From an adherence perspective, it was particularly refreshing to hear both clinicians, pharma
companies and members of the Clinical Commissioning Groups talk about ‘understanding
the patient journey’ and helping patient’s lead more healthy lives.

This was an innovation event so understandably the word on the street was all about the
latest telemedicine platforms out there and the positive impact technology can play in
improving patient health. But, actually implementing this technology and making it a
cost-efficient process to the benefit of primarily patients as wellas clinicians was a big
talking point over the two days.

Doctor Shahid Ali from the Phoenix Medical Practice in Bradford, Yorkshire was particularly
interesting around the patient setting objectives to be accountable for their own health.
Telemedicine along with data and information, being one of the ways that clinicians can
support patients in achieving their goals and ultimately take control of their health.

From the pharmaceutical industry, Jackie Parkin from GSK gave a very insightful seminar
on ‘adhering to adherence’. Jackie outlined that the adherence challenge will not go away
and it is up to all the key stakeholders (payers, clinicians, patients, providers and
pharmaceutical companies) in the process to keep working at identifying where the key
information gaps are.

There is no doubt that technology will improve the overall objective of improving patient
outcomes but understanding what the individual goes through in becoming a patient and
the treatment journey they have to undertake – is still the big challenge. The healthcare
industry is growing increasingly aware of this issue, but putting all the right pieces of this
new CCG puzzle together with the end goal of improving patient health, still has some way
to run.

Charlie Inglefield

This raises some touchy subjects not least the question around trusting one’s doctor
but also digging into the accuracy of a doctor’s consultation.

These issues bring out a number of intriguing challenges to the health authorities around the
world. The rise in repeat referrals of which one reason is through people not adhering to their
treatment, raises the inevitable question of whether a patient is taking the right medication
for the correct illness in the first place.

The irresistible pull to engage in social media and the power of the internet shows no signs
of slowing down in the healthcare industry. The spread of the web means that it is feasible to
get an accurate diagnosis but surely the doctor is the one who should have
sufficient knowledge to either diagnose or refer to a specialist to ensure an
accurate diagnosis.

Improving the communication between a doctor and patient – the first step?

Initiating a simple questionnaire to be completed in clinic or at home to answer a patient’s
concerns and symptoms is a start. With a condition like irritable bowel syndrome, patient
adherence to treatment is very poor. A punishing dosage regime contributes to patients often
hiding their condition from the doctor despite the acute physical and social side effects
suffered on a daily basis. The attitude and awareness of the GP right at the start is
crucial to patients taking their treatment and more importantly getting them better.

There are many different arguments to this topic but improving the communication
between a patient and a doctor right from the first consultation is a potential step to
tackling this worrying trend.

Charlie Inglefield

Over this past month, Sir Alex Ferguson has talked about what a key influence Fletcher has and continues to be for Manchester United and the future role he has to play for the club. That, however may be in a coaching capacity given the continued difficulties Fletcher has in managing the effects of Colitis on a daily basis.

Ulcerative Colitis is a chronic bowel condition that leads to inflammation and ulcers on the inside of the colon and can cause diarrhoea, pain, tiredness and inflammation in the eyes, skin and joints. Often this dehabilitating disease is not diagnosed properly resulting in patients not getting the right kind of treatment advice.

Lewis Moody, the legendary flanker for England revealed in his autobiography last year, the daily battle he goes through in managing his Colitis condition and the struggle of being able to continue playing at the highest level. With the punishing nature of top class rugby week in week out, it is a miracle and testimony to the bravery and skill of Moody that he played on for as long as he did – and at the level he did.

Sir Steve Redgrave, one of our greatest olympians continues to raise huge amounts of money for charities including awareness for patients suffering with Ulcerative Colitis and Moody and Fletcher are following suit.

Awareness and education into a disease like Ulcerative Colitis and other inflammatory bowel diseases continues to be vitally important given the severity of these conditions, especially if not diagnosed or treated early.

Charlie Inglefield

As reported in the UK’s Daily Telegraph recently, things could be about to change as
people begin to realize the importance of the gut and the role it plays in keeping
everything else in the body functioning. Referred to as the ‘second brain’ by experts in
this field particularly lead by Michael Gershon, a professor of anatomy and cell biology
at Columbia University in New York, the gastrointestinal tract qualifies as a
‘second brain’ because it can function by its own.

‘When I was at medical school I was taught erroneously that the brain controlled everything
– including the gut,’ he says. ‘In fact, if you cut the vagus nerve – the major nerve between
the brain and the gut – the gut would soldier on. We now know it can work completely
independently of the brain and spinal cord. While the “first brain” gets on with religion,
philosophy and poetry, the “second brain” deals with the messy business of digestion.’

Importantly diseases like Parkinson’s, osteoporosis and autism display early symptoms
in the gut.

‘It has been found that mimicking signals from the gut to the brain by stimulating the vagus
nerve can improve learning and memory, and regulate mood. It’s been used as a treatment
for epilepsy and depression, and could help conditions such as Alzheimer’s, migraine and
tinnitus.’

Given how much bacteria passes in and out of our bodies, what we eat and how much we eat
takes on even bigger significance when confronting IBS. As the Daily Telegraph reported this
month treating ‘our guts with the kind of reverence and respect we tend to afford other parts of
our bodies’ is the best possible way to combat IBS.

