Using Behavioral Science to Support Patient Adherence
Episode 485

Thom Doyle, President and Co-founder at Human Care Systems

Using Behavioral Science to Support Patient Adherence

Delivering smart touch solutions to improve patient engagement and outcomes

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Using Behavioral Science to Support Patient Adherence

Episode 485

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Recommended Book:

The Hitchhiker’s Guide to the Galaxy

Using Behavioral Science to Support Patient Adherence with Thom Doyle, President and Co-founder at Human Care Systems transcript powered by Sonix—the best automated transcription service in 2020. Easily convert your audio to text with Sonix.

Using Behavioral Science to Support Patient Adherence with Thom Doyle, President and Co-founder at Human Care Systems was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best way to convert your audio to text. Our automated transcription algorithms works with many of the popular audio file formats.

Welcome to the Outcomes Rocket podcast, where we inspire collaborative thinking, improved outcomes and business success with today’s most successful and inspiring health care leaders and influencers. And now your host, Saul Marquez.

Saul Marquez:
Welcome back to the podcast that I have the privilege of hosting Thom Doyle. He’s the President and Co-Founder of Boston based Human Care Systems. He helps biopharma companies deliver better patient experiences and outcomes. Thom is a key part of the team that invented Resilix and and it’s basically a treatment experience platform built specifically to help pharma improve the productivity of patient services. It’s a big bottleneck that Thom and his team have identified an opportunity to to reduce friction in and and the work they’re doing is fantastic. So we’re gonna be diving into into that work and some of his thoughts in health care in general. He holds a degree in Economics and Chemical Engineering from MIT and continues to to do his work there in Boston. So, such a such a pleasure to have you here with us, Thom. Thanks for joining.

Thom Doyle:
Thank you Saul, good to be here.

Saul Marquez:
Absolutely. Now, tell me, Thom, what inspires your your work in health care?

Thom Doyle:
It’s a great question Saul. I think like most people in health care who really make a difference, patients are at the core of what inspires me. In particular, there’s this problem that we identified many years ago, that many medicines working in drug development, many medicines are there’s a lot of money that goes into discovering new medicines, developing medicines, commercializing and promoting them through advertising and sales forces. And then half of doses are not taken. And that’s a huge missed opportunity, a wasted value of some of the science, but also unachieved improvements in health and in solving that problem or working towards that problem has been an inspiration for for many years. For me, it’s not a simple problem, but solving it is, I think, more very valuable, not just for the individual patients involved, but for the when we think of it on a societal level, there’s just so much lost work, lost quality of life, lost happiness that could be addressed through just helping patients to be able to take and get through the treatments that are available today.

Saul Marquez:
Yeah, I think that’s such a great point, Thom and we’re we’re all looking for a better way to to increase increase efficacy and efficacy and and help patients really do better. And the money that we spend, right, getting more out of the dollars that we spend on health care.

Thom Doyle:
Absolutely, absolutely. And it’s just one key area and there’s many others of waste in the system that that I think there’s just so much potential to get more dollars out by just doing things better.

Saul Marquez:
Agreed. So tell me, what are you and your business doing to add value to the health care ecosystem? Thom, let’s let’s dig deeper and better understand the service and technology that you guys offer.

Thom Doyle:
Great. Great. So we are business human care systems. We work with pharmaceutical companies are our clients. And we we do two primary things for them. First of all, we designed and run patient support programs. These are programs that often include a nurse as well as digital support for patients through email, through text. And they’re really designed to help patients to overcome the challenges that they face in getting started on a new treatment or taking it according to their doctors directions. And so that’s the first key service that we that we offer and that we’ve been offering since we started the business 11 years ago. We also along the way have been always developing those programs with a technology backbone behind them. In the past couple of years, we have our technologies advanced to the stage where we have begun licensing that that enterprise software, 2 pharma companies to run other patient services programs like GA’s or programs that are in adjacent spaces like helping with reimbursement and access issues for patients. And so that software business is kind of the newer part of our business and and quickly growing.

Saul Marquez:
That’s very interesting and I appreciate you diving into that. There’s so many opportunities to add value in health care. You guys have honed in to the patient engagement and pharma space. There’s a lot of other companies playing in that space. I know, maybe not for as long as you guys have. But I’d love to learn Thom, what makes you guys different and better than what’s available today.

