cancer cells; by selectivelytargeting and then modifying ordestroying the cancer cells, thespread of cancer may bediminished," it said in its patentapplication.

This patent application follows thecompany’s October 2014application for developing a pillfilled with tiny iron-oxidenanoparticles that enter thebloodstream, can identity cancertumour cells. By “painting” theinfected cells and with an attachedwearable device creating amagnetic field, the theory is targetcells could be detected. Thedevice was designed to be focusedon proactive detection rather thanreactive treatment.

Google likes to think outsideof the box and so to start ourlist, we look at what theSilicon Valley team is up to.Yes it may be at the earlystages, but it is eHealthinnovation at its best. “From the

dawn ofcivilisation to2003, fiveexabytes ofdata werecreated. Thesame amountwas created inthe last twodays.”Eric Schmidt, CEO, Googleponders on the possibilities of BigData and eHealth

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Top 10 most disruptive innovations in eHealth for Pharma

9.Drug Delivery

Electronic monitoring devices(EMD) for asthma inhalersbeyond ‘simple recording of

actuations to providing adherencepromotion features and detailedinformation about patterns ofmedication use [Chan A et al 2013];examples include 3M’s metereddose inhalers, Philips’ expansion intorespiratory drug deliverytechnologies. It’s important to notethat inhalation drug delivery systemshave been shown to improve theadministration of drugs to treatpulmonary and non-pulmonarydiseases (eg. CNS therapeutics inorder to cross the blood brain barrier(Upadhyay RK 2014), Influenzavaccine), with the biggest singleproblem often being incorrect useof a device [Ibrahim M et al 2015].Inhalation devices, critically, havebeen shown to better induce bodilyreactions, such as the immunesystem, because it is the naturalroute of an outside antigen.

• Cloud-based privacy-preservingremote ECG monitoring andsurveillance (eg. Aerotel medicalsystems, Mega ECG, ExpressDiagnostics) and of course this

feeds into drug safety studies bypharma – eg. Evoke Pharma’slead product EVK-001, which iscurrently in Phase III; or widerpharmacovigilance studies.

• Wireless device technology thattreats heart failure withoutneeding patient to visit a clinic

• There was a very interestingexample in November 2014 ofcollaboration between Servierand Boston-based startup, IntarciaTherapeutics, on a tiny drug-loaded implantable pump for thetreatment of devices. Although itdoesn’t appear to offercommunication (wirelessly)between patient and clinician, itdemonstrates things to come foreHealth, devices and pharma.

Of course, for drugmakers, pillcounters can start the process ofbetter patient compliance withmedication regimens and thusimprove clinical outcomes. Yet if weare trying to think outside of the boxwhen it comes to pills, digitalmedicines are not only beingutilized as ‘biosensors’ (asmentioned in the Google entryabove) but also as ingestible sensorsof a patients’ medication takingbehaviour and treatmentadherence (Proteus Digital Healthwork being a prime example with itbeing the first company to receive

approval by the FDA for a digital pillto monitor drug dosing; this yearthey also announced acollaboration with computer giantOracle). We should also get excitedabout the applications of ‘ePills’ inthe field of drug absorption – both inthe clinic and the real world. I wasparticularly interested to find acompany called Matesy offeringthe use of a magnetic capsuleMAARS, in combination with themagnetic monitoring system 3D-MAGMA, allowing drugs to bedelivered precisely into thegastrointestinal tract in humans andanimals – obviously a game-changer in the world of drugdelivery and formulation.

The applications of eHealthtechnology in the medicaldevice industry are well-known

Matesy - Separated capsuleelements after release by ashort magnetic impulse

Mobile networks are revolutionizing multiple aspects ofhealthcare delivery in both the developing anddeveloped world. mHealth systems can send SMS alerts toremind patients to take their prescriptions drugs at theappropriate time, a development which is becomingimportant with aging populations across the world.Researchers, clinicians are starting to strategize mobilecommunications as a channel of providing medical care,particularly to patients with little access to physicians. Forexample, the London-based start-up Cupris hasdeveloped a system – consisting of a low-cost medicaldevice to clip up on a smartphone with an attached app– to enable remote diagnosis of Ear Nose and Throatconditions without the patient seeing the doctor in person.This month (April) there was news of a novel biosensingplatform from Florida Atlantic University, to give in-housediagnostic testing for a host of bacterial and viralconditions (eg. HIV, E-coli, Staphylococcus aureas).

Decision-making in eHealth drug delivery systems iscomplex and so when we are considering theirdevelopment we must also consider diagnostic tools,usability, uptake and current regulatory constraints.

