Why medtech is moving on from products to services, and embracing platforms

24 Jan 2018

Can medtech help to turn the tide on diabetes? Image: Syda Productions/Shutterstock

In the face of competition from digital disrupters, the medtech industry needs to embrace digital healthcare platforms to deliver the services patients have come to expect.

Accenture recently interviewed 8,000 patients, and 63pc wanted more input into treatment decisions and would use patient services from life sciences companies if they were aware of them. Furthermore, more than 40pc of the millennial and Gen X cohorts stated that provision of personal services would be essential to convince them to switch to new treatments.

In a related study, Accenture interviewed 200 senior executives in pharma companies in the US and Europe, and found that nine out of 10 investments that have been made in patient services by these companies to date have delivered an above-average business impact. 95pc of pharma industry respondents plan to continue and 85pc plan to grow their investment in patient engagement technologies in the next 18 months.

With similar moves into healthcare and wellness by tech giants such as Google parent company Alphabet (Verily, DeepMind), the medtech industry faces intense competition in developing a suite of new products and services for patients. There are major questions for the medtech sector, such as: are they moving towards patient services that surround and support their products, enabling them to prove impact on patient health outcomes quickly enough? And are they embracing digital healthcare platforms, the tool of choice for developing collaborative partnerships across the broad ecosystem of stakeholders to deliver a better patient outcome?

If you know somebody with diabetes, you know that they need access to a number of products to monitor and manage this chronic disease on a day-to-day basis. There have been some life-changing medical devices and drugs brought to market in the last 40 years, to diagnose, monitor and help manage diabetes. I could wax lyrical about the developments made in medical devices that help monitor the disease – from test strips to advanced sensors that provide highly accurate measures of blood sugar levels.

In addition to the advances in biotech that have produced new treatments for diabetes, medtech has also made a considerable contribution to the treatment of the symptoms of diabetes – from devices to make it easier for patients to accurately and conveniently take their medication, to drug-eluting stents that treat the impact of diabetes in the cardiovascular system, and dialysis equipment to treat the impact in the kidney.

Yet, despite these advances, more people are at risk of developing diabetes than ever before, and a large proportion of patients with diabetes continue to see their symptoms get worse over time (due to diet and lifestyle choices and/or poor diagnosis or treatment regimens).

A combination of the scale and growth of the patient population and the very severe long-term side effects in cardiovascular disease, kidney failure, eyesight and mobility creates a healthcare time bomb for economies globally. This rather alarming graph (below) from the Center for Disease Control in the US shows just how out-of-control diabetes has become in the same period that so many new innovations have come to the market.

Line graph showing number and percentage of US population with diagnosed diabetes, 1958-2015 based on CDC figures

Graph: CDC

The graph suggests that, despite the development of exciting and innovative medical products, these are not enough; and that, perhaps, greater integration across products and services into platforms will be required to truly unlock the potential of these separate innovations. In our work, Accenture has been supporting companies such as Roche to improve how diabetes care is managed and delivered, and Roche has now acquired internet companies such as MySugr, whose apps provide seamless integration with devices and coaching for patients.

Roche is not alone. Medtronic Diabetes has announced industry collaborations with Fitbit, while Sanofi and Verily have joined forces to tackle diabetes.

‘Data analysis services will support patients’ decision-making in areas such as diet, activity and medication’

So, what are the services that will be offered in combination with the products? Quite simply, the services will be based around data analysis and personalised decision support for the individual patient. Devices such as continuous glucose monitors and activity monitors are already gathering lots of key data for patients – near-real-time data on how much sugar they have in their bloodstream and how much sugar they are burning (or not). Data analysis services will help the patient make sense of this ever-growing stream of data by analysing it and correlating it with other data sources to gain key insights on how they can better manage their disease. The services will help patients easily visualise this data to support their decision-making in areas such as diet, activity and medication.