Thom Doyle:
Yeah, it’s a great question. So there’s so the answer is somewhat different for those two different service offerings, but for the patient support program offering most of the people offering that historically have provided patient support through either sort of a standard cadence, email or text message program, do you know what to say to send reminders or to send education, educational emails once a month to patients or there particularly at the higher end, they are nurse call center driven programs where they have a big call center of nurses and they’ll call patients on a standard, you know, every month or every couple of weeks and they’ll ask patients how they’re doing. Our approach is really much more systematic than that traditional approach. And it’s designed to really deliver a personal experience for each patient. So for each patient, we identify not just the challenges, you know, that anybody’s suffering with migraines and taking this new migraine treatment might have. But we ask the patients what challenges they’re individually facing and then we personalize the support to those challenges. We’re also proactive about that. So we’re not just reading from the standard challenges, but what we’re looking at, what data we have about that patient. And we’re identifying likely next challenges that they might face so that we can proactively support them before something even becomes an issue. And then lastly, we’re omni channel. We’re not just digital or not just a nurse call center where we’re delivering communications through each of those channels in a way that interacts. So if somebody responds to a text message that they have a need for more support, we can then have a phone call come out to them. Or if they click on a link and an email five times to watch an injection video, we might identify that there’s a possible need there, need some more coaching on how to self inject and we can arrange a call or a home injection training visit for that patient. So we’re really trying to be personal, proactive and omni channel to differentiate our service offering.

Saul Marquez:
I think it’s great, Thom, and I appreciate it you’re highlighting the differences as I think about it. I’m wondering, I guess, who’s who’s mostly interested in getting this done. I mean, the obvious benefits are the patient gets a personalized treatment plan, which is which is outstanding in health care. It’s a lot about reimbursement and making sure things are covered. Kind of the big struggle for why we’re not going in the into value based care as quickly as we’d like. I guess who wins other than the patient out of this and why are drug companies interested in doing something like that?

Thom Doyle:
Great. Well, so in terms of who wins, I think one of the beauties of the business is exactly the answer to that question is that, first of all, patients win because I think that while certainly costs and reimbursement are important issues for patients, side effects are important challenges. Building a routine can be a challenge for patients who live busy lives and are trying to do other things than just take their medicine. Knowing whether the drug is working or how to look at efficacy is an important challenge. There’s a wide range of challenges that we support patients with and that helps them with their treatment. But that that ultimately helps them get that better outcomes, which helps the doctor meet their goals of helping their patients. And it meets the pharmaceutical company goals for helping patients to adhere to treatment, take treatment longer. They know there’s a clear are alive for pharmaceutical companies. Obviously, there’s value to payers. You know, the payers don’t get value when patients take a medicine, they get value when a patient gets better health. And so there’s value all across the different parts of the health ecosystem. And I think that that’s one of the things that’s excited us from the start about this opportunity.

Saul Marquez:
That’s pretty cool. So so sort of value in our ways. And and it’s it’s a win win win.

Thom Doyle:
Exactly.

Saul Marquez:
I think it’s great. You know, the reason why I’m digging there, Thom, is because we really are making a shift that I look at what you guys do as as part of that shift into a more consumer centric healthcare and.

Thom Doyle:
Yes.

Saul Marquez:
And providing a service like like you guys do really like. Wow. So you want to help me be healthier and you’re giving me service to take this medicine. I mean, the reaction is why? Right? Because that’s not really how health care has worked.

Thom Doyle:
Right. But it seems so crazy that it doesn’t. Yeah. I mean, to take a non medicine example I had. I tore my ACL a couple of years ago and had this knee surgery. And I think largely that the doctor did a great surgery. But then the doctor was largely of the view of, well, it’s your job now to get better on your own. You know, you have to do exercises, take care of yourself, take these activities. And that, you know, and I was really then on my left, on my own. And I think that it is frustrating. It’s like I could use a little bit of support here. You told me, look for what I should do or how to do it or how to work it into my life. And so, you know, we think there’s that opportunity across health care to help people, you know, not just take the you get this 30 second visit with your doctor and they give you some high level instruction. And it’s not quite enough to take action on that most of the time.