The advantage is to drive downthe overall cost of thedevelopment process, including

trial concept and protocol design,recruitment and randomization,“concluding with actionable data”.Clinical trial cost is a huge thorn inthe side of the staggering pharmagiant (Tufts Center for the Study ofDrug Development estimated it tostand, as of November 2014, at$2.558billion for a new prescriptionmedicine) and even after all theseefforts it is estimated that 30% ofcollected data is not used in FDAapplications. No wonder this is amajor priority and key disruptiveenterprise for eHealth TODAY.

Not to be pushing a particularservice provider, but Medidata has

been very vocal in the applicationof “Clinical Cloud” solutions to drivedown clinical trial costs (their 2013whitepaper can be found HERE). Thevalue of these ‘eHealth’ websystems include:

• Communication software allowingscientists and physicians to workwith data whenever they need toand from wherever.

• Location and device indepen-dence allowing drugmakers toshare resources across a largepool of users and provide‘scalability of service on a self-serve, just-in-time basis’.

• Viewing data on multiple devices.The output format is independentof the API.

• Automatic data feeds providingclean data from a single point ofdata entry.

During the critical drug process, pharma is exploring new eHealth technologies to speed upcollaboration between researchers, physicians, patients and government agencies. This canstretch from video conferencing to the clinician mobile imaging software.

Clinical trial participants arealways in one room

9 8.eHealth in Clinical trials speeding up the truly staggeringcost of inventing new drugs

As a consequence, companiesare diversifying their portfoliosand exploring new disease

areas and pathways to enhancepipeline value, including thetargeting of orphan and/or rarediseases. The traditional blockbustermodel including the challengesfrom large scale patent expiration,competition from generics &biosimilars, escalating clinical trialcost, global health care reform hasbecome less viable whilst there ishuge revenue generating potentialfor orphan drugs. I point to theexample of the yearly budget forthe NHS’ Cancer Drug Fund(GBP280million) and the axing of 16drugs from this for 2015. At the sametime, National Institute for Healthand Care Excellence (NICE) calledfor the inclusion of the £58 million-a-year Soliris into the NHS treatmentplans (with only a maximum of 200patients to benefit). Across the

industry, data suggests thatcompound annual growth rate oflaunched orphan drugs will continueto outstrip that of non-orphan drugsfor the period 2010 - 2030 (25.8%compared to 20.1%) and usingrevenue analysis, the present valueof an orphan drug sample set wasUS $1041 billion compared with US$3344 billion for the non orphan drugmarket.

As we are all well aware, pharma lives in a world whereincreased pipeline attrition coupled with increased R&Dspending means their R&D productivity is becomingincreasingly challenging. 7.

Thecriticalroleof rare disease careneeds to be moreprominent

Orphan drug cartoon fromthe FDA

Top 10 most disruptive innovations in eHealth for Pharma

Top 10 most disruptive innovations in eHealth for Pharma

So, orphan drugs are valuable.

Projects are starting to evolve inthe Rare Disease - eHealth space.The Institute of Medical Biostatistics,Epidemiology and Informatics(IMBEI) in Mainz University listed acollection of working groups in thisarea: Se-Atlas aims to provide aninnovative overview of thehealthcare options for people withrare diseases in Germany via acentral information portal andinteractive map; ZIPSE is a projectfocusing on a determined target-group-specific information path-ways and reference routines in acentral, web-based informationportal; The NIRK database wasdeveloped for the Network forIchthyosis and Related Keratinisationdisorders, and uses a telemedicineplatform to simplify location-

independent centralised collectionand distribution of patient data.

The simple fact is that patientrecruitment is a major cost factor inthe development of clinical trials, sowhen an eHealth technology allowsa company to give ‘healthcareoptions’ it can also find & recruitpatients. For rare diseases – and yes,broader trials – there is a clearchallenge in recruiting for very smallpatient populations. Pfizer, forexample, launched a mobile appand online platform (incollaboration with SanguineBiosciences) called Sangre to findand recruit people suffering from anultra-rare condition calledcongenital angalgesia (congenitalinsensitivity to pain – only 40 peoplehave been diagnosed worldwide).

Image credit:www.medicalpress.es

One of clear recent trends inthe drugs industry,particularly with the famous

patent cliff beginning in 2011, is theneed for real world evidence

generation – including evaluationsof effectiveness, safety and qualityof care - for evolving stakeholderneeds. Amongst all the challenges– geographic regions, varyingaccess and availability practicalities– pharma are starting to applyeHealth to this trend.

