F039 Patient behavior: what to consider when designing solutions? (Claire Kamoun)
Patients are getting increasingly engaged in their treatments, becoming the decision makers not just recipients of care. But to design a digital solution for patient support with high user engagement and retention is, to put it mildly, an art.
Every patient lives in a different home environment, has different personal goals and challenges, which consequently requires a highly personalized disease management solution to ensure maximum usability.
The complexity of patient behavior
Every disease has its own specifics and the patient journey of different patients differ. Everything matters: the doctors involved, the healthcare system, the health insurance, the patient’s individual situation, and her mindset. However, common traits can be found in patients with different diseases. “When you ask patients about the needs regarding psychological support, regarding the human aspect of disease management, the needs can be the same. If you identify common dimensions, a solution designed for one group of patients, can be translated to another group of patients,” says Claire Kamoun — patient centricity and digital innovation expert, currently the executive director of patient innovation at a French company MedClinik — a sister company of 360Medlink.
In 2018, Claire co-authored a comprehensive research article titled The THRIVE model: A framework and review of internal and external predictors of coping with chronic illness.
Based on existing literature, factors affecting patients were sorted into six groupings which are reflected by the acronym THRIVE:
Therapeutic interventions,
Habit and routine,
Relational-social,
Individual differences,
Values and beliefs,
Emotional factors.
A range of common factors was observed across diverse conditions. The article elaborates that when people become aware of their chronic condition and are faced with the news that the disease will be with them for the rest of their life, they must find ways of adjusting to their new circumstances.
Taken together, the key message in the literature is that, in addition to any biomedical understanding of chronic diseases, the range of features that make up the illness-experience mean that coping is a complex, dynamic, and multifaceted process driven by multiple factors.
Among other findings, the article mentions that some of the research shows that successful adaptation to a chronic disease is more strictly related to patient personality than to the severity of the disease itself.
Can technology be emphatic?
Awareness of the complexity behind patient behavior and factors affecting adherence to treatment, opens up the question: how to design new technological solutions that patients will use?
Claire believes no solution will ever fit everyone. In order to be used, a solution needs to be flexible from the start of development and constantly refined. “If you look at Google, they keep developing their algorithms all the time, and this is what keeps them relevant. We need to translate this into healthcare,” says Claire Kamoun.
TAVIE: Clinically validated patient companion
TAVIE, a product by 360medlink — a pioneer in Digital Health and Digital Therapeutics (DTx)- is a patient companion to support patients on their journey, helping them self manage their disease and encourage positive behaviors. Currently, patient companions exist for HIV, diabetes, pain relief, lymphedema, transplant recipients, survivors of acute coronary syndrome, and for improving lifestyle behavior.
TAVIE works as a digital coach for chronic patients, and among other things takes into account the patient’s cultural background. Video content is always designed with coaches from a specific culture so patients can identify with the presenter.
TAVIE is a digital support tool for patients and their doctors, and to prevent reluctance from doctors by introducing yet another IT system, TAVIE has a multi-phase roll-out process, adapted to the preferences of the users. While a digital platform for patient management exists, doctors might not be interested in it in the beginning, especially due to existing various healthcare IT applications and platforms they have to use in their clinical practice. Once they see the results with TAVIE, they can require access to the digital platform which enables improved patient overview and care.
Claire Kamoun.
As explained by Claire, who was the Brand Lead of TAVIE for two years, the virtual coach is scaling across the world and is present in the US, Canada, Europe, and Australia, to name a few sites. The secret ingredient for successful deployment is the involvement of all important stakeholders in a specific country. “Development always includes collaboration with local partners, doctors, patients groups,” says Claire.
AI plays an important role in TAVIE, enabling tailor-made content delivery, by taking into account all the specifics of individual patients. “As technology evolves we will be able to move from “I have a group of patients” to “I have a subgroup of patients” to “I have an individual patient”, says Claire, illustrating the development of precision medicine with technology.
Digital health in France
Claire’s quick comment on the French healthcare system is that the country is cautiously optimistic regarding innovations. According to Institut Montaigne, every year, France creates more startups in the health sector (biotechnologies or medical devices) than the United States does (circa 18 for 1 million inhabitants versus 10 for 1 million inhabitants). However, these young startups soon encounter obstacles to their growth. Many French startups prefer to develop their activity abroad.
One startup, that is definitely making a dent in the global digital health ecosystem, is Doctolib — the largest digital health service in Europe, which raised 150 million euros in a funding round in March, and with a 1 billion euros valuation, Doctolib became a unicorn.
France has a universal healthcare system, which is advancing slowly toward digitization on a national level. One of the steps towards technology adoption is article 51. The government introduced it for the development of telemedicine, by providing for the financing of innovative organizational experiments.