Saul Marquez:
Yeah. Now, that’s and that’s a great example to love that in. Yes. It’s super exciting work that you guys are up to. Give us a story, Thom. I mean, I’d love to hear an example of how you guys have improved outcomes or made business better.

Thom Doyle:
Yeah. Certainly. One that, let’s see. So one example is a drug that we’ve worked on for about 7 years now, and it’s a rare disease drug works for 5 different kidney disease indications that are all in the thousands of patients in the US about size populated single digit thousand, populations to self injectable, it’s got a very high side effect burden. It you know, patients because it’s rare. There’s all these feelings of isolation and nobody understands me. There’s also the it’s expensive drugs. So there’s all sorts prior authorizations and re-authorizations and various hurdles that payers but front of patients taking the drug. And so when a prescriber prescribes a drug, they request the manufacturer provide support with those challenges and including enrolling them in our our program. That information on the patient enters are Resilix CRM platform. And then we have a nurse reach out to patients. They go through an assessment with patients to identify their their needs. They address the most pressing needs in the first call and then they skip scheduled follow up calls if the patient has more needs as well as they send follow up emails, print mailings and text messages to help with the different challenges that patient individual patients are facing. And we have to improve the initiation rate for the drug. So patients who don’t get our support, fewer than 70 percent of patients who get a prescription are able to start on the drug, whereas we’ve been able to increase that to 85 percent of patients who are able to take the drug. It’s also it’s a 6 month course of therapy. And the patients who don’t receive our support, they’re about half of them quit treatment by 5 months, 6 and don’t make it through the full course of therapy, whereas we only have 14 percent of patients who quit by month 6.

Saul Marquez:
And the different,.

Thom Doyle:
You know, even more than the numbers, we have identified a whole group of patients who are just fanatic supporters of the drug and feel that it’s really helped them get their life back on track. If their condition into remission and speak very positively about their total experience. So, you know, it’s been a win from all those perspectives.

Saul Marquez:
That’s really interesting. Thom, I mean, the engagement level, helping people through, giving them that that help that you were looking for when you got your your knee surgery. You know, that’s that makes the difference. Yeah, makes a big difference. I think, like, I just got an iPhone, a new one. And I’m thinking to myself. I mean, yeah, it’s pretty easy. But I’ll tell you, something happened where I had to troubleshoot it and I call them, they help me out. It was pretty good, you know?

Thom Doyle:
Yeah. As consumers, we. Yeah, exactly. As consumers, we we’ve come to expect that when the apple is sending proactive emails, when you get your new device that say, you know, here’s some training classes and here’s some things you can try with your device. And we’ve come to expect that. And then medicine, it’s just this historically. It’s just this. Well, you’ve got a prescription. Go to it.

Saul Marquez:
Yeah. So and the change is happening. I’m seeing it, you know, and and, you know, we’re talking here today. Thom, and the work that that you guys do at human care systems is pretty neat. And how the technology that you started is now becoming something that people want to license and use. Is is a testament to that shift as well?

Thom Doyle:
Absolutely. Yeah. Well, well. Going to talk a little bit more about the technology, I think. Yeah, I here, right. It’s one of the things that that I’m most excited about our Resilix platform. It’s you know, it’s really in many ways for us it’s like a new business that’s sprouting out of our original service offering. But what’s really driving it is that so much of the growth in the pharmaceutical business has been in specialty drugs, rare disease drugs, they’re smaller populations, but their cancer drugs, for example, their smaller populations. But there’s a high burden of disease. There’s the treatments are complicated. You know, they’re injections or twice a day or they have big side effect profiles. And so pharmaceutical companies are growing their spending on all the services to help patients. And historically, they have just they’ve done a bit of that through insourcing, a lot of it through outsourcing. They tend to have a lot of different vendors. You know, they have a reimbursement support vendor and a nursing vendor and field services vendor were providing field teams out. And, you know, then they’ve got maybe an ad agency is created an e-mail program and all of those vendors and tools are helping patients in some way or another. But the data winds up in silos. Data integrations between vendors are complicated and hard, you know, and the pharma companies, of course, are like like all businesses are facing lots of cost pressures. There’s lots of payer push back is the consolidation of PBS, EMS and payers have been then put a lot of downward pressure on on pharma prices. You know, the shorter competitive timelines for entry and what not. And so our platform sort of speaks to that need. And it it’s good because the area is largely served by, you know, to the extent that pharma companies are thinking about having their own CRM platform that drives all of these different touches and coordinates it, which has been the solution in other industries. You know, they use a sort of a generic non industry specific CRM system. And it’s there’s a lot of challenges with that approach. And so our software is because it’s built for purpose, it’s faster to set up and configure. It’s designed to make it easy to really personalize to individual patient needs. And it’s built for compliance. You know, so much of such a regulated industry, the things you do matter. You know, you can’t tell a patient to take it, can’t send a text reminder to a patient to take a drug when they’re not supposed to take it. That can cause real problems. So you have to put in place lots of operational controls to ensure that, you know, that everything that you send is the right information at the right time. And so we’ve put all those things into our our platform. And that’s that’s getting us traction where we in the last 6 months we’ve sold the licenses to the platform to three of the largest and most advanced pharmaceutical companies to begin implementing across their business. And so we’re very excited about the potential that has for us.