The article “Looking ‘beyond thepill’? Start with an app – and thenfollow this to-do list?”,from Decision

Resources, is a good guide to what’sgoing on. A company such asNovartis (with its multiple sclerosissymptom tracker, SymTrac) or Sanofi(blood sugar tracking device plusapp, IBGStar) will develop an appwhich allows a patient to self-report/self-track and possibly sendinformation to their doctors. Withregards to legislative limitations,these drugmakers don’t getinvolved with the data from theseapps (its private medicalinformation) but instead hire a ITpartner who specializes in handlingsensitive data; linking the patient tothe healthcare provider. Finally wehave convergence, wherebyclinical trial results and theexperiences registered through‘eHealth’ come together to show adrug-plus-assistance combo and(fingers crossed) a favourablepricing point with payers. In relationto discussions with payers andregulators, these Apps are utilized inexpansive late stage clinical trials,where a large patient pool will givesafety, efficacy and quality of lifefeedback.

It must be noted, however, thatthe role of eHealth in drugsafety/pharmacovigilance/adverseevents is not limited to mobileapps. The EU-ADR project exploits

*cough* to provide evidencefrom patient outcome datafor HTA bodies, regulatorsand healthcare payers.

6.Why we haveApps……

Telemedicine still plays animportant role

advanced ICT to develop newways of using existing clinical andbiomedical data sources to detectAdverse Drug Reactions (ADRs) asearly as possible. The platformusing anonymous EHRs for morethan 30 million EU citizens hasalready been successful indetecting relationships betweenspecific drug classes and specificadverse events.

Finally, for pharma there is also theadded advantage of using realworld data to seek expandedindication approval – such asGenentech’s Actemra being used inactive rheumatoid arthritis in adultswho have had an inadequateresponse to one or more disease-modifying antirheumatic drugs. Aninteresting study in December 2014(published in the American MedicalInformatics Association) fromVanderbilt University MedicalCenter proposed, by studying theEHRs of 32,000 cancer patientssince the mid-1990s, that metformin(a diabetes drug that patientsgenerally find easy to tolerate)could be used in the treatment ofsome types of cancer. This couldbe a sign of things to come. Ibelieve an intriguing insight, andprediction, into things to come forEHRs and pharma.

The Salford drug trial was theworld’s first pre-license“pragmatic” randomised

controlled drug trial for asthma andchronic obstructive pulmonarydisease. It was a pioneeringcollaboration between GSK, SalfordRoyal NHS Foundation andUniversity of Manchester, wheredata was collected usingGraphnet’s CareCentric electronicpatient record to provide real worldinsight into how patients use andbenefit from their medication.

Interestingly, Dr John New, aconsultant physician at SalfordRoyal and one of the study’sdirectors, said that data on-siteshowed that “only 50-60% ofpeople regularly take theirmedication”, an implication for thecorrelation between patient careand therapy administration.Overall the study authorsanticipated that the initiativewould serve as a brenchmark forfurther pharmacovigilance andphase IV studies.

5.Obtaining real world evidence inChronic obstructivepulmonary disease (COPD).

Top 10 most disruptive innovations in eHealth for Pharma

Chronic obstructive pulmonary disease (COPD) is the 4th leading causeof death in the United States, affects 24 million people and is responsiblefor up to $32 billion annually in direct and indirect health care costs[University of Colorado, 2012]. There is clearly a huge value in pharmademonstrating the effectiveness of their interventions and the role oftheir eHealth technology to payers in this focus area – particularly asthese patients can often be associated with the highest disability andmortality. As the WHO supports:

“The delivery of healthcare services, where distance is a critical factor,by all health professionals using ICT [eHealth tech] for the exchange ofvalid information for diagnosis, treatment and prevention of disease andinjuries, research and evaluation, and for the continuing education ofhealthcare providers, all in the interest of advancing the health ofindividuals and their communities”

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4.in Alzheimer’s

Patrick Vallance, GSK’s Head ofR&D, told Reuters that the goalof finding an effective

treatment for Alzheimer’s and otherforms of dementia by 2025, was“hugely ambitious” but that poolingresources to back promising ideasfrom academic groups and smallbiotech firms would help toaccelerate research.

One of the difficulties of producinga treatment for Alzheimer’s is thatthe cognitive symptoms only start toappear in the late stages and so toidentify disease-modifying therapiesit has been necessary to assessclinicopathlogic and biomarkers.eHealth is leading from the front inthis field, with technologies that aremonitoring disease progression andimproving patient quality of life.

VPH-DARE-at-IT is the clinicaldecision support platform beingused to recognize the earlydifferential diagnosis of dementiasand its evolution. Constitutes of thismodelling system includebiochemical, metabolic, andbiomechanical brain substrates,plus genetic, clinical, demographicand lifestyle determinants.

