The value of service design in biotech and pharma

Who is the customer?  The patient, the doctor, the buyer or the payer? The customer is all of these and they are not a single person or even organisation. So how do we approach the idea of customer experience? And what do these different customers value?

We argue that biotech and pharma need to understand the customer as a complex entity and approach it in a joined up way.  Currently your fractured understanding of the customer fractures your organisation and leaves value on the table.

How do we build the value of customer experience in biotech and pharma?

Who is the customer?

Through our experience with a number of clients in the sector we have come to the understanding that the customer is best understood not as a person, role, or organisation but as a ‘customer entity’.

This entity is made up of four key actors. Patients & caregivers, clinicians, providers, and payers. The nature of this mix changes in different contexts but is a good starting point.

The issue for biotech and pharma organisations is not that they are unaware of these actors but that the business approaches them separately in silos. Value, access and policy teams focus on payers; commercial functions focus on clinicians and perhaps the provider organisation; patient experience exists but struggles to be heard against the commercial departments as patients don’t directly purchase or make decisions. The separation of these functionally with different incentive structures, skill sets and processes leads to ineffective approaches to market and missed opportunities in value creation.  

When we say customer entity we mean to convey that value is created for these four actors as they come together over the course of a treatment or other medical path. To illustrate, the process and experience of prescribing medical treatment. Underneath the seemingly simple doctor/patient interaction is a more complex set of factors that also include the provider and the payer. A treatment may not be available to a given patient due to the provider organisation’s processes or the payer’s policies. More likely the treatment may be available but come with additional requirements from these parties that impact the experience of the patient and clinician and change the way that value is created.

The picture gets more complex, as we move towards “fulfilment of the prescription”, as the prescription may be filled by a pharmacist in a retail setting and depending on the exact drug, the manufacturer may even provide support directly to patients. 

In the emerging field of personalised medicine, such as immunotherapy, the patient is part of the production of the treatment, further complicating the value exchanges.

Finally the value is only really created once the patient experiences the outcomes they hope for and this generally takes place in their lives with their care networks at a distance from the healthcare system.So creating customer value requires designing experiences that acknowledge the complex mix of clinical, operational, financial and human factors involved. It also requires knowing that all the actors within the customer entity need to be creators of this value together in the ways that they are capable of. Keeping track of these four actors can help do this. 

What is customer value?

Having established what the customer entity is we can also unpack what they value, which is of course not so simple either. We see four key things that are closely interrelated:

Patient experience – Supporting a ‘good’ patient experience – practically, emotionally and procedurally. Defining ‘good’ and ensuring that patients and carers own this definition.

Staff experience – Supporting staff to do their best work, relieving administrative burden and aligning with their ways of working. Understanding that clinicians have a set of needs both as professionals and human beings. 

Clinical outcomes – Ensuring that treatments are given the best chance to achieve the best clinical outcomes for patients and populations. Aligning what an outcome is between parties is a critical aspect of this. 

Resource effectiveness – Enabling effective use of time, money and other limited resources across the health system. Acknowledging the tension between efficiency and care.

In simple terms an effective treatment is enabled by patients and staff able to play their roles effectively to achieve the desired health outcomes. These four factors are interdependent and can experience positive or negative feedback loops as they support or undermine each other.

Good looks like an experience that enables all of these value drivers to come together – and they are often connected in virtuous relationships as a more effective use of resources is also a better experience for patients and staff and delivers clinical outcomes. For example our work on hospital discharge employs improved systems for staff to be able to plan and manage discharge in advance. This enables them to keep patients informed with no surprises – ultimately aiming to reduce hospital stays and ensure that patients have what they need to fully recover at home.

The critical factor that makes this pertinent now is that more and more patients and staff are co-producers of the treatment through their actions. If medicine is more personal; then the person most impacted (the patient) has a more significant role to play. Their ability, or the ability of their caregivers, to take on this new role is enabled by good design of their experience.

What is the value to pharma or biotech companies?

Having explored what customer value is we need to also understand why this is of interest to biotech and pharma companies through a business lens. We think that there are three key opportunities biotech and pharma can lean into and they all include actions that have system level impacts.

Improve processes to increase access
Processes including patient identification, diagnosis, prescription and treatment always have room for optimization. By strategically designing for access you can build long term effectiveness that is valued by customers.

Support product use to improve outcomes
All products can be more effective with support for patients, clinicians and healthcare providers. This support is often required to address the challenges of choosing and using a given treatment and can expand to more general condition support. The challenge is that support delivery models are less mature than product supply. Business rationale must be crystal clear for support to percist.

Creating collaborative customer relationships
The relationship with customers, patients, clinicians, providers and payers, is best approached collaboratively. Biotech and pharma organisations must find more productive ways of working with customers to create mutual value.

So how does a pharma or biotech firm approach this opportunity?

If you accept the argument that there is both value to customers and business in a focus on customer experience then the next question is what to do? What capabilities and capacity should you build in your organisation?

Understand – How and where we can create customer value
We can build knowledge about who the customer is, what they value and their role in the care ecosystem. Patients should be seen as active creators of their own health outcomes. This will enable us to incorporate these value drivers into strategies and delivery models.

This means the ability to build this knowledge, the research and the engagement with customers to gain actionable insight. It also means the capacity to build cycles of learning and insight that create deeper understanding of value creation patterns and gradually transform the organisation towards more effective value creation. Building this understanding across the organisation can create a more intuitive collective knowledge that orients the company to customer value.

Apply – Speed up the time to market at a higher level of quality and value whilst minimising risk
We can create practices for how we consider customer value in key phases of the product lifecycle.This will enable us to work better together and arrive at better delivery designs. We can use the design approach to de-risk delivery through testing of solutions or changes early. This also has the capacity to speed time to market and increase reach as a deliberate and collaborative process identifies and addresses risk early.

Insight leads to action – and action in this case is how the company interacts with customers (all aspects of them) to achieve value for them in a number of processes – from diagnosis to recovery. It is then possible to build a way of doing things that can be codified for reuse each time a treatment is made available in a new jurisdiction. Having frameworks for approaching this localisation in collaboration with customers will both speed progress and reduce risk of knowledge loss.

This capability is not often present in biotech and pharma and must be built deliberately with attention to evidence of value from the start. Our current work on this challenge is ensuring that metrics are defined in relation to customer value so that initiatives are best placed to show that value.

Scale – Replicate practices across products and territories
We can establish best practice as we build capability. Over time this will give us a knowledge base of practices that can be used and adapted for new places and products. Whilst healthcare experiences differ across geographies due to system variations we have found that the most important things – desired outcomes and values – are more common across the world.

There is a potential to have ways of developing strategies and models that cross treatment types and health contexts, building shared best practices, whilst also flexing for the differences that are very real between conditions, patient types and health systems. Knowing what is common and what is variable is the key to not starting from scratch each time.

In conclusion

We argue that a focus on customer value and how it is delivered through customer experience has huge potential for biotech and pharma

We see that the customer for biotech and pharma is best seen as an entity combining patients, clinicians, providers and payers

We understand the value drivers for this customer entity to be a combination of patient experience, staff experience, clinical outcomes and resource effectiveness

We believe that the value for business is in better processes that improve access, better support for products leading to better outcomes and experiences and finally better, more productive relationships with customers.

To achieve this biotech and pharma companies need to build the capacity for understanding customer value in a way that builds collective knowledge. They can then apply this knowledge to programs and practices that can be employed systematically to help scale the universal and thoughtfully design the specific.