Saul Marquez:
Yeah, that is very exciting. And I would say a very a very hyperniched but mean in a big market, obviously, way to help the wave of consumerism.

Thom Doyle:
Yes.

Saul Marquez:
I think it’s it’s it’s just really cool to hear about this and to know that you guys are doing this.

Thom Doyle:
You know, we have we’re excited where, you know, our clients are excited. It’s kind of a fun time and it’s reinvigorated our our growth and excitement across our business.

Saul Marquez:
I love it. Yeah, you got to be open to these types of things, listeners, as you think about the business that you have and the changing times, you know, the work that Thom and his team over at human care systems were doing has evolved. And it’s it’s now a new time and health care. And while it’s changing slowly before you know it, the change will have happened. So, you know, think about what you could do to be more creative and innovative in the services and technology that you can offer. I think Thom’s examples is really inspiring one. So what are you most proud of in your career Thom?

Thom Doyle:
Yeah, it’s a good question. I I have spent 20 of my 25 post-college years working as an entrepreneur, and I think more than anything that’s that’s probably a key part of it. It’s great that I’ve been in companies that I’ve helped found and build. I’ve been building, I love building new things. Our current business is now 11 years old and we’re tremendously proud of it. One of the, you know, one to just kind of make it a little more granularity on the recent accomplishments that I’m very proud of. As you know, I’ve always believed that you don’t really have a real business until well, until you’re getting paid. You know, just marketing and selling an idea. This is not a real business and that is in this patient services business. You know, we view it as it’s not you haven’t really launched a patient program until you’ve got the first patient and then you’re helping them. And we had about 5 months ago, we were in discussions with a major pharmaceutical company and they were 2 months before launch of a new drug, new opthamology drug, the variety of potential challenges. And they had a longstanding vendor that was that they’ve been working with for months to try to prepare for launch. And they just were losing confidence in how that was going to go, particularly from the adherence program perspective. And so they decided to put their faith in us and switch at nearly the last minute to work with us for an 8 year parents program at launch. And these are the kinds of things that historically companies spend 12 to 18 months setting up and getting prepared for gearing up for launch. And we were able to set up and launch and get our first patient in in just over two months and the first patient just a couple of business days after the drug got FDA approval. It was just such a I think that I’m so proud of it because it’s such a tangible demonstration of what we’ve built in that. And then it wasn’t me setting it up and working crazy hours overnight, that was our team and and all the great people that we have and the technology that we’ve built that we’re able to make that happen. It’s great to be able to be an observer and watch the team go in and build it up. And that’s a wonderful feeling.

Saul Marquez:
Yeah. Congratulations on that win and and the ability to execute on the win.

Thom Doyle:
Thank you. Thanks.

Saul Marquez:
So talk to me about a setback that you had something challenging that you guys dealt with. And the key learning that came out of it.