PredictND is a research projectattempting to make betterpredictions, diagnostics andmanagement of memory disorderssuch as Alzheimer’s. Like VPH-DARE-at-IT, this is part of the “VirtualPhysiological Human” (VPH) initiativeby the EU, and combines informationfrom several sources, such as clinicaltests, imaging and blood samples,whilst comparing to previously

diagnosed cases. The project recentlywon €3 million to better predict anddiagnose memory disorders (from2014-2018). Finally we have theNoTremour project creating tools topredict Parkinson’s disease and wantsto develop patient specific virtual,physiological and computationalmodels of the coupled brain andneuromuscular systems. It aspires toestablish a link between brainmodelling and neuromuscular systemswhich give a holistic representation ofthe physiology of PD patients.

Only this March, GSK, Pfizer, Lilly, J&J and Biogen Idec (alongwith Alzheimer’s Research UK and the UK government)backed a $100m venture capital fund.

Top 10 most disruptive innovations in eHealth for Pharma

Clinical development

As quoted in “Translatingcancer ‘omics’ to improvedoutcomes”, the genomics era

has yielded great advances in theunderstanding of cancer biology. Itis revealing an immense complexityin cancer genomics and itscorrelation to patient outcomes. Atthe same time, a vast expanse ofmulti-omics and patient electronichealth record databases arebecoming available, with a hugepotential to translate the informationsourced from high-through omicsand treatment history to directlyimprove clinical outcomes. A keyexample of this in the hospital care(2015) is the plan by the for-profitHCA to marry the molecular profileof tumours with a patient’s

electronic health record, pushing forbetter, targeted therapies. SarahCannon (an arm of the HCA whichruns 75 cancer centers) used thisapproach to profile the tumours of1,000 late stage cancer patientsand match them to early phaseclinical trial data; results which weresubsequently presented at theAmerican Society of ClinicalOncology. Of course all this data –including the profiles of eachcancer patient – had to beaggregated and displayed on agrand scale and in a format thatdoctors could understand. To makethis possible the HCA employedSyapse, a venture-backed start-upwhich counts IntermountainHealthcare, University of California

San Francisco and Stand Universityas clients.

Across the pond, eHealth projectsin the cancer field include TUMOUR(which ran from 2011-2013) a EUinitiative to implement a cancermodel/data repository and developtools for collection, validation andcustomization of existing models. Thishas progressed – with the injectioninto the “Virtual PhysiologicalHuman” initiative – into projects suchas VPH-PRISM - a project to giveinsight into environment-tissueinteractions in breast cancer andgive quantitative assessment of drugefficacy, surgery planning andtreatment outcome prediction;“Computational Horizons In Cancer”(CHIC) - a project to develop meta-and hyper-multi-scale models andrepositories for In Silico Oncology(funding 2013-2017) and OraMod –focusing on oral cavity cancer anddesigned to improve the earlyprediction of reoccurrence of thisdisease. Additionally, and for thedevice enthusiasts more exciting,eHealth in the EU has also stretchedinto imaging: DR THERAPAT – aplatform to integrate availableknowledge on tumour imaging,image analysis and interpretation,

Relative to other parts of the healthcare system, oncology bringshigh levels of uncertainty – including therapeutic efficacy in aspecific patient group, reimbursement levels amongst payers,

3.Oncologytherapeutics

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radiobiological models andradiation therapy for planning into arobust multi-scale digitalrepresentation – and my personalfavourite, FUSIMO – ultrasoundsurgery in moving organs.

And of course this is all feeding intohow Pharma is slowly approachingdata-sharing in their cancer drugdevelopment, either through clinicaltrial databases or EHR. Historicallypharma gathered patients’ de-identified data from insurers,pharmacies and public records(often to improve marketingstrategies) but with these provenbenefits emerging from thehealthcare system, drug companiesare starting to morph somecollaborations. The Project DataSphere initiative (which began in2012 to improve clinical trialtransparency) has been joined byPfizer, Sanofi, AstraZeneca, Bayer,Celgene and J&J (plus MemorialSloan-Kettering Cancer Center) toevaluate comparator-arm datafrom 9 clinical trials. One of the mostprogressive examples of a Pharmacompany using ‘real-world’ data –other than the Salford Lung Study –is Merck’s collaboration withPractice Fusion to alert doctors orpatients for an overdue vaccinationor test. This forms part of thecompany’s initiatives to make amark in digital health, alongside itsGlobal Health Innovation Fund, atop investor in health IT start-ups.

