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25 LIFESCIENCELEADER.COM JANUARY 2015 patient-centric systems developed by the company. "Over time we want to see more of the organization deploying what we believe to be successful strategies that include patient input." Another key metric is patient engage- ment, and she says there are a lot of ways to measure this. For instance, you could measure how many patients are using tools developed by Pfizer, such as mobile apps. "We have an app in Australia where patients can have prescribing informa- tion on their cell phone and the immedi- ate ability to click through to our medical information centers with either a call or an email in case they have questions," she relates. Another patient engagement mea- sure Pfizer considers is the number of patients using the Blue Button technol- ogy launched by the U.S. Departments of Veterans Affairs and Health and Human Services that enables Pfizer trial partici- pants to download their own electronic clinical data collected in the trial. Pfizer also considers the number of patients enrolling on Pfizer Link and the number of questions being submitted through the company's Get Healthy, Stay Healthy por- tal. But just measuring engagement is not enough. Lewis-Hall says the company is also seeking to measure satisfaction after engagement. "We ask what patients thought about the information they received," she states. "Did it satisfy your needs? Would you come again for more information?" According to Lewis-Hall, engagement satisfaction is a measure- ment you should be doing continuously. One of the metrics most exciting to the Pfizer team is the intent to act. Instead of just measuring how many patients asked for and were given information, Lewis- Hall says the intent to act is one of the best measures of effective engagement. "If I talk to you about how to stay healthy if you have diabetes and have to travel overseas, your intent to act becomes an important opportunity for us," she states. "We're tracking and using that feedback as direction for improving engagement." If you are using patient input to help shape clinical trials, you should measure how many protocol changes there are over time and compare that number to similar trials that didn't have patient input. "Want to measure how well you are listening or meeting patient needs?" Lewis-Hall asks. "Compare the number of patient suggestions to how many you actually incorporated." Pfizer's chief medical officer advises to make sure you are matching the correct tool with the correct target. " We have measures for pre-study, in-study, post-study, and in- market or in-community to determine if we hit the mark," she clarifies. Finally, don't use the excuse "We are a small or virtual company and outsource everything" as rationale for why you don't have to or can't implement or measure patient-centric programs. "Our model isn't outsourced as much as it is partner- sourced," Lewis-Hall explains. "From the very beginning, we have the opportunity with our partners to align, gain agree- ment, and confer our concerns, enthu- siasms, and mechanisms for patient engagement from inside the Pfizer walls to all the people who help us do the work outside the walls of Pfizer as partners and collaborators." In other words, if you want to put the patient at the center of your drug development universe, take an active role in developing, adopting, capturing, and measuring your patient- centric initiatives — even if you are in a fully outsourced model. L Patient-centric Means Going To Where The Patient Is In the early 1960s, approximately 40 percent of U.S. doctor-patient meetings were conducted in the home. By the 1980s this number had dropped to under 1 percent. There are a number of reasons for why the "house call" fell out of favor, including time inefficiency, inconvenience, and lack of needed medical equipment. But becoming patient-centric requires a willingness to go where the patient is. While new apps and technologies are helping the "house call" make a comeback, one media platform Pfizer is using to go where patients are is television. "We started with the CBS-syndicated show The Doctors as a platform for engaging with the public where they sit, in ways they are accustomed to and comfortable," says Pfizer's chief medical officer, Dr. Freda Lewis-Hall. Since this initial foray, the concept has migrated to include the number one-rated syndicated daytime television talk show, Dr. Phil. According to Lewis-Hall, this TV platform is highly integrated with Pfizer staff involvement by Dr. Phil to provide viewers with timely medical information and help connect consumers with additional resources (e.g., Get Healthy, Stay Healthy). Lewis-Hall learned the power of television as an educational tool early in her career. Living in Washington, D.C., she participated in a medical education program for PBS. About three weeks after the airing of an episode on diabetes, she was approached by an older gentleman while grocery shopping. "Ain't you that young child on television," she recalls him inquiring. He proceeded to inform Lewis-Hall how he had seen her on TV, and as a result, had gone to see a doctor about his condition. "Sure enough," he said, "I had a touch of sugar." Her stated goal prior to doing the show was to get one patient who didn't know they had diabetes to learn about the condition and take action. For Pfizer's chief medical officer, being patient-centric means not only going to where the patient is, but doing so one patient at a time. "My earliest learning was with a patient," she recollects. "Thirty years ago, I was using data and statistics to help inform a patient." About midway through the talk where Dr. Lewis-Hall had been explaining what typically happens to the average patient, the woman looked at her and said, "You know what? I'm not average, I'm me." TV, social media, and other patient-centric initiatives are all engagement tools. "The learning is that patient-centricity is a long road, not all patients are the same, and we are going to need to develop a pretty big toolbox to really meet their needs overall."