Thom Doyle:
So this is kind of one that I that I alluded to before, I mean obviously, entrepreneurs who have faced setbacks all the time, that that’s that’s part for the course. I think maybe every day there’s something that doesn’t go quite the way you hope it would. But one of the kind of the bigger, more strategic setbacks we had was that when we started the business, we really our initial strategy was to build these technology enabled programs to help patients. And we selected a big name cloud based CRM vendor to to build on top of and we wanted to build a proprietary software. But starting with big building block and there was a good precedent of D-VA, a company in the pharma services space that’s built you know, built a software product on top of someone else’s CRM system. So we thought that we thought, you know, there’s a precedent that seems possible, good work and it could work. But as we worked on it, we were able to do everything that we wanted. But it always took longer to set things up than we wanted to or to make changes. We had lots of there were plug ins for the texts and the emails you did. You’d work with these different then sort of subcontracted vendors and they were poor quality and had bugs and problems and were slow to resolve the challenges in their software. We spent lots of time on custom coding for each client and you know, and our teams were just frustrated with the technology. You know, everything was kind of a one off and it seemed like there was little scalability to it. And so that was kind of a slow burn setback that we that we lived with for a long time, for 7 years before we decided that enough is enough. And we we we really can do better and need to kind of start over and build from scratch. And and that’s what led to our Resilix platform, was that that shifting experience. But that’s one of my setbacks.

Saul Marquez:
You know, it’s one of those things that you just you have to go through, right, to appreciate and now that you have you and your team have gone through this, you tried building on top of a CRM. You probably understand better than most the clunkiness and and the value that you guys are providing now.

Thom Doyle:
Oh, yeah. I mean, it certainly it certainly helps in the sales pitch to say. We’ve been down the path that that you’re going down now and we know there’s a better way for sure. You know, I also am philosophically, I just think that challenges and opportunities are just two sides of the same coin and that when you face the biggest challenges that you can’t get down, you’ve got to see how there’s some some opportunity hidden there in the troubles.

Saul Marquez:
I love that. That’s a good way to to frame it. Tom, I’m going to actually just wrote that one down. I like that a lot. Thank you. I think you like that one, too, right? Two sides of the same coin, challenge and opportunity. This is great Thom. Tell me about what you’re most excited about today and maybe we already touched down in. I think it’s it’s there.

Thom Doyle:
I think yeah, I think that’s definitely the thing I’m most excited about. And, you know, in figuring out how to now build the enterprise software business, that that can scale and grow and all of that that entails.

Saul Marquez:
Yes. You know, and as I guess as we think about the customer base, I mean, you’re really kind of I mean, the number of pharmaceutical companies that you could get is limited, but I guess they would be about once you get them all in horizontal integration to the different lines of drugs that they offer, right?

Thom Doyle:
Yes, exactly. It’s I don’t know the exact size, but, you know, Farman spends in the billions of dollars on services to to help patients. And even though it seems like it, you know, it’s not an area that people are aware there’s there’s still a lot of money being thrown at this area to go after a slice of.

Saul Marquez:
Now, that’s a that’s a really great point, Thom. And I’m glad you brought it up. You know, it’s it’s not pennies we’re talking about. Yeah, it’s a big business for sure for sure. It’s a good call out. If you could have lunch with anyone Thom, would it be?

Thom Doyle:
Yeah, I’m not a big luncher but I’m.

Saul Marquez:
Or breakfast or dinner or beers.

Thom Doyle:
Yeah. Any of those? One person that I would love to meet is Elon Musk, probably entrepreneur. Many entrepreneurs think that, but I just love his energy and drive to like start so many things and and always with this massive vision for making the world a better place. I think it’s inspiring. And I’d love to know more about what is we know what he’s learned as a serial entrepreneur, what he wouldn’t do again. I think it would be a lot to learn from that conversation.

Saul Marquez:
Lot of good lessons.

Thom Doyle:
Yeah.

Saul Marquez:
Would you say is your favorite book? You’d recommend to the listeners.

Thom Doyle:
That’s somewhat of a hard question. You know, I heard there’s plenty of business books that have had some impact for me and I’m always lucky reading business books and trying to take lessons here and there, you know, and I thought about it. I’d say my favorite book is actually The Hitchhiker’s Guide to the Galaxy. And I think what I love. You haven’t read it. Well, so it’s a.. It’s this great fictional story about Arthur Dentsu. It manages to somehow get offers just as it’s about to be destroyed by aliens or looking to build a superhighway through to where we’re located. And he manages to hitchhike onto some alien vessel. But to me, it’s just such a.

