Drug Development & the User Experience

What is Tech UX?

I was recently at a local event for entrepreneurs (thanks Capital Entrepreneurs) and struck up a conversation with someone I didn’t know. His response to my standard intro question — “So, what do you do?” — was “I’m a UX guy”. Based on my “smile and nod” response, I was fortunate that he took my ignorance in stride and explained what a user experience (UX) guy does. In short, tech product development dedicates resources throughout the process to establish how users will interface with the product, resulting in the user experience.

What is the Health UX?

The conversation got me thinking about my own experience as a “health user”, which is often time consuming, frustrating and not particularly intuitive. Here are a few recent examples from my perspective.

Consumer: Having just finished open enrollment. I’ve spent hours wading through websites to research which health, dental and vision insurance programs to enroll in for 2013.  One of the most confusing  — and potentially costly – components: evaluating my health spending to ensure I take full advantage of programs like flexible spending while preparing for (seemingly always) increasing deductibles.

Support System: I’m also the concerned loved-one of someone with a recent life-changing diagnosis. As part of that, I’ve seen up-close the drama and disconnects that occur when a patient needs various types of care that may – or may not—be covered by health insurance.

Healthcare executive: I’m a consumer and support system, but I am also a cancer drug developer at a small biotech. In today’s environment, that means I need the right pharmaceutical partner to help take my drug through the FDA approval process and make it available to patients. At the same time, I am watching with great interest the pricing and reimbursement surrounding the new cancer therapies that will impact our drug as it comes to market. (The Sanofi experience with Zaltrap is a recent example of this evolving dynamic.)

How Do They End Up with Good UX in Tech?

I don’t pretend be an expert on the subject; indeed, I find this UX-UI infographic using cereal provides a concrete framework for thinking about how the pieces relate to one another. In tech, user experiences tend to be pretty good. From the outside, one reason why appears to be the consideration and documentation of the user interface are integral to developing the product. If (like me) you have never looked at the information that Apple and Android put out about designing for their products, please go take a look. I’ll just wait a bit while you check it out. Cool, right? And the guidelines don’t stop there – here’s just a short list of usability guidelines from other major players like IBM, Oracle and SAP.

Where Would Drug Development UX Come From?

Are there usability guides in providing drugs to patients? Where do we go to even look? When I think of the players in drug development (only a component of the health experience), you have biotech/pharma that develop drugs, the Food and Drug Administration that allows sale of drugs with an appropriate risk:benefit, the insurance companies that pay (in part) for the drugs and their administration costs, the health workers that give the drugs and the person who ultimately takes the drug.

The drug development UX-UI-product interplay is not as straightforward as tech. Coming back to the UX-UI infographic using cereal, both biotech/pharma and the FDA are responsible for providing a quality, useful product (drug) to patients.* Both are necessary and bear responsibilities for the product.  In our healthcare system, the user interface also must include the healthcare provider (both physician and hospital) and the payer since these entities are the ones with direct interactions with patients as they are prescribed and receive drugs.

Some interesting thoughts result. For example, treatment regimens can vary from one health care provider to another, even in the same hospital. In this scenario, a poor user interface could ruin the user experience despite having good drugs for the patient. Using the analogy above, this situation could be thought of as eating cereal with a knife rather than a spoon. Thus, treatment guidelines, such as in oncology from National Comprehensive Cancer Network, become a key component of the user interface since they impact patient access to therapies.

Does Pharma/Biotech Know How to Impact the UX?

Here’s another example.  When patients do not take their drugs as prescribed, the user experience is likely negatively impacted. Most critically, the efficacy of drugs is demonstrated with set doses of drug and decreasing the dose may decrease the ability of the drug to control disease. In addition to the inherent benefit to their patients, patient adherence is a quality metric that will be used to measure (and reward) physicians in the new world of accountable care. While adherence for new drugs in development should be planned for early on, there are many effective drugs that are already on the market that are good targets for programs to engage patients in taking their medicines to maximize benefits and minimize negative effects, a large contributor to a positive user experience.

There are efforts being made by drug makers to impact adherence. For example, Sanofi has multiple diabetes drugs on the market and they partnered with a device maker AgaMatrix on a “smart” glucose monitor iBGStar. The device integrates with iPhone and allows data tracking and sharing with the goal of improved disease management.  Another approach to improve the patient user experience is to step closer to care and further from the product itself. An example is the recent collaboration by Merck and Geisinger Health System. While the collaboration is longer term, the initial project will be a web based tool to provide multiple pathways for physicians engage with patients at risk of developing diabetes.

Who is Leading the Charge on Drug Development UX?

While all of us (from biotech/pharma to patients) are responsible for the user experience, my experience suggests that a successful usability initiative would require a champion to drive the process. The initial experiments with product design and care management tools are interesting and I hope we see additional partnerships with stakeholders to test other approaches. In order to succeed in providing good outcomes for patients that use our drugs, owning more of the UX will be a necessity for pharma/biotech.

*We could think of the FDA and pharma/biotech interaction as a more complicated (highly regulated) version of the application developer and the company that sells the smartphone.