As Gershon says, eating a well balanced and healthy diet is the way forward. Green vegetables,
fibre and cutting down on sugar, coffee and alcohol are to be recommended.

Charlie Inglefield

As recently reported in the UK’s Daily Mail, Professor John Rogers of Illinois
University and his team have been working on creating skin patches which
can be used by healthy people and for those with ongoing medical conditions.
Looking at the wider scope, having a health and wellness monitoring tool for
individuals who are in decent health will help diagnose early signs of a medical
problem.

If this latest technology innovation proves to be successful then GP appointments
could be significantly reduced, with obvious financial and HCP resource advantages.
For normal electrical procedures like ECGs and EEGs which are normally carried out
in a clinic, a patch can now do a similar job but within the comfort of a patient’s home.

These products are due to be launched in the US towards the end of the year.

Charlie Inglefield

What stops smart, highly connected global organisations like these from
harnessing the power of their highly networked, socially communicating
health consumers?

One word – risk.

The current risk factors inherent in uncontrolled conversations and
interactions within a branded context give rise to definite risks for the
Pharma industry.
Issues like adverse events & reporting responsibilities of adverse events,
privacy & regulatory concerns, the risks of breaching medical or ethical
codes – whatever the specific risk factors are, they often result in a perception
within the organisation that such a risk profile not worth the chance

However, at Partizan, we believe these conventional views should be challenged.

As internet usage grows more pervasive, as more and more older generations
connect online via easy to use devices like iPads and smart phones, and indeed,
as ‘always on’ device usage grows as a whole this opportunity grows larger.

Already, many patients turn to the internet as the first source of information for a
disease, and many also turn to social forums for support and knowledge sharing.

The key to accessing this opportunity is to ensure that any strategy delivers a balance
between the requirement for easy, knowledge rich communications amongst
patients on the one hand; and ensuring risk management strategies and
safeguards are implemented in a low cost, non invasive way on the other.

This is by no means easy, but it is possible, and Partizan is leading the
way.

Contact us to find out how we can help get your patients online and connecting
with each other socially in a risk free yet rewarding way.

Contact Nigel Cowan – nigel@partizanhealth.com

http://www.pharmatimes.com/Article/12-03-12/Pharma_must_build_enduring_relationship_with_patients_-_E_Y.aspx

Chris Keeling

As reported in the Uk’s Daily Telegraph recently, come April, any patients
who refuse to take their medication or generally do not comply to what their
condition requires, i.e. keeping active when they should be resting,
missing medical appointments, can be shown the door by their doctor.

Wasting doctors’ time and putting pressure on hospital resources
remains one of the biggest challenges to a national health service. This
approach means that patients who blatantly do not accept or manage their
treatment can be told to seek another surgery.

Radical it maybe but patient compliance levels remain very low in Europe
and the strain put on a country’s health system continues to be a concern
to the global health community. For what could be considered a ruthless
course of action to improving adherence levels, it will be interesting to see
if this kind of approach will make any progress in the Czech Republic.

Charlie Inglefield

We’ve talked gaming and its impact onhealth on this blog in the past.

As a father, I am sure that I share a common gripe with parents when it
comes to my kids’ “why are you sitting inside playing on that computer
when you could be outside kicking a ball around?” …usually followed by
a story beginning with “when I was a boy….”

Sound familiar?

In an age when childhood obesity is being seen as a serious problem, it’s
easy to point to technology as the cause of all things sedentary.

But what if computers could be used for good not evil?

What if computers actually increased activity rather than produced
coach potatoes?

Would I be saying “sure son, turn on the computer”?

For many parents and their school agedchildren in the USA this is
exactly what’s happening thanks to a social enterprise (Zamzee) who’s
social mission is; using the power of fun and technology to get people moving.

Utilizing a USB pedometer (Zamzee meter) provided to children, the Zamzee website
is a game and points site that is powered by the number of steps children take each day
as recorded by the pedometer. Each day the child is incentivised to get active so that they
can earn points that power their game. A nice way to get them moving.

The child’s progress can be tracked individually or linked to friends / classmates account
so that they can assess their progress, compete in challenges and establish healthy competition.

In a way it works as a positive feedback loop. The more they play the computer, the more they
get active. The more they get active, the more they get from the game.

So before you give the kids the “when I was a boy” story…you may want to think again.

Computer games of the future may just do more good than harm.

Nigel Cowan

The story of Fiona Argo being misdiagnosed with anorexia when
actually her condition was Crohn’s disease emphasises the importance of
health care provider awareness on irritable bowel syndrome and gastrointestinal
diseases.

There are a number of common side effects such as weight loss, vomiting and
diarrhoea which patients with Crohn’s can suffer from leading to potential misdiagnosis.
In Fiona Argo’s case, she knew that there was a physical reaction to eating food
and not a mental reaction as perceived with an eating disorder such as anorexia.

The key point to stories such as Fiona Argo’s is early diagnosis of Crohn’s disease can
lead to managing the medical complications which come with this condition and
reducing the chance of bowel surgery in later life.

Charlie Inglefield