If you have diabetes, or your physician thinks you are at risk of developing it, then you need to carefully watch and control your blood sugar levels. Too much sugar in your bloodstream is bad for many of your organs, especially for the long-term health of your kidneys and eyes, so you will benefit from support in decisions to decrease your intake of sugary food, and in decisions to get active to burn excess sugars off.

What about those ‘healthy’ smoothies you have every morning with all the nice berries, yoghurt and manuka honey? Now you can use glucose sensors from companies such as Medtronic, Dexcom and Abbott to obtain real-time, continuous, quantitative data on just how high the smoothie pushes your blood sugar compared to a bowl of porridge. That continuous data stream and the trends can be used to inform your own decision-making.

What about that temptation to crash on the couch for the evening and binge on a few episodes of your favorite boxset? Now you have data that shows you that a brisk 30-minute walk will get your blood sugar back down into the healthy range for the seventh day in a row.

What about integrating this with other services such as your health insurance? You might choose a policy where you will be rewarded or pay less for the insurance service if you make better decisions based on data. Perhaps you will get ‘micro-rewards’ for short-term progress, such as a cinema ticket for staying within the optimal blood sugar range for a week, or more significant rewards (gym membership discounts, insurance premium discounts) for maintaining your progress over longer periods.

This is, essentially, a gamification approach to rewarding commitment to a specific behaviour. And, while gamification can sometimes promote negative behaviour (for example, I have three kids who seem to be addicted to screens), in this case the aim is to help to break people’s bad habits around sugar consumption and sedentary behaviour.

‘Perhaps a combination of connected products and services can help bend the curve of the diabetes epidemic and help lots of people on their wellness journey’

This kind of service has applications beyond the existing diabetes patient population. It can be utilised by people who are at risk of diabetes or simply by very health-conscious people who want to tightly control their blood sugar levels as a form of ‘wellness’. So, perhaps a combination of connected products and services can help ‘bend the curve’ of the diabetes epidemic and help lots of people on their wellness journey. But it seems clear that more collaboration and integration across companies and sectors will be a vital part of the next wave of innovation in this and other diseases.

For all the progress made to date, the medtech sector probably can’t do it all alone. This is why Accenture believes that a push from products to services must also involve embracing platforms.

‘Digital technologies like cloud, analytics, artificial intelligence, mobility and security will be essential elements of the platform’

A platform, as defined by Geoffrey Parker and Marshall Van Alstyne, is: “A business based on enabling value-creating interactions between external producers and consumers. The platform provides an open, participative infrastructure for these interactions, and sets governance conditions for them. The platform’s purpose is to consummate matches among users and facilitate the exchange of goods, services or some sort of social currency, thus enabling meaningful value exchanges between all participants.”

In 2013, as many as 14 of the top 30 global brands by market capitalisation were platform-enabled companies. In consumer goods and services, platforms are already a reality, and market success is not only determined by the product, but also by the platform strategy.

Key characteristics of successful platforms are connectivity (or openness, plug and play), data utilisation, convenience and gravity (or attraction). Digital technologies like cloud, analytics, artificial intelligence, mobility and security will be essential elements of the platform.

A winning platform strategy must focus on specific value propositions for each of the different groups of stakeholders in the ecosystem. And, for medtech companies, this stakeholder map will include tech providers, healthcare professionals, patients, clinics, payers and government. The specifics of the therapeutic area must be catered for, as many of the key stakeholders have different viewpoints and approaches to change, depending on the nature of the clinical area; from diabetes to cancer, respiratory disease to psychiatry.

Accenture research shows that 90pc of life sciences executives see a platform-based business model and engagement with digital partners in an ecosystem as critical to the success of their businesses.

Healthcare has lagged behind other sectors – particularly retail – in the use of digital platforms. But, as patients increasingly expect platform-enabled transparency and convenience in their healthcare, and as the industry moves increasingly towards models of outcome-based treatment, that is now set to change. Exciting times ahead.

Barry Heavey is managing director of life sciences at Accenture Ireland