Sachin Jain, Merck’s Chief MedicalInformation and Innovation Officer,who was recruited specifically forthese initiatives and spearheadedthe partnership with Practice Fusion,said “This is a clear opportunity tocollaborate. [It’s] clinical decisionsupport that is actionable, targetedand delivered to clinicians at thepoint of care.”

I fully expect that the Merckinitiative, alongside GSK’s Salford Lungstudy earlier, will lead by example forPharma to get more involved ineHealth initatives in Oncology, whichare already underway.

Vaccination technology haschanged

Top 10 most disruptive innovations in eHealth for Pharma

The philanthropist even opened amock Ebola field hospital at theTED conference in March to call

for “germ games not war games”]

How ePatients may one day savethe world.

As we know from the West AfricanEbola/SARS outbreak the acceleratedimplementation of smartphone-basedhealth applications and the use of bigdata analytics will have a massive roleon global public health surveillance.One of the most striking articles Ihave come across (and this wasreleased in October 2014) was ‘Wecould’ve stopped Ebola if we’dlistened to the data’– in which itdescribes how computationalepidemiologists foresaw theapproaching holocaust. Indeed wehave a dedicated blog on our BigData Conference on ‘How Big Datacould have stopped Ebola’. E-patients are allowing researchers

to develop multiple models to showthe explosive growth – now,importantly, in real-time - of acontagion and allow information tobe relied to medical teams on theground. Even in the business worldof pharma, controlling an epidemichas to be a top priority – certainlythe WHO wasn’t happy with theirresponse – and that’s why it makesnumber two on our list.

“We’re making a globaleffort to reduce the threat ofnuclear war. Shouldn’t wedo the same to prevent thenext epidemic?” – Bill Gates

2.Epidemic control

Integrating data sets fromanonymized mobile phoneusage and demographicindicators, researchers arebuilding maps like this onethat model mobility withincountries of West Africa.Image Credit: PLOS Currents.

1.E-Patient movement

Around 40% of the world'spopulation has an internetconnection today…….

3 billion people. Slowly this‘connected world’ is becomingaccustomed to being attached tothe Internet at all times. We arebecoming a world in which itsinhabitants find it almost impossibleto go anywhere without wanting tohave this ‘Internet’. Between email,social networks, settling arguments,and messaging with friends, we allfeel like the Internet is not optionalat this point.

The consequence for thehealthcare/drug industry of courseis that our lonely patient in theirhospital bed doesn’t now just takethe doctors word to be gospel. Theyare more ‘engaged’ with thetreatment choices of their care and‘empowered’ through the criticaluse of leveraging data throughout

the world-wide-web. A ‘Google’phenomenon. As one blogger put‘Epatients are the hackers of thehealthcare world’ and this doesn’tjust mean our patient is taking moreresponsibility for their conditions -through apps, real-world tracking,as mentioned earlier – but alsovoicing their opinion on newtherapies, including those in clinicaltrials, and drug treatment options.There are even organizations thataim to spur on this evolution inmedical care, such as the Society ofParticipatory Medicine and theCenter for Advancing Health, andMayo Clinic even named a patientas a Visiting Professor for 2015 –Dave deBronkart, or ‘e-PatientDave’ – which highlights theincreased importance placed on a“union of forces” between providersand patients. You can see a shortvideo on his appointment HERE.

For the Pharmaceuticalscompanies, this means they have totake an active role in networkingwith bloggers, patient communitiesand the medical community torecognise concerns and trendspatients notice, and ultimately use

it as a platform for patientmarketing. The ePatient will have adeciding impact on everything fromdrug approval, patient recruitment,drug sales (I can’t stress how muchthe influence of a blogger canimpact a multi-billion poundbusiness), interaction with payers,medical community, drug discoveryand patient databases. Additionallythe US Affordable Care Actrestricted access to doctors by drugcompanies so the cyber-worldcould be an avenue to get into thecommunity behind the medicalindustry’s closed doors.

“An e-patient is someonewho is equipped, engaged,empowered and enabled toactively participate in his orher care.” – e-Patient Dave

The Internet is everywhere inthe clinic

Today’s examples

include:• [December 2014] When Genzyme’s multiple sclerosis drug –

Lemtrada – got rejected by the FDA in 2013, the patientcommunity mobilized. It is now approved for the treatmentof patients with relapsing forms of MS.

• [April 7, 2014] PatientsLikeMe has a 5-year agreement withGenentech on exploring online networks to researchpatients’ real world experience, including giving them aclinical trial awareness tool so they have access toinformation on on-going studies. Bruce Cooper, SVP, MedicalAffairs, Genentech commented that “We hope ourparticipation will encourage broader engagement of othersinvolved in the delivery of healthcare and support a strongervoice for patients”.

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