Saul Marquez:
Funny.

Thom Doyle:
It’s a good story. It’s hilarious about making do with what you’ve got. And happy being quick on your feet and being humble about humanity’s role in the in the universe that I think being humble is a critical value.

Saul Marquez:
Love that.

Saul Marquez:
What’s the number one health, your number one health habit?

Thom Doyle:
That’s a question that I could probably spend hours talking about. You can go on a really podcast on health habits. I love health habits. I’m always thinking about them. But I mean, it’s partly our business is in helping with behavior change in habits and but I’m always looking to apply habits to myself. To me, the most important health habit that I have is and have been able to develop is mindfulness. And really and not just, you know, I used to do meditation, but it’s not just in meditation. It’s kind of in in all times of the day being able to step back mentally from all the busyness that’s going on in your mind and to listen, observe what’s going on in the world around what’s going on internally, what I’m feeling, what’s what might be bothering me, and then to really sit with that and observe it so that I can take the right action about it. And I think that that’s something that really has given birth to every other health habit that I have. It’s something that is, you know, it’s good for physical health, it’s good for mental health, it’s good for the business. You know, come up flats, business ideas. And in reflecting and thinking mindfully, it’s good for relationships and working through anything there. It’s. I’d say it’s the master habit is mindfulness.

Saul Marquez:
Love it. Love that master habit. And what’s the best advice you’ve ever received?

Thom Doyle:
You know, I love advice that comes in the form of quick quotes that I can latch on to memorize that one of my favorites is early on and an entrepreneur had told my business partner that you got to worry about quantity over quality. And what he meant by that is, you know, where I’ve always been very concerned about delivering a quality product to my clients customers. But if you get too obsessive about quality, you you get locked in the pursuit of perfection. You don’t you don’t get things out there. And ultimately often sort of counter-intuitively, don’t deliver the best quality service. You know, what really matters is, is taking action. And it comes down to every little task you do as an entrepreneur. You know, I need to send an e-mail to try to drum up some business. Well, you know, if you try to perfect that email, you’re not going to do nearly as well as if you send the email and then send another one and send another one and then send another one and learn and keep learning through the real world experience of doing something that that’s what the quality focus gets you thinking about is the quantity focus gets you thinking about. It’s just I’ve got to take action, I got to take more action. And that eventually leads to, I think, both a greater quality and a greater rate of success.

Saul Marquez:
And I think that’s a great piece of advice, Thom, and, you know, you can have going back to that two sides of the coin idea, challenge and opportunity. And then thinking about your mindfulness habit, having that mindfulness to give you that base for the actions that are very intentional. And then just going at it. Just going.

Thom Doyle:
Yeah, yeah. Don’t overthink it.

Saul Marquez:
It’s a killer combo. I love it. So this has been great, Thom. Obviously, you guys are, you know, at the forefront of medication and hearings and health care, consumerism, both, you know, and an omni channel way. And now with with the work that you guys are doing in your software solution, your software CRM for drug companies. Give us a closing thought. And the best place where the listeners could go visit you if they want to learn more or reach out to you.

Thom Doyle:
Yeah, great. Well, so thanks again, Saul, for having me here. I really appreciate the opportunity to chat with you and you and your listeners. I guess as a closing thought, I would just offer that I think that there’s tremendous opportunity within health care to deliver better outcomes at a lower cost. If we can just, you know, really get outside of our own solution idea and meet patients, people who happen to be patients at this time in their life, understand what they’re going through and then help them with the predictable set of challenges that they might have that there’s so much opportunity for us to deliver better, better value and outcomes. And in health care, through doing that, in terms of reaching me, I can be reached on LinkedIn T h o m Doyle on LinkedIn. And I am also our Web site is HumanCareSystems.com and other those places are a good place to find me.

Saul Marquez:
Outstanding. Thom, thanks so much. Great to learn more about the awesome work you guys do. More about you as a leader and and very inspiring work and results that you guys are up to. So want to give you a big thanks as well for for spending some time with us.

Thom Doyle:
Thanks so much. Have a great day.

Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration and so much more.

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